What is reciprocity : By Federal and State Laws, you must pass a State prescribed course and test in order to work as a nursing assistant in a nursing home. You also cannot work as a nursing assistant in a nursing home in any state unless you are approved by that state.

If you already are Licensed, Certified, Registered or State Approved in your own State and want to move to another state, you will need to request reciprocity. This means that you are asking the new state to recognize the approval you received from your home state.

How to request reciprocity

1. The first step is to contact the Nurse Aide Registry in your home state and request a “Application for Enrollment By Reciprocity”. Ask them if you should send the completed form to them or to the state to which you are moving.

2. Then contact the other state and ask them the same thing. Some nursing assistants have been able to fax their request directly to the state they are moving into rather than with their home state. Do not take chances, ask. Be sure to get the name of those who talk with you and their phone numbers. Call them by name while you are talking so they remember you.

3. If the agency in your new state says it is acceptable for you to fax or mail info, then do this right away. Be sure to clarify the fax number and the mailing address. Then fax or mail your info to the attention of the person you spoke to. Ask them what items you will need to fax or mail but be prepared to send at least the following:

  • Copy of your Social Security Card
  • Copy of your drivers license (or other photo ID)
  • Copy of your present State approval
  • Copy of a recent pay stub or something to document that you have worked in a nursing home in the past two years.

Tell them where you are moving from and where to and where they can send the new card.
They may ask for other info as well

4. When you send your info, include a brief note to thank the person who took time to talk with you and ask them to call you if they need more information.

Automated lines

When you call, you may get an automated line. Most automated lines are free 800 numbers and can provide some good information. Do listen and be prepared to write down numbers, but also always try to get a connection to a real person.


Every nursing home in the country must be prepared to provide for training and testing for their nursing assistants, and should have information about the training and testing sites that are local to you. In some states, the training and testing is conducted by nursing homes, some use community colleges and still others use independent agencies. The best way to get information about the training and testing programs in your area is to talk to a trainer or DON in your area. If this does not provide the needed information, contact the Area Agency on Aging or the NATP agency in your state.

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