Direct Care Workers FAQ

Document File: 
Document Text Version

Direct Care Worker
Frequently Asked Questions
Updated February 20, 2012

1.  Q: How do I contact the Iowa Direct Care Worker Registry?
A:   Telephone: 515.281.4077
       Fax:  515.281.6259
       Address:  Direct Care Worker Registry
       Division of Health Facilities
       Lucas State Office Building – 3rd Floor
       321 East 12th Street
       Des Moines, IA 50319

2.   Q: What does CNA stand for?
A:   CNA is an acronym for Certified Nursing Assistant, which in Federal law is referred to as a “Nurse Aide”.

3.   Q:  How do I get a copy of my nurse aide course completion certificate showing how many course hours I took?
A:  The Iowa Direct Care Worker Registry does not receive or have copies of CNA certificates.  To receive a copy of your nurse aide course completion certificate, you must contact the institution where you took the course.  The certificate will have the number of course hours you completed.  There may be a cost involved in receiving a copy.

4.   Q: How can I obtain my test scores?
A:  You will need to obtain test scores from the institution where you tested.  The Direct Care Worker Registry does not receive or maintain test scores.  The registry is only notified if you “Pass” or “Fail” the exams.

5.   Q: Why am I inactive or my name isn’t on the Iowa Direct Care Worker Registry?
A:  There can be several reasons why your name isn’t on the DCW Registry.  It is possible your name was never placed on the DCW Registry by your employing entities or that your last or current employer failed to report your employment.  If no qualifying employment is reported in over twenty-four (24) months, your name automatically switches to “ineligible”.  After thirty (30) months of no reported employment, your name is deleted from the DCW Registry.  If you have qualifying employment that you feel will reinstate your active status on the DCW Registry, you should contact the Registry at 515.281.4077.

6.   Q: If I am inactive on the DCW Registry, does this mean I have lost my CNA license?
A:  CNA’s are not licensed but “certified” based on successful completion of written and skills testing.   The fact that you are not on the DCW Registry does not mean you are no longer a CNA.  You are only required to be on the DCW Registry if you are seeking employment in a Long Term Care facility (Nursing Home, Skilled Nursing Facility, or a Skilled or Swing Bed Unit of a hospital).

7.   Q: I can’t get on your website.  It says “Page Not Found” or I get a system error.
A:  If after several attempts at different times of the day, you are still unable to log on, contact the DCW Registry at 515.281.4077 for assistance.

8.   Q: How can I find my account ID and password?
A:  Contact the DCW Registry and with proper identification, (i.e., Social Security number), your account ID and password will be provided.  For additional information, visit the “Documents” section of the website at Click on the section labeled DCW Documents then click on “DCW Web” for CNAs.

9.   Q: Why am I unable to log into the database?
A:  This could be due to one of several reasons:
       If you are a new CNA, your record on the DCW Registry may not have been created yet.  It generally takes 7 – 10 business days for the DCW Registry to receive test results from the testing sites.
       ​You may not be using your correct account ID or password.  Your initial system generated account ID and password formats are case sensitive so you must key in the login information exactly as shown.
               Account ID:  Last four (4) digits of the CNA’s social security number, an underscore (_), and the first initial of the CNA’s first and last name capitalized.  For example:  6789_FL
               Temporary Password:  First five (5) digits of the CNA’s social security number, an underscore (_) and the first initial of the CNA’s first and last name capitalized.  For example:  12345_FL
       There may be someone else on the DCW Registry who has the same last four (4) digits of their social security number and initials as you have.  When that occurs, the system cannot issue the same account ID more than once.  To remedy this, the system will change the special character to something else.  In these instances, the DCW Registry will send the CNA a letter with their correct account ID and password.
       After three (3) failed login attempts, your account will be locked.  You will need to contact the DCW Registry staff to unlock your account before making any additional attempts to log into your record.
       If you have forgotten your password, on the login screen click on the tab that says “Forgot Password”.  You will be prompted for your account ID.  Once entered, the system will bring up the security questions you created on your initial login.  If you answer these questions correctly, you will then be asked to create a new password, and should then be able to log in without further issues.
       If you continue to have issues logging into the website/database, please contact DCW Registry staff at 515.281.4077 for further assistance.

10.   Q: How do I obtain a new CNA (DCW Registry) card?
A:   We no longer automatically mail DCW Registry cards, as they are now available for printing via the DCW Registry website,  All CNAs have an assigned account ID and password.  If you don’t have a computer of your own, you can use a public computer at your local library.  If you are currently employed, your employer can print a card for you as well.  As a last resort, you may contact the DCW Registry at 515.281.4077.  (See Q&A #8 for more details on how to log into your records.)

11. Q: What is my status on the DCW Registry?
A:  Statuses used by the DCW Registry at this time are:
          Eligible: A CNA has met state and federal requirements to be listed as “Active” on the DCW Registry, and is currently employable in a Long Term Care Facility (Nursing Home, Skilled Care and Skilled or Swing Bed Units of a hospital).
          Ineligible:  A CNA  has not met state and federal requirements to be listed as “Active” on the DCW Registry, and is currently not employable in a Long Term Care Facility, for one of the following reasons:
               Abuser: There has been founded abuse by this person against a resident of a licensed health care entity.  (Permanent)
               Out-of-State Abuser:  The DCW Registry has been notified of founded abuse from another state registry.  (Permanent unless the other registry notifies the DCW Registry of a reversal.)
               No Test: The DCW Registry has not received verification that the nurse aide has completed and passed both the written and skills exams at their local community college.  When passing test results are received, the nurse aide will be listed as “Active” and “Eligible”.
               No Employment:  A CNA with a gap in qualifying employment of more than 24 months will change to “No Employment” status 24 months after, (1) their date of certification or (2) the last date of qualifying employment, whichever occurs first. (See Q13) To become active again, the CNA will need to have any non-reported qualifying employment reported by the employer or they will need to challenge and pass both the written and skills competency examinations.  In Iowa, CNAs are not required to take the CNA course to challenge the exams.

12.  Q:  How can I find out my status on the DCW registry?
A:   You can determine your status by utilizing any of the following resources:
       DCW Registry Website –, looking either from the public view or by logging into the site with your assigned account ID and password.
       Registry Voice Response System (VRS):  1.866.876.1997  You may obtain your status by verifying your Social Security number when prompted to do so.
       If currently employed, you may ask your employer.  They can access the information using the VRS and our website.
       Contact DCW Registry staff at 515.281.4077.

13.  Q: How do I keep my CNA status active on the DCW Registry?
A:  You must work as a CNA at certified Long Term Care facilities (Nursing Homes, Skilled Care Facilities and Skilled or Swing Bed Units in a hospital), for at least one eight (8) consecutive hour shift within a twenty-four (24) month period.  Qualifying employment is the only way to remain active.  Education or volunteer work will not maintain a CNA in active status on the DCW Registry.

14.  Q: Who is responsible for updating the DCW Registry with nurse aide employment?
A:  Only nursing facilities, skilled nursing facilities and long term care units in hospitals are required to report CNA employment.  This reporting requirement keeps CNAs in active status on the DCW Registry.  A CNA working in another type of health care entity might not have their employment reported.

15.  Q: What information do I need to provide my employer(s)?
A:  Allow them to make copies of your course certificate, your nurse aide registry card, and copies of the letters with test scores.  They will need to verify your eligibility status on the DCW Registry as the registry card cannot be used as proof of eligibility to work.

16.  Q: How important is it for employing entities to update employment on the Iowa DCW Registry?
A:  It is very important, because qualifying employment keeps DCW Registry status active.  Employers can update hire information by logging in to the DCW Registry website, or by notifying the DCW Registry by email, US mail, telephone or fax. (For contact information, please see Q&A #1.) If manually reporting employment, facilities must update employment status for current and past employees at least every quarter.  If reporting electronically, facility employment verifications must be updated at least every 24 months.  It is suggested facilities electronically verify employment status at least yearly but they may do so as often as they wish.  If entities do not update CNA new hires as outlined, the DCW Registry information will not accurately reflect their current status.

17.  Q: An entity calls and says they have a CNA who has been working as a home health aide, but is showing as inactive on the registry.  Why?
A:  A CNA must have eight (8) hours of paid employment providing nursing or nursing related services every twenty-four (24) months in order to remain active on the DCW Registry.  Those eight hours must be consecutive with the exception of breaks and lunch.  Home health aides generally provide a variety of services (nursing and non-nursing related) for more than one client during an eight hour period.  This may not meet the federal requirement as qualifying employment.

18.  Q: A prospective employer calls and says they have a CNA applicant who has been working but is showing as “Ineligible” on the DCW Registry.  Why?
A:  The DCW Registry was developed to ensure that nurse aides are qualified to work in Long Term Care (LTC) facilities (Nursing Homes, Skilled Care Facilities and Skilled or Swing Bed Units in a hospital).  It is difficult to maintain that qualification when working in other venues where the majority of daily tasks may not include nursing or nursing-related duties as defined by the Centers for Medicare and Medicaid Services (CMS).  To remain active on the registry, CMS requires that a CNA perform eight (8) consecutive hours of nursing or nursing-related duties every twenty-four (24) months.

Long term care (LTC) facilities (Nursing Homes, Skilled Care Facilities and Skilled or Swing Bed Units in a hospital) are the only ones mandated by state and federal law to verify eligibility and report qualifying employment to the registry.  Non-LTC entities such as Assisted Living Programs, Home Health Agencies, Intermediate and Residential Care Facilities, Hospices, etc., are not required by state and federal law to verify eligibility or report employment.  Consequently, in these other settings, CNAs may perform non-nursing related duties such as housekeeping, dietary, laundry, recreation or activities, travel time from client to client, or taking clients to activities or appointments.  These do not meet the federal requirements and even though a CNA may perform some reportable duties, if the other duties are performed as well during the eight (8) consecutive hours reporting period it will disqualify the employment.

19. Q: Can the certificate of a CNA be revoked, or sanctions or discipline imposed?
A:  No.  Unlike nurses, there is no state board that licenses CNAs or imposes discipline.  The DCW Registry simply indicates whether the CNA meets state and federal qualifications to work in a Long Term Care Facility (Nursing Home, Skilled Care and Skilled or Swing Bed Units in a hospital.) See Q&A #11.

20.    Q: I am a nurse aide who has not worked in several years.  How can I get my status reactivated?
A:   Contact the local community college and set up testing dates for the written and skills portion of the nurse aide competency tests.  Once you pass both portions of the test, you will again be eligible to seek employment in a Long Term Care facility.

21.    Q: I am moving and want to transfer my certificate to/from Iowa to/from another state.  How do I do that?
A:  This process is referred to as reciprocity.  If you are transferring into Iowa an Iowa DCW Registry application form needs to be obtained from either a facility or our website at by clicking on the “Documents” link from the home page.  Upon request, the DCW Registry can send a form via US mail; however, this adds extra time to the process.  The CNA completes only Section One, while Section Two is completed by a hiring entity, if there is one.  If there is no hiring entity, Section Two is left blank.  If the CNA has a registry card/certificate from the other state, make a copy and return it with the form.  If not, make sure it is noted on the form in what state the CNA was originally certified.  The form can be returned by either mail or fax with that information identified on the form.  Once received in the office, the information will be verified with the other state.  Reciprocity is generally processed within one or two working days of receipt.

If you are transferring out of Iowa, the CNA must contact the registry of the state to which they are moving.  To find a listing of Nurse Aide Registries, click on the “Documents” link on the home page, then scroll to DCW Documents and click on the “View” link for the Directory of Nurse Aide Registries.  Staff from the out-of-state registry will send you an “Interstate Reciprocity Form” to complete.  When you have completed the appropriate section, the form should be sent to the Iowa DCW Registry to complete the registry section of the form.  The Iowa DCW Registry will then forward the completed form by US mail to the other state for processing.  When transferring out of Iowa you must have completed a 75 hour course.  If you challenged the tests in Iowa without completing a 75-hour course, the other state will require you take a nurse aide training course before transferring.

22.  Q: If an employer becomes aware that a nurse aide has a criminal conviction that occurred after hire, must the employer report this to the DCW Registry?
A:  A person employed by a facility is required by law to inform their employer within forty-eight (48) hours of any criminal conviction or entry of a founded child or dependent adult abuse record.  The employer shall verify the information within forty-eight (48) hours of notification.  If the information is validated by running a criminal background and abuse check, an evaluation by the Department of Human Services (DHS) must be done to determine continued employability. (See Q&A #25) If the information is provided by someone other than the employee, the employer must still act to verify the information within forty-eight (48) hours.  There is no requirement to report this information to the DCW Registry.

23.  Q: Why would a CNA be listed on the DCW Registry as an abuser?
A:  This would be as a result of a founded abuse determination by the Iowa Department of Inspections & Appeals (DIA).  All individuals with a founded abuse determination by DIA have the opportunity to appeal.  If a founded abuse determination is upheld after all appeal rights have been exhausted, the individual’s name is placed on the DCW Registry as an abuser.  The abuse status remains on that person’s record permanently pursuant to federal law.

24.  Q: I am not listed as an abuser on the Iowa Direct Care Worker (DCW) Registry, but I’m not allowed to work because of a hit on my criminal background check or Dependent Adult Abuse Registry/Child Abuser Registry. Why?
A:  This issue has nothing to do with the DCW Registry, but rather is a result of the Department of Human Services Record Check Evaluation.  See Q&A #26.

25.  Q: My employer indicates there is a “hit” on my record.  Why?
A:  When an entity is considering hiring a CNA, they are required by law to check four (4) different registries with three (3) different state agencies.  The Iowa Department of Inspections and Appeals (DIA) houses the Iowa Direct Care Worker (DCW) Registry, and the Department of Human Services (DHS) houses the Central Abuse Registry, which includes the Dependent Adult and Child Abuse Registry.  The Department of Public Safety (DPS), Division of Criminal Investigation (DCI) provides the Criminal Background Check.  A “hit” is generated when there is a conviction on the Criminal Background Check or a founded abuse on the Central Abuse Registry check.

26.  Q: What is a “Record Check Evaluation”?
A:  When a “hit” is triggered by something that is listed on either a CNA’s Criminal Background or Central Abuse Registry (Dependent Adult or Child Abuse) check, it requires a Record Check Evaluation by the Department of Human Services (DHS). DHS will determine whether a CNA is employable at that specific entity at that time. For more information regarding this process, contact staff at DHS directly:
Russ Saunders 515.362.7440 or
Rex Hall 515.362.7441 or

27.   Q: I am now an LPN or an RN.  What does that do to my CNA license and status on the DCW Registry?
A:  A person holding a current active LPN or RN license is not required by the Department to be active on the DCW Registry to work as a nurse aide.

28.  Q: I am a medication aide in another state.  What do I have to do to work as a medication aide in Iowa?
A:  The medication aide course in Iowa is a 50-60 hour course consisting of 40-42 classroom hours and 10-20 clinical hours.  A person who has taken a medication aide course in another state equivalent to Iowa’s medication aide course and has written documentation of certification as a medication aide in another state may become a certified medication aide (CMA) in Iowa by successfully completing a Department approved nurse aide competency examination and a medication aide challenge examination.

29.  Q: In what instances do facilities have to reimburse nurse aides for training costs?
A:  If you were hired by a nursing home or had an offer of employment from a nursing home before you completed the course, the facility must pay the full cost of the training program.  This includes both written and skills competency testing.

If you were not hired or did not have an offer of employment prior to completion of the course, but you received an offer of employment by a nursing home not later than twelve (12) months after completing the nurse aide competency evaluation program, the nursing home must reimburse the costs incurred in completing the program on a pro rata basis.  This means the nursing home may choose to divide the total cost of the course by twelve (12) and reimburse the cost of the course over twelve (12) months.

If a nurse aide pays for the course and receives an offer of employment six (6) months after completion of the course and competency exams, the nursing home would only be expected to pay 50% of the cost of the course for the six (6) months the nurse aide was employed by the nursing home.  The nursing home would not be required to pay for the six (6) months the nurse aide was not employed.

For example, a student completed the course and competency exam on April 1 and became employed by an entity from August 1 through December 31.  The employee did not work for you during April, May, June or July and also did not work for you in January, February or March.

The total cost of the course and exams was $300.  When divided by twelve (12) months, the cost per month is $25.00.  The employer is required to reimburse the CNA for five months (August, September, October, November and December) or $125.00.  It does not matter where the CNA worked before August 1 or after December 31.   The employer is only responsible for the number of months out of the twelve following course completion, that the CNA was employed by that entity.

30.  Q: Can a nursing home require me to work for them for a certain period of time since they paid for the CNA course?
A:   No.

Printed from the website on August 13, 2020 at 9:45am.