2009 National Nursing Assistant Survey

Just in case you were wondering, there is a study that supports the common knowledge that the nursing home CNA position is not a high-paying position.  (Really?) 

Excerpts from This Study’s Discussion Section:

…CNAs are low-income workers (GAO, 2001) and add that years of experience do not translate into substantially higher wages. Although the median hourly wage is above the federal minimum wage, total family incomes for CNAs nationally indicate that more than half are within the 200% poverty level. Previous studies indicate that low wages do contribute to turnover and the need to work additional jobs or overtime (Harris-Kojetin et al., 2004). Moreover, working long hours may contribute to mistakes, affecting resident safety and quality of care. Strategies that increase CNA income and also meet growing care demands, such as career lattices that enable CNAs to take on additional responsibilities and receive higher wages or career ladders through which CNAs can advance in a career path (e.g., pursuing a nursing degree), may help stabilize staffing and increase the supply of licensed nurses.

Receipt of Public Benefits

A substantial proportion of CNAs are poor or near-poor. This study finds that one third of CNAs reported receiving some kind of means-tested public assistance. Moreover, our results indicate that CNAs access public assistance at higher rates than the general population…These findings may suggest that the use of public assistance is supplementing low wages for at least some working CNAs. Additional descriptive information from the NNAS allows for assessment of which CNAs are receiving which types of public benefits. For example, controlling for age, children, and wages could provide greater insight into CNAs’ receipt of benefits.

Health Insurance

Uninsured workers can adversely affect nursing home staffing stability. More than 40% of the uninsured CNAs in this study did not participate in their employer’s plan because they could not afford their share of the premium.


Our study and others have found that more than half of CNAs incurred at least one work-related injury within the past year, rates that exceed those for almost any other profession (Hoskins, 2006). Although three quarters of the injuries in this study did not result in loss of work time due to the injury, the difference in mean and median number of injuries and time lost suggest that there is a small subgroup of CNAs with a much higher injury rate and/or more severe injuries. High injury rates and insufficient or no health insurance and sick benefits may jeopardize CNAs’ financial stability and commitment to their job or field; it may also adversely affect nursing home staffing stability…Lack of equipment (e.g., for lifting and transferring residents), lack of training on the proper use of equipment, lack of training on managing resident behaviors (e.g., combative or aggressive residents), and working short staffed are some of the reasons for CNA injuries.”

Link to the PDF document for further reading:  http://aspe.hhs.gov/daltcp/reports/2009/NNASeb.pdf


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