Advance CNA Career Pathways
The Moving Forward Coalition is a national leader in advancing certified nursing assistant (CNA) career pathways that help make nursing homes places where people want to work. The Coalition aims to promote workforce stability, enhance care quality, and create supportive environments for staff and residents by increasing opportunities for training, career development, and recognition. This promotes staff feeling valued and residents receiving consistent, high-quality care.
Why Advancing CNA Career Pathways Matters
CNAs deliver the vast majority of direct care within nursing homes and hold an essential position in supporting residents' daily needs and promoting their quality of life. When CNAs have clear and meaningful career pathways, nursing homes are better able to retain experienced staff, support continuous skill development, and build stable care teams. These conditions are strongly associated with improved resident outcomes and a healthier, more supportive workplace culture.
Why Action Is Needed Now
The nursing home sector continues to face a persistent workforce crisis marked by widespread staffing shortages and high CNA turnover. National surveys show that more than eight in ten nursing homes experience moderate to severe staffing shortages and often rely on overtime or agency staff to fill gaps, which destabilizes operations and erodes continuity of care.
The 2022 National Academies of Sciences, Engineering, and Medicine report underscores that a well-prepared, empowered, and supported workforce is foundational to nursing home quality. Improving retention among CNAs is widely recognized as one of the most immediate opportunities for impact. The Coalition’s Strengthening CNA Career Pathways implementation initiative responds directly to this challenge by advancing practical and scalable approaches that support workforce stability and improved compensation while improving care delivery.
From Consensus to Action
In response to the NASEM report’s emphasis on workforce stability and advancement, the Coalition convened an expert-led committee dedicated to advancing CNA career pathways in order to grow and strengthen the CNA workforce. The group brought together nursing home employers, workforce partners, educators, Geriatric Workforce Enhancement Programs (GWEPs), residents, and national experts to align on shared challenges and opportunities.
Through this collaborative process, participants identified the core elements needed for effective CNA career advancement and highlighted CNA registered apprenticeship programs as a promising and scalable pathway. This work emphasized the importance of employer engagement, alignment with education and workforce systems, and approaches that support both entry, advancement, and appropriate compensation within nursing home settings.
From Design to Practice
The Coalition and partners support 24 Geriatric Workforce Enhancement Programs (GWEPs) in the development, refinement, and implementation of CNA registered apprenticeship programs and related career advancement models for individuals who work or plan to work in nursing homes. Rather than producing a single guide, this work focuses on building a repository of practical resources, shared learning, and structured support that reflects real world employer and workforce needs.
Through convenings, peer learning, and technical support, GWEPs and their partners are testing approaches to apprenticeship design, employer readiness, training delivery, and CNA advancement that are feasible within diverse nursing home settings.
Practice and Ongoing Learning
How practice-based experience is generating learnings to strengthening the nursing home direct care workforce
Early learning has highlighted the importance of clear role progression, strong employer commitment, coordination across workforce partners, and training models that balance structure with flexibility. This ongoing learning is informing the refinement of resources and supports for CNA registered apprenticeship programs, strengthening their usability, relevance, and ability to support workforce stability while reinforcing person-centered care and team-based practice.
From Ongoing Learning and Practice to Policy
How implementation insights inform system‑level change
Insights from advancing CNA career pathways help clarify what systems need to better support workforce development and sustainability in nursing homes. The Coalition’s work is surfacing common barriers related to financing, regulations, training, and employer capacity, as well as opportunities to better align workforce, education, and long-term care policy.
These insights are informing broader policy and system level discussions, including elevating the vital role that GWEPs play in strengthening the long-term care workforce.
