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Caregiver training requirements in North Carolina
Short answer
North Carolina sets training rules for aides at home care agencies, but no minimum number of hours.
The rules, role by role
In-Home Aide Level II
Applies to: All home care agencies
- Training hours
- No minimum (59 hours are recommended but not required)
- Competency test
- Yes
- Yearly training
- Not required
- Certificate
- None
- State registry
- No
- Who can teach it
- Registered nurse (RN) with 2 years of direct patient care experience
In-Home Aide Level III
Applies to: Agencies that receive Medicaid reimbursement
- Training hours
- (75 hours; 101 hours are recommended)
- Competency test
- Yes
- Yearly training
- Not required
- Certificate
- Certified Nursing Assistant (CNA)
- State registry
- Yes
- Who can teach it
- RN
Federal rules that apply in every state
- Home health aides at Medicare-certified agencies need at least 75 hours of training, including at least 16 hours of supervised practical training (with 16 hours of classroom training first), and must pass a competency evaluation. They also need 12 hours of in-service training every year. 42 CFR 484.80
- Certified nursing assistants (CNAs) complete a state-approved program of at least 75 hours, including at least 16 hours of supervised practical training. Many states require more. 42 CFR 483.152
- There is no federal training standard for personal care aides(non-medical caregivers). That's set state by state, and sometimes only for Medicaid-funded work.
Before a new caregiver's first shift
- Keep proof of training — the certificate or sign-off for any training North Carolina or your payer requires.
- Check the state registry — North Carolina keeps a central registry of trained aides.
- Run the background checks your state licensing rules and your contracts require.
- Record expiry dates for CPR, TB tests and licenses, and renew them before they lapse.
Source: PHI, a review of each state's Medicaid rules, waivers and home care licensing regulations (2024–2025 policy). Checked October 2026. Rules change — confirm with your state's licensing agency before you rely on them. This is general information, not legal advice.
Regulations cited for North Carolina
- North Carolina Division of Health Service Regulation, Health Care Personnel Education and Credentialing Section. “Listing and Re-listing on the N.C. Nurse Aide I Registry.” Last modified November 9, 2016.
- North Carolina Division of Social Services (DSS). Family Services Manual, In Home Aide Services. Accessed April 8, 2025. Raleigh, NC: DSS.
- North Carolina Medicaid Division of Health Benefits. 2024. “Community Alternatives Program for Disabled Adults (CAP/DA).” Last modified September 5, 2024.
States with similar rules
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Caregiver training in North Carolina: common questions
How many hours of training does a caregiver need in North Carolina?
North Carolina sets training rules for aides at home care agencies, but no minimum number of hours. Home health aides at Medicare-certified agencies need at least 75 hours under federal rules.
Do caregivers need a certificate in North Carolina?
Yes for some roles: North Carolina recognizes the Certified Nursing Assistant (CNA) credential for in-home aide level iiis. North Carolina also keeps a central registry of trained aides.
Are home care agencies licensed in North Carolina?
Yes. North Carolina licenses home care agencies, so check the licensing rules for staff requirements beyond training, such as background checks.
Do private-pay agencies in North Carolina have to train caregivers?
Yes. North Carolina's training rules also cover aides at agencies serving private-pay clients.
Hiring in North Carolina? See caregiver pay in North Carolina, or try the free job description generator.