Realizing a need for consistent and thoroughly trained certified nursing assistants (CNAs) to care for the patients at a hospice and end-of-life care organization, Carolina Caring Chief Operations Officer Susan Nelson, had an idea:  have an in-house CNA Training Program to better prepare CNA students working for her hospice. For more than 44 years, Carolina Caring has helped those with serious illnesses and end-of-life care. Noticing the need to recruit prepared hospice and serious illness CNAs, this innovative hospice staff came up with an excellent plan to address its own internal needs by proposing this training program for grant funding.  

The current state-approved CNA curriculum does not include much hospice and end-of-life care training; therefore, many CNA new hires feel unprepared and sadly, inadequate, when working in a hospice environment. The in-house CNA training program addresses this profound need to better prepare hospice CNAs as professional healthcare providers and to provide the best care possible for its hospice patients. The program at Carolina Caring includes the full state-approved training and CNA testing but also includes additional hospice-specific training through simulated common scenarios, shadowing, and mentorship within the organization. CNAs who graduate from this program will be better prepared for what to expect, as they will have been trained first-hand by Carolina Caring staff and experts. 

The CCME Foundation provided a nominal grant in the 2022 grant cycle to cover the purchase of state-approved equipment, supplies, and curriculum to establish this in-house CNA program. The first year of the program was a learning experience. Due to the ever-changing regulations and best practices within the medical field, the team at Carolina Caring determined that there was a need for students within the program to be issued computers to receive the training materials in digital format. This eliminates the need for constant reprinting. In 2023, the CCME Foundation provided $19,150 to assist with the purchase of these laptops, which will remain within the program.  

The CNA training course includes the normal six-week curriculum but also includes an additional two weeks of hospice and serious illness training at the facility. The first class began in March 2023, and since then, Carolina Caring has implemented a two-class-per-year schedule. Students accepted into the program receive all materials, uniforms, testing fees, and a stipend for living expenses (students typically must leave other employers to be able to take the course) during the training period before beginning employment with Carolina Caring. In addition, students agree to commit to working for Carolina Caring for a minimum of six-months following graduation and state testing. Barbara Lloyd, a student in the CNA program shared, “With your help, it’s helping me to fulfill my dreams…and with hospice, now I have the opportunity to do what they did for my mom.”  

Lastly, Susan Nelson and Scott Lofland, Senior Vice President of Strategic Development, were invited to present about the program at the Association for Home & Hospice Care of North Carolina Leadership Conference in October 2023.

To learn more about this innovative training program that is addressing a critical need in health care, please visit