Why are CNAs so Poorly Paid?





This week there has been a lot of talk in the media about the movement to raise the minimum wage to $15 an hour.  While most of the attention was focused on fast food workers, advocates for direct care workers took the opportunity to highlight the negative impact that poor wages have upon caregivers and their residents. In a Wednesday article for McKnight’s, Matt Yarnell, the Executive Vice President of SEIU Healthcare Pennsylvania, pointed out that nearly one in six of the state’s nursing home workers are paid so poorly that they are forced to seek public assistance through the Supplemental Nutritional Assistance Program, Medicaid or both.

Yarnell wrote “If we are serious about providing the highest quality care for our residents, then we have to back our rhetoric with action. It means we have to provide living wages to caregivers to cut down on turnover, to not force caregivers to work excessive overtime and double shifts. It is about not forcing workers to have to look to the state for public assistance to provide for their families.”

Why are direct care workers so poorly paid? A common argument points to the low educational requirements necessary to work as a caregiver. Often this point of view comes from within the Long Term Care community itself.

It’s true that the technical skills of a caregiver can be taught relatively quickly. Things like the principles of basic hygiene, taking vitals, infection control practices and proper body mechanics are pretty straightforward and don’t require a lot of advanced study. However, while formal training serves to create a basic necessary skill set, the real education for a caregiver doesn’t begin until he or she starts working with residents and fellow coworkers. The art of caregiving is learned through a combination of practical experience and mentoring from other workers. For those open to it, this is a learning process that can last the duration of one’s caregiving career.

The real value of experienced caregivers cannot not be found in their technical skills – or in anything that formal education could provide. Rather, it is in their capacity to perform well under difficult – often unreasonable – circumstances without losing their basic sense of humanity. It can be found in their ability to engage residents on an emotional level while under the duress of constant time restraints. It can be found in their willingness to support and sometimes lead their fellow coworkers in an environment that lacks adequate formal supervision. It can be found in their desire to serve as an example of how one human being should treat another without regard to roles or circumstance.

Good caregivers have a monetary value to the Long Term Care industry beyond what their technical skills and education can provide. The industry could not exist in its present form without their effort and caring. CNAs are truly the backbone of LTC. And their heavy lifting does not always involve transferring a resident.

The real reasons why caregivers are so underpaid are rather complex and go beyond educational requirements or even greedy nursing home operators. It is a very real social problem with direct implications to the well-being of our elderly and disabled citizens and should be treated as such.  

36 thoughts on “Why are CNAs so Poorly Paid?

  1. Matt Wermer, Paris TN C-4 Quad

    It’s part of the fleecing of Medicare and other pay sources in America. I’ve found that Home Health Agencies charge $40-$60 per hour for CNA visits and only pay the CNA Caregiver like $8.00-$9.00 per hour. Something tells me the agency is raking in some serious money and not showing their appreciation by paying these hard working dependable CNA’s like they should be paid. Good Caregivers are worth so much to us people in need, and to have a large turnover because the pay is too low is a disservice to the end patient that needs good care. There should be a good 60 minutes show regarding this to expose what is going on in the Caregiver Home Health world.

    1. Anonymous

      I have been a cna since 2009, and a caregiver before that and I this type of work is not for everyone one, it takes a special person to do this kind of work! Yes, I get paid nothing for my dedication and hard work and the love I have for my patients, but like I tell them it’s not the pay that keeps me caring and loving what I do its my patients!

    2. isa

      You are so right I work for 3 agencies and I know they are changing $20-$40 an hour but I also get paid good and get treated with respect .. But yes some people are making less ,I worked in a hospital and took a huge pay cut but I love doing private duty because I am able to give my patients the one on one care they need and deserve.. it gets me so sick to even think about a fast food worker making what I make an hour ,When the idiots can’t even give you a straw or napkins and mess up your order ,and I play in shit , throw up and urine all day and I get abused mentally and physically ,And they just cook food and work a register that tells them how much change you get back.. OK I’m done I had to rant sorry

    3. Anonymous

      amen! I”m a CNA, and I”d love to stay in one job, but I still have to make a reasonable living for my family. Forcing me to search for more work down the road even if it is just a .50 raise:(

  2. Anonymous

    I agree. My residents are the ones I care about. It is very hard mentally and physically being in LTC. Yes CNA’S are the backbone of any LTC facility and deserve to be paid more.

  3. Anna

    Been a CNA for over 25 years I love my residents but when someone wants 15.00 hour for flipping burgers that makes me mad I don’t even make no where that amount !! Yes I feel like I should make more than 15.00 my job is back breaking ,heart breaking mentally exhausting so why are we paid so little !!!

    1. Anonymous

      I have worked both home health aide an a nurse aide cna in corporations that pay average for our area best being a veterans home by the state with good benefits at that time. It seems the harder we work the more the private sector thinks an aide can do with 15 to 18 or more patients to çarè for some patients needing 2_3 people to transfer them or roll them because of the size of them. Then they fire us because we get hurt transferring these people we have injuries that take time to heal that’s a laugh to get enough time to heal. The only way to make decent money as a cna was agency in our area an that was a long time ago.

  4. Anonymous

    Cna workers like myself work ourself to death for such little pay! Its sad how we are treated and how much were unappreciated!

  5. Teresa

    The part your article doesn’t say CNAs are hair stylist we are most of the time those people’s family because most families put their family members in the nursing home and forget about them so we step up and become their family and we are their counselor when they are sad or depressed I could go on about what really goes on but I want

  6. Misty

    I have been a CNA for almost 10 years and don’t even come close to making $15.00 an hour. Why should some one that has to use a computer to tell them how much change to give and flips burgers get paid more than those of us who work in an environment where we get pinched, clawed, punched, kicked, spit on, verbally abused, clean up puke, poop, urine, snot, and sometimes blood get paid? There is a huge problem in this country if those fast food workers think they deserve more than healthcare workers.

  7. Anonymous

    Well written, could not have put a more realistic description of what it takes to be a certified nursing assistant. I no longer am a CNA, but I know that it was the hardest job I ever had. Emotionally, ethically and physically.

  8. Anonymous

    My girlfriend is a cna she likes her job but i have to say from my point of veiw the pay sucks i think a cna deserves alot better not someone making fast food sorry i worked at Mcdonalds at one point fyi

  9. Anonymous

    This month I have been a CNA for 21 yrs. When I first started another CNA made the remark, ” on holidays we make what we are close to worth(when getting double pay)!!” I have hurt my back many times. I now go to the chiropractor every few weeks so I don’t have to miss work(months at a time…this has happened to me). But everyone is right, I don’t go back for the pay. I go back because I love what I do, and who I work for(my residents)!!!!

  10. Amanda mace

    I have been a CNA for 16 years. We are the rock of all facilities we know the elderly what they want what they do we know them like the back of our hand. But we are the lowest payed. We feed,bathe,change, there companion ship, ect, and even when they pass we are the ones that deal with the clean up the heart break. But then again the lowest payed. We know them more than the nurse even the family. In my opinion might not be much but there wouldn’t be a place for your mother, father, grandparent, sister,brother, to go and be took in care of if it wasn’t for CNAs Cuz we are the ones that keep facilities going.

  11. Anonymous

    I’ve been a cna for 22 years..I’ve always told my trainees that if your in this business to get rich your gonna be disappointed. I have no problem with anyone wanting to earn $15/hr..the minimum wage is not nearly enough to allow anyone to make a decent living..however the little that caregivers make is not nearly enough for the lives that we have in our hands everyday

  12. Anonymous

    Soo true, I’m a nurse & I see everyday what physically hard work these cnas do. They are the backbone of LTC. What these people get paid is nothing less than shameful. Not to mention the stress & abuse they endure. The abuse they deal with from demented patients is ridiculous.They work hard, they are spit on, kicked, cussed, slapped & work short staffed almost on a daily basis. The public doesn’t have a clue . All this for wages so low they have to depend on o.t.or public assistance to make ends meet. If anyone deserves more $ it’s these CNAs. Cause one day like it not you Will be needing one of these professionals yourself. They are a necessity in Healthcare !! Shame on you Obama !!!!

  13. tamantha mcgraw

    This true cnas are the backbones of the long term care facilities we are the underpaid people who take care of ones loved ones when others cannot.we feed ur loved ones we they no longer can feed themselves we dress ur loved ones we they cannot we transfer ones that can no longer stand walk or even bear weight on their own two feet we do alot of lifting which in turn can b over powering because we have all sizes some with little weight others quite heavy. Although we dont stop here. We shower dress give bed baths to the totally bedridden people who can no longer get out of bed for what ever health decline or disability ones may have.we r the qualified persons who make a difference in ones life when others ate not able to care for their lived ones.and yes sad to say we cnas are often not recognized or paid enough for the direct care we give. We are the people who see ur loved ones every day some days good some days not so good we are the people who are their with ur loved ones to the end. W e are their for the ones who need are care and help.we do make a difference so who ever thinks cna work is easy think again it takes a real good person to do the work we do .we are the people whom notice all the changes in a persons health when people decline in health or ones who are able to get better and go home we are the ones whom can tell u almost anything about are residents cause we work and see them on a daily basis.so please why not take time to recognize the care we give and promote better pay wages .

  14. Anonymous

    I loved my job but I’m now on disability because it ruin my body. Do CNA’s deserve a pay raise. Hell yes and then some.

  15. pattie culver

    I am a C.N.A. and have been since 1987. I worked in facilities for almost 10 years. I now work at a hospital. I am here to say that no matter where we work, it is time that we were paid the wages we deserve. We are the ones caring for the residents and patients. We are the ones who deal with the families who need a shoulder to cry on or a warm hug when they lose their loved ones. We are the ones who know how to position the patients, work the equipment find out what the patient needs and make sure their needs are communicated to the nurses . I do not consider myself as a nursing assistant as much as I used to. I do not assist the nurses. They may assist me . But, as I go through my work day, I find that I am more and more a patient’s assistant. And an advocate for them. I make sure that they are cared for and treated with respect and dignity. That they are as comfortable as possible and that they feel that someone is on their side. Often we are given far more work than we can possibly handle and no one seems to understand why we can’t do everything in one 8 hr. shift. Tonight for example, I started my night with 14 patients. The nurses took 3 as their primaries, ( usually the patients that don’t need assistance ) And I was called by a nurse who ,Since she had not seen me, was complaining that she hadn’t had an aide for 2 hrs. I had been running for 2 hrs. !!! I lost it. I had to take a break. Nurses need to know, We are only human beings. We do not come to work to be their C.N.A.’s. We come to work to care for people who need us. It is time for those who do the care to be paid a living wage. A person mowing lawns for a living makes more than we do and it’s time that someone who cares for human beings and has the skill set to do it well, to be paid accordingly. Education is not a measure of ones worth to society.

  16. Joe Kirn

    I was a cna for 23 years, nyc, pa.in.and ill.
    In the morning I had 12 minutes per resident.
    I wish that the government would take over the nursing homes; staff them sensibly. This move would be a real job creator.
    As a cna one is paid to ‘take the bullet’.

  17. Jason Haugen

    I have been in nursing for over 20 years, and have seen firsthand what different places pay and far and away most treat you like crap, however where I work now has a good union that has helped us get some of the best pay raises in the country the past 8 years, so it sounds like CNA’s LPNs etc out there need to use their protected right, and organize a union for their workplaces. Personally after seeing a couple of them I’d choose United Steelworkers as they have a lot of resources and are making healthcare their number one focus. But you can get better pay, have a say in your working conditions, have representation, protection from false or unjust write ups or terminations.

  18. Audrey Hugo

    This is why the government has to step in and take charge. Home Care Agencies are typically corrupt, they have been for a long time. Some are better than others with just a few dollars pay more than minimum wage and can be more understanding with caregiver and client support while others are nothing but crooks who operate a low-budget company with high turnover. But really, not much different. They don’t want to pay for such a valued job. I have seen it all and know it all. A great number of agencies have had lawsuits for labor violations and wage theft over the years. Live-in care are almost banned because owners of these companies don’t want to deal with the new overtime laws that took effect. The Home Care industry needs some serious reform and pay good caregivers fair wages, with benefits and raises (only for those who deserve) and make sure staff are supportive and trained to understand what it is like to work with the elderly community and it’s not always going to be glamorous. Get rid of incompetent so-called care helpers who are not professional, dependable and are behaving badly on the job who make an agency look bad (believe me, I’ve seen it all). Reduce overhead to make it only 7 people working in the office including owner. This makes for a happy caregiver and successful agency. On the other hand, this is only good for part-time employees who can afford low wage jobs, this definitely not meant for someone needing a full time income.

  19. Anonymous

    I don’t know how it is in every state, but in Illinois I had to pay for a cna course, take and pass the cna course while working a full time job, do clinicals every weekend, then pay the state to take and pass their test to certify me as able to work as a cna. we have to put in our own time and money for the privilege of cleaning butts and lifting bodies for living while making the same as I did at retail stores.

    1. Anonymous

      Great point and in retail you at least have the opportunity to gain promotions. I’ve been a cna for 11 yrs.

  20. Earlene Walker

    Some cna are poorly mistreated overworked and underpaid. Some get abuse by patients. Patients cough in their face. Urinate on floor in beds and they even pooped in bed dig their hands in it and then un knowly want to reach out and touch you. You are called their daughter their sons names. That you can not help but answer to it. In all. Some have worked all their lives to have an illness that puts them in a.nursing home. Their homes cars bank accounts are taken away. Some family members past away before them they barley have nothing and anyone. Sad story. Yet the cna take a huge beating. To many patients at one time. Poor staffing. Also a lot of cleaning poop and urine. To be underpaid. Unacceptable. With some cna they love their work and patients. They should be paid good benefits and good pay

  21. Anonymous

    Somthing needs to happen talk is cheap people need to get together and do somthing exploit the bosses making your money giving you scraps like a dog he does not care for the elders no love at all somthing needs to happen but nothing will just like the child support prob do you know how many good dads are stuck in that system most of them dnt drive lets not get in to that i feel the elders should be taken care of and the workers to be paid as high as a paramedic

  22. lui

    Not only tough job by itself, add to it the perpetuated maintained short staffing so that “they” can maximize their gains , for years people tried to defend a respectable care giver to resident ratio without success, let you guess the reason why…

  23. Anonymous

    That’s why cnas are quitting these jobs, because they are being paid poorly, for the amount of work they have to do. I don’t blame them, they should just walk out. Go on a strike.

  24. Anonymous

    CNA’s are underrated and not appreciated in the field. The amount of stress CNA’s go through is unimaginable. Dealing with patients who are angry, scared, and more angry because they are there is not unjust. Believe it or not CNA’s are not treat kindly by some of their co- workers too. Dealing with that on a weekly basis I could only imagine it destroying ones self esteem and self worth.

    Everyone should be treated fairly regardless of their level of professionalism. But that is not the case for some CNA’s.
    No man or woman should have to go through what CNA’s go through.

  25. I do care.

    I work in the industry as an Accountant. I can tell you that for the most part, it’s because the rates we are reimbursed by the state are very, very low. If we look at the economics of it, as you have, the demand is high, the supply is low, BUT the price is artificially remains low. WHY? Because the government sets the rate for the resident’s per person per day amount. That rate must then pay for ALL the resident’s basic and sometimes not so basic needs: food, x-rays, medicine, entertainment, heat, the clinical staff, the MD, equipment, everything….let me repeat….everything is on the care center. We barely scrape by and sometimes even don’t. If the government would reimburse Medicare and Medicaid (which sometimes constitutes 80-90% of our residents payer type) better, we would have more to pay CNAs a better wage.

  26. P. Sallie

    People want the Best for their Family…until it comes to paying for the Best Care!

    If people thought more about how Important ADL’s are to each and everyone one of us!
    If people who can’t help themselves don’t have someone who Truly cares to help them with something like being Fed or being Repositioned… Their Health will Surely Decline!
    CNA’s make a Difference ….CNA’s do Matter!
    CNA’s definitely Deserve more Money!!!
    Let’s start a Movement for More Money ….. Who’s in????


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