# Nephrology Nursing Certification Commission (NNCC) > The Nephrology Nursing Certification Commission® (NNCC®), formerly the Nephrology Nursing Certification Board (NNCB), was established in 1987 to develop and implement certification examinations for nephrology nursing. The NNCC is national in scope, separately incorporated, and an independent organization. It collaborates with the Center for Nursing Education and Testing (C-NET) for test development, administration, and evaluation. The NNCC is not affiliated with any provider of dialysis care or with any training program for nephrology nurses or technicians. The management firm is Anthony J. Jannetti, Inc., Pitman, New Jersey. **Mission:** The Nephrology Nursing Certification Commission (NNCC) exists to establish credentialing mechanisms to promote patient safety and to improve the quality of care provided to nephrology patients. **Philosophy:** The NNCC supports a diversity of examinations that effectively provide the opportunity for certification at various levels of education, experience, and areas of practice within nephrology nursing. **Website:** https://www.nncc-exam.org **Phone:** 888-884-6622 (888-884-NNCC), Monday–Friday, 8:30am–5:00pm Eastern **Email:** nncc@nncc-exam.org **Mailing Address:** PO Box 56, Pitman, NJ 08071-0056 **Testing Partner:** Center for Nursing Education and Testing (C-NET) — 800-463-0786 | info@cnetnurse.com --- ## About NNCC - **About Page:** https://www.nncc-exam.org/about-nncc - The NNCC is composed of nine Commissioners: eight with current experience and expertise in nephrology nursing and one public member. - Officers include: President, President-Elect, Secretary, and Treasurer. - Staff includes: Executive Director, Director of Certification Services, Certification Specialists, and an Administrative Assistant. - NNCC collaborates with professional nephrology organizations to promote, advertise, and offer certification examinations, and to recognize certified individuals. - NNCC currently provides **five active examinations** to validate clinical performance in nephrology. ### Goal To promote the highest standards of nephrology nursing practice through the development, implementation, coordination, and evaluation of all aspects of the certification and recertification processes. The Commission recognizes the value of education, administration, research, and clinical practice in fostering personal and professional growth. ### News & Newsletter - **News Archive:** https://www.nncc-exam.org/about-nncc/news — Monthly NNCC Newsletters published consistently since at least 2023. Archive available with newsletters dating back several years. --- ## Certifications Overview - **Certification Hub:** https://www.nncc-exam.org/certification — Offers a role-based filter (Nurse Practitioner, RN, LPN/LVN, Technician) to match candidates with the appropriate credential. ### Active Credentials (5 Exams) | Credential | Full Name | For | |---|---|---| | CNN-NP™ | Certified Nephrology Nurse – Nurse Practitioner | NPs in nephrology | | CNN® | Certified Nephrology Nurse | RNs in multiple areas of nephrology | | CDN® | Certified Dialysis Nurse | RNs in dialysis facilities | | CCHT-A® | Certified Clinical Hemodialysis Technician – Advanced | Experienced dialysis technicians | | CCHT® | Certified Clinical Hemodialysis Technician | All dialysis technicians | ### Discontinued Credential - **CD-LPN®/CD-LVN®:** The Certified Dialysis – Licensed Practical/Vocational Nurse credential was discontinued as of January 1, 2019 due to very limited applicant response. All exams were required to be completed by December 31, 2018. > **Note on Fees:** All pricing information has been redacted from this document. For current exam, retake, recertification, and administrative fees for all credentials, please visit the individual credential pages at https://www.nncc-exam.org/certification and https://www.nncc-exam.org/recertification, or contact NNCC directly at nncc@nncc-exam.org or 888-884-6622. --- ## Certification Details ### CNN-NP — Certified Nephrology Nurse – Nurse Practitioner™ - **URL:** https://www.nncc-exam.org/certification/cnn-np - **For:** Nurse practitioners in nephrology practice. - **Eligibility:** - Full and unrestricted RN license in the US or its territories. - National certification as a nurse practitioner. - Minimum 2,000 hours AND 2 years as an NP practicing in nephrology within the 2 years prior to application. - Minimum master's degree in nursing. - Effective 10/1/2022: 20 contact hours of approved continuing education in nephrology within the 2 years prior to application (approved by ANCC-COA, AACN, Council of Continuing Education, AANP, State Boards of Nursing, or ACCME-accredited organizations). - **Exam:** 175 questions; 4-hour time limit; passing standard score = 95 (70% correct). - **Pass rate:** Approximately 75% of first-time test takers. - **Online Practice Exam:** 50 questions; 90-day access; Practice Mode and Test Mode available. Free for approved CNN-NP exam candidates. See website for current pricing. - **Recertification cycle:** Every 5 years. - **Core References:** Contemporary Nephrology Nursing (4th ed., 2022); Core Curriculum for Nephrology Nursing (7th ed., 2020); Handbook of Kidney Transplantation (6th ed., 2017); Handbook of Dialysis (5th ed., 2015); National Kidney Foundation's Primer on Kidney Diseases (8th ed., 2023); CNN-NP Certification Preparation Guide (2016); Water for Dialysis (2023). --- ### CNN — Certified Nephrology Nurse® - **URL:** https://www.nncc-exam.org/certification/cnn - **For:** RNs practicing in multiple areas of nephrology. - **Eligibility:** - Full and unrestricted RN license in the US or its territories. - Minimum 3,000 hours of experience in multiple areas of nephrology nursing within the 3 years prior to application. - If working in outpatient hemodialysis, at least 750 hours (25%) of the 3,000 must also include one or more of: home hemodialysis, home peritoneal dialysis, inpatient acute kidney injury on KRT, inpatient critical care on KRT, CKD management (not on KRT), kidney transplant, or apheresis. - Baccalaureate or master's degree in nursing. - 30 contact hours of approved continuing education in nephrology nursing within the 3 years prior to application (approved by ANCC-COA, AACN, Council of Continuing Education, or State Boards of Nursing). - **Exam:** 150 questions; 3-hour time limit; passing standard score = 95 (70% correct). - **Online Practice Exam:** 50 questions; 90-day access; Practice and Test modes. See website for current pricing. - **Recertification cycle:** Every 3 years. - **Core References:** Contemporary Nephrology Nursing (4th ed., 2022); Core Curriculum for Nephrology Nursing (7th ed., 2020); Nephrology Nursing Scope and Standards of Practice (9th ed., 2022); Review of Hemodialysis for Nurses and Dialysis Personnel (9th ed., 2016); CMS End-Stage Kidney Disease Program Interpretive Guidance v1.1; Pearson Nurse's Drug Guide (current edition). --- ### CDN — Certified Dialysis Nurse® - **URL:** https://www.nncc-exam.org/certification/cdn - **For:** RNs practicing in dialysis facilities. - **Eligibility:** - Full and unrestricted RN license in the US or its territories. - Minimum 2,000 hours experience as an RN in nephrology nursing caring for patients who require or may require dialysis, or educating/supervising staff, within the 2 years prior to application. - 20 contact hours of continuing education in nephrology nursing from approved providers within the 2 years prior to application (approved by ANCC-COA, AACN, Council of Continuing Education, or State Boards of Nursing). - *Note: An International CDN is also available.* - **Exam:** 150 questions; 3-hour time limit; passing standard score = 95 (70% correct). - **Online Practice Exam:** 50 questions; 90-day access. See website for current pricing. - **Recertification cycle:** Every 3 years. - **Core References:** Same as CNN (Contemporary Nephrology Nursing 4th ed.; Core Curriculum 7th ed.; Scope and Standards 9th ed.; Review of Hemodialysis 9th ed.; CMS Interpretive Guidance; Drug Guide). Additional: Water for Dialysis (2023). --- ### CCHT — Certified Clinical Hemodialysis Technician® - **URL:** https://www.nncc-exam.org/certification/ccht - **For:** All dialysis technicians (entry-level credential). - **Eligibility:** - Minimum of a high school diploma or GED (copy of government-approved diploma required; name must match application). - Successful completion of a training program for clinical hemodialysis technicians including both classroom instruction and supervised clinical experience (signature of educator or certificate of completion required). - If not yet employed: provide hours of hands-on clinical experience from training program; facility administrator/manager must sign to verify RN-supervised clinical experience. - If employed within last 18 months: provide employer name and supervisor signature to verify employment. - Recommended (not required): minimum 6 months or 1,000 hours of clinical experience. - If unemployed for 18+ months: proof of current retraining and hands-on experience required. - Compliance with federal and state regulations (CMS Conditions for Coverage for ESRD Facilities). - **Exam:** 150 questions; 3-hour time limit; passing standard score = 95 (74% correct — slightly higher threshold than nursing credentials). - **Online Practice Exam:** 50 questions; 90-day access; Practice and Test modes. See website for current pricing. - **Recertification cycle:** Every 3 years. - **FailSafe Policy:** CCHT certificants who attempt but do not pass the CCHT-A examination will automatically receive CCHT recertification. - **Core References:** CMS ESKD Program Interpretive Guidance v1.1; Review of Hemodialysis for Nurses and Dialysis Personnel (9th ed., 2016); Core Curriculum for the Dialysis Technician (6th ed., 2018, MEI). Additional: Water for Dialysis (2023). --- ### CCHT-A — Certified Clinical Hemodialysis Technician – Advanced® - **URL:** https://www.nncc-exam.org/certification/ccht-a - **For:** Experienced dialysis technicians functioning in varied/advanced roles. - **Eligibility:** - 5 years of continuous employment AND minimum 5,000 hours as a clinical dialysis technician. - 30 contact hours of continuing education relevant to hemodialysis technician practice within the previous 3 years (recommended, not required, that CE be ANCC-COA, AACN, Council of Continuing Education, or State Board-approved). - Preceptor credit: max 8 contact hours from 160 precepting hours within the 3 years prior to application (Preceptor Form required). - Current national certification as CCHT, CHT, or CCNT. - Compliance with federal and state regulations (CMS Conditions for Coverage for ESRD Facilities). - **Exam:** 150 questions; 3-hour time limit; passing standard score = 95 (70% correct). - **Online Practice Exam:** 50 questions; 90-day access. Free for approved CCHT-A candidates. See website for current pricing. - **Recertification cycle:** Every 3 years. - **FailSafe Policy:** Current CCHT certificants who take but do not pass the CCHT-A exam will automatically receive recertification of their CCHT credential. - **Note:** CCHT-A can only be obtained by taking and passing the CCHT-A exam; CCHT holders cannot transfer directly to CCHT-A recertification. - **Core References:** Same as CCHT. --- ## Recertification - **Recertification Hub:** https://www.nncc-exam.org/recertification ### Recertification Cycles by Credential | Credential | Recertification Period | |---|---| | CNN-NP | Every 5 years | | CNN | Every 3 years | | CDN | Every 3 years | | CD-LPN/CD-LVN | Every 3 years | | CCHT-A | Every 3 years | | CCHT | Every 3 years | ### CNN Recertification Details - **URL:** https://www.nncc-exam.org/recertification/cnn - Initial certification is effective for 3 years from the last day of the month in which the applicant passed the examination. - **Notification:** NNCC sends reminders every ~30 days starting 120 days prior to expiration. Applicant bears ultimate responsibility. - **Two options:** 1. **Recertify by Continuing Education/Clinical Experience:** - 45 contact hours of approved CE within the 3-year period. Minimum 15 must be nephrology-specific. - Accepted CE sources: Nursing CE programs; independent study; academic credit (5 CE hrs per semester credit; 3 per quarter credit — one recertification period only); professional publications (15 hrs for book chapter/article; 45 hrs for book authorship); multimedia program development (5 hrs per program); preceptor hours (max 8 contact hrs from 160 precepting hours — Preceptor Form required). - CE must be approved by ANCC-COA, AACN, Council of Continuing Education, or any State Board of Nursing. - Submit application by last day of certification expiration month; recommend submitting 3 months early. 2. **Recertify by Examination:** - No CE submission required; all other eligibility requirements still apply. - Testing must be completed before certification expiration date. - Exam application and fee must be submitted 8 weeks prior to exam date. - **Eligibility for CNN Recertification:** - Current CNN credential. - Current, full and unrestricted RN license. - Minimum 1,500 hours experience in nephrology nursing as an RN during the last 3 years (waivable for full-time BSN students, one period only, with school verification). - **Emeritus Status:** Available to nurses age 50+ who have retired from active practice. One-time fee (see website for current amount). Emeritus credential may be used at nephrology functions. Return to active practice requires meeting current eligibility criteria and certifying by examination. - **Inactive Status:** Available for one 3-year period if unable to meet recertification requirements. CNN credential may not be used during inactive period. Cannot be extended beyond 3 years. - For current recertification fees, see https://www.nncc-exam.org/recertification/cnn. ### CCHT Recertification Details - **URL:** https://www.nncc-exam.org/recertification/ccht - **Two options:** 1. **Recertify by Continuing Education/Clinical Experience:** - 30 contact hours of CE during the 3-year certification period. Minimum 10 must be nephrology-specific. - Preceptor credit: max 8 contact hours from 160 precepting hours. - CE strongly recommended (not required) to be ANCC-COA, AACN, Council of Continuing Education, or State Board-approved. 2. **Recertify by Examination:** Submit exam application and fee; test at approved CBT site before certification expiration. - **Eligibility for CCHT Recertification:** - Current CCHT credential. - Minimum 3,000 hours of work experience as a dialysis technician within the 3-year certification period. - 30 CE contact hours relevant to dialysis technician scope of practice. - **Emeritus Status:** Age 50+; retired from active practice; one-time fee (see website for current amount). - For current recertification fees, see https://www.nncc-exam.org/recertification/ccht. --- ## Partner Organizations (Reduced Exam/Recertification Fees) Current partner organizations whose members receive reduced fees (see website for current discount amounts): - **American Nephrology Nurses Association (ANNA)** - **American Society of Nephrology (ASN)** - **National Kidney Foundation (NKF)** - **Nurses Organization of Veterans Affairs (NOVA)** Partner member discounts apply to exam fees, retake fees, and recertification fees (recertification by exam and by CE). Late fees and other administrative fees remain the same regardless of partner status. --- ## Exam Preparation ### General Tips (All Credentials) - Determine exam content from the test blueprint. - Review test specifications to identify highest-weighted content areas. - Review the exam reference list. - Focus on least-familiar areas. - Take the Online Practice Exam. - Learning strategies: attend a certification review course (offered by ANNA, NKF, ASN); check local chapter opportunities; systematically review a nephrology nursing reference textbook; participate in a study group; spend time with a colleague in an area needing review. ### Online Practice Exams Available for CNN-NP, CNN, CDN, CCHT, and CCHT-A. Each contains 50 multiple-choice questions in two modes: - **Practice Mode:** Shows correct answer and rationale after each question. - **Test Mode:** Holds results until end of test; provides Score Report with overall score and breakdown by blueprint area. - 90-day access; multiple scrambled versions available for retesting. - Approved candidates for CNN-NP and CCHT-A receive free access to the practice exam. - For current practice exam pricing, see each credential page at https://www.nncc-exam.org/certification. ### Question of the Month NNCC posts a monthly "Question of the Month" for each credential, with correct answer, rationale, and reference. Links provided on each credential page. ### Exam Caution Test preparation websites offering "tricks of testing" and shortcuts are specifically avoided in NNCC exam development. The NNCC tests on content, not test-taking skills. NNCC cannot endorse third-party review courses that are not prepared by or approved by NNCC. ### Certification Preparation Guides Free downloadable guides available for all credentials (linked from each credential page). The CNN-NP Certification Preparation Guide and Study Guide (2nd edition) are available; the Study Guide includes exam blueprint, GAPNA section articles with case studies, suggested reading, sample questions with answer key and rationale. See website for current Study Guide pricing. ### Tips for Answering Exam Questions - Focus on key words: "first," "most likely," "most important," "best" (typically boldfaced). - Anticipate the answer before reading choices, then read all four options. - Do not "read into" the question; answer based only on information presented. - It is acceptable to change answers — research shows changes are more often correct. - Do not spend too much time on one question; mark uncertain questions and return later. ### Water for Dialysis Resource - *Water for Dialysis: What You Need to Know* (NNCC, 2023) — Referenced for multiple credentials and also available as an online practice module: https://online-practice-exam.cnetnurse.com/nncc-water-module/create.php --- ## Awards, Scholarships & Grants - **URL:** https://www.nncc-exam.org/awards-scholarships-grants - NNCC offers the following annually. Application deadlines and details available on the awards page: - **Research** grants - **Career Mobility** scholarships - **Advocacy** awards - **Quality Improvement** grants --- ## Policies - **URL:** https://www.nncc-exam.org/policies ### Denial, Suspension, or Revocation of Certification Grounds include: failure to meet eligibility criteria; falsification of application or supporting materials; RN license restrictions (revocation, suspension, probation); misrepresentation of certification status; cheating on exam; applicable state/federal sanctions; failure to meet CE or work experience requirements. NNCC reserves the right to investigate violations and notify employers/State Boards of Nursing. ### Right of Appeal Individuals denied certification, who failed an examination, or had certification revoked may appeal in writing to the NNCC President within 30 days of notification. The President may appoint a 3-member committee to review the appeal in conjunction with a regularly scheduled NNCC meeting. Final decision communicated within 30 days of the meeting. Failure to appear constitutes waiver of appeal rights. ### Refunds and Cancellations - **Certification exams:** Applicant must first cancel scheduled exam with CBT agency. Written refund request (with full name, last four SSN digits, and exam name) must be received no later than 2 weeks prior to close of the 90-day testing window. Refunds issued minus application processing fee and non-refundable fees. - **Recertification applications:** Fees are non-refundable (paid for application review, not a guarantee of approval). - **Late recertification:** A late fee applies; accepted up to 18 months past expiration date. See website for current late fee amount. ### Incomplete Application Fee Assessed for: missing information, missing required signatures, required CE forms not included or incomplete, or payment processing failure. See website for current fee amount. ### Privacy NNCC reserves the right to publish certificants' names and certification expiration dates by state on the NNCC website for directory purposes. Applicant information may be used for statistical and program evaluation purposes. Information shared only with testing partner C-NET for application processing and exam administration. --- ## Resources - **Resources Hub:** https://www.nncc-exam.org/resources — Includes: Certified Directory, Exam Sites, Text Alerts, NNCC Store, References, Commissioners Only portal. ### Certified Directory - **URL:** https://www.nncc-exam.org/resources/certified-directory — Online, searchable, up-to-date database for certification verification. Displays all individuals who have not elected to keep information private. May take 6–8 weeks after passing the exam for name to appear. ### Exam Sites - **URL:** https://www.nncc-exam.org/resources/exam-sites — All NNCC examinations are administered through computer-based testing (CBT) by appointment at approved testing sites. NNCC does **not** offer at-home or internet testing. ### NNCC Text Alerts - **URL:** https://www.nncc-exam.org/resources/nncc-text-alerts — Certificants may opt in to receive certification reminder notices via text message at least 90 days prior to certification expiration. Also used for important NNCC news. - Sign up: Complete form on the website, or text **JoinNNCC** to **8553836622**. - Opt out anytime by texting "STOP"; automatically reverts to mail and email notices. ### NNCC Store - **URL:** https://www.nncc-exam.org/resources/nncc-store — Certification pins and gear available for purchase. Custom perpetual plaques available for employers to recognize certified employees (Plaque Order Form downloadable). Online store and paper order form both available. See store for current pricing. --- ## Core Reference Materials (Across All Credentials) ### Nursing Credentials (CNN-NP, CNN, CDN) - Bodin, S.M. (Ed.) (2022). *Contemporary Nephrology Nursing*, 4th ed. Pitman, NJ: ANNA. - Counts, C.S. (Ed.) (2020). *Core Curriculum for Nephrology Nursing*, 7th ed. Pitman, NJ: ANNA. - Gomez, N. (Ed.) (2022). *Nephrology Nursing Scope and Standards of Practice*, 9th ed. Pitman, NJ: ANNA. - Kallenbach, J.Z. (2016). *Review of Hemodialysis for Nurses and Dialysis Personnel*, 9th ed. St. Louis: Elsevier/Mosby. - CMS. *End-Stage Kidney Disease Program Interpretive Guidance*, Version 1.1. - NNCC. (2023). *Water for Dialysis: What You Need to Know*. Pitman, NJ: NNCC. ### CNN-NP Additional Core References - Danovitch, G.M. (2017). *Handbook of Kidney Transplantation*, 6th ed. - Daugirdas, J.T., Blake, P.G., & Ing, T.S. (2015). *Handbook of Dialysis*, 5th ed. - Gilbert, et al. (2023). *National Kidney Foundation's Primer on Kidney Diseases*, 8th ed. ### Technician Credentials (CCHT, CCHT-A) - Kallenbach, J.Z. (2016). *Review of Hemodialysis for Nurses and Dialysis Personnel*, 9th ed. - Medical Education Institute, Inc. (2018). *Core Curriculum for the Dialysis Technician*, 6th ed. Madison, WI: MEI. - CMS. *End-Stage Kidney Disease Program Interpretive Guidance*, Version 1.1. - NNCC. (2023). *Water for Dialysis: What You Need to Know*. ### Key Online Guidelines - KDIGO Clinical Practice Guidelines: http://kdigo.org/guidelines/ - National Kidney Foundation KDOQI Clinical Practice Guidelines (online) - CDC (2012). *Guidelines for Vaccinating Kidney Dialysis Patients and Patients with Chronic Kidney Disease* - ISPD Guidelines/Recommendations: Peritonitis Recommendations: 2016 Update on Prevention and Treatment - UpToDate (Wolters Kluwer) --- ## Contact & Key Links - **Contact Form:** https://www.nncc-exam.org/contact-us - **Find Exam Site:** https://www.nncc-exam.org/resources/exam-sites - **Verify Certification:** https://www.nncc-exam.org/resources/certified-directory - **Shop Store:** https://www.nncc-exam.org/resources/nncc-store - **Policies:** https://www.nncc-exam.org/policies - **C-NET (Testing Partner):** 800-463-0786 | info@cnetnurse.com