Becoming a certified nursing assistant (CNA) takes 4 to 12 weeks from start to finish, making it one of the fastest entry points into healthcare. The process involves completing a state-approved training program, passing a two-part competency exam, and applying for placement on your state’s nurse aide registry. Here’s what each step looks like in practice.
Basic Eligibility Requirements
Most states set the minimum age at 16, though some require you to be 18. Educational requirements are lower than many people expect. Illinois, for example, requires completion of at least eight years of grade school or proof of equivalent knowledge. Many states ask for a high school diploma or GED, but not all do.
Every state requires a criminal background check before you can work as a CNA. Certain convictions, particularly those involving abuse, neglect, or theft, are disqualifying. Some states offer a waiver process if you have a disqualifying conviction on your record, but approval isn’t guaranteed. You’ll also need to be free of any administrative findings of abuse or neglect in any state, not just the one where you’re applying.
Choosing a Training Program
CNA training programs are offered through community colleges, vocational schools, hospitals, nursing homes, and the American Red Cross. The federal minimum set by federal nursing home regulations is 75 hours of training, including at least 16 hours of supervised clinical work with real patients. Many states exceed this minimum. Some require 120 hours or more, so check your state’s nursing board website for the exact number.
Program costs vary widely. At Florida State College at Jacksonville, for instance, the total runs about $1,228, split between a healthcare foundations course and the nursing assistant course itself. On top of tuition, expect to pay for scrubs, a stethoscope, a blood pressure cuff, a watch with a second hand, textbooks or digital course materials, and a background and drug screening. Some nursing homes and hospitals offer free training in exchange for a commitment to work there after certification, which is worth looking into if cost is a concern.
Programs that run full-time typically wrap up in 4 to 6 weeks. Part-time or evening programs stretch to 8 to 12 weeks. Either way, you’ll spend roughly half your time in a classroom and the other half in a clinical setting.
What You’ll Learn in Training
The curriculum covers a specific set of hands-on skills you’ll need to demonstrate competency in before you can sit for the state exam. These fall into several categories:
- Infection control: Proper handwashing technique, and how to put on and remove gloves and gowns without contaminating yourself or the patient.
- Vital signs and measurements: Taking a pulse at the wrist, counting respirations, measuring blood pressure manually, recording urinary output, and weighing patients.
- Patient mobility: Helping patients walk using a transfer belt, moving them from a bed to a wheelchair, repositioning them on their side, and performing range-of-motion exercises for joints like knees, ankles, and shoulders.
- Personal care: Mouth care, denture cleaning, foot care, bathing patients in bed, perineal care, and catheter maintenance.
- Daily living assistance: Feeding patients who can’t feed themselves, dressing patients with weak or paralyzed limbs, and helping with bedpan use.
- Supportive care: Applying compression stockings to prevent blood clots.
You’ll also cover communication skills, patient rights, safety procedures, and recognizing signs of abuse or neglect. The clinical portion puts you in a nursing home or hospital where you practice these skills under the supervision of a licensed nurse.
Passing the Certification Exam
After completing your training program, you’ll take a state competency exam that has two parts: a written (or oral) knowledge test and a clinical skills evaluation. The written portion is multiple-choice and covers the concepts from your coursework. The skills portion requires you to perform a set of randomly selected clinical tasks in front of an evaluator, typically 3 to 5 skills drawn from the full list you learned in training.
States contract with third-party testing companies to administer these exams. Credentia, which runs the National Nurse Aide Assessment Program (NNAAP), is one of the largest providers and serves multiple states. Your training program will tell you exactly which company handles testing in your state and how to register. Exam fees are usually in the range of $100 to $150 for both parts, though this varies by state.
If you fail one or both portions, most states allow you to retake the exam. You’ll typically get three attempts. If you don’t pass after three tries, you may need to retake the training program before testing again.
Getting on Your State Registry
Once you pass both parts of the exam, your name is added to your state’s nurse aide registry. This is the official record that employers check to verify your certification. The process usually takes a few weeks after your exam results are submitted. Some states issue a certificate or card; others simply maintain a searchable online database.
Keeping Your Certification Active
CNA certifications expire, and the renewal cycle is typically every two years. To renew, you need to show that you’ve worked as a nurse aide during that period and completed the required continuing education hours. In Texas, for example, CNAs must complete at least 24 hours of in-service education every two years, including training on geriatric care and dementia disorders like Alzheimer’s disease. Many employers provide this training on the job, and computer-based courses are also available to meet the requirement.
If your certification lapses because you haven’t worked as a CNA, most states require you to retake the competency exam before getting back on the registry. Some states have a specific window (often 24 months of inactivity) before this kicks in.
Transferring Your CNA to Another State
There’s no single national CNA license, so if you move, you’ll need to transfer your certification to your new state. The process generally involves verifying that you’re in good standing on your current state’s registry, submitting an application to the new state, and sometimes passing an additional written test. Indiana, for example, requires out-of-state CNAs to take a written exam even if they’re already certified elsewhere. Indiana also allows transferred CNAs to work for up to 120 days while their paperwork is processed.
Each state handles reciprocity differently. Some make it straightforward; others require additional documentation or testing. Contact the nursing board in the state you’re moving to before you relocate so you know what to expect.
Salary and Job Outlook
The median annual wage for nursing assistants was $39,530 as of May 2024, according to the Bureau of Labor Statistics. Employment is projected to grow 2 percent from 2024 to 2034, which is slower than average but still translates to consistent demand. Nursing homes, hospitals, and assisted living facilities are the primary employers, and job openings tend to be plentiful because of turnover in the field.
Many CNAs use the certification as a stepping stone. Working as a CNA gives you direct patient care experience that strengthens applications to nursing school, and some employers offer tuition assistance for CNAs pursuing an LPN or RN degree.