CNAs have a surprisingly wide range of certifications available to them, from medication administration to dialysis care to hospice work. Each one builds on the clinical foundation you already have, opens doors to higher-paying roles, and can serve as a stepping stone toward becoming an LPN or RN. The right choice depends on where you want to work and what kind of patient care interests you most.
Certified Medication Aide (CMA)
One of the most popular next steps for CNAs is becoming a Certified Medication Aide. This credential allows you to administer medications to residents in long-term care facilities, assisted living communities, and sometimes correctional facilities. Without it, medication administration is outside a CNA’s scope of practice in most states.
The path involves completing a state-approved training program and passing the Medication Aide Certification Examination (MACE), a national standardized test. Training programs typically run 40 to 100 hours depending on the state, and most require you to hold an active CNA certification with no disciplinary actions on your record. Some states also require a minimum period of CNA work experience before you can enroll. Adding this credential can push your earning potential from the $17 to $18.50 per hour range typical for entry-level CNAs into noticeably higher territory, since facilities specifically seek out CMAs to reduce the burden on their nursing staff.
Patient Care Technician (PCT)
A Patient Care Technician certification expands your skill set into areas hospitals value highly: phlebotomy (drawing blood), EKG monitoring (recording heart rhythms), and specimen collection. This makes you eligible for roles in emergency departments, surgical floors, and outpatient clinics where basic nursing assistant skills alone aren’t enough.
Many PCT programs are structured as bridge programs for people who already hold CNA certification. A typical program combines nursing assistant training with phlebotomy certification, covering anatomy and physiology, medical terminology, infection control, and special specimen collections. Because you’ve already completed the CNA portion, some programs let you focus on just the additional clinical skills. The national certification exam is offered through the National Healthcareer Association (NHA), and hospitals in particular tend to prefer candidates who hold it.
Geriatric Nursing Assistant (GNA)
If you work in a nursing home or plan to, a Geriatric Nursing Assistant certification may be essential rather than optional. In Maryland, for example, all nursing assistants working in licensed comprehensive care facilities are required to pass the GNA examination. The credential signals specialized competency in caring for older adults, including managing age-related conditions like dementia, fall prevention, and end-of-life comfort care.
The GNA exam in Maryland tests 20 specific clinical skills alongside a written component. Other states may not use the GNA title specifically, but many have equivalent geriatric competency requirements for CNAs working in skilled nursing facilities. If you’re already working in elder care, this certification formalizes skills you likely practice every day and can make you more competitive for lead aide or charge aide positions.
Certified Hospice and Palliative Nursing Assistant (CHPNA)
For CNAs drawn to end-of-life care, the CHPNA credential is the recognized specialty certification. It’s offered by the Hospice and Palliative Credentialing Center and validates your ability to provide comfort-focused care to patients with serious or terminal illnesses.
The eligibility bar is experience-based: you need 500 hours of hospice or palliative nursing assistant work within the past 12 months, or 1,000 hours within the past 24 months, all performed under the supervision of a registered nurse. This means you’ll need to work in a hospice setting first before you can sit for the exam. The work itself involves pain management support, emotional care for patients and families, and recognizing changes in a patient’s condition as they approach the end of life. Hospice agencies often pay a premium for certified staff, and the credential carries weight if you later pursue nursing school with a palliative care focus.
Certified Hemodialysis Technician (CHT)
Dialysis centers are one of the fastest-growing employment settings for people with CNA backgrounds. As a hemodialysis technician, you operate the machines that filter blood for patients whose kidneys can no longer do it, monitor patients during treatments, and manage vascular access sites.
Two national certification bodies offer the credential: the Nephrology Nursing Certification Commission (NNCC) and the Board of Nephrology Examiners for Nursing and Technology (BONENT). Some states, like California, also accept state-approved standardized testing through organizations like the California Dialysis Council. Most dialysis employers provide on-the-job training before you sit for the certification exam. The work is highly technical compared to traditional CNA roles, and the pay reflects that. Dialysis technicians often earn significantly more than floor CNAs, and the schedule tends to be more predictable since many clinics operate on set treatment shifts.
Phlebotomy Technician
Phlebotomy certification is one of the quickest credentials a CNA can add, with most training programs running 4 to 8 weeks. It qualifies you to draw blood in hospitals, labs, blood banks, and outpatient clinics. Even if you don’t switch roles entirely, having phlebotomy skills makes you a more versatile hire in any healthcare setting.
The certification is available through several organizations, including the NHA and the American Society for Clinical Pathology. Programs cover venipuncture technique, capillary collection, specimen handling, and patient safety protocols. Many CNAs pursue phlebotomy as a standalone add-on rather than through a full PCT program, especially if they want to pick up shifts in a hospital lab or work part-time at a blood donation center.
Wound Treatment Associate (WTA-C)
Wound care is a growing specialty in long-term care and home health settings where chronic wounds, pressure ulcers, and surgical sites need daily monitoring. The Wound Treatment Associate certification, offered by the Wound, Ostomy and Continence Nursing Certification Board, was developed specifically to train support staff in pressure ulcer prevention and basic wound management.
As a WTA-C, you work under the direct supervision of a licensed practitioner, providing daily wound monitoring and carrying out treatment plans designed by a certified wound care nurse. The training must be delivered by a certified wound, ostomy, and continence nurse. This is a niche credential, but facilities with high wound care needs actively seek it out, and it can position you for specialized roles that come with higher pay and more autonomy in your daily work.
EKG Technician
An EKG technician certification teaches you to place electrodes, run electrocardiogram tests, and recognize basic cardiac rhythms. Cardiologist offices, hospitals, and cardiac rehabilitation centers all employ EKG techs. Training programs are short, usually 4 to 6 weeks, and the certification is offered nationally through the NHA and other credentialing bodies.
Like phlebotomy, this credential stacks well with your existing CNA skills. Many CNAs combine EKG and phlebotomy certifications to qualify for PCT roles without completing a full PCT bridge program. If cardiology interests you, this is also a practical entry point toward becoming a cardiovascular technologist with further education.
How Certifications Affect Your Pay
The financial difference between an entry-level CNA and one with specialized credentials is substantial. Entry-level CNAs with zero to two years of experience typically earn $35,000 to $38,000 annually, roughly $17 to $18.50 per hour. CNAs who move into specialized or senior roles with additional certifications can earn $50,000 to $65,000 or more, translating to $24 to $31+ per hour. The biggest jumps tend to come from certifications that let you work in higher-acuity settings: dialysis centers, emergency departments, and cardiac units pay more because the technical demands are greater.
Transferring Certifications Between States
Your base CNA certification generally transfers between states through a reciprocity process. Most states require that you were deemed competent on your home state’s registry, that your training met federal standards, and that you have no findings of abuse, neglect, or misappropriation of property on any state registry. You’ll also need to clear a criminal background check in the new state.
Advanced certifications are more complicated. National credentials like the CHPNA, MACE, or BONENT dialysis certification carry across state lines because they aren’t state-issued. But state-specific credentials like Maryland’s GNA may not have a direct equivalent elsewhere, meaning you could need additional testing or training after relocating. Before you move, check both your new state’s CNA registry requirements and whether your specialty certifications are recognized there.