A Certified Nursing Assistant (CNA) provides hands-on daily care to patients and residents (bathing, dressing, eating, moving and monitoring vital signs) under the supervision of a nurse. To become one, you complete a state-approved training program of at least 75 hours, pass your state’s competency exam, and get listed on your state’s nurse aide registry. Most people finish in 4 to 12 weeks.
CNAs are the largest group of hands-on caregivers in long-term care, and the role is one of the fastest ways into healthcare. Many nurses started as CNAs. Depending on your state, the same job may be called a Licensed Nursing Assistant (LNA), State Tested Nursing Assistant (STNA), or simply Nursing Assistant (NA).
The 6 steps to becoming a CNA
Check your state’s requirements. Every state sets its own rules on top of the federal minimum. Most require you to be at least 16–18, pass a criminal background check, and show proof of immunizations and a TB test before clinical training. Find your state’s rules on our state training pages.
Complete a state-approved training program. Federal law requires at least 75 clock hours of training, including at least 16 hours of supervised practical training with real patients under an RN or LPN. Many states require more, often 100 to 180 hours. Programs are offered by community colleges, technical schools, the Red Cross, Job Corps, and nursing homes and hospitals themselves.
Pass the competency exam. The exam has two parts: a written (or oral) knowledge test and a skills test where you perform several randomly selected tasks, such as handwashing, measuring blood pressure or transferring a patient, in front of an evaluator. Most states use a testing vendor such as Credentia, Prometric or Pearson VUE. Practice with our free CNA practice exam.
Get listed on your state’s nurse aide registry. Once you pass, your state adds you to its registry. Employers check the registry before hiring, so confirm your listing is active.
Find your first CNA job. Nursing homes, hospitals, assisted living, home health agencies and hospice all hire CNAs. Search CNA jobs near you and set up a job alert so new openings come to your inbox.
Keep your certification active. Most states renew every 2 years and require proof that you worked for pay as a nurse aide during that period. Many also require in-service or continuing education hours. If you stop working as a CNA for 24 months in a row, you may need to retrain or retest.
Tip: If a nursing home hires you, or offers you a job, before you start training, federal rules say it cannot charge you for the training, including textbooks and materials. Ask employers about paid or free training programs.
| Question | Answer |
|---|---|
| How long is CNA training? | 75 hours minimum by federal law; most programs run 4–12 weeks. Evening and weekend programs take longer. |
| How much does CNA training cost? | Commonly a few hundred dollars to around $2,000, plus exam and background-check fees. Employer-sponsored programs can be free. |
| How much do CNAs make? | The national median wage for nursing assistants was $42,260 a year (about $20 an hour) in May 2025, per BLS. The lowest 10% earned under $33,940; the top 10% over $51,980. |
| How many CNA jobs are there? | Nursing assistants held about 1.5 million jobs in 2025. |
| What’s the job outlook? | BLS projects 3% growth from 2025 to 2035, with about 203,300 openings for nursing assistants and orderlies every year, mostly from turnover. |
Pay varies a lot by state and setting.
In May 2025, median pay was highest in government jobs ($47,050), followed by nursing homes ($43,000) and hospitals ($42,310), with assisted living ($39,490) and home health ($38,040) lower. Night, weekend and per diem shifts often add a differential. See pay for your state in our CNA salary guide.
Cost figures are typical ranges, not official rates. Check the programs listed for your state.
CNA, LNA, STNA, GNA: same job, different names
The job is essentially the same everywhere; the title depends on your state.
| Title | Stands for | Where you’ll see it |
|---|---|---|
| CNA | Certified Nursing Assistant | Most states |
| LNA | Licensed Nursing Assistant | New Hampshire, Vermont |
| STNA | State Tested Nursing Assistant | Ohio |
| GNA | Geriatric Nursing Assistant | Maryland (long-term care) |
| Nurse Aide I | Nurse Aide I | North Carolina |
| NA | Nursing Assistant | Used broadly, including hospitals |
Moving to another state? Most states let you transfer an active, good-standing certification by reciprocity instead of retraining. Contact the registry in your new state before you move.
Frequently asked questions
Can I become a CNA without a high school diploma? In many states, yes. Federal rules don’t require a diploma, though some programs and employers do. Check your state’s page and the program’s admission rules.
Can I get CNA training for free? Often, yes. Many nursing homes and hospitals pay for training in exchange for a work commitment, and federal rules bar nursing homes from charging aides they’ve hired or offered a job. Workforce programs and Job Corps also offer free training.
Is the CNA exam hard? Most people who complete a full training program and practice the skills pass. The skills portion trips up more candidates than the written test, so practice each skill step by step.
How long is a CNA certification valid? Usually 2 years, renewed by showing you worked for pay as a nurse aide during that time. Rules vary by state.
Can a CNA become a nurse? Yes. Many CNAs go on to LPN or RN programs, and some employers offer tuition help. CNA experience can strengthen a nursing school application.
What’s the difference between a CNA and a medical assistant? CNAs give direct personal care, mostly in hospitals, nursing homes and home health. Medical assistants mostly work in clinics and doctor’s offices, doing both clinical and administrative tasks.
Ready to start?
Find a training program: Browse state-approved CNA programs by state
Practice for the exam: Take the free CNA practice test
Find a job: Search CNA and LNA jobs and get new jobs in your inbox with a job alert
Sources
42 CFR § 483.152 – Requirements for nurse aide training and competency evaluation programs (75-hour minimum, 16 supervised practical hours, no charge for aides employed or offered employment)
BLS Occupational Outlook Handbook: Nursing Assistants and Orderlies (May 2025 median wage and pay by setting, 2025 employment, 2025–35 outlook)
CMS QSO-26-08-NH: Nurse Aide Training and Competency Evaluation Program clarification (April 2026)
