What Is CNA Certification?
A Certified Nursing Assistant (CNA) is a healthcare professional who provides basic care to patients under the supervision of licensed nurses. CNAs work in hospitals, nursing homes, assisted living facilities, and home health settings. Certification is mandatory in every state and requires completing a state-approved training program, passing a competency exam, and meeting ongoing renewal requirements.
CNA certification is regulated at the state level, which means requirements vary significantly from one state to another. Some states require as few as 75 training hours, while others demand 120 or more. Exam formats, renewal cycles, and reciprocity rules also differ. This guide covers the specific requirements in all 50 states so you can plan your path to certification with confidence.
General Requirements Overview
While each state sets its own rules, most CNA certification pathways share these common elements:
- Age: You must be at least 16 or 18 years old (varies by state)
- Education: High school diploma or GED is not always required, but a background check is
- Training: Complete a state-approved nurse aide training program (75 to 144 hours depending on state)
- Exam: Pass both a written/oral knowledge test and a clinical skills test
- Background Check: Most states require criminal background screening before or after certification
- Health Requirements: TB test, immunizations, and physical exam may be required
- Registry: Your name must be placed on the state's Nurse Aide Registry
The CNA Certification Process
The path to becoming a CNA follows a consistent sequence across most states. The flowchart below shows each step from initial training through certification maintenance.
State-by-State CNA Requirements
The table below lists CNA certification requirements for all 50 states and the District of Columbia. Training hours, exam vendors, renewal cycles, and background check requirements may change. Verify with your state Board of Nursing before making plans.
| State | Training Hours | Exam Vendor | Renewal Cycle | Background Check |
|---|---|---|---|---|
| Alabama | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Alaska | 140 | Prometric | 24 months | Y |
| Arizona | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Arkansas | 90 | Credentia | 24 months | Y |
| California | 107 | Prometric | 24 months | Y |
| Colorado | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Connecticut | 100 | Credentia | 24 months | Y |
| Delaware | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Florida | 75 | Credentia | 24 months | Y |
| Georgia | 85 | Prometric | 24 months | Y |
| Hawaii | 100 | Pearson VUE (NNAAP) | 24 months | Y |
| Idaho | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Illinois | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Indiana | 105 | Prometric | 24 months | Y |
| Iowa | 75 | Credentia | 24 months | Y |
| Kansas | 90 | Pearson VUE (NNAAP) | 24 months | Y |
| Kentucky | 75 | Prometric | 24 months | Y |
| Louisiana | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Maine | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Maryland | 100 | Credentia | 24 months | Y |
| Massachusetts | 100 | Pearson VUE (NNAAP) | 24 months | Y |
| Michigan | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Minnesota | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Mississippi | 75 | Prometric | 24 months | Y |
| Missouri | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Montana | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Nebraska | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Nevada | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| New Hampshire | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| New Jersey | 90 | Credentia | 24 months | Y |
| New Mexico | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| New York | 144 | Credentia | 24 months | Y |
| North Carolina | 75 | Prometric | 24 months | Y |
| North Dakota | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Ohio | 75 | Credentia | 24 months | Y |
| Oklahoma | 75 | Prometric | 24 months | Y |
| Oregon | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Pennsylvania | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Rhode Island | 100 | Credentia | 24 months | Y |
| South Carolina | 75 | Prometric | 24 months | Y |
| South Dakota | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Tennessee | 75 | Prometric | 24 months | Y |
| Texas | 100 | Prometric | 24 months | Y |
| Utah | 100 | Pearson VUE (NNAAP) | 24 months | Y |
| Vermont | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Virginia | 75 | Prometric | 24 months | Y |
| Washington | 85 | Credentia | 24 months | Y |
| West Virginia | 120 | Prometric | 24 months | Y |
| Wisconsin | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| Wyoming | 75 | Pearson VUE (NNAAP) | 24 months | Y |
| DC | 75 | Pearson VUE (NNAAP) | 24 months | Y |
Training Hours Visualization
The diagram below shows how training hour requirements vary across states. The vast majority require 75 hours, but several states mandate significantly more training, particularly New York with 144 hours.
Understanding the CNA Exam
The CNA competency exam consists of two parts that both must be passed for certification. The written knowledge test assesses your understanding of patient care concepts, safety protocols, and professional responsibilities. The clinical skills test evaluates your ability to perform hands-on tasks correctly and safely.
The written test typically contains 75 to 90 multiple choice questions with a 90-minute time limit. Topics include basic nursing skills, infection control, patient rights, safety procedures, and communication. The skills test requires you to demonstrate 5 to 6 randomly selected tasks such as hand hygiene, vital signs measurement, patient transfers, and bed making. Both parts must be passed, though some states allow retakes on individual sections.
Renewal and Reciprocity
CNA certification must be renewed every 2 years in most states. Renewal typically requires completing continuing education hours (usually 12 to 24 hours) and providing proof of employment as a CNA during the certification period. Some states have different requirements for lapsed certifications.
Interstate Reciprocity: If you move to a new state, you can usually transfer your CNA certification through reciprocity. Most states honor certifications from other states as long as your name is on the original state's Nurse Aide Registry and your certification is active. The process typically involves:
- Submitting an application to the new state's Board of Nursing
- Providing verification of your current certification from the original state
- Paying a transfer fee
- Some states may require a background check in the new state
States that participate in the Nurse Aide Registry Compact make this process even smoother. Check whether your state participates in the compact for faster processing.
Common Questions About CNA Certification
How long does it take to become a CNA?
The timeline varies by state and program format. Accelerated programs can be completed in 4 to 6 weeks, while traditional programs may take 3 to 6 months. States requiring more training hours will naturally take longer. Most candidates are certified within 2 to 6 months from start to finish.
How much does CNA certification cost?
Total costs typically range from $500 to $2,000 depending on your state and training provider. This includes training program tuition ($300 to $1,500), state exam fees ($50 to $150), background check ($25 to $75), and application fees ($25 to $100). Some employers offer free training in exchange for a work commitment.
Can I become a CNA without going to school?
No. All states require completion of an approved training program before sitting for the exam. However, some states allow competency evaluation programs (CEPs) for individuals with healthcare experience, such as trained medical assistants or military medics. These programs are faster but still require passing the state exam.
What if I fail the CNA exam?
If you fail either the written or skills portion, most states allow retakes. You typically only need to retake the portion you failed. There is usually a waiting period of 1 to 3 months, and additional fees apply. Many states limit the number of retakes allowed within a certain timeframe.
Do I need to renew my CNA certification even if I am not working?
Yes. You must maintain active status on the Nurse Aide Registry regardless of employment. If you are not working as a CNA, you may be able to maintain certification through other qualifying activities like volunteering or completing education. Failure to renew results in lapsed status, which may require retesting.
What is the difference between a CNA and a certified medical assistant?
CNAs focus on basic patient care under nursing supervision, while medical assistants perform both clinical and administrative tasks under physician supervision. CNA certification is state-regulated and focused on direct patient care. Medical assistant certification is voluntary and covers a broader scope of practice.
Can I work as a CNA in multiple states?
Yes, through reciprocity. Once certified in one state, you can apply for certification in another state without retaking the exam, provided your original certification is active. Some states participate in compact agreements that streamline this process further.
Are there online CNA training programs?
Some states allow hybrid programs with online coursework for the didactic portion, but the clinical hours must be completed in person at an approved healthcare facility. Fully online programs are not accepted for state certification. Always verify that any program you choose is approved by your state's Board of Nursing.
Start Your CNA Journey
CNA certification is one of the fastest and most accessible paths into healthcare. With requirements varying by state, it is essential to research your specific state's rules before starting your training. Use the table above as your starting point, then verify details with your state Board of Nursing.
Once you understand your state's requirements, the next step is choosing a training program and preparing for the exam. Many candidates find that structured study with practice questions significantly improves their first-attempt pass rate.
Ready to start studying? Our CNA practice exams cover the exact topics tested on the NNAAP and state competency exams, with explanations for every answer.
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