How to Become a CNA in 2026: Complete Certification Guide

Certified Nursing Assistants (CNAs) provide essential hands-on patient care in hospitals, nursing homes, assisted living facilities, and home health settings. Becoming a CNA is one of the fastest paths into healthcare -- training programs can be completed in as little as 4-12 weeks. Across the 51 states we track, training hours average 98 hours, with 31 states requiring more than the federal minimum of 75 hours.

This guide walks you through the complete process of becoming a certified nursing assistant in 2026, from choosing a training program through passing your certification exam and getting listed on your state's nurse aide registry.

What Does a CNA Do?

CNAs work under the supervision of registered nurses (RNs) and licensed practical nurses (LPNs) to provide direct patient care. Their daily responsibilities include:

• Activities of daily living (ADLs): Bathing, dressing, grooming, feeding, and toileting assistance for patients who cannot perform these tasks independently
• Vital signs: Measuring and recording blood pressure, temperature, pulse, respiration rate, and oxygen saturation
• Mobility assistance: Helping patients move in and out of bed, walk, use wheelchairs, and reposition to prevent bedsores
• Observation and reporting: Monitoring patient condition and reporting changes to nursing staff
• Documentation: Recording intake/output, ADL completion, and patient observations in medical charts

Where Do CNAs Work?

CNAs work in a variety of healthcare settings, each with its own pace and patient population:

• Nursing homes and long-term care facilities: The largest employer of CNAs, providing ongoing care for elderly and chronically ill residents
• Hospitals: Acute care settings with faster pace and more varied patient conditions
• Assisted living facilities: Supporting residents who need some help with daily activities but are relatively independent
• Home health agencies: Providing one-on-one care in patients' homes
• Rehabilitation centers: Helping patients recover from surgeries, injuries, or illnesses

Training Requirements

Federal law (OBRA 1987) requires a minimum of 75 hours of training for CNAs working in Medicare- or Medicaid-certified nursing facilities. However, 31 of 51 states exceed this minimum, with some requiring 150+ hours. Training programs include both classroom instruction and hands-on clinical experience.

Training programs are offered at community colleges, vocational schools, hospitals, nursing homes, and the Red Cross. Many employers (especially nursing homes) offer free CNA training in exchange for a work commitment after certification.

The Certification Exam

After completing your state-approved training program, you must pass a competency evaluation (certification exam) to be placed on your state's nurse aide registry. The exam has two components:

• Written (or oral) knowledge test: 60-100 multiple-choice questions covering patient care, safety, infection control, communication, and legal/ethical issues
• Clinical skills test: You demonstrate 3-5 randomly selected nursing skills (e.g., handwashing, taking vital signs, repositioning a patient) on a mannequin or simulated patient

1 states use Pearson VUE as their exam provider. Other common providers include Prometric, D&S Diversified Technologies (Headmaster), and state-administered exams. Most states allow multiple exam attempts within a set timeframe.

General Steps to Become a CNA

The process is relatively straightforward compared to many other healthcare certifications. Here are the typical steps:

1. Complete a State-Approved Training Program

Enroll in and complete a CNA training program approved by your state's nursing board or health department. Programs typically run 4-12 weeks and include classroom instruction plus supervised clinical practice in a healthcare facility.

2. Complete Clinical Hours

51 of 51 states require dedicated clinical hours as part of your training. During clinicals, you practice patient care skills under direct supervision of a licensed nurse in a real healthcare setting. Federal law requires at least 16 hours of supervised clinical training.

3. Pass the Certification Exam

Schedule and pass both the written knowledge test and the clinical skills test through your state's designated exam provider. You typically need a score of 70-80% on the written test and must satisfactorily demonstrate all selected skills on the clinical test.

4. Get Listed on the State Registry

Once you pass the exam, your name is added to your state's nurse aide registry. This is your official certification. Employers verify your status through the registry before hiring. You must maintain your registry listing by meeting renewal requirements (typically employment hours and/or continuing education).

State-by-State Requirements

The table below summarizes CNA certification requirements across all 51 states we track. Click any state for the detailed breakdown.

States That Accept Out-of-State Certification

51 of 51 states accept CNA certification from other states through reciprocity or endorsement processes. If you're already certified in one state and want to work in another, you can often transfer your certification without retaking the exam -- though you'll typically need to submit an application, pay a fee, and pass a background check in the new state.

Background Check Requirements

50 of 51 states require a criminal background check as part of the CNA certification process. Additionally, 51 states check the abuse registry to ensure applicants have no history of patient abuse, neglect, or misappropriation of patient property.

• Criminal background check: Typically includes fingerprinting and a state and/or federal criminal records search. Certain convictions (especially those involving violence, theft, or abuse) may disqualify you from certification.
• Abuse registry check: The state verifies you are not listed on any nurse aide abuse registry. A listing for substantiated abuse, neglect, or exploitation permanently disqualifies you from CNA certification in most states.
• Drug screening: Some employers (though not always the state) require a drug test as a condition of employment.

Renewal and Maintaining Certification

CNA certification must be renewed periodically. Most states require you to demonstrate active employment as a CNA and complete in-service training hours to maintain your registry listing. If your certification lapses, you may need to retake the competency exam.

• Work hour requirement: Most states require documented paid employment as a CNA (typically 8 hours within the renewal period)
• In-service training: Federal law requires 12 hours of in-service training annually; some states require more
• Renewal cycle: Typically every 1-2 years depending on the state

How Long Does It Take to Become a CNA?

CNA is one of the fastest entry points into healthcare. Most people can go from zero experience to certified in 6–16 weeks:

Community colleges may offer semester-long programs (16 weeks) that include more comprehensive content. Full-time accelerated programs at some training facilities can be completed in as little as 4 weeks. The federal minimum is 75 hours of training, but 31 states require more than this minimum.

How Much Does It Cost to Become a CNA?

CNA certification is one of the most affordable healthcare career paths. Here is a typical cost breakdown:

• Training program: $500–$2,000 (community colleges and Red Cross programs on the lower end; private schools higher)
• Free training option: Many nursing homes and hospitals offer free CNA training in exchange for a work commitment (typically 6–12 months)
• Exam fee: $50–$300 depending on state
• Scrubs and supplies: $100–$200
• Background check: $25–$75

Total estimated investment: $700–$2,500+. Across the states we track, total costs (training, exam, and application fees) range from $20 to $310. See our state-by-state CNA certification page for exact fee breakdowns by state.

See our full CNA Cost by State guide →

CNA Salary & Career Outlook

CNAs provide essential patient care and are in steady demand across the healthcare system. According to the Bureau of Labor Statistics (May 2024 data):

• Median annual salary: $39,530/year (ranges from ~$24,000 to ~$60,000 depending on state and experience)
• Job growth: 2% (2024–2034), with approximately 211,800 openings per year due to high turnover and the need to replace workers who advance to other roles

Demand for CNAs is driven by the aging population, increased need for chronic disease management, and the shift toward home and community-based care settings.

Advancement path: CNA → LPN/LVN (1 year additional training) → RN (2–4 years). Registered nurses earn a median salary of $93,600/year, making CNA an excellent stepping stone into a higher-paying nursing career.

Source: U.S. Bureau of Labor Statistics, Occupational Outlook Handbook — Nursing Assistants (May 2024 data).

Frequently Asked Questions

Next Steps

Becoming a CNA is one of the fastest ways to start a healthcare career. Find your state in the table above to see the exact training hours, exam requirements, and fees for your area.

• CNA Certification Overview — All States
• Browse All State Licensing Guides

Sources

Training requirements, exam providers, and fee data are sourced from official state nursing boards and health departments.

• Individual state nursing board and health department websites (cited on each state page).
• Omnibus Budget Reconciliation Act of 1987 (OBRA) -- federal CNA training minimums.
• Pearson VUE, Prometric, and D&S Diversified Technologies (Headmaster) -- exam providers and fee schedules.

Data was last verified in February 2026. Requirements can change as states update their regulations. Always confirm current requirements with your state's nursing board or health department before enrolling in a training program.