CNA Certification Guide 2026

Becoming a Certified Nursing Assistant is one of the fastest paths into healthcare. With training programs as short as 4 weeks and strong job demand, CNA certification can launch your healthcare career or serve as a stepping stone to nursing school. Here’s everything you need to know.

What Does a CNA Do?

CNAs provide direct patient care under the supervision of licensed nurses. Daily responsibilities include:

Task Category	Examples
Activities of daily living	Bathing, dressing, grooming, toileting
Mobility	Helping patients move, walk, transfer
Vital signs	Taking temperature, pulse, blood pressure
Nutrition	Feeding assistance, intake/output tracking
Comfort	Repositioning, skin care, emotional support
Documentation	Recording observations, reporting changes

CNAs work in hospitals, nursing homes, assisted living facilities, home health, and rehabilitation centers.

CNA Certification Requirements

Federal Minimums (OBRA)

The federal Omnibus Budget Reconciliation Act (OBRA) sets minimum standards:

• 75 hours of training
• 16 hours of clinical practice
• State competency examination

State Variations

Most states exceed federal minimums:

State	Training Hours	Clinical Hours
California	150	100
Florida	120	40
Texas	75+	16+
New York	100	Included
Illinois	120	40
Ohio	75	16

Check your state’s specific requirements through our state guides.

Steps to Become a CNA

Step 1: Meet Basic Requirements

Requirement	Details
Age	16-18 minimum (varies by state)
Education	High school diploma or GED (some states)
Background	Pass criminal background check
Health	Physical exam, immunizations, TB test
English	Basic reading and communication

Step 2: Complete Training Program

Choose an approved training program:

Program Type	Duration	Cost	Pros/Cons
Community college	8-16 weeks	$500-$1,500	Structured, financial aid eligible
Vocational school	4-8 weeks	$800-$2,000	Fast, focused
Nursing home/hospital	4-8 weeks	Often free	Free but work commitment
Red Cross	4-10 weeks	$500-$1,200	Recognized, standardized
Online + skills lab	Varies	$300-$800	Flexible, self-paced theory

Step 3: Pass the State Exam

The CNA competency exam has two parts:

Written/Oral Exam:

• 60-100 multiple choice questions
• Topics: basic nursing skills, safety, patient rights, communication
• Passing score varies by state (typically 70-75%)

Clinical Skills Test:

• Demonstrate 3-5 randomly selected skills
• Performed on mannequin or actor
• Must pass all selected skills

Common skills tested:

• Hand hygiene
• Vital signs measurement
• Patient positioning
• Transfers and mobility
• Personal care (bed bath, oral care)
• Bed making
• Range of motion exercises

Step 4: Apply for State Registry

After passing both exam components:

1. Apply to state CNA registry
2. Pay registration fee ($10-$50)
3. Receive certification
4. Maintain certification through work requirements

CNA Training Programs

What to Look For

Factor	What to Check
State approval	Must be approved by your state health department
Pass rates	Ask for their exam pass rate statistics
Clinical sites	Where will you do hands-on training?
Schedule	Day, evening, weekend options?
Job placement	Do they help with employment?
Cost transparency	All fees disclosed upfront?

Free CNA Training Options

Many employers offer free training:

Nursing homes and long-term care facilities:

• Train you for free
• You work for them afterward (typically 6-12 months)
• Breaking commitment may require repaying training costs

Hospitals:

• Some offer CNA training programs
• Competitive admission
• Often lead to hospital employment

State programs:

• Some states fund CNA training for qualifying individuals
• Check your workforce development office

Red Flags in Training Programs

• Not approved by state health department
• Won’t disclose pass rates
• No clinical component
• Pressure to sign up immediately
• Significantly cheaper than comparable programs
• No refund policy disclosed

CNA Exam Details

Exam Administration

Most states use one of these testing companies:

• Prometric — Operates in many states
• Pearson VUE — Another major provider
• D&S Diversified Technologies — Headmaster testing
• State-run programs — Some states administer their own

Exam Costs

Component	Typical Cost
Written exam	$25-$75
Skills exam	$75-$100
Total exam	$100-$150

Retake fees apply if you don’t pass on the first attempt.

Preparing for the Exam

For the written test:

• Review your training materials thoroughly
• Take practice tests (many free online)
• Focus on patient rights, safety, infection control
• Understand scope of practice (what CNAs can/cannot do)

For the skills test:

• Practice each skill until it’s automatic
• Focus on hand hygiene (before, during, and after)
• Communicate with the “patient” throughout
• Check for safety at every step
• Review the evaluation criteria

Common Reasons for Failing

Issue	How to Avoid
Forgetting hand hygiene	Wash before and after EVERY skill
Not communicating	Explain what you’re doing throughout
Safety violations	Check brakes, bed position, call light
Rushing	Take your time, be thorough
Test anxiety	Practice until skills are second nature

CNA Renewal and Maintenance

Staying Certified

Requirement	Details
Work requirement	Typically 8 hours paid work every 2 years
Renewal period	Usually every 2 years
Renewal fee	$10-$50
CE requirements	Some states require continuing education

If Your Certification Lapses

Options vary by state:

• Some allow reinstatement with fee
• Others require retaking the competency exam
• Extended lapses may require retraining

Keep your certification active, even if you’re not currently working as a CNA.

CNA Career Paths

Entry-Level Positions

Setting	Typical Pay	Notes
Nursing home	$14-$18/hr	Most common entry point
Hospital	$16-$22/hr	More competitive, better pay
Home health	$13-$17/hr	Flexible, one-on-one care
Assisted living	$13-$16/hr	Less acute, relationship-focused
Rehab facility	$15-$19/hr	Help patients recover function

Advancement Options

With additional training:

• Medication aide/technician
• Home health aide
• Patient care technician (PCT)
• Monitor technician
• Phlebotomist

With more education:

• Licensed Practical Nurse (LPN) — 12-18 months
• Registered Nurse (RN) — 2-4 years
• Medical assistant — 9-12 months

CNA to RN Pathway

Many nurses start as CNAs. Benefits include:

Advantage	How It Helps
Patient care experience	Builds assessment skills early
Healthcare exposure	Confirms nursing is right for you
Income while in school	Work flexible shifts during nursing school
Networking	Connections for recommendations, jobs
Nursing school applications	Healthcare experience strengthens applications

CNA Costs Breakdown

Total Investment

Expense	Range
Training program	$0-$1,500
Textbooks/supplies	$50-$150
Uniform/scrubs	$30-$75
State exam	$100-$150
Background check	$50-$100
CPR certification	$25-$75
Total	$255-$2,050

Ways to Reduce Costs

• Employer-sponsored training (often free)
• Community college programs (financial aid eligible)
• Workforce development grants
• State-funded training programs
• Red Cross scholarships

Job Search Tips

Where to Look

Source	Notes
Indeed, ZipRecruiter	Filter by “CNA” or “nursing assistant”
Facility websites	Apply directly to hospitals, nursing homes
Staffing agencies	Flexibility, variety of assignments
State job boards	Government and non-profit positions
Networking	Clinical site connections from training

New CNA Resume Tips

• List your training program and certification
• Include clinical rotation hours and sites
• Highlight any healthcare experience (even volunteer)
• Mention specific skills confidently performed
• Include CPR/BLS certification

Interview Preparation

Be ready to discuss:

• Why you want to be a CNA
• How you handle difficult patients
• Physical demands of the job
• Your long-term career goals
• Availability and scheduling flexibility

Next Steps

Ready to become a CNA?

1. Check state requirements — Find your state
2. Research training programs — Compare approved programs in your area
3. Consider free options — Check if local facilities offer sponsored training
4. Budget appropriately — Plan for training, exam, and supply costs
5. Schedule training — Choose a program that fits your timeline
6. Prepare for the exam — Study throughout training, not just at the end

CNA certification is an accessible entry point into healthcare with strong job demand and clear advancement pathways. Whether it’s your long-term career or a stepping stone to nursing, the skills and experience you gain will serve you well.