We asked 111,130 job seekers about their Certified Nursing Assistant (CNA). This is what they told us:
According to the US Code of Federal Regulations, a certified nursing assistant (CNA) is any individual that performs nursing or nursing-related services for residents in a hospital or facility.1 Also known as nurse aides, CNAs often work in long-term care or skilled nursing facilities. They usually perform tasks such as repositioning patients to prevent bed sores, assisting MDs and RNs, taking vital signs, assisting patients with personal hygiene tasks, cleaning and disinfecting resident rooms and assisting with basic medical procedures.
As part of the Nursing Home Reform Act passed in 1987, nurse aides must meet a set of training and evaluation standards, and they must be added to the Nurse Aide Registry in their state in order to work with residents in long-term care facilities. The Nurse Aide Registry contains a list of all certified nurse aides that have successfully completed training and passed an exam. It also lists any complaints against individual nurse aides.
The federal guidelines apply to all 50 states, but some states have additional requirements, and the paths to certification can vary by state. Each state enforces these regulations, so it is important to make sure you are certified in the state that you will work in as a CNA. Some states have reciprocity agreements, which means you may be able to transfer your certification if you move to another state. In most cases, there is no cost to the individual for training and assessment. The facility where the individual is employed, or has been offered employment, will generally provide the training and testing free of charge. Community colleges and technical schools also offer training, usually paid for by the student. In some cases, once the individual is hired at a facility, they will be reimbursed for their training and certification expenses.
A CNA assists registered nurses or medical doctors in long-term care facilities with basic tasks. To obtain a nursing assistant certification, an individual must complete a training program that consists of at least 75 hours of training and pass a two-part exam consisting of a written or oral section and a skills demonstration.2 The oral portion is offered in English or Spanish. In many cases, individuals seeking certification earn it through their place of employment, as most long-term care facilities offer this training as part of the hiring process. There is no cost to the trainee. However, some individuals choose to take training on their own through a community college or technical school. They must pay for this on their own, but they are sometimes reimbursed once they have an offer of employment. Upon demonstrating competence by completing the required training and passing the exam, candidates are placed on their state Nurse Aide Registry.3
CNA instructors are usually registered nurses who have been approved by their state to train and supervise nursing assistants. In most cases, an individual simply submits an application to the state along with supporting documentation. Most CNA instructors must have at least two years of experience as a registered nurse, with at least one of those years working in a long-term care facility. CNA instructors must also have experience teaching adults or show proof of completion of a course on adult education. If there is a fee attached to approval of a CNA instructor, the candidate’s employer usually provides payment.
There are a few other job positions and certifications which are often confused with CNAs. While they are similar, they often have different training and certification requirements.
A caregiver generally cares for the elderly or disabled but has no formal training or certification.
Home Health Aide (HHA)
A home health aide provides home-based care to the elderly, chronically ill or disabled. In most states, there is a training and certification requirement for HHAs, similar to CNAs. The main difference is that most CNAs provide care in long-term care facilities instead of in-home environments.
Patient Care Aide (PCA)
Patient care aides are caregivers who assist patients with feeding, hygiene and mobility. In general, they receive on-the-job training and are often not certified.
Determine which path to certification is most appropriate based on your background and education. If you have no training, you will need to go through training. If you already have a medical certification or experience, you may be able to skip training.
Since most employers provide training free of charge, you may decide to seek employment first. Federal law prohibits most nurse aides from paying for training and certification, so many employers must carry that cost. If an individual decides to obtain training independently, they will be reimbursed once they are hired in a facility.
If you choose to go directly to a training program, you can find courses at local community colleges and technical schools. Some high schools offer training programs for their enrolled students. This option will usually require payment up-front.
Training not only teaches the necessary skills for a CNA, it also prepares the assistant for examination. Training consists of a combination of classroom learning and hands-on clinical learning. Areas focused on include basic patient care, observation of patients, human physiology and anatomy, safety protocols and patient rights.
Most states require applicants to pass a criminal background check before they can register for an exam. The background check usually requires the applicant to be fingerprinted. Most states are specifically looking to learn whether or not the candidate has been involved in crimes against the elderly or disabled. Some states also require a TB test and proof of vaccinations.
After you’ve completed training, you should be ready to take your state-approved nurse aide exam. Most states offer the NATIONAL NURSE AIDE ASSESSMENT PROGRAM (NNAAP) or a similar exam for nursing assistant certification.4 The exam consists of two parts: an oral or written knowledge test and a skills test. The candidate has the choice of completing the knowledge test orally or in written form, depending on how they feel most comfortable. The test is available in English and Spanish in most states. Study materials are available on the NNAAP website.
Once you successfully pass the exam, your name will be placed on your state Nurse Aide Registry. In most cases, your employer will take care of the paperwork to do this, but it is important to check and make sure your name appears correctly on the registry.
1. “Electronic Code of Federal Regulations”. Michigan.gov. Retrieved on February 6, 2020.
2. “42 CFR § 483.152 - Requirements for approval of a nurse aide training and competency evaluation program”. Legal Information Institute. Retrieved February 6, 2020.
3. “Nurse Aide Registries”. NCSBN. Retrieved on January 2, 2020.
4. “NNAAP Exam”. NCSBN. Retrieved on January 2, 2020.
Editorial content last updated: February 2020
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“I wish I would have known to expect to love your residents. Many people say you shouldn't, but you can't help it.”
“Would have done it earlier before that time”
“I wish I would have started at a much younger age so I could have grown in nursing I found that I have a love for this type of work not saying that it's to late to honest it take a different type person to be a CNA we spend the most time with the patient and you have to have a love for them.”
“Nothing really. I love my profession.”
“There are jobs EVERYWHERE once you obtain your certification. Lots of different options from home health care, long term care facilities, and hospitals.”
“The job will push you to do better, it is a lot to handle, but seeing the people taken care of is worth everything. Take it one day at a time!”
“Go for it , it don't just stop there as a CNA you can climb up the ladder in nursing .”
“Don't obtain it if your heart is not in the job.”
All information on this page, including but not limited to price, cost, instructions, descriptions, and the content of a certification course, is presented for informational purposes only, may be an approximation, is subject to change, and may have been generated by third parties. Prior to enrolling in a course for a certification, please contact the proper school or certification administrators for information regarding certification requirements.