What You Need to Do to Become a Certified Nursing Assistant

A Certified Nursing Assistant (CNA) license requires you to complete a state-approved training program, pass a written exam, and pass a skills test. The entire process typically takes between four and twelve weeks, depending on whether you attend full-time or part-time classes. You do not need a high school diploma in most states, though some programs prefer it, and you do not need prior medical experience.

The path differs slightly by state — some states call it a CNA certificate rather than a license, and a few states have different names for the role altogether. But the core steps are the same everywhere: find an approved program, complete the coursework, take the state exam, and get your name on the state registry. Once you pass, you can work in hospitals, nursing homes, assisted living facilities, and home care agencies.

Key Takeaways

  • You must complete a state-approved CNA training program before you can sit for the exam; self-study alone will not get you certified.
  • The written and skills exams are administered by your state's health department or a contracted testing vendor, not by the training program itself.
  • Your state's nursing board website lists all approved programs in your area and the current exam schedule and fees.
  • Most states require you to renew your CNA license every two years, usually by paying a renewal fee and sometimes by completing continuing education hours.
  • Some employers will hire you as a CNA trainee before you are certified, but you cannot work independently or use the CNA title until you pass the exam.

Finding and Choosing an Approved Training Program

Your state's nursing board or health department maintains a list of approved CNA programs. You can find this list on the board's website by searching "[your state] approved CNA programs" or "[your state] nursing assistant training." The programs are offered through community colleges, vocational schools, hospitals, nursing homes, and private training companies. Most charge between $500 and $2,000 for the full course.

When comparing programs, check the length (full-time programs run four to eight weeks; part-time programs run eight to twelve weeks), the schedule (some offer evening or weekend classes), and whether the program includes exam preparation. Ask whether the program's graduates pass the state exam on the first attempt — this is a real measure of how well the program teaches the material. Some programs may provide you can retake their course free if you do not pass the exam.

A few states allow you to complete your training through an employer — some hospitals and nursing homes run their own CNA programs and will train you on the job. If you go this route, make sure the program is state-approved before you enroll, because not all employer programs meet state standards.

What the Training Program Covers

CNA training covers patient hygiene and grooming, how to move and transfer patients safely, vital signs (blood pressure, temperature, pulse, respiration), catheter care, infection control, and how to communicate with patients and the healthcare team. You will also learn the legal and ethical rules that explore to nursing assistants in your state, including patient privacy and your scope of practice — what you can and cannot do.

The program includes both classroom instruction and hands-on practice in a lab setting. You will practice on mannequins and with other students before you work with real patients. Some programs include clinical hours in an actual healthcare facility, where you work under supervision. The number of required classroom and clinical hours varies by state, but most states require between 75 and 180 hours total.

Registering for and Taking the State Exam

After you finish your training program, your instructor will give you a completion certificate. You use this certificate to register for the state exam. The exam is administered by your state's health department or by a private testing vendor contracted by your state — the most common vendor is Pearson Vue, but some states use other companies.

The exam has two parts: a written test with multiple-choice questions about patient care, safety, and communication, and a skills test where you perform five tasks in front of an examiner. The written test usually has 60 to 100 questions and takes one to two hours. The skills test takes about 30 minutes and includes tasks like taking vital signs, helping a patient bathe, and moving a patient safely.

You register for the exam through your state's nursing board website or through the testing vendor's website. The exam fee ranges from $100 to $300, depending on your state. Most states offer the exam multiple times per month, so you can usually find a test date within a few weeks of finishing your program.

Passing the Exam and Getting Your License

You must pass both the written and skills portions to become certified. The passing score varies by state but is usually around 70 percent on the written exam. If you fail either part, you can retake it, though you may have to wait a set number of days (often 30 days) before your next attempt and pay the exam fee again.

After you pass, your state's nursing board will send you a CNA license or certificate (the name depends on your state) and add your name to the state registry. This usually takes one to four weeks. Some states issue the license when ready after you pass the skills test, and others mail it to you. You can check the registry online to confirm you are listed — employers often verify your status this way before hiring you.

CNA License Renewal and Continuing Requirements

Most states require you to renew your CNA license every two years. Renewal usually costs between $50 and $150 and involves filling out a form and paying the fee to your state's nursing board. Some states require you to complete continuing education hours — typically between 12 and 24 hours per renewal period — through approved courses on topics like patient safety or infection control.

A few states require you to work a minimum number of hours as a CNA during the renewal period (often 8 to 16 hours per year) to keep your license active. If you let your license expire, you will have to retake the exam to become certified again, not just pay a renewal fee. Check your state's nursing board website for the exact renewal important date and requirements for your state.

What Happens If You Move to Another State

CNA licenses are state-specific — your license from one state does not automatically work in another. However, many states have reciprocity agreements, which means they will recognize your CNA license from another state without requiring you to retake the exam. Some states call this "endorsement" or "licensure by endorsement."

To move your license to a new state, contact that state's nursing board and ask about reciprocity. You will usually need to submit an process, pay a fee (typically $50 to $200), and provide proof that your original license is in good standing. The process takes two to six weeks. If the state you are moving to does not have reciprocity with your current state, you will have to complete a new training program and pass that state's exam.

Frequently Asked Questions

Do I need a high school diploma or GED to become a CNA?

Most states do not require a high school diploma, but some training programs prefer it or require it as a condition of enrollment. A few states require a diploma or GED to sit for the exam. Check with your state's nursing board and the specific program you are interested in to confirm their requirements.

Can I work as a CNA while I am still in training?

Some employers hire you as a CNA trainee or nursing assistant trainee before you are certified, but you cannot use the CNA title or work independently. You must work under direct supervision and cannot perform certain tasks. Once you pass the exam, you can work as a fully certified CNA.

What if I fail the exam?

You can retake the exam after waiting the required number of days (usually 30 days) and paying the exam fee again. Most people pass on the second attempt. If you fail multiple times, consider retaking the training program or finding a tutor who specializes in CNA exam preparation.

How much does a CNA make?

CNA wages vary widely by state, employer, and location. According to the U.S. Bureau of Labor Statistics, the median hourly wage for nursing assistants was around $16 to $18 per hour as of 2023, but this varies significantly. Check job postings in your area to see what employers are offering.

Can I become an RN or LPN after getting my CNA license?

Yes. Many people use a CNA license as a stepping stone to nursing school. Some community colleges offer programs where you can earn your LPN (Licensed Practical Nurse) or RN (Registered Nurse) credential. Your CNA experience will help you understand patient care and may give you an advantage in nursing school.