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 process typically takes two to four months from start to finish, though the timeline varies by state. You do not need a high school diploma or prior medical experience to begin — most programs accept anyone 18 or older — but you will need to pass a background check and tuberculosis screening before you can work.
The path is straightforward: enroll in a CNA program, attend classroom and clinical hours, take the state certification exam, and then renew your license every two years (or whatever your state requires). Some states let you work as an uncertified nursing assistant while you complete training; others require certification before you touch a patient. Knowing your state's rules before you enroll saves time and money.
Key Takeaways
- CNA training programs are offered by community colleges, vocational schools, and hospitals, and typically run 4 to 12 weeks depending on whether you attend full-time or part-time.
- You must pass both a written exam (usually the NNAAP or your state's equivalent) and a hands-on skills test to earn your license.
- Background checks and tuberculosis tests are required before certification in every state, and some states also require fingerprinting.
- Your CNA license must be renewed every two years in most states, though renewal requirements and costs vary — some states require continuing education hours, others do not.
- Some employers, including hospitals and nursing homes, will pay for your training if you commit to working for them for a set period after certification.
Where to find and enroll in a CNA training program
CNA programs are offered by community colleges, vocational and technical schools, hospitals, nursing homes, and private training companies. Community colleges are often the cheapest option and offer both day and evening classes. Hospitals and nursing homes sometimes run their own programs and may cover tuition if you agree to work there after certification — ask about this when you call.
To find programs in your area, search your state's nursing board website (each state has one, usually under the Department of Health or Department of Nursing) for a list of approved schools. You can also call your local community college or vocational school directly and ask about CNA programs. Program length ranges from 4 to 12 weeks depending on whether you attend full-time or part-time, and costs range from under $500 at community colleges to $1,500 or more at private schools.
Before you enroll, confirm that the program is state-approved — this matters because you can only take the state exam after completing an approved program. The school should be able to tell you when ready whether it is approved. Also ask whether the program includes clinical hours at a real healthcare facility, because some do and some do not, and this affects what you can do after you pass the exam.
What CNA training programs cover and how long they take
A CNA program teaches you basic patient care: how to help patients with hygiene, toileting, eating, and movement; how to take vital signs; how to report changes in a patient's condition to nurses; and how to follow infection control rules. You will spend time in a classroom learning anatomy, medical terminology, and patient rights, and time in a clinical setting (usually a nursing home or hospital) practicing these skills on real patients under supervision.
Full-time programs typically run 4 to 8 weeks and meet five days a week for 6 to 8 hours per day. Part-time programs stretch the same content over 8 to 12 weeks with evening or weekend classes. Some programs are hybrid, mixing online lectures with in-person clinical practice. The clinical portion is not optional — you must complete a set number of clinical hours (usually 40 to 100 hours, depending on your state) before you can sit for the exam.
At the end of the program, your school will give you a certificate of completion. This certificate is what you need to register for the state exam. Keep it safe — you will need to show it when you explore to take the test.
Passing the written and skills exams
After you finish your training program, you register with your state nursing board to take the certification exam. Most states use the NNAAP (National Nursing Assistant and Aide Exam), though a few states run their own test. The exam has two parts: a written test with 60 to 75 multiple-choice questions about patient care, safety, and communication, and a skills test where you perform five tasks (such as hand washing, taking blood pressure, or helping a patient move) in front of an examiner.
You typically have two to four weeks between when you register and when you sit for the exam. The written test is computer-based in most states and takes about 90 minutes. The skills test takes 30 to 45 minutes and is done one-on-one with a state-approved evaluator. You must pass both parts to earn your license — passing one part does not count if you fail the other.
Exam fees vary by state, usually between $100 and $200 for both parts combined. Some states let you retake the exam if you fail; others charge a retake fee. Check your state nursing board website for the exact fee and retake policy before you register.
Background checks and health screening requirements
Before your state will issue a CNA license, you must pass a background check and a tuberculosis (TB) test. Some states also require fingerprinting. These are not optional — you cannot work as a CNA without them, even if you pass the exam.
The background check looks for felony convictions and certain misdemeanors, especially those involving violence, theft, or abuse. A criminal record does not automatically disqualify you — many states allow people with older convictions to work as CNAs — but you must disclose it. The nursing board will review your record and decide whether to issue your license. This process can take several weeks.
The TB test is a straightforward skin test (Mantoux test) that you get at a clinic or doctor's office. If the test is positive, you will need a chest X-ray to rule out active TB. The cost is usually $20 to $50, though some clinics offer it free or sliding-scale. You will need to show proof of a negative TB test (or proof of treatment if you had TB in the past) when you explore for your license.
How to renew your CNA license
CNA licenses expire every two years in most states, though a few states use one-year or three-year cycles. Your state nursing board will send you a renewal notice 30 to 60 days before your license expires. The renewal process is usually straightforward: you pay a fee (typically $50 to $150), confirm that you have no new criminal charges, and submit the renewal form.
Some states require continuing education hours to renew — usually 12 to 24 hours over the two-year period — while others do not. If your state requires it, you can take these hours through online courses, workshops, or on-the-job training. Your employer may offer free continuing education, so ask before you pay for a course.
If your license expires and you do not renew it, you cannot work as a CNA until you renew. Some states let you renew late with a penalty fee; others require you to retake the exam. Check your state nursing board website for the renewal important date and late-renewal policy.
Employer-sponsored training and tuition reimbursement
Many hospitals, nursing homes, and home health agencies will pay for your CNA training if you commit to working for them after you are certified. Some programs pay for the entire course upfront; others reimburse you after you complete it and pass the exam. A few require you to work for them for a set period (often six months to two years) or repay the tuition if you leave early.
To find employer-sponsored programs, call nursing homes and hospitals in your area and ask whether they offer CNA training. Some advertise it on their website under "Careers" or "Jobs." If you are already working in a healthcare setting as an uncertified aide, ask your manager whether the employer will pay for your certification — many do for current employees.
Employer-sponsored training is often faster and cheaper than enrolling on your own, and you may have a job waiting for you after you pass the exam. The trade-off is that you are committing to work for that employer, and leaving early can cost you money.
Frequently Asked Questions
Do I need a high school diploma or GED to become a CNA?
Most CNA programs do not require a high school diploma or GED, though some do. Call the program directly to ask about their requirements. If a program requires a diploma and you do not have one, you can look for a different program or pursue your GED first.
Can I work as a nursing assistant while I am training to be a CNA?
Yes, in most states. You can work as an uncertified nursing assistant (sometimes called a patient care technician or aide) while you complete your CNA training. Once you pass the exam and earn your license, you can work as a certified nursing assistant. Some employers require certification before hiring, so check the job posting.
What happens if I fail the CNA exam?
You can retake the exam. Most states let you retake it within 30 to 90 days, though you may have to pay the exam fee again. Some states limit the number of retakes in a certain time period. Check your state nursing board website for the retake policy and fee.
How much does a CNA license cost in total?
Costs vary widely by state and program. Training programs range from $500 to $1,500, exam fees are typically $100 to $200, and background check and TB test fees are usually $50 to $100 combined. Total out-of-pocket cost is often $700 to $1,800 if you pay for everything yourself, though employer-sponsored programs may be free.
Can I transfer my CNA license to another state?
CNA licenses are state-specific and do not automatically transfer. If you move to another state, you will need to check that state's nursing board website to see whether you can reciprocate (transfer) your license or whether you need to retake the exam. Some states have reciprocity agreements; others do not.