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 — usually in that order. The whole process typically takes 4 to 12 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 require it or a GED. After you pass both exams, your state's nursing board issues your certificate, which you then renew every two years (the renewal period varies by state).

The path differs slightly by state — some states call it a CNA certificate rather than a license, some require a background check, and some let you work as a CNA-in-training while waiting for your exam results. But the core steps are the same everywhere: find an approved program, complete the coursework and clinical hours, register for the state exam, pass it, and register your certificate with your state board.

Key Takeaways

  • You must complete a state-approved CNA training program that includes classroom instruction and supervised clinical practice in a healthcare setting.
  • After training, you register for and pass both a written exam and a hands-on skills test administered by your state's nursing board or an approved testing vendor.
  • Your state's nursing board issues your certificate once you pass both exams; the certificate is valid for two years in most states, though some states use different renewal periods.
  • Some states allow you to work as a CNA-in-training before your exam results arrive, but you cannot use the CNA title or perform certain tasks until you are officially certified.
  • A few states require a background check or fingerprinting before you can sit for the exam or receive your certificate.

Finding and Enrolling in a State-Approved CNA Program

Your state's nursing board maintains a list of approved CNA training programs. You can find this list on your state board's website — search "[your state] nursing board approved CNA programs" or "[your state] CNA training programs." Programs are offered by community colleges, vocational schools, hospitals, nursing homes, and private training companies. Most programs run 4 to 12 weeks depending on whether you attend full-time or part-time.

When you contact a program, ask whether it is currently approved by your state board, how many classroom hours and clinical hours it includes, what the tuition is, and when the next class starts. Some programs are free or low-cost if you commit to working at that facility after certification. Community colleges are often the cheapest option and may offer financial aid or payment plans. Before you enroll, confirm that the program's exam pass rate is publicly available — this tells you whether graduates actually pass the state test.

You will need to provide proof of identity and, in some states, proof that you have no disqualifying criminal convictions before you start. A few states require you to submit fingerprints to the state board before you can sit for the exam, so ask your program whether your state has this requirement.

What the Training Program Covers

CNA training includes both classroom instruction and supervised clinical practice. The classroom portion covers anatomy and physiology, patient hygiene and grooming, catheter care, vital signs, infection control, patient rights, and communication with patients and healthcare staff. You will learn the legal and ethical boundaries of the CNA role — what you can and cannot do without a nurse's supervision.

The clinical portion takes place in a real healthcare setting, usually a nursing home, hospital, or assisted living facility. You work under the supervision of a licensed nurse and perform tasks on actual patients: bathing, dressing, toileting, transferring patients, taking vital signs, and reporting changes in patient condition. Most programs require 40 to 100 clinical hours, though this varies by state. Your clinical instructor evaluates whether you can perform these tasks safely and correctly.

By the end of the program, you should be able to demonstrate all the skills that appear on the state exam. Your program will tell you which exam vendor your state uses — the two largest are Prometric and Pearson VUE — and help you register for your exam date.

Registering for and Taking the State CNA Exam

After you finish your training program, you register for the state exam through your state's nursing board or through the testing vendor (Prometric or Pearson VUE, depending on your state). Registration usually costs $100 to $200. You will need to provide proof that you completed an approved training program — your program gives you a certificate of completion for this purpose.

The exam has two parts: a written test and a skills test. The written test is multiple-choice and covers the knowledge you learned in class — patient care, safety, infection control, and communication. It usually has 50 to 100 questions and you have 1.5 to 2 hours to complete it. The skills test is hands-on: you perform five to six tasks in front of an examiner, such as taking blood pressure, helping a patient bathe, or transferring a patient from bed to chair. The examiner watches to see whether you follow proper technique and safety procedures.

You must pass both parts to receive your certificate. If you fail one part, most states let you retake only that part without retaking the whole exam. Retake fees vary by state but usually cost $50 to $150 per attempt.

After You Pass: Getting Your Certificate and Starting Work

Once you pass both the written and skills exams, your state's nursing board issues your CNA certificate. This usually takes 1 to 4 weeks after you pass. Some states mail you a physical certificate; others issue it electronically and you can print it yourself. Your certificate shows your name, certificate number, and expiration date.

You can begin working as a CNA once your certificate is issued. Some states allow you to work as a "CNA-in-training" or "CNA candidate" before your exam results arrive, but you cannot use the CNA title or perform certain patient care tasks until you hold the actual certificate. Ask your employer what they require before you start.

Keep your certificate in a safe place and bring it to every job interview. Some employers ask to see the original; others accept a copy. You will need the certificate number when you renew.

Renewing Your CNA Certificate

Most states require you to renew your CNA certificate every two years. A few states use different renewal periods — check your state board's website for the exact important date. Renewal usually costs $50 to $150 and requires you to submit a renewal form and proof of payment to your state board.

Some states require continuing education hours to renew — typically 12 to 20 hours over the two-year period. These hours can come from online courses, workshops, or on-the-job training. Your employer may offer these courses for free. Other states do not require continuing education but do require proof that you have worked as a CNA during the renewal period — usually at least a certain number of hours per year.

A few states require you to pass a refresher exam or retake the full exam to renew. Check your state board's renewal requirements well before your certificate expires so you have time to complete any required coursework or exams.

State-by-State Differences You Should Know

CNA requirements vary significantly by state. Some states require a high school diploma or GED; others do not. Some states require a background check or fingerprinting; others do not. Some states require continuing education to renew; others require proof of work hours instead. A few states have reciprocity agreements that let you transfer your CNA certificate from another state, but most do not — if you move, you usually have to get certified in your new state.

The exam itself is standardized across most states, but a few states write their own exam instead of using the national exam. The cost of training, the exam fee, and the renewal fee also vary widely. Before you enroll in a program, visit your state's nursing board website and read the CNA requirements for your specific state. The board's website will tell you which programs are approved, what the exam requirements are, what the renewal requirements are, and how much everything costs.

Frequently Asked Questions

Can I work as a CNA while I am waiting for my exam results?

Some states allow you to work as a "CNA-in-training" or "CNA candidate" after you finish your training program but before your exam results arrive. You can perform patient care tasks under supervision, but you cannot use the CNA title or work independently. Other states do not allow this. Ask your state board or your employer what the rules are in your state.

What happens if I fail the CNA exam?

If you fail the written test or the skills test, you can retake that part. Most states let you retake it within 30 to 90 days. You pay a retake fee (usually $50 to $150) and register again through the testing vendor. Many people pass on the second or third attempt. If you fail multiple times, some states require you to retake the full training program before you can sit for the exam again.

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

Most states do not require a high school diploma or GED to become a CNA, but some do. A few states require you to be at least 18 years old. Check your state board's website to see whether your state has these requirements. If your state does require a diploma and you do not have one, you will need to get your GED before you can enroll in a CNA program.

How much does CNA training cost?

CNA training costs vary widely depending on where you take it. Community colleges typically charge $500 to $2,000 for a full program. Private training companies may charge $1,000 to $3,000. Some hospitals and nursing homes offer free or low-cost training if you agree to work there after certification. Some programs accept financial aid or offer payment plans. The exam fee is usually $100 to $200, and renewal fees are typically $50 to $150 every two years.

Can I transfer my CNA certificate to another state?

Most states do not have reciprocity agreements, so you cannot automatically transfer your CNA certificate when you move. You will usually need to get certified in your new state. A few states have reciprocity with neighboring states, so check your new state's nursing board website. Some states let you explore for a temporary permit while you complete the new state's requirements, but this varies.