CNA Certification Guide USA (State by State Basics)
Becoming a Certified Nursing Assistant (CNA) is one of the fastest routes into stable, in-demand healthcare work in the US — usually just weeks of training, often paid for by an employer. This guide explains what a CNA does, the training and exam, how the state registry works, and what to expect for pay.
What a CNA does
A CNA provides hands-on, everyday care under the supervision of nurses, in settings like nursing homes, hospitals, assisted-living facilities and home care. Typical duties include:
- Helping patients with bathing, dressing, eating and mobility
- Taking and recording vital signs
- Repositioning patients and assisting with daily living
- Reporting changes in a patient’s condition to nurses
It’s physical, people-focused work with steady demand — and it’s a recognized first step toward LPN/RN nursing later.
Approved training programs
You must complete a state-approved CNA program. Federal law sets a floor of at least 75 hours (classroom instruction plus supervised clinical practice), and many states require more. Programs are offered by:
- Community colleges and vocational schools
- The Red Cross and similar organizations
- Care employers — many nursing homes and hospitals run free or sponsored programs to hire you afterward
Always confirm the program is approved by your state’s nurse aide registry — an unapproved course won’t let you sit the exam.
The competency exam and registry
After training you take the state competency exam, which has two parts:
- A written (or oral) knowledge test, and
- A hands-on skills test, where you perform care tasks correctly.
Pass both, and you’re added to your state’s nurse aide registry — the official list that proves you’re certified and lets employers verify you. Your certification must be renewed periodically (commonly every two years), usually requiring recent work hours.
How requirements vary by state
The federal 75-hour minimum is just the floor. States differ on:
- Total training hours required,
- The exam provider and exact format,
- Renewal rules and required work hours, and
- Reciprocity — most states let you transfer an active certification when you move, by applying to the new state’s registry.
Check your specific state’s nurse aide registry for its exact rules before you enroll.
Typical pay
CNA pay varies by state and setting, but it’s solid entry-level healthcare work — and night, weekend and holiday shift differentials push it higher. Hospitals often pay more than nursing homes, and experience plus extra certifications raise it over time. Many CNAs clear $20+/hour with no degree, especially on premium shifts.
Tip: Ask employers about free CNA training. Lots of care providers will pay for your course and exam in exchange for a work commitment — you get certified without the upfront cost.
Official resources
Looking for care work? Browse current nurse assistant jobs in London and care roles, and see other jobs that pay $20+ with no degree.
Frequently asked questions
How long does CNA training take?
Federal rules require at least 75 hours of state-approved training (classroom plus supervised clinical hours), and many states require more — often 100 to 150+. Most programs run about 4 to 12 weeks.
Is CNA certification valid in every state?
Certification is granted by each state's nurse aide registry, so it's state-specific. However, most states offer reciprocity, letting you transfer an active certification when you move — you apply to the new state's registry.
Do I have to pay for CNA training?
Sometimes, but not always. Many nursing homes, hospitals and care employers offer free or sponsored CNA training in exchange for working with them, and some community college programs have financial aid.