Certified Nursing Assistant Requirements 2026
CNA requirements follow a consistent framework in every state: complete a state-approved training program, pass a two-part competency exam, clear a criminal background check, and get listed on the state nurse aide registry. Federal law sets the training floor at 75 hours. Most states require more. Select your state below for the requirements that apply to your jurisdiction.
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The path to CNA certification runs through four steps in every state: training, examination, background clearance, and registry placement. What varies is the detail inside each step, and those details matter. Your state sets the approved program list, determines how many training hours are required above the federal minimum, and decides which exam vendor administers your competency evaluation. This page covers the national framework. The state selector below covers the specifics for your jurisdiction.
On this page:
- The Federal Framework That Sets the Floor
- Training Program Requirements
- The CNA Competency Exam
- Background Check Requirements
- The Nurse Aide Registry
- Find CNA Requirements in Your State
- Frequently Asked Questions
The Federal Framework That Sets the Floor
Federal law establishes a national baseline for CNA training and certification. The Omnibus Budget Reconciliation Act of 1987, known as OBRA 87, requires anyone working as a nurse aide in a Medicare or Medicaid-certified nursing facility to complete at least 75 hours of approved training and pass a competency evaluation. This applies in every state. You can find the federal regulatory framework at the CMS nursing home guidance page.
Those 75 hours must include both classroom instruction and supervised clinical practice. OBRA 87 also specifies what the curriculum has to cover: nurse aide roles and responsibilities, communication and interpersonal skills, infection control, safety and emergency procedures, personal care skills, and the mental health and social needs of residents.
The 75-hour floor is a minimum, not a standard. Most states require more, and some require considerably more. States set their own rules for approved training providers, minimum clinical hours, exam retake policies, and registry maintenance. Federal law defines the baseline. States build on top of it.
Training Program Requirements
Before you can sit for the competency exam, you have to complete a state-approved training program. States maintain their own lists of approved providers. Completing a program that isn’t on your state’s list generally won’t qualify you to register, so confirm approval status before you enroll.
Program types: Community colleges and vocational schools offer the most widely available CNA training. Red Cross programs operate in many states. Hospital systems, home health agencies, and long-term care facilities sometimes run state-approved programs as well. Some are employer-sponsored, meaning the facility covers training costs in exchange for a commitment to work there after certification.
Training hours: Federal law requires at least 75 hours total, including at least 16 hours of supervised clinical practice. In practice, most state programs run longer. State requirements generally range from the federal minimum of 75 hours to roughly 175 hours, depending on the state and program type. The clinical component, supervised patient care practice under a licensed nurse, typically runs 16 to 40-plus hours, depending on the state. These figures shift when states update their rules, so verify with your state’s registry or training provider.
What the training covers: All approved programs address the core competencies required for the exam: basic nursing skills, personal care, infection control, vital signs, range-of-motion exercises, and communication with patients and care teams. Most programs also include dementia care, residents’ rights, and reporting obligations.
The CNA Competency Exam
After completing an approved training program, you’ll sit for a two-part competency evaluation before you can be listed on the registry. Both parts must be passed to complete certification.
The written or oral exam tests your knowledge of nursing assistant concepts, patient care principles, and regulatory requirements. Most states offer an oral version as an accommodation. The exam is standardized within each state but administered by different vendors. Prometric, Pearson VUE, and PSI are among the most common CNA testing vendors used by states, though some states work with other contractors. Your training program or state board of nursing can tell you how to register.
The clinical skills exam is where most candidates feel the most pressure. You’ll perform a set of randomly selected nursing tasks in front of a trained evaluator. Common tested skills include handwashing technique, taking vital signs, transferring a resident from bed to wheelchair, providing oral care, and measuring urinary output. Each skill has to be performed in the correct sequence and meet specific competency criteria.
Most states allow multiple retake attempts if you don’t pass on the first try, but the number of allowed attempts and the retake window vary by state. Some states require candidates who exhaust their retake attempts to repeat the full training program before testing again.
Background Check Requirements
Background checks are required at two levels for most CNAs: at the registry and at the point of employment.
Federal law prohibits Medicare and Medicaid-certified nursing facilities from employing anyone who has been found guilty of abuse, neglect, or misappropriation of resident property. States are required to maintain nurse aide registries and record findings of abuse, neglect, or misappropriation. Many employers and state agencies also screen applicants against federal exclusion databases such as the OIG List of Excluded Individuals and Entities, though screening practices vary by state and setting. Criminal background checks are required by most states as well, though what qualifies as a disqualifying offense and whether there’s an appeals process varies by jurisdiction.
At the facility level, nursing homes and home health agencies typically run separate background checks as an employment condition. Some states mandate fingerprint-based checks for all healthcare workers. What’s disqualifying can differ by setting: hospital employment standards may not be the same as long-term care standards in the same state.
If you have a prior conviction, contact your state nurse aide registry before you enroll in a training program. Most registries have a formal process for reviewing individual circumstances, and some states allow waivers for certain offenses.
The Nurse Aide Registry
The nurse aide registry is the official state list of individuals authorized to work as CNAs. Getting placed on it is the final step. Without it, you can’t legally work in a Medicare or Medicaid-certified facility in that state.
After you pass your competency exam and clear your background check, your training program or the exam vendor typically submits your information directly to the registry. In some states, you’ll file a separate application. Each state’s registry is maintained by a different agency, often the state board of nursing, sometimes the department of health, or an agency for aging and disability services. For a general overview of what nurse aide certification involves before diving into state-specific rules, see our nurse aide overview.
Maintaining active status: Federal regulations require CNAs to perform nursing or nursing-related services for monetary compensation at least once every 24 months. CMS guidance commonly interprets this as at least one documented workday. States can set requirements above this federal baseline. If your active status lapses, you may need to retake the competency exam or complete additional training before you can work again.
Reciprocity and interstate endorsement: CNAs who want to work in a different state don’t always have to start over. Most states offer some form of reciprocity, endorsement, or certification transfer process for out-of-state CNAs. You’ll typically apply for endorsement, submit documentation of your current certification, and clear a background check in the new state. The receiving state may still require additional training or testing if its requirements exceed your original state’s. Some states impose additional testing or competency-verification requirements on certain out-of-state CNAs, depending on their training, work history, or certification status.
Find CNA Requirements in Your State
Requirements vary meaningfully from state to state, in training hours, exam vendors, background check standards, and registry maintenance rules. Select your state below for the specific requirements, approved program lists, and registry contact information for your jurisdiction.
Select a State to Find Nursing Assistant/Nurse Aide Requirements
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Frequently Asked Questions
What does a CNA do?
CNAs provide direct patient care under the supervision of RNs and LPNs. Day-to-day tasks include helping patients with bathing, dressing, eating, and mobility; taking and recording vital signs; maintaining clean patient environments; and reporting observations to the nursing team. CNAs work primarily in nursing homes and long-term care facilities, though hospital, home health, and rehabilitation settings also employ them.
How long does it take to become a CNA?
Most CNA training programs take four to twelve weeks, depending on whether you attend full-time or part-time. After finishing the program, scheduling and passing the competency exam, and completing the registry process, it adds a few weeks. In total, most candidates go from enrollment to registry listing within 2 to 4 months.
Can I transfer my CNA certification to another state?
Most states offer some form of reciprocity, endorsement, or certification transfer process for active, in-good-standing CNAs. The process typically requires an application, documentation of your current certification, and a background check in the receiving state. Some states may require additional training or testing depending on your work history or the requirements of the receiving state. Contact the nurse aide registry in your destination state for the specific steps.
Is CNA certification the same as a nursing license?
No. A state nurse aide registry issues CNA certification and authorizes you to work as a nursing assistant in licensed facilities. It’s not a nursing license. LPNs and RNs hold nursing licenses, which require completion of a nursing program, passing the NCLEX, and licensure through the state board of nursing. The scope of practice, education pathway, and regulatory structure are distinct.
Can working as a CNA help me become an RN?
CNA experience is practical preparation for nursing school, though it doesn’t substitute for the formal education requirements. Many nursing programs give preference in admissions to applicants with direct patient care experience, and CNA work qualifies. In some programs, documented CNA experience can reduce required clinical hours. For a closer look at how the CNA credential fits into the nursing career ladder, see our guide on making the transition from CNA to RN.
Key Takeaways
- 75 hours is the floor, not the standard — Federal law sets a minimum; most states require more, so verify your state’s specific training hours before enrolling.
- State-approved programs only — Completing a non-approved program won’t qualify you to test or register, regardless of how many hours it runs.
- Two-part exam, both parts required — The competency evaluation includes a written or oral knowledge test and a hands-on clinical skills demonstration.
- Background checks happen at two levels — Registry placement and facility employment, each of which involves separate screening; a prior conviction doesn’t automatically disqualify you, but contact your state registry before starting training.
- The registry is the finish line — You’re not authorized to work in a Medicare or Medicaid-certified facility until you’re listed on your state’s nurse aide registry.
Select your state above to find approved CNA training programs, registry contact information, and the specific certification requirements for your jurisdiction.