How to become a CNA

1. 1Check your state's CNA requirements

   Time: 1-2 hoursSources 1, 7

   Each state approves its own training programs and sets the hours, exam vendor, minimum age, background check rules and title (CNA, STNA, LNA or another). Federal law sets only the floor. Look up your state's nurse aide registry or the agency that runs it, usually the health department or board of nursing, and use the CareerOneStop License Finder to see what applies where you live before paying for a course.

2. 2Find a state-approved training program

   Time: 1-2 weeksCost: $0 if facility-sponsored; otherwise variesSources 2, 1

   Programs run at community colleges, technical schools, high schools, hospitals and nursing homes. Only a state-approved program qualifies you for the competency exam. If you can, ask nursing homes whether they hire trainees: under federal rules, a facility cannot charge aides it employs or has offered a job for any part of the program, including textbooks, and if a facility hires you within 12 months of finishing, the state must arrange pro rata reimbursement of what you paid.

3. 3Complete the training, including supervised clinical hours

   Time: 3 weeks to 3 monthsCost: Varies by programSources 2

   Federal rules require at least 75 clock hours, with at least 16 hours of supervised practical training, and many states require more. Topics include infection control, safety and emergencies, residents' rights, communication, basic nursing skills such as vital signs, personal care, and caring for people with dementia. The clinical portion places you in a nursing home or hospital, doing real care while a nurse watches.

4. 4Pass the state competency exam

   Time: One dayCost: Set by your state and its test vendorSources 3, 4, 5

   The exam has two parts, and you must pass both. In states that use the NNAAP, the written test has 70 multiple-choice questions, or an oral version of 60 questions plus 10 reading comprehension items, and the skills test asks you to perform five randomly chosen skills, such as handwashing or measuring blood pressure, in front of a nurse evaluator. Federal rules give you at least three chances to pass.

5. 5Get listed on the state registry and start work

   Time: Days to a few weeksSources 3, 8, 1

   Once you pass, the state adds you to its nurse aide registry, and nursing homes must check the registry before letting you work as an aide. Employers also run their own orientation on their policies and equipment. Many ask for a current CPR or BLS card and a background check. If you later move, the new state will tell you how to transfer your registry status.

6. 6Keep your certification active

   Time: OngoingSources 8, 9

   Nursing homes must give each aide at least 12 hours of in-service training a year, including dementia care and abuse prevention. Staying certified also depends on working: if you go 24 months in a row without paid nursing-related work, federal rules require a new training program or a new competency evaluation. States set their own renewal periods and may add continuing education.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Safe lifting and transfers

Moving a person from bed to wheelchair many times a shift is where both patients and CNAs are most often hurt.

Noticing small changes

CNAs see residents more than anyone else, so they are often first to spot a new sore, a fever or a sudden change in mood or behavior.

Patience with dementia

Residents with memory loss may resist care or not recognize you, and calm, repeated reassurance gets the task done without distress.

Respect for dignity and privacy

Helping adults bathe and use the toilet requires a matter-of-fact, respectful manner that protects their privacy and their rights.

Accurate charting

Vital signs, food intake and bowel movements recorded by CNAs feed directly into the nurse's decisions and the facility's care plan.

Stamina for long shifts

Twelve-hour, night and weekend shifts on your feet are common, and short staffing can stretch the workload further.

O*NET 31.0 rates these skills as most important for the occupation: active listening, monitoring, reading comprehension, speaking, critical thinking.

Training cost

$0–$4.6K

Before financial aid

Time

1-3 months

Typical path

Median pay

$42,260

All US jobs: $50,980

Payback once qualified

No premium

Pay above the all-jobs median vs. cost

Low: $0, because federal rules bar a nursing facility from charging aides it employs, or has offered a job, for any part of the training or competency evaluation, and some facilities run free programs. High: one year of College Scorecard median public in-state tuition for the practical nursing and nursing assistant certificate family, $4,616. That family also covers longer LPN programs, so most CNA courses cost well below this figure. Exam fees are set by each state and its test vendor and are not included, nor are scrubs, background checks or a CPR card.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Licensed practical nurse (LPN/LVN)$64,400 median

  A state-approved practical nursing program, usually about a year, followed by the NCLEX-PN exam and a state license.

• Registered nurse$97,550 median

  An associate or bachelor's degree in nursing and the NCLEX-RN exam; CNA experience often helps with nursing school admission.

• Medication aide

  Additional state-approved training and an exam in states that allow certified aides to give certain medications.

• Medical assistant$45,690 median

  A certificate or associate program in medical assisting, for those who want clinic work with regular daytime hours.

• EMT$44,470 median

  A state-approved EMT course and the national or state EMT exam, for CNAs who want emergency care.