CNA in Alabama 2026: Training, Certification, Salary, and Requirements
Alabama CNA requirements: 75 hours training (federal minimum), Prometric exam (70 questions + 5 skills), Alabama DHR Nurse Aide Registry (not Board of Nursing). Salary $24K–$30K. Top employers: UAB, Baptist Health, Huntsville Hospital. Updated 2026.
Alabama Key Facts and Figures
Alabama Important Details
Alabama requires exactly 75 hours of CNA training — the federal minimum set by OBRA 1987 — making it one of the most accessible states for CNA certification. Training must include at least 16 hours of classroom/theory instruction and at least 16 hours of supervised clinical practice in a licensed nursing facility. The remaining hours can be split between laboratory training and additional instruction at program discretion. Programs must be approved by the Alabama Department of Public Health (ADPH). Training is available at community colleges, technical colleges, the Red Cross, hospitals, and some long-term care facilities offering employer-sponsored programs.
- Total Required Hours: 75 hours minimum
- Classroom/Theory Hours: Minimum 16 hours
- Clinical Hours: Minimum 16 hours
- Remaining Hours: Lab and combined instruction
- Federal Minimum: 75 hours (AL meets exactly)
- Note: Lowest training requirement in the US — tied with several other states
Alabama uses Prometric to administer the state CNA competency exam. The written section contains 70 multiple-choice questions with a 90-minute time limit. The clinical skills evaluation requires demonstrating 5 randomly selected skills from the approved Alabama skills list. Candidates must pass both sections within 24 months of completing their approved training program, with up to 3 total attempts. An oral version of the written test is available for candidates with documented reading difficulties. Prometric testing sites in Alabama are located in Birmingham, Montgomery, Huntsville, and Mobile.
- Written Section: 70 questions, 90 minutes
- Skills Section: 5 randomly selected skills
- Passing Score: 70% written, all skills passed
- Exam Provider: Prometric
- Oral Option: Available for candidates with reading difficulties
- Attempts: 3 attempts within 24 months of training completion
Alabama requires a criminal background check for CNA candidates seeking employment in Medicaid/Medicare-certified facilities. The check is processed through the Alabama Bureau of Investigation (ABI) and includes state and federal criminal history. The Alabama DHR Nurse Aide Registry maintains records of any substantiated findings of abuse, neglect, or misappropriation of property. Any CNA with such a finding on the registry is barred from working in any federally certified long-term care facility in Alabama. Employers are required to verify DHR registry status before hiring.
- Check Type: State + national fingerprint-based check
- Administered By: Alabama Bureau of Investigation (ABI)
- Disqualifying: Abuse, neglect, exploitation convictions
- Registry Block: Alabama DHR Nurse Aide Registry — findings of abuse bar employment
Before beginning clinical rotations at an Alabama nursing facility, CNA students must provide proof of a negative TB test (Mantoux PPD or QuantiFERON Gold) within the past 12 months, a physician's physical clearance form, and current CPR/BLS certification. Most approved programs also require current immunizations including the Hepatitis B series, MMR, Varicella, Tdap, and seasonal influenza vaccine. Individual training programs may have additional requirements beyond the ADPH minimum. These documents must typically be submitted before the first clinical day.
- TB Test: Required within 12 months
- Physical Exam: Physician clearance required
- Immunizations: Hep B, MMR, Varicella, Tdap, Flu
- CPR: BLS certification required
Alabama Detailed Breakdown
Birmingham and the metro area — including Jefferson, Shelby, Blount, St. Clair, and Walker counties — is Alabama's dominant CNA market. The University of Alabama at Birmingham (UAB) Health System is the state's largest employer of CNAs and one of the top academic medical centers in the Southeast, offering competitive wages, tuition reimbursement, and clear career ladders. UAB Hospital, Children's of Alabama, and Grandview Medical Center are all major CNA employers in the city. Ascension St. Vincent's Health System operates four hospitals in the Birmingham metro and actively recruits CNAs with employer-sponsored training. Jefferson State Community College and Lawson State Community College both offer state-approved CNA programs at community college tuition rates (approximately $500–$1,200 for Alabama residents). American Red Cross Birmingham chapter also runs periodic CNA training cohorts. Hospital CNAs in Birmingham average $14–$18/hour; SNF and home health positions average $12–$15/hour. CNA scholarships and workforce development grants through Alabama Career Centers (AlabamAworks!) are available for eligible candidates throughout the metro.
Alabama Costs and Pricing
Alabama Step-by-Step Process
Find an Alabama-Approved CNA Program
Complete Prerequisites and Enrollment
Complete 75-Hour Training
Register with Prometric
Pass the Alabama CNA Competency Exam
Get Added to the Alabama DHR Nurse Aide Registry
Begin Employment in Alabama
Alabama Essential Checklist
Alabama DHR Nurse Aide Registry: One of the Few States Using a Human Resources Agency
Alabama is one of only a handful of states where the Certified Nursing Assistant registry is managed by the Department of Human Resources (DHR) rather than the Board of Nursing or a Department of Health. This administrative distinction has significant practical implications for CNA candidates, employers, and out-of-state applicants seeking reciprocity.
Why DHR and Not the Board of Nursing? Alabama's nurse aide regulatory framework was established under the state's human services infrastructure rather than its professional licensing system. The Alabama DHR Nurse Aide Registry (accessible at dhr.alabama.gov) maintains the official list of certified nurse aides in good standing, including any findings of abuse, neglect, or misappropriation. Because this is a DHR function — not a healthcare licensing function — the registry operates somewhat differently from states where the Board of Nursing controls CNA records. Reciprocity applications, registry verifications, and status inquiries all go through DHR, not through the Alabama Board of Nursing.
What the Alabama DHR Registry Contains: The registry lists every Alabama-certified CNA, including their certification status (active/inactive/expired), the date of initial certification, the date of most recent renewal, and any substantiated findings of abuse, neglect, or misappropriation of resident property. Any individual with a substantiated finding is permanently barred from employment in any Medicaid/Medicare-certified long-term care facility in Alabama. Employers are legally required to check the DHR registry before hiring any CNA.
Reciprocity Through Alabama DHR: CNAs certified in other states must apply for reciprocity directly through the Alabama DHR — not through a nursing board — by submitting verification of their current registry status, a completed Alabama reciprocity application, and passing an Alabama criminal background check. Most states with valid active CNA certifications and clean registry records can transfer without retesting. Processing takes 4–8 weeks. See our CNA reciprocity guide for a full multi-state comparison. If your out-of-state certification has lapsed (more than 24 months of no paid nursing employment), you will likely need to retake the full Prometric competency exam.
Alabama Advantages and Disadvantages
- +Only 75 hours required — the federal minimum and among the shortest in the US, allowing entry in 2–3 weeks full-time
- +UAB Health System in Birmingham is one of the Southeast's premier academic medical employers, offering strong wages and career advancement
- +Prometric exam is well-supported nationally — resources, practice tests, and scheduling are widely available
- +Severe rural CNA shortage creates guaranteed employment for candidates willing to work in Black Belt and rural counties
- +Low cost of living across most of Alabama means CNA wages stretch significantly further than in coastal states
- +ACCS community college system offers affordable CNA programs at 24+ campuses statewide
- +Alabama DHR registry is searchable online — streamlined verification process for employers and candidates
- +Growing senior population in Huntsville metro driving new healthcare development and rising wages
- −Salary range ($24K–$30K) is below the national CNA median and below neighboring Georgia and Florida
- −Rural Black Belt counties have very few approved training programs, making access to certification difficult without transportation
- −Alabama DHR registry (not Board of Nursing) can confuse out-of-state reciprocity applicants unfamiliar with the system
- −Limited union presence in Alabama means fewer collective bargaining protections and slower wage growth for CNAs
- −Rural facility wages ($11–$13/hr) are among the lowest in the Southeast
- −Alabama's overall healthcare infrastructure investment lags behind Southeast peers, limiting specialty CNA career paths
- −High summer heat and humidity can be challenging for CNAs doing home health visits in non-air-conditioned rural homes
About the Author
Registered Nurse & Healthcare Educator
Johns Hopkins University School of NursingDr. Sarah Mitchell is a board-certified registered nurse with over 15 years of clinical and academic experience. She completed her PhD in Nursing Science at Johns Hopkins University and has taught NCLEX preparation and clinical skills courses for nursing students across the United States. Her research focuses on evidence-based exam preparation strategies for healthcare certification candidates.