How to Become a CNA 2026 — Step-by-Step Guide
Learn how to become a CNA in 2026. Complete step-by-step guide covering training programs, state exam, registry listing, and your first job as a Certified Nursing Assistant.
What Is a CNA?
A Certified Nursing Assistant (CNA) provides direct patient care under the supervision of a licensed nurse. CNAs assist patients with daily activities such as bathing, dressing, feeding, and vital sign monitoring in hospitals, nursing homes, assisted living facilities, and home health settings. Becoming a CNA is one of the fastest routes into the healthcare profession. The entire process — from enrolling in a training program to receiving your certification — typically takes 6 to 12 weeks. The demand for CNAs remains strong, with the U.S. Bureau of Labor Statistics projecting steady growth through 2033.
Meet Basic Requirements
Complete an Approved CNA Training Program
Pass the State Competency Exam
Get Listed on the State Nurse Aide Registry
Apply for Your First CNA Job
Step 1: Meet Basic Requirements
Before enrolling in a CNA training program, you must meet a set of baseline requirements. These vary slightly by state, but most states require the following: Age: You must be at least 18 years old in most states. Some states permit 16- or 17-year-olds to train with parental consent, but employment at most facilities requires age 18. Education: A high school diploma or GED is the standard requirement. Some programs may accept applicants who are currently enrolled in high school if they are in a vocational track. Background Check: All states require a criminal background check before you can be placed on the nurse aide registry. Certain felony convictions — particularly those involving abuse, neglect, or exploitation — may permanently disqualify candidates. Minor offenses are evaluated case-by-case. Health and Immunizations: Most training programs and employers require proof of immunizations (TB test, hepatitis B, MMR, varicella), a physical exam, and drug screening. Requirements vary by facility type. English Proficiency: The state competency exam is administered in English, so reading comprehension at a basic level is necessary. Some testing vendors offer limited language accommodations — contact your state's testing vendor for details.Step 2: Complete an Approved CNA Training Program
Federal law (the Omnibus Budget Reconciliation Act of 1987) requires that CNA training programs include a minimum of 75 hours of instruction, with at least 16 hours of supervised clinical practice. Most states set their own higher minimums — many require 120 to 175 hours total. Only state-approved programs qualify you to sit for the competency exam. You can find approved programs through your state's health department or Department of Health and Human Services website.
Community colleges offer the most widely recognized and affordable CNA programs. Many qualify for federal financial aid (Pell Grant), making them accessible to low-income students. Courses combine classroom theory with lab and clinical rotations at local nursing facilities.
- Duration: 6–16 weeks
- Cost: $300–$1,500
- : Leads to college credit
- : Financial aid often available
Vocational schools specialize in trade and technical training. CNA programs at vocational schools tend to be shorter and more intensive, with a focus entirely on the skills needed to pass the state exam. They are a good choice for adults who want to enter the workforce quickly.
- Duration: 4–8 weeks
- Cost: $500–$2,500
- : No general ed requirements
- : Often has evening/weekend options
Many hospitals run their own CNA training programs, particularly when facing staffing shortages. These programs are often free or heavily subsidized in exchange for a work commitment after certification. Clinical hours are completed within the hospital itself, giving trainees direct experience.
- Duration: 4–12 weeks
- Cost: Free to $1,000
- : Direct hiring pipeline
- : Real hospital clinical hours
Some programs offer the theory portion online with required in-person clinical hours at a local partner facility. These are ideal for working adults who need schedule flexibility. Note: states require clinical skills to be performed in person — fully online CNA programs do not qualify for certification.
- Duration: 4–16 weeks
- Cost: $400–$2,000
- : Classroom work online
- : In-person clinical required by law
Free CNA Training Options
Step 3: Pass the State Competency Exam
After completing your state-approved training program, you must pass the CNA State Competency Exam to earn certification. This exam is administered by one of two national testing companies depending on your state: Prometric or Pearson VUE. The exam has two parts — both must be passed to receive certification:The written portion tests your knowledge of CNA duties, patient rights, infection control, safety, basic nursing skills, and communication. Most states use a 70-question format. You need a score of 70–80% to pass, depending on the state.
- : 60–70 multiple-choice questions
- : 70–90 minutes to complete
- : Covers patient care, safety, infection control, and rights
- : Oral version available for low-literacy candidates
An evaluator observes you performing randomly selected clinical skills from a standardized list. Skills typically tested include handwashing, taking blood pressure, providing denture care, positioning a patient, and applying a transfer belt. You must correctly complete each skill per the state's checklist.
- : Perform 3–5 randomly selected skills
- : Each skill scored on a checklist
- Common skills: handwashing, vital signs, catheter care
- : Must pass all selected skills to pass this section
Exam Tips and Retake Policy
Most states allow candidates to take the exam up to three times within 24 months of completing training. If you fail after three attempts, you must repeat the CNA training program before retesting. To maximize your chances of passing on the first attempt: - Use official state skills checklists during practice — evaluators score each step - Practice verbal communication during skills (announce each action out loud) - Review infection control procedures, especially handwashing technique - Take multiple practice exams to prepare for the written portion Our CNA Classes Near Me guide includes tips for finding programs with strong first-time pass rates.Step 4: Get Listed on the State Nurse Aide Registry
Once you pass both parts of the competency exam, your name is submitted to the State Nurse Aide Registry. This registry is a public database maintained by each state that records all CNAs who are authorized to work. Employers are required by federal law to verify that any CNA they hire is listed on the registry and has no findings of abuse, neglect, or misappropriation of property. Being listed on the registry is your official proof of certification — it is more important than any paper certificate. How the process works: 1. Pass the state competency exam (both parts) 2. Your testing vendor (Prometric or Pearson VUE) reports your results to the state 3. The state adds your name to the registry, usually within 7–14 business days 4. You receive a registry number or certificate confirmation 5. You can verify your status online through your state's health department portal Renewal: CNA certification must be renewed every two years in most states. To renew, you must have worked a minimum number of hours as a CNA (commonly 8 hours of paid nursing-related work) during the renewal period. Some states also require continuing education.
How to Check Your Registry Status
Step 5: Apply for Your First CNA Job
With your name on the state registry, you are legally qualified to work as a CNA. Most new CNAs find their first position within two to four weeks of completing certification. Where CNAs work: - Skilled nursing facilities (nursing homes): The largest employer of CNAs. High demand, entry-level positions widely available, opportunities for full-time work and benefits. - Hospitals: CNAs work as patient care technicians (PCTs) in med-surg, ICU, and ED units. Usually pays higher than nursing homes. - Assisted living facilities: Lower acuity than nursing homes; residents are more independent. Commonly hires new CNAs. - Home health agencies: CNAs visit patients in their homes. Higher independence, flexible scheduling, lower patient-to-CNA ratios. - Hospice care: Specialized end-of-life support. Emotionally demanding but meaningful work with a defined patient population. Starting salary: Entry-level CNAs earn between $15 and $20 per hour in most states, with higher wages in urban areas and for night or weekend shifts. See our full CNA Pay guide for state-by-state salary data.How Long Does It Take to Become a CNA?
The full timeline from starting your training program to receiving your first paycheck typically runs 8 to 16 weeks. Here is a realistic breakdown: - Training program: 4–16 weeks depending on program intensity and your schedule - Exam scheduling wait: 1–3 weeks (Prometric and Pearson VUE testing centers book quickly) - Registry processing: 1–2 weeks after passing your exam - Job search and hiring: 1–4 weeks The fastest route — an intensive vocational program with an available exam slot — can place you in your first job in as little as 6 weeks. Part-time evening programs at community colleges may stretch the training phase to 4 months. For a detailed breakdown by program type, see our guide: How Long Does It Take to Become a CNA?Career Progression After CNA Certification
CNA certification is often the first step on a longer healthcare career path. Many nurses, nurse practitioners, and healthcare administrators began as CNAs. The hands-on patient care experience you gain as a CNA provides a foundation that formal nursing education alone cannot replicate. Common advancement paths from CNA:Becoming an LPN is the most common next step for CNAs. LPN programs typically take one year and qualify you to administer medications, perform more complex assessments, and take on charge responsibilities at long-term care facilities.
- : 12–18 month accredited program
- : Pass the NCLEX-PN exam
- Median salary: ~$59,000/yr
- : CNA experience counts toward admission at many programs
CNA experience significantly strengthens RN program applications and helps during clinical rotations. Many community colleges offer ADN programs designed for working CNAs and LPNs.
- : Associate Degree in Nursing (2 yrs) or BSN (4 yrs)
- : Pass the NCLEX-RN exam
- Median salary: ~$89,000/yr
- : Many programs offer LPN-to-RN bridge paths
Some CNAs advance laterally by adding specialty certifications rather than pursuing a full nursing degree. Specialized CNAs often earn higher hourly wages and work with specific patient populations.
- : Restorative Nursing Assistant (RNA)
- : Geriatric Nursing Assistant
- : Psychiatric Nursing Assistant
- : Dialysis Technician (with additional cert)
Medical assisting is a parallel path that transitions CNAs from facility-based care to outpatient clinical settings. The work is less physically demanding, with different duties including scheduling, medical records, and minor clinical procedures.
- Certificate programs: 9–12 months
- : Certified Medical Assistant (CMA) exam
- : Works in physician offices and clinics
- : Broader administrative + clinical duties
CNA Salary: What to Expect in 2026
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About the Author
Registered Sanitarian & Food Safety Certification Expert
Cornell University College of Agriculture and Life SciencesThomas Wright is a Registered Sanitarian and HACCP-certified food safety professional with a Bachelor of Science in Food Science from Cornell University. He has 17 years of experience in food safety auditing, regulatory compliance, and foodservice management training. Thomas prepares food industry professionals for ServSafe Manager, HACCP certification, and state food handler examinations.