Massachusetts requires a minimum of 100 hours of DPH-approved CNA training — the federal minimum that Massachusetts uses as its floor — split between classroom instruction and supervised clinical practice. The Massachusetts Department of Public Health (MA DPH) maintains the state's Nurse Aide Registry, and certification testing is conducted by Prometric, the national testing company used by the majority of US states. What makes Massachusetts uniquely distinctive is its concentration of world-class healthcare institutions: Massachusetts General Hospital, Brigham and Women's Hospital, Beth Israel Deaconess Medical Center, Boston Children's Hospital, and the broader Partners HealthCare (Mass General Brigham) network offer CNAs exceptional career advancement opportunities and competitive compensation. Massachusetts CNAs earn $36,000–$44,000 annually — among the highest in the United States — driven by the Boston metro premium and a strong union presence through 1199SEIU. A uniquely Massachusetts resource is the MassHire career center network, which partners with DPH-approved programs to offer fully funded free CNA training for eligible job seekers. With over 40,000 working CNAs across the state, the Greater Boston metro — Cambridge, Somerville, Quincy, and the immediate Boston area — is the dominant job market, followed by Worcester in Central Massachusetts, Springfield in the west, and coastal communities from Cape Cod to the North Shore.
Massachusetts requires a minimum of 100 hours of training at a DPH-approved nurse aide training program — meeting the federal minimum under OBRA '87. At least 60 hours must be classroom or lab instruction covering basic nursing skills, anatomy and physiology, infection control, resident rights, mental health and social service needs, personal care, safety, and emergency procedures. The remaining 40 hours must be supervised clinical practice in a DPH-approved long-term care facility. Programs are offered at community colleges, vocational schools, Red Cross chapters, hospitals, and nursing homes throughout the Commonwealth. Massachusetts requires a CORI (Criminal Offender Record Information) and SORI (Sex Offender Registry Information) check before students begin clinical placements.
The Massachusetts CNA competency exam is administered by Prometric — the standard national testing company used by most states, making it straightforward for candidates familiar with the national format. The exam has two components: a written knowledge test (multiple-choice, 70 questions) and a clinical skills evaluation (5 randomly selected skills). Both components must be passed within 24 months of completing training. Testing sites are available in Boston, Worcester, Springfield, and other locations statewide. The written exam can also be taken as an oral/audio exam for candidates with reading challenges.
Boston and the Greater Metro area is Massachusetts' dominant CNA job market by a wide margin, with hundreds of approved training programs and an exceptional concentration of world-class healthcare employers. The top employers in the region include Massachusetts General Hospital (the largest hospital in New England), Brigham and Women's Hospital, Beth Israel Deaconess Medical Center, Boston Children's Hospital, Tufts Medical Center, and the broader Mass General Brigham (formerly Partners HealthCare) network. Boston is also home to major academic medical centers including Boston Medical Center (BMC), which serves as a safety-net hospital and major public-sector CNA employer. Training programs are widely available at Bunker Hill Community College, Roxbury Community College, and the American Red Cross of Massachusetts. The 1199SEIU union represents a significant portion of Boston-area healthcare workers, including CNAs at major hospitals and long-term care facilities, providing union benefits, step increases, and shift differentials. Boston metro CNAs typically earn $17–$22/hour, with hospital system CNAs at Mass General Brigham reaching $20–$25/hour for experienced staff. Cambridge, Somerville, Quincy, and Brookline all have strong CNA job markets tied to the Boston healthcare cluster.
Worcester and Central Massachusetts represent the state's second-largest CNA market. The dominant employer is UMass Memorial Medical Center — the University of Massachusetts' flagship academic medical center — which is the largest employer in Central Massachusetts. Saint Vincent Hospital (Tenet Healthcare) is the other major Worcester acute-care facility. The Worcester area also has a large long-term care and skilled nursing facility sector serving the aging Central MA population. Quinsigamond Community College and Worcester State University both offer or support CNA training programs in the region. The MassHire Central career center in Worcester actively partners with DPH-approved programs to fund free CNA training for eligible workers — making Worcester one of the best cities in the state to enter the profession at zero cost. Worcester CNAs typically earn $16–$20/hour, somewhat below Boston but with a significantly lower cost of living. Gardner, Fitchburg, Leominster, Milford, and the broader Central MA corridor all have active long-term care and post-acute care CNA job markets.
Springfield and Western Massachusetts form a distinct healthcare market anchored by Baystate Health — the dominant regional health system headquartered in Springfield, operating Baystate Medical Center (a Level I trauma center), Baystate Wing Hospital in Palmer, Baystate Franklin Medical Center in Greenfield, and Baystate Noble Hospital in Westfield. Mercy Medical Center (Trinity Health) and Cooley Dickinson Hospital in Northampton round out the major acute-care employers. Springfield Technical Community College (STCC) offers DPH-approved CNA training programs, and the MassHire Hampden County career center in Springfield provides funding support for eligible CNA trainees. Western MA CNA wages are typically $15–$18/hour — lower than Boston but proportionate to the lower cost of living in communities like Holyoke, Chicopee, Westfield, and Agawam. The Pioneer Valley has a significant long-term care sector given its older-than-average population demographics, providing steady CNA employment across nursing homes, assisted living facilities, and home health agencies.
Cape Cod and the South Shore of Massachusetts represent a distinctive CNA market shaped by the region's large seasonal and retirement population. Cape Cod Hospital (Cape Cod Healthcare) in Hyannis and Falmouth Hospital are the primary acute-care employers on the Cape, both of which hire CNAs for their hospital units and affiliated post-acute care facilities. The South Shore is anchored by South Shore Hospital in Weymouth (South Shore Health), which is a major community hospital employer for CNAs in Quincy, Braintree, Plymouth, and surrounding communities. The Cape and South Shore have a high density of skilled nursing facilities, assisted living communities, and adult day programs driven by the region's significant senior population. Cape Cod Community College offers CNA training in the region. Seasonal fluctuations affect some facilities, though long-term care employers maintain year-round CNA staffing needs. CNAs in this region typically earn $16–$20/hour, with some premium for healthcare workers willing to commute to more remote Cape locations.
North Shore and Lowell/Merrimack Valley form another strong secondary CNA market in Massachusetts. The North Shore is served by Beverly Hospital, Salem Hospital, and Lahey Hospital and Medical Center in Burlington — all major hospital employers for CNAs. Salem and Beverly are part of the Beth Israel Lahey Health system, providing career mobility across multiple facilities. Lowell General Hospital (Tufts Medicine) and nearby Lowell Community Health Center are major employers in the Merrimack Valley region. Lowell is also home to Middlesex Community College, which offers DPH-approved CNA training programs. The North Shore and Lowell corridor has a substantial long-term care sector — Peabody, Lynn, Salem, Lowell, and Lawrence all have multiple skilled nursing facilities and home health agencies. MassHire Merrimack Valley (Lawrence/Haverhill) and MassHire Metro North (Malden/Woburn) both offer workforce funding for CNA training candidates. North Shore and Lowell CNAs typically earn $16–$20/hour, with the 1199SEIU union active in several long-term care facilities in the region.
Visit the MA DPH website (mass.gov/dph) to search the official list of approved nurse aide training programs. Massachusetts has approved programs at community colleges, vocational schools, Red Cross chapters, hospitals, and nursing homes statewide. Verify the program appears on the current DPH-approved list before enrolling — programs not on the list cannot register candidates with Prometric. Consider MassHire career centers for funded free training opportunities.
Complete a TB test (PPD or chest X-ray), physical examination, and required immunizations (MMR, varicella, flu, hepatitis B). Obtain CPR/BLS certification from the American Heart Association or Red Cross. Initiate CORI (Criminal Offender Record Information) and SORI (Sex Offender Registry Information) background checks — required before clinical placement and typically processed within 1–2 weeks. Gather required immunization records per facility requirements.
Attend your DPH-approved program: minimum 60 hours of classroom instruction and 40 hours of supervised clinical practice. Topics include basic nursing skills, resident rights, infection control, anatomy and physiology, personal care, mental health needs, and safety procedures. Massachusetts programs range from intensive 3–4 week daytime tracks to 8–10 week evening/weekend formats for working adults. Programs at Bunker Hill Community College, Quinsigamond Community College, and Springfield Technical Community College are popular choices.
After completing your training program, your school will register you with Prometric. You'll receive an Authorization to Test (ATT) letter with instructions to schedule your exam online at prometric.com. Schedule both the written knowledge exam and clinical skills evaluation at your preferred testing location. Testing sites are available in Boston, Worcester, Springfield, and other locations. The exam fee is approximately $130–$150 for both components.
Take and pass the written knowledge exam (70 multiple-choice questions, 70% passing score) and the clinical skills evaluation (5 randomly selected skills from the state-approved skills list). Both components must be passed within 24 months of completing training. If you fail one component, you may retake it up to 3 times within 24 months without retaking training. Skills practice with a qualified skills examiner is strongly recommended before the exam.
After passing both exam components, Prometric submits your results to the MA DPH Nurse Aide Registry. Registry processing typically takes 2–4 weeks. You can verify your status by searching the online registry at mass.gov/dph. Employers are legally required to verify a CNA's registry status before hiring for patient care roles in licensed facilities. Registry listing confirms your certification is active, unencumbered, and valid to work in Massachusetts long-term care settings.
Massachusetts offers one of the strongest free CNA training programs in the country through the MassHire career center network — a statewide system of over 30 one-stop career centers funded by the Massachusetts Executive Office of Labor and Workforce Development (EOLWD). MassHire career centers partner with DPH-approved CNA training programs to fund tuition, fees, books, and sometimes even transportation and childcare for eligible job seekers.
To qualify for MassHire-funded CNA training:
Key MassHire locations that regularly fund CNA training include:
MassHire funding covers DPH-approved programs at community colleges, Red Cross chapters, and other approved providers. Call your local MassHire office or visit masshirestatewide.com to check current CNA program availability and eligibility. Many participants complete CNA training at zero personal cost through this program.