A CNA license — formally called a Certified Nursing Assistant certification — is a state-issued credential that authorizes you to provide basic patient care in nursing homes, hospitals, assisted living facilities, and home health settings. Each state maintains a CNA registry, which is a public database of all individuals who have met the training and competency requirements established by that state's health authority.
Unlike some healthcare licenses, CNAs are not licensed through a national body. Instead, each state sets its own training hour requirements, competency exam standards, and renewal schedules. This means your CNA license is technically state-specific, though most states participate in a reciprocity system that allows certified CNAs to transfer their credentials without starting training over from scratch.
The CNA credential is regulated under federal law — specifically the Omnibus Budget Reconciliation Act of 1987 (OBRA 87), which established minimum training requirements for nursing aides working in Medicare- and Medicaid-certified facilities. States may impose requirements above the federal minimum (75 training hours) but cannot go below it. In practice, most states require between 75 and 175 hours of combined classroom and clinical training.
Earning your CNA license follows a standardized process across all states, though the specific requirements vary. Here is the general pathway:
Enroll in a CNA training program approved by your state's health department or Board of Nursing. Programs are offered at community colleges, vocational schools, Red Cross chapters, long-term care facilities, and some hospitals. Most programs run four to twelve weeks, depending on the state's hour requirements. Federal minimum is 75 hours (combining classroom instruction and clinical practice); states like California require 160 hours, while Texas requires 75 hours.
After completing your training, you must pass the state competency examination, which has two parts: a written (or oral) knowledge test and a skills demonstration portion. The written test typically consists of 60 to 90 multiple-choice questions covering nursing assistant duties, patient rights, infection control, safety, and communication. The skills test requires you to demonstrate five randomly selected clinical skills in front of an evaluator. Pearson VUE and Prometric administer the exam in most states.
Once you pass the competency exam, the testing vendor typically submits your results directly to the state registry. In some states, you may need to submit a separate application along with your exam results, background check, and application fee. Processing times range from a few days to a few weeks. You are not legally permitted to work as a CNA until your name appears on your state's registry.
The CNA registry is a publicly searchable database maintained by each state. Employers are required by law to check the registry before hiring a nursing assistant, but CNAs can also look up their own credentials to confirm their active status, certification number, and expiration date.
Each state has its own registry portal. Most allow free public searches by name, Social Security Number (last four digits), or certification number. To find your state's registry, search for '[State] CNA registry' or '[State] nurse aide registry' — the official state health department or Board of Nursing site will have the lookup tool.
Your registry record shows your name, certification number, current active status, expiration date, and any flags for substantiated findings of abuse, neglect, or misappropriation of property. It is critical to ensure your name is spelled correctly and your expiration date is accurate — discrepancies can delay employment.
Your certification number (also called certificate number or license number) is assigned when you first appear on the state registry. It appears on your certificate document and on your online registry entry. If you have lost your certificate, you can retrieve your certification number by searching the state registry or calling your state's registry office directly.
CNA reciprocity — also called endorsement or reciprocity — allows a certified nursing assistant who holds an active, unencumbered license in one state to apply for certification in another state without repeating training or retaking the full competency exam. Most states participate in reciprocity, making it relatively straightforward to relocate and continue working as a CNA.
To transfer your CNA license through reciprocity, you typically need to:
A few states have additional hurdles for reciprocity applicants. California requires all CNAs — including those transferring — to meet the state's 160-hour training requirement. If you trained in a state with fewer hours, California may require you to complete additional training. New York requires transfer applicants to demonstrate active employment as a CNA within the past 24 months. Always contact the new state's registry office before applying to confirm current requirements, as they change periodically.
Most states process reciprocity applications for a nominal fee or free. States known for streamlined, low-cost reciprocity processes include Ohio, North Carolina, Missouri, and Wisconsin. Some states in the Nurse Licensure Compact (NLC) — primarily for RNs and LPNs — are working toward similar multi-state agreements for CNAs, though as of 2025 no formal multi-state CNA compact exists. Each CNA must apply individually to each state where they wish to work.
CNA certifications do not last indefinitely — they must be renewed on a regular schedule, typically every two years. Renewal requirements vary by state but generally involve demonstrating active employment as a CNA and completing continuing education hours.
Most states require that you have worked a minimum number of hours as a paid nursing assistant during the certification period to renew. The federal minimum is eight hours of paid work as a CNA within the two-year certification period. Many states match this minimum, while others require more. In California, CNAs must complete 48 hours of in-service education every two years in addition to meeting the employment requirement.
Some states require continuing education units (CEUs) for CNA renewal. Topics may include infection control updates, resident rights, dementia care, and safety procedures. Your employer's in-service training often counts toward these hours — check with your HR department to confirm documentation requirements.
If your certification lapses, you cannot legally work as a CNA until it is reinstated. Most states allow a grace period reinstatement for recently expired certifications, which may require completing continuing education hours and paying a late fee. If your certification has been expired for more than a specified period (often two to four years), you may be required to retake the full competency exam — and in some cases, repeat the training program.