Becoming a CNA requires a certification, and which state you’re in will dictate the requirements to become a CNA to some extent. The coursework required to become a CNA is similar from state to state. The classes are similar due to the Omnibus Budget Reconciliation Act of 1987 which set minimum standards for Nursing Assistant educational requirements.
Differing CNA Requirements by State
One of the main differences in how one gets CNA certified from state to state is the required classroom and clinical hours in an accredited CNA program and the required clinical hours. Minimum class hours are federally mandated at 75 hours, though some states require as many as 180 (Maine).
State Minimum Training Hours Minimum Clinical Hours
Alabama 75 16
Alaska 140 80
Arizona 120 40
Arkansas 90 16
California 150 100
Colorado 75 16
Connecticut 100 50
Delaware 150 75
District of Columbia 120 75
Florida 120 40
Georgia 85 24
Hawaii 100 70
Idaho 120 32
Illinois 120 40
Indiana 105 75
Iowa 75 30
Kansas 90 45
Kentucky 75 16
Louisiana 80 40
Maine 180 70
Maryland 100 40
Massachusetts 75 16
Michigan 75 16
Minnesota 75 16
Mississippi 75 16
Missouri 175 100
Montana 75 25
Nebraska 75 16
Nevada 75 n/a
New Hampshire 100 60
New Jersey 90 40
New Mexico 75 n/a
New York 100 30
North Carolina 75 16
North Dakota 75 16
Ohio 75 16
Oklahoma 75 16
Oregon 155 75
Pennsylvania 80 37.5
Rhode Island 100 20
South Carolina 100 40
South Dakota 75 16
Tennessee 75 35
Texas 100 40
Utah 100 24
Vermont 80 30
Virginia 120 40
Washington 85 50
West Virginia 120 55
Wisconsin 120 32
Wyoming 75 16
Additional differences from state to state include the number of questions on the written portion of the CNA exam and the amount of time allotted for the exam. Further, the clinical skills test may require certain skills to be demonstrated while other states may not. If you’d like to practice up for the CNA certification exam and the skills test, CNA Free Training provides a number of resources including our free CNA practice test and our guide to acing the CNA skills exam.
Depending on the state you’ll be aiming to gain your CNA certification in, they may use one of four different providers for CNA exams. That list is as follows:
- Headmaster: AZ, MA, MN, MT, ND, NH, NJ, NV, OH, OR, SD, TN, WI, VT
- Credentia: AL, AK, CA, CO, DC, GA, MD, MS, NC, PA, RI, SC, WA
- Prometric: AR, CT, DE, FL, HI, ID, LA, MI, NM, NY, OK, TX, VT, WY
- Additionally – several states that previously used the American Red Cross as the third party facilitator of CNA testing now use their own specific testing entities: (as of December 31st, 2023, the American Red Cross ceases to offer CNA exam facilitation, https://www.redcross.org/take-a-class/lp/certified-nursing-assistant-nat )
- IL: Southern Illinois University at Carbondale
- IN: Ivy Tech Community College
- KY: Kentucky Community and Technical College System
- ME: Maine Registry of Certified Nursing Assistants and Direct Care Workers
- NH: Excel Testing
- UT: Utah Nursing Assistant Registry
- WV: Professional Healthcare Development
The table below highlights the different skills tested by the provider, with the required skills highlighted.
Skill Pearson Vue Prometric Headmaster
Hand Hygiene (Hand Washing) x* x* x
Applies one knee-high elastic stocking x x
Assists to ambulate using transfer belt x x* x
Assists with use of bedpan x x x
Cleans upper or lower denture x x x
Counts and records radial pulse x x x
Counts and records respirations x x x
Donning and removing PPE (gown and gloves) x
Dresses client with affected arm x x
Feeds client who cannot feed self x x x
Gives modified bed bath (face and one arm, hand and underarm) x x
Measures and records blood pressure x x
Empty, measure and record urinary output x x
Measures and records weight of ambulatory client x x
Performs modified passive range of motion (PROM) for one knee and one ankle x x
Performs modified passive range of motion (PROM) for one shoulder x x
Positions client on side x x x
Provides catheter care for female x x
Provides foot care on one foot x x
Provides mouth care x x x
Provides perineal care (PERI-CARE) for female x x
Transfers from bed to wheelchair using transfer belt x x x
Indirect Care x*
Change bed linen while the resident remains in bed (not tested in Wyoming) x x
Provide hand and nail care x x
Gives partial bed bath and back rub x
Provide resident with passive range of motion (ROM) exercises to one elbow and wrist x
Abdominal Thrust x
Ambulation with cane or walker x
Back rub x
Dressing client x
Fluid intake x
Hair care x
Mouthcare of a comatose client x
Passing fresh water x
Range of motion exercise x
Transfer from wheelchair to bed using a gait belt x
Additional State-by-State CNA Requirements
There are some near-universal elements from state to state in terms of how to get a CNA license, such as having a high school diploma or GED equivalent, proof of immunization, the ability to pass a background check, and valid identification. However, there are other discrepancies as far as requirements and processes. Some of these include:
- Educational and background requirements to become a CNA
- Cost of application and testing
- Application process
- CNA certification renewal process
- Lists of approved educational providers
- Required score to achieve CNA certification
Another CNA site has a comprehensive list of state-by-state requirements, approved programs, and additional information on items like continuing education for CNAs. The links below will take you directly to the individual state pages.
Additional CNA Certification FAQs
Beyond the technical ins and outs of CNA classes and the certification process there are also a number of other concerns people have as they look to successfully complete the CNA certification process. We’ll do our best to provide those answers below.
How long does it take to become a CNA? How long are CNA classes?
As the chart above illustrates, the minimum required classroom hours to become a CNA is 75 hours, and a maximum of 180. This is usually accompanied by two weeks in a clinical setting (the hours there may vary slightly as well). Typically, the entire program will take roughly 4-12 weeks to complete.
What is the cost of CNA certification?
The cost of your CNA certification depends on a number of factors, the main one being the cost of your CNA classes. Estimates for the average cost of a CNA program is around $1,300, though that could be high or low depending on your location. Fortunately, there are a number of ways to knock down this figure through scholarships or by finding grants or work exchange programs. We have a massive database of programs in each state that provide free and paid CNA classes. Follow that link and select your state to find a location that offers CNA classes near you.
Many medical centers and nursing homes will offer to pay for your certification with an agreement that you will work for that organization for a set period of time after you achieve your CNA certification. Beyond that, there is typically a fee paid to take the CNA written exam and skills test. On average, you can expect this cost to be around $100 to $150 for the application fee and the examination fee.
What do I need to know about CNA recertification?
Once you’re certified as a CNA, you’ll need to be recertified periodically to maintain your licensure. If you don’t renew your certificate before it expires you’ll have to pay a delinquency fee. Whether you’re going after a CNA renewal or recertification the process is basically the same.
- Find out the time period required for renewal (most states are two years, though this can vary)
- Complete the CNA renewal form. You should receive this four months before your certificate expires. If you change addresses or don’t receive the form, contact your state’s registry to obtain the form. You must complete this form to begin the recertification process.
- Completion of continuing education requirements (often this is 48 hours of continuing education for every two years). This will typically cover items like domestic violence, patient rights, medical record documentation, and first aid.
- Pass a routine background check. This will usually check for things like felony charges, which could pose problems in the recertification process.
- Check your renewal status online to make sure you have been recertified/renewed.
A couple more notes on CNA recertification.
- Most states will require that you prove you have worked as a CNA at some point in the previous 24 months leading up to your renewal.
- Many employers will pay for continuing education courses, so be sure to ask your employer about this to save yourself those costs.
More helpful links
If you’ve read this far you’ve clearly got an interest in becoming a CNA. The following links will provide you with a tremendous amount of information on things like preparing for the CNA written examination, how much to expect from a CNA salary, finding places where CNAs can work (like nursing homes), putting together a CNA resume, and what to expect from CNA interview questions.