Certified Nursing Assistant
Certification requirements, cost and salary by state
Certified Nursing Assistants provide hands-on patient care — helping with bathing, dressing, feeding, mobility, and recording vital signs — under the supervision of registered nurses or LPNs. They work in nursing homes, hospitals, assisted living facilities, and home health settings. CNA certification is one of the fastest entry points into healthcare, typically requiring 4–12 weeks of state-approved training and a competency exam.
Time to certify
Required exam
Exam cost
Education
Renewal
Annual openings
What it's actually like
A day-to-day reality check, grounded in current practitioner sources — not just the salary math.
Hours / week
Shifts: 8 or 12 hours.
Weekends
Where you work: skilled nursing facility, hospital, assisted living facility.
Physical demand
HighThe role requires frequent lifting and transferring of patients, extensive periods of standing and walking, and repeated bending or stooping.
Stress level
HighStress stems from heavy workloads, high patient-to-staff ratios, and the emotional toll of caring for ill and dying patients.
A typical shift
- Assist 8-15 residents with activities of daily living, including bathing, dressing, grooming, and toileting.
- Measure and record vital signs such as blood pressure, temperature, pulse, and respiration for all assigned patients.
- Turn and reposition bedridden patients every two hours to prevent bedsores.
- Serve meals and assist residents with eating, carefully documenting their food and fluid intake and output.
- Answer patient call lights promptly and respond to their needs or requests.
- Clean and sanitize patient rooms, change soiled bed linens, and empty bedpans.
- Transport patients between their room and other areas of the facility, such as for therapy or dining.
check_circle Best fit if
- —You have a high degree of compassion and patience for individuals who are ill, disabled, or in distress.
- —You possess significant physical stamina and are comfortable being on your feet for long shifts and lifting/moving people.
- —You can remain emotionally stable and calm when dealing with stressful situations, including medical emergencies and patient death.
- —You are highly observant and detail-oriented, able to notice and report small changes in a patient's condition.
cancel Skip if
- —You are squeamish about or uncomfortable with close contact with bodily fluids and performing personal hygiene tasks for others.
- —You require a physically easy job, as this role involves constant activity, lifting, and potential for back strain.
- —You are seeking a career with significant upward mobility without the need for additional formal education.
- —You are easily stressed or emotionally drained by heavy workloads and high-stakes environments.
Sources cited (23)
- cnaprograms.org
- carestaffingprofessionals.com
- gabrielhealth.org
- cnacertifiednursingassistant.com
- nursa.com
- cnaclassesneworleans.com
- carerev.com
- shiftkey.com
- nih.gov
- reddit.com
- northeastmedicalinstitute.com
- allnursingschools.com
- midwesttech.edu
- wgu.edu
- interimhealthcare.com
- lyndenhealthed.org
- pmi.edu
- cna.plus
- pchslive.com
- indeed.com
- cynamed.com
- quora.com
- youtube.com
The Landscape
State-to-state differences in licensing requirements are substantial. Initial training hours vary wildly, from a mere 16 hours in states like Minnesota and Colorado to a demanding 100 hours in California and Missouri. While all 51 states require a license, the ongoing renewal criteria differ significantly; most require minimal work hours, but a few, such as Oregon and Vermont, demand a substantial 400 hours of paid work every two years, which can be a significant commitment for part-time CNAs. Many states also mandate a criminal background check, which is a universal hurdle for entry into the profession. A closely-related path worth comparing is the Medical Assistant certification. If you're choosing an entry-level healthcare path, our Certified Nursing Assistant vs. Medical Assistant guide contrasts training time, clinical exposure, and starting wages. If you're thinking about advancing further, see how Certified Nursing Assistant compares to Licensed Practical Nurse in time-to-credential, pay, and scope of practice.
Certified Nursing Assistant by State
Licensing cost, reciprocity, and median pay across all 50 states.
| State | License | Licensing cost | Reciprocity | Median | vs. National |
|---|---|---|---|---|---|
| Alabama | Yes | $135 | Endorsement | $34,140 | -19.2% |
| Alaska | Yes | $570 | Endorsement | $46,370 | +9.7% |
| Arizona | Yes | $130 | Re-exam | $44,780 | +6.0% |
| Arkansas | Yes | $150 | Endorsement | $34,430 | -18.5% |
| California | Yes | $140 | Endorsement | $47,630 | +12.7% |
| Colorado | Yes | $140 | Endorsement | $47,380 | +12.1% |
| Connecticut | Yes | $118 | Endorsement | $44,790 | +6.0% |
| Delaware | Yes | $115 | Endorsement | $42,030 | -0.5% |
| District of Columbia | Yes | $165 | Endorsement | $47,700 | +12.9% |
| Florida | Yes | $205 | Endorsement | $37,510 | -11.2% |
| Georgia | Yes | $130 | Endorsement | $37,680 | -10.8% |
| Hawaii | Yes | $225 | Endorsement | $45,350 | +7.3% |
| Idaho | Yes | $68 | Endorsement | $38,650 | -8.5% |
| Illinois | Yes | $85 | Endorsement | $45,960 | +8.8% |
| Indiana | Yes | $100 | Re-exam | $38,330 | -9.3% |
| Iowa | No | $175 | Endorsement | $39,350 | -6.9% |
| Kansas | Yes | $75 | Re-exam | $38,010 | -10.1% |
| Kentucky | Yes | $115 | Endorsement | $38,370 | -9.2% |
| Louisiana | Yes | $100 | Endorsement | $30,510 | -27.8% |
| Maine | Yes | — | Endorsement | $47,070 | +11.4% |
| Maryland | Yes | $125 | Endorsement | $43,240 | +2.3% |
| Massachusetts | Yes | $110 | Endorsement | $46,680 | +10.5% |
| Michigan | Yes | $125 | Endorsement | $39,570 | -6.4% |
| Minnesota | Yes | $265 | Endorsement | $46,680 | +10.5% |
| Mississippi | Yes | $114 | Endorsement | $31,520 | -25.4% |
| Missouri | Yes | $135 | Endorsement | $37,680 | -10.8% |
| Montana | Yes | $97 | Endorsement | $40,900 | -3.2% |
| Nebraska | Yes | — | Endorsement | $40,000 | -5.3% |
| Nevada | Yes | $200 | Endorsement | $45,490 | +7.6% |
| New Hampshire | Yes | $140 | Endorsement | $47,870 | +13.3% |
| New Jersey | Yes | $76 | Re-exam | $46,830 | +10.8% |
| New Mexico | Yes | $132 | Endorsement | $39,390 | -6.8% |
| New York | Yes | $115 | Endorsement | $48,590 | +15.0% |
| North Carolina | Yes | $140 | Endorsement | $38,460 | -9.0% |
| North Dakota | Yes | $275 | Endorsement | $45,820 | +8.4% |
| Ohio | Yes | $104 | Endorsement | $39,010 | -7.7% |
| Oklahoma | Yes | $160 | Endorsement | $35,930 | -15.0% |
| Oregon | Yes | $212 | Endorsement | $49,830 | +17.9% |
| Pennsylvania | Yes | $121 | Endorsement | $44,590 | +5.5% |
| Rhode Island | Yes | $200 | Endorsement | $46,440 | +9.9% |
| South Carolina | Yes | $140 | Endorsement | $37,220 | -11.9% |
| South Dakota | Yes | $170 | Endorsement | $38,800 | -8.2% |
| Tennessee | Yes | $110 | Re-exam | $37,990 | -10.1% |
| Texas | Yes | $125 | Endorsement | $37,500 | -11.3% |
| Utah | Yes | $110 | Endorsement | $39,840 | -5.7% |
| Vermont | Yes | $150 | Endorsement | $47,130 | +11.5% |
| Virginia | Yes | $140 | Endorsement | $43,200 | +2.2% |
| Washington | Yes | $240 | Endorsement | $49,180 | +16.4% |
| West Virginia | Yes | $125 | Endorsement | $36,720 | -13.1% |
| Wisconsin | Yes | $163 | Endorsement | $45,130 | +6.8% |
| Wyoming | Yes | $165 | Endorsement | $39,160 | -7.3% |
Related Certifications
Compare Certified Nursing Assistant head-to-head
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