You become a CNA by completing a state-approved nurse aide training program, passing your state's two-part competency exam, and getting listed on your state's nurse aide registry.
Federal rules set the floor — no less than 75 clock hours of training, including at least 16 hours of supervised practical training — and each state approves programs, runs the exam and keeps the registry.
Here is the full route, step by step.
What does it take to become a CNA?
Becoming a certified nursing assistant takes four things: meeting your state's entry requirements, completing a state-approved nurse aide training program, passing the state's competency evaluation, and getting listed on the state nurse aide registry.
What varies is everything stacked on top of that path.
Federal rules set the floor: a state-approved nurse aide training and competency evaluation program of no less than 75 clock hours, including at least 16 hours of supervised practical training (42 CFR 483.152).
Each state specifies which programs it approves as meeting that federal standard (42 CFR 483.151) and keeps its own nurse aide registry.
The hour totals, entry details and exam logistics that differ from state to state are the parts each state writes on top of the floor.
The registry listing is the credential at the end: per BLS, nursing assistants must be on the state registry to work in a nursing home.
This page walks the route at the national level; the CNA career guide covers the job itself — duties, settings, scope and pay.
Confirm your state's requirements before you enroll
Step 1: Meet the eligibility basics (age, education, background)
Start at the door.
The education the federal rules name for nurse aides is one thing: completion of a state-approved nurse aide training and competency evaluation program, which must run no less than 75 clock hours.
A degree is not part of that federal standard.
Minimum age is decided state by state: our national research did not confirm a single minimum age for CNA training or testing, so check the age your state requires before you plan around a birthday.
The same goes for background screening: check the screening requirements your state's nurse aide agency or registry publishes before you pay for a class.
One eligibility-adjacent fact is worth knowing up front, because it shapes your first job: before a nursing facility lets anyone work as a nurse aide, it must receive registry verification that the person met the competency requirements.
Step 2: Finish a state-approved training program
The approval is the gate.
Each state specifies which nurse aide training and competency evaluation programs it approves as meeting the federal requirements, and only a state-approved program leads to the nurse aide registry (42 CFR 483.151).
The federal floor is no less than 75 clock hours of training, and states may require more.
At least 16 of the hours must be supervised practical training: time in a laboratory or similar setting where you perform tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse.
Federal rules also require at least 16 hours of training before any direct contact with a resident.
That early block covers communication and interpersonal skills, infection control, safety and emergency procedures, promoting residents' independence, and respecting residents' rights.
The required skill list goes on from there: personal care skills every program must teach include bathing, grooming including mouth care, dressing, toileting, assisting with eating and hydration, proper feeding techniques, skin care, and transfers, positioning and turning.
Where do approved programs live?
BLS says they are offered in high schools, community colleges, vocational and technical schools, hospitals, and nursing homes.
Your state's registry, or the agency that approves programs, keeps the current list — start there, because a class that is not on it will not get you onto the registry, whatever its website promises.
One train-on-the-job route exists on the nursing home side: federal rules let a nursing facility use someone as a nurse aide for up to 4 months on a full-time basis while that person works toward competence.
During that window the facility may use the person only as a full-time employee who is enrolled in a state-approved program, has demonstrated competence through one, or is otherwise deemed competent — and states may set shorter limits.
Step 3: Pass the competency exam and get on the registry
Training ends with the nurse aide competency evaluation, and the federal rules spell out its shape (42 CFR 483.154).
There are two parts: a written or oral examination — the aide chooses between them — and a skills demonstration made up of randomly selected tasks.
You must pass both parts.
The skills demonstration is administered and evaluated by a registered nurse with at least one year of experience caring for the elderly or the chronically ill.
If an attempt does not go your way, federal rules require states to allow at least three attempts at the evaluation; a state may cap the number, but never below three.
Passing converts you from candidate to credential.
Federal rules require your state to add a record of your successful evaluation to the nurse aide registry within 30 days of finding you competent, and states may not impose any charges related to being listed.
For test-day logistics — the format, the fee and how to schedule — ask your state's registry or your training program for the current details before you book.
Step 4: Land your first CNA job
Your first job starts with a check, not a résumé.
Before a nursing facility allows anyone to serve as a nurse aide, it must receive registry verification that the person met the competency requirements, and it must check every state registry it believes has information on them.
That is why the registry listing, not the course certificate, is the document of this trade: BLS puts it plainly — nursing assistants must be on the state registry to work in a nursing home.
On pay: BLS reports a median annual wage of $42,260 for nursing assistants as of May 2025, the occupation that covers CNAs in every setting.
The same source projects 3% employment growth for nursing assistants and orderlies from 2025 to 2035, with about 203,300 openings per year.
The CNA salary page breaks the wage data down by state.
When you are ready to apply, the CNA jobs board here lists senior and home care openings — nursing homes, home health and hospice providers, assisted living and memory care communities, and the agencies that staff them.
Protect the credential once you have it.
If a nurse aide goes 24 consecutive months without providing nursing or nursing-related services for pay, federal rules require completing a new training and competency evaluation program or a new competency evaluation.
Your state's registry may layer renewal or reactivation rules on top, so check its requirements before taking a long break from paid nurse aide work.
How long and how much does it all take?
Time first.
How long the program runs follows your state's required hours and your schedule: the federal floor is no less than 75 clock hours, and states may require more.
The American Red Cross discontinued its Nurse Assistant Training program — no Red Cross Nurse Assistant Training course has been scheduled after December 31, 2023 — so today's classes come from the schools, colleges, hospitals and nursing homes described in step 2.
For a rough length, the Red Cross's CNA training page describes CNA classes as generally lasting at least 4–12 weeks, with some programs up to 6 months, depending on the state.
After the program, the state's clock takes over: the registry gets 30 days from your passing record to list you, and states must allow at least three attempts at the exam if you need them.
Money next.
Our national research did not confirm a typical tuition or exam fee — the only national pricing figures our researchers found were on lead-gen sites, not primary sources — so compare the approved programs in your state directly.
Federal law does give one group a route with the bill covered.
No nurse aide who is employed by, or has an offer of employment from, a nursing facility on the day they start a nurse aide training and competency evaluation program may be charged for any part of it, textbooks and required course materials included.
The same no-charge and reimbursement protections cover the competency evaluation.
If you pay your own way and a nursing facility hires you — or offers you a job — within 12 months of finishing, the state must provide for reimbursement of your training costs on a pro-rata basis while you work as a nurse aide.
How it is paid, by the facility or the state, is set by each state.
Those protections attach to employment by a Medicare- or Medicaid-certified nursing facility, not to every student who enrolls — they are narrower than free training for everyone.
Listing on the registry itself costs nothing: states may not impose any charges related to registration.
Can you become a CNA online?
Not end to end — and the reason is written into the federal rules.
Nurse aide training must include at least 16 hours of supervised practical training, which means performing tasks on an individual in a laboratory or similar setting under the direct supervision of an RN or LPN.
The competency evaluation adds an in-person skills demonstration on top.
That hands-on requirement is why a CNA credential cannot be earned entirely online; at most, the classroom or theory portion can be delivered online where the state allows it.
The line to check with any program is approval, not format.
Only state-approved programs lead to the registry, so before paying for an online or hybrid course, find it on your state's approved-program list.
A program that promises certification with no supervised practical hours and no skills test is not a route to the registry.
If you want the flexibility of online study, ask programs directly how they split the hours.
Theory online, with the supervised practical training and the skills demonstration in person, is the shape that fits the federal rules — where the state allows the theory portion online.
Career information, not licensing, legal, medical or tax advice: training, exam and registry rules are state rules on a federal floor, so confirm the current requirements with your state's nurse aide registry or the agency that approves programs before you enroll, test or apply.