CNA Certification – State Differences

CNA Training

In the United States, there are federal regulations that determine the many details for mandatory training and certification processes for Certified Nursing Assistants. Despite these federal guidelines, each state has a unique approach to instruction and employment for CNAs. It can be difficult to find answers about your specific state because there are so many different policies, and this leaves many scratching their heads without the answer they’re seeking. This is a general idea of how each state differs in their certification requirements for nurse aides.


The biggest difference between each state’s training requirements is the total number of instruction hours necessary to challenge the certification test. The federal government sets the minimum at 75 hours, and many states are content with that number. But other states require additional training, with some requiring as many as 180 hours. Even when two states have the same number of required hours, the make-up of those hours can be very different. For the most part, the clinical portion of training is always longer than the classroom portion. In some states, classroom training is less than a third of the required instruction, and in others it makes up over 50%. And there are even states that don’t require any training to be completed before the certification exam can be challenged.


Each state uses its own format for the certification test. Most handle the process through their Board of Nursing and Nurse Aide Registry, but others employ private test-providing companies to handle distribution and results. In these cases, it is important to register with your state board and the test provider in order to avoid any delays or mix-ups with your application and test-score. The one aspect of testing that all states share is the basic format of the test. All certification tests come in two parts: a written section and a skills section. The written section is a multiple-choice test with anywhere between 50 and 80 questions. The skills section requires that nurse aides perform basic and complex tasks randomly selected by the test proctor on the day of the exam.


In general, it isn’t possible to be employed as a CNA without passing the certification test. However, there are some exceptions in several states. It is possible to begin working as a nursing assistant before passing the competency evaluation if an offer of employment is received before graduating from training. In this case, the trainee must apply for a temporary certificate from their Nurse Aide Registry. Temporary certificates only last a few weeks and will not suffice for permanent employment.

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