What is a certified nursing assistant? CNA job and training
Free to read: this guide is paid for by ads. No school, employer or test provider pays to be mentioned, and we don't rank programs. How we make money.
On this page
The short answer
A certified nursing assistant (CNA) gives everyday care, like help with bathing, dressing and eating, under the direction of licensed nursing staff. Federal rules say a state-approved nurse aide training program must have "no less than 75 clock hours of training", followed by a competency evaluation. Nursing homes check the state's nurse aide registry, with a few exceptions, before someone starts work as an aide. 1 2 5
What a certified nursing assistant does
A CNA is a hands-on helper on the care team. The US Department of Labor's O*NET database describes the job like this: "Provide or assist with basic care or support under the direction of onsite licensed nursing staff." 1
In plain terms, that's the daily help people need when they can't do everything for themselves. O*NET's list of duties includes "feeding, bathing, dressing, grooming, toileting, or ambulation of patients in a health or nursing facility." Ambulation just means helping someone walk. 1
O*NET also lists single tasks. Two of them: "Turn or reposition bedridden patients." And "Feed patients or assist patients to eat or drink." 1
Notice the words "under the direction of". A CNA isn't a nurse. You work under licensed nursing staff. 1 In training, students must not perform "any services for which they have not trained and been found proficient by the instructor." 2
Other names for the same job
Job ads don't all say CNA. O*NET lists the job titles workers report. Among them are "Licensed Nursing Assistant (LNA)", "Patient Care Assistant (PCA)" and "State Tested Nursing Assistant (STNA)". 1
Federal law uses "nurse aide" for the role in nursing homes. 2 So if your state's website talks about nurse aides rather than CNAs, it means the same kind of job.
The training: 75 hours at the federal minimum
Federal rules set the floor for nurse aide training. A state-approved program must, "at a minimum", "Consist of no less than 75 clock hours of training". It must also "Include at least 16 hours of supervised practical training." 2
That practical part is hands-on. You work on real tasks "under the direct supervision of a registered nurse or a licensed practical nurse." 2
Some lessons come first. Before any direct contact with a resident, the program must include "At least a total of 16 hours of training" in set areas. These cover communication, infection control, safety and emergency procedures, residents' independence and residents' rights. The course list also includes "Taking and recording vital signs" and "Transfers, positioning, and turning." 2
The 75 hours is a minimum, not a fixed number. Your state approves the programs, so check its nurse aide registry or health department for the hours it asks for. 2 There's more on the course itself in our guide to how CNA training programs run.
The competency exam: a test and a skills check
After training comes the competency evaluation. It has two parts.
The first is a written or oral exam. You get to pick: the rules say it must "Allow an aide to choose between a written and an oral examination." An oral exam "must be read from a prepared text in a neutral manner." 3
The second is a skills demonstration. It uses "randomly selected items" from a pool of "the tasks generally performed by nurse aides." That pool "must include all of the personal care skills" from the training list. 3
Who gives the exam? Either the state itself or a state-approved group. That group can't be a nursing home taking part in Medicare or Medicaid. 3 Your state can tell you which group runs its exam. That group's candidate handbook is the authority on what you'll be asked to do.
Certified, licensed or registered?
People often say "CNA license". The federal rules describe something a little different: a state list of trained aides. "The State must establish and maintain a registry of nurse aides". 4
Nursing homes check that list. Before someone serves as a nurse aide, "a facility must receive registry verification that the individual has met competency evaluation requirements". There are two exceptions. One is someone who "Is a full-time employee in a training and competency evaluation program approved by the State". The other is someone who can prove they recently passed and "has not yet been included in the registry." 5
Long breaks matter too. Picture "a continuous period of 24 consecutive months" with no paid "nursing or nursing-related services". After that, the rule says you "must complete a new training and competency evaluation program or a new competency evaluation program." 5 Your state's registry has its own renewal details.
What CNA training costs, and when it's free
Prices vary from program to program, and there isn't one national fee. One federal rule matters a lot here, though.
Say a nursing home employs you, or has offered you a job, on the day your program starts. Then you can't be "charged for any portion of the program". That includes "any fees for textbooks or other required course materials". 2
There's also a rule for people who pay first. It covers you if a nursing home hires you, or offers you a job, "not later than 12 months after completing" the program. Then "the State must provide for the reimbursement of costs" on a "pro rata basis" while you work as a nurse aide. 2 Pro rata means in proportion. Ask your state registry how it handles this.
CNA pay and job numbers
O*NET shows national figures from the Bureau of Labor Statistics. It lists "Median wages (2025) $20.32 hourly, $42,260 annual" for nursing assistants. Median means half earn more and half earn less. 1
The same page gives "Employment (2025) 1,505,900 employees" and "Projected job openings (2025-2035) 196,200". 1 These figures were read on 7 November 2026, and O*NET credits them to "Bureau of Labor Statistics 2025 wage data". 1
Frequently asked questions
What is a certified nursing assistant in simple words?
It's someone who helps people with daily care, like bathing, dressing, eating and moving around, while working under licensed nursing staff. O*NET describes the job as providing "basic care or support under the direction of onsite licensed nursing staff." 1
How many hours of training does a CNA need?
Federal rules set a minimum of "no less than 75 clock hours of training", including "at least 16 hours of supervised practical training". Your state approves programs and can ask for more, so check its nurse aide registry. 2
Is a CNA the same as a nurse?
No. A CNA works "under the direction of onsite licensed nursing staff". During training, hands-on practice happens under the supervision of "a registered nurse or a licensed practical nurse". 1 2
Can I get CNA training for free?
Sometimes. If a nursing home employs you or has offered you a job when your program starts, federal rules say you can't be "charged for any portion of the program". That includes textbooks and other required course materials. Ask the employer or program about any work commitment. 2
Sources
- Nursing Assistants (31-1131.00), O*NET OnLine, US Department of Labor. Checked 7 November 2026.
- 42 CFR 483.152: Requirements for approval of a nurse aide training and competency evaluation program, Legal Information Institute, Cornell Law School. Checked 7 November 2026.
- 42 CFR 483.154: Nurse aide competency evaluation, Legal Information Institute, Cornell Law School. Checked 7 November 2026.
- 42 CFR 483.156: Registry of nurse aides, Legal Information Institute, Cornell Law School. Checked 7 November 2026.
- 42 CFR 483.35: Nursing services, Legal Information Institute, Cornell Law School. Checked 7 November 2026.