Last updated: February 19, 2026. This guide is educational and summarizes federal baseline rules plus common state workflows.
CNA Requirements in 2026: Fast Answer
CNA certification is state-regulated, but every state workflow follows the same core pattern:
- Meet eligibility/background requirements.
- Complete a state-approved nurse aide training program.
- Pass a competency exam (knowledge + skills).
- Get listed on the state nurse aide registry.
- Maintain active status through work/renewal rules.
Federal Baseline (What States Build On)
Under federal long-term-care framework:
- NATCEP programs must include no less than 75 clock hours.
- Program must include at least 16 hours of supervised practical training.
- Competency evaluation includes a written or oral exam plus skills demonstration.
- States maintain nurse aide registries and can remove aides with no qualifying nursing services for 24 consecutive months.
States can and do set higher requirements than the federal minimum.
Step-by-Step State Process (2026)
Step 1: Confirm Eligibility
Common state checks:
- minimum age (often 16-18)
- identity/legal work documentation
- criminal background and fingerprint screening rules
- health screening/immunization requirements by program/employer
Step 2: Complete State-Approved Training
Most programs include:
- classroom/theory
- skills lab
- clinical practice
Typical Training Range
| Requirement Type | Typical Range |
|---|---|
| Total hours | 75 to 180+ (state-specific) |
| Clinical component | State/program specific |
| Program length | 4 to 12 weeks |
Step 3: Pass the Competency Exam
Most state testing models include two parts:
- knowledge test (written or oral)
- skills exam with randomly selected tasks
You must pass both components to move to registry listing.
Step 4: Registry Listing and First Employment
After passing:
- results are sent to the state registry
- certification/listing posts after processing
- employers verify registry status before hire
Step 5: Maintain Certification
Most states run renewal cycles (often every 2 years) with active-work and, in some states, CE or in-service requirements.
State Timeline Model (Realistic)
| Phase | Typical Duration |
|---|---|
| Program enrollment + onboarding | 1-3 weeks |
| Training completion | 4-10 weeks |
| Exam scheduling + testing | 1-4 weeks |
| Registry posting + job onboarding | 1-4 weeks |
| Total path | ~6-16 weeks |
Cost Planning (2026)
| Cost Area | Typical Range |
|---|---|
| Training tuition | Varies widely by provider and state |
| Exam fees | State/vendor dependent |
| Background/fingerprint | State dependent |
| Uniform/supplies/health docs | Program dependent |
Some employers or workforce programs reimburse part or all training costs.
Reciprocity Basics (State-to-State Transfers)
Many states allow endorsement/reciprocity-like transfer pathways, but requirements differ.
Common transfer requirements:
- active status in original state registry
- no disqualifying findings
- good standing documentation
- state-specific application and timelines
Always verify with destination state registry before relocating.
Renewal and Active-Status Rules
Federal registry rules allow removal after 24 consecutive months with no qualifying nursing or nursing-related services. States can layer extra renewal obligations (such as forms, employer verification, and in-service hours).
Common Mistakes That Delay Certification
- Taking a non-approved training program.
- Waiting too long to schedule the competency exam.
- Failing documentation checks (ID/background forms).
- Letting registry status lapse after long inactive periods.
- Assuming reciprocity is automatic between states.
4-Week Exam Prep Sprint (After Training)
Week 1
- patient safety, infection control, communication basics
Week 2
- ADLs, mobility, elimination, nutrition workflows
Week 3
- skills checklists + timed scenario drills
Week 4
- full mixed sets + final critical-step review