1.1 Maryland CNA-I Path
Key Takeaways
Since April 1, 2026, Maryland has two titles: a CNA-I can work in any setting, including a nursing facility or skilled nursing facility, and a CNA-II cannot work in a nursing facility or skilled nursing facility.
New applicants can only be certified as CNA-I, and every applicant completes an approved training program and passes the nursing assistant competency evaluation, even for hospital-only work.
A Maryland nursing assistant training program runs at least 100 hours: at least 60 hours of classroom and lab instruction and 40 hours of supervised clinical training, 16 of them in long-term care or care of the elderly or chronically ill (COMAR 10.39.02.06).
Credentia (NNAAP) or D&SDT-Headmaster gives the competency evaluation; the Maryland Board of Nursing (MBON) issues the certificate, keeps the registry, and handles renewals.
Former CNA/GNAs became CNA-I and former CNAs became CNA-II with the same certificate number; there is no separate GNA designation, though some older vendor and employer pages still say GNA.
Maryland's CNA-I and CNA-II Titles
Maryland's nursing assistant law changed on April 1, 2026 (HB1125/SB0999 of 2024, as amended by Chapter 416 of 2025). There are now two titles:
- CNA-I can work in any practice setting, including a nursing facility or skilled nursing facility (long-term care).
- CNA-II can work in any setting except a nursing facility or skilled nursing facility.
New applicants can only apply for CNA-I. Only people who held a CNA certificate on March 31, 2026 can be CNA-II, so no one new enters that title. Every applicant now takes the nursing assistant competency evaluation, even someone who only plans to work in a hospital.
The change was automatic for people already certified. A CNA/GNA became a CNA-I and a CNA without the GNA designation became a CNA-II; the certificate number did not change, and there is no separate GNA designation any more. A CNA-II who wants to work in long-term care completes a Board-approved nursing assistant training program and passes the competency evaluation. Older vendor pages, employer forms and study materials may still say "GNA": read that as CNA-I.
Credential Map
| Maryland title | What it means | Who controls it |
|---|---|---|
| CNA-I (formerly CNA/GNA) | Any practice setting, including nursing facilities and skilled nursing facilities; the only title open to new applicants | Maryland Board of Nursing |
| CNA-II (formerly CNA) | Any setting except a nursing facility or skilled nursing facility; no new CNA-II certificates | Maryland Board of Nursing |
| CMA (Certified Medicine Aide) | Medication path built on active CNA-I status and full-time CNA-I experience | Maryland Board of Nursing |
| Dialysis technician | Separate certification | Maryland Board of Nursing |
The First-Time Candidate Sequence
- Complete a Board-approved nursing assistant training program or acute care nursing assistant training program, or a listed equivalent (a qualifying portion of a nursing education program, or service-member training the Board finds equivalent).
- Register with your testing vendor: Credentia (NNAAP) or D&SDT-Headmaster. Ask your program which one it uses.
- Take the knowledge test (written or oral with Credentia; knowledge or audio with Headmaster) and the skills test.
- Pass both parts. Sit for the evaluation within 24 months of finishing training.
- Apply to MBON for CNA-I certification and complete the criminal history records check (State and FBI, with fingerprints). Employers verify your status with MBON's online lookup.
Do not blur the training and testing steps. Only Board-approved programs count: after April 1, 2026, the Board cannot certify an applicant who attended a CNA-only program that does not meet federal requirements. A cheaper or more convenient course is worthless for certification unless it is actually approved.
How to Think About Eligibility
COMAR 10.39.01.05 lists the routes into initial certification. You must have completed an approved nursing assistant training program, an approved acute care nursing assistant training program, a portion of an approved nursing education program that the Board finds meets the training requirements, or service-member training the Board finds substantially equivalent, and passed the competency evaluation. You must be at least 16 to apply (Health Occupations §8-6A-05). A nursing assistant certified and in good standing in another state with essentially similar requirements can apply by endorsement.
A training program runs at least 100 hours (COMAR 10.39.02.06): at least 60 hours of classroom and lab instruction, including at least 16 hours of in-person lab, and 40 hours of supervised clinical training, with at least 16 of those clinical hours in long-term care or caring for the elderly or chronically ill.
Maryland also links CNA-I to career progression. A Certified Medicine Aide must be an active CNA-I in good standing who is currently employed, with either 2 years of full-time CNA-I experience in a facility licensed under 42 CFR Part 483 or 1 year in a facility licensed in Maryland under COMAR 10.07.02, and must complete a Board-approved CMA program of at least 60 hours (at least 30 hours of theory and 30 hours of supervised clinical training). That is not a beginner task, and the exam may use it as a distractor against the entry-level path.
Exam Scenario Pattern
One trap is naming the testing vendor as the agency that "certifies" you. That is backward. A testing vendor schedules, gives, scores, and reports the exam. Maryland uses Credentia and, since the Board approved it on October 23, 2024, D&SDT-Headmaster. MBON issues CNA-I and CNA-II certificates, keeps the registry, and handles renewals. When a question asks who controls the credential, answer MBON.
When it asks where to create an account, schedule, reschedule, or pull a score report, answer your testing vendor.
Then master the 2026 naming change. The old GNA is now CNA-I, the old CNA is now CNA-II, and new applicants can only become CNA-I. On the exam, recognize both vocabularies but answer with the current title.
Scope of Practice You Carry Into Every Domain
The credential defines what you may legally do, so the path chapter is really a scope chapter in disguise. A Maryland CNA may take and record vital signs, assist with activities of daily living (bathing, dressing, grooming, toileting, feeding, ambulation), reposition residents, measure intake and output, apply non-sterile dressings when delegated, and report observations to the nurse. A CNA may not administer medications (that requires the separate CMA credential), perform sterile procedures, insert or remove tubes, give injections, interpret results, or change the care plan.
| Within CNA scope | Outside CNA scope |
|---|---|
| Measuring and recording vitals, height, weight, I&O | Diagnosing, assessing, or interpreting findings |
| Assisting with ADLs and safe transfers | Administering medications (CMA only) |
| Non-sterile delegated tasks; reporting to the nurse | Sterile procedures, injections, IV care |
| Reinforcing the care plan | Creating or changing the care plan |
When a scenario shows a resident with chest pain, a new pressure injury, or a refusal of care, the CNA's job is to observe, report to the nurse, and document the facts — never to treat or decide. Carrying this boundary into every question is the most reliable single strategy for the Maryland knowledge exam, because the role-of-the-nurse-aide domain is woven through physical care, psychosocial, and ethics items alike.
A Maryland candidate finished an approved nurse aide program in 2026 and wants to work in a licensed nursing facility. Which statement best describes the credential path?
Pass the competency evaluation and be certified as a CNA-I, the only title new applicants can receive.
Become a CNA-II by training alone, then add a separate GNA designation for nursing-home work.
Skip certification because the employer plans to schedule the competency evaluation later.
Earn the medicine aide credential first, then apply for CNA certification in Maryland.
Who is responsible for Maryland nursing assistant certification and the registry after the testing vendor reports exam results?
The training program director
The candidate's first employer
The testing site proctor
The Maryland Board of Nursing
Sections you finish are checked off in the contents.