1.1 Maryland CNA/GNA Path

Why Maryland Has a CNA/GNA Path

Maryland's nursing assistant credential has two tiers, and they were renamed effective April 1, 2026. The base certificate — 100-hour Board-approved training plus MBON registration — was historically called Certified Nursing Assistant (CNA) and is now CNA-II. By itself it does not authorize work in a licensed comprehensive care facility (the legal term Maryland uses for a nursing home). To staff long-term care you must hold the higher tier, historically the Geriatric Nursing Assistant (GNA) and now CNA-I, which requires passing the NNAAP-style competency exam on top of training.

For the exam, anchor this: the base training certificate (CNA / now CNA-II) is the foundation, and the nursing-home credential (GNA / now CNA-I) layers the competency exam on top of it. Because the Credentia handbook and many facility pages still say "GNA" during the changeover, know both vocabularies.

This distinction trips up candidates because many say they are "taking the Maryland CNA exam," while the official Credentia handbook describes the Maryland National Nurse Aide Assessment Program (NNAAP) as the route to GNA registration. In practice a candidate must satisfy Maryland eligibility, pass both exam parts, and be processed by MBON before the status is useful for nursing-home employment. Credentia runs the test; MBON owns the credential and the registry. Mixing those two roles is the single most common exam trap in this chapter.

Credential Map

The First-Time Candidate Sequence

1. Complete an MBON-approved nursing assistant or GNA training route, or qualify under a listed equivalent (student nurse, expired-certificate, or out-of-state endorsement route).
2. Apply through Credentia / CNA365 for the Maryland NNAAP exam.
3. Take the knowledge exam (written or oral) and the skills evaluation.
4. Pass both parts within the official Maryland window.
5. Credentia reports passing results to MBON, which enters the GNA designation for online verification.

Do not blur the training and testing steps. MBON warns that programs must be approved before they accept students; graduates of unapproved programs are not eligible for certification or the GNA examination through that route. A cheaper or more convenient course is worthless for licensure unless it is actually MBON-approved.

How to Think About Eligibility

For a new candidate the most testable route is completion of a Board-approved 100-hour nursing assistant training program that includes required supervised clinical experience in a Maryland licensed nursing home. The handbook lists other routes — reciprocity/endorsement for out-of-state aides in good standing, recently-expired certificate holders, and nursing students who have completed a fundamentals course — but first-time exam prep should center the standard 100-hour path unless your own status differs.

Maryland also links GNA to career progression. A Certified Medicine Aide must hold an active GNA, have at least one year of GNA experience, and complete an MBON-approved 60-hour community-college medication course before that exam. That is not a beginner task; it is a later credential built on active nursing-home work, and the exam may test it as a distractor against the entry-level GNA path.

Exam Scenario Pattern

The classic trap is naming the testing vendor as the agency that "certifies" you. That is backward. A testing vendor schedules, administers, scores, and reports the exam — Maryland uses Credentia (through its CNA365 platform), and since October 2024 MBON has also approved Headmaster / D&S Diversified Technologies (D&SDT) as a second vendor to expand testing capacity for the redesignation. MBON owns the Nursing Assistant Certification Program, CNA-I/CNA-II (GNA) registration, the registry, and 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 Credentia/CNA365.

Finally, master the 2026 naming transition, because it reverses the labels. Under House Bill 1125 (2024), MBON's CNA redesignation regulations took effect April 1, 2026, and the terms flipped: the old GNA (the credential required for nursing homes, earned by passing the NNAAP-style competency exam) is now CNA-I, while the old base CNA (100-hour training plus Board registration, not authorized to practice in long-term care) is now CNA-II. So the credential you need for a Maryland nursing home is now called CNA-I, and the entry-level certificate that cannot staff long-term care alone is CNA-II.

The Credentia 2024 handbook and many facility pages still use the older "GNA" wording during the changeover, so on the exam recognize both vocabularies and remember the mapping: GNA = CNA-I (nursing-home credential, requires the exam); CNA = CNA-II (base certificate, training only).

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/GNA 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/GNA 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.

When a scenario shows a resident with chest pain, a new pressure injury, or a refusal of care, the GNA'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.