CNA Career Guide 2026. how to become a Certified Nursing Assistant

What does a CNA do?

CNAs provide hands-on care to patients and residents in skilled nursing facilities, long-term care centers, hospitals, and assisted living communities. You work under a licensed nurse (LPN or RN), and you spend more time directly with patients than almost anyone else on the team.

Day to day, that means helping with activities of daily living (ADLs). Bathing, dressing, eating, and getting around. You also take vital signs, document how residents are doing, and answer call lights. When something changes with a resident, you're usually the first person to notice, which makes you a key link to the rest of the nursing team.

In skilled nursing, you'll help residents recovering from surgery or managing long-term conditions. The work is physical and it can be hard, but a lot of CNAs say the relationships are what keep them in it. You get to know the same residents for months or years.

CNA training requirements

One of the biggest advantages of becoming a CNA is that training is short. Most programs run 4 to 12 weeks. Here's what to expect.

• Minimum training hours: Federal law requires at least 75 hours of training, but most states require 120 to 180 hours. Your state's nursing board sets the specific requirement.
• Classroom instruction: Covers anatomy basics, infection control, patient rights, communication skills, nutrition, and emergency procedures.
• Clinical practice: Hands-on training in an actual healthcare facility under the supervision of a licensed nurse. You'll practice the skills you learned in the classroom with real patients.
• Cost: CNA programs typically run $500 to $2,000. Many employers, including skilled nursing facilities, will cover training in exchange for a work commitment.

How to get CNA certified

After you finish training, you take your state's CNA competency exam. Two parts:

1. Written (or oral) exam: Multiple-choice questions, typically 60 to 100 of them. Passing is around 70 to 80 percent, depending on your state.
2. Clinical skills test: You demonstrate 3 to 5 randomly selected skills in front of a nurse evaluator. Handwashing, taking blood pressure, positioning a patient, and range-of-motion exercises show up a lot.

Most states let you retake the exam if you don't pass the first time. Once you're certified, you'll be listed on your state's Nurse Aide Registry. Certification usually needs to be renewed every two years, which means a minimum number of paid work hours and some continuing education.

CNA salary in 2026

CNA pay depends heavily on state, facility type, and how long you've been working. Per the BLS OES May 2024 report, the national median is $39,530/year, or $19.00/hr. The 10th to 90th percentile range runs from $31,390 to $50,140.

A few things move the number:

• Location: Higher cost of living generally means higher pay. CNAs in Pennsylvania, Illinois, and Virginia tend to earn above the national average.
• Shift differentials: Nights and weekends usually pay $1 to $3 more an hour. Over a year that's $2,000 to $6,000 extra.
• Experience: New CNAs start at the low end. After 2 to 3 years you should be in the middle or upper part of the range.
• Facility type: Skilled nursing facilities usually pay more than assisted living or home health because the care is higher acuity.

Where CNAs work

CNAs are hired in pretty much every healthcare setting, but most work in long-term care. The main options:

• Skilled nursing facilities (SNFs): The largest employer of CNAs. SNFs provide 24/7 care for residents who need ongoing medical attention or rehab.
• Long-term care facilities: Similar to SNFs, focused on residents who need help with daily living for longer stretches.
• Hospitals: CNAs work on med-surg floors, rehab units, and in the ED, supporting the nursing team.
• Home health: One-on-one care in a patient's home. More flexible schedule, but pay is often lower than a facility role.
• Assisted living: Residents are more independent, so the work is physically easier than an SNF.

Career growth. What comes after CNA?

For a lot of nurses, CNA is the first step. Plenty of LPNs and RNs started here. The hands-on time is what makes the rest of the coursework click, and it also helps you figure out whether nursing is actually what you want long term.

• CNA to LPN: LPN programs take 12 to 18 months. Your CNA experience gives you a real edge in the clinical work, and some programs award academic credit for it. BLS median LPN salary: $62,340/year, a $22,810 jump from the CNA median.
• CNA to RN: Go ADN (2 years) or BSN (4 years). BLS median RN salary: $93,600/year, a $54,070 increase over the CNA median.
• Specialized CNA roles: Medication aide, hospice aide, restorative aide. Higher pay and a bit more training, without a full LPN program.

A lot of employers offer tuition reimbursement for CNAs going back to school. That's one of the reasons SNFs are a strong starting point. Many of them will help pay for your next credential.

How to get discovered as a new CNA

Demand for CNAs is strong. Per the BLS, nursing assistant jobs are projected to grow about 4% through 2033, with roughly 216,000 openings a year. In a lot of states, facilities just can't fill positions fast enough. The most effective ways to get in front of them:

1. Submit your resume through CareGigs: A recruiter on our team reads every submission and checks our partner facilities for a match. Submit your resume.
2. Contact facilities directly: A lot of SNFs are always hiring. Once your certification is active, call or walk in and introduce yourself.
3. Work your CNA program: Talk to classmates and instructors. Clinical sites often hire the students who rotated through. A referral is one of the fastest ways in.
4. State Nurse Aide Registry: Once you're on your state's registry, facilities can verify your credentials and contact you directly.