CNA jobs: certification, nursing home rules and pay
Nursing assistants, often called CNAs, complete a state-approved program, pass a competency exam and go on a state registry. Federal rules set the minimum.
Figures on this page use US rates checked October 27, 2026. Check the dated sources because rates and eligibility rules change, and state rules differ.
Pay at a glance: BLS wage estimates
National wage estimates for Nursing Assistants (SOC 31-1131) from the Bureau of Labor Statistics Occupational Employment and Wage Statistics program, May 2025 reference period. These are wages paid to workers, not prices charged by agencies, and they vary by state, employer and setting.
- Median hourly wage
- $20.32
- Median annual wage
- $42,260
- Employment, May 2025
- 1,448,910
Source: BLS OEWS, Nursing Assistants, median hourly wage (accessed October 27, 2026); BLS OEWS, Nursing Assistants, median annual wage (accessed October 27, 2026); BLS OEWS, Nursing Assistants, employment (accessed October 27, 2026).
A certified nursing assistant (CNA) provides basic care and helps patients with daily living, usually under the direction of a nurse. Nursing assistants typically complete a state-approved program, pass a competency exam and go on a state registry, with federal rules setting a minimum for the training.
Titles vary. BLS calls the job "nursing assistant," and the 2018 Standard Occupational Classification definition also covers nursing care attendants, nursing aides and nursing attendants. "CNA" is the usual abbreviation for certified nursing assistant.
What a nursing assistant does
BLS says nursing assistants provide basic care and help patients with activities of daily living. The 2018 Standard Occupational Classification definition, as quoted in an HHS report, says the work is done under the direction of onsite licensed nursing staff and includes monitoring health status, feeding, bathing, dressing, grooming, toileting and helping patients walk, in a health or nursing facility. It may include medication administration and other health-related tasks.
Where CNAs work
BLS says most nursing assistants work in nursing and residential care facilities and hospitals:
| Employer type | Share of nursing assistants |
|---|---|
| Nursing care facilities (skilled nursing) | 36% |
| Hospitals | 32% |
| Continuing care retirement communities and assisted living | 11% |
| Home healthcare services | 5% |
| Government | 3% |
BLS also says nursing assistants have one of the highest rates of injuries and illnesses of all occupations. See nursing homes and assisted living to see who operates near you.
Training and certification
BLS says nursing assistants often need to complete a state-approved education program, and they typically pass their state's competency exam. Those who pass are placed on a state registry, and they must be on the registry to work in a nursing home.
Federal rules set the floor for those programs. Under 42 CFR 483.152 a program must:
- total no less than 75 clock hours of training;
- include at least 16 hours of supervised practical training, under a registered nurse or licensed practical nurse;
- cover at least 16 hours of communication, infection control, safety and emergency procedures, promoting independence and residents' rights before any direct resident contact;
- cover basic nursing skills, personal care skills, mental health and social service needs, care of residents with cognitive impairment, restorative services and residents' rights;
- be taught by or under the general supervision of a registered nurse with at least 2 years of nursing experience, including at least 1 year in long-term care.
Under 42 CFR 483.35, a nursing facility must not use someone as a nurse aide for more than 4 months on a full-time basis unless the person has completed a training and competency evaluation program or been found competent under the rules. The facility must receive registry verification before allowing someone to serve as a nurse aide, unless an exception applies, and it must complete a performance review of every nurse aide at least once every 12 months and provide regular in-service education.
States add their own rules. The federal rules are a minimum, and your state approves the programs and runs the registry. Carevo does not summarize state requirements here. Ask your state's nurse aide registry or health department which programs it approves.
CNA pay
The BLS wage estimates for nursing assistants are in the box at the top of this page, with the source and the May 2025 reference period. They are wages paid to workers, not prices charged by facilities, and they are national, so pay in your state and setting can be higher or lower. BLS publishes nursing assistants separately from home health and personal care aides. Their figures are on the home health aide and personal care aide pages.
How to find CNA jobs
Nursing homes, hospitals and assisted living communities hire most nursing assistants. Browse nursing homes, assisted living and home health agencies in your state and contact the employers directly. Ask whether they hire while you finish training and whether they help pay for it.
Carevo is a connection platform. It is not an employer and it does not place workers. For the wider picture across roles, see caregiver jobs.
Caregiver registration is coming to Carevo
Carevo is a connection platform. It is not an employer, it does not place workers and it does not guarantee work. Registration for caregivers is not open yet. If you want to hear when it is, email [email protected].
Common questions
How do I become a CNA?
BLS says nursing assistants typically complete a state-approved education program and pass their state's competency exam, then go on the state registry. Federal rules require an approved program to include at least 75 clock hours of training, with at least 16 hours of supervised practical training. Your state sets the rest.
How much do CNAs make?
BLS reports a national median of $20.32 an hour, or $42,260 a year, for nursing assistants (SOC 31-1131) in May 2025. That is the national median for wages paid to workers. Pay in your state and setting can be higher or lower.
Where do CNAs work?
BLS says most nursing assistants work in nursing and residential care facilities and hospitals. It lists nursing care facilities at 36%, hospitals at 32%, continuing care retirement communities and assisted living at 11%, and home healthcare services at 5%.
Do you need to be on a registry to work in a nursing home?
Yes. BLS says nursing assistants must be on the state registry to work in a nursing home. Federal rules in 42 CFR 483.35 also require a nursing facility to receive registry verification before it lets someone serve as a nurse aide, unless an exception applies.
Can I work as a nurse aide in a nursing home while I am training?
Federal rules say a nursing facility must not use someone as a nurse aide for more than 4 months on a full-time basis unless the person has completed a training and competency evaluation program or has been found competent under the rules. Your state may have its own limits.
Does Carevo hire CNAs?
No. Carevo is a connection platform, not an employer, and it does not place workers. Caregiver registration is coming. The note at the bottom of this page says how to hear when it opens.
Sources
- BLS Occupational Outlook Handbook: Nursing Assistants and Orderlies accessed October 27, 2026
- BLS OEWS time series: Nursing Assistants (31-1131), median hourly wage, May 2025 accessed October 27, 2026
- BLS OEWS time series: Nursing Assistants (31-1131), median annual wage, May 2025 accessed October 27, 2026
- HHS ASPE: Definitions and Occupational Characteristics of Direct Support Professionals (January 2025) accessed October 27, 2026
- eCFR: 42 CFR 483.152, Requirements for approval of a nurse aide training and competency evaluation program accessed October 27, 2026
- eCFR: 42 CFR 483.35, Nursing services accessed October 27, 2026
Review status: Carevo checked this page against the primary sources listed above. It has not been professionally reviewed by a registered nurse, licensed social worker, benefits counselor or attorney. See our editorial standards.
This page is general information, not financial, legal or medical advice. Rules and services vary by state and by individual circumstances. Use the official sources and decision-maker named on the page. Carevo is a connection platform, not a care provider.