What Certifications Does a CNA Need? (2026 Guide)

The short answer is two: active CNA certification on your state’s nurse aide registry, and a current BLS card. That’s the floor for almost every CNA job in the country in 2026. Everything else is optional — but some of those optional credentials change which doors open and which stay closed.

This guide walks through what’s required, what’s genuinely useful, and what’s a credential mill that costs money and doesn’t move the needle.

The two credentials every CNA needs

1. Active state CNA certification

CNA certification is regulated state-by-state, not federally. The federal floor (set by the Nursing Home Reform Act of 1987 / OBRA ’87) is 75 training hours including 16 hours of supervised clinicals, plus passing a state competency exam. Each state then runs its own nurse aide registry, and many states require more than the federal minimum:

• States that meet the 75-hour federal minimum. The majority of states use the federal floor or close to it.
• States that require more. California, Maine, Oregon, Alaska, and several others mandate higher training hours — in some cases double the federal minimum. If you’re training in one of these states, you’ll spend more time in the program but it generally transfers to other states without retraining.
• State-specific exam. Most states use the Pearson VUE or Prometric/Headmaster CNA exam, which has a written portion and a hands-on skills demonstration. A few states use their own custom exam.

To find your state’s exact rules, search for “[your state] nurse aide registry” — that’s the official source. Don’t rely on general training-school marketing pages, which are often outdated.

2. BLS for Healthcare Providers

BLS (Basic Life Support) is the more advanced version of CPR designed for healthcare workers. Almost every employer requires it specifically — not generic CPR — and they want it from American Heart Association or American Red Cross. The card is valid for two years and a typical class runs 4–6 hours including a hands-on skills check.

Some CNA training programs include BLS in the program; some don’t. If yours didn’t, schedule it before you start applying. An expired BLS card is one of the fastest reasons a hiring manager moves on to the next resume in the stack.

Optional credentials that actually move the needle

Not every CNA needs these. Whether they’re worth your time and money depends on the setting you want to work in. In rough order of how often we see them pay off:

Dementia care certification (essentiALZ)

The Alzheimer’s Association’s essentiALZ certification is widely recognized in long-term care and memory care. It’s relatively cheap and quick to earn, and it’s a real signal to a memory-care unit hiring manager that you understand person-centered dementia care. If your local market has a lot of memory care facilities, this is the highest ROI optional credential.

Medication aide / medication technician (CMA, QMA, TMA)

Medication aides can administer routine medications under nurse supervision in long-term care, assisted living, and group homes (the rules vary by state and setting). The credential goes by different names — CMA (Certified Medication Aide), QMA (Qualified Medication Aide), TMA (Trained Medication Aide). It typically requires a separate state-approved class on top of your CNA training. In states where this credential is recognized, it usually translates directly into a higher hourly wage and broader job options.

CNA II (advanced CNA)

A handful of states — most notably North Carolina and Oregon — have a CNA II credential that lets you perform additional tasks like specimen collection, sterile dressing changes, and certain catheter care. It requires additional training on top of your base CNA. If you’re in a state that recognizes it, this credential can be the difference between SNF work and hospital med-surg work.

Phlebotomy (PBT)

Not common for a CNA, but in some hospital systems CNAs cross-train as phlebotomists. If your facility allows CNAs to draw labs (state and facility-specific), the PBT credential makes you significantly more valuable on a busy med-surg or telemetry unit. It’s also a clear signal that you’re progression-minded.

EKG / telemetry monitoring

Hospital telemetry units often run an in-service training that lets CNAs interpret basic rhythms and recognize when to escalate to the RN. This is rarely a standalone credential — it’s usually facility-provided — but if you’ve completed it, list it on your resume. It’s a strong signal you can handle a higher-acuity unit.

Hospice and palliative care (CHPNA)

The Certified Hospice and Palliative Nursing Assistant credential (CHPNA, from the HPCC) is targeted at CNAs who work specifically in hospice or palliative care. If that’s where you want to work, this is the credential that signals serious commitment to it.

Credentials that aren’t worth your money

There’s a long tail of online “certifications” that promise to differentiate your CNA resume and don’t. Some patterns to be skeptical of:

• Generic “patient care technician” certificates from for-profit online schools. Most facilities don’t recognize these, and they don’t replace your state CNA credential.
• $300 “CNA continuing education bundles” that don’t actually count toward your state’s CEU requirements. Check with your state registry first.
• “Specialty” certificates that aren’t recognized by any major credentialing body. If you’ve never heard a hiring manager mention it, it’s probably not real.

Reciprocity: moving your CNA cert to another state

If you’re moving across state lines, you don’t have to retake your CNA program. Most states have reciprocity, which means you can transfer your active certification by submitting an application and proof of training to the new state’s nurse aide registry. The process typically takes 2–6 weeks and includes a background check and confirmation that your training met the new state’s minimums.

One important note: you can’t legally work as a CNA in the new state until your name appears on that state’s registry. Plan your move with that timeline in mind. Don’t accept a job in the new state assuming the transfer will be done by your start date unless you’ve already submitted the paperwork.

How to list certifications on your resume

Format: credential name, issuing body, expiration date. Skip the certification number itself — it’s a privacy risk and hiring managers don’t need it. (More on that in the pillar guide.)

Put this block at the top of your resume, right after your contact info, before your summary or experience. CNA hiring managers screen credentials first; making them hunt for this section is the fastest way to lose a screen.

Frequently asked questions

Do CNAs need a license or a certification?

Technically a certification, listed on a state nurse aide registry. The terms “license” and “certification” get used interchangeably in job postings, but you should always verify your active status on your state’s nurse aide registry — that’s the official source of truth for hiring.

Do CNA certifications transfer between states?

Most states have reciprocity, meaning you can transfer your active certification by submitting an application and proof of training to the new state’s nurse aide registry. The process typically takes a few weeks. You can’t work as a CNA in the new state until that transfer is complete.

Is BLS the same as CPR?

BLS (Basic Life Support) is a more advanced version of CPR designed for healthcare providers. Most facilities specifically require BLS — not generic CPR — from American Heart Association or American Red Cross. The card is valid for two years.

Should I get CNA II, medication aide, or dementia care certifications?

Depends on your setting goal. CNA II is recognized in some states (notably North Carolina and Oregon) and lets you do additional clinical tasks. Medication aide is valuable in long-term care. Dementia care certifications are useful in memory care units. None of them are required for a baseline CNA job.

Related reading for CNAs