Yes, a Certified Nursing Assistant (CNA) can be certified to work in more than one state, but this portability is not automatic. CNAs are healthcare professionals who provide direct patient care under the supervision of a licensed nurse. Because the certification to practice is authorized at the state level, a CNA must take specific administrative action to gain authorization in any state beyond the one where they originally trained and tested. This process ensures that every healthcare worker meets the specific public safety and competency standards of the state where they are employed.
Understanding State-Based CNA Certification
CNA certification operates under a framework of federal requirements but is administered entirely by individual state regulatory bodies. The federal Omnibus Budget Reconciliation Act of 1987 (OBRA) established a minimum standard, including a requirement for at least 75 hours of training, that every state must meet. Beyond this floor, each state’s Board of Nursing or Department of Health develops its own rules for training, examination, and renewal.
This state-specific regulation is why a certification earned in one jurisdiction is not valid for practice in another. The State Nurse Aide Registry serves as the official database that tracks the active status and any findings of abuse or neglect against a CNA. To work legally, a CNA’s name must appear on the registry of the specific state where they are employed.
The Process of Endorsement (Reciprocity)
The mechanism for securing certification in a new state is called endorsement, although it is frequently referred to as reciprocity. Endorsement is the formal process where a receiving state accepts the training and competency evaluation completed in your original state, based on the premise that the initial training program met federal standards.
The new state’s regulatory body will verify your good standing by checking your status on your original State Nurse Aide Registry. Your current certification must be active and completely unencumbered for a successful endorsement. Any administrative finding of patient abuse, neglect, or misappropriation of property recorded on your home state’s registry will prevent you from gaining certification in the new state.
Step-by-Step Guide to Getting Certified in a Second State
The first step in seeking authorization is to contact the Nurse Aide Registry or Board of Nursing in the state where you intend to practice. You must then secure and submit the correct formal application, typically labeled as an “Endorsement Application.” This application requires proof of your current, active certification from your original state.
The application submission is accompanied by the payment of all required administrative fees, which vary widely between jurisdictions. You will also need to provide official documentation that verifies the successful completion of your state-approved CNA training program and competency examination. A mandatory part of this process in nearly all states is the completion of a new background check, often requiring fingerprinting.
Key Differences in State Certification Requirements
Training and Examination Standards
While the federal minimum for CNA training is 75 hours, many states require significantly more instruction, and these differences can complicate the endorsement process. For example, states like Maine require 180 hours of training, while California mandates 160 hours. If your initial training hours fall short of the new state’s statutory requirement, you may be required to complete additional coursework or specific modules before your endorsement is granted.
Background Check Policies
Background check policies are a major point of variation because states maintain different definitions for what constitutes a disqualifying conviction. A felony or certain misdemeanors related to patient safety, theft, or abuse that may have been cleared in your home state could still block endorsement in another. The receiving state will conduct its own criminal history review, and the outcome is dependent on that state’s unique regulations regarding offenses that prohibit working with vulnerable populations.
Required Work Hours
States have specific minimum work requirements necessary to maintain an active status on the registry, and these must be met for endorsement. The federal standard requires a CNA to have performed at least eight hours of paid nursing-related services within a 24-month period. However, some states impose a higher threshold. If you fail to meet the new state’s minimum work hour requirement, you may be required to retake the state’s competency examination even if you were endorsed previously.
Why CNAs Are Not Part of the Nurse Licensure Compact
Many healthcare workers mistakenly believe that CNA certification is included in the multi-state authorization system used by higher-level nursing professionals. The Nurse Licensure Compact (NLC) is a formal agreement that applies only to licensed nurses, specifically Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). The NLC allows these professionals to hold one multi-state license to practice in all compact states.
Certified Nursing Assistants are explicitly excluded from the NLC because their credential is a certification, not a full professional license. This distinction means that a CNA does not have the option of a single multi-state credential.
Maintaining Multiple Active State Certifications
Holding active certification in multiple states requires diligent attention to the different renewal cycles and ongoing requirements for each registry. Each state sets its own schedule for certification renewal, which typically occurs every two years, and the expiration dates will likely not align. You must track these deadlines carefully to avoid having a certification lapse.
The most challenging ongoing obligation is meeting the minimum work hour and Continuing Education Unit (CEU) requirements for each state individually. You must ensure that you are documenting sufficient paid work hours and completing the necessary CEUs to satisfy the specific renewal criteria for every registry where you maintain an active status.