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In the United States, the certified nursing assistant (CNA) typically works in a nursing home or hospital, and performs everyday living tasks for the elderly, chronically sick, or rehabilitation patients who cannot care for themselves. There are some differences in scope of care across CNAs based on title and description. CNAs must become certified based on respective states' requirements. Although each state's requirements are a little different, the general requirements are listed below:

  1. Pass an accredited course.
  2. Pass that state’s respective CNA exam.
  3. Pass a practical exam that will monitor the ability to perform basic CNA activities.
  4. Have a certain amount of on-duty experience while under supervision.
  5. Register within the state in which the exams were performed.

Once the above requirements are completed, the person will then be certified for that respective state. Moving to a different state, however, would require recertification in the new state, unless both states use the NNAAP standard. In this case, the new state would accept previous NNAAP test scores and allow registration. These certification exams are distributed by the state. Classes to study for these exams are provided by the American Red Cross; as well as other providers. The courses offered encompass all facets that are addressed in the state exams from communication to health terms to sensitivity.