CNA Programs & Career Opportunities in Maryland

Before starting your training, it's important to know what Maryland requires for CNA certification. Meeting these standards ensures you're eligible to test, be placed on the state registry, and work in approved healthcare settings, especially in licensed nursing homes where a Geriatric Nursing Assistant (GNA) designation is also required.

Eligibility

• Program enrollment: To work in a Maryland nursing home, you must complete a Maryland Board of Nursing–approved nursing assistant training program that qualifies you for both Certified Nursing Assistant (CNA) certification and the Geriatric Nursing Assistant (GNA) exam. The program must include at least 100 hours of instruction, with a minimum of 40 hours of supervised clinical practice in a Maryland-licensed nursing home.
• Good standing: Candidates must be eligible for placement on the Maryland Nurse Aide Registry, with no substantiated findings of abuse, neglect, or misappropriation on any state nurse aide registry.

Training Hours & Clinicals

Maryland's Board-approved CNA/GNA programs must provide a minimum of 100 total hours of training, including at least 40 hours of supervised clinical practice in a Maryland-licensed nursing home. Before any direct resident contact, programs must complete 16 hours of required instruction covering federally mandated OBRA topics, including the role of the CNA, infection control, safety and emergency procedures (such as the Heimlich maneuver), the care environment, communication skills (observing, recording, reporting, and interpersonal relationships), legal and ethical considerations, and promoting resident independence and dignity.

Certification Exam (NNAAP / GNA)

To be recognized as a Geriatric Nursing Assistant for work in nursing homes, you must pass the Maryland version of the National Nurse Aide Assessment Program (NNAAP), administered by Credentia on behalf of the Maryland Board of Nursing:

• Knowledge test: 70 multiple-choice questions in written format, or an oral version with 60 multiple-choice questions plus 10 reading-comprehension questions. Candidates are given up to two hours to complete the knowledge exam. The oral test is available in English and Spanish.
• Skills evaluation: A timed demonstration of five nurse aide skills, including embedded hand hygiene and at least one measurement task (such as recording blood pressure, weight, or pulse). You have 30 minutes to complete all five skills. You must correctly perform all critical steps and a sufficient number of non-critical steps to pass.

You must pass both the knowledge and skills components to obtain the GNA designation. You have up to 12 months from completing your training program to take the exam for the first time. After your first attempt, you have a total of four (4) attempts within 24 months of your training completion date to pass both parts of the exam. Candidates who do not pass within this window are required to complete a new Board-approved training program before retesting.

Placement on the Registry & Working as a CNA

Once you meet training requirements and pass the required exams, your name is placed on the Maryland Nurse Aide Registry, maintained by the Maryland Board of Nursing. To work as a nursing assistant in a licensed nursing home, you must hold active Maryland CNA certification and have the GNA credential indicated on the registry. Employers are required to verify your registry status before hiring. In line with federal OBRA rules, a Medicare- or Medicaid-certified nursing facility may employ a trainee for up to 120 days while training and testing are completed.

Renewal & Continued Eligibility

Maryland CNA and GNA credentials must be renewed every 24 months (biennially) for a fee of $40. Your certification expires on the 28th day of your birth month in either an odd or even year, depending on your birth year. To remain active, you must have recent paid employment providing nursing or nursing-related services under appropriate supervision during the certification period. You can renew online through the Maryland Board of Nursing CNA Renewal Portal beginning 60 days before and up to 30 days after your expiration date. Those who do not meet recent-practice requirements may be required to retest and, in some cases, retrain in order to regain active status. The Board may also require additional documentation if there have been any abuse, neglect, or misappropriation findings.

Reciprocity (Out-of-State CNAs)

If you are certified as a CNA in another state and your certification is active and in good standing, you may apply for Maryland CNA certification by endorsement. The Maryland Board of Nursing will verify that your out-of-state training and certification meet federal OBRA standards (including completion of an approved nurse aide training program). Candidates who are not currently listed on any state registry, or whose prior training does not meet Maryland's requirements, must complete a Maryland Board–approved 100-hour training program before becoming certified. To work in Maryland nursing homes, endorsed CNAs must also meet the requirements for the GNA designation, which may include passing the Maryland NNAAP exam.

Costs & Reimbursement

Examination fees for the Maryland NNAAP are set by Credentia. Current fees (as of 2024) are:

• Written examination only: $45
• Oral examination only: $45
• Skills examination only: $85
• Complete competency evaluation (Written/Oral and Skills): $130

All fees are non-refundable once submitted. Candidates should verify current fees in the Maryland Nurse Aide Candidate Handbook before registering.

Under federal law, if you are employed by—or receive an offer from—a Medicare- or Medicaid-certified nursing facility at the time you begin training, the facility is responsible for covering your training and testing costs. If you are hired within 12 months after completing training, the facility must reimburse those costs on a prorated basis.

Sources: Maryland Board of Nursing — Nursing Assistant Certification Program, Credentia — Maryland Nurse Aide Testing, Maryland Nurse Aide Candidate Handbook (Credentia, 2024), 42 CFR 483.152 — Federal Nurse Aide Training Requirements