Introduction: Understanding CNA salary norms and room for improvement
Certified nursing assistants (CNAs) are vital to the well-being of hospital patients, long-term care center residents, and skilled-nursing facility residents. They ensure people are comfortable and have their basic needs covered — at a time when they cannot take care of themselves. The industry as a whole is facing real challenges that will impact CNA salaries, including the coming “Silver Tsunami,” when 73 million people will be aged 65 and over.
CNA salary overview
According to the Bureau of Labor and Statistics, the average CNA salary is $36,220 per year, roughly $17.41 per hour. But pay varies from state to state and facility to facility.
This article discusses CNA salary, but not all CNAs earn a salary. For example, independent CNAs may work PRN shifts and charge by the job, and may charge more than a salaried CNA earns if you compare on a per-hour basis.
Factors affecting regional variations in CNA salary
Regionally, CNA salaries differ based on costs of living (both tend to be higher in metropolitan areas) and demand for CNA services. Areas experiencing a higher demand for CNAs may pay more, but that’s not always the case. Here’s how the average nursing assistant salary breaks down by region and by state:
West
- Washington $47,620
- Oregon $39,242
- California $43,722
- Nevada $40,285
- Idaho $37,822
- Montana $36,312
- Wyoming $38,207
- Utah $34,870
- Colorado $34,600
- Alaska $38,101
- Hawaii $38,786
Midwest
- North Dakota $36,996
- South Dakota $37,024
- Nebraska $32,025
- Kansas $32,864
- Minnesota $38,310
- Iowa $36,989
- Missouri $32,917
- Wisconsin $39,468
- Illinois $35,910
- Indiana $37,863
- Michigan $33,105
- Ohio $35,616
Southwest
- Arizona $37,805
- New Mexico $35,735
- Texas $39,151
- Oklahoma $33,578
Southeast
- Arkansas $30,192
- Louisiana $31,944
- Mississippi $34,183
- Alabama $31,986
- Tennessee $34,858
- Kentucky $30,680
- Georgia $37,207
- Florida $31,953
- South Carolina $33,406
- North Carolina $30,501
- Virginia $35,342
- West Virginia $32,264
Northeast
- Maine $39,958
- Vermont $40,295
- New Hampshire $37,438
- Massachusetts $40,413
- New York $44,760
- Rhode Island $37,066
- Connecticut $36,725
- New Jersey $39,494
- Pennsylvania $37,444
- Delaware $34,769
- Maryland $35,289
2023 average CNA salary data by Zip Recruiter
Exploring the other factors influencing CNA salary
Education
Generally, CNAs need to have a high school diploma or GED. Typically, they must also complete a CNA certification program and be licensed to work before they begin to practice. Length of certification programs vary from state to state but most take between four and 16 weeks. Each state has its own requirements for licensure — you can find your state’s requirements on its health department website.
Once licensed, additional certifications can help you increase your nursing assistant salary. Here are some of the certifications that CNAs get:
1. Medical Assistant
Medical assistants do everything that CNAs do, but they can also assist with additional clinical tasks, such as administering medications and drawing blood, as well as administrative tasks like record keeping.
According to BLS, the average CMA salary is $40,700 or roughly $19.57 per hour. CMA opportunities are expected to increase by 14% over the next nine years (the average job growth rate sits at 3%).
There are several medical assistant certification programs available, all with different requirements and focuses, such as:
Certified Medical Assistant (CMA) is a designation provided by The American Association of Medical Assistants.
Registered Medical Assistant (RMA) is a certification obtained through American Medical Technologists.
National Certified Medical Assistant (NCMA) is available through the National Center for Competency Testing.
Certified Clinical Medical Assistant (CCMA) is a certification from the American Healthcareer Association.
2. Medication Aide
Medication aides can earn more than CNAs. In addition to their CNA duties, medication aides keep medication records and ensure that residents and patients take medication on time at the proper dosage, according to physician instructions. Each state has different requirements for medication aide certification, so check with yours.
3. Hospice CNA
The Hospice and Palliative Nurses Association offers a certification for CNAs who have experience in hospice and palliative care, which may increase salary.
In addition to specialized certifications, CNAs can make more money with more experience, in cities or towns with increased demand for services, and in certain settings.
Experience
Facilities may be willing to pay more for experienced CNAs. Experience tends to be measured in the number of years in the field, or number of hours worked, and experience in the setting in which the position is offered.
Increased demand
With an aging population and the rise in chronic illnesses, CNAs are more in-demand than ever. There are currently 4.6 million direct care workers in the U.S., and as the 65+ population increases, the demand for CNAs is expected to almost double. The BLS forecasts a 5% growth rate in opportunities for nursing assistants by 2031, which is slightly higher than 3%, the average job growth rate.
More than 53% of non-RN direct care workers leave the industry every year, and that plays into compensation rates at the facility level as well. Whenever and wherever the demand for CNAs is higher, wages can increase.
Facility type
Hospitals, skilled nursing facilities, home healthcare — different settings offer different levels of compensation.
Additionally, facilities offer full- and part-time team members compensation packages, which can include educational opportunities that lead to greater future earning potential.
The work of a certified nursing assistant (CNA)
Overview of what CNAs do
CNAs help patients with activities of daily living, monitor vital signs and assist nurses as needed. Some of their duties include:
- Preparing rooms for admissions.
- Patient transferring and positioning, bathing, person-centered care.
- Documenting a patient's health issues/vital signs and reporting to the Nurse on Duty.
- Interacting with a resident’s or patient’s family.
- Assisting nursing teams to ensure the highest quality of care is provided.
Importance of CNAs in the healthcare system
CNAs serve on the frontlines of patient care, keeping patients and residents comfortable and clean and relaying important information to the rest of their medical team.
Because they interact with patients and residents more than other healthcare professionals, CNAs may be able to offer licensed practical nurses, registered nurses and physicians additional insights into the patient’s or resident's condition.
Training and certification requirements for CNAs
CNAs must generally have a high school diploma or GED, and most states require CNAs to complete a state-approved training program, pass a competency exam and may have other requirements. If a CNA wishes to advance in the medical field, there are many options.
Career paths for CNAs
LPN/LVN: Licensed practical nurse and licensed vocational nurse
What is an LPN/LVN?
LPNs (or LVNs in Texas and California) have the same duties, but the name of the role changes depending on geographical location: Only Texas and California use LVN. LPNs and LVNs are essential members of a facility's medical team.
What does an LPN do?
LPNs and LVNs perform tasks like:
- Administering medication and treatment protocols.
- Charting and recording.
- Observing patients and residents.
- Performing specific procedures, such as reading and recording vital signs, measuring and recording weight and height, and running other diagnostic tests.
How much do LPNs and LVNs earn?
The average salary for U.S.-based LPN/LVNs is $55,860 per year or $26.86 per hour.
What’s the process of becoming certified as an LPN/LVN?
The first step is to complete an accredited practical nursing program, which can be found at community and vocational colleges. The second step is to pass the National Council Licensure Examination for Practical Nurses (NCLEX-PN). Then, state licensure is required, along with other state-specific requirements.
Registered Nurse (RN)
What is an RN?
Registered nurses either have a bachelor’s degree in nursing (BSN) or an associate degree in nursing (ADN). Like most bachelor’s degrees, BSN degrees take around four years to complete, although accelerated programs are out there. Associate degrees in nursing generally take two years.
What does an RN do?
RNs provide a variety of healthcare services, including:
- Performing and interpreting diagnostic tests.
- Patient assessments.
- Carrying out physician orders.
- Preparing patients for treatments.
- Administering medications.
- Maintaining and documenting medical records.
- Counseling patients and their families on how to manage medical issues.
How much do RNs earn?
The average salary for RNs in the U.S. is $89,010 per year, roughly $42.80 per hour.
Nurse Practitioner
What is a nurse practitioner?
Nurse practitioners do everything that RNs do, but they also have some expanded responsibilities and duties. In certain states, nurse practitioners can even practice without the supervision of a doctor. To become a nurse practitioner, you must have a BSN and an advanced degree, such as a master’s degree in nursing (MSN).
How much can nurse practitioners earn?
The average salary for nurse practitioners in the U.S. is $124,680 per year, about $59.94 per hour.
Negotiating and maximizing CNA salary or pay
CNA salaries range from person to person, state to state and facility to facility, and pay may not be in a salary at all, like when CNAs are paid on a per-day basis. As in any field, it’s critical to learn how to negotiate and advocate for yourself so that you can secure the highest nursing assistant salary or pay possible.
Tips for negotiating a higher CNA salary or pay and increasing your earning potential
- Understand industry norms: Know the average CNA salaries for your city and state. Make sure you’re familiar with what CNAs at your experience level earn, too.
- Highlight your certifications: If you possess advanced certifications, ensure prospective facilities know and make sure those certifications stand out in your resume.
- Demonstrate your value: Gather recommendations from past facilities and talk about the relationships you’ve built with prior patients and residents during the interview process.
CNA: An essential role with income potential
CNAs are essential in creating ideal patient outcomes and safeguarding the well-being of all in acute-care, long-term-care and skilled-nursing facilities. This entry-level role opens doors to many career paths and provides the opportunity to have a real effect on patient well-being.
In the coming decade, as the 65+ population continues to grow, the demand for CNAs will grow alongside it. CNAs will have more opportunities to work, and that may increase the compensation available to these critical healthcare workers.
