How to Become a CNA in Tennessee

Becoming a CNA in Tennessee requires completing a state-approved training program of at least 75 hours, passing a two-part competency exam, and getting listed on the Tennessee Nurse Aide Registry. The full process takes 6 to 10 weeks. Cost runs from $0 to about $2,600, depending on which program you choose.

Free training exists through Ballad Health in Northeast Tennessee, and financial aid through WIOA can cover 100% of costs for eligible applicants. Tennessee employs 23,030 certified nursing assistants according to the Bureau of Labor Statistics (2024), with demand spread across nursing homes, hospitals, and home health settings statewide.

This guide covers every step: state requirements, training programs and costs, the updated exam format (100 questions as of October 2024), the registry, salary data, reciprocity rules for out-of-state CNAs, renewal requirements, and career paths after certification.

Tennessee CNA Certification at a Glance

Here’s what CNA training and certification in Tennessee looks like from start to finish.

Category	Details
Timeline	6-10 weeks from start to certified
Cost	$0-$2,600 (free options through Ballad Health and employer programs)
Minimum age	16 for registry eligibility; 18+ required by most training programs
Education	No diploma required by state (ATB assessment available at some programs)
Training	75 hours minimum (most programs deliver 120+ hours)
Exam	100-question written test + 5-skill clinical evaluation ($98 total)
Passing score	80% on each skill + 100% on all bolded Key Steps; 75% on written (75/100 correct)
Testing vendor	D&S Diversified Technologies (Headmaster) via TMU portal
Registry	Tennessee Nurse Aide Registry (automatic enrollment after passing)

Browse Tennessee CNA programs near you to compare approved options by location and cost.

Meet Tennessee’s CNA Requirements

Before you enroll in a training program, confirm you meet these basic requirements.

Age
Tennessee allows 16-year-olds on the nurse aide registry. Most training programs require you to be at least 18. Contact any program directly before applying if you are under 18.

Education
Tennessee does not require a high school diploma or GED for CNA certification. Some state-approved programs offer an Ability to Benefit (ATB) assessment as an alternative. Not every program offers ATB, so confirm with your chosen school before assuming it is available.

Background check
A criminal background check is mandatory. Checks are fingerprint-based and processed through the Tennessee Bureau of Investigation (TBI) and the FBI, typically via IdentoGO. Do not book an appointment until your training program provides you with their specific ORI Number or Service Code. Without it, your results won’t route to the school and you’ll pay for a second check ($35-$50). Turnaround is typically 1-2 weeks.

Tennessee disqualifies applicants with felony convictions involving abuse, neglect, or mistreatment of a vulnerable person. Misdemeanor convictions do not automatically disqualify you at the state level, but individual programs and clinical sites may have stricter policies. The check applies to both program enrollment and clinical placements.

Tennessee Abuse Registry. Separate from the criminal background check, employers are legally required to check the Tennessee Department of Health’s Abuse Registry before hiring. You can be certified but unhireable if listed. Check your own status at the TN Abuse Registry Search.

Identification
You need a valid government-issued photo ID and a Social Security number (or ITIN).

Health screenings
Most programs require a physical exam, drug screening, TB test, and Hepatitis B vaccination record before clinical rotations. These are program-level requirements, not state mandates. Requirements vary by school.

Requirements are established by the Tennessee Department of Education CNA Guidelines and confirmed by Career Academy Memphis program documentation.

Complete a State-Approved Training Program

How to verify a program is state-approved
Before you enroll, confirm the program appears on Tennessee’s official approved nurse aide training list. You can verify approval through the Tennessee Health Facilities Commission or search for approved testing sites on the Headmaster TMU TN Portal. Do not pay tuition until you verify approval status.

When comparing programs, ask before enrolling:
1. Is this program currently state-approved for Tennessee nurse aide training?
2. How many clinical hours are included?
3. What is the total cost including books, supplies, background check, and exam fees?
4. What is the next available start date?
5. What is your first-attempt pass rate on the state exam?

What Training Covers

Tennessee requires a minimum of 75 hours of state-approved training, including at least 16 hours of supervised clinical experience in an actual healthcare facility. Federal regulation 42 CFR 483.152 sets 75 hours as the national floor, and Tennessee meets it exactly.

Most programs exceed the minimum. The TCAT system delivers 120 hours. Ballad Health runs 100 hours: 60 classroom, 40 clinical.

Training covers the 24 clinical skills tested on the state exam: patient care fundamentals, vital signs measurement, infection control, communication techniques, mobility assistance, and personal hygiene care. A 75-hour program finishes in 2 to 4 weeks full-time; 120-hour programs take 4 to 8 weeks; evening and weekend formats can stretch to 2 to 3 months.

If reading that list of skills sounds overwhelming, here is what one CNA student described when the gap between watching and doing hit them:

“When the instructor demonstrates for us, yes I can understand what she does and why she does it. The moment I do with a partner, everything and I mean everything is gone out the brain.”

(87 upvotes, r/cna)

This is exactly why the 16-hour clinical minimum matters. Programs with 40 or more clinical hours give you significantly more time to build muscle memory before your skills evaluation.

Tennessee CNA Training Programs and Costs

Program	Location	Tuition	Total Est. Cost	Hours	Format
Ballad Health	Northeast TN	FREE	$0	100 (60 classroom + 40 clinical)	Hybrid available
TCAT Oneida-Huntsville	Oneida	$576	~$755	120	In-person
TCAT Knoxville	Knoxville	$591	~$850	120	In-person
Career Academy Memphis	Memphis	$1,350	$1,350 (all-inclusive)	120	In-person
TCAT Harriman	Harriman	$1,249	~$1,573	120	In-person, evenings available
Southern Adventist University	Collegedale	~$2,000	~$2,000	Varies	Hybrid

TCAT tuition figures exclude textbooks, supplies, and exam fees. TCAT Oneida adds $179 for textbooks (total ~$755). TCAT Harriman adds $324 in supplies (total ~$1,573). Career Academy Memphis’s $1,350 is all-inclusive and covers tuition and materials. Career Academy Memphis is also a registered testing site, so you can train and take your state exam in the same location.

For guidance on evaluating your options, see how to choose a CNA program.

Free and Low-Cost CNA Training in Tennessee

Ballad Health offers completely free CNA training in Northeast Tennessee. The program runs 100 hours, covers tuition, textbooks, and exam fees, and has 18 classes scheduled for 2026. An employment commitment with Ballad Health is expected after completion. Apply at balladhealth.org.

Some nursing homes offer free training under OBRA, the federal law funding facility-based CNA programs. You train while working at the facility, and they cover all costs including exam fees. A post-certification work commitment is standard.

There is no fully online CNA path in Tennessee. Skills like patient transfers and vital sign measurement require hands-on evaluation. Some programs, including Ballad Health and Southern Adventist University, offer hybrid formats with online coursework and in-person clinicals. If you are looking for online CNA classes, hybrid is the closest available option in Tennessee.

Pass the Tennessee CNA Competency Exam

Tennessee’s competency exam has two parts, both administered by D&S Diversified Technologies (Headmaster) through the TMU portal at tn.tmutest.com. For an overview of what the CNA exam covers nationally, see our exam guide. You can take both parts on the same day or separately.

Written Knowledge Test

The written test has 100 multiple-choice questions, a 90-minute time limit, and a 75% passing score (75 correct out of 100). The test was updated on October 21, 2024. It previously had 75 questions. If any resource lists 75 questions, it is outdated.

If English is not your first language or you have a documented reading difficulty, you can request an oral version of the test. Contact Headmaster before scheduling to arrange this.

Practice ahead of time with the CNA practice exam. Headmaster’s own practice materials also closely mirror the actual exam format.

Clinical Skills Evaluation

You will demonstrate 5 skills randomly selected from a pool of 24. Handwashing is always included as one of the first skills. You have 35 minutes total.

An evaluator scores every step of each skill demonstration. To pass, you must achieve at least 80% on the aggregate steps of each skill AND complete 100% of all bolded “Key Steps.” Bolded steps are safety-critical actions: locking bed brakes, performing hand hygiene, identifying the patient. Missing a single bolded step fails that entire skill, regardless of your overall score. Skills are drawn from the pool of 24 and include: taking vital signs, making an occupied bed, patient transfers, range of motion exercises, catheter care, and feeding assistance.

Three consecutive failures on either part trigger mandatory retraining. You must complete a new state-approved training program before retesting. Both parts must be passed within 24 months of completing your training, per the Tennessee Department of Education CNA Guidelines.

For a full breakdown of evaluator scoring criteria, see the CNA skills test guide. For study strategies that match the exam format, see how to study for the CNA exam.

Scheduling, Fees, and Retake Policy

Schedule through the TMU portal at tn.tmutest.com. Career Academy Memphis is a registered testing site, so if you train there, you can test in the same building.

Exam Component	Fee
Written/oral knowledge test	$30
Clinical skills evaluation	$68
Total	$98

Challenge testing: individuals with relevant nursing education or military medic experience may be eligible to challenge the exam without completing a full training program. Georgia reciprocity applicants may also qualify. Contact Headmaster at (888) 401-0465 to confirm.

Get Listed on the Tennessee Nurse Aide Registry

After you pass both exam portions, you are automatically added to the Tennessee Nurse Aide Registry. No separate application is required.

The registry is your official certification record. Employers are required to verify active registry status before hiring, and this is where they check. The registry is administered by D&S Diversified Technologies (Headmaster) on behalf of the Tennessee Department of Health.

Your responsibility: keep your name and address current. If you move or change your name, update your registry record through the TMU portal at tn.tmutest.com.

For registry lookup instructions, status verification, and employer verification tools, see the Tennessee Nurse Aide Registry guide.

How Much Does CNA Training Cost in Tennessee?

Total cost for CNA certification in Tennessee runs from $0 to about $2,600, depending on your program and financial aid eligibility.

Full Cost Breakdown

Expense	Cost Range
Tuition	$0 (Ballad Health) to $2,000 (Southern Adventist University)
Textbooks/supplies	$0-$324 (varies by program)
Exam fees	$98 ($30 written + $68 skills)
Background check	$25-$60
Physical exam/drug screen	$50-$150
Total estimated range	$0-$2,632

Tuition alone does not capture your full out-of-pocket cost. Budget for scrubs, a background check, drug screening, TB test, and exam fees in addition to whatever the program charges. These extras can add $150-$300 to any program’s listed tuition.

Financial Aid and Funding Options

Eight funding pathways can reduce your cost, and several can eliminate it entirely.

Aid Program	What It Covers	Who Qualifies
WIOA (Workforce Innovation and Opportunity Act)	100% of tuition, books, uniforms, supplies, exam fees	Income-eligible adults, dislocated workers, youth
SNAP E&T	Tuition + transportation	Current SNAP recipients
GI Bill / VR&E	Full tuition at approved schools	Post-9/11 veterans
MyCAA	Up to $4,000	Eligible military spouses
Pell Grant	Tuition at eligible institutions	Federally eligible students
Employer tuition reimbursement	Varies (often tuition + exam fees)	Employees of participating TN healthcare facilities
Nursing home employer-sponsored training	Free training + books + testing fees	Hired employees at participating facilities
TCAT payment plans	Spreads tuition over time	TCAT students

WIOA is the most broadly available option. It can cover 100% of CNA training costs for eligible applicants, including tuition, books, uniforms, and exam fees. Contact your local American Job Center or visit gwiktn.org/cna for Tennessee-specific details. If you are in Northeast Tennessee, Ballad Health’s free program is the straightforward starting point.

CNA Salary in Tennessee

What Tennessee CNAs Earn

Before you look at the numbers, here is the honest context: Tennessee CNA pay is below the national average, and the work is physically demanding. That said, the breakdown below shows exactly where the money is and what the tradeoffs are across settings.

Tennessee CNAs earn an average of $36,750 per year, or about $17.67 per hour, according to the Bureau of Labor Statistics (2024 OES survey). That is roughly $2,780 below the national CNA average of $39,530. The cost of living in many Tennessee metros is also below the national average, which offsets some of that gap.

Experience Level	Annual Salary	Hourly Rate
Entry-level	$28,000-$29,000	$13.50-$14.00/hr
Average	$32,000-$38,000	$16.00-$18.00/hr
Top earners	$44,000-$50,000	$21.00-$24.00/hr
Agency/travel CNAs	varies	$17.00-$22.00/hr

Job-board estimates (ZipRecruiter, Indeed) sometimes show slightly higher figures because they reflect current posting rates rather than verified wages paid. Treat job-board numbers as directional, not precise. For the most reliable data, use the BLS figures above.

One of the most common salary questions for prospective CNAs:

“Can CNAs make $1000 a week?” — Google People Also Ask

At Tennessee’s average of $16-$18/hour, a 40-hour week earns $640-$720 before taxes. Reaching $1,000 per week requires roughly $25/hour or significant overtime. Agency CNAs at $17-$22/hour working 50+ hour weeks can approach that number, but it is not a typical full-time staff wage at a nursing home or hospital.

Salary by Setting and Location

Setting	Typical Hourly Range
Nursing home/long-term care	$13.50-$16.00/hr
Hospital	$16.00-$20.00/hr
Home health	$14.00-$17.00/hr
Agency/travel	$17.00-$22.00/hr
Government facility	$17.00-$21.00/hr

Pay by setting is only part of the picture. Here is what many CNAs find when they actually work in long-term care:

“We have 23 residents on a floor with 3 CNAs, but most days it’s only 2. Meaning it’s roughly a 8-12 resident to staff ratio… I HATE having to ‘skimp’ on proper care, but with a resident to staff ratio of 1:12 it’s IMPOSSIBLE!”

(79 upvotes, r/cna)

Hospitals and home health agencies typically maintain lower patient-to-CNA ratios than nursing homes. The facility type you choose matters as much as the hourly rate when you are deciding where to apply.

One piece of practical advice that surfaces consistently in CNA communities before starting any new position:

“You are legally entitled to your breaks. Don’t ask your coworkers if you can go on break, TELL them you are going on break.”

(79 upvotes, r/cna)

Tennessee has no state law mandating meal or rest breaks for adult workers. Most healthcare employers set break policies in their employee handbooks. Know your facility’s policy before your first shift.

Transferring Your CNA Certification to Tennessee

Standard Reciprocity Process

If you hold an active CNA certification from another state, Tennessee accepts reciprocity from most states. Your certification must be active and in good standing. The process takes less than a week and costs $20-$25.

How to apply:

1. Go to tn.tmutest.com or the Headmaster website at hdmaster.com
2. Complete the online reciprocity application
3. Provide a valid government-issued photo ID and Social Security card
4. Pay the $20-$25 processing fee
5. Wait for processing (typically less than one week)

Contact Headmaster’s reciprocity office at (888) 401-0465 or [email protected] with questions.

States That Cannot Transfer (FL, GA, NC)

Tennessee does NOT accept CNA reciprocity from Florida, Georgia, or North Carolina. Each state gets a different path.

Florida and North Carolina: You must complete a Tennessee-approved training program and pass the full Tennessee competency exam. Full retraining and retesting are required.

Georgia: Georgia CNAs may be eligible to challenge the Tennessee exam without completing a new training program. Contact Headmaster at (888) 401-0465 to confirm your eligibility before making plans based on this option.

This exception catches many CNAs off guard, especially those relocating from neighboring states. Knowing it upfront saves weeks of confusion and lets you plan your timeline before your move.

Renewing Your Tennessee CNA Certification

Renewal Requirements

Your Tennessee CNA certification is valid for 24 months. To renew, you need proof of at least 8 hours of paid nursing or nursing-related work in a licensed or certified healthcare facility during that period, as required by the Tennessee Health Facilities Commission.

What counts toward the 8-hour requirement:
– Paid work in a nursing home, hospital, home health agency, or other licensed healthcare facility

What does NOT count:
– Private duty work
– Sitter or companion work
– Work in a private physician’s office

Proof accepted: a pay stub, payroll printout, or notarized attestation form. Renew online through the TMU portal at tn.tmutest.com or through LARS at lars.tn.gov.

What Happens If Your Certification Expires

If your certification lapses, you must provide proof of 8 hours of qualifying work for each year since your certification expired. If you cannot document qualifying hours, you will need to complete a new training program and pass the state exam again.

Check your current status on the Tennessee Nurse Aide Registry before your renewal deadline to confirm your active standing.

Career Advancement After CNA in Tennessee

CNA to LPN Bridge Programs

Not every CNA plans to stay at this level, and that is by design. One Reddit poster with a year of nursing home experience described what pushes many CNAs to move forward:

“I spent year as CNA in nursing home. My first job in healthcare… I like healthcare. But I hate who I become after year of this job.”

(104 upvotes, r/cna)

That experience is common. CNA to LPN bridge programs in Tennessee let you build directly on your existing patient care training and clinical hours. Several TCATs and community colleges offer LPN programs that treat CNA experience as a prerequisite advantage. Bridge programs typically take 12 to 18 months and roughly double your earning potential.

Path	Additional Training	Typical Pay vs. CNA
CNA to LPN (bridge program)	12-18 months	~2x CNA pay
CNA to RN (ADN or BSN)	2-4 years	~2.5-3x CNA pay
CNA to Specialty Tech (phlebotomy, EKG, med aide)	3-6 months each	+$2-5/hr per certification

Other Advancement Paths

CNA skills transfer across healthcare roles more broadly than most people expect:

“I’m an EMT who started as a CNA. One of my former medic partners also started as a CNA, and we frequently found ourselves giving elderly patients their walkers… These skills stick with you!”

(71 upvotes, r/cna)

Whether you advance to LPN, RN, EMT, or another healthcare role, the patient care fundamentals you develop as a CNA carry forward. Tennessee’s 23,030 CNA positions span nursing homes, hospitals, home health, hospice, and clinics, giving you direct patient care experience that strengthens any nursing school application.

CNA work is also one of the most AI-proof jobs without a degree because hands-on patient care cannot be automated. For a full picture of what a CNA does day to day before you commit to training, that guide covers the complete role.