A CNA (Certified Nursing Assistant) and an LPN (Licensed Practical Nurse) are both entry-level healthcare roles, but they differ significantly in training length, scope of practice, salary, and career trajectory. CNAs complete 4–12 weeks of training and earn a state certificate. LPNs complete roughly one year of formal education and pass a national licensing exam.
The right choice depends on your timeline, financial situation, and where you want to go in your nursing career. CNAs can begin working in weeks and often use the role as a foundation before pursuing further education. LPNs earn more, take on greater clinical responsibility, and have more flexibility across healthcare settings – but the path to licensure takes longer and costs more.
This guide breaks down both roles so you can make an informed decision.
CNA vs LPN at a glance
| Feature | CNA | LPN |
|---|---|---|
| Training length | 4–12 weeks | 12–18 months |
| Education required | High school diploma or GED | High school diploma or GED |
| Licensing exam | State competency exam (written + skills) | NCLEX-PN (national) |
| Median hourly wage | $20.32/hr | $30.96/hr |
| Median annual salary | $42,260 | $64,400 |
| Works under | RN or LPN supervision | RN or physician supervision |
| Can administer medications? | No (except in some states, limited) | Yes (most settings) |
| Can perform IV therapy? | No | Yes (with training, in most states) |
| Patient assessment duties | Basic – vital signs, ADLs, reporting | Expanded – clinical assessment, care planning input |
| Career bridge options | CNA to LPN, CNA to RN | LPN to RN bridge programs widely available |
What CNAs do
A certified nursing assistant provides basic patient care under the supervision of an RN or LPN. The role is hands-on and physical – CNAs spend more time with individual patients than most other members of the care team.
Core duties include:
- Measuring and recording vital signs (blood pressure, pulse, temperature, respiration)
- Assisting with activities of daily living (bathing, dressing, grooming, mobility)
- Repositioning patients to prevent pressure injuries
- Feeding patients who need assistance
- Documenting patient status and reporting changes to supervising nurses
- Providing companionship and communication – especially important in long-term care
CNAs work across a wide range of settings: nursing homes and long-term care facilities, hospitals (as patient care technicians or nursing assistants), home health agencies, assisted living facilities, and rehabilitation centers. Long-term care is the most common employer. Of the roughly 1,441,500 nursing assistant jobs the Bureau of Labor Statistics counted in its May 2025 wage estimates, skilled nursing care facilities account for about 492,000 and continuing care retirement communities and assisted living facilities for a further 150,000 – around 45% of the occupation between them. General medical and surgical hospitals are the next largest employer at roughly 426,000.
CNAs are not licensed – they hold a state certificate and are listed on their state’s nurse aide registry. Each state sets its own minimum training hour requirements. The federal floor is 75 hours, set by the Omnibus Budget Reconciliation Act of 1987 and codified at 42 CFR § 483.152; roughly 19 states use that floor unchanged, while the rest set higher requirements that top out at 180 hours in Maine and 175 in Missouri. The certification exam includes a written portion and a hands-on skills demonstration.
What LPNs do
A licensed practical nurse (called an LPN in most states, and an LVN – Licensed Vocational Nurse – in California and Texas) holds a nursing license issued after passing the NCLEX-PN exam. LPNs perform a broader range of clinical tasks than CNAs and work with greater independence – though they still practice under the supervision of an RN or physician.
Core duties include:
- Performing clinical assessments and monitoring patient status
- Administering medications orally, via injection, and through IVs (scope varies by state and facility)
- Wound care and dressing changes
- Inserting urinary catheters
- Collecting specimens for lab testing
- Contributing to care planning and documenting patient progress
- Educating patients and families on home care, medications, and follow-up
LPNs work in a similar range of settings to CNAs but with expanded opportunities: physician offices and outpatient clinics, long-term care, hospitals, correctional facilities, schools, and home health agencies. Physician offices and outpatient settings employ a larger proportion of LPNs than CNAs.
LPN programs are offered at community colleges, vocational schools, and some hospital-based programs. They typically run 12–18 months for full-time students. Curriculum includes classroom instruction in pharmacology, anatomy, nursing fundamentals, and mental health, combined with clinical rotations in hospitals and long-term care facilities.
Training and education compared
CNA training
CNA programs are short, affordable, and widely available. Many are offered through:
- Community colleges (often the most structured)
- Vocational and technical schools
- Nursing homes and long-term care facilities (some offer free or subsidized training in exchange for a work commitment)
- Online programs with in-person skills checkoffs (availability varies by state)
Training typically costs $500–$2,000 for program tuition, though employer-sponsored programs can bring that cost to zero. Total training hours range from the federal 75-hour floor up to 180 hours depending on state requirements. After completing training, you take a state competency exam – a written test plus a hands-on demonstration of core nursing assistant skills.
LPN training
LPN programs take significantly longer and cost more – typically $7,000–$25,000 depending on the institution. Community college programs are generally the most affordable option. Program content includes:
- Anatomy & physiology
- Pharmacology and medication administration
- Nursing fundamentals
- Medical-surgical nursing
- Maternal-child health
- Mental health nursing
- Clinical rotations (hospitals, nursing homes, clinics)
After completing the program, LPN graduates take the NCLEX-PN – a computerized adaptive exam that tests clinical judgment and nursing knowledge. Passing is required for licensure in all 50 states. In 2025, 86.6% of first-time US-educated candidates passed (47,470 of 54,818), down from 88.4% in 2024.
Salary comparison
Both roles pay more in high-cost-of-living states (California, Massachusetts, Hawaii, Washington) and in specialty settings like hospitals versus long-term care.
CNA salary:
- Median hourly wage: $20.32 (Bureau of Labor Statistics, May 2025)
- Annual median: $42,260
- Bottom 10%: $33,940 or less
- Top 10%: above $51,980
- Hospital settings tend to pay higher than nursing homes
See the CNA salary guide for state-by-state breakdown.
LPN salary:
- Median hourly wage: $30.96 (Bureau of Labor Statistics, May 2025)
- Annual median: $64,400
- Bottom 10%: $49,740 or less
- Top 10%: above $83,440
- Home health and physician office LPNs often earn competitively with hospital LPNs
At the median, an LPN earns $22,140 more per year than a CNA – about 52% more. The gap widens at the top of each range: the highest-paid 10% of LPNs clear $83,440, while the equivalent CNA threshold is $51,980.
See the LPN salary guide for more detail on earning potential by setting and state.
Scope of practice: where the lines are
The most important practical distinction between the two roles is scope of practice – the legally defined range of tasks each can perform. These lines are set by state nursing boards, not employers, and they vary somewhat by state.
What CNAs cannot do (in most states):
- Administer medications of any kind (exceptions exist for very limited oral meds in some states)
- Perform IV therapy or manage IV lines
- Conduct formal clinical assessments
- Take verbal or telephone orders from physicians
- Create or modify care plans independently
What LPNs can do that CNAs cannot:
- Administer oral, topical, injectable, and (with training) IV medications
- Perform clinical assessments and document nursing observations
- Perform wound care, catheter insertion, and tube feedings
- Triage patients in outpatient settings
- Supervise CNAs and nursing assistants
- Take physician orders in most states
The distinction matters both for the work itself and for liability. An LPN working beyond their scope of practice – or a CNA performing tasks reserved for licensed nurses – faces serious legal and professional consequences.
Career progression: where each path leads
From CNA
The CNA role is often a starting point. Many nurses began as CNAs before pursuing further education. Common pathways forward:
- CNA to LPN: Most LPN programs accept CNA experience and some offer advanced placement or credit for documented skills. See the CNA to LPN bridge programs guide.
- CNA to RN: With adequate prerequisites and academic preparation, CNAs can apply directly to RN programs (ADN or BSN). Some community colleges offer CNA-to-ADN articulation agreements. See the CNA to RN bridge guide.
- Specialization as a CNA: Some CNAs develop specialized skills in settings like memory care, hospice, or pediatrics – though formal specialization credentials are limited compared to licensed roles.
From LPN
LPNs have a well-established advancement pathway:
- LPN to RN: LPN-to-RN bridge programs allow LPNs to earn an associate or bachelor’s degree in nursing with credit for prior LPN education and clinical hours. These programs typically run 12–18 months for the additional coursework. See the LPN to RN bridge programs guide.
- Specialization as an LPN: LPNs can develop expertise in long-term care management, IV therapy, wound care, or dialysis. Some states allow LPNs to sit for specialty certifications.
How to decide between CNA and LPN
Start with CNA if:
- You need to begin earning income quickly (within 4–12 weeks)
- You want to test whether direct patient care is the right fit before committing to a longer program
- You are planning to pursue RN licensure and want clinical experience first
- You have limited funds for education upfront
Start with LPN if:
- You want meaningful clinical responsibility from the outset – medication administration, assessments, care planning
- You are not planning to pursue RN licensure immediately (LPN is a sustainable career in long-term care and physician office settings)
- You have one year available for full-time study
- You want to work in a setting that requires a license (many physician offices and some hospital units hire LPNs but not CNAs)
Neither path is a dead end. Most CNA and LPN programs build credit toward further nursing education, and clinical experience in both roles prepares you well for RN licensure programs. The difference is timing and scope.
For more detail on how to become a CNA specifically, see the how to become a CNA guide.
Summary
CNAs and LPNs both provide direct patient care, but their training, pay, and clinical authority differ substantially. CNAs are state-certified after 4–12 weeks of training and earn a median $42,260 annually; LPNs are licensed after roughly one year of formal education and earn a median $64,400. LPNs administer medications, perform clinical assessments, and supervise CNAs – tasks outside the CNA scope of practice. Both roles offer clear pathways to RN licensure for those who want to advance.
References
- U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics, Nursing Assistants (SOC 31-1131),” May 2025 estimates (median annual wage $42,260; median hourly wage $20.32; 10th percentile $33,940; 90th percentile $51,980).
- U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics, Licensed Practical and Licensed Vocational Nurses (SOC 29-2061),” May 2025 estimates (median annual wage $64,400; median hourly wage $30.96; 10th percentile $49,740; 90th percentile $83,440).
- U.S. Bureau of Labor Statistics, “Occupational Employment and Wage Statistics, Nursing Assistants (SOC 31-1131),” May 2025 industry-specific estimates (total employment 1,441,500; skilled nursing care facilities ~492,050; continuing care retirement communities and assisted living ~150,140; general medical and surgical hospitals ~425,740), U.S. Department of Labor.
- U.S. Bureau of Labor Statistics, “Licensed Practical and Licensed Vocational Nurses,” Occupational Outlook Handbook, U.S. Department of Labor, 2025.
- National Council of State Boards of Nursing, “2025 NCLEX Examination Statistics,” Research Brief Volume 96, NCSBN, June 2026, Table 14 (first-time US-educated NCLEX-PN pass rate 86.6%, 47,470 of 54,818; NCLEX-RN 86.7%). Prior-year comparison from “2024 NCLEX Examination Statistics,” Research Brief Volume 94, NCSBN, July 2025, Table 14 (NCLEX-PN 88.4%).
- U.S. Government, “42 CFR § 483.152 – Requirements for approval of a nurse aide training and competency evaluation program,” Electronic Code of Federal Regulations (federal 75-hour OBRA 1987 minimum for nurse aide training), accessed 2026.
- National Council of State Boards of Nursing, “NNAAP & MACE,” NCSBN.org (state competency exam structure for nurse aides – written plus skills demonstration), accessed 2026.
- ONET OnLine, “Wages & Employment Trends: Nursing Assistants (31-1131.00) and Licensed Practical and Licensed Vocational Nurses (29-2061.00),” National Center for ONET Development (mirror of BLS May 2025 OEWS national and state wage estimates), accessed 2026.