GNA stands for Geriatric Nursing Assistant, a certified nursing professional who specializes in caring for elderly patients. The role is similar to a Certified Nursing Assistant (CNA) but requires additional training and a state exam focused specifically on geriatric care. GNAs work primarily in long-term care facilities, and federal law requires that all nursing assistants working in licensed comprehensive care facilities hold GNA certification.
What a GNA Does
A Geriatric Nursing Assistant provides hands-on daily care for elderly patients. This includes helping with bathing, dressing, feeding, mobility, and other activities of daily living. Beyond direct patient care, GNAs are responsible for sanitizing and restocking medical supplies and equipment, maintaining infection control practices, using proper body mechanics when lifting or repositioning patients, and recognizing and reporting safety hazards.
GNAs are also trained to identify sentinel risks, which are unexpected events that could cause serious harm to a patient. They’re expected to know their role during emergencies and to report any equipment malfunctions. The work is physically demanding and detail-oriented, with a strong emphasis on patient safety and infection prevention.
How a GNA Differs From a CNA
The most practical difference is specialization. CNAs work with patients of all ages across many healthcare settings. GNAs work exclusively with elderly populations, typically in nursing homes and long-term care centers. Because of that focus, GNAs complete more training and must pass a state-administered exam, while CNAs in many states do not face the same exam requirement.
Despite being an entry-level position, a GNA is considered more qualified than both home health aides and standard CNAs. That additional qualification reflects the complexity of geriatric care, where patients often have multiple chronic conditions, cognitive decline, and higher fall risk.
Certification Requirements
To become a GNA, you first need to hold a CNA certification. From there, you complete a 100-hour geriatric-specific training program that covers both classroom instruction and clinical skills. After finishing the program, you take a state exam that includes a written portion and a clinical skills demonstration.
If you don’t pass the exam, you can retake it, but there are limits. In Maryland, for example, if you fail any portion of the GNA exam four times within 24 months of completing your training program, you have to repeat the entire 100-hour program before trying again. The same applies if the 24-month window expires regardless of how many attempts you’ve made.
Once certified, GNAs must maintain an active listing on their state’s GNA registry. The Maryland Board of Nursing, which is one of the primary regulatory bodies for this credential, processes GNA certifications and renewals and maintains a combined CNA/GNA database where employers can verify credentials. Federal law requires states to maintain a GNA registry that tracks certification status and any disciplinary actions.
Where GNAs Work
The most common setting for GNAs is a long-term care facility or nursing home, since federal regulations require the credential in these environments. But GNAs also find positions in assisted living facilities, hospitals with geriatric units, home healthcare services, hospice programs, and rehabilitation centers. The aging U.S. population means these settings continue to need staff, though overall employment growth for nursing assistants is projected at about 2 percent from 2024 to 2034, which is slower than average.
Salary Expectations
GNA pay falls in line with the broader nursing assistant category. The Bureau of Labor Statistics reported a median annual wage of $39,530 for nursing assistants in May 2024, which works out to roughly $18.96 per hour. Actual pay varies by state, facility type, and experience. GNAs working in hospitals or metropolitan areas generally earn more than those in rural nursing homes, and per diem or PRN (as-needed) shifts sometimes offer higher hourly rates to fill staffing gaps.
Is GNA Certification Worth It?
If you’re already a CNA and you want to work in a nursing home or long-term care facility, GNA certification isn’t optional. Federal law requires it. But even beyond that requirement, the credential opens doors that a standard CNA license doesn’t. It signals specialized knowledge in a patient population that’s growing rapidly, and it positions you for roles in memory care, palliative care, and other geriatric specialties.
For people considering nursing as a longer-term career, working as a GNA provides clinical experience that’s valuable when applying to LPN or RN programs. The daily exposure to complex patients, medication management, wound care observation, and interdisciplinary team communication builds a practical foundation that classroom learning alone can’t match.