An LNA, or Licensed Nursing Assistant, is a frontline healthcare worker who provides hands-on patient care under the supervision of nurses. The role is functionally the same as a Certified Nursing Assistant (CNA), but the “licensed” title reflects a higher level of state regulatory oversight in the states that use the designation. LNAs help patients with daily activities like bathing, eating, and moving around, while also performing basic clinical tasks such as measuring vital signs and drawing blood.
LNA vs. CNA: Why the Name Differs
Most states call the role a Certified Nursing Assistant, but a handful, including New Hampshire and Arizona, use the title Licensed Nursing Assistant. The distinction isn’t just cosmetic. In Arizona, for example, LNAs must complete a criminal background check and log at least 160 hours of practice every two years to renew their license. A standard Registry CNA in that state only needs 8 hours of practice in the same period, and no background check is required. The LNA designation generally signals stricter oversight by the state board of nursing, both before and after the license is issued.
Despite the naming difference, salary data, training pathways, and core responsibilities overlap almost entirely. If you see a job posting for a CNA, the work is the same as what an LNA does in a state that uses that title.
What an LNA Does Every Day
LNAs are often the people patients interact with most. Their core duties center on activities of daily living: helping patients bathe, dress, use the toilet, and eat. They turn and reposition patients who can’t move on their own, transfer them between beds and wheelchairs, and serve meals. Beyond personal care, LNAs take vital signs like blood pressure and temperature, listen to patients’ health concerns, and relay that information to the supervising nurse.
The scope of practice can extend well beyond basic care, depending on the state and the work setting. New Hampshire’s Board of Nursing, which uses the LNA title, publishes a detailed list of approved tasks. LNAs there can perform EKGs, draw blood, conduct bladder scans, apply pulse oximeters, adjust oxygen flow rates for stable patients, and remove indwelling urinary catheters. In long-term care settings specifically, they may also administer over-the-counter medications, apply medicated creams, perform clean intermittent catheterization, manage colostomy care for stable patients, and even administer tube feedings via pump.
There are clear boundaries. LNAs cannot insert IV lines, place feeding tubes, perform sterile procedures, remove sutures, teach patients about their conditions, or call in prescriptions to a pharmacy. These tasks require a licensed practical nurse or registered nurse. The general rule: LNAs handle routine, non-sterile care for patients whose conditions are stable and whose care plans are already established.
Training and Licensing Requirements
Becoming an LNA requires completing a state-approved training program that includes both classroom instruction and supervised clinical hours. Federal regulations require at least 16 hours of classroom training before any direct patient contact, followed by a minimum of 40 hours of supervised clinical experience. Many state programs exceed these minimums.
After finishing a training program, candidates must pass a competency exam. This typically has two parts: a written test covering nursing fundamentals and a skills demonstration where candidates perform hands-on tasks in front of an evaluator. Once certified, LNAs are placed on their state’s nurse aide registry. Staying on the registry requires meeting renewal criteria, which vary by state but generally include a minimum number of practice hours and, for states using the LNA designation, periodic background checks.
Where LNAs Work
Nursing and residential care facilities are the most common employers. In these settings, LNAs often become the primary caregivers for residents who stay for months or years, building relationships that few other healthcare roles allow. Hospitals also employ large numbers of LNAs, particularly on medical and surgical floors where patients need frequent repositioning, vital sign checks, and help with mobility.
Beyond those traditional settings, LNAs work in assisted living communities, continuing care retirement facilities, home health agencies, hospice programs, and community health organizations. Home care roles tend to involve more independence, since the LNA may be the only caregiver present during a shift, while hospital and nursing home positions involve closer coordination with a larger clinical team.
Salary and Job Outlook
The median annual wage for nursing assistants (including both CNAs and LNAs) is $39,430, which works out to about $18.96 per hour. Pay varies by setting: hospital-based positions pay a median of $40,170 per year, skilled nursing facilities pay around $39,170, and assisted living communities pay roughly $38,500. The top 10% of earners make over $50,140 annually, while the lowest 10% earn $15.09 per hour or less.
Wages have been climbing. The national average annual wage rose from $36,220 in 2022 to $41,270 in 2024, a jump of nearly $5,000 in two years. Demand is projected to stay strong as the population ages and the need for care of chronic conditions like heart disease and diabetes grows.
Physical Demands and Work Schedule
LNA work is physically strenuous. You spend most of your shift on your feet, lifting and repositioning patients, and assisting with transfers. Nursing assistants have one of the highest rates of workplace injuries and illnesses of all occupations, primarily due to the repetitive physical demands of moving patients.
Because hospitals and care facilities operate around the clock, LNAs frequently work nights, weekends, and holidays. Twelve-hour shifts are common in many facilities, and overtime is often available given persistent staffing shortages in long-term care.