CNA Training in Michigan

Michigan requires at least 75 hours of nurse aide training: 16 classroom hours before you work with residents, 16 supervised clinical hours in a long-term care setting, and 43 more hours of any mix. The Department of Licensing and Regulatory Affairs (LARA) permits programs and runs the Nurse Aide Registry, and Headmaster runs the state exam.

If you work at, or have a job offer from, a nursing home, county medical care facility, or hospital long-term care unit, you can be reimbursed for training, testing, and registration. Below you'll find each step, pay, ways to train free, and permitted programs statewide.

Training

75+ Hours

Median Pay

$19.03/hr

Exam Cost

$175

CNA student practicing patient care in Michigan
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The 4 Steps to Certification in Michigan

1

Pick a State-Approved Program

LARA permits every nurse aide training program. Your options:

  • ✓Community colleges: including Macomb, Grand Rapids, Lansing, Delta, Kellogg, and Washtenaw.
  • ✓Nursing homes and medical care facilities: many train people they hire, and you can be reimbursed if you work there.
  • ✓Private schools: set their own prices. Classroom hours can be in person or virtual; lab and clinical hours are always in person.
2

Complete at Least 75 Hours

Michigan splits the 75 hours like this:

16 Hours
Classroom, before resident contact
16 Hours
Supervised clinical (long-term care)

The other 43 hours can be any mix of classroom, lab, and clinical. After graduating, you can work as a temporary nurse aide for up to 4 months while you finish testing.

3

Pass the Headmaster Exam

A written (or oral) knowledge test and a skills test. You get 3 tries at each.

Knowledge + skills, first attempt$175
Knowledge retake$175
Skills retake$175
Certificate of registration (LARA)$40
After you pass: create a MILogin account, request access to MI-NATES, and submit your new nurse aide application with the $40 fee. MI-NATES doesn't work in Safari, so use Chrome or Edge.
4

Stay Active

Renew every 24 months in MI-NATES, up to 45 days before your expiration date.

  • ●Work at least 40 hours in paid nursing or nursing-related services in the last 24 months.
  • ●Complete 12 hours of CE each year including abuse, neglect, and care plan training. This rule applies to certificates expiring on or after March 23, 2026.
  • ●Pay $40 to renew. A lapsed certificate means you can't work as a CNA.

💰 How to Get CNA Training Free in Michigan

Get hired first, or get help paying.

Employer Reimbursement

✨ Paid Back When You Work There
ℹ️If you work at, or have a job offer from, a nursing home, county medical care facility, or hospital long-term care unit, you can be reimbursed for training, testing, and registration costs under federal rules.
⚡Keep your receipts and ask your employer about reimbursement.

Facility Training Programs

✨ Train Where You Work
ℹ️Some nursing homes and medical care facilities run their own permitted programs, including Lenawee Medical Care Facility, Thornapple Manor, and Iron County Medical Care Facility.
⚡Ask local facilities whether they hire and train nurse aides.

Michigan Works! (WIOA)

✨ Grant-Funded, If You Qualify
ℹ️Your local Michigan Works! agency can pay for approved training if you're unemployed, laid off, or low-income.
⚡Apply before you enroll.

Michigan CNA Pay by Area

Michigan CNAs earn about $1.29 an hour less than the national median.

Area Median Hourly Median Annual CNAs Employed
Michigan (statewide)$19.03$39,57043,290
United States (national)$20.32$42,2601,505,900

Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025, Nursing Assistants (31-1131). Medians exclude overtime and shift differentials.

What It Costs to Get Certified

Work at a nursing home or medical care facility and you can be reimbursed for the main costs.

Tuition

$0 with employer

Colleges and private schools set their own prices. Employers covered by federal rules must reimburse you.

State Exam

$175

Knowledge and skills tests together, first attempt, through Headmaster.

Retakes

$175 each

For each knowledge or skills retake.

Registration

$40

To get your certificate of registration. Renewal is also $40 every 24 months.

Moving to Michigan?

If you're a certified nurse aide in another state, you can apply for reciprocity in Michigan.

Active CNA in Another State

Create a MILogin account, request access to MI-NATES, and complete the reciprocity application there. LARA has a video that walks you through it.

Lapsed or Never Tested

If you're no longer active in another state, expect to train and test in Michigan.

Questions? Call

(517) 284-8961

LARA Nurse and Medication Aide Section

CNA Schools in Michigan

State-permitted nurse aide training programs across Michigan: community colleges, private schools, and facility programs. Search by name, city, or county, or filter by county.

ProgramCityCountyWebsite
1st Step CNA Training LLC3085 Bay Rd, Saginaw, MI 48603 Saginaw Saginaw Website
1st Step Healthcare Training LLC7800 Outer Dr W, Detroit, MI 48235 Detroit Wayne Website
A-List Healthcare Training Academy25900 Greenfield Rd, Oak Park, MI 48237 Oak Park Oakland Website
Achieve Career Training10680 Haggerty Rd, Van Buren Twp, MI 48111 Van Buren Twp Wayne Website
Advanced Care Training37554 Hills Tech Dr, Farmington Hills, MI 48331 Farmington Hills Oakland Website
Agape Health Care Schools221 S Mitchell St, Cadillac, MI 49601 Cadillac Wexford Website
Alpena Community College-Oscoda campus5800 N Skeel Ave, Oscoda, MI 48750 Oscoda Iosco Website
ALR Educational Health Services - Buchanan Campus502 Claremont St, Buchanan, MI Buchanan Berrien Website
ALR Educational Health Services Inc315 E Main St, Niles, MI 49120 Niles Berrien Website
Assist 1 Medical Center1116 Voorheis Rd, Waterford, MI 48328 Waterford Oakland Website
Back to Basics Wellness, Lifestyle812 E State St, Cassopolis, MI 49031 Cassopolis Cass Website
Baker College / Corporate Training1020 S Washington St, Owosso, MI 48867 Owosso Shiawassee Website
Barnabas Healthcare School of Professional Studies24235 W 7 Mile Rd, Detroit, MI 48219 Detroit Wayne Website
Bay College2001 N Lincoln Rd, Escanaba, MI 49829 Escanaba Delta Website
Bay de Noc Community College2801 N US Highway 2, Iron Mountain, MI 49801 Iron Mountain Dickinson Website
Bay Mills Community College12214 W Lakeshore Dr, Brimley, MI 49715 Brimley Chippewa Website
Bronson Nurse Aide Training Program601 John St, Kalamazoo, MI 49007 Kalamazoo Kalamazoo Website
Calvin University CNA training program3201 Burton St SE, Grand Rapids, MI 49546 Grand Rapids Kent Website
Career Building Institute LLC8904 Woodward Ave, Detroit, MI 48202 Detroit Wayne Website
Carepro Healthcare Training43700 Woodward Ave, Bloomfield, MI 48302 Bloomfield Oakland Website
Center for Medical Training3100 Ivanrest Ave SW, Grandville, MI 49418 Grandville Kent Website
Certified Nurse Aide (CNA) Program3555 E Patrick Rd, Midland, MI 48642 Midland Midland Website
Certified Nurse Aide Program (CNA)6919 N Waverly St, Dearborn Heights, MI 48127 Dearborn Heights Wayne Website
Certified Nursing AssistantFlint, MI Flint Genesee Website
Certified Nursing Assistant3055 Harrison St, Saginaw, MI 48604 Saginaw Saginaw Website
Charter Health Care Training Center1055 Charter Dr, Flint, MI 48532 Flint Genesee Website
Clark Retirement Community1551 Martin Luther King Jr St SE, Grand Rapids, MI 49506 Grand Rapids Kent Website
CNA Academy LLC1010 Antietam Ave, Detroit, MI 48207 Detroit Wayne Website
CNA Life Training Center1358 E Bristol Rd, Burton, MI 48529 Burton Genesee Website
CNA Online Grand Traverse County2950 Lafranier Rd, Traverse City, MI 49686 Traverse City Grand Traverse Website
CNA Online Lansing600 W Saint Joseph St, Lansing, MI 48933 Lansing Ingham Website
CNA Online Marshall5775 Beckley Rd, Battle Creek, MI 49015 Battle Creek Calhoun Website
CNA Online Sault Ste. Marie1011 Meridian St, Sault Ste. Marie, MI Sault Ste. Marie Chippewa Website
CNA Online The Lodge at Taylor22950 Northline Rd, Taylor, MI 48180 Taylor Wayne Website
Commonwealth Home Health NetworkMonroe, MI Monroe Monroe Not listed
Davis Training Institute5151 Hampton Pl, Saginaw, MI 48604 Saginaw Saginaw Website
Delta College419 E Ellsworth St, Midland, MI 48640 Midland Midland Website
Delta College1961 Delta Rd, University Center, MI 48710 University Center Bay Website
Delta Schoolcraft Intermediate School District100 N Cedar St, Manistique, MI 49854 Manistique Schoolcraft Website
Detroit Business InstituteDetroit, MI Detroit Wayne Website
Devoted Healthcare Training Center42463 GARFIELD, Clinton Township, MI Clinton Township Lenawee Website
DJ Jacobetti Nurse Aid Training425 Fisher St, Marquette, MI 49855 Marquette Marquette Website
Dobie RoadOkemos, MI Okemos Ingham Not listed
Dream Healthcare AcademySterling Heights, MI Sterling Heights Macomb Not listed
DRM International Learning Center809 Center St, Lansing, MI 48906 Lansing Ingham Website
Eastwood Nursing Center900 Maas St, Negaunee, MI 49866 Negaunee Marquette Website
EPiC Nurse Aide Training Program6021 Henry Rd, Hastings, MI 49058 Hastings Barry Website
Evergreen Health Training Institute17700 Northland Park Ct, Southfield, MI 48075 Southfield Oakland Website
Excellent Choice HealthCare Training Center LLC30104 Ford Rd, Garden City, MI 48135 Garden City Wayne Website
Excelling Nursing Academy Inc.21100 Osmus St, Farmington Hills, MI 48336 Farmington Hills Oakland Website
FaithWorks CNA AcademyDewitt, MI Dewitt Clinton Not listed
Flat River Medical202 S Lafayette St, Greenville, MI 48838 Greenville Montcalm Website
Flat River Medical, LLC1200 Wright Ave, Alma, MI 48801 Alma Gratiot Website
Flat River Medical, LLC21996 Northland Dr, Paris, MI 49338 Paris Mecosta Website
Genanscot Services15850 E Warren Ave, Detroit, MI 48224 Detroit Wayne Website
Genesis Healthcare Training Academy24350 Joy Jd, Redford, MI Redford Wayne Website
Gentle Hands of Integrity LLC2470 Collingwood St, Detroit, MI 48206 Detroit Wayne Website
Glen Oaks Community College62249 Shimmel Rd, Centreville, MI 49032 Centreville St. Joseph Website
Gogebic Community College47420 M-26, Houghton, MI 49931 Houghton Houghton Website
Gogebic Community CollegeIronwood, MI Ironwood Gogebic Website
Gogebic Community College - Ontonagon701 Parker Ave, Ontonagon, MI 49953 Ontonagon Ontonagon Website
Gogebic Community College/GOISDE4946 Jackson Rd, Ironwood, MI 49938 Ironwood Gogebic Website
Goodwill Industries of Greater Grand Rapids3777 Sparks Dr SE, Grand Rapids, MI 49546 Grand Rapids Kent Website
Graham Health Education Nurse Aide TrainingNorton Shores, MI Norton Shores Muskegon Not listed
Grand Rapids Community College143 Bostwick Ave NE, Grand Rapids, MI 49503 Grand Rapids Kent Website
Grayling Nursing and Rehabilitation Community331 Meadows Dr, Grayling, MI 49738 Grayling Crawford Website
Groves at Kalamazoo Valley Community College, TheKalamazoo, MI Kalamazoo Kalamazoo Not listed
Hazel Findlay Country Manor1101 S Scott Rd, Saint Johns, MI 48879 Saint Johns Clinton Website
Healing Healthcare Training Institute LLC Pontiac CampusPontiac, MI Pontiac Oakland Not listed
Health Care Solutions and Career Group15800 W McNichols Rd, Detroit, MI 48235 Detroit Wayne Website
Health Career Pathways3010 Gull Rd, Kalamazoo, MI 49048 Kalamazoo Kalamazoo Website
Health Career Solutions, PLLC20600 Eureka Rd, Taylor, MI 48180 Taylor Wayne Website
Heart to Heart Healthcare Training1000 W Saint Joseph St, Lansing, MI 48915 Lansing Ingham Website
Helping Hands Training Program for CENAs, LLC430 Mack Ave, Detroit, MI 48201 Detroit Wayne Website
Henderson Health - Nurse Aide Trainer Program41570 Hayes Rd, Clinton Township, MI 48038 Clinton Township Macomb Website
Hickory Ridge of Temperance951 Hickory Creek Blvd, Temperance, MI 48182 Temperance Monroe Website
Huron Valley Adult Education4200 White Oak Trail, Commerce, MI 48382 Commerce Oakland Website
I-XCELL Training Institute LLC4375 E Holland Rd, Saginaw, MI 48601 Saginaw Saginaw Website
IHM Senior Living Community, INC610 W Elm Ave, Monroe, MI 48162 Monroe Monroe Website
Inle Healthcare Training,llc32524 Warren Rd, Westland, MI 48185 Westland Wayne Website
Iron County Medical Care Facility1523 US Highway 2, Crystal Falls, MI 49920 Crystal Falls Iron Website
Irving's Professional17036 9 Mile Rd, Eastpointe, MI 48021 Eastpointe Macomb Website
JACC Adult Career Education6800 Browns Lake Rd, Jackson, MI 49201 Jackson Jackson Website
Kellogg Community College14055 26 Mile Rd, Albion, MI 49224 Albion Calhoun Website
Kellogg Community College100 Van Buren St W, Battle Creek, MI 49017 Battle Creek Calhoun Website
Kellogg Community College125 Seeley St, Coldwater, MI 49036 Coldwater Branch Website
Kellogg Community College-FehsenfeldHastings, MI 49058 Hastings Barry Website
Keweenaw Bay Ojibwa Community College770 N Main St, L'Anse, MI 49946 L'Anse Baraga Website
Kirtland Community College Nurse Aide Training Program4800 W 4 Mile Rd, Grayling, MI 49738 Grayling Crawford Website
Lake Michigan College2891 116th Ave, Allegan, MI 49010 Allegan Allegan Website
Lake Michigan College2755 E Napier Ave, Benton Harbor, MI 49022 Benton Harbor Berrien Website
Lake Michigan College125 Veterans Blvd, South Haven, MI 49090 South Haven Van Buren Website
Lansing Community College515 N Washington Sq, Lansing, MI 48933 Lansing Ingham Website
Lenawee Medical Care Facility200 Sand Creek Hwy, Adrian, MI 49221 Adrian Lenawee Website
Mackinac Straits Long Term Care1140 N State St, Saint Ignace, MI 49781 Saint Ignace Mackinac Website
Macomb Community College14500 E 12 Mile Rd, Warren, MI 48088 Warren Macomb Website
Madonna University Nurse Aide Training Program36600 Schoolcraft Rd, Livonia, MI 48150 Livonia Wayne Website
Marwood Nursing & Rehab1300 Beard St, Port Huron, MI 48060 Port Huron St. Clair Website
Mary Lee Community Health & Training Center25548 5 Mile Rd, Redford, MI 48239 Redford Wayne Website
Medilodge of Monroe481 Village Green Ln, Monroe, MI 48162 Monroe Monroe Website
Medilodge of Port Huron5635 Lakeshore Rd, Fort Gratiot, MI 48059 Fort Gratiot St. Clair Website
Medilodge of Rogers City555 N Bradley Hwy, Rogers City, MI 49779 Rogers City Presque Isle Website
Medilodge of Yale90 Jean St, Yale, MI 48097 Yale St. Clair Website
Medpro Healthcare Training LLC31201 Chicago Rd S, Warren, MI 48093 Warren Macomb Website
Michigan Career & Technical Institute-Kalamazoo612 N Park St, Kalamazoo, MI 49007 Kalamazoo Kalamazoo Website
Michigan Career and Technical Institute11611 Pine Lake Rd, Plainwell, MI 49080 Plainwell Allegan Website
Michigan Career and Technical Institute - Benton Harbor499 E Main St, Benton Harbor, MI 49022 Benton Harbor Berrien Website
Michigan Healthcare Academy, LLC33 N River Rd, Mt. Clemens, MI 48043 Mt. Clemens Macomb Website
Mid Michigan CollegeHarrison, MI Harrison Clare Not listed
Montcalm Community College2800 College Dr, Sidney, MI 48885 Sidney Montcalm Website
Mott Community College - Lapeer550 Lake Dr, Lapeer, MI 48446 Lapeer Lapeer Website
Mott Community College-Fenton2100 W Thompson Rd, Fenton, MI 48430 Fenton Genesee Website
N.u.r.s.e.s. (IIMD)111 E Kirby St, Detroit, MI 48202 Detroit Wayne Website
Newlight Institute of Health Sciences & Applied Studies31500 W 13 Mile Rd, Farmington Hills, MI 48334 Farmington Hills Oakland Website
Noble Healthcare Training LLC3721 W Michigan Ave, Lansing, MI 48917 Lansing Eaton Website
Norlite Nursing CenterMarquette, MI Marquette Marquette Not listed
North Central Michigan College CNA Fast Track Program416 Connable Ave, Petoskey, MI 49770 Petoskey Emmet Website
Northern Michigan Health Training School1760 Garfield Rd S, Traverse City, MI 49696 Traverse City Grand Traverse Website
Northern Training and Assessment CNA training programHoughton Lake, MI Houghton Lake Roscommon Not listed
Nurse Aide2370 Linden Rd, Flint, MI 48532 Flint Genesee Website
Nurse Aide Training16167 Meyers Road, Detroit, MI Detroit Wayne Website
Nurse Aide Training Course22115 Gratiot Ave, Eastpointe, MI Eastpointe Macomb Website
Nurse Aide Training Program7800 Outer Dr W, Detroit, MI 48235 Detroit Wayne Website
Nurse Aide/Home Health Aide221 S Quarterline Rd, Muskegon, MI 49442 Muskegon Muskegon Website
Nurse Assistant1159 E Michigan Ave, Ypsilanti, MI Ypsilanti Washtenaw Website
Nursing Aide Training Program18600 Haggerty Rd, Livonia, MI 48152 Livonia Wayne Website
Nursing Detroit CNA Program2470 Collingwood St, Detroit, MI 48206 Detroit Wayne Website
Oakland Community College22322 Rutland Ave, Southfield, MI 48075 Southfield Oakland Website
Odyssey Educational Center18600 James Couzens Fwy, Detroit, MI 48235 Detroit Wayne Website
Parrish Academy24293 Telegraph Rd, Southfield, MI 48033 Southfield Oakland Website
PES School of Nursing Education1063 4 Mile Rd., Grand Rapids, MI Grand Rapids Kent Website
Premier Medical Academy LLC437 Fern Ave, Jackson, MI 49202 Jackson Jackson Website
Prosperous Healthcare Training15308 E 8 Mile Rd, Detroit, MI 48205 Detroit Wayne Website
Prosperous Healthcare Training, LLC43700 Woodward Ave, Bloomfield Hills, MI 48302 Bloomfield Hills Oakland Website
Purpose Healthcare Institute-Allen Park10551 Allen Rd, Allen Park, MI 48101 Allen Park Wayne Website
R&A Staffing Agency LLC16825 W Warren Ave, Detroit, MI 48228 Detroit Wayne Website
Ready Rescue Training CenterDetroit, MI Detroit Wayne Not listed
Reliable Training InstituteLivonia, MI Livonia Wayne Website
Reliable Training Institute27170 Grandriver, Redford, MI Redford Wayne Website
Ross Medical Education Center8110 Murphy Dr, Brighton, MI 48116 Brighton Livingston Website
Ross Medical Education Center3488 Plainfield Ave NE, Grand Rapids, MI 49525 Grand Rapids Kent Website
Ross Medical Education Center2600 N Saginaw Rd, Midland, MI 48640 Midland Midland Website
Ross Medical Education Center6235 S Westnedge Ave, Portage, MI 49002 Portage Kalamazoo Website
Sanilac Career Center - Adult/Community Education175 E Aitken Rd, Peck, MI 48466 Peck Sanilac Website
Sauk Trail Education Center110 West St, Jonesville, MI 49250 Jonesville Hillsdale Website
Save 1 CPR, LLC22012 Woodward Ave, Ferndale, MI 48220 Ferndale Oakland Website
ScrubbedIn Healthcare Training LLC5555 Conner St, Detroit, MI 48213 Detroit Wayne Website
Sokol Health Care Training10751 S Saginaw Rd, Grand Blanc, MI 48439 Grand Blanc Genesee Website
Southwestern Michigan College58900 Cherry Grove Rd, Dowagiac, MI 49047 Dowagiac Cass Website
Southwestern Michigan College33890 US Highway 12, Niles, MI 49120 Niles Berrien Website
Stepping Stones Educational Systems955 W Norton Ave, Muskegon, MI 49441 Muskegon Muskegon Website
Success Healthcare Training LLCSt. Clair Shores, MI St. Clair Shores Macomb Not listed
Talent Hub Health7800 Outer Dr W, Detroit, MI 48235 Detroit Wayne Website
The Bridge To Care CNA Training Academy, LLC6264 Dixie Hwy, Bridgeport, MI 48722 Bridgeport Saginaw Website
The Maples Certified Nursing Assistant Program210 Maple Ave, Frankfort, MI 49635 Frankfort Benzie Website
Thompson M-TEC13565 Port Sheldon Street, Holland, MI Holland Ottawa Website
Thompson M-TEC Westshore12331 James St, Holland, MI 49424 Holland Ottawa Website
Thornapple Manor MCF2700 Nashville Rd, Hastings, MI 49058 Hastings Barry Website
Top Tier Healthcare Training CenterWayne, MI Wayne Wayne Not listed
Tri-City CNA Academy LLC.559 E Isabella Rd, Midland, MI 48640 Midland Midland Website
Trilogy Health Services Michigan CNA ProgramCommerce Charter Township, MI Commerce Charter Township Oakland Website
Trilogy Health Services Michigan CNA Program3500 Coolidge Rd, Lansing, MI 48823 Lansing Ingham Website
Uniting Nurses - Nursing Assistant437 N Monroe St, Monroe, MI Monroe Monroe Website
Virtuous Healthcare Academy22223 Gratiot Ave, Eastpointe, MI 48021 Eastpointe Macomb Website
Washtenaw Community College4800 E Huron River Dr, Ann Arbor, MI 48105 Ann Arbor Washtenaw Website
Wayne County Community College District9555 Haggerty Rd, Belleville, MI 48111 Belleville Wayne Website
Wayne County Community College District8200 Outer Dr W, Detroit, MI 48219 Detroit Wayne Website
Wellspring Lutheran Services1390 Maple Dr, Fairview, MI 48621 Fairview Oscoda Website
Wellspring Monroe Nurse Aide Training Program1236 S Monroe St, Monroe, MI 48161 Monroe Monroe Website
West Shore Community College3000 N Stiles Rd, Scottville, MI 49454 Scottville Mason Website
Williams Healthcare TrainingSouthfield, MI Southfield Oakland Not listed
Yes We CNA LLCDetroit, MI Detroit Wayne Not listed
Zayleigh Alexander Training Center, LLC3060 Madison Ave SE, Wyoming, MI 49548 Wyoming Kent Website

No programs match. Try a nearby city or pick "All counties."

Before you call: Ask for the total price, including the $175 exam and $40 registration, and whether Michigan Works! can help pay. Classroom hours may be online, but lab and clinical hours are always in person.

Source: Michigan LARA, BCHS Public Registry, active Nurse Aide Training Programs (October 2026), with addresses and websites from the state training program map. High school and school district career-tech programs are not included. The state list does not include phone numbers. Programs without a matching address show city only. Know of a closed program or a wrong number? Report a correction.

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Michigan CNA Questions, Answered

Who certifies CNAs in Michigan?

The Department of Licensing and Regulatory Affairs (LARA), Bureau of Community and Health Systems, permits training programs and runs the Nurse Aide Registry. Headmaster runs the state exam.

How long is CNA training in Michigan?

At least 75 hours: 16 classroom hours, 16 supervised clinical hours in long-term care, and 43 more hours of any mix.

How much does the CNA exam cost in Michigan?

$175 for the knowledge and skills tests on your first attempt. Each retake is $175. The certificate of registration is $40.

Is there an age requirement?

There is no age requirement for training and testing in Michigan, only for employment.

Can I get CNA training for free in Michigan?

If you work at, or have a job offer from, a nursing home, county medical care facility, or hospital long-term care unit, you can be reimbursed for training, testing, and registration. Michigan Works! can also help pay if you qualify.

How do I renew my CNA certificate in Michigan?

Renew in MI-NATES every 24 months. You need at least 40 hours of paid nursing work in the last 24 months, 12 hours of continuing education each year, and the $40 fee.