State terminology varies. A registry is the official list of certified nursing assistants. A competency evaluation assesses nurse aide knowledge and practical skills. Reciprocity, endorsement and transfer describe a destination state reviewing an existing credential. None of these terms means approval is automatic.
Credential and registry terms
CNA (certified nursing assistant)
A nursing assistant who has met the certification or registry requirements of a state. The title and renewal rules are set by each state. States also set training hours, which for nursing-home aides cannot be lower than the federal minimum. The U.S. Bureau of Labor Statistics describes nursing assistants as workers who provide basic care and help patients with activities of daily living under licensed-nurse supervision. BLS nursing-assistant overview ↗
Nursing assistant or nurse aide
General terms for the same role. “CNA” usually refers to a certified or registry-listed assistant. Some states use “nurse aide,” “nursing assistant,” “licensed nursing assistant” or another title in their rules.
State registry
The official state list of nursing assistants who meet that state’s requirements. Employers and the public use the registry to verify active status. A certificate card alone may not prove current status. Check the official registry or agency page linked in the state resource directory.
Competency evaluation
A state-approved assessment of nurse aide knowledge and practical skills. States differ in how they document training, skills assessment and testing. Illinois, for example, describes a written competency test after approved training. Use your state’s current instructions for the provider, passing standard and retake rules. Start with the state resource directory or read the IDPH explanation of Illinois competency requirements, checked November 4, 2026.
Registry verification
Official confirmation of your registry status. It may be sent by the state registry, the testing vendor or the applicant, depending on the destination state. A screenshot or certificate copy is not always accepted. Follow the destination state’s current instructions; the state resource directory links to each agency.
Reciprocity, endorsement and transfer
States use these terms for pathways involving an out-of-state credential, but eligibility rules differ. Follow the receiving agency’s terminology and instructions. That agency decides whether your training, testing, work history and registry status qualify. An existing credential does not guarantee approval. Use the transfer planner or a destination guide.
In-service training or continuing education
Education completed after initial training. A state may require continuing education for credential renewal, while an employer may have a separate duty to provide in-service training. These requirements are not interchangeable. Federal nursing-facility rules require at least 12 hours of nurse aide in-service training each year; that requirement alone does not establish a state’s renewal rules. Check the renewal section of your state hub and 42 CFR § 483.95(g), checked November 4, 2026.
Training and testing terms
NATCEP
Nurse Aide Training and Competency Evaluation Program. The federal framework for nurse aide training and evaluation under 42 CFR § 483.152. States use it in different ways, and state-approved programs must still meet state rules. 42 CFR § 483.152 ↗
NNAAP
National Nurse Aide Assessment Program. A nurse aide testing program used by some states. NNAAP is not a national license, and not every state uses it. The state’s current handbook controls the content and passing standard. Credentia test-taker resources ↗
OBRA
The Omnibus Budget Reconciliation Act of 1987. Federal law that established nurse aide training, competency evaluation and registry requirements for Medicare- and Medicaid-certified nursing homes. State rules can require more than the federal minimum. 42 CFR Part 483 ↗
TMU
An online testing and registry system used by D&S Diversified Technologies/Headmaster in several states. TMU is a vendor system, not a state agency. The state page or handbook controls which applications and records use TMU. D&S Headmaster ↗
Testing vendor
A company contracted by a state to administer the competency evaluation or manage registry services. Common examples include Prometric, Credentia and D&S Diversified Technologies/Headmaster. Vendor contracts and state routes change, so confirm the current provider on your state hub.
State-specific titles and systems
LNA (licensed nursing assistant)
A state-specific title used in some states, including New Hampshire and Vermont. It generally refers to a nursing assistant who holds the state’s license or credential. Do not assume the same training or scope rules apply in another state.
GNA (geriatric nursing assistant)
A term used in Maryland’s earlier CNA/GNA system. Effective April 1, 2026, Maryland law renamed the former CNA/GNA designation CNA-I and the former CNA designation CNA-II. Older forms may still use GNA; confirm the credential and pathway with the Board before applying. The Maryland state guide links to agency instructions. Source: Board guidance on the 2026 designation changes, checked November 6, 2026.
SRNA (state registered nurse aide)
A Kentucky title for a nurse aide listed on the Kentucky Nurse Aide Registry. The title is state-specific; it is not a national credential.
CNA-I and CNA-II
Maryland designations used under the Maryland Board of Nursing’s 2026 certification changes. The Board says that starting April 1, 2026, a former CNA-only program does not qualify an applicant for initial certification, even if they attended before that date. Confirm the current designation and program requirements with the Board. Source: Board guidance on the 2026 designation changes, checked November 6, 2026.
Medication aide titles
Medication aide credentials are separate from CNA certification. Titles, training and application rules vary by state. Check your state hub and the state agency before you assume a CNA credential covers giving medications.
TULIP
The Texas Unified Licensure Information Portal. Texas uses TULIP for nurse aide applications, including the reciprocity request. The Texas Health and Human Services Commission decides approval.
MOBILE
Florida’s published endorsement pathway for out-of-state CNAs. The Florida Board of Nursing decides whether an applicant qualifies under this pathway. Approval is not automatic.
SMT Notice
A Texas email notice that provides the registration link for nurse aide testing. Follow the current TULIP and testing-provider instructions; do not rely on an old email.
How to use this glossary
Start with the term that appears in your state’s application or handbook. Then open the official source linked on your state hub and confirm the definition that applies to you. If a term is not defined here, use the state’s own glossary or contact the agency. Do not substitute another state’s definition.