Huduma CNA ProgramsA NAC in Washington is a Nursing Assistant-Certified, the state's official title for what most of the country calls a certified nursing assistant (CNA). The Washington State Department of Health (DOH) issues the credential, written NA-C on the certificate, after you complete a Board of Nursing-approved training program of at least 108 clock hours, pass a two-part exam that costs $155 in total, and clear a background check. Functionally, a NAC and a CNA are the same job; the only difference is the label Washington prints on the credential.
This article explains what the title means, what a NAC can and cannot do, how it relates to the NAR and HCA credentials, and exactly what it takes to earn and keep one.
NAC, NA-C, and CNA: three names for one credential
Washington's nursing assistant rules use the term "nursing assistant-certified," abbreviated NA-C in the DOH database and NAC in everyday speech and in the exam name (the "NAC exam"). Employers, job boards, and training schools in the state use "CNA" and "NAC" interchangeably, and the federal nurse aide registry treats a Washington NA-C exactly like any other state's CNA.
| Term | Who uses it | What it refers to |
|---|---|---|
| NA-C | DOH credential records, Provider Credential Search | The formal credential type |
| NAC | Job postings, schools, the "NAC exam" | Spoken and written shorthand for NA-C |
| CNA | National usage, federal rules, most job seekers | The same occupation; Washington recognizes it as NA-C |
| NAR | DOH records, nursing facility HR | Nursing Assistant-Registered, a provisional credential before certification |
If you search for "CNA classes" in Washington, you will find NAC programs. If you hold a CNA from another state and move here, you apply to become an NA-C by endorsement. There is no separate "CNA" credential in Washington.
What a NAC actually does
A NAC provides hands-on, delegated nursing care under the supervision of a licensed nurse. The day-to-day work is the core of resident and patient care:
- Bathing, dressing, grooming, toileting, and oral care
- Transfers, ambulation, positioning, and range-of-motion exercises
- Measuring and recording vital signs, weight, and intake and output
- Feeding assistance and monitoring of eating and swallowing
- Observing and reporting changes in condition to the nurse
- Infection control, including hand hygiene and isolation precautions
- Communication with residents, families, and the care team
What a NAC does not do without additional authorization: administer medications (that requires the medication assistant endorsement), perform sterile procedures, or make independent nursing assessments. Certain tasks such as blood glucose testing or applying prescribed ointments can be assigned to a NAC through nurse delegation in specific settings. The boundaries are detailed in Washington's CNA scope of practice.
Where NACs work in Washington
The credential is required in skilled nursing facilities under federal rules and is the standard hiring credential in hospitals. Common employers include UW Medicine, Harborview, Swedish, Providence, MultiCare, Virginia Mason Franciscan (including St. Francis in Federal Way), Valley Medical Center in Renton, and the state's veterans homes. Assisted living communities and adult family homes also hire NACs alongside Home Care Aides.
Pay is approximate, but Indeed job-posting data from August 2026 puts the Washington average at about $23.62 per hour, with Seattle at roughly $23.80 and Everett at about $24.89. Shift differentials for evenings, nights, and weekends commonly add $1.50 to $4 per hour on top of base pay.
How a NAC is different from a NAR and an HCA
Three credentials sit close together in Washington's long-term care workforce, and applicants regularly confuse them.
Nursing Assistant-Registered (NAR). A provisional DOH credential that allows a facility to employ you before you are certified. No exam is required, but a NAR hired by a nursing facility has four months from the hire date to finish training and pass the exam. A NAR is not a NAC; it is the step before one.
Home Care Aide (HCA). A separate DOH credential for caregivers in home care, assisted living, and adult family homes. Training is 75 hours and is approved by DSHS rather than the Board of Nursing. An HCA cannot work as a nursing assistant in a skilled nursing facility, but an active HCA credential opens a shortcut to NAC through the bridge route.
Nursing Assistant-Certified (NAC). The full credential: training, exam, background check, and annual renewal. It is the only one of the three that satisfies the federal nurse aide requirement for nursing homes.
The comparison of NAR vs NAC in Washington goes deeper on the first two.
What it takes to become a NAC
Washington sets a higher training floor than the federal minimum of 75 hours. Under WAC 246-841A-440, an approved program must deliver at least 108 clock hours split three ways:
| Component | Minimum hours | Where |
|---|---|---|
| Classroom theory | 35 | Program classroom |
| Skills lab | 33 | Program lab with equipment |
| Supervised clinical | 40 | Licensed nursing facility |
| Total | 108 |
Instructors must be licensed nurses with recent direct-care experience, and programs must allow every student at least four attempts at the skills competency exam.
After training, the exam has two parts taken in a fixed order:
- Skills test (Part 1). An in-person demonstration of assigned skills, administered by the training program or scheduled through the Board of Nursing's online scheduling if the program does not test. Fee: $100, paid to the test site.
- Knowledge test (Part 2). An online written test (an oral version is available) delivered by Credentia. Fee: $55. You can only register after your skills pass is recorded.
Total exam cost is $155. Then you apply to the DOH, pay the application fee on the current fee schedule, and pass a name-based statewide background check. The Washington NAC exam guide covers each part in detail.
Faster routes for people who already hold a credential
If you already have an active Washington HCA credential, you do not repeat the full 108 hours. You complete a bridge program instead. Huduma CNA Programs in Federal Way runs a 40-clock-hour HCA–CNA Bridge (36 instructional hours plus 4 hours of mock testing) for $800 tuition, compared with the 4-week, 108-hour CNA Traditional program at $1,100. Both lead to the same NA-C credential.
Nursing students, military medics, out-of-state CNAs, and medical assistants each have their own eligibility route to the exam; the DOH labels these routes E1 through E9.
How long a NAC credential lasts
A Washington NA-C expires every year on the holder's birthday and is renewed through the DOH online portal. There is no continuing education requirement for a standard NA-C. Holders of the medication assistant endorsement must document 8 hours of medication-specific continuing education and 250 hours of employment as a medication assistant each cycle.
If the credential lapses for less than three years, you can reactivate it by paying the renewal fee plus a late fee. After three years or more, the DOH generally requires retraining and retesting.
How to verify that someone is a NAC
The DOH's Provider Credential Search is Washington's public nurse aide registry. Enter a name or credential number and the record shows the credential type (Nursing Assistant Certified or Nursing Assistant Registered), status, issue and expiration dates, and any disciplinary action. Employers check it before hiring and again at renewal. See the Washington CNA registry article for a walkthrough.
Why Washington uses "NAC" instead of "CNA"
Washington's nursing assistant rules define two credential levels, registered and certified, and name them in that word order: nursing assistant, then status. Writing the credential as NA-C keeps it parallel with NA-R. The convention has survived every rule revision, including the exam changes that took effect October 1, 2023. When an out-of-state employer asks for a "CNA license number," give them the NA-C credential number from the DOH.
Frequently asked questions
Is a NAC the same as a CNA? Yes. NAC (Nursing Assistant-Certified) is Washington's name for a certified nursing assistant. The duties, the federal registry listing, and the employer expectations are the same.
Do I need a NAC to work in a nursing home in Washington? Nursing facilities can hire you as a NAR while you train, but you must become a NAC within four months of hire to keep working there. Hospitals and most other employers expect the NAC before or shortly after hire.
How much does it cost to become a NAC? Exam fees total $155 ($100 skills plus $55 knowledge). Training tuition varies by school; Huduma CNA Programs charges $1,100 for the traditional program and $800 for the HCA bridge, plus about $105 for books and supplies. DOH application fees follow the current fee schedule.
How long does it take to become a NAC? A full-time traditional program runs about four weeks for the 108 hours. Add time for the two exam parts and DOH processing; most people finish in two to three months from the first day of class.
Can a NAC give medications? Not without the medication assistant endorsement, which requires an approved program and carries its own continuing education and employment-hours requirement at renewal.
Does a Washington NAC transfer to other states? Other states verify your NA-C through the DOH's Provider Credential Search and accept it by endorsement if your training and status meet their rules. Keep the Washington credential active until the new one is issued.
For the rules behind the credential, read Washington State CNA requirements in 2026, then check upcoming class dates if you are ready to start.
Which path may fit you?
Already an eligible HCA?
Review the HCA–CNA Bridge Program and confirm the active Washington HCA credential requirement before choosing a class.
Explore the HCA–CNA Bridge ProgramStarting CNA training?
Review CNA Traditional, the complete training route for learners who are not entering through the HCA bridge route.
Explore the CNA Traditional Program