Credentia vs Prometric vs Headmaster: Which CNA Test Does Your State Use?

Before you study for the CNA exam, you need to know who's grading you. The CNA test you'll take in New York looks nothing like the one in Arizona — different skills, different written format, different passing thresholds. Three companies run almost every CNA exam in the United States, and each state picks one (or in some cases, offers two). Here's the full breakdown of the CNA test by state.

The quick answer

There are three national CNA testing companies plus a handful of state-run programs. Your state almost certainly uses one of these:

• Credentia — administers the NNAAP (National Nurse Aide Assessment Program). Used by roughly 20 states, mostly along the East Coast and the South.
• Prometric — the CNA testing arm of the larger Prometric testing company. Used by about 15 states including Florida, Texas, and New York.
• Headmaster (D&SDT) — also called D&SDT-Headmaster or Hdmaster. Covers around 15 states, concentrated in the Mountain West and Upper Midwest.
• State-run programs — a few states (Illinois, Indiana, Iowa, Kansas, Maine, Nebraska, New Hampshire, Puerto Rico) operate their own CNA exam through the state board of nursing instead of contracting one of the three companies.

A handful of states — Alabama, California, Maryland, New Jersey, Oklahoma, and South Dakota — offer two CNA testing options. You choose which one to sit for when you register.

State-by-state: who runs your CNA exam

States using Credentia (NNAAP)

• Alaska
• Colorado
• District of Columbia
• Georgia
• Guam
• Nevada
• North Carolina
• Northern Mariana Islands
• Pennsylvania
• Rhode Island
• South Carolina
• Tennessee
• U.S. Virgin Islands
• Virginia
• Washington

States using Prometric

• Connecticut
• Delaware
• Florida
• Hawaii
• Idaho
• Louisiana
• New York
• Texas
• Vermont
• West Virginia

States using Headmaster (D&SDT)

• Arizona
• Arkansas
• Kentucky
• Massachusetts
• Michigan
• Minnesota
• Mississippi
• Missouri
• Montana
• New Mexico
• North Dakota
• Ohio
• Oregon
• Utah
• Wisconsin
• Wyoming

Dual-provider states (you pick one)

• Alabama — Credentia or Prometric
• California — Credentia or Headmaster
• Maryland — Credentia or Headmaster
• New Jersey — Headmaster or Prometric
• Oklahoma — Headmaster or Prometric
• South Dakota — Headmaster or Prometric

State-board-only programs

• Illinois
• Indiana
• Iowa
• Kansas
• Maine
• Nebraska
• New Hampshire
• Puerto Rico

What's actually different between the three?

Credentia (NNAAP)

Credentia runs the NNAAP — the most widely used CNA exam in the country, developed by Pearson VUE before Credentia took it over. Two components:

• Written (or oral) test: 60 multiple-choice questions. A scaled score of 70+ passes.
• Skills test: 5 randomly assigned skills out of 23 total. Handwashing is always one of them.

NNAAP skills follow a tight checklist format. The evaluator marks you off on specific bolded steps — miss a "critical" step (like failing to wash hands or identifying the wrong patient) and you fail the entire skill even if everything else is perfect. Learn more on our Credentia CNA practice test page.

Prometric

Prometric administers CNA exams in large-population states — Florida, Texas, New York, Louisiana. Two components:

• Written test: 60 multiple-choice questions (some states use 70). A scaled score of 70+ passes.
• Skills test: 5 randomly assigned skills out of 22 total, including handwashing as a required first skill.

Prometric's skills checklists are slightly more forgiving on minor procedural steps but stricter on infection-control criticals. Timing also tends to be tighter — you get around 30–35 minutes for all five skills combined. See our Prometric CNA practice test page for a deeper breakdown.

Headmaster (D&SDT)

Headmaster, officially D&SDT-Headmaster (sometimes stylized "Hdmaster"), covers much of the West and Upper Midwest. Two components:

• Written test: 75 multiple-choice questions. Passing threshold varies by state but is typically 75%.
• Skills test: 4 randomly assigned skills out of 22–26 depending on the state, plus indirect-care points scored across every task.

Headmaster weights indirect care heavily — privacy, communication, patient identification, and body-mechanics awareness are scored continuously during the skills exam, not just as discrete checklist items. Candidates coming from Credentia states are often surprised by how much these "soft" steps count. Our Headmaster CNA practice test page walks through the indirect-care scoring rubric.

Why the CNA testing provider matters

The three exams cover the same clinical territory — vital signs, transfers, ADLs, infection control — but they grade differently, time you differently, and emphasize different skills. Studying a Credentia checklist when your state uses Headmaster is one of the most common reasons first-time candidates fail the CNA exam. Generic CNA prep books don't tell you which version they're written for; ours do.

How to confirm which CNA exam you'll take

If you're enrolled in a state-approved training program, your instructor will register you for the correct exam. If you're preparing on your own or testing out of reciprocity:

1. Check your state's Nurse Aide Registry website. The registry page usually names the testing vendor.
2. Look at the CNA exam scheduling portal. If it sends you to credentia.com, prometric.com, or hdmaster.com, that's your answer.
3. If your state is on the dual-provider list above, you'll choose during registration — pick whichever testing center is closer or has earlier available dates.

Frequently asked questions

What's the difference between NNAAP and the CNA exam?

NNAAP is the CNA exam in Credentia states. "NNAAP" stands for National Nurse Aide Assessment Program — it's the brand name for the Credentia-administered test. If your state uses Credentia, passing the NNAAP adds you to your state's Nurse Aide Registry as a CNA.

Is Headmaster the same as Hdmaster or D&SDT?

Yes — all three names refer to the same company. The full corporate name is D&SDT-Headmaster, the web domain is hdmaster.com, and most candidates just call it "Headmaster."

Can I take the CNA exam in a different state than where I was trained?

Usually not directly. Most states require that you either complete training in that state or apply for reciprocity. If the two states use the same testing company (for example, Florida and Texas both use Prometric), reciprocity tends to be faster.

Which CNA test is hardest?

None is objectively harder — they test the same core clinical skills. Candidates typically find the exam hardest when they study the wrong version's checklist. Preparing from materials tailored to your state's testing provider is far more important than which provider you got.

Do all three companies use the same passing score?

No. Credentia (NNAAP) and Prometric both use a scaled score of 70+ to pass the written section. Headmaster typically requires around 75% correct. Skills-test pass criteria differ by state — some require passing every assigned skill; others allow missing one.

Start with the right prep for your state

The fastest way to study without wasting time on the wrong format: start from your state's page. We've built state-specific word search books pulled directly from each provider's official skill checklist — free, instant download.

Find your state and download your free CNA skills word search →
Browse all 50 state CNA exam prep guides