Nursing Assistant (CNA) in Portsmouth, NH

The Salary Picture: Where Portsmouth Stands

As a local, I can tell you that Portsmouth's cost of living is no joke, and it directly impacts what a Nursing Assistant (CNA) can expect to earn. The median salary for a CNA in the Portsmouth metro area is $37,004/year, which breaks down to an hourly rate of $17.79/hour. This sits slightly above the national average for nursing assistants, which is $35,760/year. While that gap isn't massive, every dollar counts in a coastal New England town.

The job market here is tight. The Bureau of Labor Statistics (BLS) and state data indicate there are only about 44 CNA jobs in the entire metro area, which includes surrounding towns like Rye and Newington. The 10-year job growth is 4%, which is slower than the national average. This means competition can be fierce for full-time positions with benefits, especially at the top employers. Most openings come from replacing retirees or filling temporary gaps, not from massive expansions.

To break down what you can realistically expect based on experience, here’s a local perspective:

| Experience Level | Estimated Portsmouth Salary Range | Notes |
| :--- | :--- | :--- | :--- |
| Entry-Level (0-2 years) | $32,000 - $36,000/year | Typically starts at nursing homes or per-diem hospital work. You'll likely start at the lower end of the median. |
| Mid-Level (3-5 years) | $36,000 - $41,000/year | With solid experience and maybe a specialty (like geriatrics), you can hit or exceed the median, especially at a hospital. |
| Senior-Level (5-10 years) | $41,000 - $45,000/year | Often involves shift differentials, charge CNA roles, or positions at the larger regional medical centers. |
| Expert/Specialist (10+ years) | $45,000 - $50,000+ | This is rare and typically requires additional certifications (e.g., Restorative, Phlebotomy) and a role in education or a critical care setting. |

When you compare Portsmouth to other New Hampshire cities, the trade-off becomes clear. While the $37,004 median is competitive, it’s not the highest in the state. Cities like Manchester or Nashua have a larger volume of healthcare employers and a lower cost of living, potentially offering a better financial balance for a CNA. The trade-off in Portsmouth is quality of life—the ocean, historic charm, and a strong community feel—but you have to budget carefully.

Insider Tip: Don’t just look at the base salary. Many local employers offer differential pay for evening, night, and weekend shifts. This can add $2 to $4 per hour to your base rate, significantly boosting your annual income. It’s essential to ask about shift diffs during any interview.

The Real Take-Home: After Taxes and Rent

Let’s be blunt: the math is challenging. With a median salary of $37,004, your monthly take-home pay after state and federal taxes will be approximately $2,400 to $2,500. Meanwhile, the average rent for a one-bedroom apartment in the Portsmouth area is $1,582/month. That means housing alone consumes 63-66% of your net income, which is well above the recommended 30% threshold.

Here’s a realistic monthly budget breakdown for a CNA earning the median salary:

Expense Category	Estimated Cost	Notes
Housing (1BR Rent)	$1,582	This is the metro average. Portsmouth city proper is higher; outlying towns are slightly lower.
Utilities	$150 - $200	Includes electricity, heat (oil/gas can be pricey in winter), and internet.
Groceries	$350 - $400	Portsmouth has limited budget grocery options (no Aldi, one Walmart). Market Basket is the go-to for savings.
Car Payment/Insurance	$300 - $500	Essential. Public transit (COAST) is limited. Car insurance is high in NH.
Health Insurance	$150 - $300	Varies wildly if your employer offers a plan.
Miscellaneous	$200 - $300	Gas, cell phone, personal care, occasional eating out.
Total Estimated Outflow	$2,732 - $3,282
Monthly Take-Home (Net)	$2,400 - $2,500	Deficit: -$232 to -$782/month

Can they afford to buy a home? On a single CNA income of $37,004, it is virtually impossible to buy a home in the Portsmouth area. The median home price is over $600,000. Even a modest condo or a home in a neighboring town like Dover or Rochester (which have lower prices) would require a dual-income household or a significant down payment. The path to homeownership typically involves gaining additional certifications, moving into a management role, or partnering with a higher-earning spouse.

Insider Tip: Many local CNAs live in more affordable, neighboring towns like Dover, Rochester, or even Exeter and commute into Portsmouth. The commute is usually 20-30 minutes, and rent can be $300-$500 less per month, making a huge difference in your budget.

Where the Jobs Are: Portsmouth's Major Employers

Because the job market is small, knowing who the key players are is critical. Here are the primary employers for CNAs in the Portsmouth region:

1. Portsmouth Regional Hospital (Part of HCA Healthcare): The largest employer. They hire CNAs for Med-Surg, Orthopedics, and Emergency Department. Hiring is steady but competitive. They offer a robust benefits package and tuition reimbursement, which is a major draw.
2. Appledore Medical Group: A large multi-specialty practice affiliated with MaineHealth. They have clinics in Portsmouth and surrounding areas. They often hire CNAs for their primary care and specialty offices (e.g., cardiology, oncology). These roles are typically Monday-Friday, day-shift, and highly sought after.
3. Atrium Post-Acute Care of Portsmouth: A skilled nursing and rehabilitation facility. They are one of the largest consistent hirers of CNAs in the area. Work can be demanding but offers steady full-time hours and experience in long-term care.
4. Edgewood Centre: Another major skilled nursing facility in Portsmouth. They focus on long-term care and memory care. Hiring is frequent due to the nature of the work and turnover. A great place to gain foundational experience.
5. Seacoast Grace Care Center (in nearby Exeter): While not in Portsmouth proper, this is a significant employer just 15 minutes away. It’s a nonprofit, faith-based facility often praised for its community feel. Worth the short commute.
6. Various Home Health Agencies: Companies like HomeCare & Hospice or Visiting Nurse Association of the Seacoast hire CNAs for in-home care. Hours can be less predictable but offer flexibility and one-on-one patient care.
7. Local Dialysis Centers (e.g., Fresenius Medical Care): These centers require CNAs for patient care and logistics. It's a specialty niche with specific training, often leading to higher pay.

Hiring Trends: The trend is toward specialized care. Employers are increasingly looking for CNAs with experience in geriatrics, dementia care, or rehab. Certifications in CPR/BLS are a must, and any extra training (like phlebotomy or EKG) makes your application stand out. Most hiring happens in the spring and fall, coinciding with the end of academic semesters for nursing students.

Getting Licensed in NH

New Hampshire has a straightforward but mandatory process to become a Certified Nursing Assistant (CNA).

Requirements:

1. Complete a State-Approved Training Program: The program must be at least 75 hours, combining classroom instruction and clinical training. In our area, programs are offered at Great Bay Community College (in Portsmouth), Seacoast School of Technology (in Exeter), and various private career schools (like Northpointe Career Training Center in nearby Plaistow, MA, which is accepted in NH).
2. Pass the Competency Exam: This is a two-part exam (written/oral and skills) administered by Credentia (the state’s testing vendor). You must pass both sections to be listed on the state registry.
3. Register with the NH Nursing Assistant Registry: Once you pass the exam, your name is added to the registry, which is maintained by the NH Department of Health and Human Services. Employers will verify your status here.

Costs:

• Training Program: $1,000 - $2,500. Great Bay CC is on the lower end for residents; private schools are more expensive. Some employers, like Portsmouth Regional Hospital, may offer tuition reimbursement or even direct training programs in exchange for a work commitment.
• Exam Fee: ~$100 (paid to Credentia).
• Background Check: ~$25 - $50 (required by most employers and the state).

Timeline to Get Started:

• 1-2 months to complete the training program (depending on full-time or part-time schedule).
• 1-3 weeks to schedule and receive results for the competency exam.
• 1-2 weeks for the background check and registry processing.
• Total: You can be a licensed CNA and job-ready in 2 to 4 months from the start of your training.

Insider Tip: If you already hold an active CNA license from another state, you can apply for reciprocity through the NH Board of Nursing. It's a streamlined process, but you must contact them immediately to start the paperwork, as it can take several weeks.

Best Neighborhoods for Nursing Assistant (CNA)s

Living close to work is key to saving on gas and time. Here’s a breakdown of neighborhoods and nearby towns, balancing commute and cost:

1. Downtown Portsmouth: The epicenter of healthcare (Portsmouth Regional Hospital, many clinics). Walkable, vibrant, but extremely expensive. Rent for a 1BR can easily exceed $2,000/month. Best for those with a partner or roommates.
2. West End / South End: Residential areas just outside downtown. Quieter, more residential feel. Commute to the hospital is 5-10 minutes by car. 1BR rents are high but slightly better than downtown, around $1,700 - $1,900.
3. The "North End" (Rye, New Castle): Beautiful coastal living, but very expensive and isolated from other services. Commute to Portsmouth is easy (10-15 mins), but you’ll be driving for groceries and other needs. 1BR rents are $1,800+.
4. Dover (15 mins north): The most popular and practical choice for healthcare workers. It's a larger city with more affordable housing, a full-service downtown, and a direct commute via Route 16. 1BR rents average $1,200 - $1,500. This is where many of your future coworkers likely live.
5. Rochester (20 mins north): Even more affordable than Dover, with a growing downtown and easy access to the highway. Commute to Portsmouth is 20-25 minutes. 1BR rents can be found for $1,100 - $1,400. A great option for maximizing your budget.

Insider Tip: If you work a night shift (7 PM - 7 AM), traffic is non-existent, making longer commutes from Dover or Rochester very manageable. Many night-shift workers prefer living in these towns for the space and savings.

The Long Game: Career Growth

With a 4% 10-year growth rate, advancement requires proactive effort. The standard path is to gain experience and pursue further education.

• Specialty Premiums: As mentioned, shift differentials are common. Furthermore, obtaining a Restorative Nursing Assistant (RNA) certification can add $1-2/hour to your wage. Specializing in areas like dialysis or hospice care also commands a higher salary due to the required expertise.
• Advancement Paths:
  1. Lead CNA / Charge CNA: Taking on supervisory duties within your unit.
  2. Further Education: The most common path is to use employer tuition benefits to become a Licensed Practical Nurse (LPN) or Registered Nurse (RN). Great Bay Community College and other area schools have strong LPN/RN programs. This is the single most effective way to increase earning potential long-term.
  3. Non-Clinical Roles: Move into roles like Patient Care Coordinator or Health Unit Coordinator, leveraging your clinical experience in an administrative capacity.
• 10-Year Outlook: The demand will remain steady in nursing homes, home health, and hospitals. However, the field will continue to be competitive. CNAs who invest in additional certifications (like BLS instructor, phlebotomy, or EKG tech) or who bridge to nursing will have the best prospects for salary growth and job security in the coastal NH/ME region.

Insider Tip: Network within your workplace. The best job openings (especially those coveted day-shift, Monday-Friday clinic jobs) are often filled by internal referrals before they are ever posted publicly. Build a good reputation, and you’ll hear about opportunities first.

The Verdict: Is Portsmouth Right for You?

Deciding to work as a CNA in Portsmouth is a lifestyle choice as much as a career one. The financial math is challenging, but the quality of life can be exceptional if you manage your budget carefully.

Pros	Cons
High Quality of Life: Beaches, historic downtown, excellent restaurants, and outdoor activities are all at your doorstep.	Very High Cost of Living: Rent and general expenses are significantly above the national and state averages.
Strong Healthcare Hub: Access to major hospitals and clinics for your own healthcare needs.	Limited Job Market: Only 44 jobs means less choice and more competition for the best positions.
Proximity to Nature & Boston: Easy access to stunning coastline and a 1-hour drive to Boston for entertainment.	Low Salary Growth: A 4% 10-year growth rate suggests slow advancement unless you pursue further education.
Stable Employers: Portsmouth Regional Hospital and established nursing homes are stable employers.	Car Dependent: You will need a reliable car; public transit is not sufficient for commuting.

Final Recommendation:
Portsmouth is a viable option for a CNA if you are willing to live in a more affordable neighboring town like Dover or Rochester and commute. The salary of $37,004 is manageable with a roommate, a partner, or strict budgeting. It's an ideal location for a CNA who is planning to use employer tuition benefits to advance to an LPN or RN within a few years, using the great local colleges. For a CNA seeking a standalone, comfortable living wage to buy a home immediately, other NH cities like Manchester or Nashua may be a more financially prudent choice. Portsmouth rewards those who value its unique coastal New England lifestyle and are strategic about their career and living expenses.

FAQs

1. Can I make a living wage as a CNA in Portsmouth on the median salary?
It’s very challenging on a single income. The median salary of $37,004 results in a monthly deficit when paying average rent of $1,582. To make it work, you will likely need to live with a roommate or partner, secure a higher-paying shift differential, or live in a more affordable suburb like Dover.

2. Is it easy to find a job as a new graduate CNA?
It’s competitive but possible. New graduates should apply to nursing homes (Atrium, Edgewood) and per-diem positions at Portsmouth Regional Hospital first. These are the most common entry points. Having a pristine resume, excellent references from your clinicals, and basic life support (BLS) certification is essential.

3. What’s the best way to get affordable CNA training in the area?
The most cost-effective option is through Great Bay Community College in Portsmouth for NH residents. It’s a state-approved program and is typically the most affordable. Some employers, like Portsmouth Regional Hospital, sometimes offer paid training programs in exchange for a commitment to work for them for a set period after graduation.

4. Are there jobs outside of Portsmouth that are worth the commute?
Absolutely. Many CNAs commute south to York Hospital in Maine (about 30 minutes) or even to the larger Massachusetts General Hospital or Exeter Hospital (both about 45-60 minutes). These hospitals often have more jobs and can offer higher pay, but the commute and tolls must be factored into your budget.

5. Do I need a car if I live in Dover but work in Portsmouth?
Yes. While there is a bus (COAST) that connects Dover to Portsmouth, the schedules are not reliable for shift work, especially for early mornings, late nights, or weekends. A car is a non-negotiable requirement for most healthcare jobs in the Seacoast region.