CNA Program Information

The certified nurse assistant (CNA) training program is required by the Omnibus Nursing Home Act and Section 198.082, RSMo, 1994.

The CNA training program prepares individuals for employment in a long-term care facility. The program teaches skills in resident care under the direct supervision of a licensed nurse.

The state approved course requires the individual to complete 75 hours of classroom training, 100 hours of on-the-job training and successfully complete a two part final examination. The two part final examination includes a written (or oral) and practicum examination. Some of the topics covered include: basic nursing skills; fire safety; disaster training; resident safety and rights; and social and psychological problems of residents and the methods of caring for the mentally confused residents, such as those with Alzheimer's disease.

Some individuals may be allowed to challenge and take just the final exam (written and practical) without completing the entire course only when the individual meets special circumstances and has approval of the state agency.

Active Status

Missouri Registry Active CNA Status means that the CNA has met all the requirements for training and testing in Federal regulation 483.152 and State regulation 19 CSR 30-84.010. This individual is eligible to be employed as a CNA in a long-term care facility if there has been no finding of abuse, neglect or misappropriation of property. The employer must check to see that the individual does not have a Federal Indicator or is not listed on the Missouri Employee Disqualification List (EDL) before employing the individual.

Inactive Status

Missouri Registry Inactive CNA Status means that the DHSS records show the CNA did not perform paid nursing services of at least one (1) day in a twenty-four (24) consecutive month period of time. The CNA may not work as a Certified Nurse Assistant in a Long-Term Care (LTC) facility when listed as Inactive.

Your status may be changed from inactive to active if you have received paid employment in the provision of nursing services. You must submit a copy of your social security card, proof of employment, return address, and daytime telephone number. Proof of employment may include: (1) a letter from your employer on official letterhead verifying dates of employment, position held, and job duties; (2) copy of W-2 form; (3) copy of pay stubs; or (4) Social Security employment statement. Submit the above information to: Department of Health and Senior Services, Attn: Health Education Unit, P.O. Box 570, Jefferson City, MO 65102.

If you cannot show proof of paid employment in the provision of nursing services for a two-year period of time you may request to challenge the examination by submitting a copy of your social security card, return address and a daytime telephone number to the above address.

All employment documentation will be verified. The DHSS will notify the individual in writing within seven (7) to ten (10) working days regarding the request.

If the individual has a Certified Medication Technician (CMT) certificate or Insulin Administration (IA) certificate, these certifications are also inactive. When the individual has regained Active CNA status, the CMT and IA certifications will also be considered Active.

Expired Status

Missouri Registry Expired CNA Status means that the DHSS records show the CNA did not perform paid nursing services in five (5) consecutive years. The CNA cannot work as a Certified Nurse Assistant in a Long-Term Care (LTC) facility when listed as Expired.

The CNA must submit proof of paid nursing service employment or take the entire CNA course. Proof of employment may include: (1) a letter from your employer on official letterhead verifying dates of employment, position held, and job duties; (2) copy of W-2 form; (3) copy of pay stubs; or (4) Social Security employment statement. Submit the above information to: Department of Health and Senior Services, Attn: Health Education Unit, P. O. Box 570, Jefferson City, MO 65102.

All employment documentation will be verified. The DHSS will notify the individual in writing within seven (7) to ten (10) working days regarding the request.

If the individual has a Certified Medication Technician (CMT) certificate or Insulin Administration (IA) certificate, these certifications are also expired. When the individual has regained Active CNA status, the CMT and IA certifications will also be considered Active.

Federal Indicator Status

Federal Regulation 42 CFR 483.75 requires the Registry to document any findings against a CNA of Abuse, Neglect, or Misappropriation of Property. Any individual who is a CNA, employed in a certified facility and found guilty of Abuse, Neglect, or Misappropriation of Property will receive a Federal Indicator on the Missouri State Registry.

Certified long-term care facilities and the long-term care wing of a hospital are prohibited from allowing a person to work or volunteer, in any capacity, whose name appears on the Registry with a Federal Indicator. These providers are required to check the Registry before allowing the individual to work or volunteer and they must not continue to employ a person whose name appears on the Registry with a Federal Indicator.

CNA Registry verification is required of employers before allowing an individual to serve as a Certified Nurse Assistant. The employer must seek Registry verification from all states the facility believes will have information on the individual.

CNA Challenge

Receiving approval to challenge means that individuals who meet special criteria (listed below) are not required to take the entire certified nurse assistant course but rather will be allowed to take just the final examination (written and practical) to become a CNA in Missouri.

  • Individuals enrolled in an RN or LPN program and who have successfully completed a Fundamentals of Nursing course that included a clinical rotation within the last five years (submit the following documentation: a copy of transcript) or;
  • RN or LPN nursing licensure candidates who have failed state licensure examination (submit the following documentation: a copy of nursing program certification of completion and notice of fail from Board of Nursing) or;
  • Individuals who are listed as active on another state's CNA register and who are in good standing on that register (submit the following documentation: a copy of out-of-state certificate. If current active dates or employments dates are not tracked on your state's register you must submit proof of employment verification within the last 2 years) or;
  • Students who have completed a nursing program outside the United States and who are awaiting licensure in this country (submit the following documentation: a copy of out of country license or certificate, copy of school transcript translated to English and a copy of out of country criminal background check translated to English) or;
  • Individuals who were trained in a long-term care unit of a hospital and who have been employed there for at least twelve (12) months (submit the following documentation: a copy of hospital training and a letter verifying dates of employment and position held) or;
  • Any other persons whose background, education and training in gerontology and health occupations includes the components of the approved training curriculum may challenge the examination after taking those portions of the course as determined to be necessary based on evaluation of their credentials by the supervisor of Health Education, Division of Senior Services and Regulation or;
  • Individuals listed on the Missouri State Certified Nurse Assistant Register on inactive status (submit the following documentation: a copy of Missouri certificate) or;
  • Individuals trained in acute care sections of hospitals as nursing assistants or persons trained as psychiatric aides may challenge the examination after;
    • completing the orientation module with special emphasis on geriatric residents' needs and orientation to the facility, and;
    • completing the one hundred (100) hours of on-the-job training in a long-term care facility or long-term care unit of a hospital. (submit the following documentation: a copy of hospital training and a letter verifying dates of employment and position held and/or copy of psychiatric certificate.)

Individuals meeting any of the above requirements must submit a written request to the DHSS at the address listed in the right bar. Each request must include a clear copy of the individual's social security card; return address, a daytime telephone number and all additional documentation.