Frequently Asked Questions

CNA Questions - CMT Questions - Instructor/Examiner & Clinical Supervisor Questions - General Program Questions - Registry Update Questions

CNA Questions

1. I challenged the Certified Nurse Assistant (CNA) exam and failed. What do I do?
2. I took the written or practicum CNA exam and failed. May I retake the CNA exam?
3. The facility where I work lost their ability to offer CNA, but there was a class in progress at the time. What happens to the students?
4. I took the CNA exam several months ago, but I'm not on the CNA registry. What do I do?
5. I completed my CNA course, but didn't take the exam. May I do that now?
6. How do I transfer my out-of-state CNA certification to Missouri?
7. The registry says I'm an inactive CNA, but I've been working.
8. Where can I take the CNA exam?
9. What are the qualifications to get into a CNA class?
10. From hire date, how long may I work in a certified facility without being a Certified Nurse Assistant (CNA)?
11. Which nursing services may I provide while in training?
12. Is it possible for me to challenge or take the Missouri CNA examination without taking the class?
13. I am a nursing student may I be a Certified Nurse Assistant?
14. If a CNA student has finished all theory classes and on-the-job training but gets fired or leaves employment before the test date are they entitled to a copy of their Appendix A-B?
15. I was dismissed or left my place of employment prior to completing the CNA course, do I have to start the course over?
16. When does my CNA license expire?
17. How do I keep my CNA license active?
18. The register says my CNA license is inactive, how do I get it back to active status?
19. Is it required for me to have twelve (12) hours of in-service each year in order to keep my CNA license active?
20. What is the difference between my CNA certificate being inactive and expired?
21. I have been doing private duty work, will this count toward keeping my CNA certificate active?
22. May I be hired by a facility as a nurse assistant without being certified on the Missouri register?
23. I don't read very well, may the CNA examiner read the examination to me?
24. If the student fails the CNA examination may that student be retested the same day?
25. I received a letter of approval to challenge the CNA examination but have lost it, where may I get a copy?

CMT Questions

1. I want to take a Certified Medication Technician (CMT) course. What are the qualifications?
2. I passed my CMT exam, may I pass medications in a facility?
3. I am a medication technician in another state. How do I transfer my certification to Missouri?

Instructor/Examiner & Clinical Supervisor Questions

1. As an instructor, how many CNA students may I have in class?
2. I would like to become a CNA instructor/examiner, what are the qualifications?
3. What are the "Train the Trainer" classes and where do I go for them?
4. As an examiner may I refuse to retest a student that has failed the first time?
5. As an examiner may I refuse to test a student that is disruptive or disrespectful?

General Program Questions

1. I took my CNA, CMT or Insulin exam several months ago, but I have never received my certificate.
2. I have a Level I Medication Aide (LIMA) certification, where may I pass medications?
3. I am a CMT and/or a LIMA, can I give insulin injections?
4. I have a Federal Marker for abuse, neglect or misappropriation of funds. When may I go back to work in a nursing home or nursing agency?
5. What is the Department of Health and Senior Services address?
6. What is the Department of Health and Senior Services fax number?
7. Does Missouri have online CNA verification yet ?
8. Where may I get a copy of my CNA, CMT, LIMA or Insulin Administration certificate?
9. If I have been removed from the State Employee Disqualification Listing (EDL), why can't I work in a nursing home?
10. My last name has changed. How do I get a new certificate with my current name on it?
11. My certificate has the wrong social security number on it, how do I get it corrected?
12. What is the cost for the CNA, CMT, LIMA or Insulin Administration courses?

Registry Update Questions

1. I am an instructor and my name has changed. How do I change my information on the registry?
2. I am a clinical supervisor and my name has changed. How do I change my information on the registry?
3. I am an instructor and my address is not listed or listed incorrectly on the registry. How do I update my address?
4. I am a clinical supervisor and my address is not listed or listed incorrectly on the registry. How do I update my address?

CNA Questions

1. I challenged the Certified Nurse Assistant (CNA) exam and failed. What do I do?
If you were given a letter of approval from this office to challenge the exam, you may only have one chance at passing the exam. If you fail the exam, you must take the CNA course.

2. I took the written or practicum CNA exam and failed. May I retake the CNA exam?
If you took the full course and failed either the written portion or the practicum portion of the exam, you may retake the failed portion up to two (2) additional times within 90-days of the first failure. If you do not retake the test within 90-days you must retake the course.

3. The facility where I work lost their ability to offer CNA, but there was a class in progress at the time. What happens to the students?
When the letter comes from the Health Education Unit (HEU) notifying the facility of their ineligible status, there will be enclosed a form called "CNA Class Roster for Ineligible Facility". This form must be completed and returned to the HEU. Any students that were in class prior to the ineligible date may complete their class.

4. I took the CNA exam several months ago, but I'm not on the CNA registry. What do I do?
Contact the school/facility where you took the course or ask which association they sent your paperwork to. If you challenged the exam, contact the examiner and request further information. If your paperwork has not been sent in for certification, call (573) 526-5686 and ask for the CNA registry or HEU.

5. I completed my CNA course but didn't take the exam. May I do that now?
The course consists of 75-hours of theory, 100-hours of on-the-job training, and a 2-part final exam. Until all parts are completed, you have not completed the course. State regulations allow an individual up to 6 months to get back into the course. If 6 months have passed since the last day you attended any portion of the course, you must retake the entire course.

6. How do I transfer my out-of-state CNA certification to Missouri?
If you are currently active on another state’s register, Missouri will allow you to challenge the Missouri CNA exam to become registered as a CNA in Missouri. Submit a copy of the out-of-state certificate, copy of social security card, return address, daytime phone number, and work verification of 8-hours in every 2 years from certification unless the out-of-state registry tracks your employment. (Federal regulation 483.154)

7. The registry says I'm an inactive CNA, but I've been working.
If you have paid employment in the provision of nursing services that we do not have a record of, you must submit copies of your social security card, proof of employment, return address, and day time telephone number. Proof of employment may be: (1) a letter from your employer verifying dates of employment, position held, and job duties; (2) copy of W-2 form; or (3) copy of pay stubs. 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 verification will be verified. A letter from the HEU notifying you of our decision will be returned to you within 7-10 working days.

8. Where can I take the CNA exam?
If you are employed in a nursing facility, check with your director of nursing or charge nurse to see if they are an approved training agency and able to offer you the exam.

If you are not employed in a nursing facility or do not intend to be, you should contact an area vocational technical school or community college, that is approved to offer the CNA course, within your driving area to schedule the exam.

9. What are the qualifications to get into a CNA class?
The qualifications are:

•  18 years of age unless enrolled in a high school health occupation class.

•  Not listed on Missouri Department of Health and Senior Services employee disqualification list (EDL).

•  Not found guilty to certain classifications (see regulations for detail).

10. From hire date, how long may I work in a certified facility without being a Certified Nurse Assistant (CNA)?
You have 4 months from hire date to take classes, become certified and placed on the register.

11. I am an uncertified nurse assistant. Which nursing services may I provide while in training?
You may only do the services/competencies that you have been taught and found competent in.

12. Is it possible for me to challenge or take the Missouri CNA examination without taking the class?
Yes, certain persons with training and experience may challenge the test. See regulation 19CSR30-84.010 (6)(B) 1., 2., 3., 4., 5., 6., and 7. (7)(C)(D) and CNA regulation 19CSR30-84.010 (6).

13. I am a nursing student may I be a Certified Nurse Assistant?
Yes, but you must take the CNA final examination. In order to be approved to take the final examination you must submit a copy of your transcript showing completion of Fundamentals of Nursing and a clinical rotation with a passing grade, a copy of your social security card, a return address and a phone number where you can be reached during the day. Once this information is received and verified you will receive a response within seven (7) to ten (10) working days.

14. If a CNA student has finished all theory classes and on-the-job training but gets fired or leaves employment before the test date are they entitled to a copy of their Appendix A-B?
Yes.

15. I was dismissed or left my place of employment prior to completing the CNA course, do I have to start the course over?
An individual who leaves the course prior to completing it has up to six months to re-enter the course.

16. When does my CNA license expire?
Federal regulation requires that an individual work at least eight (8) hours, for pay, in the provision of nursing services without a two (2) year break to remain active. If you have a five (5) year break in employment your certificate will expire. If your certificate expires you will either need to prove employment or retake the CNA course.

17. How do I keep my CNA license active?
Federal regulation requires that an individual work at least eight (8) hours, for pay, in the provision of nursing services without a two (2) year break to remain active. If your register status shows inactive we do not have your employment history.

18. The register says my CNA license is inactive, how do I get it back to active status?
If you have paid employment in the provision of nursing services that we do not have a record of, you must submit copies of your social security card, proof of employment, return address, and daytime telephone number. Proof of employment may be: (1) a letter from your employer on their official letterhead verifying dates of employment, position held, and job duties; (2) copy of W-2 form; or (3) copy of pay stubs.

If you have not been working you are required to challenge the examination. Submit a copy of your social security card; return address and a daytime telephone number to the above address. A response will be generated within seven (7) to ten (10) working days.

19. Is it required for me to have twelve (12) hours of in-service each year in order to keep my CNA license active?
A long-term care facility is required by state regulation to provide 12 hours of in-service to nursing personnel. If you are not employed in a long-term care facility you are not required to have the 12 hours of in-service in order to keep your certificate active.

20. What is the difference between my CNA certificate being inactive and expired?
Your CNA certificate is considered inactive if the register shows a two (2) year break in employment in the provision of nursing services. Your CNA certificate is considered expired if the register shows a five (5) year break in employment in the provision of nursing services. If your certificate is inactive you may challenge the examination to obtain active status. If your certificate is expired you are required to retake the course to obtain active status.

21. I have been doing private duty work, will this count toward keeping my CNA certificate active?
It may. You will need to submit proof of employment, which may be: (1) a copy of a form 1099; (2) copy of W-2 form; (3) copy of pay stubs; or (4) a letter proving private duty from the Power Attorney for whom you are caring for along with proof of the Power of Attorney.

22. May I be hired by a facility as a nurse assistant without being certified on the Missouri register?
A facility may hire an individual as a nurse assistant. The facility must have the nurse assistant trained and on the register within four months from the date of hire.

23. I don't read very well, may the CNA examiner read the examination to me?
Yes, the examiner may read the exam in a neutral tone of voice and only what is on the exam.

24. If a student fails the CNA examination may that student be retested the same day?
Yes, if the examiner agrees to do so.

25. I received a letter of approval to challenge the CNA examination but have lost it, where may I get a copy?
Contact the Section for Long Term Care for a copy.

CMT Questions

1. I want to take a Certified Medication Technician (CMT) course. What are the qualifications?
(1) You must be a CNA and have been listed on the register for 6 months.

2. I passed my CMT exam, may I pass medications in a facility?
You may pass medications for up to 60-days if the facility has a copy of your score sheet showing a passing score.

3. I am a medication technician in another state. How do I transfer my certification to Missouri?
Missouri requires all Certified Medication Technicians to be a Certified Nurse Assistant.

You may be eligible to challenge the Missouri examination if you are listed as a Certified Medication Technician on another state's register as active and in good standing. You must submit a copy of your out-of-state certificate, a letter of recommendation from previous long-term care employer on facility letterhead, copy of your social security card, a return address and a phone number where you can be reached during the day. Once this information is received and verified with the out-of-state register you will receive a response within seven (7) to ten (10) working days.

Instructor/Examiner & Clinical Supervisor Questions

1. As an instructor, how many CNA students may I have in class?
The ratio shall be a maximum of one (1) to fifteen (15) and it is recommended that the ratio be one (1) to ten (10) or less.

2. I would like to become a CNA instructor/examiner, what are the qualifications?
You may review the qualifications here.

3. What are "Train the Trainer" classes and where do I go for them?
"Train the Trainer" classes are held by the certifying associations. They are courses designed to teach RNs and LPNs how to be a state certified instructor, examiner and/or clinical supervisor for the CNA, CMT, LIMA and Insulin Administration. You may take the courses through one of the certifying associations

4. As an examiner may I refuse to retest a student that has failed the first time?
Yes.

5. As an examiner may I refuse to test a student that is disruptive or disrespectful?
Yes.

General Program Questions

1. I took my CNA, CMT, or Insulin exam several months ago, but I have never received my certificate.
Contact the school or facility where you took your exam. The association who issued the exam normally returns the certificate to the school/facility where you took your exam. If the school/facility paid for the certificate, they may not want to give it up. However, you may call the Health Education Unit at (573) 526-5686 or go to the CNA Registry Search page and find out which certifying association printed your certificate.

2. I have a Level I Medication Aide (LIMA) certification, where may I pass medications?
You may pass medications only in a Licensed Residential Care Facility or Assisted Living Facility.

3. I am a CMT and/or a LIMA, may I give insulin injections?
No, you may give insulin injections only if you are on the registry as Insulin Administration Certified.

4. I have a Federal Marker for abuse, neglect or misappropriation of funds. When may I go back to work in a nursing home or nursing agency?
If you are listed on the Missouri CNA register with a Federal Marker for abuse, neglect or misappropriation of funds you can never again work in a nursing home that has Medicaid or Medicare residents.

5. What is the Department of Health and Senior Services address?
You can find the address here.

6. What is the Department of Heath and Senior Services fax number?
You can find the fax number here.

7. Does Missouri have online CNA verification yet?
Yes, the URL is https://webapp01.dhss.mo.gov/cnaregistry/CNASearch.aspx.

8. Where may I get a copy of my CNA, CMT, LIMA or Insulin Administration certificate ?
Contact the certifying association that issued your certificate. If you do not know which certifying association issued your certificate you may call the Health Education Unit at (573) 526-5686 or go to the CNA Registry Search page and find out which certifying association printed your certificate.

9. If I have been removed from the State Employee Disqualification Listing (EDL), why can't I work in a nursing home?
If you were added to the EDL for an offense while working in a nursing home that was certified to care for Medicaid/Medicare patients and you were a CNA you were also added to the Missouri Register with a "federal indicator". Federal regulations forbid a CNA who is found guilty of an offense for abuse, neglect or misappropriation of funds or property to ever again work in a nursing home that cares for Medicaid/Medicare patients.

10. My last name has changed. How do I get a new certificate with my current name on it?
Contact the certifying association that issued your certificate. If you do not know which certifying association issued your certificate you may call the Health Education Unit at (573) 526-5686 or go to the CNA Registry Search page and find out which certifying association printed your certificate.

11. My certificate has the wrong social security number on it, how do I get it corrected?
Contact the certifying association that issued your certificate. If you do not know which certifying association issued your certificate you may call the Health Education Unit at (573) 526-5686 or go to the CNA Registry Search page and find out which certifying association printed your certificate.

12. What is the cost for the CNA, CMT, LIMA or Insulin Administration courses?
The cost varies depending on the type of course you are taking and where. The schools set their own pricing guidelines. If you are employed in a long-term care facility that is licensed to care for Medicaid/Medicare patients you may not be charged for the Certified Nurse Assistant (CNA) course or any materials required for the course.

Registry Update Questions

1. I am an instructor and my name has changed. How do I change my information on the registry?
Fill out the Update Registry form. You may then go to Check Registry from the Home Page and print a copy of your status page. The status page fulfills all state requirements for proof of certification. The registry will usually be updated within one to two (2) working days.

2. I am a clinical supervisor and my name has changed. How do I change my information on the registry?
Fill out the Update Registry form. You may then go to Check Registry from the Home Page and print a copy of your status page. The status page fulfills all state requirements for proof of certification. The registry will usually be updated within one to two (2) working days.

3. I am an instructor and my address is not listed or listed incorrectly on the registry. How do I update my address?
Fill out the Update Registry form. You may then go to Check Registry from the Home Page and print a copy of your status page. The status page fulfills all state requirements for proof of certification. The registry will usually be updated within one to two (2) working days.

4. I am a clinical supervisor and my address is not listed or listed incorrectly on the registry. How do I update my address?
Fill out the Update Registry form. You may then go to Check Registry from the Home Page and print a copy of your status page. The status page fulfills all state requirements for proof of certification. The registry will usually be updated within one to two (2) working days.