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.

If you are currently certified in another state and in good standing, you can apply for reciprocity with Missouri.  Once your application has been approved, you may log into TMU and print off your Missouri CNA certificate.

Reciprocity request form

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

You may change your status from inactive to active if you completed and can provide proof of nursing related services. Use the link provided to renew/update your CNA certification, The CNA renewal fee is $20.00.

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 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 nursing related services every 24 months or take the entire CNA course.
Your status may be changed from expired to active if you have performed duties in the provision of nursing services. Click on this link to submit your work update/renew your CNA certification with Headmaster D & S.  The CNA renewal fee is $20.00.

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 who were enrolled in professional (RN) or practical (LPN) program for at least four (4) months or who are enrolled in this program and have successfully completed a Fundamentals of Nursing course that included a clinical rotation within the last five years may challenge the final examination of the course. (Submit the following documentation: an official copy of the transcript with a letter on school letterhead from the program director verifying successful completion of the fundamentals of nursing and clinical rotation) 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 certified and active on another state’s nurse aide registry shall not be required to challenge the final examination. The individual shall submit, in writing to the department, a request to be added to the Missouri Certified Nurse Assistant Registry. At a minimum, the request shall include: the individual’s legal name; Social Security number; current address; telephone number; email address, if applicable; and proof of their current certified nursing assistant certificate. The department will respond in writing, either approving or denying the request to be added to the registry.
  • 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 have completed the Unlicensed Assistive Personnel (UAP) training (submit the following documentation: an official letter, signed and dated from the Administrator or HR representative that verifies UAP training, that consists of 175 hours has been completed and verifies employment has been within the last two years) or;
  • Individuals listed on the Missouri State Certified Nurse Assistant Register on inactive status (submit the following documentation: a copy of Missouri certificate or the Missouri CNA registry print-out) 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 Regulation and Licensure.
  • Individuals meeting any of the above requirements must submit a written request to the Each request must include a clear copy of the individual's social security card; return address, a daytime telephone number and all additional documentation.

Allow seven (7) to ten (10) for a response.  Note: It takes six (6) to eight (8) weeks from the test date for your name to be added to the registry.