State terminology: Certified nurse assistant (CNA). Missouri CNA registry guidance ↗ · terminology checked November 5, 2026.
Missouri at a glance
| Agency and any testing or registry providers | Missouri Department of Health and Senior Services, Health Education Unit |
|---|---|
| Official state hub | Open the official state page ↗ |
| Training guidance | Standard route reviewed · checked November 4, 2026 |
| Transfer guidance | Standard route reviewed · checked November 4, 2026 |
| Renewal guidance | See Missouri CNA renewal requirements |
Training sources checked November 4, 2026. Standard route reviewed.
How do you become a CNA in Missouri?
Missouri’s basic CNA course requires 75 hours of instructional training and 100 hours of supervised on-the-job training, for a total of 175 hours.[1] [2] [3] Completing training alone does not give you a state credential. Before enrolling, check the state’s testing requirements and what it takes to get the credential or be listed on the registry.
What else should you know about training?
- The final competency examination has a written or oral part and a practicum part; the written exam contains 75 questions.[1] [2] [4]
- Missouri uses D&S Headmaster/TMU for CNA testing and registry profiles.[1]
Where can you find training programs?
Missouri approved facility and school training agencies ↗[1] Before you enroll, confirm with the state that the exact program and training site are currently approved. Check the total hours, clinical placement and costs as well.
What are the steps?
Choose an approved training agency
Use the DHSS-approved facility or school training-agency lists.[1]
Complete 75 classroom and 100 on-the-job hours
Confirm the clinical placement and supervision arrangements with the agency.[3]
Pass the two-part final exam
Use the approved written/oral and practicum process.[2]
What should you confirm with the state?
- Program costs, start dates and availability vary. Confirm them directly with the school.
- The 100 on-the-job hours are facility-based and may require an employer or clinical placement; confirm before enrolling.
Where did this information come from?
- Missouri Certified Nurse Assistant (CNA) ↗
Checked November 4, 2026 · Reviewed from a printout dated November 4, 2026: 75 hours of classroom training, 100 hours of on-the-job training, and a two-part final exam (written or oral, and practicum).
- Missouri CNA Registry FAQ ↗
Checked November 3, 2026 · Minimum 75 classroom hours and 100 clinical hours; 75-question exam
- 19 CSR 30-84 Training Program for Nursing Assistants ↗
Checked November 4, 2026 · 19 CSR 30-84.010, reviewed from a copy saved November 4, 2026. (4): basic course of 75 instructional hours and 100 supervised on-the-job hours. (18): 8 hours of documented work every 24 months; inactive less than 5 years without work proof must challenge the final exam; inactive more than 5 years must complete the basic course.
- Missouri Nurse Aide Candidate Handbook, version 15.0 (D&SDT-Headmaster) ↗
Checked November 4, 2026 · Updated September 2026. Registry renewal: every 24 months; at least 8 consecutive paid hours of nursing or nursing-related services in the previous 24 months; self-attest in TMU; reminders 60 days before expiration; self-pay or sponsor payment. Knowledge test: 75 multiple-choice questions.
See reviewed CNA training programs →
How do you transfer an out-of-state nurse aide credential to Missouri?
Agency and any providers named in the sources: Missouri Department of Health and Senior Services, Health Education Unit. Sources checked November 4, 2026. This summary does not decide individual eligibility.
Which pathway applies to you?
Online reciprocity request — Active CNA in good standing in another state
Key requirement: Upload verification of out-of-state certification and other evidence requested by the application.
Inactive Missouri challenge review — Missouri record inactive after a two-year employment break
Key requirement: An inactive aide without qualifying work may challenge; failure requires the full Missouri course. A five-year employment break is described as expired and may require retraining.
What are the first steps for Online reciprocity request?
Submit once through the linked TMU form
Do not email reciprocity documents unless a named representative arranged it; approval allows certificate printing.
What should you confirm?
- The application link opens a TMU form-selection page. Confirm the correct form with the state.
- Confirm the five-year lapse boundary, document list and fee in the current application.
What will the Missouri planner ask?
- Which pathway applies to you? (Online reciprocity request, Inactive Missouri challenge review)
- Have you previously held CNA certification in Missouri? (Yes, No, I’m not sure)
How do you renew or maintain your nurse aide credential in Missouri?
The state sets the renewal cycle and any requirements for work hours and continuing education. This section summarizes the sources we reviewed. Follow the official instructions if they differ.
| Renewal cycle | Every 24 months. |
|---|---|
| Paid work requirement | Documentation, such as pay stubs, a W-2 or an employer letter, of at least one day (8 consecutive hours) of paid nursing or nursing-related work in each 24-month period. Facility, out-of-state and private-duty work can all be submitted. |
| CE or in-service | The candidate handbook's renewal section lists work hours and a fee, not continuing education. |
| Renewal window | Renew online in TMU: enter your employment, upload proof of your 8 hours and pay the $20 renewal fee. Reminders go out by email and text 60 days before expiration, and your employer can pay the fee for you. |
| If the credential lapses | If you've been inactive less than five years and can't document the work, you can challenge the final exam, with one attempt at both the written and skills parts. If you fail, or you've been inactive more than five years without work documentation, you must complete the full CNA course and exam. |
Missouri CNA certification renews every 24 months. You need documentation of at least 8 consecutive hours of paid nursing or nursing-related work in that period; facility, out-of-state and private-duty work can count. You renew online in TMU, upload your proof and pay the $20 renewal fee, which you or your employer can pay; reminders go out 60 days ahead. The renewal page and handbook don't list continuing education. If you've been inactive less than five years without work proof, you get one attempt to challenge the exam; after five years, or if you fail, you must retake the full course.
Source: CNA Registry Frequently Asked Questions ↗ Missouri DHSS: CNA renewals and work updates ↗ CNA Challenge (Missouri DHSS) ↗ Missouri Nurse Aide Candidate Handbook, version 15.0 (D&SDT-Headmaster) ↗ Health Education Unit News – CNA Renewals (Missouri DHSS) ↗ 19 CSR 30-84 Training Program for Nursing Assistants ↗
Open the official Missouri registry or agency page ↗ · Compare CNA renewal requirements by state