The Certified Nurse Assistant (CNA) role is an entry point into the healthcare profession, providing foundational patient care under the supervision of licensed nursing staff. CNAs assist patients with personal care, vital signs, and mobility in various settings, including long-term care facilities, hospitals, and clinics. Achieving certification in Missouri requires navigating a specific, multi-step process established by state regulations. This guide outlines the necessary steps, from meeting initial requirements to maintaining active professional status on the state registry.
Meeting the Initial Eligibility Requirements
Applicants must satisfy mandatory prerequisites before enrolling in a CNA training program. Individuals must generally be at least 18 years old, though an exception exists for 16 and 17-year-olds enrolled in an approved high school health services occupation program. Candidates must also demonstrate eligibility to work in the United States.
A mandatory criminal background check is required for all individuals seeking certification to protect patient safety. This screening involves checking against the Missouri Employee Disqualification List (EDL) and the Family Care Safety Registry. Missouri Statute section 660.035 guides the state’s requirements regarding convictions that could potentially disqualify an applicant from employment. Furthermore, many training providers require a recent negative tuberculosis (TB) test or other health screenings before clinical participation.
Completing State-Approved Training
Certification requires successful completion of a nurse aide training program formally approved by the Missouri Department of Health and Senior Services (DHSS). The state mandates a comprehensive program totaling 175 hours of instruction. This total is divided into two distinct components designed to ensure both theoretical understanding and practical competence:
A minimum of 75 hours of classroom training, covering topics such as basic nursing skills, infection control, patient rights, and communication techniques.
A minimum of 100 hours of supervised clinical practice. This hands-on experience takes place in a real healthcare setting, such as a nursing facility, under the direct supervision of a licensed nurse, allowing students to apply classroom knowledge to actual patient care scenarios.
These state-approved programs are commonly offered through community colleges, vocational technical schools, and certain long-term care facilities. Upon successful completion, the program administrator submits documentation to the state, granting the student eligibility to schedule the competency examination. Individuals who meet specific challenge requirements, such as nursing students who have completed clinical rotations, may be eligible to bypass the training program and proceed directly to the examination.
Passing the Missouri CNA Competency Exam
After completing the required training, candidates must pass the state-mandated competency examination, administered by a state-contracted testing service, currently D&S Headmaster. The exam is composed of two separate sections. Both the knowledge and the skills components must be passed within six months of completing the training program to achieve certification.
The first component is the knowledge test, which can be taken as either a written or an oral examination, consisting of multiple-choice questions covering the curriculum studied in the classroom portion. The content evaluates understanding of safety procedures, restorative services, and basic care principles. Candidates typically must achieve a score of 80% or higher to pass this section.
The second part is the practical skills demonstration, where the candidate performs a selection of patient care tasks in front of an evaluator. This hands-on test assesses the ability to safely and accurately perform procedures like measuring vital signs, assisting with transfers, and providing personal hygiene. If a candidate fails either section, they are allowed two retakes, for a total of three attempts. Failure on the third attempt requires the candidate to retake the entire state-approved training program before retesting.
Official Listing on the State Registry
Successful passing of both the knowledge and skills portions of the competency exam is the final step before certification. The testing vendor electronically submits the successful results to the Missouri Department of Health and Senior Services (DHSS). This action triggers the automatic placement of the individual’s name on the Missouri Health Care Provider Registry (HCPR).
The registry listing is the official verification of certification and is the primary resource employers use to confirm a CNA’s active status and eligibility for employment. No separate application or fee is required for this initial listing, as the process is integrated with the exam results submission. Once listed, the individual can log into the state’s online system to view and print their official Missouri CNA certificate.
CNAs certified in another state who wish to work in Missouri must apply for reciprocity. Applicants submit documentation to DHSS demonstrating their out-of-state certification is active and in good standing, and that they meet Missouri’s standards for training and testing. DHSS reviews these applications before granting Missouri certification and listing the individual on the state registry.
Maintaining Your Certification
Once certified, a CNA must maintain their status to continue working in a certified healthcare setting in Missouri. Certification operates on a two-year (24-month) renewal cycle. The primary requirement for renewal is demonstrating a minimum of eight hours of compensated nursing or nursing-related services within the preceding 24-month period.
This work must be documented and submitted through the state’s online portal, TestMaster Universe (TMU), to verify continued professional engagement. Acceptable forms of documentation include pay stubs or W-2 forms from an approved healthcare employer. Failing to meet this minimum work requirement will cause the certification status to become inactive on the registry.
If the certification lapses for five consecutive years without recorded paid nursing services, the status becomes expired. An expired status requires the individual to retake the entire state-approved training course and pass the competency examination again to regain active certification.