To become a Certified Nursing Assistant (CNA) in Missouri, you must complete a state-approved training program, pass the nurse aide competency exam, and be listed on the Missouri Nurse Aide Registry. This guide explains how to obtain, verify, renew, or reinstate your CNA license and transfer an active credential from another state—based on current regulations from the Missouri Department of Health and Senior Services (DHSS).
- How to Get Your CNA License in Missouri
- How to Verify Your CNA License in Missouri
- How to Renew Your CNA License in Missouri
- How to Reinstate Your CNA License in Missouri
- How to Transfer Your CNA License to Missouri
- Missouri Nurse Aide Registry
- State-Approved CNA Programs in Missouri
- Frequently Asked Questions
- Key Takeaways
How to Get Your CNA License in Missouri
To earn a CNA license in Missouri, you must meet training and testing requirements. Missouri DHSS oversees the process, which is managed through the TestMaster Universe (TMU) system by D&SDT-Headmaster.
Step 1: Complete a State-Approved CNA Training Program
Enroll in a DHSS-approved program that includes:
- 75 hours of classroom instruction
- 100 hours of on-the-job clinical training
All training must be supervised by a licensed nurse. You must finish the program before testing eligibility is granted. Your instructor will record completion in TMU and submit your exam approval form.
Step 2: Activate Your TMU Account
After your record is entered, TMU will email login instructions. Visit the Missouri TMU portal, reset your password, and complete your demographic profile.
You cannot schedule the CNA exam until your TMU account is complete. Incomplete accounts may result in a “No Show” status and forfeited fees.
Step 3: Pay for the CNA Exam
If your training program does not prepay, you must submit payment in TMU with a credit or debit card before scheduling.
| Exam Type | Fee |
|---|---|
| Knowledge Exam or Retake | $30 |
| Knowledge Exam (Audio Format) or Retake | $40 |
| Skills Test or Retake | $95 |
Ask your instructor if costs are covered or if a voucher is provided before paying.
Step 4: Schedule and Take the CNA Exam
Once payment is confirmed, log in to TMU to schedule. You may take the knowledge and skills exams together or separately.
Knowledge Exam
- 75 multiple-choice questions
- Time limit: 60 minutes
- Passing score: 80%
This computer-based exam offers an audio option; bring wired headphones if selected. Scratch paper and calculators are available. Do not click “End Exam” until directed by the proctor.
Skills Exam
- 3 or 4 randomly assigned tasks
- Mandatory skill: Handwashing
- Time limit: 30 minutes
- Passing score: All key steps plus 80% of remaining steps
You must perform tasks before an RN Test Observer. Corrections may be made if time permits. Verbalizing steps is not accepted unless directed.
Exam Retaking Policy
You must pass both components within one year of starting training. All attempts must be completed within 90 days of your first exam. A maximum of three total attempts is allowed. Failure to pass within these limits requires repeating the full training program.
Step 5: Get Listed on the Missouri Nurse Aide Registry
After passing both parts, Headmaster submits your scores to DHSS, and your name is added to the Missouri Nurse Aide Registry. No separate application or fee is required.
Official results appear in TMU after 7:00 p.m. Central Time on the following business day.
Need help? Call Headmaster at (888) 401-0462 for exam support or DHSS at (573) 526-5686 for registry questions.
How to Verify Your CNA License in Missouri
Use the Missouri Nurse Aide Registry to confirm certification status, work eligibility, and disciplinary findings.
Step 1: Access the Official Registry
Visit the Missouri Nurse Aide Registry. The registry is maintained by D&SDT-Headmaster with DHSS.
Step 2: Choose a Search Method
Select an option from the Search By dropdown:
- Registration Number
- Full Name
- Last Four Digits of SSN
Step 3: Enter Your Details
Type your information into the Look For field and click Search.
Step 4: Review Your Certification Status
Results display:
- Full legal name
- Certification number
- Status: Must show Active to work as a CNA
- Issue and expiration dates
- Disciplinary findings: Abuse, neglect, or misappropriation (if applicable)
Phone Verification: Call D&SDT-Headmaster at (800) 393-8664, Monday–Friday, 7:00 a.m.–7:00 p.m. CT.
How to Renew Your CNA License in Missouri
To remain active on the Missouri Nurse Aide Registry, you must renew every 24 months through TMU. Follow these steps:
Step 1: Confirm Eligibility
You may renew if you:
- Completed at least 8 hours of paid nursing-related services in the past 24 months
- Can provide acceptable documentation
Acceptable proof includes pay stubs, W-2s, or signed employer letters. Duties must be nursing-related. If denied, you have 15 business days to resubmit corrected documents.
Step 2: Access the TMU System
Go to the Missouri TMU portal and click “Sign In”.
- Use “Forgot Your Password?” if needed
- For assistance, call Headmaster (800) 393-8664 or DHSS (573) 526-5686
Step 3: Submit Employment Renewal
If eligible, you may see: “You have certifications that can be renewed.” Click the link to proceed. If not:
- Click the “Employment” tab
- Select “Add Employment Renewal”
Then enter:
- Certification: Select “Nurse Aide”
- Employer: Choose from the dropdown or enter manually
- Start Date: Date you began working
- End Date: Leave blank if still employed
- Hours Worked: At least 8
Upload proof of employment by clicking “Choose Files” and then “Add File”.
Step 4: Pay the Renewal Fee
- Fee: $20 (non-refundable)
- Options: Credit Card or Sponsor Payment
Enter details and click “Pay Now” or select Sponsor Payment and click “Create”.
Step 5: Await Employer Approval
Your renewal will show as “Pending Employer Approval” until verified in TMU.
Step 6: Verify Your Certification
Once approved, your license is renewed for 24 months. Check your status in TMU or at the registry search page. TMU sends reminders 60 days before expiration. Keep your contact info current.
Note: If expired for five or more years, you must complete new training and retake the exam. No refresher option exists.
How to Reinstate Your CNA License in Missouri
If your license has been expired for five years, you must complete new training and pass the exam to regain active status.
Step 1: Complete a State-Approved CNA Training Program
The program must include:
- 75 hours of classroom instruction
- 100 hours of clinical training
After completion, your instructor enters your record into TMU, making you exam-eligible.
Step 2: Access Your TMU Account
Sign in at the TMU portal. If needed, use “Forgot Your Password?” or call Headmaster at (888) 401-0462.
You must complete your TMU profile before scheduling.
Step 3: Pay the Exam Fees
- Knowledge Exam: $30
- Skills Exam: $70
- Total: $100
The audio Knowledge Exam option adds $10.
Step 4: Schedule Your Exams
Once fees are paid, schedule in TMU. Options include regional test sites, in-facility events, or remote proctoring. Bring valid photo ID and wear scrubs with closed-toe shoes.
Step 5: Pass the Missouri CNA Exam
- Knowledge Exam: 75 questions; passing score 80%
- Skills Exam: 3–4 tasks; must include all required steps and achieve 80%
You have three attempts within one year of training start to pass both exams. Otherwise, you must retake training.
Step 6: Confirm Your CNA License Status
After passing, your license is reinstated on the Missouri Nurse Aide Registry. Verify through TMU or the registry search.
Need assistance? Contact Headmaster at (888) 401-0462 or DHSS at (573) 526-5686.
How to Transfer Your CNA License to Missouri
If certified in another state, you may transfer to Missouri through reciprocity, without repeating training or testing.
Step 1: Confirm Eligibility
- Hold an active CNA certification in another U.S. state
- No findings of abuse, neglect, or misappropriation
- Alabama applicants: Must show at least 8 hours of paid CNA work in the past 24 months
Step 2: Access the Reciprocity Application
Go to the Missouri CNA Reciprocity Application. No login is required.
Step 3: Complete the Online Form
Provide:
- Full legal name, date of birth, SSN
- Phone, email, mailing address
- Out-of-state CNA license number and expiration
- Issuing state
Step 4: Upload Required Documents
- Copy of out-of-state CNA certificate or registry printout
- Alabama applicants: Recent pay stub showing at least 8 hours of CNA work
Step 5: Submit Your Application
DHSS reviews applications in the order received. Incomplete or unverifiable requests will be denied.
Step 6: Verify Your Certification
If approved, your status appears as Active on the Missouri Nurse Aide Registry. You may log in to TMU to print your Missouri CNA certificate.
Need assistance? Contact Headmaster at (888) 401-0462 or DHSS at (573) 526-5686.
Missouri Nurse Aide Registry
The Missouri Nurse Aide Registry (MOCNAR), maintained by D&SDT-Headmaster with the Missouri Department of Health and Senior Services (DHSS), is the official record of CNAs authorized to work in licensed long-term care facilities statewide. The registry includes certification status, renewal eligibility, training history, and any substantiated findings of abuse, neglect, or misappropriation. Employers must verify active status before hire, while CNAs use it to confirm certification, renew credentials, and update information. All testing, renewals, reciprocity, and status updates are managed through the TMU® portal.
Contact Information
Missouri Department of Health and Senior Services (DHSS)
- Address: PO Box 570, Jefferson City, MO 65102
- Phone: (573) 526-5686
- Email: cnaregistry@health.mo.gov
- Website: cna.dhss.mo.gov
D&SDT-Headmaster (Registry Provider)
- Mailing Address: PO Box 6609, Helena, MT 59604
- Phone (Registry): (888) 401-0465
- Fax: (406) 442-3357
- Email: missouri@hdmaster.com
- Registry Search: Missouri Nurse Aide Registry Search
State-Approved CNA Programs in Missouri
The following CNA programs are approved by DHSS. When comparing, consider tuition, scheduling, location, clinical partnerships, and job placement support.
Frequently Asked Questions
Do CNA programs in Missouri include CPR or First Aid certification?
No. CPR and First Aid are not required in the CNA curriculum, though some programs may offer them separately.
Can I challenge the CNA exam without completing a training program?
Yes. If you meet eligibility criteria, such as recent nursing education or foreign licensure, you may challenge the exam. Only one attempt is allowed. If unsuccessful, you must complete the full training program.
When should I schedule my CNA exam after training?
Once your instructor marks training complete in TMU, you may schedule. Headmaster recommends scheduling at least 14 days in advance.
Can I request a review of my CNA exam results?
Yes. Submit a Test Review Request within three business days. A $25 deposit is required and refunded if a scoring error is confirmed.
Can I be reimbursed for CNA training and testing costs?
Yes. If hired by a Medicaid-certified facility within 12 months of training, the facility must reimburse your costs with proof of payment. Employers must retain records and bill Medicaid through eMOMED.
Does Missouri send renewal notices or certificates by mail?
No. Renewal notices are sent by email or text. Certificates must be downloaded from your TMU account.
Can I hold CNA, CMT, and IA certifications at the same time?
Yes. If your CNA certification is active, your Certified Medication Technician (CMT) and Insulin Administration (IA) credentials remain active.
What does a “Federal Indicator” mean on my record?
A Federal Indicator shows a substantiated finding of abuse, neglect, or misappropriation. You are ineligible to work in federally funded long-term care facilities.
Can I work as a CNA if I have a criminal background?
You cannot work in a licensed facility if you are listed on the Employee Disqualification List (EDL). Employers must check eligibility before hire.
Key Takeaways
- Complete approved training: Finish a DHSS-approved program with 75 hours of classroom instruction and 100 hours of clinical practice.
- Pass both exam components: Successfully complete the knowledge and skills exams administered by D&SDT-Headmaster.
- Appear on the state registry: Once certified, your active status is posted on the Missouri Nurse Aide Registry through the TMU® system.
- Renew every 24 months: Submit proof of at least 8 hours of paid CNA work within the past 24 months through TMU with employer verification.
- Reinstate if expired: Inactive CNAs may renew with proof of qualifying work; certifications expired for five or more years require new training and exams.
- Transfer by reciprocity: Apply through TMU with verification of active out-of-state certification. Alabama applicants must also provide proof of 8 hours of paid CNA work within the past 24 months.
Sources
- Missouri Department of Health and Senior Services – Nurse Aide Registry
- Missouri TMU – TestMaster Universe Portal
- Search the Missouri Nurse Aide Registry
- DHSS – Certified Nurse Assistant (CNA)
- How to Renew Your Certification in TMU – Headmaster
- D&SDT-Headmaster – Missouri CNA Testing Portal
- Missouri Nurse Aide Candidate Handbook (2025)
- DHSS – CNA Challenge Eligibility
- DHSS – CNA Reciprocity Application Instructions
- Missouri CNA Reciprocity Application
