CNA in Missouri 2026: Training, Certification, Salary, and Requirements
Free CNA in Missouri 2026: 🟢 Training, practice test with questions and answer explanations. Prepare for the 2026 exam with instant scoring.
CNA: upcoming dates and official changes
- Aug 1, 2026: Connecticut (Prometric) implements new exam pricing: $48 for written only, $48 for oral only, $125 for bundled written and clinical skills, effective August 1, 2026.[5]
- Jul 1, 2026: Idaho (Prometric) raises CNA exam fees to $34 each for written and oral exams, plus test site fees, effective July 1, 2026.[6]
- Passing score (written or oral): Set per state; no national percentage published.[1]
- Retake policy: Minimum 3 attempts required; aides must be told which areas they failed before each retake.[1]
- Validity: 2 years from issuance in most states.[2]
- Renewal: State-specific; typically 2-year cycles with continuing education requirements (12–24 hours per year) and paid-work requirements.[3]
- Delivery (in-person): In-person written or oral exam plus in-person skills demonstration at approved test centers.[1]
- Eligibility (training): Minimum 75 clock hours approved training (federal requirement); at least 16 hours supervised practical training.[1]
- Score release: Days to weeks; varies by state and vendor (no national standard).[4]
Numbers in brackets link to the official sources listed under Sources & last verified. Dates that have passed are removed automatically.
CNA Exam at a Glance
| Item | Detail | Source · Verified |
|---|---|---|
| Passing score (written or oral) | Set per state; no national percentage published[1] | Centers for Medicare & Medicaid Services · Oct 14, 2026 |
| Retake policy | Minimum 3 attempts required; aides must be told which areas they failed before each retake[1] | Centers for Medicare & Medicaid Services · Oct 14, 2026 |
| Validity | 2 years from issuance in most states[2] | archive.regulations.delaware.gov · Oct 14, 2026 |
| Renewal | State-specific; typically 2-year cycles with continuing education requirements (12–24 hours per year) and paid-work requirements[3] | cdph.ca.gov · Oct 14, 2026 |
| Delivery (in-person) | In-person written or oral exam plus in-person skills demonstration at approved test centers[1] | Centers for Medicare & Medicaid Services · Oct 14, 2026 |
| Eligibility (training) | Minimum 75 clock hours approved training (federal requirement); at least 16 hours supervised practical training[1] | Centers for Medicare & Medicaid Services · Oct 14, 2026 |
| Score release | Days to weeks; varies by state and vendor (no national standard)[4] | floridasnursing.gov · Oct 14, 2026 |
Missouri Detailed Breakdown
The Kansas City metro area — on the Missouri side encompassing Jackson County, Clay County, and Cass County — is Missouri's largest CNA market. Kansas City, MO anchors this region with a mix of acute care hospitals, skilled nursing facilities, home health agencies, and assisted living communities. Saint Luke's Health System, one of the most respected integrated health systems in the Midwest, operates Saint Luke's Hospital of Kansas City and multiple satellite campuses — a major CNA employer known for strong wages and career advancement. HCA Midwest Health operates several Kansas City-area hospitals including Research Medical Center and Menorah Medical Center. Veterans Affairs Medical Center Kansas City employs a significant number of CNAs serving Missouri's veteran population. For training, Metropolitan Community College (MCC) — with campuses across the KC metro — offers some of the most accessible and affordable DHSS-approved CNA programs in Missouri. Penn Valley Community College (MCC Penn Valley, Kansas City) and State Fair Community College also offer CNA pathways. CNA wages in Kansas City, MO average $13–$17/hour, with hospital positions at Saint Luke's and HCA reaching $17–$21/hour. Free CNA training programs may be available through Missouri Workforce Development centers and employer-sponsored programs at long-term care facilities. Important: CNAs working on the Kansas side of the KC metro must hold a separate Kansas CNA certification — see the KC Metro dual licensing highlight below.
Missouri Essential Checklist
- ✓Be at least 16 years old (most Missouri programs require 16–18; verify with your specific program)
- ✓Provide valid government-issued photo ID (Missouri driver's license, passport, or state ID)
- ✓Complete a criminal background check through the Missouri State Highway Patrol (MSHP) — fingerprint-based
- ✓Verify you are not listed on Missouri's Employee Disqualification List (EDL) via the DHSS website
- ✓Obtain a negative TB test within the past 12 months (Mantoux PPD or QuantiFERON Gold blood test)
- ✓Pass a physical examination by a licensed physician, PA, or APRN
- ✓Obtain current CPR/BLS certification (American Heart Association or American Red Cross)
- ✓Complete required immunizations: Hep B series, MMR, Varicella, Tdap, annual Flu
- ✓Complete any pre-enrollment drug screen required by your training program
- ✓Enroll in and complete a Missouri DHSS-approved 75-hour CNA training program
- ✓Complete minimum 16 hours of classroom/theory instruction
- ✓Complete minimum 16 hours of supervised clinical practice at a licensed Missouri nursing facility
- ✓Receive your official training program completion certificate
- ✓Register for both exam sections through D&S Diversified Technologies (not Prometric)
- ✓Pass written knowledge exam (70 questions, 70% minimum passing score, 105 minutes)
- ✓Pass clinical skills evaluation (5 randomly selected skills — all skills must be passed)
- ✓Confirm placement on the Missouri DHSS Nurse Aide Registry (allow 2–4 weeks after exam passage)
- ✓Renew certification every 2 years: provide proof of 8 hours paid nursing service within the period
Missouri Advantages and Disadvantages
- +Only 75 hours required — the federal minimum; most full-time programs complete in 2–3 weeks
- +D&S Diversified exam (same vendor as Kansas, Georgia, Arizona) — extensive national prep resources available
- +BJC HealthCare and Mercy offer some of the Midwest's best CNA wages, benefits, and career advancement
- +Two major metro markets (St. Louis and Kansas City) provide diverse employment options and specialties
- +DHSS registry is straightforward to navigate online — status checks, lookups, and renewal are web-accessible
- +Low cost of living — CNA salary of $26K–$32K stretches further in Missouri than coastal markets
- +HCBS waiver programs fund home-based CNA positions across all 114 counties — flexible work options statewide
- +KC metro dual MO/KS certification is achievable and dramatically expands job placement options
- +Missouri has a large and growing senior population, ensuring sustained CNA demand across the state
- −Salaries ($26K–$32K) are below the national median — coastal and Sun Belt markets pay significantly more
- −DHSS manages the registry (not the Board of Nursing) — candidates must know the correct agency for inquiries
- −Rural Missouri counties (Bootheel, northern MO) have limited CNA training programs and lower wages ($11–$13/hr)
- −KC metro cross-border licensing adds complexity — dual MO/KS certification requires extra steps and fees
- −D&S Diversified exam (not Prometric) — verify practice resources specifically match the D&S NNAAP format before studying
- −Missouri Employee Disqualification List (EDL) blocks many candidates with prior healthcare violations
- −Limited public transportation in many Missouri cities — CNAs may need reliable personal transportation
- −Only 75 hours of training is minimal by national standards — some candidates feel underprepared for clinical realities
Pros and Cons at a Glance
| Pros | Cons |
|---|---|
| D&S Diversified exam (same vendor as Kansas, Georgia, Arizona) — extensive national prep resources available | DHSS manages the registry (not the Board of Nursing) — candidates must know the correct agency for inquiries |
| BJC HealthCare and Mercy offer some of the Midwest's best CNA wages, benefits, and career advancement | KC metro cross-border licensing adds complexity — dual MO/KS certification requires extra steps and fees |
| Two major metro markets (St. Louis and Kansas City) provide diverse employment options and specialties | D&S Diversified exam (not Prometric) — verify practice resources specifically match the D&S NNAAP format before studying |
| DHSS registry is straightforward to navigate online — status checks, lookups, and renewal are web-accessible | Missouri Employee Disqualification List (EDL) blocks many candidates with prior healthcare violations |
| KC metro dual MO/KS certification is achievable and dramatically expands job placement options | Limited public transportation in many Missouri cities — CNAs may need reliable personal transportation |
Free CNA Study Tools
Interactive CNA resources on PracticeTestGeeks, free to start:
- CNA practice test — 3,000+ questions with instant scoring and answer explanations
- CNA flashcards — review key terms and concepts card by card
- CNA study guide — topic-by-topic overview of what the exam covers
- CNA cheat sheet — one-page printable summary for last-minute review
Sample CNA Practice Questions
Try these questions from our free CNA practice tests. The correct answer and an explanation follow each question.
A CNA is working in a state where, with additional certification and under specific circumstances, they are permitted to perform certain advanced tasks. Which of these tasks would most likely require this type of special certification?
- A. Performing range-of-motion exercises on a post-stroke resident.
- B. Discontinuing a resident's indwelling urinary catheter.
- C. Assisting a resident with using a metered-dose inhaler.
- D. Documenting a resident's fluid intake and output.
Answer: B. Discontinuing a resident's indwelling urinary catheter.
While specific regulations vary by state, discontinuing (removing) an indwelling urinary catheter is an invasive procedure that is generally outside the standard CNA scope. Some states or facilities may allow a specially trained CNA to perform this task. The other tasks, such as assisting with inhalers (but not administering the medication independently), performing restorative exercises, and documenting I&O, are more commonly within the standard CNA role.
A CNA's certification in Florida became null and void 3 years ago after they failed to meet renewal requirements. To regain active status, what must the individual do?
- A. Complete 48 hours of continuing education and pay a reactivation fee.
- B. Take a refresher course and pass the skills portion of the competency exam.
- C. Work 100 hours under the direct supervision of a Registered Nurse.
- D. Reapply for licensure and meet all current initial application requirements.
Answer: D. Reapply for licensure and meet all current initial application requirements.
According to the Florida Board of Nursing, once a CNA license becomes 'Null and Void,' it cannot be reactivated or renewed. The individual must start the process over by reapplying for licensure and complying with all laws and rules that are current at the time of the new application.
Which of the following observations about a resident's stool should be reported to the nurse immediately?
- A. Brown, formed stool after a meal
- B. Small, dark, tarry stool with a foul odor
- C. Stool that is slightly soft
- D. Infrequent stool after a low-fiber diet
Answer: B. Small, dark, tarry stool with a foul odor
Dark, tarry (melena) stool suggests upper GI bleeding and requires immediate nurse notification.
A resident with moderate dementia is resistant to eating meals. Which intervention should the CNA try FIRST?
- A. Force-feed the resident using a syringe
- B. Offer finger foods that the resident can eat independently
- C. Skip the meal and document poor appetite
- D. Threaten to take away privileges if the resident refuses
Answer: B. Offer finger foods that the resident can eat independently
Finger foods promote independence and may be more acceptable to residents who resist being fed or using utensils.
Take the full CNA practice test
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- Centers for Medicare & Medicaid Services — passing score, retake policy, delivery, eligibility (official source). “The State shall establish the passing standard for the written or oral examination and for the skills demonstration.” Verified Oct 14, 2026.
- archive.regulations.delaware.gov — validity (official source). “CNA certification shall be effective for 2 years following the date of issue and shall expire 2 years following such date” Verified Oct 14, 2026.
- cdph.ca.gov — renewal (official source). “Certificates are renewed every two years, and the required training is 48 hours of in-service training or continuing education” Verified Oct 14, 2026.
- floridasnursing.gov — score release (official source). “After you pass both components and your application is fully processed, the Board adds you to the Registry and mails your certificate. The process can…” Verified Oct 14, 2026.
- prometric.com — other (official source). “Effective August 1, 2026, the following exam pricing will be implemented” Verified Oct 14, 2026.
- prometric.com — other (official source). “Effective July 1, 2026, the following exam pricing will be implemented: $34 written, $34 oral, plus test site fees” Verified Oct 14, 2026.
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How this page was made: written with AI tools. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy
Sources & references
Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy
- floridasnursing.gov — Eligibility, exam format · verified Oct 2026
- law.cornell.edu — Eligibility · verified Oct 2026
- law.cornell.edu — Test delivery · verified Oct 2026
- prometric.com — Exam information · verified Oct 2026