CNA in Montana : Training, 2026 — Free Practice Questions & Answers

CNA in Montana 2026: Training, Certification, Salary, and Requirements

🌆 Billings / Eastern MT

Billings is Montana's largest city and its dominant CNA job market. Billings Clinic, Montana's largest physician-led health system and Level II trauma center, is the region's most significant CNA employer — offering competitive wages, comprehensive benefits, and clear career advancement pathways from CNA to LPN to RN. SCL Health (now Intermountain Health) St. Vincent Healthcare, a major Catholic health system hospital in Billings, employs hundreds of CNAs across inpatient and long-term care settings. Riverstone Health (the public health authority for Yellowstone County) and numerous skilled nursing facilities, assisted living communities, and home health agencies round out Billings' CNA market. City College at MSU Billings offers one of the most accessible DPHHS-approved CNA programs in Eastern Montana, with affordable community college tuition and multiple start dates. The American Red Cross — Montana Chapter also runs CNA training courses in Billings. CNA wages in Billings average $14–$17/hour, with Billings Clinic and Intermountain offering the highest rates at $16–$20/hour. Eastern Montana outside Billings — including Miles City, Glendive, Sidney, and Wolf Point — has smaller but high-demand CNA markets, particularly in rural critical access hospitals and Indian Health Service facilities on the Fort Peck, Fort Belknap, and Crow reservations. Rural CNA positions often include housing stipends or relocation assistance due to severe staffing shortages in these communities.

🏔️ Missoula / Western MT

Missoula is Montana's second-largest city and home to the University of Montana, making it a younger, education-focused market with a growing healthcare sector. Providence St. Patrick Hospital, affiliated with Providence Health & Services, is the primary acute care hospital in Western Montana and one of Missoula's largest CNA employers. Village Health & Rehabilitation and a growing network of assisted living facilities serve the region's expanding senior population. Missoula Aging Services coordinates a wide range of home-based care programs, creating CNA employment opportunities in home health settings throughout the county. The University of Montana College of Health and Missoula College (UM Western) offer DPHHS-approved CNA training programs with favorable community college rates. CNA wages in Missoula average $13.50–$17/hour, with Providence St. Patrick leading at the top end. Western Montana's Flathead Valley — including Kalispell and Whitefish — is another significant CNA market, anchored by Logan Health (formerly Kalispell Regional Medical Center), a large regional system serving the Glacier National Park corridor. The Flathead Reservation (Confederated Salish and Kootenai Tribes) also employs CNAs through tribal health programs. Flathead Valley CNA wages generally match Missoula levels, with Logan Health offering the strongest benefit packages in the region.

🌾 Great Falls / Central MT

Great Falls is Montana's third-largest city and a significant regional healthcare hub for Central Montana. Benefis Health System, the dominant hospital system in Great Falls, operates the largest acute care facility in Central Montana and is the region's primary CNA employer. Benefis runs a Level II trauma center and multiple specialty clinics, with consistent demand for CNAs across inpatient, rehab, and long-term care units. Montana Veterans Home in Columbia Falls and the Montana State Veterans Cemetery in Glendive reflect Montana's significant veteran population, and VA-affiliated facilities throughout Central Montana provide stable CNA employment with federal benefits. Montana State University — Great Falls (MSU-GF) offers a DPHHS-approved CNA training program, often cited as one of the most affordable in the state. The surrounding Central Montana region — including Havre, Lewistown, and Malta — consists primarily of rural critical access hospitals and Indian Health Service facilities on the Blackfeet, Rocky Boy, and Fort Belknap reservations. CNA positions in these rural Central Montana communities often pay at or below the state median ($13–$15/hour) but include significant non-wage benefits: employer-sponsored housing, relocation assistance, sign-on bonuses, and flexible scheduling that allow CNAs to work additional per-diem shifts at regional facilities.

🏔️ Bozeman / Gallatin Valley

Bozeman and the Gallatin Valley represent Montana's fastest-growing CNA market, driven by rapid population growth, Montana State University's expanding health programs, and a booming senior relocation market attracted by Bozeman's outdoor recreation amenities. Bozeman Health (Bozeman Health Deaconess Hospital) is the primary acute care facility in the Gallatin Valley and consistently ranks among Montana's better-paying CNA employers at $15–$19/hour with competitive benefits. Bridger Orthopedic and Sports Medicine and the rapidly expanding network of assisted living and memory care facilities serving Bozeman's growing retiree population create additional CNA demand. Montana State University — Bozeman's nursing program feeds into CNA pathways, and Gallatin College MSU offers DPHHS-approved CNA training at community college rates. Bozeman's rapid growth has created a healthcare workforce shortage that paradoxically benefits CNAs: starting wages in Bozeman have risen significantly to $15–$19/hour base, above the statewide average. Helena, Montana's capital, and Butte also constitute significant CNA markets. St. Peter's Health in Helena is the primary employer for the capital region, while St. James Healthcare (Intermountain) in Butte serves the southwestern Montana mining belt. Helena and Butte CNA wages average $13.50–$16.50/hour, with state government-linked benefits packages available for CNAs employed by state-operated healthcare facilities.

Montana Essential Checklist

Be at least 16 years old (verify minimum age with your specific DPHHS-approved program)

Provide valid government-issued photo ID (MT driver's license, passport, or state ID)

Complete a criminal background check through Montana DPHHS

Obtain negative TB test within the past 12 months (Mantoux PPD or QuantiFERON Gold)

Pass a physical examination by a licensed physician, APRN, or PA

Obtain current CPR/BLS certification (American Heart Association or American Red Cross)

Complete required immunizations (Hep B series, MMR, Varicella, Tdap, annual Flu)

Pass pre-enrollment drug screen if required by your specific program or clinical site

Enroll in and complete a DPHHS-approved 75-hour CNA training program

Complete minimum 16 hours of supervised clinical practice at a licensed MT facility

Receive program completion certificate from your DPHHS-approved training provider

Pass written knowledge exam (70 questions, 70% minimum passing score, 105 minutes)

Pass clinical skills evaluation (5 randomly selected skills, all must be passed)

Wait for Montana DPHHS Nurse Aide Registry placement (2–4 weeks after exam passage)

Verify your active registry status online through the Montana DPHHS website

Renew every 2 years: provide proof of 8 hours paid nursing service within the renewal period

If applying to tribal/IHS facilities: confirm tribal enrollment or hiring preferences with specific facility HR

Montana Advantages and Disadvantages

Pros

Only 75 hours required — the federal minimum and one of the shortest CNA training requirements in the US; fastest path to certification
Montana DPHHS registry is straightforward to navigate online — lookups and status verification are accessible
D&S Diversified exam (same vendor as Kansas, Missouri, Arizona, Georgia) — extensive national prep resources match the MT exam format
Severe rural healthcare shortages create strong demand statewide — CNAs are actively recruited with bonuses and housing stipends
Tribal health and IHS positions offer federal-level benefits, loan repayment, and competitive wages rarely found in rural healthcare
Bozeman's rapid growth has pushed CNA wages above $15–$19/hour — Montana's fastest-growing and highest-paying non-hospital CNA market
Low cost of living — CNA salary of $28K–$34K goes further in Montana compared to coastal markets, especially outside Bozeman
Montana's scenic beauty and outdoor recreation culture appeal strongly to CNAs seeking work-life balance outside urban environments
Strong reciprocity framework — active MT CNA certification transfers easily to most states via DPHHS, expanding career mobility

Cons

Salaries ($28K–$34K) are at the lower end nationally — Billings and Bozeman pay better but still below coastal markets by $8,000–$15,000/year
Only 75 hours required — meets federal minimum only, which is the bare floor; some states require 120–175 hours for better preparation
Rural Montana counties have extremely limited CNA training programs and significantly lower wages ($12–$14/hour) in remote areas
Harsh winters and geographic isolation in much of the state create transportation challenges for clinical training and employment
Montana has limited public transit — CNAs almost universally need a personal vehicle, especially for rural or tribal health positions
D&S Diversified exam (not Prometric) — must use D&S-specific practice resources; many generic national CNA prep materials reference Prometric
DPHHS registry (not Board of Nursing) — candidates must navigate a less familiar agency than most national certification resources reference

How many hours of training are required to become a CNA in Montana?

Montana requires a minimum of 75 hours of DPHHS-approved CNA training — the exact federal minimum established under OBRA '87. Montana does not exceed the federal floor, making it one of the shorter CNA training requirements in the US. Programs must include classroom instruction (minimum 16 hours), skills laboratory practice, and a minimum of 16 hours of supervised clinical training at a licensed Montana nursing facility or approved healthcare setting. Full-time accelerated programs complete in 2–3 weeks; part-time programs take 6–10 weeks. All programs must be approved by the Montana Department of Public Health and Human Services (DPHHS).

Who administers the CNA exam in Montana — D&S Diversified or Prometric?

Montana uses D&S Diversified Technologies to administer the CNA competency exam — NOT Prometric. This is a critical point of confusion for Montana candidates, as Prometric administers exams in many other states and is the vendor referenced by most generic national CNA study resources. D&S Diversified administers both the written knowledge test (70 questions, 105 minutes, 70% to pass) and the clinical skills evaluation (5 randomly selected skills, all must be passed). After completing your DPHHS-approved training program, you register directly with D&S Diversified for scheduling. Testing sites are available in Billings, Missoula, Great Falls, Helena, Bozeman, and Butte.

Which agency manages the Montana Nurse Aide Registry?

The Montana Department of Public Health and Human Services (DPHHS) manages the Montana Nurse Aide Registry — not the Montana Board of Nursing. This is a key distinction that confuses many candidates who search for their state board of nursing instead. DPHHS regulates nurse aide certification, maintains the registry, handles reciprocity applications, and maintains the abuse/neglect/exploitation findings registry. After passing both sections of the D&S Diversified exam, DPHHS processes your registry placement within 2–4 weeks. Registry status can be verified online through the Montana DPHHS website at dphhs.mt.gov.

What are the top CNA employers in Montana?

Montana's top CNA employers include Billings Clinic (Montana's largest physician-led health system), Intermountain Health / St. Vincent Healthcare in Billings, Providence St. Patrick Hospital in Missoula, Benefis Health System in Great Falls, Logan Health (formerly Kalispell Regional) in the Flathead Valley, Bozeman Health Deaconess Hospital, and St. Peter's Health in Helena. Indian Health Service facilities and tribal health programs on Montana's seven reservations are also significant employers, particularly for CNAs seeking federal benefits and loan repayment eligibility. Critical access hospitals throughout rural Montana actively recruit CNAs with signing bonuses and housing stipends.

Can I work as a CNA at tribal health facilities in Montana?

Yes. Montana's seven federally recognized tribes — Blackfeet Nation, Crow Nation, Northern Cheyenne Tribe, Confederated Salish and Kootenai Tribes, Fort Belknap Indian Community, Fort Peck Assiniboine and Sioux Tribes, and Little Shell Chippewa Tribe — all operate tribal health programs or partner with the Indian Health Service (IHS). CNA positions at these facilities are open to all candidates, though tribal members and Alaska Native individuals receive Indian Preference in hiring per ISDEAA Title V. IHS-direct positions include federal employee benefits (health insurance, FERS retirement, paid leave) and may qualify for NHSC loan repayment assistance. Wages at tribal/IHS facilities ($14–$19/hr) often exceed comparable positions at nearby non-tribal rural facilities.

How do I renew my Montana CNA certification?

Montana CNA certifications must be renewed every 2 years through the Montana DPHHS Nurse Aide Registry. To renew, you must demonstrate that you have completed a minimum of 8 hours of paid nursing employment as a nurse aide (or in a related direct patient care capacity) within the preceding 24 months. This employment requirement means CNAs who have not worked in the field for 2+ years must complete a competency evaluation or retraining program before renewal. Renewal is processed through DPHHS and does not require retaking the D&S Diversified exam as long as your registry status has not lapsed. Contact Montana DPHHS at dphhs.mt.gov for current renewal fees and procedures.

What is the CNA salary in Montana?

Montana CNA salaries range from approximately $28,000–$34,000 annually ($13.50–$16.50/hour) statewide. Billings and Bozeman offer the highest wages — hospital CNAs at Billings Clinic and Bozeman Health earn $15–$20/hour, well above the state average. Missoula and Great Falls fall in the $13.50–$17/hour range. Rural and tribal health positions often pay $13–$17/hour but may include significant non-wage benefits: sign-on bonuses ($1,500–$3,500), housing stipends, relocation assistance, and federal benefits for IHS positions. Staffing agency and per-diem CNA positions in Billings and Bozeman can reach $18–$24/hour but typically lack benefits.

Can I transfer my out-of-state CNA certification to Montana?

Yes. Montana DPHHS accepts reciprocity applications from CNAs who hold a current, active certification in another state with no abuse, neglect, or exploitation findings. The reciprocity process allows qualified CNAs to be added to the Montana DPHHS Nurse Aide Registry without retaking the D&S Diversified exam. You will need to submit proof of your current out-of-state certification, provide documentation of your work history, and pass Montana's background check requirements. Contact Montana DPHHS directly for current reciprocity application fees and processing timelines. Conversely, active Montana CNA certification transfers to most other states through their respective reciprocity processes.

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