How to Get Your CNA Certification in Missouri (MO): 2026 Guide
Missouri requires 175 total training hours and uses Headmaster for CNA testing. Passing requires 80% on the written exam — higher than most states.
Missouri has one of the longest CNA training requirements in the country: 175 total hours — more than double the federal minimum. After completing a state-approved program, candidates take the Headmaster nurse aide exam. Missouri also has one of the highest passing thresholds: 80% on the written portion, and 100% on critical skill steps.
This guide explains Missouri's program, costs, exam structure, and testing sites across the Show-Me State.
Missouri CNA at a glance
- Testing vendor: Headmaster
- Training hours: 175 total (75 classroom + 100 clinical/lab)
- Exam format: 75-question knowledge test + skills test
- Passing score: 80% on written; 100% on critical skill steps
- Exam fee: approximately $135 combined
- Registry: Missouri Department of Health and Senior Services (DHSS)
- Renewal: 24 months
Who oversees CNA certification in Missouri
The Missouri Department of Health and Senior Services (DHSS) approves training programs and maintains the registry. Headmaster administers the competency exam under contract. DHSS also reviews reciprocity applications for out-of-state CNAs.
Training programs in Missouri
Missouri requires 175 hours of training — more than double the federal minimum of 75 hours. The high-hour standard reflects Missouri's emphasis on clinical readiness before employment. Programs are offered at:
- Community colleges (St. Louis Community College, Metropolitan Community College Kansas City, Moberly Area Community College, Ozarks Technical Community College, State Fair Community College, North Central Missouri College, East Central College, Crowder College, Jefferson College)
- Private training academies
- Long-term care facilities with in-house programs
- Some high school career and technical education programs
Most programs run 8–12 weeks. Tuition typically ranges from $900 to $2,000 plus $100–$200 for uniforms, textbooks, and the Missouri State Highway Patrol background check (Name/CHRI/FBI).
The Missouri CNA exam: Headmaster details
The Headmaster exam has two parts:
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Knowledge Test — 75 multiple-choice questions covering resident rights, basic nursing skills, infection control, communication, and safety.
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Skills Test — hands-on demonstration of randomly selected skills in front of a Headmaster nurse evaluator.
Missouri's passing score is 80% on the written portion — higher than most states' 70% threshold. You must also perform 100% of critical skill steps correctly; missing any single critical step causes automatic failure.
How much does the Missouri CNA exam cost?
- Written + skills combined — ~$135
- Knowledge retake — ~$60
- Skills retake — ~$80
- State background check — $15–$25
- State registry listing — included
Training program tuition is paid separately and ranges $900–$2,000. Combined with the longer training time, Missouri's total cost-of-entry is among the highest in the country.
Where to take the test in Missouri
- St. Louis — frequent testing; multiple Headmaster partner sites
- Kansas City — regular sessions; multiple sites
- Springfield — periodic testing; OTC-area dates
- Columbia — scheduled through partner programs; limited dates
- Joplin — limited dates; book early
- Cape Girardeau — limited dates; book early
- St. Joseph — limited dates; book early
Missouri's testing footprint covers the St. Louis and Kansas City metros well. Rural counties and the Ozarks region candidates may travel 60–90 minutes to the nearest active site.
Scheduling and what to bring on test day
Bring government-issued photo ID (driver's license or passport), your Headmaster test confirmation, and clinical scrubs. The skills portion may be scheduled on a separate day from the knowledge portion. Arrive early for ID verification.
After you pass: Missouri certification and renewal
Headmaster reports passing scores to DHSS, which lists you on the Missouri Nurse Aide Registry within 7–14 days. Your name appears on the public registry at health.mo.gov. Certification is valid for 24 months. To renew, complete at least 8 hours of paid nurse aide work during the certification period under the supervision of an RN.
Common pitfalls specific to Missouri
- 175-hour requirement: More than double the federal minimum; attendance is critical.
- 80% passing score: Higher threshold than most states — don't rely on training alone.
- Critical skill steps: Missing any single critical step causes automatic skill failure. Practice each skill until it's automatic.
- Longer program length: Plan 8–12 weeks for training; the time commitment is significant.
FAQ
How long does it take to become a CNA in Missouri? Most students finish training in 8–12 weeks and add 2–4 weeks for exam scheduling and registry listing.
Why does Missouri require 175 hours? Missouri emphasizes extensive clinical preparation before employment. The high-hour standard is by design.
How much is Missouri CNA training? Plan $900–$2,000 for tuition plus $150–$200 for supplies, the background check, and the exam fee.
What happens if I fail a skill step in Missouri? Missouri uses a critical-step rule: if you miss a single critical step, the entire skill section is failed. Practice each skill until every step is automatic before test day.
Practice for the Missouri CNA exam at /exam and review skills at /skills.
