Certified Nurse Assistant (CNA) · rules checked October 22, 2026

Missouri CNA certification: stay active, lapse, and transfer rules

Document at least 8 hours (one day) of paid nursing or nursing-related work in each 24-month period and submit proof yourself through TMU (pay stub, W-2, or employer letter on letterhead). Your employer is then emailed to verify the work before the renewal completes. There is no fee-only renewal without the work.

Is my certification still active?

If you have never worked for pay since certifying, use your certification date.

The Missouri facts

CredentialCertified Nurse Assistant (CNA)
RegistryMissouri Certified Nurse Assistant Registry (Missouri Department of Health and Senior Services) · 573-526-5686
Training required175 hours
ExamHeadmaster (D&SDT-Headmaster) — $135 (written $32 · skills $103)
How renewal worksStays active through paid work inside the window — no calendar expiry while you keep working. Renewal fee: $20.
Keep-active work ruleDocument at least 8 hours (one day) of paid nursing or nursing-related work in each 24-month period and submit proof yourself through TMU (pay stub, W-2, or employer letter on letterhead). Your employer is then emailed to verify the work before the renewal completes. There is no fee-only renewal without the work.
Continuing educationNo continuing education requirement for registry renewal; the paid-work report is the whole requirement.
Who reports your workYou do — nobody files it for you

Changing soon: Exam fee reports conflict ($125 vs $135). The $135 figure has the detailed breakdown ($32 knowledge + $103 skills) in multiple current guides; confirm in TMU at registration. The $20 TMU renewal/documentation fee is charged by Headmaster, not DHSS.

If your Missouri certification has lapsed

The cheaper route — while it lasts

After a 2-year break in employment on the register your certificate is Inactive. While Inactive (under a 5-year break) you may challenge the examination: one attempt at the knowledge and skills tests, with no retraining, to return to active status.

Past that line

After a 5-year break in employment on the register your certificate is Expired and you may be required to retake the full 175-hour CNA course and pass the exam again. Failing a challenge exam also requires completing the full CNA course before you can test again.

Two different clocks trap people: Inactive at 2 years, Expired at 5 years. The challenge route is one attempt only. DHSS challenge eligibility also covers defined groups besides inactive CNAs: RN/LPN students with Fundamentals plus clinical within 5 years, RN/LPN candidates who failed licensure, foreign-educated nurses awaiting US licensure, and UAP/Patient Care Tech completers whose training hours mirror the 175-hour CNA training.

Transferring INTO Missouri

Application fee: $0 · typical processing: About 7-10 business days per secondary guides. Active certification in another US state in good standing with no findings of abuse, neglect or misappropriation. Apply for reciprocity through DHSS/TMU with documentation of your current certification; no retraining or exam. Work-history requirement: Documentation of at least 8 hours of paid nursing-related work in the prior 24 months is reported in secondary reciprocity guides. Free per current fee tables and reciprocity guides.

The table below is computed for an active aide in good standing, trained to the origin state's standard hours. Your own hours or status can change your row — run the transfer checker with your real facts.

Certified inVerdict for MissouriFeeWhy
AlabamaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
AlaskaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
ArizonaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
ArkansasAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
CaliforniaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
ColoradoAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
ConnecticutAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
DelawareAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
District of ColumbiaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
FloridaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
GeorgiaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
HawaiiAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
IdahoAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
IllinoisAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
IndianaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
IowaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
KansasAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
KentuckyAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
LouisianaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
MaineAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
MarylandAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
MassachusettsAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
MichiganAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
MinnesotaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
MississippiAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
MissouriSame state — no transfer needed
MontanaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
NebraskaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
NevadaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
New HampshireAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
New JerseyAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
New MexicoAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
New YorkAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
North CarolinaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
North DakotaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
OhioAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
OklahomaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
OregonAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
PennsylvaniaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
Rhode IslandAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
South CarolinaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
South DakotaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
TennesseeAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
TexasAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
UtahAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
VermontAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
VirginiaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
WashingtonAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
West VirginiaAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
WisconsinAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.
WyomingAccepted — with conditions$0Missouri accepts active certifications with a work-history requirement.

Included in the $39 CNAStatusCheck Kit

The kit carries Missouri's full recovery path — the forms, the order to file them, the phone scripts — plus transfer checklists for every destination. See the kit →

Sources — checked October 22, 2026