CNA Certification Process in Iowa

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To become a CNA in Iowa, you take a 75-hour course, 30 hours of it clinical, pass a written (or audio) knowledge test and a skills test, and get listed on the Iowa Direct Care Worker Registry kept by the Department of Inspections, Appeals, and Licensing (DIAL). Since January 2026, you register and pay for the knowledge test through Headmaster’s TestMaster Universe, and community colleges serve only as test sites; the skills test is run separately by a community college or Health Tech Associates. You need 70 percent on each part, and you get three tries at each.

Iowa CNA requirements at a glance

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Free CNA training in Iowa

Federal rules protect nurse aides who train for jobs in nursing homes that take Medicare or Medicaid. If one of those facilities employs you, or has offered you a job, on the day your approved program starts, it can’t charge you for any part of it, including textbooks and required materials. If you pay for a program yourself and a facility hires you, or offers you a job, within 12 months of finishing, the state must reimburse your costs on a pro-rata basis for the time you work there as a nurse aide (42 CFR 483.152(c)). Ask nursing homes near you whether they sponsor students.

What to check before you pay for a CNA program in Iowa

  • It’s on the state’s approved list. Only an approved program makes you eligible for the competency exam.
  • Its hours meet the state minimum, including the supervised clinical hours, and it tells you where the clinical training happens.
  • The price is complete: tuition, textbooks, uniform, background check and the exam fee.
  • It explains how you register for the exam and when you can test after you finish.
  • It doesn’t promise 100% online certification. Supervised hands-on training is required, so a course with none can’t lead to certification.

In Iowa, DIAL approves CNA course plans but doesn’t issue the certificate, and nurse aides are certified, not licensed. The state rule designates DIAL to approve training and competency evaluation programs under the federal standards in 42 CFR 483.152. DIAL also points to a Nurse Aide Denial List in its Health Facilities database that names facilities that have lost training privileges, so check it before you sign up for facility-based training.

The Iowa CNA exam

Iowa’s competency test has two parts. Iowa has approved D&S Diversified Technologies-Headmaster to test and score the knowledge exam, on-site or remotely proctored. As of January 2026, community colleges serve only as testing sites and proctors, and Headmaster’s TestMaster Universe handles registration, payment and exam records. The knowledge test costs $50 at an Iowa community college or remotely through Headmaster, or $70 remotely through Credentia.

The knowledge exam has 70 multiple-choice questions, you get up to 60 minutes, and you need 70 percent to pass. An audio (oral) version costs nothing extra, but you must choose it before you pay your testing fee. For the skills exam, you test either at an Iowa community college, which runs the exam itself ($115), or with Health Tech Associates ($135). By rule, 70 percent is also passing on the skills demonstration.

You get three opportunities to pass each part, and you retake only the part you failed. If you fail either part three times, you must retake the 75-hour course and start a new testing cycle. DIAL also says you must pass both tests within four months of your hire date.

The Iowa nurse aide registry and renewal

DIAL keeps the Iowa Direct Care Worker Registry. Employers, verification companies and other states’ registries can check a CNA’s status by first and last name, city, county of residence or registry number, and you can search CNA records online the same way.

Your certification itself doesn’t expire, and there’s no renewal application. To stay active, you need at least eight hours of qualifying employment in a two-year period, and only your Iowa employer can report those hours to registry staff; you can’t report them yourself. If you go 24 months without working as a CNA, your standing on the registry expires, and you must retake both competency tests to get your status updated. If you work in a certified long-term care facility, you also need 12 hours of in-service training each year.

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Moving to Iowa with a CNA from another state

If you’re on another state’s registry, you can apply online to transfer to Iowa through the Direct Care Worker Registry website, which takes applications for out-of-state reciprocity; register for an account first. Processing time varies, so allow at least two weeks. Ask DIAL’s registry staff what documents to have ready before you apply.

Colleges in Iowa that reported CNA completions

These 7 institutions reported 1,404 nursing assistant completions (CIP 51.3902) to the federal IPEDS survey for July 2024 to June 2025. Many approved CNA programs, such as those run by nursing homes, private training schools and the Red Cross, don’t report to IPEDS, so check the state’s approved-program list too.

Institution City Type Completions
Western Iowa Tech Community College Sioux City Public 438
Eastern Iowa Community College District Davenport Public 313
Southeastern Community College West Burlington Public 240
Iowa Central Community College Fort Dodge Public 187
North Iowa Area Community College Mason City Public 112
Iowa Western Community College Council Bluffs Public 79
Southwestern Community College Creston Public 35

Source: IPEDS 2024–25 Completions and Institutional Characteristics, National Center for Education Statistics (provisional release); awards to first majors at all award levels.

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Sources

Last reviewed November 2026.