Certified Nursing Assistants (CNAs)

Nurse and doctor with patient

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Certified nursing assistants (CNAs, also referred to as nurse aides) provide personal care including feeding, bathing, and assisting patients with personal hygiene. CNAs check patients' vital signs, make progress assessments, deliver meals, maintain a secure environment, and perform treatments and other tasks. A CNA works under supervision of a licensed nurse. Plans for all CNA courses taught in Iowa need to be approved by DIAL, but DIAL does not issue the certificate. A nurse aide is certified in Iowa, not licensed.

Summary

  • Code Citations:
  • Requirements:
    • Must either enroll themselves or be sponsored by their employer to take the 75-hour course and competency tests provided by a testing site. Thirty of the 75 course hours are clinical. After one has completed the course and passed both the skills and written competency tests, the individual's name and scores are submitted automatically to DIAL. The individual is placed on the Iowa Direct Care Worker (DCW) Registry and issued a six-digit ID number.
    • If a person is currently on a direct care worker/CNA registry in another state, they can learn how to transfer to the Iowa registry here.  
  • Cost:
    • The cost of the 75-hour training course is determined by the community college or entity where the course is offered. However, for aides working in a certified nursing home, this fee is typically paid by the employer.
    • The cost for exams is about $60 for written test and $115 for the skills test.
  • Processing Time: Varies; please allow at least two weeks after successful completion of the CNA course before your name shows on the DCW Registry.
  • Additional Information:
    • The certification itself does not expire.
    • DIAL does not have copies of CNA certificates. Please contact the college or entity where you took your CNA course for a copy of your course certificate.
    • Please follow the instructions on this page if you would like to print your Direct Care Worker Registry card.
    • A CNA only needs to be active on the registry if they want to work in an Iowa long-term care facility (nursing home). If employed as a nurse aide in a certified long-term care facility, the facility must provide and the aide must complete 12 hours of in-service training per year. To remain active on the registry, the aide must perform at least eight hours of qualifying employment in a two-year period. A CNA's standing on the registry expires if the CNA stops working as a CNA for 24 months.
    • If a nurse aide does not work as a CNA for two years or more, the aide will have to retake both competency tests to get their status updated on the registry and to be eligible to work at a long-term care facility in Iowa.
    • Individuals who are found guilty of abusing, neglecting, or mistreating residents by a court of law or who have a finding of abuse, neglect, mistreatment, or misappropriation of resident property  will be designated as not eligible for employment on the Iowa Direct Care Worker Registry.

Nurse Aide Training

  1. The 75-hour CNA course can be taken at at an Iowa community college or through one of the following approved facilities or private entities (below) approved to offer CNA training.
  2. To take the CNA comp/written (knowledge) exam, you have two options:
  • Take the exam at an Iowa community college. As of January 2026, community colleges now serve only as testing sites and proctors. Registration, payment, and exam records are handled by TestMaster Universe/Headmaster. The cost is $50 for a proctored test taken at an Iowa community college.
  • Take the exam remotely online via Headmaster ($50) or Credentia ($70).

If a facility plans to pay for an employee’s written exam at a community college, the facility must complete the Facility Account Information Application (third-party sponsor application through Headmaster).

  1. To take the CNA skills exam, you have two options.
  • Take the exam at an Iowa community college. This is managed through the college and not via Headmaster or Credentia. The cost to take a skills exam at an Iowa community college is $115.
  • Take the exam from Health Tech Associates. They are listed in the "Private Entities Offering Certified Nursing Assistant Course" tab below. The cost for taking the skills exam with Health Tech Associates is $135.

About the Direct Care Worker Registry

Please visit the Iowa Direct Care Worker Registry page on this website for additional information.