How to get a Certified Nursing Assistant (CNA) license in Iowa

Iowa nursing assistant licenses

Iowa issues 2 nursing assistant credentials. Each has its own section below; the table shows what each one covers and its headline requirements.

Who needs a Certified Nursing Assistant (CNA) license

Personal care (feeding, bathing, hygiene), vital signs, progress assessments, meals, safe environment, and treatments and other tasks, under the supervision of a licensed nurse.²

Work that does not need this license:

• Registry listing is needed only for work in long-term care (nursing homes, skilled nursing facilities, skilled or swing-bed hospital units); CNAs do not need to be on the registry to work in other facility types.¹

Other rules on who may do this work:

• A nursing facility may not use someone as a nurse aide for more than four months unless they are competent and trained; the candidate must pass both tests within four months of hire.¹

Requirements for a Certified Nursing Assistant (CNA) license

Education or training

At least 75 clock hours²
75-hour state-approved nurse aide course (30 of the 75 hours clinical), at an Iowa community college or a DIAL-approved facility or private entity.²
Who may teach it: Course must be a nurse aide training and competency evaluation program (NATCEP) approved by DIAL for up to two years at a time, under 42 CFR 483.152; facilities with certain enforcement histories cannot run programs.⁶
Alternative: Veterans, active-duty and reserve members with comparable military training (e.g. hospital corpsman/medical service specialist, DD 214) plus 75 clock hours of practical experience are deemed to meet the training requirement, but must still pass the competency examination.⁶
Alternative: People trained outside the Iowa state-approved program may take a challenge competency evaluation after presenting evidence of prior formal training.⁵

Exam

CNA competency tests: written (knowledge) test and skills test¹
Given by: Written test: TestMaster Universe/Headmaster (proctored at Iowa community colleges or remote) or Credentia (remote). Skills test: Iowa community colleges or Health Tech Associates.²
Passing score: 70 percent or above on each part⁶
When you can take it: After completing the 75-hour course.²
Written (knowledge) test, or oral⁶
Skills demonstration test²
Retakes: Three opportunities to pass each part; only the failed part is retaken; after three failures of either part, the 75-hour course must be taken again before re-testing.⁶
Time limit: Both tests must be passed within four months of the hire date (for aides working in a facility).¹

Background check

Background check required³
Findings of resident abuse, neglect, mistreatment or misappropriation make a person ineligible for employment on the registry.²

Also required

A nursing facility that hires (or offers a job to) an aide within 12 months of completing training must reimburse the aide's course, book and test costs pro rata over the first year.⁶

Also required

Employees of Medicare/Medicaid nursing facilities must complete the Nurse Aide Registry Application within the first 30 days of employment.⁶

How much a Certified Nursing Assistant (CNA) license costs

You pay TestMaster Universe/Headmaster (exam fee), Credentia (exam fee), Iowa community college (exam fee) and Health Tech Associates (exam fee).

Each line is a separate charge as the board lists it. The board does not publish a combined total, so none is shown here.

How to apply

1. Complete a 75-hour DIAL-approved CNA course (community college, approved facility or private entity). The program runs Iowa criminal history and abuse registry checks before you start.²
2. Register and pay for the written (knowledge) test through Headmaster (TestMaster Universe) at a community college or remotely, or remotely through Credentia; take the skills test at a community college or Health Tech Associates.² ia.tmutest.com²
3. Pass both tests (70% each). The testing entity reports scores to DIAL and you are placed on the Iowa Direct Care Worker Registry with a six-digit ID; allow at least two weeks.¹
4. Create a Direct Care Worker account on the registry site (Google or Microsoft login) to keep your details current and print your registry card.⁷ dia-hfd.iowa.gov⁸

Apply online

dia-hfd.iowa.gov⁹

Temporary or provisional license

No temporary certificate; an uncertified aide may work in a nursing facility for up to four months while completing training and testing.¹

Processing time

Allow at least two weeks after passing for the name to appear on the DCW Registry; transfers from other states also take at least two weeks.²

Renewal and continuing education

When it expires

Certification does not expire, but active registry status lapses if no qualifying employment (at least 8 hours) is reported in a 24-month period.²

Continuing education

At least 12 hours each renewal period²

Approved courses

In-service training is provided by the employing long-term care facility.¹⁰

If it expires

If hours worked before expiry were not reported, the employer (administrator or director of nursing) sends a letter on letterhead with the duties and dates; the CNA cannot report their own hours.¹¹
After two years or more without CNA work, both competency tests must be retaken to work in Iowa long-term care.²

Renew online

dia-hfd.iowa.gov¹⁰

Moving to Iowa with a license from another state

These are the routes DIAL publishes for the Certified Nursing Assistant (CNA) license. The other nursing assistant licenses have their own routes in their sections below.

Military service members, veterans and spouses: Veterans, active-duty and reserve members with comparable military medical training and 75 clock hours of practical nurse-aide experience are deemed to meet the training requirement but must pass the competency examination.⁶

Certified Medication Aide (CMA)

May administer medications in nursing homes (NF/SNFs), ICF/IIDs, residential care facilities and other facility types in Iowa.⁴

Requirements

Education or training

At least 50 clock hours⁴
DIAL-approved medication aide course (50+ hours), offered at Iowa community colleges and some other organizations.⁴
Who may teach it: Course must be department (DIAL)-approved.⁵
Alternative: Nursing students or graduate nurses may take a challenge exam instead of the course after recent clinical/nursing theory and pharmacology courses and an instructor's competency statement.⁴

Experience

At least 480 hours of on-the-job training⁵
Before the course, the rule requires completing nurse aide training/testing, working at least 480 hours in the same facility, and a recommendation letter from that facility.⁵

Exam

Medication aide challenge examination (DIAL-approved, administered by an Iowa community college)⁴
Given by: Iowa community colleges (challenge exam)⁴

Background check

Background check required³
Facility requests a Department of Public Safety criminal history check and HHS child and dependent adult abuse record checks before employment.³

How to apply

1. Meet the course prerequisites set by rule (nurse aide training/testing, 480 hours in the same facility, employer recommendation letter) or qualify for the challenge exam as a nursing student/graduate nurse.⁵
2. Complete a DIAL-approved medication aide course (community colleges and listed organizations) or pass the community-college challenge exam.⁴
3. Keep your course certificate; DIAL keeps a CMA registry but not copies of certificates.⁴

From another state

City and county rules

Certified Medication Aide (CMA)No local license: medication aides are certified under DIAL rules statewide.⁴

Certified Nursing Assistant (CNA) / nurse aide, listed on the Iowa Direct Care Worker RegistryNo local license: Iowa CNAs are placed on the statewide Iowa Direct Care Worker Registry kept by DIAL.¹²

Check a license or report a problem

Before you hire a nursing assistant in Iowa, you can confirm the license is current on the board's own search. Every board we cover in Iowa is on the Iowa license lookup page.

Look up a license

dia-hfd.iowa.gov⁸

Laws and rules

The requirements above come from these laws and board rules.

• 441 IAC 81.13 Nurse aide requirements and training and testing programs (Iowa HHS rules; administered by DIAL)
• 481 IAC 58.11 and 58.21 (nursing facility staffing; medication administration)
• Iowa Code § 135C.33 (record checks for employees and certified nurse aide trainees)
• 42 CFR 483.35, 483.151-483.158 (nurse aide training, competency evaluation and registry)
• 481 IAC 58.21(6) (medication administration in nursing facilities)
• Iowa Code § 135C.34 Medication aide — certification

Rule changes since January 2024

• February 1, 2026: 441 IAC 81.13 amended by ARC 9859C (effective 2/1/26).⁶
• January 1, 2026: Written CNA test registration, payment and records moved to TestMaster Universe/Headmaster; community colleges now only host and proctor (DIAL says "As of January 2026"; exact day not given).²

Common questions

Certified nursing assistant (CNA) licenses in other states

• Alabama
• Alaska
• Arizona
• Arkansas
• California
• Colorado
• Connecticut
• Delaware
• District of Columbia
• Florida
• Georgia
• Hawaii
• Idaho
• Illinois
• Kentucky
• Louisiana
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Mississippi
• Missouri
• Montana
• Nebraska
• Nevada
• New Hampshire
• New Jersey
• New Mexico
• New York
• North Carolina
• North Dakota
• Ohio
• Oklahoma
• Oregon
• Pennsylvania
• Rhode Island
• South Carolina
• South Dakota
• Texas
• Utah
• Virginia
• Washington
• West Virginia
• Wyoming