How to Become a CNA (Certified Nursing Assistant) in Iowa

Checked against Iowa Department of Inspections, Appeals, and Licensing (DIAL), Iowa Direct Care Worker (DCW) Registry · Verified 2026-10-14

Exam: Required
Training: Required
Term: Doesn't expire; stay active by working 8 hours every 24 months
State fee: See state office
Certified by: Iowa Department of Inspections, Appeals, and Licensing (DIAL), Iowa Direct Care Worker (DCW) Registry

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Who can apply

You must complete the 75-hour CNA course from a DIAL-approved program (community college, facility or private entity).
You must pass both the written (knowledge) test and the skills test with at least 70% on each.
If you are working as a nurse aide in a long-term care facility, you must pass both tests within four months of your hire date.

Step by step

Complete a DIAL-approved 75-hour CNA course (30 of the hours are clinical).
Register in D&SDT-Headmaster's TestMaster Universe (TMU) at ia.tmutest.com (your program enters you, or you apply with the Nurse Aide Testing Request) and pay the written-exam fee.
Take the knowledge exam at an Iowa community college or online with a remote proctor (Headmaster or Credentia).
Take the skills exam at an Iowa community college or with Health Tech Associates.
The testing entity reports your results to DIAL, which places you on the Iowa DCW Registry with a six-digit ID number.

Official application →

Training and exam

Training: Iowa requires a 75-hour DIAL-approved course, and 30 of the 75 hours are clinical. This equals the 75-hour federal minimum and is above its 16-hour supervised-practical floor. DIAL approves the course plans; DIAL does not issue the certificate itself.

Exam: Since early 2026, Iowa's knowledge exam is registered, paid and scored through D&S Diversified Technologies-Headmaster (TMU). It has 70 multiple-choice questions in 60 minutes, and you need 70% to pass. You can take it at a community college or remotely ($50), or online with Credentia ($70). The skills exam is run by the community colleges ($115) or Health Tech Associates ($135), and you also need 70%. You get three chances to pass each part; if either part is failed three times, you must retake the 75-hour course and start a new testing cycle.

Practice for the CNA written exam free — physical care skills, safety & infection control, and the nurse aide role →

What it costs in Iowa

Fixed amounts are set by the state. Items marked “your quote” are priced by private sellers, so enter what you’re quoted.

75-hour CNA course tuition (set by the college or entity)$
Knowledge exam (DIAL lists $50 through Headmaster or $70 online through Credentia, but also says written test costs about $60)$
Skills exam (community college $115; Health Tech Associates $135)$115–$135

Estimated total in Iowa$115–$135Plus 2 items with no state-set price. Add your quotes above to complete the total.

Cost details from the state

Knowledge (written) exam: $50 through Headmaster at a community college or remotely; $70 online through Credentia. (DIAL's registry-placement page still says 'approximately $60' for the written test.)
Skills exam: $115 at an Iowa community college; $135 with Health Tech Associates.
Course tuition is set by the college or entity; for aides working in certified nursing homes the employer typically pays. If a nursing facility hires you within 12 months after you finish, it must repay one-twelfth of your course, book and test costs for each month you work there, until one year from when you completed the course (441 IAC 81.13(3)).
Headmaster test review deposit (optional): $25.

Help while you start out in Iowa

Starting out on an entry-level wage? Check the SNAP income limits in Iowa by household size.

How long it takes

DIAL says processing time varies and to allow at least two weeks after passing both tests before your name shows on the DCW Registry.

What other sites get wrong about Iowa

Myth: Iowa community colleges run both CNA exams themselves, so you register and pay directly with the college.

Fact: Since January 2026 community colleges only host and proctor the written test; registration, payment and records are handled by TestMaster Universe/Headmaster. Only the skills exam is still managed by the college. source

Myth: Iowa CNAs must renew their certification every two years.

Fact: DIAL says the certification itself does not expire. You stay active on the registry when an employer reports at least eight hours of qualifying paid work in each two-year period. source

Staying on the registry

Renewal: DIAL says the CNA certification itself does not expire, but your active status on the DCW Registry does if you do not work as a CNA for 24 months. To stay active you need at least eight hours of paid nursing or nursing-related work in each two-year period, and your employer (not you) must report it to DIAL. Long-term care facilities must also give at least 12 hours of in-service training per year. If you go two years or more without qualifying work, you must retake both competency tests.

Online options: The knowledge exam can be taken online with a remote proctor through Headmaster ($50) or Credentia ($70). The skills exam is in person at a community college or Health Tech Associates. DIAL does not say whether course classroom hours can be taken online.

Good to know in Iowa

Transferring from another state: If you are on another state's CNA registry, apply online through the Iowa Direct Care Worker Registry website. DIAL says to allow at least two weeks for processing.

Where you need to be listed: You must be active on the DCW Registry to work as a nurse aide in an Iowa nursing home, skilled nursing facility, or skilled or swing-bed hospital unit. CNAs do not need to be on the registry to work in other settings.

Sources

General information, not legal advice. Fees and rules change — confirm with Iowa Department of Inspections, Appeals, and Licensing (DIAL), Iowa Direct Care Worker (DCW) Registry before you apply.