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

Who can apply

• You must complete a DPH-approved nurse aide training program, or have a DPH-approved Nurse Aide Training Waiver application.
• You must pass both the knowledge and skills parts of the Massachusetts nurse aide competency exam.
• Nurse aides with substantiated findings of abuse, neglect, misappropriation of resident property or exploitation are listed on the Registry with those findings.

Step by step

1. Complete a DPH-approved nurse aide training program (currently at least 75 hours).
2. Your training program registers you with D&S Diversified Technologies-Headmaster in the TMU system. Finish your TMU account.
3. Pay the testing fees in TMU ($30 knowledge, $70 skills) and schedule your exam at mc.tmutest.com.
4. Pass the knowledge exam (in person or remotely proctored) and the in-person skills test.
5. DPH lists you on the Massachusetts Nurse Aide Registry. Paper certificates are not issued; employers check your status online.

Official application →

Training and exam

Training: 105 CMR 156.300 sets the minimum at 75 hours, which matches the federal minimum (at least 16 of the federal 75 hours must be supervised practical training). Courses must cover every module of DPH's minimum standard curriculum. In an April 2026 advisory memo, DPH said it will raise the minimum to 87 hours, including 21 hours of supervised practical training. The memo did not set an effective date for the change.

Exam: DPH's testing vendor is D&S Diversified Technologies-Headmaster. The knowledge exam has 60 multiple-choice questions in 60 minutes, and you need 76% to pass. The skills test is three or four tasks in 40 minutes. You can take the exam in English, Spanish, Chinese or Haitian Creole. You get four attempts at the knowledge exam and three at the skills test. If you use them up, you must complete a new DPH-approved training program before testing again.

What it costs in Massachusetts

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

How long it takes

DPH says to allow at least three weeks after the exam to receive your results and for your name to appear on the license verification website.

What other sites get wrong about Massachusetts

Staying on the registry

Renewal: Renew every 24 months online in DPH's Health Professions Licensing System (required since December 4, 2023). To be eligible, you must have worked for pay as a nurse aide doing nursing or nursing-related services for at least eight consecutive hours in the previous 24 months. If your certification has already expired, you may still renew through work experience if you are currently employed as a nurse aide and have worked with no break since before it expired; otherwise you may need to retake the certification test. Nurse aides with misconduct restrictions on the Registry cannot renew.

Online options: Headmaster offers a remotely proctored knowledge exam you can take from home or elsewhere; the skills test is in person. DPH's rules do not say whether training can be taken online.

Good to know in Massachusetts

Transferring from another state: Apply for reciprocity in TMU (Form 9110) if your certification in another state is current and in good standing and you have never been certified in Massachusetts. Headmaster charges a processing fee for this form but its page does not state the amount.

Training waiver: If you meet the qualifications in 105 CMR 156, you can apply for a Nurse Aide Training Waiver and go straight to the competency exam.

Working before you are certified: A long-term care facility must have new nurse aides complete training within 90 days of starting work. It cannot keep you working as a nurse aide for more than four months unless the Registry shows you are certified.

Upcoming changes: DPH's April 2026 memo says approved programs must update their curricula to the revised state CNA Curriculum Framework, and revised exams are expected to roll out in early 2027.

Sources

• Mass.gov DPH - Learn how to become a certified nurse aide in Massachusetts
• Mass.gov DPH - Advisory Memo: New Certified Nurse Aide (CNA) Curriculum Framework (April 2026)
• 105 CMR 156.300 - Minimum Curriculum Standards (Cornell LII)
• 105 CMR 156.100 - Nurse aide training requirements for long-term care facilities (Cornell LII)
• D&SDT-Headmaster - Massachusetts Nurse Aide Candidate Handbook (May 2026, v7.0)
• DPH Nurse Aide Registry Services notice - alternate-language exams and end of free first exam (hosted by Headmaster)
• D&SDT-Headmaster - Massachusetts CNA testing home
• 42 CFR 483.152 - Requirements for approval of a nurse aide training and competency evaluation program (Cornell LII)
• Mass. DPH - Renewal information for Massachusetts certified nurse aides (Wayback 2026-03-14)