CNA Classes & Programs in Montana

Before starting your training, it's important to understand exactly what Montana requires to become a Certified Nursing Assistant (CNA). In Montana, nursing assistants must obtain certification through the Montana Department of Public Health and Human Services (DPHHS), which maintains the Montana Nurse Aide Registry through its Certification Bureau. Meeting these requirements allows you to complete the required training and competency examinations, receive your Montana CNA certification, and work in nursing homes, hospitals, assisted living facilities, and other healthcare settings throughout the state.

Eligibility

• Program enrollment: The standard pathway requires completion of a Montana DPHHS-approved Nurse Aide Training Program (NATP). Approved programs are offered through nursing facilities, community colleges, vocational schools, and other authorized training providers.
• Age and admission requirements: Individual training programs may set their own admission requirements, including minimum age, educational prerequisites, health screenings, or immunizations. Some Montana programs accept students beginning at age 16. Applicants should confirm the requirements directly with their chosen training provider.
• Background checks: CNA training programs and healthcare employers may require criminal background checks before admitting students or allowing them to participate in clinical training or employment. Montana healthcare facilities must also comply with applicable employee-screening requirements, including checking the Nurse Aide Registry for findings of resident abuse, neglect, or misappropriation of property. Applicants should confirm any required background checks and supporting documentation with their training program and prospective employer.
• Alternative pathways: Montana permits eligible individuals to challenge the state CNA competency examination without first completing an approved nursing assistant training program. Candidates must follow D&SDT-Headmaster's challenge application process and successfully pass both examination components. Challenge candidates have one opportunity to pass. Those who fail either component must complete a Montana DPHHS-approved training program before testing again. Certain students enrolled in Montana nursing programs who have completed specified qualifying nursing courses may also apply for CNA certification through the state's Nursing Student Application pathway. Individuals already certified as nursing assistants in another state may qualify for interstate endorsement.

Training Hours & Clinicals

Montana-approved Nurse Aide Training Programs must meet the federal minimum of 75 total hours of training, including at least 16 hours of supervised practical training. Supervised practical training may take place in a laboratory or another appropriate setting where students demonstrate nursing assistant skills under the direct supervision of a registered nurse (RN) or licensed practical nurse (LPN).

Before having direct contact with residents, trainees must complete at least 16 hours of introductory instruction covering essential subjects, including communication and interpersonal skills, infection control, safety and emergency procedures, promoting residents' independence, and respecting residents' rights.

The curriculum also covers basic nursing skills, personal care, mental health and social-service needs, care of individuals with cognitive impairments, restorative services, and patients' rights. Montana's published core curriculum includes instruction in preventing abuse and neglect, reporting and documentation, taking vital signs, nutrition and hydration, infection prevention, and providing respectful care to older adults and individuals with disabilities.

Supervised practical training allows students to demonstrate essential nursing assistant duties, including assisting with bathing and dressing, transferring and positioning residents, feeding assistance, taking vital signs, and maintaining a safe care environment. Approved programs may include additional supervised clinical experience in healthcare facilities beyond the federal practical-training minimum.

Under federal training regulations followed by Montana, nurse aide training must be performed by or under the general supervision of a registered nurse with at least two years of nursing experience, including at least one year providing long-term care facility services. Instructors must also have completed training in teaching adults or possess appropriate experience teaching adults or supervising nursing assistants.

Under federal regulations, Medicare- or Medicaid-certified nursing facilities may employ an individual as a nurse aide for up to four months while the individual completes the required training and competency evaluation, subject to applicable supervision and competency requirements. Montana's nursing facility guidance confirms this limited training-period employment provision. Continued employment in a position requiring CNA certification depends on successful completion of the applicable requirements.

Competency Exam (Knowledge & Skills)

After completing an approved training program, candidates must pass the Montana nurse aide competency examination administered by D&SDT-Headmaster through its TestMaster Universe (TMU) system. The examination consists of a knowledge test and a manual skills evaluation.

• Knowledge examination: The examination contains 72 multiple-choice questions covering essential nursing assistant knowledge, including infection control, safety, residents' rights, personal care, basic nursing skills, communication, and recognizing changes in patients' conditions. Candidates have 90 minutes to complete the examination and must achieve a score of at least 75% to pass. An English-language audio version is available for candidates who prefer to have the questions read aloud.
• Manual skills examination: Candidates must demonstrate three or four assigned nursing assistant tasks under the observation of a registered nurse test observer. The examination begins with a mandatory task incorporating handwashing, followed by two or three additional randomly assigned tasks. Candidates have up to 35 minutes to complete the examination. To pass, they must correctly perform all critical steps and at least 80% of the remaining steps on each assigned task.

The manual skills examination assesses practical competencies such as infection prevention, personal care, transferring and positioning residents, mobility assistance, and other essential nursing assistant duties. The mandatory first task is one of four: assisting with a bedpan, emptying a urinary drainage bag while wearing a gown and gloves, perineal care for a female resident, or perineal care for a male resident. Candidates must demonstrate handwashing using soap and water as part of the assigned mandatory task.

Under Headmaster's Montana Candidate Handbook, candidates have up to three attempts to pass each examination component within six months of completing their approved training program. After six months, the training cycle expires and the candidate is no longer eligible to test based on that training.

Candidates who fail only one component may retake that component without repeating the portion they have already passed, provided they remain within the applicable testing limits. Challenge candidates follow a stricter rule: if they fail either component of their initial challenge examination, they must complete an approved nursing assistant training program before retesting.

Examination registration, scheduling, and results are managed through Headmaster's TMU system. The initial knowledge and skills examinations are scheduled through approved Montana testing locations. Candidates retaking only the knowledge examination may also have access to a remotely proctored testing option.

Placement on the Registry & Working as a CNA

After completing the required training and successfully passing both examination components, candidates must apply for certification through the Montana Nurse Aide Registry, administered by the Montana Department of Public Health and Human Services.

Montana now requires CNA certification applications to be submitted through the state's online BOUNDS portal. Paper and PDF applications are no longer accepted. Candidates who completed an approved training program and passed their examinations must select the Certified Nurse Aide credential type and submit the CNA by Exam Application.

D&SDT-Headmaster electronically transmits passing examination results to the Montana Certification Bureau. Once the application has been submitted and the department has received the examination results, the application is reviewed and the successful candidate is placed on the Montana Certified Nurse Aide Registry.

Montana also provides a separate Nursing Student Application through BOUNDS for qualifying nursing students. Eligible applicants must have completed one of the nursing courses recognized by the state and arrange for an official transcript to be submitted to the Certification Bureau. This pathway is distinct from the standard CNA training and examination process.

Once certified, nursing assistants can verify their certification status through Montana's online registry verification system. Healthcare employers use the registry to confirm that a CNA holds current certification and to check for any documented findings of abuse, neglect, or misappropriation of property.

In Montana, CNA certification is issued by DPHHS rather than the Montana Board of Nursing. The Board of Nursing regulates licensed nurses and certain other nursing-related credentials, but it does not issue standard CNA certificates.

Certified nursing assistants perform nursing and nursing-related duties under appropriate nursing supervision. Their responsibilities may include assisting patients with activities of daily living, personal hygiene, mobility, nutrition, and other basic care needs. Additional requirements may apply to specialized roles, including home health aide services.

Certification Renewal

Montana CNA certification must be renewed every two years. To maintain active certification, nursing assistants must meet the state's qualifying employment requirements and submit their renewal application before their certification expires.

Under Montana's published nursing facility guidance, CNAs must have completed at least one eight-hour shift of paid nursing or nursing-related employment during the preceding 24 months to qualify for renewal. Qualifying work must involve the provision of nursing or nursing-related services for monetary compensation. Volunteer work does not satisfy the paid-employment requirement.

Montana now requires all CNA renewals to be completed online through the BOUNDS portal. Renewals may be submitted beginning 90 days before the certificate's expiration date. Paper applications and renewals submitted by email are no longer accepted.

To renew, CNAs must create or access their individual BOUNDS account using their name and Montana CNA certificate number. Each account requires a unique email address. Renewal applications submitted through the portal are processed automatically, and nursing assistants can confirm their updated certification status through the state's online verification system.

Montana bases renewal on paid work. Separately, nursing assistants employed by Medicare- or Medicaid-certified nursing facilities are subject to federal in-service training requirements. These facilities must provide at least 12 hours of in-service training annually to maintain nurse aide competency, including training related to dementia care and preventing resident abuse.

CNAs who have not performed qualifying paid nursing or nursing-related work for 24 consecutive months may lose their eligibility to remain active on the Nurse Aide Registry. Under federal requirements and Montana's nursing facility guidance, individuals who no longer meet the employment requirement must successfully complete a new approved nurse aide training and competency evaluation program or an approved competency evaluation to regain eligibility.

Nursing assistants whose certification has expired should verify their current status with the Montana Nurse Aide Registry before accepting employment in a position requiring active CNA certification. Depending on their circumstances, additional competency testing or retraining may be necessary.

Reciprocity

Montana offers interstate endorsement for nursing assistants who hold a current CNA certification or registration in another U.S. state or territory. Eligible applicants may transfer their certification to Montana without completing a new Montana-approved CNA training program or repeating the state competency examination.

Applicants must submit the Montana Nurse Aide Registry Interstate Endorsement Application through the BOUNDS portal. The application process requires applicants to create an individual portal account, activate the account through their email address, and complete the endorsement application.

Under the state's published interstate endorsement instructions, applicants must provide at least one current CNA certification or registration number from another U.S. state or territory. The Certification Bureau uses the information provided to review the applicant's existing certification and eligibility for placement on Montana's registry.

Applicants should ensure their out-of-state certification is current and that their identifying information matches the records maintained by their originating state. The Montana registry may require additional information to resolve certification verification issues before approving an endorsement application.

Individuals who previously applied for interstate endorsement through Montana's older email or online application procedures but cannot locate their certificate through the current registry verification system must submit a new application through BOUNDS.

Once the endorsement application has been approved, the applicant is placed on the Montana Nurse Aide Registry and can verify their certification through the state's online system. Applicants should confirm their Montana certification status before beginning employment in a position requiring active CNA certification.

Montana's interstate CNA endorsement process is separate from its Home Health Aide endorsement. Individuals seeking Montana Home Health Aide endorsement must first hold a Montana CNA certificate and complete the additional home health aide training required by a Montana home health provider. The Montana Nurse Aide Registry does not accept Home Health Aide interstate endorsements.

Costs & Reimbursement

The cost of CNA training in Montana varies by approved training provider. Community colleges, nursing facilities, vocational schools, and other educational institutions may charge different tuition and materials fees. Some healthcare employers offer facility-sponsored CNA training or cover examination costs for individuals who agree to work at their facilities.

According to D&SDT-Headmaster's Montana Candidate Handbook, effective February 2025, the published competency examination fees are:

• Written knowledge examination: $20
• Audio knowledge examination: $31
• Manual skills examination: $77

The combined cost of the standard written knowledge and manual skills examinations is $97. Candidates who select the audio examination instead of the written version pay $108 for both components. Retesting fees apply when candidates repeat an unsuccessful examination component. Applicants should confirm the current examination charges through Headmaster's TMU registration system before making payment.

Under federal rules, the state may not charge nurse aides any fee for being listed on the Nurse Aide Registry. The examination fees above are paid to D&SDT-Headmaster, not to the state.

Under federal law, an individual who is employed by a Medicare- or Medicaid-certified nursing facility, or who has received an offer of employment from one, when beginning an approved nurse aide training and competency evaluation program may not be charged for the required training, textbooks, course materials, or competency evaluation.

If an individual pays for an approved nurse aide training and competency evaluation program and becomes employed by or receives an offer of employment from a Medicare- or Medicaid-certified nursing facility within 12 months after completing the program, the first nursing facility that hires them, or offers them a job, must reimburse their training and testing costs on a prorated basis while they work there as a nurse aide. These federal reimbursement requirements do not apply to every healthcare employer or training provider.

Montana Medicaid's Nursing Facility and Swing Bed Services Manual confirms these reimbursement requirements and explains that qualifying nursing facilities must cover eligible training and testing costs for nurse aides they employ or have offered employment to when training begins. Nursing assistants who paid for their own approved training should retain receipts and contact their employing nursing facility to determine whether they qualify for reimbursement.

Sources: Montana Department of Public Health and Human Services – Montana Nurse Aide Registry, Certification, Renewal, and Interstate Endorsement, Montana Board of Nursing – CNA Information, Montana DPHHS – Nurse Aide Training Program Core Curriculum Requirements, Montana DPHHS – Nurse Aide Training Program Application and Curriculum Checklist, D&SDT-Headmaster – Montana CNA Testing Information, D&SDT-Headmaster – Montana Nurse Aide Candidate Handbook (Effective February 2025), Montana Medicaid – Nursing Facility Provider Manual (Nurse Aide Requirements, Registry Renewal, and Training Reimbursement), Montana DPHHS – Federal and State Regulations for CNAs, 42 CFR 483.152 – Federal Nurse Aide Training Requirements, 42 CFR 483.154 – Nurse Aide Competency Evaluation, 42 CFR 483.156 – Nurse Aide Registry Requirements, 42 CFR 483.95 – Nursing Facility In-Service Training Requirements