CNA Classes & Programs in North Dakota

Before starting your training, it's important to understand exactly what North Dakota requires to become a Certified Nurse Aide (CNA). Meeting these requirements allows you to complete the state competency examinations, obtain certification through North Dakota Health and Human Services (ND HHS), and be listed on the North Dakota Nurse Aide Registry so you can work as a certified nurse aide in nursing facilities throughout the state.

Eligibility

• Program enrollment: The standard pathway requires completion of a North Dakota Health and Human Services (ND HHS)-approved Certified Nurse Aide Training and Competency Evaluation Program. Approved training programs are offered through nursing facilities, educational institutions, and other authorized providers.
• Age and admission requirements: North Dakota does not establish a universal minimum age for CNA certification in Administrative Code 33-43-01. Individual training programs may have their own admission requirements, including age, educational readiness, or other prerequisites. Applicants should confirm these requirements directly with their chosen training provider.
• Background screening: Training programs and healthcare facilities may require criminal background checks or registry screenings before students participate in clinical training or begin employment. Certain criminal convictions or substantiated findings of abuse, neglect, or misappropriation of resident property may affect eligibility for training, certification, or employment.
• Alternative pathways: North Dakota previously allowed eligible individuals to challenge the CNA competency examination without completing the standard training program. However, the state discontinued the challenge pathway effective July 1, 2024. Individuals seeking initial CNA certification must now complete an approved training program unless they qualify through interstate endorsement or another pathway specifically authorized by ND HHS. Previously certified North Dakota CNAs whose registry status has expired may qualify for reactivation by examination.

Training Hours & Clinicals

North Dakota-approved Certified Nurse Aide Training Programs must provide at least 75 total hours of training, including a minimum of 16 hours of supervised practical training. The training program must be conducted under the general supervision of a qualified instructor, typically a registered nurse with at least two years of nursing experience, including one year providing long-term care services.

Before having any hands-on contact with residents or patients, nurse aide trainees employed by nursing facilities must complete at least 16 hours of classroom instruction covering communication and interpersonal skills, infection control, safety and emergency procedures including the Heimlich maneuver, promoting residents' independence, and respecting residents' rights.

The remainder of the curriculum covers basic nursing skills, personal care, mental health and social-service needs, care of residents with cognitive impairments, basic restorative services, and residents' rights. Supervised practical training provides experience with essential nursing assistant duties, including assisting with activities of daily living, measuring vital signs, transferring and positioning residents, and maintaining a safe care environment.

Under North Dakota regulations, individuals employed by nursing facilities who are pursuing CNA certification must complete the remaining training and competency evaluation requirements within four months of their first day of employment as a nurse aide. During this period, trainees may perform nursing or nursing-related services under the supervision of a licensed nurse, but they may not perform tasks for which their competency has not been established unless directly supervised.

Competency Exam (Knowledge & Skills)

After completing an ND HHS-approved training program, candidates must pass North Dakota's nurse aide competency evaluation, administered by D&SDT-Headmaster through the TestMaster Universe (TMU) system at approved testing locations.

The examination consists of two components:

• Knowledge examination: The written examination consists of 72 multiple-choice questions, with a time limit of 90 minutes. Candidates must score at least 75% to pass. An electronic audio version is available for candidates who request it in advance, with an additional testing charge.
• Manual skills examination: Candidates must demonstrate three or four assigned nurse aide skills within 30 minutes. The examination includes one mandatory first task incorporating handwashing, followed by two or three randomly selected tasks. To pass, candidates must correctly perform all mandatory critical steps and achieve at least 80% on each assigned skill.

Candidates have up to three attempts to pass each examination component. If a candidate fails the knowledge examination or skills examination three times, they must complete another ND HHS-approved nurse aide training program before testing again. Candidates who fail only one component generally need to retake only that component.

Examination scheduling, results, and retesting are managed through TMU. Official examination results are generally available through the candidate's TMU account after 7:00 p.m. Central Time on the next business day following the examination.

Placement on the Registry & Working as a CNA

After successfully completing the required training and competency examinations, candidates must meet the applicable ND HHS registration requirements to be placed on the North Dakota Nurse Aide Registry with the designation Certified Nurse Aide (CNA). The registry is maintained by the Health Facilities Unit of North Dakota Health and Human Services.

North Dakota distinguishes between several registry categories, including Certified Nurse Aide (CNA), Nurse Aide (NA), Home Health Aide (HHA), Medication Assistant I, and Medication Assistant II. The CNA designation applies to individuals who have met the state's approved certification requirements for providing nursing or nursing-related services in nursing facilities. Other categories have separate training, competency, and registration requirements.

The registry records certification status and validated findings involving abuse, neglect, misappropriation of resident property, or other misconduct. Employers can verify an individual's registration status through the state's online Nurse Aide Registry system.

Certification Renewal

North Dakota CNA registry status is valid for 24 months. To maintain active certification, CNAs must submit the required renewal information and verify qualifying nurse aide employment during the preceding two years.

To qualify for renewal, a CNA must have performed at least 8 hours of paid nursing or nursing-related services during the preceding 24 months. Volunteer work and unpaid training do not satisfy this requirement.

North Dakota's CNA registry uses a renewal period based on the individual's certification and employment record. Unlike the separate Nurse Aide and Home Health Aide categories, which generally follow a September 30 renewal schedule, CNA registration has a flexible expiration date tied to the applicable registry requirements.

If a CNA has not completed the required eight hours of qualifying paid work during the preceding 24 months, they must successfully complete another department-approved training and competency evaluation program or a department-approved competency evaluation to regain current registry status.

Previously certified North Dakota CNAs whose registration has expired may qualify for reactivation by examination. Under the current Headmaster guidance, applicants must have been previously listed on the North Dakota CNA Registry, must have completed an ND HHS-approved nurse aide training program, and must be able to provide proof of that training. Eligible applicants can apply through TMU and regain certification by passing both the knowledge and manual skills examinations.

There is no state application or renewal fee for the Certified Nurse Aide category. This fee exemption does not automatically apply to other North Dakota registry categories, such as Nurse Aide, Home Health Aide, or Medication Assistant.

Reciprocity

North Dakota offers reciprocity (interstate endorsement) for Certified Nurse Aides who have met another state's approved training and competency requirements and hold current registry status in good standing.

Applicants must provide proof of their existing out-of-state certification and meet North Dakota's requirements for active CNA registry status. Individuals with validated findings of abuse, neglect, misappropriation of resident property, or other disqualifying misconduct may be ineligible for endorsement.

Applicants who meet North Dakota's interstate endorsement requirements may be placed on the North Dakota Nurse Aide Registry with the Certified Nurse Aide designation. Approved applicants generally do not need to repeat North Dakota's 75-hour training program or take the state's competency examinations.

Reciprocity applications are processed through the North Dakota Nurse Aide Registry. Applicants should obtain confirmation of their North Dakota registry status before beginning employment in a nursing facility that requires CNA certification.

Costs & Reimbursement

The cost of CNA training in North Dakota varies by approved training provider. Nursing facilities, community colleges, and other educational institutions may charge different tuition and materials fees. Some employers offer facility-sponsored training or cover the cost of certification examinations for eligible employees.

North Dakota's competency examinations are administered through D&SDT-Headmaster. Examination fees depend on the component being taken, and additional charges may apply for audio examinations or retesting. Candidates should consult the current North Dakota Nurse Aide Candidate Handbook and TMU registration system for applicable testing fees.

North Dakota does not charge a fee for initial CNA registration or CNA renewal. However, other registry categories, including Nurse Aide and Home Health Aide, generally have a separate $25 nonrefundable application or renewal fee.

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, eligible training and testing expenses must be reimbursed on the applicable prorated basis. These federal reimbursement requirements do not apply to every healthcare employer or training provider.

Sources: North Dakota Health and Human Services – Nurse Aide Registry and Certified Nurse Aide, North Dakota Health and Human Services – Certified Nurse Aide Information, North Dakota Health and Human Services – Nurse Aide Training and Competency Evaluation Program, North Dakota Administrative Code 33-43-01 – Nurse Aide Training, Competency Evaluation, and Registry, D&SDT-Headmaster – North Dakota CNA Testing, D&SDT-Headmaster – North Dakota Nurse Aide Candidate Handbook (Effective April 2025), 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