North Dakota CNA Requirements 2026
North Dakota CNAs must complete a state-approved nurse aide training program of at least 75 hours, then pass a knowledge and skills competency exam administered through D&SDT-Headmaster. After passing both components, candidates apply to the North Dakota Department of Health and Human Services for placement on the Nurse Aide Registry. Certification is valid for two years.
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North Dakota’s Certified Nurse Aides are regulated by the North Dakota Department of Health and Human Services (DHHS). Oversight was transferred from the Board of Nursing to the DHHS Health Facilities Unit in 2011, and that unit has managed both the registry and training program approvals ever since.
North Dakota draws a formal distinction between Certified Nurse Aides (CNAs) and Nurse Aides (NAs). NAs are registered by the DHHS but aren’t held to the same training and examination requirements as CNAs. Some care settings require CNA certification for employment. Others accept NA registration. Both designations are tracked on the state registry, and the Health Facilities Unit sets minimum standards for each. CNAs who later pursue RN or LPN credentials can find state-specific information on North Dakota nursing license requirements.
Use the links below to jump to training requirements, exam details, the application process, and renewal information.
- CNA Training Requirements
- Competency Exam Requirements
- Applying for CNA Certification
- Renewing Your CNA Certification
- Out-of-State CNAs
CNA Training Requirements
CNA programs in North Dakota must be approved by the DHHS before candidates who complete them are eligible to test. Approved nurse aide training programs (NATPs) are at least 75 hours long, which meets the federal minimum. Programs run at community colleges, state colleges, care facilities, medical centers, and high schools across the state.
The 75-hour curriculum combines classroom instruction with hands-on clinical training. At least 16 of those hours must be completed before a student has any contact with nursing home residents. From that point forward, students work under close supervision until the program instructor confirms they’ve demonstrated the required competencies. North Dakota doesn’t allow fully online CNA certification programs. Some schools offer a hybrid format where lecture content is delivered online, but clinical training must be completed in person at an approved facility.
Some prospective CNAs receive training while employed at a nursing facility rather than through a school. The same rules apply: 16 hours of pre-contact training minimum, and supervised performance throughout the program until competency is confirmed.
For the current list of DHHS-approved nurse aide training programs, visit hhs.nd.gov/certified-nurse-aide-information.
Competency Exam Requirements
Before earning CNA certification, candidates must pass a two-part competency evaluation: a knowledge assessment and a skills assessment. Both components must be passed within the same training cycle.
D&SDT-Headmaster currently administers the competency exam for North Dakota. Once a candidate completes a NATP, the training program registers them in the exam portal. Candidates receive login credentials from D&SDT-Headmaster and must complete their account setup before scheduling either exam component. For scheduling information and current test site locations, contact Headmaster at (800) 393-8664 or [email protected], or visit the North Dakota page of the Headmaster website at hdmaster.com/testing/cnatesting/ndakota/ND_CNA_Home.htm.
Knowledge Assessment
The knowledge assessment includes 72 multiple-choice questions covering nurse aide duties, patient rights, safety, and infection control. It’s available in written or oral (audio) format. Candidates who take the oral version receive audio-read questions through headphones and must also complete a word recognition component. A passing score on both portions is required to pass the oral assessment.
Skills Assessment
The skills test requires candidates to demonstrate three or four randomly selected nurse aide tasks drawn from the DHHS-approved skill set. Hand hygiene is a mandatory first task. Candidates have 30 minutes to complete all assigned tasks and must correctly perform every key step and at least 80% of all non-key steps on each task to pass. The Headmaster candidate handbook, available on the North Dakota page of the Headmaster website, lists every skill that may be evaluated and explains what examiners are looking for in each demonstration.
Attempt Limits and Retesting
Candidates have three attempts at each component within six months of their testing eligibility date. The knowledge and skills components are tracked separately, so three failed attempts at one component don’t automatically affect the other. If a candidate needs to retest after a failure, they’ll pay the applicable retest fee before a new exam date can be scheduled. After three failed attempts at either component within that six-month window, the candidate must enroll in and complete another DHHS-approved training program before they’re eligible to test again. Contact D&SDT-Headmaster or your training program to confirm current exam and retest fees.
Applying for CNA Certification
Candidates can apply for examination and initial certification at the same time. After passing both the knowledge and skills assessments, the final step is completing the Nurse Aide Initial Application through the DHHS online services portal at services.ndhhs.gov/nurseaide. The application fee is $25 (non-refundable). Verify the current fee with DHHS before applying, as fees are subject to change.
The application includes screening questions about disciplinary history, felony arrests, and any conditions that could affect safe practice. Candidates who answer “yes” to any of these questions will go through a review process before certification is issued. In some cases, written explanation and supporting legal documents will be required.
Once the application is approved, the candidate’s name is added to the North Dakota Nurse Aide Registry. The “Print Registrant Card” tool on the registry portal at services.ndhhs.gov/nurseaide/verify lets candidates and employers confirm registry status. The registry listing includes issue and expiration dates and any findings of abuse, neglect, or misappropriation.
NA registration without CNA certification follows a separate path, also available through the DHHS online services portal. NA applicants must demonstrate competency in required skills as verified by a registered nurse, but aren’t required to complete a formal training program or pass the standard competency exam.
Renewing Your CNA Certification
North Dakota CNA certification is valid for two years from the date of issuance. DHHS mails renewal notices approximately 60 days before the expiration date to the last known address on file with the registry. It’s the CNA’s responsibility to keep contact information current with the registry.
To qualify for renewal, a CNA must have worked at least eight hours in a paid nursing-related role under RN or LPN supervision during the two-year certification period. There is no renewal fee. Renewal is processed through the DHHS online services portal. Candidates log in with their last name, Social Security number, and registry number. A successful renewal extends certification for an additional two years.
CNAs who can’t document the required work hours are not eligible for standard renewal. They can apply for Reactivation by Exam through the TMU portal, which requires retaking both the knowledge and skills components of the competency exam. To be eligible for Reactivation by Exam, the candidate must have previously held a listing on the North Dakota Nurse Aide Registry and must have originally earned certification through a DHHS-approved training program rather than the challenge pathway. Note: as of July 1, 2024, the challenge exam option is no longer available for new candidates.
Some CNAs use the credential as a first step toward RN licensure. Those looking to advance from CNA to RN will find that prior aide experience counts toward clinical hours in many bridge programs.
Out-of-State CNAs
North Dakota endorses CNAs who hold current registry status in another state, provided they meet that state’s training and assessment requirements and have no adverse findings on their record. Endorsement applications are submitted through the DHHS online services portal.
Applicants provide the date of their most recent nursing-related work, a list of states where they hold or have held CNA certification, and information about their training program. The endorsement application includes the same screening questions about disciplinary history and legal background as the initial application. A “yes” answer to any screening question requires a written explanation and, in some cases, supporting legal documents. The endorsement form can be submitted electronically through the portal.
For questions about endorsement or registry status, contact the DHHS Nurse Aide Registry at (701) 328-2353 or email [email protected]. The registry office is at 1720 Burlington Drive, Suite A, Bismarck, ND 58504.
CNA certification requirements vary by state. Find nursing licensure requirements by state for CNAs, RNs, LPNs, and advanced practice nurses.
Frequently Asked Questions
How long does a North Dakota CNA certification last?
North Dakota CNA certification is valid for two years from the date of issuance. To renew, you must have worked at least eight hours in a paid nursing-related role under RN or LPN supervision during that period. There is no renewal fee. If you can’t document the required work hours, you can apply for Reactivation by Exam through the TMU portal, which requires retaking both the knowledge and skills components.
Do I need to finish a training program before taking the competency exam?
Yes. North Dakota requires completion of a DHHS-approved nurse aide training program before you can sit for the competency exam. The minimum program length is 75 hours. There’s no testing-only option for first-time applicants and no pathway to substitute work experience for the required training.
What happens if I fail the competency exam?
You have three attempts at each component within six months of your testing eligibility date. The knowledge and skills exams are tracked separately. If you fail one component three times within that window, you’ll need to complete another approved training program before you can test again. A retest fee applies for each attempt after the first failure, so contact D&SDT-Headmaster before scheduling to confirm the current rate.
Can I transfer my out-of-state CNA certification to North Dakota?
Yes. North Dakota endorses CNAs who are currently listed on another state’s registry and have no adverse findings on their record. You’ll submit an endorsement application through the DHHS online services portal and provide documentation of your training program and work history. No additional training is required if you meet the endorsement criteria.
What’s the difference between a CNA and a Nurse Aide in North Dakota?
North Dakota recognizes both Certified Nurse Aides (CNAs) and Nurse Aides (NAs). CNAs must complete an approved training program and pass a formal competency exam. NAs must demonstrate competency as verified by a registered nurse, but aren’t held to the same formal training and examination standards. Some facilities require CNA certification. Others accept NA registration. Both are tracked on the state registry maintained by the DHHS Health Facilities Unit.
Key Takeaways
- 75-hour training program required — North Dakota requires completion of a DHHS-approved nurse aide training program before candidates can sit for the competency exam. Fully online programs don’t satisfy the state’s clinical training requirement.
- Two-part competency exam through D&SDT-Headmaster — Candidates must pass a 72-question knowledge assessment and a skills test within three attempts and six months of testing eligibility. Three failed attempts at either component require completion of a new training program before retesting.
- Certification renews every two years at no cost — Renewal requires at least eight hours of paid nursing-related work under RN or LPN supervision during the certification period. Candidates who can’t document work hours must apply for Reactivation by Exam through the TMU portal.
- Out-of-state endorsement is available — CNAs currently listed on another state’s registry with no adverse findings can apply for North Dakota endorsement through the DHHS online services portal without repeating training.
Select your state to find approved CNA programs, application links, and certification requirements near you.