CNA Requirements in Iowa

Becoming a Certified Nurse Aide in Iowa is regulated by the Iowa Department of Inspections, Appeals, and Licensing (DIAL), which approves all Nurse Aide Training Programs, oversees the Direct Care Worker Registry, and as of January 2026 contracts with TestMaster Universe/Headmaster as the central testing administrator. Iowa requires the federal minimum of 75 hours of training — with roughly 45 classroom/lab hours and at least 30 clinical hours — which is identical to neighboring Missouri and Nebraska but well below California's 160-hour standard.

Iowa is unusual among Midwestern states in that DIAL itself does not charge an application fee for initial registry placement; your costs are training tuition (often $0 at employer-sponsored programs or roughly $400-$1,200 at a community college) plus the TMU exam fees of approximately $50-$70 for the written portion and $115-$135 for the skills portion. The cheapest, most common pathway is to complete a community college NATP and then test at that same college's testing site. Many Iowa long-term care facilities also sponsor free training in exchange for a 3-12 month work commitment.

Once you have passed both portions of the exam, your results flow to DIAL and your name is added to the Iowa Direct Care Worker Registry, typically within 7-14 days. From that point you are authorized to work as a CNA in any Iowa-licensed nursing facility, hospital, home health agency, or hospice. Iowa CNA status itself does not expire, but you must complete at least 8 hours of paid nursing services every 24 months or your registry status will lapse — a meaningfully lower work threshold than the 100-hour-per-cycle requirement in some other states.