CNA Requirements in North Dakota
Step-by-step guide to becoming a Certified Nursing Assistant in North Dakota: the training, exam, background check, and timeline you need to plan for.
Find North Dakota CNA Training ProgramsNorth Dakota CNA Requirements at a Glance
Minimum Age
16
Training Hours
75 hours minimum
Time to Certification
8-14 weeks
Exam Vendor
D&SDT-Headmaster (delivered through the TestMaster Universe / TMU platform)
Becoming a CNA in North Dakota
North Dakota's CNA pathway is administered by the Health Facilities Unit within the North Dakota Department of Health and Human Services (NDHHS), based in Bismarck. The unit is the CMS-designated agency for nurse aide registration and oversees Nurse Aide Training Programs, the Headmaster competency exam contract, and the public Nurse Aide Registry.
Compared to most states, North Dakota stands out for its low-cost approach: there is no state application fee, no renewal fee, and many rural long-term care facilities sponsor candidates through free training in exchange for a short work commitment. This has made CNA training one of the most accessible entry points into healthcare across the prairie and along the Bakken oil corridor.
Training programs are concentrated at the state's two-year colleges-Bismarck State College, NDSCS-Wahpeton, Lake Region State College, Williston State College, and Dakota College at Bottineau-as well as at long-term care facilities, tribal colleges on the Standing Rock, Spirit Lake, and Turtle Mountain reservations, and a number of high school career and technical education programs.
Detailed North Dakota CNA Requirements
Regulatory Body
North Dakota Department of Health and Human Services, Health Facilities Unit (NDHHS)
Minimum Age
You must be at least 16 years old to begin CNA training in North Dakota.
Education Requirement
No minimum education required by statute; applicants must be at least 16 years old. Most training programs require a high school diploma or GED, but it is not a state-level mandate.
Training Hours
75 hours minimum required.
Minimum of 75 hours total, including at least 16 hours of classroom instruction before any direct patient contact and a clinical practicum supervised by a licensed nurse
Background Check
Criminal history record check through the North Dakota Bureau of Criminal Investigation (BCI) plus FBI fingerprint check submitted during application
Competency Exam
Administered by D&SDT-Headmaster (delivered through the TestMaster Universe / TMU platform). Two-part D&SDT-Headmaster competency evaluation: a 60-question written or oral knowledge test and a hands-on skills evaluation of 5 randomly assigned skills, including hand hygiene
Cost: $250 combined Skills + Knowledge Exam through D&SDT-Headmaster (audio version of the Knowledge Exam adds $10); retake fees are $120 knowledge or $170 skills
Application Fee
No initial registration fee charged by NDHHS once the exam is passed
Total Cost Estimate
$500-$1,500 including tuition, background check, and Headmaster testing fees
Where You Can Work
Skilled nursing facilities, basic-care facilities, hospitals, assisted living, home health, hospice, and Indian Health Service facilities across North Dakota
What's Different About North Dakota
North Dakota does not charge a state fee to be added to the nurse aide registry or to renew, making it one of the most affordable CNA pathways in the country.
How to Become a CNA in North Dakota: Step by Step
Confirm eligibility and choose an NDHHS-approved program
You must be at least 16 years old. North Dakota does not impose a high school diploma requirement at the state level, although individual schools may. Search the NDHHS Health Facilities Unit list of approved Nurse Aide Training Programs (NATPs) to identify a program at a community college, tribal college, long-term care facility, or hospital near you.
Complete a 75-hour Nurse Aide Training Program
Curriculum is set by NDHHS under N.D. Admin. Code 33-07-06 and 33-43-01 and includes at least 16 hours of pre-clinical instruction in topics such as resident rights, communication, infection control, and safety before any hands-on resident care begins. Programs typically run 3 to 8 weeks depending on schedule.
Register for the Headmaster competency exam
Your program will help you create a candidate profile in the TestMaster Universe (TMU) platform operated by D&SDT-Headmaster. The Knowledge Test contains 60 multiple-choice items and may be taken in written or oral format; the Skills Test consists of five randomly assigned hands-on procedures (one always being hand hygiene).
Pass both portions within two years of training
You have up to two years from completing your training to pass both sections. You may attempt each component three times; if you fail a component three times, you must repeat the full 75-hour training program before re-testing. A score of 75% or higher is required on the written portion.
Get added to the North Dakota Nurse Aide Registry
Once you pass both components, Headmaster reports your results directly to NDHHS, which adds you to the Nurse Aide Registry. There is no separate registration fee. You will receive a CNA number that employers use to verify your status through the public registry at services.ndhhs.gov/nurseaide/verify/.
Complete the required background check on hire
North Dakota performs the criminal background check at the point of employment rather than during licensure. Your employer will submit BCI and FBI fingerprint paperwork, and you must self-disclose any past convictions. Certain offenses listed in the federal Elder Justice Act will permanently disqualify a candidate.
Renew your registration every two years
Renewal is free in North Dakota provided you complete it before your expiration date. You must attest to at least 8 hours of paid nursing-related work performed under licensed nurse supervision within the prior 24 months. If you have not worked the minimum hours, you must retest with Headmaster to be reinstated.
Frequently Asked Questions
How much does it cost to become a CNA in North Dakota?
Out-of-pocket costs are unusually low. NDHHS does not charge a registration fee, and renewal is free. Tuition at a community college typically runs $400-$900, but many candidates train tuition-free at a long-term care facility in exchange for a 4- to 12-month work commitment. The main remaining cost is the Headmaster testing fee, which is approximately $125 for the combined written and skills exam.
Who administers the CNA competency exam in North Dakota?
The state contracts with D&SDT-Headmaster, headquartered in Helena, Montana. Testing is delivered through the TestMaster Universe (TMU) online platform, with both written/oral knowledge tests and in-person skills evaluations available at regional test sites and at many in-facility testing centers attached to approved training programs.
Can I challenge the CNA exam in North Dakota without taking a training course?
Generally no. North Dakota requires completion of an NDHHS-approved 75-hour Nurse Aide Training Program before scheduling the Headmaster competency exam. Limited exceptions exist for nursing students who can document equivalent clinical hours within an accredited RN or LPN program, but those exceptions require pre-approval from the Health Facilities Unit.
How often must I work to keep my North Dakota CNA registration active?
You must perform at least 8 hours of paid nursing-related services under the supervision of an RN or LPN within the 24 months preceding your renewal date. The work can occur in any healthcare setting-skilled nursing facility, basic care, hospital, home health, hospice, or assisted living. If you fall short, you must retake the Headmaster competency exam to be reinstated.
Does North Dakota offer CNA reciprocity from other states?
Yes. Out-of-state CNAs in good standing with a registry that uses a state-approved training program of at least 75 hours can apply for endorsement directly through services.ndhhs.gov/nurseaide. NDHHS verifies your status with your home-state registry; the process is free and typically takes 2 to 4 weeks. There is no testing requirement for endorsement applicants in good standing.
Where can I verify a North Dakota CNA's registry status?
The public lookup is hosted at services.ndhhs.gov/nurseaide/verify/. You can search by name or registry number to confirm current status, expiration date, and whether any findings of abuse, neglect, or misappropriation of property have been entered against the registrant. Employers are required to check the registry before hiring and at every renewal.
Free Study Materials for the North Dakota CNA Exam
The D&SDT-Headmaster (delivered through the TestMaster Universe / TMU platform) exam used by the North Dakota Department of Health and Human Services, Health Facilities Unit (NDHHS) tests both knowledge and hands-on skills. Use these free study guides to prepare for the topics most commonly tested in North Dakota:
Infection Control
Standard precautions, PPE, hand hygiene, transmission-based precautions, and biohazard handling for the North Dakota CNA exam.
Basic Nursing Skills
Vital signs, intake/output, positioning, transfers, and range of motion — the largest block on the D&SDT-Headmaster (delivered through the TestMaster Universe / TMU platform) skills test.
Personal Care & Elimination
Bathing, peri-care, oral care, toileting, and incontinence management — heavily tested D&SDT-Headmaster (delivered through the TestMaster Universe / TMU platform) skills in North Dakota.
Safety & Emergencies
RACE/PASS fire safety, fall prevention, choking, CPR, and seizure care — required knowledge for North Dakota CNA candidates.
Communication Skills
SBAR handoff, therapeutic communication, and adaptations for hearing, vision, and dementia residents — tested throughout the D&SDT-Headmaster (delivered through the TestMaster Universe / TMU platform) exam.
Patient Rights
OBRA '87 resident rights, HIPAA, advance directives, and freedom from restraints — graded on every North Dakota CNA practical exam skill.
Data Collection & Reporting
Objective vs subjective data, pain scales, what to report immediately, and documentation rules used on the North Dakota exam.
Body Systems & Conditions
Cardiovascular, respiratory, nervous, and endocrine basics, plus pressure-injury staging — frequently tested on the North Dakota written exam.
End-of-Life Care
Hospice vs palliative care, Kübler-Ross stages, and postmortem care for North Dakota CNAs working in long-term care.
Mental Health & Dementia
Delirium vs dementia, sundowning, validation therapy, and de-escalation — frequently tested on the D&SDT-Headmaster (delivered through the TestMaster Universe / TMU platform) written exam in North Dakota.
Legal & Ethical Issues
Scope of practice, the four elements of negligence, mandatory reporting, and ethical principles every North Dakota CNA must know before working.
Test yourself for the North Dakota CNA exam
Free D&SDT-Headmaster (delivered through the TestMaster Universe / TMU platform) Practice Tests
The D&SDT-Headmaster (delivered through the TestMaster Universe / TMU platform) written exam used in North Dakota has 60 scored multiple-choice questions. Drill our free NNAAP-style practice tests until you can consistently score above 80%, then walk into the testing center confident.
Ready to Start Your North Dakota CNA Career?
Find approved training programs, free study materials, and license verification tools for North Dakota.