CNA Requirements in Iowa — Training, Exam & Registry

How to become a CNA in Iowa: a 75-hour state training minimum — verified from Iowa Department of Inspections, Appeals, and Licensing (DIAL).

Source-verified

Requirements below are drawn from Iowa Department of Inspections, Appeals, and Licensing (DIAL) — which maintains the Iowa Direct Care Worker Registry and approves nurse aide training and competency evaluation programs. DIAL is explicit that it does not award the credential itself: 'Plans for all CNA courses taught in Iowa need to be approved by DIAL, but DIAL does not issue the certificate.' The certificate comes from the community college, facility or private entity that taught the 75-hour course. Iowa's Board of Nursing licenses nurses and has no role here. (official site) and last verified August 16, 2026. Boards change fees and rules often — confirm before acting.

Requirements at a glance

What the credential is: Iowa says it in one line: 'A nurse aide is certified in Iowa, not licensed.' The sentence immediately before it is the one that surprises people: 'Plans for all CNA courses taught in Iowa need to be approved by DIAL, but DIAL does not issue the certificate.' So Iowa has a split model — the STATE approves the training program and the competency evaluation and maintains the registry, while the CERTIFICATE of completion is issued by the community college, health care facility or private entity that ran the course. WHO OPERATES THE REGISTRY: DIAL. '[DIAL] shall establish and maintain a registry of nurse aides in accordance with 42 CFR 483.156... In addition, the registry shall contain a record of known convictions by a court of law of a person convicted of abuse, neglect, mistreatment, or misappropriation of resident property' (441 IAC 81.13(5)'a'). WHAT YOU GET: 'The individual is placed on the Iowa Direct Care Worker (DCW) Registry and issued a six-digit ID number.' WHEN THE REGISTRY IS EVEN REQUIRED: only for long-term care. 'CNAs are only required to be on the registry if they are seeking employment in a long-term care facility', and DIAL's own announcement of remote testing spells out the corollary — 'Neither testing nor placement on the registry are required for CNAs who plan to work in an assisted living facility, hospital, or other health care facility that is not a nursing home.'
The path, in Iowa's own sequence: 'Must either enroll themselves or be sponsored by their employer to take the 75-hour course and competency tests provided by a testing site. Thirty of the 75 course hours are clinical. After one has completed the course and passed both the skills and written competency tests, the individual's name and scores are submitted automatically to DIAL. The individual is placed on the Iowa Direct Care Worker (DCW) Registry and issued a six-digit ID number.' There is a separate registry APPLICATION step for people already working: 'Persons employed as nurse aides shall complete the Nurse Aide Registry Application within the first 30 days of employment', and 'A nurse aide who is not employed may apply for inclusion on the registry by submitting a copy of completed application to the nurse aide registry' (441 IAC 81.13(5)'b'). Once the registry has the signed application and the training and testing information, 'an electronic notification will be sent to the nurse aide that includes the registry ID number for the nurse aide to use when accessing the online registry.'
The four-month clock: This is Iowa's hard deadline and it runs from the HIRE DATE, not from the course. DIAL: 'The candidate must pass both a written and a skills test within four months of their hire date.' The rule behind it is the facility-side prohibition: 'A facility shall not use any person working in the facility as a nurse aide for more than four months, on a permanent basis in accordance with the exceptions and provisions specified in 42 CFR 483.25(d)' (441 IAC 81.11(19)'a'(2)).
Who pays — and the pro rata refund formula: DIAL: 'The cost of the 75-hour training course is determined by the community college or entity where the course is offered. However, for aides working in a certified nursing home, this fee is typically paid by the employer.' If you paid your own way and are hired afterwards, the rule sets out an unusually precise refund: where a person not employed (and without an employment offer) 'becomes employed by, or receives an offer of employment from, a facility no later than 12 months after completing a nurse aide training and competency evaluation program... the facility shall reimburse the nurse aide for costs incurred in completing the program or competency evaluation on a pro rata basis during the period in which the person is employed as a nurse aide.' The formula: '(1) Add all costs incurred by the nurse aide for the course, books, and competency evaluations. (2) Divide the total arrived at in subparagraph (1) above by 12 to prorate the costs over a one-year period and establish a monthly rate. (3) The nurse aide shall be reimbursed the monthly rate each month the nurse aide works at the facility until one year from the time the nurse aide completed the course' (441 IAC 81.13(3)'a').
Criminal history — checked before the training, and again before employment: Iowa runs the check at the CLASSROOM DOOR as well as the employer's door. Iowa Code 135C.33(9) requires that 'Prior to a student beginning or returning to a certified nurse aide training program, the program shall' either request a criminal history check from the Department of Public Safety plus child and dependent adult abuse record checks, or access the single contact repository to perform them. A student with a record cannot enter the clinical component 'unless an evaluation has been performed by the record check evaluation system', which 'has final authority in determining whether prohibition of the student's involvement in the clinical education component is warranted.' A limited provisional route exists while checks are pending, and a narrower 60-day one for a simple-misdemeanour alcohol offence under Iowa Code 123.47 or a first OWI offence under 321J.2(1). Students carry a reporting duty with teeth: a student convicted of a crime or entered in the abuse registry after the checks 'shall inform the certified nurse aide training program of such information within forty-eight hours', and failing to do so 'commits a serious misdemeanor.' One efficiency: if the program is run by a health care facility and the student takes a job there within 30 days of finishing, those checks 'shall be deemed to fulfill the requirements for such checks prior to employment.'
Iowa publishes no age, education or language prerequisite: Searched on 2026-08-16 across all of DIAL's nurse aide and Direct Care Worker Registry pages, 441 IAC 81.13 and 81.11(19), and Iowa Code 135C.33: no minimum age, no high school diploma or GED requirement, and no English-literacy condition is stated for a person seeking Iowa nurse aide certification. This record therefore asserts none. What Iowa does gate on is the criminal-history and abuse-record screening above, which happens before the training rather than after it.
Medication Aide — a boundary, not a step: The certified medication aide is a separate Iowa credential under Iowa Code 135C.34, with its own certification, its own search on the same registry database, and its own challenge examination. It is named here only to mark the line; this record does not cover it.

Legal basis

Iowa Department of Inspections, Appeals, and Licensing (DIAL) — which maintains the Iowa Direct Care Worker Registry and approves nurse aide training and competency evaluation programs. DIAL is explicit that it does not award the credential itself: ‘Plans for all CNA courses taught in Iowa need to be approved by DIAL, but DIAL does not issue the certificate.’ The certificate comes from the community college, facility or private entity that taught the 75-hour course. Iowa’s Board of Nursing licenses nurses and has no role here. administers certified nursing assistant licensing in Iowa. Every figure below is verified against the board’s own official pages and dated. Who must personally hold a credential — the contractor, the business, or the individual worker — is set out under Requirements.

What it’s called

Iowa uses THREE names for the same person and they are not interchangeable in the state’s own writing. ‘Certified nursing assistant (CNA)’ is the term DIAL uses in its page titles and headings. ‘Nurse aide’ is the term in the administrative rule, in the registry application, in the training-program rules and in the ‘Nurse Aide Denial List’. ‘Direct care worker (DCW)’ is the term for the REGISTRY, and Iowa is explicit that the registry is narrower than the phrase sounds: ‘In Iowa, only certified nursing assistants (CNAs), also called nurse’s aides, are placed on the Direct Care Worker Registry.’ So an Iowa ‘direct care worker registry number’ is a CNA number. ‘CNA license’ is a folk term Iowa contradicts directly — ‘A nurse aide is certified in Iowa, not licensed’ — and the thing that expires is the registry standing, not the certification. Two more distinctions worth holding: NATCEP, the Nurse Aide Training and Competency Evaluation Program, is the programme rather than the person, and the rule uses it as a noun for the approved provider; and the CERTIFIED MEDICATION AIDE is a separate Iowa credential under Iowa Code 135C.34 with its own certification and its own search on the same state database. Finally, the agency’s name changed: the rule text and DIAL’s own pages still contain occasional references to ‘DIA’, the Department of Inspections and Appeals as it was before licensing functions were merged in, and the nurse aide rules physically live in the Human Services [441] chapter of the Iowa Administrative Code even though DIAL administers them.

License types & fees

Type	Notes	Who Its For
Placement on the Iowa Direct Care Worker (DCW) Registry as a certified nursing assistant	Iowa's own words on what this is: 'A nurse aide is certified in Iowa, not licensed.' But the state is not the certifier — DIAL approves the course and runs the registry, while the certificate of course completion comes from the training entity, which is why DIAL says 'DIAL does not have copies of CNA certificates. Please contact the college or entity where you took your CNA course for a copy of your course certificate.' What DIAL issues instead is a registry entry and 'a six-digit ID number'. THE CERTIFICATION AND THE REGISTRY STATUS EXPIRE ON DIFFERENT TERMS, and this is the Iowa fact most often stated wrongly: 'The certification itself does not expire', while registry standing does — 'A CNA's standing on the registry expires if the CNA stops working as a CNA for 24 months.'	A person who wants to work as a nurse aide in an Iowa long-term care facility. DIAL draws the boundary tightly: CNAs 'must be listed on the Iowa Direct Care Worker Registry to be eligible for work in an Iowa long-term care facility (nursing home, skilled nursing facility, or a skilled or swing bed unit of a hospital)', and 'CNAs do not need to be on the registry to work in other types of facilities.'
Registry placement by reciprocity from another state's registry	DIAL: 'When a CNA wants to transfer to Iowa from another state registry, they may apply online [at] the Direct Care Worker Registry website. Processing time varies; please allow at least two weeks.' The registry site itself carries the entry point — 'Complete your online application for the Iowa Direct Care Worker Registry and out-of-state reciprocity.' Going the other way is the other state's process: 'If you wish to transfer from Iowa to another state registry, please first contact the registry in that state.'	A nurse aide already listed on another state's registry who wants to work in an Iowa nursing home.
Deemed to have met the requirement — pre-1989 completions and military-trained applicants	441 IAC 81.13(1) treats a nurse aide as satisfying the training-and-competency requirement in several defined cases: completion of a program before July 1, 1989 where at least 60 clock hours were substituted for 75 and the difference has since been made up in supervised practical training or in-service education; a finding of competence after training 'of at least 100 clock hours' duration'; service 'as a nurse aide at one or more facilities of the same employer in Iowa for at least 24 consecutive months before December 19, 1989'; or completion before July 1, 1989 of a program DIAL determines would have qualified at the time. THE MILITARY ROUTE IS SEPARATE AND STILL LIVE: a veteran, active duty service member or reservist who has completed 'a U.S. military training program that includes a curriculum comparable to the nurse aide training program', documented by a diploma, certification or 'Form DD 214 showing completion of hospital corpsman or medical service specialist or equivalent training', who documents '75 clock hours of practical experience in a nurse aide role, which may include classroom instruction, prior equivalent experience, or a combination of the two', and who passes the competency examination (441 IAC 81.13(1)'b').	Applicants who never took the modern Iowa 75-hour course but whose training Iowa recognises by rule.
Certified medication aide — a separate credential on the same database	Iowa certifies medication aides separately under Iowa Code 135C.34, and the registry site runs a second search alongside the direct care worker search whose own form fields include a training-college filter. The statute's reciprocity provision shows how the two credentials are stacked: DIAL 'shall establish a procedure to allow a person who is certified as a medication aide in another state to become certified in this state upon completion and passage of both the certified nurse aide and certified medication aide challenge examinations, without additional requirements for certification, including but not limited to, required employment in this state prior to certification.' This record covers the nurse aide only.	Not covered by this record.

Who does NOT need this license — exemptions

IOWA’S BOUNDARY IS THE SETTING, NOT THE TASK, AND IT IS DRAWN NARROWLY. Registry placement is required only for long-term care: ‘CNAs are only required to be on the registry if they are seeking employment in a long-term care facility’, which DIAL defines as a ’nursing home, skilled nursing facility, or a skilled or swing bed unit of a hospital’, and ‘CNAs do not need to be on the registry to work in other types of facilities.’ DIAL’s own announcement puts the exclusion in the affirmative: ‘Neither testing nor placement on the registry are required for CNAs who plan to work in an assisted living facility, hospital, or other health care facility that is not a nursing home.’ So an Iowa aide working in assisted living, a hospital ward, a group home or an intermediate care facility is outside the registry requirement — though if that aide IS on the registry, work in several of those settings can still count toward staying active, which is why DIAL tells assisted living programs, intermediate care facilities, residential care facilities and group homes how to report hours by letter. WHO COUNTS AS A NURSE AIDE AT ALL: the rule’s definition excludes three categories — ‘Nurse aide means any person providing nursing or nursing-related services to residents in a facility who is not a licensed health professional, a registered dietitian, or someone who volunteers to provide these services without pay’ — and ’licensed health professional’ is itself defined to mean ‘a physician; physician associate; nurse practitioner; physical, speech or occupational therapist; registered professional nurse; licensed practical nurse; or licensed or certified social worker’ (441 IAC 81.11(19)‘a’(1)). THE TIME-LIMITED ALLOWANCE: ‘A facility shall not use any person working in the facility as a nurse aide for more than four months, on a permanent basis in accordance with the exceptions and provisions specified in 42 CFR 483.25(d)’, which DIAL states to candidates as ‘The candidate must pass both a written and a skills test within four months of their hire date.’ NOT FOUND on 2026-08-16 in any Iowa source read: any exemption for nursing students, for family caregivers, or for private-duty aides working in a private home. This record makes no claim about those.

Fees

IOWA CHARGES NO STATE FEE TO BE PLACED ON THE REGISTRY, TO RENEW, OR TO TRANSFER IN — none appears on any DIAL nurse aide page or in 441 IAC 81.13. What you pay is the training and the two tests. TESTING, as DIAL currently publishes it: the written (knowledge) exam is ‘$50 for a proctored test taken at an Iowa community college’ or, taken remotely online, ‘$50’ via Headmaster or ‘$70’ via Credentia; the skills exam is ‘$115’ at an Iowa community college or ‘$135’ with Health Tech Associates. A SECOND, OLDER SET OF FIGURES SITS ON THE SAME SITE AND IS REPORTED HERE RATHER THAN SUPPRESSED: DIAL’s summary box on the CNA page still says ‘The cost for exams is about $60 for written test and $115 for the skills test’, and its step-by-step placement page says ‘The cost for exams are approximately $60 (written) $115 (skills).’ The $50/$70/$115/$135 list is the one presented as current and is the one attached to the January 2026 change in how the written test is registered and paid for; the $60 figure is the one Iowa has not updated. FACILITY SPONSORSHIP OF THE WRITTEN EXAM has its own form: ‘If a facility plans to pay for an employee’s written exam at a community college, the facility must complete the Facility Account Information Application (third-party sponsor application through Headmaster).’ TRAINING: ‘The cost of the 75-hour training course is determined by the community college or entity where the course is offered. However, for aides working in a certified nursing home, this fee is typically paid by the employer.’ Iowa publishes no tuition figure and sets no cap. If you paid and are then hired within 12 months, the pro rata reimbursement formula in 441 IAC 81.13(3)‘a’ applies — see requirements.

Exam

TWO PARTS, BOTH REQUIRED, AND A 70 PERCENT PASS MARK. ‘Successful completion of both written and skills tests is required to be placed on the Iowa Direct Care Worker Registry.’ The rule sets the standard: ‘A score of 70 percent or above is passing for both the written or oral and skills demonstration parts of the test’ (441 IAC 81.13(4)‘a’(1)) — note that Iowa’s rule recognises an ORAL form of the knowledge test alongside the written one. THREE ATTEMPTS PER PART, AND THE PENALTY FOR FAILING: ‘Each person shall have three opportunities to pass each part of the test. If one part of the test is failed, only that part need be taken a second or third time. If either part of the test is failed three times, the 75-hour course shall be taken or retaken before the test can be taken again’ (441 IAC 81.13(4)‘b’(2)). DIAL states the same rule on its candidate page: ‘If a potential CNA does not pass either one of the tests in three attempts, they must retake the 75-hour course AND begin a new testing cycle.’ A candidate who fails must be told in writing within ten working days after the test is scored which areas were not passed and that three opportunities exist. RESULTS AND REPORTING DEADLINES ARE IN THE RULE, NOT JUST IN PRACTICE: ‘The competency testing entity shall inform the nurse aide of the test score within 30 calendar days of the completion of the test and shall inform the nurse aide registry of the nurse aide’s scores within 20 calendar days after the test is administered’, and ‘A record of successful completion of the competency evaluation shall be included in the nurse aide registry within 30 days of the date the person is found to be competent.’ DIAL’s own candidate guidance says the wait is shorter in practice — ‘please allow at least two weeks’ — and its 2025 announcement said students who pass both parts ‘will be automatically added to the Iowa Direct Care Worker (DCW) Registry within 10–14 days after test completion.’ WHAT IOWA DOES NOT PUBLISH: the number of questions on the written test, the time allowed, or the number and selection method of the skills demonstrated. Those were searched on 2026-08-16 across every DIAL nurse aide page, 441 IAC 81.13, and the Iowa testing-request application, and are not stated; this record therefore gives no figure for them.

Renewal & continuing education

THE CERTIFICATION DOES NOT EXPIRE. THE REGISTRY STATUS DOES. DIAL states the first half plainly — ‘The certification itself does not expire’ — and the second half just as plainly: ‘To remain active on the registry, the aide must perform at least eight hours of qualifying employment in a two-year period. A CNA’s standing on the registry expires if the CNA stops working as a CNA for 24 months.’ The federal source is named: ‘The Centers for Medicare and Medicaid Services (CMS) requires that a CNA perform at least a day of nursing or nursing-related duties every 24 months.’ THE AIDE CANNOT DO THIS PERSONALLY, AND THAT IS THE POINT MOST OFTEN MISSED: ’the only way a CNA can remain active on the Iowa Direct Care Worker Registry is if their Iowa employer reports their hours to registry staff’, and ‘a CNA cannot report their own hours to the registry, nor can the CNA provide a letter verifying employment from the employer to DIA directly.’ WHO IS OBLIGED TO REPORT: ‘Long-term care facilities are the only entities mandated by state and federal law to verify eligibility and report qualifying employment to the registry. In Iowa, health care employment agencies that employ CNAs at long-term care facilities must also report hours for their employees working in long-term care facilities.’ Others may report but are not required to. HOW: electronically, by logging in to DIAL’s Health Facilities Database / Direct Care Worker Registry — available to long-term care facilities and, DIAL lists, hospices, hospitals, home health care agencies and ambulatory surgical centres. Everyone else reports on paper: assisted living programs, intermediate care facilities, residential care facilities and group homes must send DIAL ‘a job description and an attestation letter on facility letterhead to registry staff showing the CNA has performed at least eight hours of paid, nursing or nursing-related duties.’ DIAL advises facilities to ‘consider electronic verification of employment status at least yearly prior to their annual survey.’ NO CONTINUING EDUCATION IS REQUIRED OF THE AIDE TO KEEP REGISTRY STATUS. What Iowa requires instead is work — eight hours of paid nursing or nursing-related duties in a 24-month period, reported by the employer. The 12-hour figure people quote is a FACILITY duty and it attaches only to long-term care: ’long-term care facilities only are required to provide (and CNAs are required to complete) at least 12 hours of in-service training per year’, which DIAL states elsewhere as ‘If employed as a nurse aide in a certified long-term care facility, the facility must provide and the aide must complete 12 hours of in-service training per year.’ Note the careful wording — the obligation to PROVIDE it runs to the facility, the obligation to COMPLETE it runs to the aide, and neither is described anywhere as a condition of remaining on the Direct Care Worker Registry. Searched 2026-08-16 across all DIAL nurse aide and registry pages and 441 IAC 81.13: no course, hour count, approved-provider list or renewal education requirement exists for the individual CNA.

How to apply

Applications are handled by Iowa Department of Inspections, Appeals, and Licensing (DIAL) — which maintains the Iowa Direct Care Worker Registry and approves nurse aide training and competency evaluation programs. DIAL is explicit that it does not award the credential itself: ‘Plans for all CNA courses taught in Iowa need to be approved by DIAL, but DIAL does not issue the certificate.’ The certificate comes from the community college, facility or private entity that taught the 75-hour course. Iowa’s Board of Nursing licenses nurses and has no role here.. Start at the official application page .

Verify a license in Iowa

Iowa Department of Inspections, Appeals, and Licensing — the Direct Care Worker Registry & Health Facility Database, DIAL’s own application, which the agency links from every CNA page as ‘View the registry’ and ‘Iowa Direct Care Worker Registry website’. publishes a public license search , searchable by identification number (the six-digit registry ID), first name, last name, city or county (multi-select from all 99 Iowa counties). It covers Iowa Direct Care Worker Registry entries — that is, Iowa CNAs. The tool labels itself ‘DCW SEARCH — Look up eligibility status of Direct Care Workers’, and the search-by list above was read from the live search form’s own inputs on 2026-08-16, not from a description of it. DIAL states who it is for and what it will not do: ‘Potential employers, verification companies, and other states’ registry staff can check the Iowa DCW Registry to verify the status of a CNA by first and last name, city, county of residence, and registry number. This registry number is the only unique identifying number that DIAL can publicly share or confirm.’ The agency is emphatic that identity data stays out of it — ‘Registry staff will not search by personally identifiable information (e.g., date of birth or any part of a Social Security number); please do not email this type of information to the registry.’ TWO PRACTICAL NOTES. Results can be taken away in bulk: ‘Search results can be downloaded as PDF or CSV files.’ And a search result has no web address of its own — the page submits your search back to itself, so you cannot bookmark, forward or cite a result, and an automated watch on this address sees only the empty form. The same site is also the front door for applying: ‘Complete your online application for the Iowa Direct Care Worker Registry and out-of-state reciprocity.’ Expect a delay before a new CNA appears — DIAL says to allow at least two weeks, and its rule allows the testing entity 20 calendar days to report scores and the registry 30 days to enter the record.

Records come from Iowa Department of Inspections, Appeals, and Licensing — the Direct Care Worker Registry & Health Facility Database, DIAL’s own application, which the agency links from every CNA page as ‘View the registry’ and ‘Iowa Direct Care Worker Registry website’.’s own system. LicensingAtlas does not hold license records and cannot confirm any individual’s status — the date on this page refers to the requirements described above, not to anyone’s credential.

Frequently asked questions

Is an Iowa CNA licensed or certified?

Certified — and Iowa says so in exactly those words: ‘A nurse aide is certified in Iowa, not licensed.’ But the state is not the body that hands you the certificate. DIAL approves the course plan and runs the registry, while the certificate of completion comes from the college, facility or private entity that taught your 75-hour course. That is why DIAL says it ‘does not have copies of CNA certificates’ and tells people to contact their training provider for one. What the state gives you is a place on the Iowa Direct Care Worker Registry and a six-digit ID number.

How many training hours does Iowa require to become a CNA?

75 hours, and DIAL states the split: ‘Thirty of the 75 course hours are clinical.’ The course can be taken at an Iowa community college — which offer ‘both classroom studies and hands-on clinical training’ — or at one of the health care facilities and private entities DIAL approves and lists by name on its CNA page. Programs are re-approved on a two-year cycle, and facilities with recent enforcement history are barred from offering training at all; DIAL publishes that as a searchable Nurse Aide Denial List.

Do I have to be on the Iowa registry to work as a CNA?

Only if you want to work in long-term care. Registry placement is required ’to be eligible for work in an Iowa long-term care facility (nursing home, skilled nursing facility, or a skilled or swing bed unit of a hospital)’, and DIAL is explicit that ‘CNAs do not need to be on the registry to work in other types of facilities.’ Its 2025 announcement put it even more directly: ‘Neither testing nor placement on the registry are required for CNAs who plan to work in an assisted living facility, hospital, or other health care facility that is not a nursing home.’

Who gives the Iowa CNA exam, and what does it cost?

The two halves are handled differently, and this changed in January 2026. The written (knowledge) test is registered and paid for through TestMaster Universe/Headmaster — community colleges ’now serve only as testing sites and proctors’ — at $50 for a proctored test at a community college, $50 remotely online via Headmaster, or $70 remotely online via Credentia. The skills test stays in person: $115 at an Iowa community college, which manages it directly rather than through either vendor, or $135 with Health Tech Associates. DIAL’s own summary box elsewhere on the same site still quotes older figures of about $60 for the written and $115 for the skills test. Iowa charges no state fee to be placed on the registry.

What score do I need to pass, and how many tries do I get?

70 percent, on each part, with three attempts each. Iowa’s rule states: ‘A score of 70 percent or above is passing for both the written or oral and skills demonstration parts of the test’, and ‘Each person shall have three opportunities to pass each part of the test. If one part of the test is failed, only that part need be taken a second or third time. If either part of the test is failed three times, the 75-hour course shall be taken or retaken before the test can be taken again.’ If you fail, you must be told in writing within ten working days which areas you did not pass. Note that Iowa’s rule recognises an oral form of the knowledge test as well as a written one.

How long do I have after being hired to finish testing in Iowa?

Four months from your hire date. DIAL states it as a candidate rule — ‘The candidate must pass both a written and a skills test within four months of their hire date’ — and the underlying regulation puts it on the employer: ‘A facility shall not use any person working in the facility as a nurse aide for more than four months, on a permanent basis.’

Does an Iowa CNA certification expire, and is there continuing education?

The certification does not expire; your registry status does. DIAL: ‘The certification itself does not expire’ — but ‘To remain active on the registry, the aide must perform at least eight hours of qualifying employment in a two-year period’, and ‘A CNA’s standing on the registry expires if the CNA stops working as a CNA for 24 months.’ There is no continuing education requirement on you as an individual. The 12 hours of annual in-service training you may hear about is something a long-term care facility must provide and you must complete as its employee — Iowa never describes it as a condition of registry standing.

Why did my Iowa registry status expire even though I was working?

Because in Iowa you cannot report your own hours — your employer must. DIAL: ’the only way a CNA can remain active on the Iowa Direct Care Worker Registry is if their Iowa employer reports their hours to registry staff’, and ‘a CNA cannot report their own hours to the registry, nor can the CNA provide a letter verifying employment from the employer to DIA directly.’ Only long-term care facilities and the staffing agencies that place CNAs in them are legally required to report; hospices, hospitals, home health agencies and ambulatory surgical centres can report electronically but are not compelled to, and assisted living programs, intermediate care facilities, residential care facilities and group homes must send a letter. If your status has already flipped to expired, your employer sends DIAL a letterhead attestation — naming your registry ID, hire and separation dates and the specific duties — covering at least eight hours worked after your last verification but before you expired.

What happens if I have not worked as a CNA in Iowa for over two years?

You test again. DIAL: ‘If a nurse aide does not work as a CNA for two years or more, the aide will have to retake both competency tests to get their status updated on the registry and to be eligible to work at a long-term care facility in Iowa.’ Note that Iowa asks for both tests, not just one, and note the alternative route above: if you actually did work qualifying hours during the period and nobody reported them, an employer letter can still fix the record.

How do I check whether someone is on the Iowa Direct Care Worker Registry?

Use DIAL’s own Direct Care Worker Registry and Health Facility Database. Its DCW search accepts an identification number, first name, last name, city, and one or more of Iowa’s 99 counties, and results can be downloaded as PDF or CSV. DIAL will not search on identifying data: ‘Registry staff will not search by personally identifiable information (e.g., date of birth or any part of a Social Security number)’, and the registry number ‘is the only unique identifying number that DIAL can publicly share or confirm.’ A search result has no address of its own, so you cannot bookmark or forward one. Allow at least two weeks after testing before expecting a new name to appear.

See every license and certification LicensingAtlas covers in Iowa.

Sources & verification

Last verified against these sources: August 16, 2026.

We re-fetch every cited source on a weekly schedule: see what changed at the agencies, or every correction we have ever made.

LicensingAtlas states licensing and certification requirements categorically from official sources. It is a reference, not legal or career advice, and requirements change frequently — confirm details with the issuing board before you act.