Missouri — The Show-Me State
Missouri requires 175 total training hours — more than most states — but facility-based programs run by nursing homes are frequently completely free, and the Missouri Health Care Association's online-centered track lets you complete much of your training on your own schedule.
Missouri is different from most states: it requires 175 total training hours — 75 hours of classroom instruction plus 100 hours of on-the-job training — well above the 75-hour federal minimum most states use. This means Missouri isn't a "2-week" state, but it has a genuine speed-and-cost advantage other states don't: facility-based programs run by nursing homes and hospitals are frequently completely free, since your 100 on-the-job hours are built directly into paid or supervised work at the facility.
The Missouri Health Care Association (MHCA) runs one of the state's few online-centered programs: 75 hours of online coursework (100 days to complete) plus 100 required hours of on-the-job training at a partner facility, for a $135 total exam fee. The competency exam is the Missouri Nurse Assistant Competency Exam (MO-NACE), administered by D&S Diversified Technologies (Headmaster) — not Prometric, despite what some older sources claim. You must take MO-NACE within 12 months of starting your training program.
Use our verified school locator below to instantly find DHSS-approved facility-based and school-based programs starting near your zip code — from St. Louis and Kansas City to Springfield and beyond.
Most states use the 75-hour federal minimum. Missouri requires 175 hours total: 75 hours of classroom instruction plus 100 hours of on-the-job training, per Section 198.082 RSMo and the Omnibus Nursing Home Act. This is why school-based Missouri programs typically run 8-16 weeks rather than 3-4. The upside: because 100 of those hours are on-the-job, facility-based programs can fold your training directly into paid or supervised work — making Missouri one of the better states for a genuinely free path to certification, even if it isn't the fastest.
Speed & cost comparison
Because Missouri's 175-hour requirement rules out true "2-week" programs, the real advantage is cost — facility-based training routinely costs nothing. Here are Missouri's best speed-and-cost combinations.
| Program / School | Location | Speed | Cost | What Makes It Special |
|---|---|---|---|---|
| Facility-Based Training Agencies | Nursing homes statewide | Varies — often fastest to a paycheck | Often FREE (6-12 mo. commitment) | 100 on-the-job hours built into paid or supervised work at the facility. DHSS-approved list published at data.mo.gov. |
| Missouri Health Care Association (MHCA) | Statewide (online-centered) | 100 days for online portion | $135 exam fee; contact for tuition | 75 hours online coursework, self-paced within 100 days, plus 100 hours on-the-job training at a partner facility. Multiple 2026 cohort start dates. |
| St. Charles Community College | St. Charles (St. Louis metro) | Standard or accelerated tracks | Community college rates | Choice of online or on-campus instruction, both paired with a months-long clinical internship. Practice tests and exam guidance included. |
| Seasons Care Center | Kansas City | Contact for schedule | Contact for tuition | State-approved training provider. One of 8 CNA programs available in the Kansas City area. |
| St. Louis Job Corps | St. Louis | Full residential program | FREE — federal program | Part of the largest free education program in the United States. Includes paid-for training and daily living expenses. |
| Clyde C. Miller Career Academy | St. Louis | High school career pathway | FREE for enrolled students | Career and technical education with senior-year internships. Unique early-entry pathway for young Missourians. |
Because 100 of Missouri's 175 required hours are on-the-job training, a facility-based program run by a nursing home effectively lets you start working (and often earning) from day one while your training hours accumulate. Most require a 6-to-12-month employment commitment after certification, but the training itself is frequently completely free. Always verify the facility appears on DHSS's official approved list at data.mo.gov before enrolling.
If you're a nursing student who completed a Fundamentals of Nursing course with clinical rotation in the last five years, a nursing graduate who failed the state licensure exam, or someone with equivalent UAP/PCT training at 175+ hours, you may qualify to "challenge" the MO-NACE exam directly — skipping the training program altogether. Challengers get only one attempt, so this route makes sense only if you're confident in your existing preparation.
2026 salary data
Missouri CNAs earn a median of $30,198-$36,260/year ($14-$17.43/hr) — below the national average. Kansas City ranks as the 10th top-paying metro area in the country for CNAs at nearly $16/hr, and Southeast Missouri is one of the top nonmetropolitan areas nationally for CNA job concentration.
| City / Area | Avg Hourly | Avg Annual | Key Notes |
|---|---|---|---|
| St. Louis | $14–$16/hr | ~$29,120–$33,280 | Nearly 20,000 CNAs employed — highest concentration in the state. Multiple free training pipelines including Job Corps. |
| Kansas City | $15–$17/hr | ~$36,260 | 10th top-paying metro area in the country for nursing assistants. 8 CNA programs available including free options. |
| Springfield | $14–$16/hr | ~$29,120–$33,280 | Southwest Missouri healthcare hub with steady CNA demand. |
| Southeast Missouri (nonmetro) | $13–$15/hr | ~$27,040–$31,200 | One of the country's top nonmetropolitan areas for CNA employment, with nearly 4,000 CNA jobs. |
| Top 10% (statewide) | $19+/hr | ~$40,000 | Hospital and specialty-unit positions pay significantly above the state average. |
Sources: BLS OES May 2024, CNAClasses101.com Missouri (2026), CNAClasses.com Missouri (2026). Missouri's below-average CNA wages are partially offset by a lower cost of living statewide. Actual pay varies by facility, shift, and experience.
Landing your first job
Financial aid & free options
Your next step
Missouri LPN bridge programs are available through community colleges and vocational schools statewide, both online and on-campus. Because Missouri is a full NLC compact state, an LPN license earned here carries multistate practice privileges across 43 jurisdictions.
175 hours total (75 classroom + 100 on-the-job). MO-NACE exam via D&S Headmaster, $135. Missouri Nurse Aide Registry. Facility-based programs often free.
Community colleges and vocational schools statewide, online and on-campus. ~12 months. Missouri's NLC membership means multistate practice rights on graduation.
University of Missouri, Saint Louis University, and numerous ADN bridge programs statewide. Missouri's compact license carries across 43 NLC jurisdictions.
For moms in Missouri