How to Become a CNA in North Dakota

Becoming a CNA in North Dakota requires 75 hours of approved training, passing a two-part competency exam, and placement on the state’s Nurse Aide Registry. The total cost runs from $940 to $1,555, or as low as $290 if an employer sponsors your training. North Dakota splits CNA oversight between two separate agencies, so knowing who handles what saves you time from the start.

Requirement	Details
Training hours	75 minimum (30 classroom + 45 clinical)
Timeline	4-10 weeks
Cost range	$650-$1,265 (or free through employer)
Exam fee	$250 (both parts)
Minimum age	16 years old
Education required	None (no high school diploma or GED needed)
Passing score	75% minimum
Registry	NDHHS Nurse Aide Registry

No education requirement means CNA certification is one of the most accessible healthcare career paths in North Dakota. You must be at least 16, pass a criminal background check, and complete an approved program. The two-agency structure — NDHHS for registry and training, NDBON for background checks and renewal — is explained below.

How to Become a CNA in North Dakota: Step-by-Step

Many people come to CNA certification at a crossroads. The path forward doesn’t require a degree, years of prerequisites, or tens of thousands in tuition.

“I need a little encouragement. Due to life’s circumstances I am starting my life again. The only thing I can afford at the moment is a CNA course.”
(223 upvotes, r/cna)

Here’s exactly what CNA certification looks like in North Dakota, broken into five steps with real costs at each stage.

Step 1: Meet Basic Eligibility Requirements.
You must be at least 16 years old. No high school diploma or GED is required (research.com). You’ll also need to pass a criminal background check before starting clinical training.

Step 2: Complete Your Background Check.
The North Dakota Board of Nursing (NDBON) manages the Criminal History Record Check for all CNA applicants. You’ll submit two fingerprint cards for both FBI and BCI checks. The fee is $40, paid to the ND Attorney General. You may also pay a separate fee to the fingerprinting agency you use. Submit your fingerprint cards as soon as you enroll, or even before. Processing typically takes 2-4 weeks, and most programs will not let you begin clinical hours until the check clears. Your training program’s admissions office can confirm the exact deadline for their start date.

Step 3: Complete an Approved Training Program.
NDHHS requires at least 75 hours of state-approved training — 30 classroom hours and 45 clinical hours. Programs run 4-10 weeks. Costs range from $650 to $1,265, or $0 with employer sponsorship.

Step 4: Pass the Competency Exam.
The exam has two parts: a written knowledge test (72 multiple-choice questions) and a skills evaluation (3-5 demonstrated skills). The combined fee is $250 (NDSCS). Passing score is 75% on both portions.

Step 5: Get Placed on the Nurse Aide Registry.
After passing both parts, NDHHS adds your name to the North Dakota Nurse Aide Registry. This is your official proof of certification and what employers verify before hiring. Registration is free for CNAs.

Cost component	Range
Training program	$650-$1,265 (or free)
Competency exam	$250
Background check	$40
Total	$940-$1,555 (or $290 with employer-paid training)

The detailed breakdown of each step starts with the part most people find confusing: North Dakota’s two-agency system.

Understanding North Dakota’s Two-Agency System

North Dakota splits CNA oversight between two agencies. Knowing which one to contact saves you time and misdirected phone calls.

I need to…	Contact	URL / Phone
Find an approved training program	NDHHS	hhs.nd.gov
Take the competency exam	NDHHS	hhs.nd.gov
Get placed on the Nurse Aide Registry	NDHHS	[email protected] / (701) 328-2352
Verify your CNA certification	NDHHS	services.ndhhs.gov/nurseaide/public/registryverification
Transfer my CNA from another state	NDHHS	Online application at hhs.nd.gov
Complete my background check	NDBON	ndbon.org/chrc/
Register as a UAP	NDBON	ndbon.org
Renew my certification	NDBON	NDBON Nurse Portal

NDHHS (Department of Health and Human Services)

NDHHS is your go-to for anything related to getting certified and staying on the registry. They approve training programs, manage the nurse aide competency exam, maintain the Nurse Aide Registry, and process reciprocity applications. Contact: [email protected] or (701) 328-2352.

NDBON (Board of Nursing)

NDBON handles the regulatory side: background checks, UAP registration, and certification renewal through the NDBON Nurse Portal. No other ND resource currently explains this split. RegisteredNursing.org links to NDBON for registry functions that NDHHS actually handles. If you contact the wrong agency, you’ll get redirected. This table prevents that.

Approved CNA Training Programs in North Dakota

North Dakota requires at least 75 hours of state-approved training, split between 30 classroom hours and 45 supervised clinical hours (NDHHS). Under ND Administrative Code 33-07-06, you must complete at least 16 of those classroom hours covering infection control, safety procedures, patient rights, and communication skills before any direct patient contact. Most programs run 4-10 weeks depending on schedule format.

Program Comparison

Four programs serve different regions of the state. Here’s how they compare:

Program	Location	Hours	Cost	Includes Textbook	Format
NDSCS (TrainND Southeast)	Wahpeton	75	$650-$750	No	Hybrid (online classroom + in-person clinical)
Bismarck State College	Bismarck	76	$689-$719	Yes	In-person
TrainND NW (Williston State)	Williston	80	$1,265	No	In-person
Lake Region State College	Devils Lake	80	~$689	Varies	In-person

Bismarck State is the only program that includes the textbook in tuition — textbooks typically add $30-$60 at other programs. TrainND Northwest in Williston costs nearly double the others and serves the western oil patch region. The geographic spread covers much of the state: Wahpeton (southeast), Bismarck (central), Williston (northwest), Devils Lake (northeast).

Browse all North Dakota CNA programs to compare options near you. Our guide to choosing a CNA program covers what to evaluate beyond cost.

How Much Does CNA Training Cost in North Dakota?

Training runs $650 to $1,265. Add the competency exam ($250) and background check ($40) to get your total certification cost.

Scenario 1: Self-pay, lowest cost

Item	Cost
Training (NDSCS/TrainND SE)	$650
Competency exam	$250
Background check	$40
Total	$940

Scenario 2: Self-pay, highest cost

Item	Cost
Training (TrainND NW, Williston)	$1,265
Competency exam	$250
Background check	$40
Total	$1,555

Scenario 3: Employer-sponsored training

Item	Cost
Training (facility-paid)	$0
Competency exam	$250
Background check	$40
Total	$290

Employer-sponsored training is worth investigating. Here’s proof it’s real:

“said facility paid for my CNA training and was my first ever job as a CNA”
(2,489 upvotes, r/cna)

Under federal law (42 CFR 483.152), Medicare and Medicaid-certified nursing facilities must provide or pay for CNA training for their employees. To find facilities offering paid training in North Dakota, contact nursing homes and long-term care centers directly and ask about NATCEP-sponsored positions. Rural areas with high CNA demand are the most likely to offer this.

Can You Take CNA Classes Online in North Dakota?

No fully online CNA programs exist in North Dakota. The state requires 45 hours of hands-on clinical practice at an approved facility, which can’t happen remotely. Some programs offer hybrid formats: Bismarck State and NDSCS allow online classroom instruction with in-person clinicals. If you need schedule flexibility, those hybrid options are the closest available.

Free CNA Training in North Dakota

Under the federal OBRA 1987 mandate (42 CFR 483.152), any Medicare or Medicaid-certified nursing facility must provide or pay for CNA training for employees who complete certification within 12 months of hire. In North Dakota, this means nursing homes, skilled nursing facilities, and some hospitals will train you at no cost if you commit to working there. This arrangement is especially common in rural ND where facilities compete for qualified applicants.

The CNA Competency Exam in North Dakota

North Dakota requires a two-part CNA exam covering both written knowledge and hands-on clinical skills. You must pass both parts with a minimum score of 75%.

Written Knowledge Test

The written exam has 72 multiple-choice questions covering material from your training: patient care, safety, infection control, communication, and patient rights. You have 90 minutes. An oral exam option is available for candidates with reading difficulties or for whom English isn’t a first language — contact NDHHS to request it before scheduling.

The written test covers the same content your training program taught. Learn how to study for the CNA exam with a structured approach before test day.

Skills Evaluation

You’ll perform 3 to 5 skills selected randomly from the full NATCEP skill list. An evaluator watches and scores each skill in real time. You have 30 minutes total. Common skills include handwashing, vital signs, patient positioning, ambulation, and personal care tasks.

These are the same skills you practiced during clinical training. For step-by-step walkthroughs of the most common skills, visit our CNA skills test preparation section.

Testing Vendor and Scheduling

North Dakota’s approved CNA test vendor is Headmaster (D&S Diversified Technologies). Exams are hosted at regional sites including NDSCS (Wahpeton) and Bismarck State, but all scheduling and results are managed through the Headmaster North Dakota portal. After completing your training program, your instructor submits your eligibility to Headmaster’s testing system. Schedule your exam through the portal once your eligibility is confirmed. Testing is available at regional sites across the state, including Wahpeton, Bismarck, and other locations listed on the Headmaster site. If you have questions about scheduling or test site availability, contact Headmaster directly through the portal.

Before test day, work through a CNA practice exam to get familiar with question format and pacing.

Retake Rules

If you fail either portion, you retake only that portion — not the one you passed. Written retest: $95. Skills retest: $195. You have two retake attempts within two years of completing training. After two failures on either portion, you must complete a new training program before retesting.

Read more about retaking the CNA exam for preparation strategies.

The exam is a real challenge, but people pass it every day, including first-time test-takers straight out of high school programs.

“i’m 17 in HS and went through a career and technology program in my school where i can get my cna. i’m low key proud of myself”
(671 upvotes, r/cna)

Once you pass both portions, your name goes on the North Dakota Nurse Aide Registry and you can begin working as a CNA immediately.

The CNA Challenge Test in North Dakota

If you have healthcare experience but no formal CNA training, North Dakota may allow you to take the competency exam without completing a training program. This pathway is called the challenge test, and zero other ND resources currently cover it.

Who Qualifies

NDHHS evaluates eligibility case by case. Individuals who typically qualify include nursing students who have completed clinical fundamentals, military medics, and experienced but uncertified healthcare workers who can document they’ve performed CNA-level skills in a healthcare setting. NDHHS compares your documented experience against the state’s 75-hour training curriculum standards.

How to Apply

Contact NDHHS at [email protected] or (701) 328-2352 to request an eligibility review before scheduling anything. If approved, you sit for the same two-part exam as standard candidates: the same written test, the same skills evaluation, the same $250 fee, and the same 75% passing standard. Since you’re skipping formal training, review the full NATCEP skill list thoroughly before test day.

Background Check Requirements for CNAs in North Dakota

The Criminal History Record Check (CHRC) is required for all Unlicensed Assistive Personnel in North Dakota, including CNAs. NDBON manages this process, not NDHHS — one of the key two-agency distinctions that matters practically.

What the CHRC Covers

You’ll submit two completed fingerprint cards (or one electronic submission) to NDBON. Both the FBI and BCI (ND Bureau of Criminal Investigation) checks are run (NDBON CHRC FAQ). The fee is $40, payable to the North Dakota Attorney General. Processing typically takes 2-4 weeks. Because you cannot begin clinical hours without a cleared check, submit your fingerprint cards at least 3 weeks before your program’s clinical start date. Late filing is a common reason students are delayed or dropped from their cohort.

Disqualifying Offenses

A criminal record doesn’t automatically disqualify you. North Dakota uses a “substantially related” standard: NDBON evaluates whether your criminal history is substantially related to the duties of a CNA (NDBON). Offenses involving patient abuse, neglect, financial exploitation, or misappropriation of patient property are typically disqualifying. Less serious offenses are reviewed based on recency, nature, and evidence of rehabilitation. For specific questions about your situation, the NDBON CHRC FAQ outlines the review process in detail.

CNA Reciprocity in North Dakota

North Dakota CNA reciprocity is free and requires no additional exams or fingerprinting. If you hold an active CNA certification in good standing from any US state, territory, or DC, you can transfer to North Dakota through a straightforward online application.

Requirements

• Active CNA certification in good standing from any US state, territory, or DC
• No additional exams required
• No fingerprinting required for reciprocity transfers
• Application submitted online to NDHHS (reciprocity is handled by the registry side, not NDBON)

Both TheCNAGuide.com and Credenza Health confirm North Dakota as a free reciprocity state. Many states charge fees or require additional exams. North Dakota does neither.

How to Apply

Submit your application online through NDHHS. NDHHS verifies that your existing credentials meet federal and state standards. For processing status, contact [email protected] or (701) 328-2352. After your transfer is confirmed, check your status on the Nurse Aide Registry to confirm placement.

How to Renew Your CNA in North Dakota

North Dakota CNA renewal is free and happens every two years through the NDBON Nurse Portal. Your registry status lives at NDHHS, but renewal is processed through NDBON.

Renewal Requirements

Renewal is required every two years. You must have completed at least 8 hours of paid nursing or nursing-related work during the 24-month renewal period. The renewal fee is $0. Complete your renewal online at the NDBON Nurse Portal. NDBON sends renewal reminders before your expiration date.

What Happens If Your Certification Lapses

If you don’t complete 8 hours of paid nursing work within 24 months, your certification expires. There is no “inactive” status that preserves it. Reinstatement typically requires retaking the competency exam or completing a new training program. Contact NDHHS at [email protected] for your specific reinstatement options.

CNA Salary in North Dakota

According to the May 2023 BLS Occupational Employment and Wage Statistics (the most recent available), the average CNA salary in North Dakota is $44,190 per year, or approximately $21.24 per hour. That’s about 12% above the national average of $39,530. North Dakota employs approximately 6,920 CNAs statewide.

Some older resources still cite figures around $23,786/yr for North Dakota CNAs. That data is years out of date — current BLS data shows nearly double that figure.

Salary Distribution

Level	Annual Salary	Hourly Rate	Source
10th percentile (entry)	$33,150	~$15.94	BLS May 2023
25th percentile	$37,760	~$18.15	BLS May 2023
Mean	$44,190	~$21.24	BLS May 2023
75th percentile	$49,700	~$23.89	BLS May 2023
90th percentile	$56,280	~$27.06	BLS May 2023

Entry-level positions start around the 10th-25th percentile range. Most CNAs reach the mean within a few years through experience, shift differentials, or moves to higher-demand facilities.

CNA pay in North Dakota is above average, but the work is physically demanding.

“I hate this job. Every day it’s something new. My muscles hurt, my thighs and calves and feet and back and neck hurt… this job is physically and mentally NOT SUSTAINABLE”
(444 upvotes, r/cna)

These realities don’t mean CNA work is impossible or not worth pursuing. They mean that going in with accurate expectations and a plan for self-care matters as much as the certification itself.

Many CNAs enter the field planning to advance to LPN or RN. For some, the experience confirms that plan. For others, it changes it entirely.

“I’m currently a CNA with 3 years experience at a hospital. When I first started this job I had the intention of being a nurse. That quickly faded. I’m getting ASSAULTED by dementia/CIWA patients daily.”
(~303 upvotes, r/cna)

Whether CNA work reinforces or redirects your career goals, the certification gives you firsthand healthcare experience that no classroom can replicate. Explore CNA career paths to see where your certification can lead.

Pay by Region

BLS publishes metro-area wage data for North Dakota’s largest employment centers. Rural and western oil-region facilities generally pay above the state mean due to higher demand and fewer available CNAs. If you’re flexible on location, targeting a rural or energy-sector facility is the fastest path to above-average pay without changing roles.

Learn more about why become a CNA in North Dakota and how the state’s labor market positions new CNAs.