Michigan CNA Exam 2026: The Complete Nurse Aide Competency Guide
Michigan requires every paid nurse aide working in a federally certified nursing facility to complete a state-approved training program, pass the Michigan Nurse Aide Competency Evaluation, and be listed on the Michigan Nurse Aide Registry. The program is overseen by the Michigan Department of Licensing and Regulatory Affairs (LARA), Bureau of Community and Health Systems (BCHS) and delivered by D&S Diversified Technologies LLP / Headmaster (D&SDT-Headmaster) through the Michigan TestMaster Universe (TMU) portal at mi.tmutest.com.
Heads up — Michigan does NOT use Prometric. Some older guides still list Prometric as the Michigan vendor. LARA's current contract is with Headmaster via TMU. The Headmaster Michigan Candidate Handbook effective January 1, 2025 is the authoritative rulebook for 2026 testing.
This 2026 guide walks through every step — LARA approval, Headmaster registration, the 65-question knowledge test, the full 17-task Michigan skill list, the new 2026 continuing-education rule, MI-NATES registry mechanics, reciprocity from 43 approved states, and Michigan CNA salaries in Detroit, Grand Rapids, and Lansing.
Michigan CNA Exam at a Glance
| Component | Details |
|---|---|
| Official name | Michigan Nurse Aide Competency Evaluation (Knowledge + Skill) |
| Regulator | Michigan LARA — Bureau of Community and Health Systems (BCHS) |
| Test vendor | D&SDT-Headmaster via mi.tmutest.com |
| Knowledge test | 65 multiple-choice questions, 60 minutes (written or audio) |
| Skill test | 3–4 tasks randomly drawn from 17 published skills, 30 minutes total |
| First task | Always one of the "mandatory first tasks" (bedpan with output, catheter care, or PPE with urinary drainage) |
| Hand hygiene | Evaluated inside several tasks (not a standalone skill) |
| Training requirement | 75 hours minimum (federal OBRA floor) per Michigan NATCEP approval |
| Attempts | Up to 3 attempts within 24 months of training to pass both parts |
| Passing scores | 74% knowledge test / 80% on each skill task (every critical step correct) |
| MI-NATES initial fee | $20 initial application (new Michigan CNA) |
| MI-NATES renewal fee | $40 every 24 months (effective March 7, 2024) |
| CE rule (effective March 23, 2026) | 12 hours CE annually / 24 hours per renewal period — must include abuse, neglect, and care plan training |
| Work requirement for renewal | At least 40 paid hours of nursing or nursing-related services during the prior 24-month cycle |
| Temporary Nurse Aide (TNA) | Work up to 4 months in a Michigan facility after graduation while awaiting Headmaster testing |
| Reciprocity fee | $40 application fee (out-of-state CNAs applying into Michigan) |
| Handbook in force | Michigan Candidate Handbook, effective January 1, 2025 |
Step 1: Complete a LARA-Approved Michigan Nurse Aide Training Program
Federal OBRA '87 sets a 75-hour minimum for nurse aide training nationwide. Michigan adopts that floor exactly (one of roughly 30 states that stays at 75 hours — California, Florida, New York, and Virginia require more). Your program must be on the LARA BCHS list of approved Michigan Nurse Aide Training and Competency Evaluation Programs (NATCEP).
Typical approved Michigan pathways:
- Community colleges and ISDs — Schoolcraft, Oakland CC, Macomb CC, Washtenaw CC, Grand Rapids CC, Wayne County CC, Lansing CC, Mott CC, Kellogg CC, and most intermediate school districts
- Long-term care employer-sponsored programs — free training in exchange for a 6- to 12-month work commitment at the sponsoring facility
- American Red Cross Michigan chapter (traditional fee-based program)
- High school health-science academies for students 16+
- Private schools such as Ross Medical, Dorsey Schools, and hospital-based academies
Your program must provide classroom instruction and supervised clinical practice. You cannot have direct resident contact until you have completed at least 16 hours of classroom instruction covering infection control, safety, communication, emergencies, and residents' rights (federal 42 CFR 483.152).
Waivers and Alternate Routes
You may sit for the exam without a full Michigan NATCEP if you are:
- A nursing student who completed a Fundamentals of Nursing course at an approved nursing program
- A foreign-trained nurse with credentials accepted by LARA
- A military medic or corpsman with documented equivalent training
Document your equivalency with LARA BCHS before scheduling in TMU — contact BCHS-CNA-Registry@michigan.gov or (517) 284-8961.
Try a FREE Michigan CNA Practice Test
Our Michigan-aligned question bank mirrors the D&SDT-Headmaster blueprint — Role of the Nurse Aide, Communication, Resident Rights, Psychosocial Care, Cognitive Care, Basic Nursing Skills, Personal Care, Restorative Services, Safety, Infection Control, Data Collection, and Resident Care scenarios.
Step 2: Register for the Headmaster Competency Evaluation (TMU)
- Go to mi.tmutest.com and create a candidate TMU account (email address becomes username)
- Enter demographics exactly as they appear on your Social Security card
- Confirm your training program reported your eligibility to Headmaster
- Choose knowledge-only, skill-only, or the combined event
- Select written or audio format for the knowledge test
- Pay by credit/debit card or redeem an employer voucher
The 24-Month / 3-Attempt Window
Federal law gives you three attempts within 24 months of completing training to pass both the knowledge and skill tests. Miss that window (or exhaust all three attempts) and you must complete a new LARA-approved training program before testing again.
2026 Headmaster Fees (Michigan)
Testing fees are published in the Michigan Candidate Handbook effective January 1, 2025. The combined knowledge-plus-skill event typically runs around $125 for first-time candidates; retakes are priced per component. Always confirm the exact amount displayed in your TMU cart before submitting payment — Headmaster updates state schedules periodically, and the TMU cart price governs.
| Component | Typical fee |
|---|---|
| Knowledge test only (written) | ~$32 |
| Audio knowledge (ESL-friendly) | ~$37 (add ~$5) |
| Skill test only | ~$93 |
| Combined knowledge + skill | ~$125 |
Fees are non-refundable once you are scheduled into a test event. Rescheduling at least 3 business days before the event is free in TMU.
MI-NATES Registry Fee (Separate From Testing)
Passing the Headmaster test is step one. Step two is paying the separate $20 initial application fee in MI-NATES to get your official Michigan CNA certificate and placement on the Nurse Aide Registry. Without that step, you are not a Michigan-certified CNA even if you passed testing. The $40 fee applies at every 24-month renewal — it is not the price of your very first registration.
Work as a Temporary Nurse Aide (TNA) While You Wait
After you graduate from a LARA-approved program but before you test, Michigan lets you work as a Temporary Nurse Aide for up to 4 months in a federally certified facility. Your employer reports you to LARA as a TNA. If you have not passed both Headmaster parts within that 4-month window, you cannot continue working until you do. Use TNA time to bank paycheck hours while you drill for the exam.
Step 3: The Knowledge Test — 65 Questions, 60 Minutes
The Michigan knowledge test is a single 65-item multiple-choice test drawn from federal OBRA '87 subject areas. Every item is four-option multiple choice. There is no guessing penalty — answer every question.
Subject categories (Headmaster Michigan test plan):
- Role of the Nurse Aide (scope of practice, delegation, chain of command)
- Communication (verbal, nonverbal, active listening, cultural sensitivity)
- Resident Rights (OBRA rights, HIPAA, grievance procedures, advance directives)
- Psychosocial Care — Mental Health and Social Needs
- Care of the Cognitively Impaired (dementia, validation, redirection)
- Basic Nursing Skills (vital signs, observation, I&O, positioning)
- Personal Care Skills (bathing, grooming, perineal care, dressing)
- Restorative Services (ROM, ambulation, prosthetics)
- Safety / Emergency (falls, fire, choking, restraints)
- Infection Control (standard and transmission-based precautions)
- Data Collection & Reporting (observation, documentation, change-in-condition)
- Resident Care scenarios (clinical vignettes)
Michigan does not publish a fixed per-category count. Master the entire OBRA blueprint rather than chasing "heaviest" domains.
Audio (Oral) Option for ESL / Slow Readers
If English is your second language, Headmaster's audio version reads each item aloud through headphones. It typically adds a few dollars to the fee but does not change the passing standard. Audio is the single highest-value accommodation candidates underuse — if you read slowly, take it.
Step 4: The Skill Test — 17 Published Tasks, 3–4 Drawn at Random
An Headmaster Nurse Aide Evaluator pulls three or four skills at random from Michigan's published list of 17 skill tasks. You have 30 minutes total. To pass each task you must perform every critical (key) step correctly and earn at least 80% of all listed steps on that task.
Your first skill is always one of the "possible mandatory first tasks" that exercise hand-washing and PPE technique: bedpan with urine measurement, catheter care on a manikin, or don/doff PPE with urinary drainage bag and output measurement. Miss hand hygiene or ID steps here and everything downstream is harder.
The 17 Michigan Skill Tasks (Mock Skills, effective January 1, 2025)
| # | Task |
|---|---|
| 1 | Apply a Knee-High Anti-Embolic (Elastic) Stocking to a Resident's Leg |
| 2 | Assist a Resident to Ambulate Using a Gait Belt |
| 3 | Assist a Resident with the Use of a Bedpan, Measure and Record Urine Output WITH HAND WASHING (possible mandatory first task) |
| 4 | Catheter Care for a Female Resident WITH HAND WASHING (manikin; possible mandatory first task) |
| 5 | Denture Care — Clean an Upper or Lower Denture (single plate) |
| 6 | Donn [Put On] PPE (Gown & Gloves), Empty a Urinary Drainage Bag, Measure and Record Output, and Doff PPE WITH HAND WASHING (possible mandatory first task) |
| 7 | Dress a Resident with an Affected (Weak) Side in Bed |
| 8 | Assist a Dependent Resident with a Meal in Bed |
| 9 | Foot Care for a Resident on One Foot |
| 10 | Modified Bed Bath — Whole Face and One Arm, Hand, and Armpit |
| 11 | Mouth Care — Brush a Resident's Teeth |
| 12 | Passive Range of Motion for a Resident's Hip and Knee |
| 13 | Passive Range of Motion for a Resident's Shoulder |
| 14 | Perineal Care for a Female Resident WITH HAND WASHING |
| 15 | Position a Dependent Resident in Bed on Their Side |
| 16 | Transfer a Resident from Their Bed to a Wheelchair Using a Gait Belt |
| 17 | Vital Signs: Count and Record a Resident's Radial Pulse and Respirations |
Note: Manikins are used only for the catheter care skill (Task 4). Every other skill uses a live actor playing the resident. Stocking, dressing, bed bath, and perineal care use a clothed/partially draped actor — you expose only what the task requires.
Universal Critical Steps (apply to almost every task)
- Knock and greet the resident; introduce yourself by name and title
- Explain the procedure in plain language, even if the actor stays silent
- Perform hand hygiene (sanitizer to dryness) before touching the resident
- Provide privacy — close door and pull the privacy curtain
- Raise the bed to working height and lock bed brakes
- Expose only the body part required by the task
- Use proper body mechanics at all times (bent knees, neutral spine)
- At the end: lower the bed, place the call light within easy reach, and perform hand hygiene again
- Maintain respectful, courteous interpersonal interactions throughout (Headmaster scores this)
- Record/report measurements within tolerance — urine output within 25 mL of the RN Observer's measurement
Miss any of these and the entire task fails. Practice them until they are automatic.
Build Your Skills Checklist Knowledge
Our AI tutor walks you through each of the 17 published Michigan tasks with the exact key-step sequence Headmaster evaluators score against — with the "why" behind each step so the sequence sticks under test-day pressure.
6-Week Michigan CNA Study Plan
| Week | Focus | Daily Goal |
|---|---|---|
| 1 | Role of NA + Resident Rights + Communication | 30 practice questions/day |
| 2 | Safety + Infection Control + Mandatory-first-task drill (Tasks 3, 4, 6) | 30 questions + PPE rehearsal aloud |
| 3 | Personal Care (Tasks 7, 10, 11, 14) + Restorative Services (Tasks 12, 13) | Practice 5 personal-care tasks with a partner |
| 4 | Basic Nursing Skills + Vital Signs (Task 17) | Master radial pulse and respirations; 40 questions/day |
| 5 | Transfers + Ambulation (Tasks 2, 16) + Cognitive/Mental Health content | Full 65-question timed practice exam |
| 6 | Final review + 3 timed practice tests | Mock skill test with timer; rehearse all 17 tasks |
Most Michigan candidates need 40–80 hours of focused review on top of their formal 75-hour training program.
Michigan-Specific Pitfalls That Fail Candidates
Headmaster evaluators are strict on procedural sequencing. The failures below drive most Michigan retakes:
- Reading questions too fast — knowledge items often hinge on a single qualifier ("first", "best", "most appropriate"). Slow down on every "first/initial" prompt and look for the safety-priority answer.
- Forgetting that the first task is always one of three — practice bedpan-with-output, catheter care, and PPE-with-drainage until the whole sequence (including hand washing at the sink) is automatic.
- Using sanitizer when soap and water are required — mandatory-first-tasks and perineal/catheter care require a full soap-and-water hand wash at the sink, not sanitizer. Failing to turn off the faucet with a clean, dry paper towel fails the task.
- Output measurement outside the 25 mL tolerance — place the graduate on a flat surface, squat so the meniscus is at eye level, and record what you read, not what you expect.
- Skipping the "explain the procedure" step because the actor stays silent — say it anyway; evaluators score what they hear.
- Forgetting to lock wheelchair brakes before any transfer (Tasks 2 and 16) — automatic failure on the transfer.
- Gait belt under the armpits or too loose — belt belongs at the waist over clothing, tight enough that two fingers fit underneath.
- Counting respirations visibly — keep your fingers on the wrist as if checking the pulse, then count for a full 60 seconds so the rate stays natural (Task 17).
- Letting the call light fall out of reach at the end of a task — place it on the unaffected side and verify the resident can press it.
- Rolling or bunching the anti-embolic stocking (Task 1) — leave it smooth and wrinkle-free and check the toes for pressure before lowering the bed.
- Forgetting MI-NATES after passing testing — Headmaster reports your pass to LARA, but your Michigan certificate is NOT active until you log into MI-NATES, pay the $40 application fee, and print the certificate.
Test-Day Checklist
The Michigan Candidate Handbook lists what you must bring and what is forbidden. Show up unprepared and Headmaster will turn you away without a refund.
- ✅ Two forms of ID — one government photo (driver's license, state ID, or passport) plus one signed secondary (Social Security card, employer badge, or credit card)
- ✅ Admission ticket / scheduling confirmation printed from TMU with your candidate ID number
- ✅ Closed-toe non-slip shoes and clean scrubs; hair tied back above the collar; no artificial nails, no nail polish, fingernails trimmed short
- ✅ Wristwatch with a second hand — no smartwatches, no fitness trackers, no phone clocks
- ✅ Arrive 30 minutes early — late arrival forfeits your fee with no makeup option
- ❌ No phone, books, notes, gum, food, or beverages in the testing room; lockers are usually provided
- ❌ No jewelry other than a plain wedding band and small stud earrings
If sick, snowed in, or facing an emergency, call Headmaster the day before at 888-401-0462 to reschedule without losing the fee.
Practice Like It's Test Day
Use the Test-Mode option to time yourself for the full 60 minutes on 65 questions. Review every wrong answer with our AI tutor before your second pass.
After You Pass: MI-NATES and the Michigan Nurse Aide Registry
Step 1 — Apply in MI-NATES
After Headmaster reports your passing scores, log into your MILogin account and request access to MI-NATES (Michigan Nurse Aide Training and Enforcement System). Submit your nurse aide application, pay the $20 non-refundable initial application fee online, and LARA issues your Michigan registration number. You appear on the public BCHS Nurse Aide Public Registry immediately. (Note: MI-NATES is not compatible with Safari — use Chrome or Edge.)
Michigan does not issue paper cards by default — log in to MI-NATES, select "View/Print Certificate," and save or print it for your employer.
Step 2 — Renew Every 24 Months
Your Michigan CNA certificate expires every 24 months. To renew in MI-NATES you must attest to both of the following:
- Work: at least 40 paid hours of nursing or nursing-related services during the prior 24-month renewal cycle. Paid hours worked as a Michigan Certified Medication Aide (CMA) count toward this requirement.
- Continuing education: 24 hours of CE per renewal period — 12 hours per calendar year — effective March 23, 2026 (Rule R 400.315). CE must include abuse, neglect, and care plan training. Renewal is $40.
You can renew as early as 45 days before your expiration date. LARA emails a 45-day renewal reminder if your MI-NATES email is current.
Michigan CE — What Actually Counts
Michigan accepts CE from nursing board courses, colleges, approved CE vendors, and in-service training provided by your employer. Common gotchas:
- Combined abuse/neglect courses satisfy both topic requirements in one — no need to take two separate courses
- Nursing-home employees typically meet the 12-hour requirement through employer in-services alone
- Home-health and non-facility CNAs must seek CE independently — budget-friendly option: the MWTEC CE package (~$50) covers all required Michigan topics
- Implicit bias training (1 hour/year) and human trafficking training (one-time) are required for most Michigan health professionals — counts toward the 12-hour annual total
- No upload at renewal. You attest in MI-NATES and keep documentation (course name, location, hours, topic, date completed) for 4 years in case LARA audits you under R 400.315
Lapsed Certificates
- Lapsed less than 2 years — renew in MI-NATES by attesting to the CE and work hours.
- Lapsed 2 years or more — you must retake a LARA-approved training course AND the Headmaster competency exam.
Michigan does not maintain a detailed history of lapsed periods longer than about 7 years, so keep your own employment records if you plan to re-enter later.
Reciprocity Into Michigan (Out-of-State CNAs)
Michigan accepts reciprocity from 43 approved states under Section 333.21913 of the Michigan Public Health Code. Your out-of-state program must have:
- Complied with federal OBRA '87 (42 CFR Part 483) requirements
- Included at least 75 course hours
- Included a competency evaluation (no exemptions)
You must also be in good standing with no substantiated findings of abuse, neglect, or misappropriation.
Process:
- Create a MILogin account, then request MI-NATES access.
- In MI-NATES, file the out-of-state application (no paper forms, no fingerprints).
- Pay the $40 non-refundable application fee.
- Michigan pulls your home-state verification electronically and issues a Michigan registration number.
Approved states (MI-NATES list as of January 2026): Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin, and additional states per the LARA BCHS Nurse Aide Registry page. Confirm your state's status on the official page before paying.
Reciprocity OUT of Michigan
Important: LARA/BCHS no longer completes reciprocity forms for other states and does not process paperwork for Michigan CNAs seeking to transfer out. The destination state pulls your Michigan record directly from the public Nurse Aide Registry. Apply through the target state's registry and provide your MI registration number.
BCHS Nurse Aide Registry Contact
- Phone: (517) 284-8961
- Email: BCHS-CNA-Registry@michigan.gov
- MI-NATES/MILogin Technical Help: 1-833-757-7309 or LARA-BCHS-App-Help@michigan.gov
- Public Registry Lookup: nurseaideregistry.apps.lara.state.mi.us
Michigan CNA Salary & Job Outlook (2026)
Michigan employs roughly 40,000+ certified nursing assistants across nursing homes, hospitals, home health, and hospice. April 2026 aggregator and BLS data:
| Source | Hourly | Annual |
|---|---|---|
| BLS (Michigan CNA OEWS) | ~$16.50 | ~$34,320 |
| ZipRecruiter (MI average, March 2026) | ~$17.49 | ~$36,375 |
| Vivian / travel rates | $18–$22 | $37,000–$46,000 |
| Salary.com (MI median) | ~$18.72 | ~$38,920 |
| Indeed (MI average) | ~$20.00 | ~$41,600 |
By Michigan metro (2026):
- Detroit-Warren-Dearborn: $18.00–$19.50/hr (hospital systems pay top of range)
- Grand Rapids: ~$17.06/hr (PayScale April 2026)
- Lansing / East Lansing: $16.75–$18.50/hr (Sparrow, McLaren)
- Ann Arbor: $19.00–$22.00/hr (Michigan Medicine premium)
- Flint / Saginaw: $16.00–$17.50/hr
- Kalamazoo: $17.25–$18.75/hr (Bronson Healthcare)
Sign-on bonuses of $1,000–$3,000 are common at Henry Ford Health, Corewell Health (formerly Beaumont + Spectrum), Michigan Medicine, Trinity Health Michigan, and McLaren system hospitals. Night and weekend differentials typically add $1.50–$3.00/hr.
Michigan CNA → CMA → LPN → RN Ladder
Michigan has a well-defined career ladder:
- CNA → Certified Medication Aide (CMA): additional LARA-approved training; CMA hours count for CNA renewal; MI CMA wages typically $19–$22/hr
- CNA → LPN: 12–18 months at Schoolcraft, Mott CC, Lansing CC, or Wayne County CC (Michigan LPN median ≈ $56,000)
- LPN → ADN → BSN: 1–4 additional years; Michigan RN median ≈ $79,000
Many Michigan long-term care and hospital employers reimburse tuition for CNAs advancing into LPN/RN programs.
Pass the Michigan CNA Exam — Free, Today
Our Michigan-aligned course covers every Headmaster subject area, every one of the 17 testable skill tasks, and includes:
- Hundreds of practice questions matched to the Michigan Candidate Handbook (effective January 1, 2025) blueprint
- Step-by-step skill checklists with critical steps highlighted — including the three possible mandatory first tasks
- AI-powered explanations for any wrong answer
- Timed mock exams that match the 65-question, 60-minute format
- Updated April 2026 for the current handbook and the March 23, 2026 continuing-education rule
No credit card. No paywall. Just pass.
Official Michigan CNA Resources
- Michigan LARA — Nurse Aide Registry — official regulator page
- BCHS Nurse Aide Public Registry Lookup — verify your status
- Michigan LARA — Nurse Aide Trainers and Training Programs
- Headmaster Michigan CNA Testing Hub
- Michigan TMU Scheduling Portal — create your candidate account
- Michigan Mock Skills PDF (effective January 1, 2025) — full 17-task list
- Michigan MI-NATES FAQs (January 22, 2026)
- Headmaster testing: 888-401-0462 | michigan@hdmaster.com
- LARA BCHS Nurse Aide Registry: (517) 284-8961 | BCHS-CNA-Registry@michigan.gov
- MI-NATES Technical Help: 1-833-757-7309 | LARA-BCHS-App-Help@michigan.gov
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