Ohio STNA Exam 2026: The Complete State Tested Nurse Aide Guide
In Ohio, a Certified Nursing Assistant is officially called a State Tested Nurse Aide (STNA) -- but the job is the same: provide direct, hands-on care to residents in nursing homes, hospitals, hospices, and home-health settings under the supervision of a licensed nurse. To work as an STNA in Ohio, you must complete a 75-hour ODH-approved training program and pass a two-part competency exam administered by D&S Diversified Technologies (Headmaster) under the authority of the Ohio Department of Health (ODH).
This guide walks you through everything Ohio-specific: the exact 79-question written test, all 21 skills on the current Ohio skills list, the $120 fee structure, the 2-year/3-attempt rule, the 24-month registry renewal rule, and reciprocity from other states. Every claim below is verified against the official ODH and Headmaster (hdmaster.com) sources for 2026, including the Ohio Nurse Aide Candidate Handbook Version 27 (effective December 1, 2025) -- the current rulebook that introduced major skill-list and fee changes most competing guides still have not caught.
Quick-Look: Ohio STNA Exam at a Glance
| Item | Detail |
|---|---|
| Official Name | State Tested Nurse Aide (STNA) |
| Regulator | Ohio Department of Health (ODH) |
| Test Vendor | D&S Diversified Technologies / Headmaster |
| Handbook Version | Version 27 (effective December 1, 2025) |
| Training Required | 75 hours minimum (59 classroom/lab + 16 clinical) |
| Written Questions | 79 multiple-choice |
| Written Time | 90 minutes |
| Written Passing Score | 70% (about 56 of 79 correct) |
| Skills Tested | 3 or 4 tasks randomly drawn from a list of 21 |
| Skills Time | 35 minutes total |
| Skills Passing Score | 80% of non-key steps AND every bolded key step on each task |
| Total Fee | $120 ($30 knowledge + $90 skills); audio knowledge is $40 + $90 = $130 |
| Attempts Allowed | 3 within 2 years of training completion |
| Renewal | Every 24 months -- work at least 7.5 consecutive paid nurse-aide hours |
| Minimum Age | 16 (most programs require 18) |
Start Your FREE Ohio STNA Prep Today
No signup, no credit card. Practice questions modeled directly on the D&S Headmaster blueprint, AI explanations for every wrong answer, and the full 21-skill checklist with bolded key steps.
How Ohio STNA Differs From a Generic CNA Exam
Most "CNA" study material is written for the national NNAAP / Credentia / Pearson VUE exam used by ~25 states. Ohio does NOT use that exam. If you study generic CNA material you will get blindsided by these Ohio-specific differences:
- 79 written questions, not 60-70. Ohio's knowledge test is longer than the NNAAP standard.
- 3 or 4 skills tasks, not 5. The December 2025 Version 27 handbook changed the skills exam from five tasks to three or four tasks in the same 35-minute window.
- 21 skills on the list, not 25. The Version 27 handbook (December 1, 2025) reduced the skill list from 25 to 21 and restructured several tasks.
- Hand washing is embedded, not standalone. Hand washing is no longer a separate skill task on the Ohio list. Instead, it is built into skills that require it (bedpan, perineal care, urinary drainage, catheter care) as a critical "with Hand Washing" step.
- PPE don/doff is now embedded. Several skills now bundle donning and doffing PPE (gown, gloves, goggles) as part of the task rather than testing it separately.
- D&S "bolded key steps" auto-fail the task if missed. The handbook calls these "critical/key steps" and you must perform every one correctly, plus 80% of the non-key steps, on each assigned task.
- Catheter care for a female resident is now an explicit Ohio skill (Skill 9) -- most generic CNA prep barely covers it.
- Registry renewal is work-hour based, not test-based. 7.5 consecutive paid nurse-aide hours every 24 months keeps you active.
Ohio STNA Prerequisites (Before You Enroll)
Before a NATCEP program will accept you -- and before D&S will test you -- Ohio requires:
- Minimum age 16. Most programs set their internal floor at 18; a few accept 16 with parental consent.
- High school diploma or GED preferred (not a state mandate but required by nearly every NATCEP-approved program and every Ohio employer).
- Fingerprint-based criminal background check -- BCI (Ohio Bureau of Criminal Investigation) and FBI. Convictions under ORC 109.572 (abuse-related offenses, theft from elderly, sex crimes, certain drug felonies) are permanent disqualifiers.
- Two-step TB (Mantoux) skin test or IGRA blood test -- results within the last 12 months. Positive PPD requires a clear chest X-ray.
- Immunization records: MMR, Tdap, varicella, hepatitis B series (or declination), annual flu, and COVID-19 per employer policy.
- Physical exam / health statement signed by a provider within the past 12 months attesting you can lift 50 lbs and stand 8 hours.
- Valid Social Security number -- you MUST bring the original card on test day (a letter from the Social Security office is NOT accepted).
Step 1: Complete a 75-Hour ODH-Approved Training Program
Federal OBRA law sets a 75-hour floor for nurse aide training. Ohio adopts that minimum exactly (one of the lowest in the country -- California requires 150 hours, Florida 120, New York 100). The 75 hours break down as:
- 59 hours classroom + skills lab (theory, infection control, communication, documentation, mental health, residents' rights)
- 16 hours supervised clinical at a long-term care facility (hands-on resident care)
Key rules:
- The program must be on the NATCEP (Nurse Aide Training & Competency Evaluation Program) approved list -- verify at the ODH NATCEP page before paying tuition. Training at a non-approved program does NOT count.
- You can begin direct resident care after the first 16 hours of training.
- Programs run 2.5 to 10 weeks (accelerated full-time vs. evening/weekend).
- Tuition: $400-$1,200. Many Ohio nursing homes offer free training in exchange for a 90-day to 1-year work commitment.
- Alternative pathways: nursing students who completed a fundamentals course covering personal care, infection control, and safety, OR hospital aides with at least 12 months of recent (within 5 years) experience, may sit for the exam without completing a NATCEP program.
Step 2: Register for the D&S / Headmaster Exam
After your training program submits your name to D&S Diversified, you'll receive eligibility to schedule. Plan around these facts:
- Processing time: D&S needs 10 working days to process your application before you can test.
- Scheduling: Online via the TestMaster Universe (TMU) portal at oh.tmutest.com -- this is the D&S scheduling system (not the
hdmaster.cominfo page). You'll create an account using the same legal name that appears on your Social Security card. - Handbook version: Candidate Handbook Version 27 (effective December 1, 2025) is the current rulebook. Download it from the Headmaster Ohio page before test day.
- Fees (2026, per Version 27 handbook): $30 knowledge + $90 skills = $120 total. Audio (oral) version of the knowledge exam adds a $10 extra charge ($40 total for audio knowledge), so audio + skills = $130. Skills retake alone: $90. Knowledge retake alone: $30. Audio retake: $40.
- Test sites: Regional test centers across Ohio (Columbus, Cleveland, Cincinnati, Dayton, Toledo, Akron, Youngstown) plus on-site testing at many training programs.
- Both portions on the same day: Plan for 6 hours at the test site (per D&S guidance).
- Remotely proctored knowledge retakes: Version 27 allows retake of the knowledge exam from home with a remote proctor (Zoom). Skills must still be done in person.
Pass the Ohio STNA on Your First Try -- FREE
Our Ohio STNA practice bank mirrors the D&S knowledge test domain mix, with full-length 79-question simulators and a separate skills checklist module covering all 21 Ohio skills.
Step 3: Master the Written Knowledge Test (79 Questions, 90 Minutes)
The Ohio knowledge test is 79 multiple-choice questions delivered in pencil-and-paper, computer, or oral (audio) format. You have 90 minutes (about 68 seconds per question -- pace yourself). The official D&S blueprint covers 12 content domains with the exact question counts published in the D&S Ohio Candidate Handbook (Version 27, effective December 1, 2025):
| Domain | Exact Qs | What's Tested |
|---|---|---|
| Safety | 8 | Falls, fire (RACE/PASS), restraints, body mechanics, choking |
| Infection Control | 7 | Standard precautions, PPE, chain of infection, isolation |
| Personal Care | 9 | Bathing, oral care, perineal care, grooming, dressing |
| Basic Nursing Skills | 9 | Vital signs, I&O, positioning, ROM, catheter care |
| Mental Health | 7 | Dementia, depression, anxiety, behavioral interventions |
| Care Impaired (Cognitively Impaired) | 6 | Validation, redirection, environmental cues |
| Communication | 6 | Verbal/nonverbal, active listening, cultural sensitivity |
| Data Collection | 5 | Observation, documentation, change-in-condition reporting |
| Disease Process | 5 | Common chronic conditions, signs/symptoms |
| Older Adult Growth & Development | 5 | Physical and psychosocial aging changes |
| Resident Rights | 5 | OBRA rights, HIPAA, abuse reporting, advance directives |
| Role and Responsibility | 7 | Scope of practice, chain of command, delegation, reporting |
| Total | 79 |
Passing: The D&S Ohio Candidate Handbook (Version 27) states you must score 70% or better to pass the knowledge portion -- roughly 56 of 79 questions correct.
Five Highest-Yield Written-Test Topics (Ohio-Specific)
Based on item analysis from training programs and student debriefs:
- Standard precautions vs. transmission-based precautions -- when to use a gown, gloves, mask, or N95.
- Resident rights under OBRA -- refusal of care, privacy, freedom from restraint, grievance procedures.
- Abuse and neglect reporting -- Ohio mandatory-reporter rules, immediate verbal report to charge nurse, written incident report.
- PPE donning and doffing sequence -- now embedded in multiple skills on the Ohio skills list, so the knowledge test weights it heavily.
- Recognizing change-in-condition -- vital sign abnormalities, mental status shifts, skin breakdown stages, choking/aspiration signs.
Step 4: Master All 21 Ohio Skills (You'll Demonstrate 3 or 4)
On skills test day, you will perform 3 or 4 randomly drawn tasks in 35 minutes (the Version 27 handbook, effective December 1, 2025, reduced the task count from five to three or four). The RN Test Observer reads a scenario for each task immediately before you perform it. You must correctly perform every bolded key/critical step AND 80% of all non-key steps on each assigned task. Missing one bolded key step automatically fails that task regardless of your overall score.
Here is the full current Ohio 21-skill list (from the D&S Ohio Candidate Handbook Version 27):
| # | Skill | High-Risk Key Steps |
|---|---|---|
| 1 | Apply an Anti-Embolic Stocking on a Resident's Leg | Resident supine, no twists/wrinkles, heel aligned |
| 2 | Assist a Resident to Ambulate using a Gait Belt | Belt over clothing, two fingers fit, walk on weak side |
| 3 | Assist a Resident to Ambulate with a Walker using a Gait Belt | Walker advanced first, weak leg next, strong leg last |
| 4 | Assist a Resident with a Bedpan, Measure and Record Output with Hand Washing | Privacy, raise HOB if allowed, measure output in mL |
| 5 | Bed Bath (Partial) for a Resident -- Whole Face and One Arm, Hand, and Underarm | Eyes inner-to-outer, change water if cool/soiled |
| 6 | Change a Male Resident's Brief and Provide Perineal Care with Hand Washing | Clean front to back, perineal care, fresh wipe per stroke |
| 7 | Denture Care -- Clean a Resident's Upper or Lower Denture | Line sink with towel/water, cool water rinse only |
| 8 | Don PPE (Gown, Gloves, Goggles/Face Shield), Empty a Urinary Drainage Bag, Measure and Record Output, Doff PPE with Hand Washing | Bag below bladder, no spout-to-container contact |
| 9 | Don PPE (Gown and Gloves), Provide Catheter Care for a Female Resident, Doff PPE with Hand Washing | Clean front to back, perineal care, fresh wipe per stroke |
| 10 | Dress a Bedridden Resident with an Affected (Weak) Side | Weak arm in first, strong arm out first |
| 11 | Feed a Dependent Resident in Bed | HOB at least 30 degrees, verify diet, check temp, allow swallow |
| 12 | Hair Care for a Resident | Detangle ends first, ask resident preference |
| 13 | Make an Occupied Bed | Raise side rail, log roll, no shaking linens |
| 14 | Mouth Care -- Brush a Resident's Teeth | HOB up, gloves, swab inspection |
| 15 | Nail Care for a Resident | File straight across, do not clip a diabetic resident's nails |
| 16 | Perineal Care for a Female Resident with Hand Washing | Front to back, single stroke per area, fresh washcloth surface |
| 17 | Position a Resident in Bed on Their Side | Pillow support, body alignment, call light within reach |
| 18 | Range of Motion for a Resident's Hip and Knee | Support joint above and below, stop at resistance/pain |
| 19 | Range of Motion for a Resident's Shoulder | Support elbow and wrist, full ROM unless contraindicated |
| 20 | Stand and Pivot-Transfer a Resident from Their Bed to a Wheelchair using a Gait Belt | Lock wheels, weak side near chair, pivot on strong leg |
| 21 | Vital Signs -- Take and Record a Resident's Pulse and Respirations | Count respirations without telling resident, count pulse full 60 seconds, record on flow sheet |
The 5 "Always-Tested-On-Every-Skill" Key Steps
Before EVERY assigned task, perform these or you fail the task:
- Knock and greet the resident by name
- Identify yourself and explain the procedure
- Perform hand hygiene (hand washing or alcohol-based hand rub per the skill's instructions)
- Provide privacy -- close door, pull curtain
- At the end: lower bed, raise side rail per care plan, place call light within reach, perform hand hygiene, report task to nurse
Missing any of these five = automatic task failure regardless of how well you performed the rest.
What Changed in the December 2025 Version 27 Handbook
If you studied from an older guide, the Ohio skills list was overhauled on December 1, 2025:
- Removed: Hand Washing as a standalone skill, Abdominal Thrust on Conscious Resident (Heimlich), Making an Unoccupied Bed, Weighing an Ambulatory Resident, Vest Restraint in Bed, Transfer from Wheelchair to Bed, Vital Signs including Temperature (now pulse and respirations only).
- Added/restructured: Catheter Care for a Female Resident (new explicit skill), Change a Male Resident's Brief and Provide Perineal Care (new), PPE don/doff bundled into skills 8 and 9, Stand and Pivot-Transfer (renamed from Transfer Bed to Wheelchair).
- Hand Washing is now embedded as a critical step inside skills 4, 6, 8, 9, and 16 (those marked "with Hand Washing").
- Tasks per test dropped from 5 to 3 or 4.
Step 5: 6-Week Ohio STNA Study Plan (50-80 Hours)
| Week | Hours | Focus | Activities |
|---|---|---|---|
| 1 | 8-10 | Knowledge foundation | Domains: Role, Communication, Infection Control; 50 practice Qs |
| 2 | 8-10 | Safety + Personal Care | Domains: Safety, Personal Care; lab practice on bed making, bathing, perineal care |
| 3 | 10-12 | Basic Nursing Skills | Vital signs (pulse and respirations), I&O, positioning, ROM |
| 4 | 8-10 | Rights, Mental Health, Data Collection | OBRA, HIPAA, dementia care; abuse reporting scenarios |
| 5 | 10-12 | Full skills lab | All 21 skills with a partner; videotape yourself; check bolded key steps |
| 6 | 6-10 | Final review | 2-3 full 79-Q practice exams; weakest skills re-drilled; rest day before test |
Most candidates who pass on the first attempt log 50-80 total hours of self-study on top of the 75-hour training program.
Practice Like It's Test Day
Use the Test-Mode option to time yourself for the full 90 minutes on 79 questions. Review every wrong answer with our AI tutor before your second pass.
Test-Day Checklist (D&S / Headmaster Ohio)
Bring:
- Original Social Security card (NOT a photo or copy -- auto-rejection without it; a letter from the Social Security office is NOT accepted)
- Government-issued, photo-bearing, signed, non-expired ID (driver's license, state ID, or signed U.S. passport)
- Admission letter / scheduling confirmation from Headmaster
- Two #2 pencils with erasers (paper-based test sites)
- Watch with a second hand (no smart watches -- needed for counting respirations and pulse)
- Full clinical scrubs (top and pants or skirt) and closed-toe non-slip shoes (tennis shoes); any color/design is allowed per Version 27
- Hair tied back, short clean nails, no artificial nails, no jewelry except plain wedding band and small studs
Leave at home:
- Cell phone, smart watch, fitness tracker (lockers usually provided)
- Bags, backpacks, food, drinks (water bottle sometimes allowed)
- Notes, study sheets, hats, gum
Arrive 30 minutes early. Late arrival = forfeited fee, no refund, must reschedule.
The 10 Most Common Ohio STNA Mistakes (and How to Avoid Them)
- Studying from an outdated 25-skill list. The December 1, 2025 Version 27 handbook cut the list to 21 skills and dropped hand washing as a standalone task. Make sure your study material matches Version 27.
- Enrolling in a non-NATCEP program. Always verify the program on the ODH NATCEP-approved list BEFORE paying tuition.
- Forgetting your original Social Security card. D&S will turn you away. No exceptions, and a letter from the Social Security office is not accepted.
- Wearing street clothes to the written exam. Both written and skills require full clinical scrubs in Ohio.
- Skipping hand hygiene between tasks. Even though hand washing is no longer a standalone skill, it is a bolded key step inside skills 4, 6, 8, 9, and 16 -- missing it fails that task.
- Telling the resident you're "counting respirations." Telling them changes their breathing -- count silently while pretending to take their pulse.
- Using hot or warm water on dentures. Always cool water -- heat warps acrylic. Auto-fail on Skill 7.
- Front-to-back perineal care reversed. Always front to back, fresh washcloth surface per stroke. Auto-fail on Skills 6, 9, and 16.
- Failing to lock wheelchair brakes before any transfer. Auto-fail on Skill 20.
- Missing the 2-year / 3-attempt window. If you don't pass within 2 years and 3 tries of training completion, you must retake the entire 75-hour program.
The Ohio Nurse Aide Registry: Renewal & Reciprocity
Renewal (Every 24 Months)
Ohio uses work-based renewal, not continuing-education-based renewal. To stay active on the Ohio Nurse Aide Registry:
- Work at least 7.5 consecutive paid hours OR 8 hours within a 48-hour period of nursing or nursing-related services for compensation as a nurse aide during each 24-month period.
- Your employer submits the HEA 7713 verification form to ODH; for home health, a letter on company letterhead signed by HR/RN/administrator listing your hire date, last date worked a 7.5-hour shift, job title, and direct patient care duties is required.
- Renewal is FREE -- there is no fee to maintain active status. (Some third-party sites incorrectly cite a $65 renewal fee; Ohio STNA registry renewal has no fee.)
- A W-2 alone is NOT accepted as proof -- it does not show job duties.
- If you do NOT meet the work requirement, you must retake both the knowledge and skills exams to be reinstated.
- 12-hour annual in-service rule: If you work in a long-term care facility, Ohio Administrative Code 3701-17-07 and 3701-17-07.1 require 12 hours of employer-provided in-service training each year (covers infection control, abuse prevention, resident rights, dementia care, etc.). Your employer -- not you -- tracks this, but missed in-services can block your ability to work direct resident care until caught up.
Reciprocity (Transfer Into Ohio)
Ohio accepts reciprocity transfers from all U.S. states and territories (subject to verification that your home-state training was OBRA-compliant and you have no findings of abuse, neglect, or misappropriation of property). The most common transfer sources are neighboring states -- Indiana, Kentucky, Michigan, Pennsylvania, and West Virginia.
Process:
- Complete the HEA 6907 Reciprocity Application.
- Attach a clear copy of your original Social Security card and government photo ID showing date of birth.
- Section II is completed by your home-state Nurse Aide Registry confirming OBRA-compliant training and no findings of abuse, neglect, or misappropriation of property.
- Submit by mail, fax, or email to ODH (online not accepted).
- Fee: $0 -- reciprocity is free.
- Processing: typically 2-4 weeks.
ODH Nurse Aide Registry contact:
- Address: 246 N. High Street, Columbus, OH 43215
- Phone: (800) 582-5908 (in-state) | (614) 752-9500 (out-of-state)
- Email: NAR@odh.ohio.gov
- Fax: (614) 564-2461
Ohio STNA Career Outlook & Salary (2026)
Ohio employs roughly 70,000+ nursing assistants -- among the top states by total CNA/STNA jobs (BLS OEWS data). Aging demographics and Ohio's dense network of long-term care facilities (one of the highest per-capita nursing-home counts in the U.S.) mean STNA demand is projected to grow roughly 2% through 2034 (BLS national projection for nursing assistants, 2024-34).
| Setting | Hourly Wage | Annual |
|---|---|---|
| Ohio mean (all settings) | $19.16 | $39,840 |
| Hospitals (acute care) | $22-$25+ | $45,000-$52,000 |
| Skilled nursing facility | $17-$19 | $35,000-$39,500 |
| Home health | $15-$18 | $31,200-$37,400 |
| Hospice | $18-$21 | $37,400-$43,700 |
By Ohio metro:
- Columbus: $20+/hr (highest Ohio metro)
- Cincinnati: $19.50+/hr
- Cleveland: $19+/hr
- Toledo: $17.50+/hr
- Akron: $18+/hr
Ohio mean wage and employment figures from BLS OEWS May 2024 for SOC 31-1131 Nursing Assistants (Ohio-specific). National median annual wage for nursing assistants was $39,530 in May 2024 (BLS OOH). Sign-on bonuses of $1,000-$3,000 are common in Cleveland, Columbus, and Cincinnati metro hospitals.
CNA -> LPN -> RN Ohio Career Ladder
Ohio is one of the best states for nurse-aide-to-RN bridging due to the Ohio Board of Nursing's structured articulation. Many Ohio community colleges (Hocking, Cuyahoga, Columbus State, Sinclair, Owens) offer:
- STNA -> LPN: 12-18 months (Ohio LPN salary approximately $54,000)
- LPN -> ADN: 1-2 additional years
- ADN -> BSN: 12-24 months online (Ohio RN salary approximately $78,000)
Many STNAs work part-time at nursing homes (which often pay tuition reimbursement) while completing nursing school.
Pass the Ohio STNA With Confidence
Our free Ohio STNA prep program includes:
- 197+ practice questions across all 12 D&S knowledge domains
- Full 21-skill checklist with bolded key steps highlighted (Version 27 handbook)
- AI-powered explanations for every wrong answer (10 free AI sessions daily)
- Full-length 79-question simulator that mirrors test-day timing
- Updated for 2026 with the December 1, 2025 D&S Ohio Candidate Handbook Version 27
No signup required. No credit card. Just open the page and start practicing.
Official Ohio STNA Resources
- Ohio Department of Health -- Nurse Aide Registry -- official regulator
- Ohio Nurse Aide Registry Lookup -- verify your status
- D&S Diversified Technologies / Headmaster Ohio Page -- schedule your exam
- Ohio Nurse Aide Candidate Handbook Version 27 (December 1, 2025) -- official rulebook
- Ohio Nurse Aide Registry Requirements -- renewal rules and HEA 7713
- Ohio NATCEP Approved Programs List -- verify training before paying tuition
Take courses on Udemy
Study guide on Mometrix
Buy on Amazon
Practice exams on ExamEdge