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 25 skills on the Ohio skills list, the $104 fee structure, the 2-year/3-attempt rule, the 24-month registry renewal rule, and reciprocity from Indiana, Kentucky, Michigan, Pennsylvania, and West Virginia. Every claim below is verified against the official ODH and Headmaster (hdmaster.com) sources for 2026.
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 |
| Training Required | 75 hours minimum (59 classroom/lab + 16 clinical) |
| Written Questions | 79 multiple-choice |
| Written Time | 90 minutes |
| Written Passing Score | 75% (≈ 60 / 79 correct; some sources cite 70% — confirm at test session) |
| Skills Tested | 5 randomly drawn from a list of 25 |
| Skills Time | 35 minutes total (~7 min per skill) |
| Skills Passing Score | 80% per skill, all critical steps |
| Total Fee | $104 written ($26) + $78 skills (or $42 oral + $78) |
| Attempts Allowed | 3 within 2 years of training completion |
| Renewal | Every 24 months — work ≥ 7.5 consecutive paid hours |
| Minimum Age | 16 (most programs require 18) |
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No signup, no credit card. Practice questions modeled directly on the D&S Headmaster blueprint, AI explanations for every wrong answer, and the full 25-skill checklist with bolded critical 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.
- 5 skills, not 3. You demonstrate five tasks, drawn live from the 25-skill list.
- Hand washing AND PPE are scored separately on many testing days — both critical-step heavy.
- D&S "bolded steps" auto-fail the skill if missed (NNAAP calls these "critical steps" but Ohio's bolded list is published in the Headmaster Candidate Handbook and is unique).
- Vest Restraint in Bed (Skill 23) is on Ohio's list — most other states removed restraint demonstrations years ago.
- Antiembolic stocking application is an Ohio skill; almost no other state tests this.
- 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.
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.tmuniverse.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): $26 written + $78 skills = $104 total. Oral version: $42 + $78 = $120. Skills retake alone: $78. Written retake alone: $26.
- 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).
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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 25 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 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 |
|---|---|---|
| Basic Nursing Skills | 9 | Vital signs, I&O, positioning, ROM, catheter care |
| Personal Care Skills | 9 | Bathing, oral care, perineal care, grooming, dressing |
| Safety & Emergency | 8 | Falls, fire (RACE/PASS), restraints, body mechanics, choking |
| Infection Control | 7 | Standard precautions, PPE, chain of infection, isolation |
| Role & Responsibility | 7 | Scope of practice, chain of command, delegation, reporting |
| Mental Health | 7 | Dementia, depression, anxiety, behavioral interventions |
| Communication | 6 | Verbal/nonverbal, active listening, cultural sensitivity |
| Care of Cognitively Impaired | 6 | Validation, redirection, environmental cues |
| Data Collection & Reporting | 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 |
| Total | 79 |
Passing: Historically 75% (≈ 60/79), but several 2026 third-party sources cite 70% (≈ 56/79). The D&S Ohio Candidate Handbook Version 27 (effective December 1, 2025) is the authoritative word — plan to hit at least 75% correct to be safe, and always confirm the current cut score at your test session.
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.
- Restraint alternatives — Ohio still tests vest restraint application as a skill, so you also need to know the alternatives (toileting schedules, environmental modifications, companionship).
- Recognizing change-in-condition — vital sign abnormalities, mental status shifts, skin breakdown stages, choking/aspiration signs.
Step 4: Master All 25 Ohio Skills (You'll Demonstrate 5)
On skills test day, you will perform 5 randomly drawn tasks in 35 minutes (about 7 minutes each). Hand Washing is ALWAYS one of the five. You must score 80% per skill AND complete every "bolded" critical step. Missing one bolded step = automatic skill failure.
Here is the full Ohio 25-skill list (from the D&S Ohio Candidate Handbook):
| # | Skill | High-Risk Critical Steps |
|---|---|---|
| 1 | Hand Washing | 20 sec lather, water never above elbows, paper towel to turn off faucet |
| 2 | Abdominal Thrust on Conscious Resident | Verify choking, fist above navel, confirm dislodged |
| 3 | Ambulation Using a Gait Belt | Belt over clothing, two fingers fit, walk on weak side |
| 4 | Ambulation with Walker | Walker advanced first, weak leg next, strong leg last |
| 5 | Applying Antiembolic Stocking to One Leg | Resident supine, no twists/wrinkles, heel aligned |
| 6 | Bedpan / Fracture Pan and Output | Privacy, raise HOB if allowed, measure output in mL |
| 7 | Denture Care | Line sink with towel/water, cool water rinse only |
| 8 | Dressing Resident | Weak arm in first, strong arm out first |
| 9 | Emptying a Urinary Drainage Bag | Don gloves, bag below bladder, no spout-to-container contact |
| 10 | Feeding the Dependent Resident | HOB ≥ 30°, verify diet, check temp, allow swallow |
| 11 | Hair Care | Detangle ends first, ask resident preference |
| 12 | Making an Occupied Bed | Raise side rail, log roll, no shaking linens |
| 13 | Making an Unoccupied Bed | Bottom sheet wrinkle-free, mitered corners |
| 14 | Mouth Care | HOB up, gloves, swab inspection |
| 15 | Nail Care, One Hand | Soak hand, file straight across, no clipping diabetics |
| 16 | Partial Bed Bath (Face, Arm, Hand, Underarm) | Eyes inner-to-outer, change water if cool/soiled |
| 17 | Perineal Care for a Female | Front to back, single stroke per area, fresh washcloth surface |
| 18 | Position Resident on Left Side | Pillow support, body alignment, call light returned |
| 19 | Range of Motion: Hip & Knee | Support joint above and below, stop at resistance/pain |
| 20 | Range of Motion: One Shoulder | Support elbow and wrist, full ROM unless contraindicated |
| 21 | Transfer Bed → Wheelchair (Gait Belt) | Lock wheels, weak side near chair, count to 3 |
| 22 | Transfer Wheelchair → Bed (Gait Belt) | Lock wheels, footrests up, pivot on strong leg |
| 23 | Vest Restraint in Bed | MD order assumed, V-neck in front, quick-release knot, check q15 min |
| 24 | Vital Signs: Temperature, Pulse, Respiration | Count respirations without telling resident, record on flow sheet |
| 25 | Weighing an Ambulatory Resident | Balance scale at zero, no shoes, record in lb or kg |
The 5 "Always-Tested-On-Every-Skill" Critical Steps
Before EVERY skill (not just hand washing), perform these or you fail the skill:
- Knock and greet the resident by name
- Identify yourself and explain the procedure
- Wash hands (or use alcohol-based hand rub if allowed for that skill)
- Provide privacy — close door, pull curtain
- At the end: lower bed, raise side rail per care plan, place call light within reach, wash hands, report task to nurse
Missing any of these five = automatic skill failure regardless of how well you performed the rest.
Step 5: 6-Week Ohio STNA Study Plan (50–80 Hours)
| Week | Hours | Focus | Activities |
|---|---|---|---|
| 1 | 8–10 | Knowledge foundation | Domains 1–3 (Role, Communication, Infection Control); 50 practice Qs |
| 2 | 8–10 | Safety + Personal Care | Domains 4–5; lab practice on bed making, bathing, perineal care |
| 3 | 10–12 | Basic Nursing Skills | Vital signs (temp/pulse/resp + manual BP), 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 25 skills with a partner; videotape yourself; check bolded 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)
- ✅ Government-issued photo ID (driver's license, state ID, 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 and closed-toe non-slip shoes (required for both written AND skills — yes, even the written portion)
- ✅ Hair tied back, no artificial nails, nails trimmed short, 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)
- 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.
- Wearing street clothes to the written exam. Both written and skills require full clinical scrubs in Ohio.
- Skipping hand washing between skills. Hand wash is required not only as Skill 1 but BEFORE and AFTER every other skill.
- Telling the resident you're "counting respirations." Telling them changes their breathing — count silently while pretending to take 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 Skill 17.
- Failing to lock wheelchair brakes before any transfer. Auto-fail on Skills 21 and 22.
- 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.
- Letting your registry status lapse. No paid 7.5-consecutive-hour shift in 24 months = removed from the registry. You then must retest, and if your training was > 2 years ago, you also must retrain.
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 48 hours of nursing services performed for compensation as a nurse aide during each 24-month period.
- Your employer submits the HEA 7713 verification form to ODH.
- Renewal is FREE — there is no fee to maintain active status.
- If you do NOT meet the work requirement, you must retake both the written and skills exams to be reinstated.
- 12-hour annual in-service rule: If you work in a long-term care facility, federal OBRA requires 12 hours of employer-provided in-service training each calendar 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 transfers from all U.S. states and territories (subject to verification), with formal reciprocity agreements with:
- Indiana
- Kentucky
- Michigan
- Pennsylvania
- 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, 3rd Floor, 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 75,000+ nursing assistants — among the top 5 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 8–10% through 2032.
| Setting | Hourly Wage | Annual |
|---|---|---|
| Statewide median | $17.41 | $36,220 |
| Hospitals (acute care) | $20–$22+ | $42,000–$46,000 |
| 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: $18.26/hr
- Cincinnati: $18.05/hr
- Cleveland: $17.67/hr
- Toledo: $16.90/hr
- Akron: $17.20/hr
Salary data from BLS OEWS, ZipRecruiter (March 2026), Salary.com, and PayScale. 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 ≈ $54,000)
- LPN → ADN: 1–2 additional years
- ADN → BSN: 12–24 months online (Ohio RN salary ≈ $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 25-skill checklist with bolded critical steps highlighted
- AI-powered explanations for every wrong answer
- Full-length 79-question simulator that mirrors test-day timing
- Updated for 2026 with the latest D&S Ohio Candidate Handbook
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 STNA Candidate Handbook (PDF) — official rulebook
- HEA 6907 Reciprocity Form — transfer in from another state
- Ohio NATCEP Approved Programs List — verify training before paying tuition
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