Training & Careers

CNA and Entry-Level Healthcare Jobs in Missouri: Paths and Pay

Now Hiring St. Louis Editorial TeamUpdated 2026-09-298 min read

Last verified: September 29, 2026. Prices, start dates and pay change often. Confirm with each school or employer. DHSS, FCSR, STLCC and St. Charles Community College details were rechecked on this date; the BLS local wage table comes from an interactive tool we could not re-open, so confirm those figures at the BLS link in the sources.

Healthcare is one of the few fields where you can start with a few weeks of training and no degree, work in it the same season, and then decide whether to keep climbing. In the St. Louis area the doors in are mostly the same: certified nurse assistant (CNA), phlebotomist, medical assistant and patient care technician. They are not the same job, and they do not have the same rules. Here is how each works in Missouri, what it costs where we could confirm a price, and what the local pay data says.

What these jobs pay in the St. Louis area

These figures come from the U.S. Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics survey, May 2025 data, for the St. Louis, MO-IL metropolitan area, which covers both sides of the river. Wages are per hour unless noted.

Job	Jobs in metro	Mean wage	Median wage	Annual mean
Home health and personal care aides	44,200	$16.55	$16.58	$34,430
Orderlies	440	$17.42	$17.13	$36,240
Nursing assistants (CNAs)	14,620	$19.58	$18.81	$40,720
Medical assistants	6,170	$21.02	$21.50	$43,730
Phlebotomists	670	$21.25	$22.00	$44,200
Licensed practical nurses (for comparison)	5,180	$32.63	$31.31	$67,860

Two takeaways. First, entry pay for CNAs is modest: the lowest-paid tenth of St. Louis nursing assistants earned $16.97 an hour or less, and the top tenth earned $22.54 or more. Second, the jump to a licensed practical nurse is large, more than $13 an hour on the mean. That is why many people use a CNA job or a similar role as a first step, not a final one. BLS does not track patient care technician as its own category, so we cannot give you a metro wage for that title.

Path 1: Certified nurse assistant (CNA)

A CNA helps residents and patients with daily care under the supervision of a licensed nurse. Missouri's Department of Health and Senior Services (DHSS) describes the training as preparing you for employment in a long-term care facility, so nursing homes and similar places are the main employers, though hospitals and home care agencies hire nurse assistants too.

Training. The state-approved course is 75 hours of classroom training plus 100 hours of on-the-job (clinical) training, 175 hours in all. The course ends with a two-part exam: a written (or oral) test and a hands-on skills test. DHSS names Headmaster as the testing vendor and lists 800-393-8664 for questions.

Where to train. Only DHSS-approved training agencies count. Those include community colleges, vocational and high school programs, private schools, hospitals, licensed nursing homes and Missouri Veterans Homes. DHSS keeps two searchable lists on the state's data portal, one for facility-based programs and one for schools. Check your program against them before paying. DHSS's Health Education Unit can help at cnaregistry@health.mo.gov.

A local price example. St. Charles Community College lists its CNA course at $350 for classroom plus $600 for clinical, $950 in total. It also runs an accelerated summer version of about eight weeks. To enroll, it asks for acceptable results from a Family Care Safety Registry background screening completed in the previous 90 days, a negative two-step TB test within a year, current flu and COVID-19 vaccinations and a urine drug screen. You need to be 18 for the clinical portion, and the course wants an 80% average on exams. Other schools' requirements will be similar but not identical.

Ask about facility-paid training. This one is easy to miss. Under Missouri's Medicaid reimbursement program, nursing facilities can be reimbursed for nurse assistant training, and DHSS states that nurse assistants who are employed by, or have a job offer from, a facility cannot be charged for that training. If a nursing home offers to train you as part of hiring, that is a real path, but read the paperwork on what you owe if you leave. DHSS also says a facility must reimburse you, prorated, if you paid for training within 12 months before being hired.

The background check step: Family Care Safety Registry

Many healthcare training programs in Missouri, including the ones we checked below, ask you to register with the Family Care Safety Registry (FCSR), the state's background screening system. According to the FCSR, its checks include Missouri State Highway Patrol criminal history, the Missouri Sex Offender Registry, the child abuse and neglect database and the Employee Disqualification List (EDL). The EDL names people barred from working in certain care settings.

What that means for you: before you spend money on a course, ask whether anything in your history could keep you from clinical placement. A conviction does not always end the road, but rules differ by offense and employer, and it is far better to find out before you pay tuition. The FCSR help line is 866-422-6872 (weekday hours are listed on its site), and its email is fcsr@health.mo.gov. Registration steps and any fee are on the FCSR site, and we could not confirm the current fee, so check it there.

Path 2: Phlebotomy

Phlebotomists draw blood in hospitals, labs, clinics and donation centers. St. Charles Community College lists a phlebotomy course at $775, a hybrid format with 120 clinical hours scheduled four to five days a week. Its prerequisites include an acceptable FCSR screening, current flu, MMR, hepatitis B and COVID-19 vaccines and a negative two-step TB test. Private schools in the metro also offer short phlebotomy courses. We did not verify their prices or accreditation, so compare and ask what certification exam the course prepares you for and whether the employers you want accept it. Employers, not the state, usually decide what credential they want, so check job postings first.

Phlebotomy has the highest median in the table above, at $22.00 an hour in the St. Louis area, but there are far fewer of these jobs (670) than CNA jobs (14,620). More competition per opening is a fair trade-off to weigh.

Path 3: Medical assistant

Medical assistants work in clinics and doctors' offices, taking vitals, preparing patients and doing clinical and office tasks. St. Louis Community College runs an employer-funded medical assistant program with a structure worth knowing about:

16 weeks, full time, mixing classroom, skill labs, online work and clinical practice.
No tuition for the student. Clinical employer partners (BJC Medical Group or St. Luke's Medical Group) fund it and provide paid on-the-job training starting at the beginning of the program.
In return, graduates commit to working full time for the training employer for two years.
You must be 18 with a high school diploma or equivalent, register with the FCSR, and pass interviews, a criminal background check, drug screening, a physical exam and an immunization review.

STLCC says planning is underway for upcoming classes and lists no fixed start dates. Email acceleratedjobtraining@stlcc.edu or call 314-984-7777 to be notified. The two-year commitment is the trade-off, so make sure you would be comfortable at that employer before you sign. Medical assisting is also offered as a credit program at colleges, which takes longer and costs tuition.

Path 4: Patient care technician (PCT)

Patient care technicians usually work in hospitals doing bedside care that overlaps with CNA work, and often add tasks such as taking EKGs or drawing blood, depending on the employer. St. Charles Community College lists a six-week accelerated PCT program as tuition-free through a partnership with BJC HealthCare. The listing says students are paid employees, the starting wage is $17.50 an hour and there is a 12-month minimum commitment. Applicants must be at least 18, have a high school diploma or equivalent, pass a criminal background check, drug screen and physical exam and have documented immunizations, including flu and COVID-19.

How to choose

Have no money for tuition? Look first at employer-funded options: the STLCC medical assistant program, the SCC and BJC patient care technician program, and nursing facilities that train CNAs as part of hiring. Compare the length of the work commitment.
Want the fastest start? The CNA course, at roughly eight weeks in accelerated form, is one of the quickest, and the demand shows in the 14,620 nursing assistant jobs in the metro.
Want higher pay per hour right away? Phlebotomy and medical assistant medians are above the CNA median in local BLS data, but training and hiring paths differ.
Want to move up? Ask employers about tuition help for nursing programs. Licensed practical nurses in the metro averaged $32.63 an hour in the same survey.

Common mistakes

Paying a school that is not approved. For CNA, confirm the agency on the DHSS lists first.
Ignoring the background check until the end. Register and check your record early.
Signing a work commitment without reading it. Know what happens if you leave, are laid off or your hours change.
Missing the immunization deadlines. Flu, COVID-19, TB tests and MMR requirements can add weeks if you have to schedule them at the last minute.
Assuming the pay is the same everywhere. The figures above are metro averages. Hospitals, nursing homes and clinics pay differently.

Frequently asked questions

How long does it take to become a CNA in Missouri? The state course is 175 hours (75 classroom, 100 clinical). Accelerated programs can finish in about eight weeks, as at St. Charles Community College. Longer, part-time formats take more.

Can I be charged for CNA training if a nursing home hires me? DHSS states that nurse assistants employed by, or with a job offer from, a Medicaid-certified nursing facility cannot be charged for training costs the facility can seek reimbursement for. Ask exactly what your facility will cover.

Do I need the Family Care Safety Registry for every healthcare job? Not every employer asks, but the programs we checked (STLCC and SCC) require it. Ask each employer or school, and confirm the current process on the FCSR site.

Is a CNA the same as a patient care tech? No. Missouri sets CNA training and exam rules through DHSS. The PCT title is set by employers, and duties vary by hospital.

This article is general information, not legal or career advice. Requirements are set by DHSS and each school or employer, so confirm current details with them.

Sources

Looking for a first healthcare job or a program that pays you to train? Join the free Now Hiring In St. Louis Facebook group or get free job alerts. We cannot promise anyone a job, so always confirm details with the employer.