How to get your Home Health Aide Certification

Home Health Aide Certification

What is a Certified Home Health Aide?

A Home Health Aide (HHA) is someone who provides services to patients who have physical or cognitive impairment or other disabilities and are elderly. Their responsibilities include administering medication depending on the policies of the company they work for and state regulations.

  • Monitoring the patient’s vitals, changing bandages, personal hygiene, etc.
  • Operate medical equipment related to Patient Care
  • Providing and assisting with personal care services such as bathing, grooming, dressing, and toileting.
  • Taking patients to medical appointments, accompanying them on errands, or running errands for them.
  • Assisting or providing housework for patients. Usually not exceeding the degree of what the patient wants.
  • Following the patients’ individualized care plans.

How do I become a Certified Home Health Aide?

Caregiving-related careers, such as Home Health Aide (HHA), are growing very rapidly. The growth is expected to continue due to the Baby Boomer generation now needing eldercare.

There are also others with temporary or permanent physical and mental disabilities that need professional assistance on a regular basis.

Working as a home health aide is not for everyone. However, if it’s something that you’re sure you want to do, becoming a Home Health Aide can be incredibly rewarding and is relatively easy.

You don’t even need a high school diploma or GED to get started. Some agencies even provide the training to help you become certified.

HHA’s are not be confused with personal care aides or home care aides as they are not certified positions and are limited in the types of care they can provide.

What about Salaries?

The Home Health Aide’s salary depends on the geographical location and how much experience they have.

However, here are the averages for the Home Health Aide salary according to the U.S. Department of Labor:

  • Entry-level with no prior experience – Usually in the bottom 10 percent, $8.00-$10.00 per hour or less than $18,550 annually
  • Mid-level, some experience or has been in the field for about five years – Usually $11.00-$14.00 per hour or about $23,000-$25,000 annually.
  • Top-level, a lot of experience or have been in the field for ten years or more – Usually $15.00-$20.00 per hour or $31,000-$35,000 annually.

What’s the Difference Between an HHA, Personal Care Assistant (PCA), and CNA?

In some states, CNAs (or Certified Nursing Assistants) can do things that HHA’s are not. These include transferring a patient from the bed to the wheelchair, administering medications, recording changes in the patients’ health conditions, and reporting to physicians.  

In turn, unlike HHA’s, CNA’s don’t usually do the housework, accompany patients on errands or take walks with them.Home Health Aide Certification

A PCA does essential homemaking, running errands, bathing, and toileting needs. The HHA goes a bit further and is trained to handle preparing specific diets and, in some states, can take a patient’s vitals. However, the main difference is that the HHA received formal training and has to pass the Home Health Aides certification exam and have obtained your Home Health Aide Certificate.

Where can I find HHA training?

Web searches and calling agencies in or near your local area are the two most effective ways you can find training. The Home Health Aide certification cost varies between schools and agencies.

Some agencies offer free training. All you need to do is show up with a reference, a Social Security card, and valid identification, such as a Driver’s License.

If you choose to go to a vocational school or community college, the tuition included in your Home Health Aide certification cost can range between $300 and $650.

Some agencies that offer job training require you to work with them directly for a certain period of time. Either way, you probably will get a placement almost immediately, which will help you to pad your Home Health Aide Resume. 

The demand for HHA’s is currently very high, especially with the first of the Baby Boomer generation now needing eldercare services.

To ensure that the training curriculum is state-approved and will place you with an agency with Medicare and Medicaid funding.

Many hospitals, residential facilities, group homes include training in CPR (cardiopulmonary resuscitation) and basic safety techniques, but their programs are often not state-regulated, so they can’t offer certification.

Once you have met your educational requirements and any additional requirements of your state and have your HHA certification, and have been working in the Home Health Care field for a little. At the same time, you may decide you want to advance your medical career.

Many choose to build on their home health aide training and pursue an associate’s degree through a technical school as a CNA (certified nursing assistant) or LPN (licensed practical nurse) or even pursue becoming a registered nurse.

National Association of Home Care and Hospice (NAHC) Certification

Once you have completed your courses, the next step is to go to the NAHC for the observation and written test. The Home Health Aide certification exam covers a wide range of topics, from home health financing to risk management. Certification gives you a boost to your Home Health Aide resume showing employers that you have the comprehensive knowledge necessary for the job.

The demonstration includes showing how to properly bathe a patient, make a bed, transfer a patient, etc. In some places, a full day is spent on the demonstrations.

Requirements to Become a Home Health Aide

In the United States, you will need a high school diploma or GED and obtain specific training to meet your individual states’ requirements to become a Home Health Aide. Even after you have received your home health care aide certificate, many states require you to take additional home health aide classes as professional development to maintain your certification.

It may also take you longer to work your way up. As a result, HHA’s have at least a high school diploma or a GED. You also have to be at least 18 to start a training program in an HHA program. You also have to have the ability to read and write in English at the sixth-grade level.

Many times, HHA’s learn on the job under the supervision of a nurse, LPN, or other more experienced aides. However, some states require training with a vocational school, community college, or home health agency.

You must have good communication skills and the appropriate interpersonal skills to build rapport with the patients and their families. Gaining trust is very important as the patient and their families are basically putting the patient’s lives in your hands.

Time management skills are also essential. If you’re working through an agency, chances are, you’ll only have three hours at the most to get everything done. Even if you’re not, the patient will probably not want you in their home all day.

Depending on the number of your patients, you will also probably have a full schedule and will need to give yourself plenty of time to drive or catch your ride between patients’ homes.

Good attention to detail is very important, especially if you take the patient’s vitals and administer medications.

Good physical health is essential as you will be on your feet much of the time and doing a lot of lifting. You also have to prove that you’re mentally prepared for the job as well. Being an HHA is incredibly intimate.

You may also be dealing with patients who have Dementia, Alzheimer’s Disease, and other mental illnesses or disabilities, and they can be incredibly challenging to work with at times. Also, most agencies require a background check because you will be working with older adults while other family members are not at home.

What does a home health aide do?

Patients with Dementia, Alzheimer’s Disease, brain injury, etc., might not always understand who you are and why you’re there. It’s not always easy to deal with them when they don’t, and you can’t force your services on them if they refuse.

Always give reasonable space to patients who are being difficult. Never take it personally. It’s not about you per se. It’s about the patient being terrified because they can’t figure out what’s going on.Home Health Aide Certification

Patients and their families sometimes want things done in a certain way. If so, and it’s safe for the patient, honor that. Remember, you’re there to make the patient’s life as comfortable as possible for the end of their lives and their time of need.

Sometimes patients who are lonely and isolated may not want you to leave. It’s natural to feel bad for them and to want to stay. However, if you have multiple patients, you owe it to everyone, including yourself, to maintain your schedule.

You may at times get patients who have mental or chronic illnesses such as Paranoid Schizophrenia or Bipolar Disorder. Patients with these illnesses often have paranoid delusion systems. For example, they often think that people are targeting them personally, that someone is trying to steal from them, etc.

They may even think that you’re there to harm them and could get defensive with you at times as a result. Remember, they’re much more scared than you are, so don’t let it frighten you. If they really don’t want you there, it may be best to honor that for the day. They tend to do best when under little to no stress, and their illnesses tend to get worse when they’re stressed.

However, one of the ultimate rewards is that you get a sense of continuity since you get to work with patients in their homes. The patients and families, in turn, get a sense of much-needed reassurance and stability. In the process, you establish a bond with the patient and they with you.

Some patients with Dementia, etc., may no longer understand the value of the things around them. As a result, they might try to give gifts away to you, which could include money.

If you work with an agency, it’s best to follow their policy on it. But even if you don’t and you’re in doubt, it’s best not to. First, you don’t know if it could be an inheritance. Second, their family could accuse you of stealing from them, which could result in the revocation of your certificate or, worse, a lawsuit.


While being a home health aide is a rewarding career that may seem easy enough on the surface, it does take a little homemaking and first aid skill. Also, every patient and family is different and can vary in temperament.

In general, however, being an HHA is very rewarding as there is a deep sense of servitude with it. Even when patients are difficult, you always walk away knowing that you’re making their lives much easier and better than they would be.

According to the U.S. Bureau of Labor Statistics and Occupational Outlook Handbook, job growth and the healthcare field and basic health-related services are growing rapidly as our population ages. If you’re looking for a career with a high level of job security this is a good place to start.

By Bryan Greene 

Home Health Aide Certification