How to get your Home Health Aide Certification

Home Health Aide Certification

Why become a Certified Home Health Aide?

Home Health Aide CertificationCaregiving-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 many others with temporary or permanent physical and/or mental disabilities who need personal 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.

What is a Certified Home Health Aide?

A home health aide (HHA) is someone who provides services to patients who have physical or cognitive disabilities and/or 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, etc.
  • Providing and/or 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

Home Health Aide Certification

What about Salaries?

The home health aide salary depends on the geographical location and how much experience he or she has.

However, here are the averages for the home health aide salary:

  • 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 once have 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 10 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, CNA’s (or Certified Nursing Assistants) are allowed to 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. Home Health Aide Certification  
In turn, unlike HHA’s, CNA’s don’t usually do the housework, accompany patients on errands or take walks with them.

A PCA simply does basic 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. The main difference, however, is that the HHA received formal training and has to pass the home health aide certification exam.

Where can I find HHA training?

Web searches and calling agencies in or near your local area are the two most effective ways that 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 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 that is Medicare and/or Medicaid funding. Many hospitals, for example, include basic aide training but their programs are often not state-regulated and so they can’t offer certification.

National Association of Home Care and Hospice (NAHC) Certification

Once you have completed all of 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. This 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 some areas, you don’t even need a high school diploma or GED to become a home health aide. However, if you don’t and don’t have any experience, you will probably start out in the bottom 10 percent.

It may also take you longer to work your way up. As a result, most HHA’s have at least a high school diploma or a GED. You also have to be at least 18 to start training 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 an RN, LPN, or other more experienced aides. However, some states require training with a vocational school, community college, or home health agency.

Home Health Aide Certification

You must have fair interpersonal skills in order to gain a rapport with the patients and their families. Gaining trust is very important as the patient and their families are both basically putting the patient’s lives in your hands.

Time management skills are also important. 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 is probably not going to 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’re taking the patient’s vitals and administering 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/or other mental illnesses or disabilities and they can be incredibly challenging to work with at times.

What Else to Know About the Job

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 he or she can’t figure out what’s going on.

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/or their time of need.

Home Health Aide Certification

Sometimes patients who are lonely and/or 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 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 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.

One of the ultimate rewards, however, is that since you get to work with patients in their homes, you get a sense of continuity. 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 he or she 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 simply 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 him or her, which could result in the revocation of your certificate or worse, a lawsuit.


While being a home health aide 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 being difficult, you always walk away knowing that you’re making their lives much easier and better than they would be.

By: Bryan Greene

Bryan "BG" GreeneAbout the Author: Bryan has over 30 years of business experience in B2B Sales, Sales Support, and Customer Service and a strong passion for learning new things.
Learn more about Bryan here.