Home Health Aide Certification – What to Know

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Thinking about pursuing a home health aide certification? Maybe you’ve heard of the hiring bonuses or you’ve seen others doing the job and thought, “Maybe that’s something I could do.”

You might be wondering: What training do I need? What does the pay look like? Is this a strenuous job? Are the hours reasonable?

If these are questions you’re asking, you’re in the right place. This is what you need to know about a home health aid (HHA) certification.

What do Home Health Aides Do?

While the work largely depends on the person you’re helping take care of (someone recovering from surgery has different needs from someone with Alzheimer’s), there are some basic foundational skills you’ll have to accomplish in this job.

Home health aides most commonly assist with the activities of daily living. They are not a medical provider. And that’s completely fine. In reality, the people that need an HHA actually need an HHA on a more regular basis than they need a doctor.

Think about how many times you have to use the bathroom in a day. As an HHA, you’ll often be at the care recipients side more than just about everybody else. In a sense, you will be their first responder.

Home health aides are most often responsible for:

• Assisting the with getting dressed and undressed
• Helping with toileting (read: often doing everything in the bathing process)
• Assisting in the preparation of meals
• Helping keep family members updated one patients’ well-being
• Helping with light housekeeping activities such as sweeping, laundry, and cleaning
• Helping with locomotion, whether that be via wheelchair, walker, or a steady hand
• Passing medication (with additional certifications)
• Providing conversation and social engagement

This is by no means a complete list of what is expected of an HHA, but it will help you to have a fundamental understanding of what it is that HHAs do.

It should be pointed out that the last bullet point – keeping the person company – is a much larger aspect of the job than many understand when they sign on. Human beings are created as social creatures. We do not do well in isolation. Where much of this work involves frail or elderly people who don’t have the same social opportunities as the rest of us, being there to listen and engage is as important as every other task.

Considering that you’ll be near the person(s) you’re helping throughout your shift, you’ll need to be able to carry on a conversation with them. A good home health aide is a friend as well.

If being friendly, maintaining a conversation, demonstrating patience with those who can be frustrating, or simply being empathetic is hard for you, look elsewhere for a job. There are too many HHAs out there who are great in all other aspects of the job but make for terrible company. For the sake of everyone, consider something that is more in line with your strengths and abilities.

This is a job that requires interpersonal skills – something that is sadly lacking in today’s society.

Home Health Aide Certification Requirements

One of the very first things you need to understand about becoming a home health aide is that there are often different requirements from the federal to the state level. Basically, the federal government within the United States has a set list of criteria for what qualifies one to become a certified home health aide.

However, there are a handful of states out there which have decided that this federal level of training is not strict enough. If you reside/are looking to work as an HHA within one of these states, you’re going to have to get an additional level of training than if you lived in a state that did not have these restrictions.

The federal level is the foundation, however, so let’s look at what the US federal government requires of you first.

For starters, you’re going to have to attend a HHA training program which encompasses 13 subject areas through both classroom settings and supervised practicals. In case you were wondering, a practical is nothing more than hands-on experience. You’ll be up and practicing HHA skills during this timeframe either on a dummy, on another student within the course, or on an actual patient (it depends on where you’re training).

This training course is mandated to consist of at least 75 hours, so you’re likely looking at a 2–3-week course before you can become an HHA. Of those 75 hours, at least 16 of them must involve supervised practicals where you are getting hands-on experience of working through the skillset. Classroom knowledge is good, but there’s no substitution for going through the manual skills that you’re going to be using daily to better ensure that you are able to safely and effectively do what is going to be required of you.

After completing the necessary hours, the federal government then states that you must pass a competency evaluation to ensure that you are indeed prepared and qualified to work as a home health aide.

The federal government doesn’t really specify what this exam is to entail, it just says that you must pass this examination with the label of a satisfactory knowledge. Should you pass this examination, you then must register with the state that you want to work in.

This is where state HHA requirements come in and a bit more confusion gets added to the mix.

As previously mentioned, there are some states that are stricter in their HHA certification process than others. This isn’t to say that it is virtually impossible or exponentially more difficult to become an HHA in these states, but instead indicates you’ll likely have to spend more hours in the classroom and practical setting.

For many states this means you’ll also have to become registered as a certified nurse’s assistant simultaneously to becoming an HHA if you want to work as such. Now, it appears as if the only states which have this requirement are Alaska, Hawaii, Idaho, Kansas, Kentucky, Maine, Maryland, Montana, New Hampshire, North Carolina, Rhode Island, South Dakota, Utah, Vermont, Washington, Wisconsin, and Wyoming.

Similarly, these same states also all require a specific state exam before you can call yourself a home-health aide.

The only oddball within the United States within this regard is Oklahoma. At the moment, it appears as if Oklahoma is the only state in the Union that requires you to take a state-specific examination (which means there are likely stricter training requirements here than elsewhere) which does not also require becoming a certified nurse’s assistant.

If you live in Oklahoma this works out to your benefit for the most part. While you still must take the state-specific exam, it means you don’t have to spend the extra time and money that it takes to also become certified as a nurse’s assistant.

Where to Begin Your Certification Search

So, you’ve decided to take the plunge but need direction on where to turn next? We’ve got your back. For those who are looking for courses, may we recommend the following:

Penn Foster – They actually have a fully online program here that can be completed for $700 at the time of this writing. If you’re concerned about being in a room full of other people or don’t have the time to attend classes at any school around time, online schooling may be just what you’re looking for. You can complete everything at your own pace on your own schedule.

That’s a lot of benefit and flexibility you can get there.

Corner Stone Healthcare – Based out of Washington state, this course only costs $345 at the time of this writing. Everything there can be completed online except for the skills lab which must be done in-person. If you live on the west coast, this may be something to investigate.

Ashworth – An online program, Ashworth will let you become certified for close to $650. That’s right about where most programs out there you’ll find cost, and this serves as a convenient means of getting the certifications that you need to begin your new job.

Your Local Community College – Saunter over to your local community college and pick up a copy of their course catalog. Odds are that you’ll find a HHA course offered here, in-person, at a very reasonable price.

Your Local Hospital – Hospitals often have their own HHA programs as well, with the benefit that many of these will waive the tuition requirements if you sign an employment contract with the hospital for a certain number of years after you graduate. This is a very popular method of HHA employment where it is available.

What Does Home Health Aide Training Cover?

We previously mentioned that HHA courses have 13 different subjects that they are required to cover. If we include the practical skills, what you’ll be studying are:

Basic concepts of healthcare – You must understand the foundations of what you’re doing first, and it’s here in your training course you’ll learn the 101.

Life support – Many of your patients are likely to be placed on life support at some point in time. This will help you to know what is expected of you in such a situation.

Technology common in the medical field – If your patient needs to regularly check their blood pressure, you don’t want a sphygmomanometer to be an alien object to you. This section of your coursework will help you to better understand some of the most common technology that you’ll see.

Communication and working with people – You’ll be working with people all day long during your shift, and as a result, you need to know how to be pleasant and to communicate effectively while doing so. Here is where you’ll learn what is expected of you in this department.

Ergonomics – You must keep yourself safe. Learning proper biomechanics for moving heavy people who cannot help themselves is key to not getting injured.

First aid and CPR – You won’t be trained to be a paramedic here, but you will learn some basic skills that could easily help to save a life.

Person care – Bathing, dressing, and assisting with the restroom are all covered in this section. This is what you’re going to be doing on the job more than anything else, so pay attention.

Nutrition – This plays a much larger role in peoples’ health than many people give it credit for. Make sure that you understand the fundamentals of nutrition here so that you don’t end up giving your patient potato chips because you think they’re a vegetable.

Cleaning and care of homes – A clean home helps to keep your patient healthy. If you let it sit and fester, sickness is going to fester as well.

Common diseases – Given that you’re bound to be dealing with a patient that has some form of chronic disease, you’re going to need to know a little bit about them. You’ll learn about that here.

Continuing Education Requirements?

To the best of this author’s knowledge, there are no CEU requirements on the federal level to becoming and maintaining a HHA certification. However, that very well may be different depending on which state you work in and for whom you work for.

For example, it does appear that some states do require a set number of continuing education units in order to maintain your certification. You can find out the requirements for your state and through the this link.

Many hospital systems out there require all their employees to gather in-house CEUs, and if that’s where you’re working, you can very well expect to have to do some type of paperwork/busywork to maintain your HHA certification.

Skills Needed to Become a Home Health Aide

If you suffer from test anxiety, you’re likely worried about whether you’ll be able to successfully pass the examination. What skills are going to be required of you? Is there a lot to memorize? Are the skills you’re going to have to know technically difficult?

To help alleviate any of these fears, let’s take a closer look at just what a home health aide does. To start, the population base that HHAs work with is predominantly the elderly. This isn’t the sole population that HHAs work with – there are younger patients with chronic diseases, learning conditions, mental disorders, etc. – that need 24/7 HHA assistance as well, but for the most part it is a safe bet to say the large majority of HHA patients are the elderly.

This means there are going to be people who have suffered from stroke, heart attack, Parkinson’s, Alzheimer’s, dementia, and numerous other health problems which require their having a bit of extra assistance as they go about their daily lives.

Some of the things these people are going to need your help with are getting dressed in the morning, using the bathroom, bathing, eating, brushing their teeth, being transported about town, moving throughout the house, and more.

It’s all very basic activities of daily life, but these people cannot do these things without outside assistance. That’s where you come in.

Who Will You Be Taking Care of as a Home Health Aide?

Being a home health aide often means helping people who have mental illnesses (e.g., schizophrenia, chronic depression, autism), physical impairments (e.g. paralysis, amputees, mobility issues), chronic disease conditions (e.g. diabetes, rheumatoid arthritis, dementia), or just age-related issues.

What is the Difference Between an HHA and a CNA?

It can get somewhat confusing when someone starts talking about home health aides and certified nurse assistants (CNAs). The jobs often overlap, but there are also some important distinctions between the two.

For starters, becoming an HHA is a faster process than becoming a CNA. In many cases, becoming an HHA only requires taking in-house training. It is a job that closely resembles becoming a personal care aide (PCA).

In contrast, becoming a CNA involves someone (sometimes an employer) paying several hundred dollars to attend a state-approved instruction course, getting several hours of clinical experience (where you’ll be changing adult diapers, assisting people bathe, and brushing others’ teeth for free), and then passing an exam. The Red Cross offers CNA training.

While becoming an HHA can also require passing an exam, it is a much easier process than what is required of a CNA. Both of these jobs may also require passing a background check.

Jobwise, being a CNA allows you to perform more tasks than what an HHA can do. Mainly this involves greater responsibility and working with different pieces of medical equipment that an HHA cannot.

When it comes to location, you’ll typically always find home health aides working at private residences. This is where most of their patients reside – though there are some HHAs that work in nursing facilities – whereas CNAs are virtually only found in hospitals, nursing homes, and assisted living facilities.

Being an HHA is much more pleasant when you consider the patient load as well. An HHA only ever works with one other patient (perhaps two if it’s a couple you’re taking care of). In contrast, a CNA often has an entire wing of a nursing home that they alone are responsible for. A CNA ends up getting run ragged over the course of their shift as a result.

A home health aide is still a challenging – and oftentimes frustrating – job, but that is one area which is a clear winner over being a CNA.

How to Get Certified as a Home Health Aide

To get certified as a home health aide, first consider where it is that you want to work. There may be a chance that the location will allow you to complete in-home training. In fact, this is often the case.

All you have to do is sign up for one of these courses, pass the brief exam, and you now have your certification to work as a home health aide. That’s all there is to it!

Home Health Aide Certifications Vary by State

Keep in mind though that HHA certification requirements may vary state by state. Some states are more strict than others with what is needed to legally work as an HHA. A quick Google search will help you to determine just what exactly you need to do regardless of which state you live in.

Demands of the Job

While you don’t need to be Hulk Hogan to work as a home health aide, don’t get any notions that this is a physically easy job. Being a home health aide is physically demanding. If you are helping someone who is overweight, has mobility issues, that needs help with dressing or getting out of a chair, you are going to need a steady amount of strength to accomplish your job.

If you end up working with somebody with Alzheimer’s or dementia, just keep in mind that sometimes these patients can end up being somewhat physically combative as well. Not all of them and not all the time, but this is something to consider when you sign up for the job.

You need to be able to engage in strenuous physical work. There can also be a lot of down time as well, sitting down, talking, and providing company.

If you are living with a great deal of chronic pain yourself, or have mobility issue (e.g. a bad back), working as an HHA is probably not for you.

Average Pay

What you’ll be paid for your job as an HHA will depend on where you are working, but the mean pay in 2018 was $12.18 per hour. That makes for an annual wage of $25,330 (Bureau of Labor Statistics).

A CNA in contrast earned $32,050. What you have to question is whether or not that extra money year is worth the extra effort required of a CNA (source). If you plan to work in the field for a long time, it most likely is.

Job Prospects

There is no shortage of opportunity out there for the aspiring home health aide. If one looks at the statistics that are being pumped out of the US Bureau of Labor Statistics, between 2018 and 2028 there is expected to be a 36% growth rate in the number of HHA positions throughout the US.

The primary reason for this is the graying of the American population. You have the baby boomer wave and people living longer than they ever have. It’s because of this that a large swath of the American population is considered old. Considering that older people are more prone to health issues, this means many more home health aide workers will be needed.

Final Thoughts on Becoming a Home Health Aide

If you have mastered the above skills, you likely have everything you need to work as a great home health aide. Though the skills in and of themselves aren’t difficult to master, do not deceive yourself into thinking that this is an easy job. Working as a home health aide can be both mentally and physically draining, depending upon the patient whom you are working with.

Nevertheless, this can be a very emotionally rewarding job to take on if you are looking for a way to both make a difference and to help bring in some cash flow. It is not a lucrative position to take – you likely won’t earn more than $30,000 per year by doing such, but it is a way to get paid to help people should you be in a position where you are financially ok but need some extra money to help offset costs.

If you are retired and living off your savings but are looking for grocery and Christmas present money for your grandkids, this very well may be a great way to help to make ends meet. If you’re looking to work as an HHA for your career path, just know that financially things are going to be very tight. In such an instance, you’re going to be better off financially by using your HHA job to get the patient care hours that are needed to get accepted into medical school, physical therapy school, physician’s assistant school, or the like.

What are your thoughts on becoming a certified home health aide? Do you know of anybody who has done such? Have you done it yourself? What has been your experience on the process of becoming certified within your state? Let us know int the comments below!