Home Health Aide (HHA) with an elderly patient in the hospital

Home health aides are caregivers who assist people in their everyday lives. 

They help people stay comfortable in their homes, whether on the mend or aging. From adults with disabilities to elderly patients, HHAs are there to support everyone’s health, happiness, and comfort.

Being a home health aide is a career dedicated to acts of service. They assist with the “little things” that are incredibly important to your patients’ quality of life. HHAS are there to make life easier for their patients, from dressing and feeding to grocery shopping and running errands.

If you’re interested in helping others this way, read on to discover how to become a home health aide in your state.

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What are the steps to becoming a certified Home Health Aide (HHA)?

You can become a home health aide by earning an HHA certification in your state. Unlike nurses, home health aides don’t need a college degree. If you want to start immediately, you can start your career track right after high school.

Some people want to become home health aides for a family member. States set their own requirements for this, but you should be able to become a caregiver for your relative after you complete your HHA training.

In some states, you can also qualify to get paid as a home health aide for your family member through Medicaid’s Self-Directed Services and a Home and Community-Based Services (HCBS) Program. 

1. Possess a High School Diploma or Equivalent

All home health aides must have a high school or general education diploma (GED). If you’re currently in high school, pay special attention to your science classes. Biology and anatomy are great introductions to medicine and healthcare careers. 

You can also earn your high school diploma or GED online, even if you’re over 21. Research your state's high school programs or online GED programs to learn more.

2. Study for and Pass a Certified Home Health Aide Program

You can get certified as an HHA through the National Association for Home Health Care & Hospice. Many community colleges also offer HHA certifications, which follow state guidelines. 

A community college can offer you the opportunity to learn in a classroom with aspiring HHA students. Most programs last between 14 and 25 weeks. 

You’ll study exciting topics like nutrition, communication, how to care for patients, and anatomy and physiology. Most programs also include two clinical experiences — these allow you to work directly with patients and build confidence in your skills. 

HHAs don’t provide any medical treatment. Instead, they help with living tasks, like mobility assistance, emotional support, feeding, bathing, toileting, and personal hygiene. Another essential part of an HHAs job is being a friend to their patients. 

Many people who require home healthcare struggle with isolation. A good HHA is always there to alleviate their loneliness and share humor, smiles, and laughter with their patients. You need to have genuine empathy and compassion for those who need assistance. 

Communication is also essential because HHAs can work with patients with Alzheimer’s, Down’s syndrome, and autism. Understanding how to communicate with these patients can be challenging, but it’s also immensely rewarding when you know you’ve reached them. It’s a bond you will never forget, even if you move on to another assignment. 

3. Meet Your State’s Minimum Hours of HHA Training 

Most states require 75 to 120 hours of HHA training, usually done through your HHA certification program. During your training, you’ll work in home care with actual patients under the supervision of a licensed professional. 

Some states also require home health aides to pass the national medication aide certification exam (MACE) before being licensed. Because each state’s requirements vary, we suggest choosing a program based on your region.

If you’re studying to be an HHA online, look for programs offered by community colleges or vocational schools in your state.

4. Pass a State Evaluation to Become a Certified HHA

Before applying for jobs, you may need to pass the national medication aide certification exam (MACE). In addition, you will likely need at least 75 hours of training and 16 hours of clinical experience before earning your HHA certification.

In some states, the requirements are much higher. For example, home health aides in Alaska need a minimum of 140 hours of training and 80 hours of clinical work. This site has an interactive map that can help determine how many hours you’ll need to become an HHA in your state.

5. Gain HHA experience

Once you’ve completed your training, it’s time to start working as an HHA. Many agencies place certified home health aides with patients, so you won’t have to look for them independently.

We suggest working with a home healthcare agency as you start your career. It’s the safest way to protect yourself and patients from liability. Working through an employer can also give you access to health benefits and a reliable income. 

Some HHAs may want to work for private clients, but they must do this at their discretion. You don’t get the same level of coverage or protection if you work for individual families. 

Can you become an HHA online?

You can start studying to become an HHA online, but you’ll have to complete your state’s required clinical hours in person. HHAs need anywhere from 16 to 80 hours of clinical work to be certified by their state. 

However, you can get a head start and begin studying HHA courses online.

What is the difference between a Home Health Aide and a Personal Care Aide?

A personal care aide (PCA) has less specialized training than a home health aide. A personal caregiver doesn’t need any formal requirements, though they usually undergo some training when they start their jobs. 

Home health aides have completed a certification program and are more qualified to assist a variety of patients. Most work through certified home health agencies that are licensed and regulated by their state’s department of health.

Because of their additional training, HHAs can do tasks PCAs aren’t qualified to do, such as:

  • Take basic vital signs and report them to a nurse.

  • Change basic wound dressings.

  • Handle more complex nutritional needs, like patients with allergies or dietary restrictions. 

What positions can you progress to from being a Home Health Aide?

HHAs can’t be promoted from their positions, so you’ll have to pursue additional education to qualify for another title. Job paths for an HHA include certified nurse assistant (CNA), licensed practical nurse (LPN/LVN), and registered nurse (RN). The requirements to move forward will also depend on your state’s requirements. 

How to Become a CNA from HHA

Home health aides and certified nurse assistants have a lot in common. They both assist patients with daily living activities and love serving in a caregiving role. The main difference is that CNAs have further qualifications to assist registered nurses in homes, hospitals, nursing homes, rehab facilities, and other healthcare settings.

A CNA must complete a Certified Nursing Assistant program in their state, then pass a state exam to earn their certification. CNAs are more regulated than HHAs, and their pay is higher on average. 

Being a CNA also opens the door to working with more patients in different settings. For example, you may enjoy getting to help the elderly in nursing homes or working with a wide variety of people in a hospital. They can also find work in other long-term facilities and rehab centers. 


A home health aide can also take additional courses to become a licensed practical or licensed vocational nurse if you’re in Texas or California.

LPNs are one level below registered nurses. They work in the same settings as CNAs and RNs but have further education to perform even more tasks. The LPN still provides a great deal of hands-on assistance, but they also do things that directly help RNs and physicians.

LPN responsibilities may include:

  • Checking vital signs

  • Keeping patient records

  • Positioning patients

  • Providing mobility assistance through physical support, walkers, and wheelchairs 

  • Feeding

  • Bathing and toileting 

  • Helping patients with oral hygiene and personal grooming

  • Administering oral medications given by an RN and prescribed by a physician

  • Assisting nurses with treatment procedures

To become an LPN/LVN, you’ll have to pass the  National Licensure Examination (NCLEX-PN). This certifies you as a practical nurse in your state, and you’ll need to register with your state’s board of nursing.


Becoming an RN is many HHAs dream. If you want to provide the highest level of patient care and pursue medical specializations, then becoming an RN is your best path.

Registered nurses support doctors and patients in homes, hospitals, healthcare clinics, and more. They can specialize in caring for a specific type of patient, like the elderly (geriatrics) and children (pediatrics). 

No matter what you want to do in medicine, there is a role in nursing for you. If you wish to work exclusively in homecare or treat patients in rehabs and nursing homes, being an RN gives you the greatest job opportunities, independence, and pay. 

There are even LPN to RN courses you can take to accelerate your career growth. 

To become an RN, you’ll need to:

  • First, earn an associate’s or bachelor’s degree in nursing (ADN or BSN).

  • Next, study for and pass the NCLEX-RN exam.

  • Finally, become a registered nurse through your state’s nursing board. 

There are many ways to shape your journey as an aspiring RN from universities with prestigious nursing schools, online programs, and community colleges. 

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Do your HHA exam qualifications expire?

HHA certifications may expire depending on your state. For example, HHA certification in Florida requires all home health aides to complete HIV/AIDS training every 12 months and hold valid certifications in CPR.

If you are working through the Centers for Medicare and Medicaid Services (CMS), you’ll have to follow federal regulations for training. The federal law requires all HHAs to complete a minimum of 75 training hours and 16 hours of clinical experience. 

Individual laws have their own HHA rules, and private home healthcare agencies that don’t work through Medicaid or Medicare do not have to enforce any regulations.

We suggest thoroughly researching your state’s HHA laws. Check your state’s department of health to see what HHAs need and how often they have to renew certifications.

How much do HHAs make?

On average, HHAs earn $28,314.90 per year. 

Salaries throughout the United States range between $20,500.00 and $36,120.00. 

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How long does it take to become a Home Health Aide?

The amount of time it takes to become a home health aide varies by state. However, on average, expect to spend at least 14 weeks in training as you work toward your required hours and clinical experience. 

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