Home Health Aide Training 101: How to Become an HHA in 2018

You’re tired of simply going from job to job with little or no opportunity for advancement, so it’s time for a career you can be happy with and successful in long term!

You’ve decided the healthcare field is for you and want pursue home health aide training – and it’s exciting!

But now what?


HHA training

You need to know how to get your HHA certification!

You’ve heard stories about searching for programs, state exams, federal requirements, hours of studying, and aren’t sure what needs to be done first…

So, it’s easiest to start at the beginning!

This article will break down your journey in four easy steps, from finding the home health aide training program that’s right for you to advancing your career.

Check out the sections below to get started!

1. Research Different Types of Home Health Aide Training Options

Not everyone learns in the same style, and not everyone has the same resources to attend the same type of home health aide training.

It is important to remember that there are many options available, and you are sure to find the right one for you!

It just takes a little research to get started:

Where can I get home health aide training?

Not all states require formal training to be a home health aide, but most do.

If you plan to work for a home health agency that receives patient reimbursement from Medicare or Medicaid, you will be required to complete the minimum federal requirements for training.

Your state’s health department will be able to confirm if training is required.

For states that do require home health aide training:

HHA training is available through a variety of schools, agencies, and formats depending on where in the country you live. As you research your program, consider the options that may work best for you.

Not everyone learns in the same style, and not everyone has the same resources to attend the same type of home health aide training.

It is important to remember that there are many options available, and you are sure to find the right one for you!

It just takes a little research to get started:

  • ​Would you prefer a quick program that will get you working in the field quickly? Perhaps you should check with some local home health agencies to see if they offer free training to potential employees.
  • Is your budget limited? Why not check with your local state assistance agencies to see if your circumstances qualify you for free or low-cost training.
  • Would you benefit more from a program that is a little longer and more in depth? Maybe it’s a good idea to check out the local community colleges in your area to see if they offer HHA training in an upcoming term or semester.
  • Does your schedule or transportation limit the amount of time you can spend in a classroom? Checking out HHA training online might be a way to go for you.

Can I get my home health aide certification online?

Yes, HHA training is available online!

When looking into distance learning programs, you have to consider the expenses the school must cover to create the convenience you receive to learn the material on your own terms.

So the bottom line is:

Receiving a home health aide certification online will cost you some money.

A program like Ashworth College's HHA online courst starts at $659.

And while some people prefer it, the online learning format is not for everyone. As you research your programs, consider:

  • Online academies are unlikely to be local to your area. You may not have immediate answers to your questions that come up during your training.
  • Online academies are unlikely to be local to your area. You may not have immediate answers to your questions that come up during your training.
  • Since they are geared toward those wishing to have a flexible schedule, HHA classes online may take longer to complete than courses in a traditional classroom.
home health aide training online

If you find a home health aide online training program that may be right for you, be sure to check with your state and some desired future employers to be sure your certification will be acceptable.


Pro Tip: If you happen to find programs offering free home health aide classes online or for very cheap, they are unlikely to be legitimate.

Be sure you thoroughly review the program curriculum and accreditation before signing up to make sure you are not wasting your time on a program that will not benefit you.

If the program's website looks or feels sketchy, that's probably because it is.

Are there requirements to apply for home health aide training?

Most types of schooling have some sort of entrance standards to begin training, and HHA training is no different.

Typical home health aide training requirements include:

  • A successful health assessment, which may involve:
  • Clean toxicology screening
  • A negative TB test within the last six months
  • Clean toxicology screening
  • Life time search of expanded criminal background check
  • Fingerprinting
  • Ability to read and write at a competent level 
  • While no formal high school diploma or GED is necessary to be a home health aide, some programs may require it.
HHA interview questions

In addition to typical entrance requirements, agencies that offer free training to potential employees may also look for these things:

  • Reliable work history and references
  • Appropriate ID and proof of eligibility to work in the US
  • Ability to participate in a professional interview, either by phone or in person
  • A flexible schedule

How much does home health aide training cost?

home health aide certification cost

It depends.

That’s an answer nobody wants to hear, I know.

But cost can truly vary, from free to upwards of $1500, and is decided by a number of factors:

Things like where in the country your training is located, who regulates your training facility, and what type of funds your training facility accepts from patients as compensation can all have an affect on the out-of-pocket expense you may owe.

Is it possible to find free HHA training?

free home health aide training


Free home health aide certification is possible!

You just have to know where to look:

It's not uncommon to find home health agencies willing to provide free HHA training and job placement to eligible participants, provided they meet entrance requirements and agree to an employment contract upon their successful completion.

If you are interested in free home health aide training, check with some of the following local offices in your area to see if they have programs you may qualify for:


Be sure to keep in mind: While training can be free, sometimes there are out of pocket expenses associated with the certification process. There may be fees for things like:

  • Fingerprinting
  • Background check
  • Certification exam
  • Testing resources and materials

How long is HHA training?

You can expect a minimum of 75 hours of instruction.

If that sounds like too many hours to be sitting in a classroom listening to an instructor lecture endlessly, fear not!

You wouldn’t be alone if you consider yourself a hands-on learner, and it’s just one of the reasons why home health aide training might be right for you!

It has been shown that students who are allowed to put their skills to the test as they learn have increased retention, more personal confidence, and enhanced critical thinking.

critical thinking

No doubt home health aides benefit from such traits as they enter the field – and it’s no wonder your training includes this type of education!

Your home health aide program will include a combination of classroom and supervised practical training.

“Supervised practical training” means you will have the opportunity to demonstrate knowledge you acquired in the classroom in a laboratory or other setting – hands-on training at it’s finest!

While federal law does not specify the amount of time that must be spent in each, it does dictate that at least 16 hours of classroom training be provided prior to a student beginning their minimum 16 hours of supervised practical training.

Looking Ahead: It’s likely minimum instruction requirements will increase to meet the demands of this growing field. In fact, some states are already adjusting their standards to meet anticipated updated expectations.

The Institute of Medicine recently released a report suggesting minimum training be increased from 75 to 120 hours.

Thinking about it in context, one could argue this suggested increase in training hours confirms The Bureau of Labor Statistics prediction the HHA field will grow by 38% between 2014 and 2024. Increased training to meet increasing demands – makes sense, right?

Is it possible to get free 2 week HHA training?

free 2 week HHA training


It is not uncommon for free HHA training programs to have strict attendance policies, which are meant to accommodate the rigorous training schedules.

Programs like Home Aides of Central New York in New York City, for example, offer their 75 hours of training via 12 unpaid classroom days and 2 paid supervised clinical experience days, 8:30 am to 5:00 pm Monday through Friday.

Can I take my home health aide training in Spanish or any other languages?


HHA classes can be taught in a variety of languages, and are likely to be more available in areas with a higher demand.

HHA training in Spanish

Keep in mind that all programs and instructors must receive the appropriate state approvals to be valid. This means that programs approved in English cannot simply be taught in another language - the additional language must be approved as well.

Contact your state’s health department to be directed to approved non-English programs in your area.

2. Complete a State Approved HHA Training Program

You know you’ve got what it takes to be a successful home health aide, and you know which type of training program will work best for you.

But what happens once you’re actually in class?

What will I learn during my HHA classes?

HHA classes

While programs may include information that is specific to your state, all home health aide classes must include the topics outlined below, per the Code of Federal Regulations 484.36:

  • ​"Communication skills
  • Observation, reporting, and documentation of patient status and the care or service furnished
  • Reading and recording temperature, pulse, and respirations 
  • Basic infection control procedure
  • Basic elements of body functioning and changes in the body function that must be reported to an aide's supervisor
  • Maintenance of clean, safe, and healthy environment
  • Recognizing emergencies and knowledge of emergency procedures
  • The physical, emotional, and developmental needs of and ways to work with the populations served by the home health agency, including the need for respect for the patient, his or her privacy and his or her property
  • Appropriate and safe techniques in personal hygiene and grooming that include:
  • Bed bath
  • Sponge, tub, or shower bath
  • Shampoo, sink, tub, or bed
  • Nail and skin care 
  • Oral hygiene 
  • Toileting and elimination
  • Safe transfer techniques and ambulation
  • Normal range of motioning and positioning
  • Adequate nutrition and fluid intake
  • Any other task that the hiring agency may choose to have the home health aide perform"

Looking Ahead: While it’s important to understand the state and federal requirements of the job, you should also take some time to consider some personal aspects – namely, the type of environment you would be comfortable working in every day. Kelli Hansen, RN, lists nine things, as an example:

  1. Are you comfortable going into a patient’s house alone?
  2. Would you be willing to work in an area that may experience a higher rate of crime?
  3. Are you self-motivating, requiring little direction from a supervisor?
  4. Are you able to interact directly with a patient’s family comfortably?
  5. Are you able to provide adequate care in a patient’s home, even if it is cluttered or unsanitary?
  6. What is your preferred work pace? Do you need an environment that is slow and focused, or fast and exciting?
  7. Can you properly lift and move your patient without injuring yourself?
  8. Do you have allergies to mold or pets? Would you be able to work in a home where either is present?
  9. Would you be comfortable providing care to a patient of the opposite sex?

You want to be sure to consider all facets of the job as you begin your journey as a HHA. After all, your ultimate goal is long-term success and happiness in your career! Your work environment will surely play a role in both aspects.

Who teaches HHA classes?

HHA nurse

Receiving an education in the healthcare field is no joke, and your home health aide training is no different!

No worries, though:

Your home health aide instructor will know their stuff!

Every part of your program will require instruction by or under the direct supervision of a registered nurse. This RN will have no less than two years of experience, with at least one year directly providing home health care.

In other words, they’ll have been there and done that! Who better to learn your skills from?

Looking Ahead:  Once you are a working home health aide, if your patient is one who receives skilled nursing care, you will receive your patient’s assignment and written care instructions from a registered nurse (or other supervising professional, if the patient is under the care of a physical therapist or other doctor, for example).

Your supervising RN will then be required to conduct on-site visits at least every two weeks.

If you are caring for a patient that does not receive skilled nursing care, you will still have supervisory visits from a RN at least every 60 days.

Since these visits occur less frequently, your RN will be sure to conduct their visit while you – the home health aide – are providing care to the patient. This method helps to confirm your patient is receiving the proper attention.

Am I required to take my training again if I was previously certified?

HHA competency test

Some states allow a home health aide competency test or evaluation to be performed instead of repeating training.

The evaluation contains a written exam and demonstration of necessary skills.

  • ​“A nursing assistant with one year of full-time experience in a general hospital within the past five (5) years;
  • An individual with documented home health aide or nurse aide training and competency evaluation from an out-of-state training program;
  • A home health aide with documented home health aide training and competency evaluation who has not been employed as a home health aide for 24 consecutive months;
  • A nursing student who has documented evidence of successful completion of course work requiring mastery of home health aide tasks within the past 24 months. Documentation would include a transcript with passing grade(s) and course description(s) or skills checklist signed by the nursing school instructor.
  • Your state’s health department or a local home health agency will help you to determine if you are eligible.

3. Complete Your HHA Certification and the Required Evaluations

So what’s next? You need to know how to become a home health aide!

You attended all of your required training hours and didn’t miss a day.

You did it!

What can I expect the home health aide test to be like?

certified home health aide test

It’s time for the HHA exam you’ve heard so much about!

Once you have completed the required classroom and supervised practical training, the Code of Federal Regulations specifies that a competency evaluation must be performed before you begin working in your field.

This final evaluation will combine a written or oral exam and a demonstration of the home health aide skills you learned during your training.

While exact home health aide testing standards may vary by state and agency, they must all require:

  • An evaluation performed by a registered nurse
  • Evaluation observing the student's performance of:
  • Communication skills
  • Reading and recording temperature, pulse, and respiration
  • Appropriate and safe techniques in personal hygiene and grooming
  • Safe transfer techniques and ambulation
  • Normal range of motion and positioning
  • All other topics in training may be evaluated using written oral examination   
  • Any task evaluated as "unsatisfactory" may not be performed by the student aide without direct supervision of a registered nurse
  • Additional training of the task will be required and additional evaluations will be performed until determined "satisfactory"
  • A home health aide is considered to have successfully passed the competency evaluation once all tasks are marked "satisfactory"

Looking Ahead: It’s never too early to start preparing! Take advantage of home health aide practice test questions that are available and get a head start on your studying!

Do I need a home health aide certification to work as a HHA?

Not all states require a HHA certification for employed home health aides, but many employers can still require it due to preference.

States that do require it often issue home health aide certifications once an individual completes an approved training program and competency evaluation. In these instances your training facility will likely assist you in completing the HHA certification process.

home health aide certification

Many times, official certifications are submitted to a state office and can be tracked through online registries. Certifications usually remain valid as long as skills are used regularly and continuing education requirements are met.

Your state’s health department or local home health agencies are good resources for specific answers regarding your state’s regulations.

Are there continuing education requirements to be a home health aide?


Exact requirements can vary by state and agency, but you can expect a minimum of:

  • ​A performance review no less than every 12 months by a qualified home health agency
  • At least 12 hours of in-service training during every 12 month period (as a bonus, this in-service training can be completed while you are providing care to your patient)
  • In-service training to be conducted under the general supervision of a qualified registered nurse
  • The RN will have a minimum of two years nursing experience, with at least one year directly providing home care

In other words, you will be a life long learner!

4. Know Your Industry

The folks at the Bureau of Labor Statistics crunch a bunch of numbers, all day, every day, so that we can know impressive information like this about home health aide jobs:

How much do home health aides make and what factors can affect an HHA salary?

Just like any industry, there are many things that can have an impact on the kind of salary you will make as a home health aide:

Like where in the country you’re located and the overall growth of the field.

The BLS lists a few key items for us:

  • The rate of growth for the home health aide industry is 38% - much higher than average for other professions analyzed by the BLS
  • 2016 saw an average annual certified home health aide salary of $22,600 across the country, with the highest 10% of workers seeing wages upwards of $30,610
  • There were more than 913,500 jobs for home health aides in 2014, and 348,400 more are expected to be added by 2024
HHA salary

It’s exciting to see how quickly this field is expanding! A reassurance you have picked an excellent long-term career.

Is it important to have a home health aide resume?

You bet!

You’ve probably heard of the game “Six degrees of separation,” right?

Well turn those “degrees” into “seconds” and that’s the average amount of time you have to impress a potential employer.


A famous study by TheLadders found that recruiters spend an average of only six seconds reviewing an individual resume.

Talk about needing to make a good first impression! So as you begin to put fingertips-to-keyboard for your first resume draft, there are no doubt some important things to keep in mind.

home health aide resume

This study emphasized the importance of:

  • Being organized - make sure your resume is laid out in a manner that is easy to follow
  • Being clear - use the “less is more” approach, and make sure information on your resume is concise and to the point
  • Being detail oriented - pay attention to keywords in open job descriptions and use your resume to explain how you are the best fit

Pro Tip: As you pursue your career, keep your network in mind! In addition to a stellar resume, a home health aide reference letter can set your application ahead of the rest.

As you apply for positions that interest you, ask your professional contacts, like instructors or supervisors, if they would mind writing a letter of reference for you.

These letters can showcase your skills and work ethic, and further support why you are the right person for the job!

Start applying for home health aide jobs

Finding open positions to apply for is exciting! But finding an open position that combines your chosen career with benefits that may be important to you while employed is more exciting.

Keep some of these factors in mind as you browse job openings:

  • Does the company offer appropriate work/life balance?
  • Is the work schedule offered one you can accommodate?
  • Do they offer paid time off?
  • What do the company benefits look like?
  • Do they offer advancement opportunities?

You are looking for a long-term career, so it is important to find a good compromise of the benefits that are important to you as you submit applications.

Wrapping Up

Now that your armed with plenty of information about your HHA training, you're ready to take the first step toward the career of your dreams!  You can check out some of our additional resources to learn even more about this exciting field!

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