How to become a home health care aide

How to become a home health care aide

If you’re looking for a career working hands-on with patients in the medical field but you don’t have the time or money to train to become a nurse, one option is to become a certified home health aide. Many aging seniors prefer the comfort of staying in their homes to a nursing home, and home health aide services allow them, or anyone else with chronic illnesses or impairments, to remain safe and healthy at home.

“A lot of people don’t want to go to other places besides their homes nowadays,” says Debra Blank, a certified home health aide with Right at Home in Frederick, Maryland. Blank, who has been named Right at Home’s Caregiver of the Year, says she got into the field 13 years ago because she wanted to be able to help people and make them smile.

“Even if I only change one person’s life, it makes me feel so good to know I’ve done something to help someone, because there are so many people out there who need help,” she says.

Blank also appreciates getting to work out of patients’ homes. Unlike a sterile hospital environment where people constantly come and go, you get the continuity of working with the same patients over a long period, she says. You get to know their habits and routine, and you also develop close bonds. “I’ve had about four or five patients for three years at a time, and not only do I become family to them, but it’s like I have a second family, because they take you in and make you feel like you’re part of the family,” she says.

Certified home health aides like Blank help with basic tasks such as bathing, dressing, basic hygiene and transfers. You may sometimes be asked to do light housekeeping and errands. In some states, you can also help administer medication and take vital signs under direction of a healthcare practitioner. While some tasks are similar to those performed by nurses, there are fewer medical duties as a home health aide due to fewer training and education requirements. Your responsibilities are more focused on helping your patient get around, maintain hygiene and be comfortable.

How to get trained and certified as a home health aide

To become a certified home health aide, you don’t necessarily need education beyond a high school diploma or equivalent, though you must get certified through a training program. Andrea Devoti is the Executive Vice President of the National Association for Home Care & Hospice, and she’s also a nurse who ran a home care agency in Westchester, Pennsylvania, for 18 years. Devoti says that while state laws vary on exact requirements, the industry standard for certification programs is 120 hours of classroom training and 40 to 60 hours of clinical work.

You can get certified by the National Association of Home Care and Hospice (NAHC), but many community colleges offer their own home health aide certification, Devoti says, as do some nonprofit organizations, home health agencies and skilled nursing facilities. You may also find certification programs at vocational schools. Tuition for a home health aide certification program typically ranges from $300 to $650.

While many hospitals also offer basic aide training, Devoti says, be cautious since these programs don’t always meet the requirements to get certified by a state.

What you will learn in training

“The classroom work is training on basic personal care needs: how to give all kinds of baths and showers, as well as other personal care, including mouth care and all those things that we normally take for granted and do for ourselves,” Devoti says.

She adds that certification training also teaches you basic medical signs and symptoms, how to take temperature and pulse and how to tell when someone appears flushed, which can indicate a fever or other health issue. “Some schools teach how to do blood pressure, as well, and then how to report those things to a higher level clinician, as well as basic transfers in and out of bed and chairs,” she says. It’s a detailed program that prepares you to work with patients, she explains.

At the end of your training, you will sit for a certification exam. In addition to being tested on your knowledge, you also have to demonstrate what you’ve learned. “In some cases it can be a full day where they’re observed doing various baths, making a bed and transferring a patient, and they’re given scores on how they’ve done to get certified,” Devoti says.

Pay and outlook for certified home health aides

According to the Bureau of Labor and Statistics, the 2019 median pay for a home health aide was $12.71 per hour or $26,440 per year.

However, Devoti says pay can vary greatly depending on location and your state’s wage laws. She says depending on the geography, home health aide pay can be anywhere from $9-18 per hour.

Here’s the good news: Home health aides can obtain additional certifications that can increase pay. “They can get other certificates in things like geriatrics, cardiac patients or behavioral issue patients so they can actually specialize and get recognition, and many places will pay more for that,” Devoti says. She’s found that additional certifications typically allow aides to command from 50 cents to a dollar an hour more.

There are also plenty of job opportunities in this field. “With the aging Baby Boomers, more and more people are wanting to be at home,” Devoti says. “So they’re asking for certified home care aides, and it’s just a booming part of the industry. We get calls every week asking if we know where there are people who want to be certified home health aides.”

According to the Bureau of Labor and Statistics, the future job outlook for certified home health aides is excellent and will continue to grow. The projected percent change in employment from 2019 to 2029 is 34%.

Not only is this a field where there’s ample work, but if you love your job as a certified home health aide and want to get paid more, Devoti says the occupation is a great launching pad to become another type of clinician. For example, you could get more training and become a physical therapist, respiratory therapist or even a registered nurse.

Plus, you get to make a difference in people’s lives every day. “I’ve always felt that giving makes you feel so much better than taking,” Blank says. “This work just makes you feel so good about yourself, and you’re showing other people that you care about them and you’re compassionate for them.”

How Long Does It Take, What Degree Do You Need, and More

How to become a home health care aide

Home Health Aides

Home Health Aides provide routine individualized healthcare such as changing bandages and dressing wounds, and applying topical medications to the elderly, convalescents, or persons with disabilities at the patient's home or in a care facility. Monitor or report changes in health status. May also provide personal care such as bathing, dressing, and grooming of patient.

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Table of Contents

What degree do you need

High School Diploma

One of the most common questions that we always get is what major or degree do I need to become Home Health Aides or what courses do I need to take.

We also asked Home Health Aides what did they major in college or university and here are the top 5 most popular majors that came up.

Home Health Aide

Although a high school diploma or equivalent is not generally required, most home health aides have one before entering the occupation. Some formal education programs may be available from community colleges or vocational schools. Courses should focus on meal preparation, housekeeping and social activities.

Featured Schools

How hard is it

You may need some previous work-related skill, knowledge or experience to be a Home Health Aide . For example, a bank teller would benefit from experience working directly with the public.

Careers in this difficulty category need anywhere from a few months to one year of on-the-job training.

How to become a home health care aide

Due to the aging of baby boomers and increased life expectancy, the number of senior citizens over the age of 65 is increasing every year. With that comes the increasing need for medical and personal care as well. This offers great business opportunities for entrepreneurs in the healthcare industry.

If you’re considering owning a business in the home health care industry, you might be wondering “Where do I start?” Before we get into the necessary steps for starting a home health care agency, what actually is a home health care business?

Defining a Home Health Care Agency

The term “home health care” is fairly straightforward. It basically means that medical professionals or professional caregivers go into individual’s homes and provide some sort of help or care.

Medical home health care would be nursing services, wound care, monitoring of one’s health such as blood pressure and mental state. This type of care is needed when someone gets out of the hospital or for senior citizens.

Home care that is provided by caregivers is based around the need for basic day-to-day assistance. For example, home care aides will prepare meals, clean the house, help change or dress an individual or drive them to or from doctors appointments.

This article will discuss the specifics in starting a medical home health care business that is covered by Medicare, Medicaid and private paid.

Starting a Home Health Care Business? Follow These Steps:

NOTE: PRN Funding is NOT an authority on starting a home health care business. PRN Funding’s expertise is with invoice factoring. Home health care companies have the ability to factor once they have invoices lined up. Until your home health care company has invoices, please do not contact PRN Funding concerning funding.

Step 1: Create a business plan.

This is the first step in starting any type of business. You need to make a business plan for your home health care agency because it is the base of your company and will be needed for each step to follow. A business plan includes the following:

  • Executive summary – Explain the basics of your company.
  • Company description – Write the mission and goals of your home health care agency.
  • Services – Describe what services you will be providing.
  • Marketing plan – How will people learn about your business? Decide the pricing of your business as well.
  • Management and organization – Describe the ownership structure of you healthcare business.
  • Operational plan – Explain the facility and staff, as well as supplies you will need to operate.
  • Financial plan – This is where you will write a cash flow projection, balance sheet snapshot and break-even analysis.

Step 2: Register with the state.

In order to receive payment from Medicare and Medicaid, your agency needs to meet the requirements put in place. Certify your agency by completing your state’s home care application for a license.

You will also need to incorporate your business, get your tax identification and register for your NPI (National Provider Identification) number. These requirements for starting a home health care agency depend on a state-to-state basis.

Step 3: Obtain Medicare and Medicaid certifications.

By obtaining these certifications, your agency will be able to provide health care services such as nursing care, physical therapy, and other services and get paid by Medicare and Medicaid plans.

Be aware that this process of becoming accredited can take longer than you think, sometimes even up to a year. To apply and go through the survey process, visit In addition to getting these certifications, some states require business owners of home health care agencies to complete a jurisprudence exam.

Step 4: Hire a great staff.

Since your home health care business is providing personal service to patients, you want a staff that represents and reflects what you want your business to be.

There are many ways to go about hiring the perfect workers for your agency. Many businesses take to social media, for example.

Once you interview potential staff members, make sure you conduct thorough background checks to avoid legal action if there is any problem with care from an employee.

Step 5: Get your clients.

Once you have a business plan in place and your ideal staff lined up, it’s time to get clients and start operating your business. This step is one of the most difficult parts of owning any type of business, especially a service-based business like a home health care agency.

Effective marketing strategies are crucial for obtaining clients. Here are some basic marketing ideas you can implement to get your business going:

  1. You need to have an online presence. Build yourself a basic website to get your information and name out there. There are many free hosts that help you create a functioning website. You can always come back to your website and improve it and edit it as needed, but in order to get clients for your home healthcare business, you’ll need a website to represent your company.
  2. Let Google know you exist. Register your healthcare agency with Google so your address, hours and phone number can be accessible for potential clients. This is easy, but make sure you have your website first.
  3. Know your differentiating factors. If you have a prospective client, let them know what makes you different and better than the competition. Outline this for your employees and on your website to send a clear brand message.
  4. Join local groups and organizations. Show your professionalism and get your name out there by joining local groups and associations, such as the National Association for Home Care & Hospice.

Step 6: Have a solid financing plan for growth.

PRN Funding does NOT provide startup capital for your home health care agency. However, once you have invoices from customers, PRN Funding may be able to offer your business funding via invoice factoring.

Once you start billing Medicare, Medicaid or third-party insurers, the slow payment periods can cause some stress on you as the business owner. Accounts receivable factoring is used by home healthcare agencies and businesses to bridge the gap between payment periods.

Invoice factoring allows you to be advanced an amount to pay employees and continue growing your healthcare business. You company will have more money for expenses and take the stress of cash off your mind so you can focus on your business operations.

North Dakota home health aides work under the supervision of registered nurses to provide personal care services to people with serious health challenges. Those who complete programs and otherwise meet standards may be listed as nurse aides on a state registry.

Direct care workers may perform similar personal care tasks for different types of agency. Some patients will be just getting out of the hospital and will be receiving in-home services by physician prescription. Other patients will be stable but in need of long-term care. Training requirements will vary, as will job titles. One can learn the basics, though, with as little as 75 hours of training.

Select a North Dakota Home Health Aide Topic:

North Dakota Home Health Agencies and Other Home Care Agencies

North Dakota licenses home health agencies operating within its borders. As of mid-2017, there are 23 home health agencies in North Dakota. There are far more employment options, though, than this. Not all agencies that have RNs and unlicensed caregivers on board are home health agencies as defined in North Dakota code. Part of the definition of a home health agency is that services are provided with the approval of a physician ( Typically home health agencies are organizations where people are referred by doctors and hospitals; they participate in federal programs that pay for client care when very specific requirements are met.

Some agencies that are not technically home health agencies accept state moneys for care provided in the home. They are under state regulation as ‘qualified service providers’. Their employees must meet certain requirements. There are some well-known home care franchises and organizations operating in North Dakota. One won’t find them on a list of home health agencies. They may be found, however, through a search of qualified providers on the North Dakota Department of Human Services website ( An example is Visiting Angels in Minot.

Meeting Home Health Aide Training Standards

HHAs who work for home health agencies licensed in North Dakota must meet training/ competency evaluation standards at the federal level. Training programs are at least 75 hours and include at least 16 hours of clinical work; clinical training commences at some point after he individual has had at least 16 hours of education.

The training curriculum will include the following:

  • Maintaining a safe, healthy environment
  • Safe and appropriate techniques for grooming and hygiene
  • Safe techniques for ambulation and transfer
  • Positioning and range of motion
  • Recognizing emergencies and knowing what to do

In some cases, HHAs may be qualified on the basis of competency evaluation programs.

North Dakota administrative code states that if there are any discrepancies between state and federal standards the higher of the two is in effect.

The HHA Application Process

HHA applications can be found in the ‘CNA registry’ section of the Department of Health ( The applicant will answer professional fitness questions. There is a $25 fee.

Highly Rated Home Health Agencies in North Dakota

Medicare issues star ratings to certified agencies. Two separate ratings are issued: quality of care and patient surveys. North Dakota ratings trend very slightly above the national average; this is as of 2017. The following agencies have 4.5 or 5 stars in both categories:

  • Altru’s Home Health in Grand Forks
  • CHI Health at Home in Breckenridge

Ratings do not constitute an actual endorsement.

Meeting Requirements to be a Direct Care Provider for a Qualified Service Provider

Agencies that offer services such as personal care and respite care must ensure that their employees meet state mandates. Employees will need to have a qualifying health credential or go through a qualification process to demonstrate that they have the skills. The Certified Nurse Aide (CNA) is a qualifying credential. CNAs complete approved CNA programs and go through an evaluation process.

Individuals without qualifying credentials will need to be competent with approximately 20 skills. This means knowing “generally accepted methods” for various tasks including hand washing/ infection control, bathing clients, assisting with self-administered medications, assisting with incontinence issues, planning and preparing basic meals, making beds, and transferring patients using several techniques, including transfer belt. Competency must be verified by a health professional such as a doctor or registered nurse.

It is necessary to have competence in all of these basic home care duties even if one is hired to provide care for someone who does not require all.

Agencies may provide more advanced skills. They are granted endorsements to do so.

Hospice Employment

North Dakota also sets requirements for individuals employed as ‘homemaker and home health aide” by hospices. They must complete organized training programs that are applicable to the settings where they will be working.

Career Outlook and Average Home Health Aide Salary in North Dakota

North Dakota home health aide employment has been projected to increase by 28% between 2014 and 2024.

North Dakota home health aides enjoy an average hourly pay of $15.95 — this is the second highest average in the nation and is topped only by Alaska. Workers who are classified as ‘personal care aides’ don’t, on average, make a lot less: $15.33. This is the highest in the nation (In this category, it’s Alaska that comes in at #2.)

Rural North Dakota needs home health aides — and often pays well for their services. The average hourly pay in the Far West nonmetropolitan area is $17.21. In the Far East nonmetropolitan area, it’s $16.51. Both these areas are in the top five highest paying nonmetropolitan markets nationwide. Bismarck, with an average wage of $15.45, is #8 out of all metropolitan areas in the country. For personal care aides, it ranks #1 — $15.55 is the reported average.

While becoming a home health aide does not generally require a formal education like that of nurses or doctors (some states do require a minimal amount of education beyond high school or a high school diploma/GED), you can become certified. Becoming certified may help you get a leg up on your competition, open up your career field and even boost your pay!

If you work for an agency that is funded by Medicare or Medicaid, you must meet minimum standards of training prior to being hired. Also, many states have their own requirements and regulations regarding training for employment in the field, especially if the agency you plan to work for is a certified home health or hospice agency. Because of these regulations and requirements, you may be required to obtain some formal training and pass exams which often include demonstrating competency in necessary skills. Often, certified home health agencies will provide the needed training, testing and assessments. In other cases, you can find preparatory classes offered at community colleges or through vocational/technical schools.

Home Health Aide State Certification

Home health aide certificate programs provide courses on basic medical care, patient care, emergency response, medical terminology, health care supervision and patient support as well as home maintenance and organizational skills. Each state has their own certification program and requirements. Some states require 75 hours of training while other states require 120 hours or more. Regardless of the number of hours required for certification by your state, during this time you will learn to administer medications properly, healthy cooking, and how to assist with the patient’s personal hygiene. You will also learn to take vital signs, including blood pressure and pulse.

Home Health Aide National Certification

The National Association of Home Care and Hospice (NAHC) offers national certification for home health aides that is voluntary. In order to become certified by the NAHC, you must complete 75 hours of training and pass a comprehensive exam. Though this certification is voluntary, you may find that having it increases your career prospects as well as your hourly wages.

Career Advancement

Becoming a home health aide is a great stepping stone in the home health care field. Once you have worked as a home health aide for several years, you can consider advancing your career through further training and becoming a certified nursing assistant (CNA) and then perhaps later even a Licensed Practical Nurse (LPN). CNAs require at least a high school diploma or GED plus training. Just as with becoming certified as a home health aide, states have different training requirements for becoming a CNA. LPNs generally require a diploma from a community college or accredited online course.

Becoming a home health aide is a rewarding career in which you get to help people each day by providing personal care. While becoming certified as a home health aide is not always necessary, it can open up your career field and increase your pay. Becoming certified can also give you peace of mind, knowing that you have the necessary skills to care for your patients’ every need. Plus, becoming a certified home health aide can help you to advance your career in the future, by becoming a CNA or later, an LPN.

the purpose of this letter is to advise home care agencies and hospices of revisions to the guide to operation of a home health aide training program that will become effective for all home health aide training programs (hhatps) july 1, 2012. these requirements supersede previous guidelines issued by the department. the new york state department of health established requirements for the approval and re-approval of hhatps on august 19, 1992. these requirements are based on federal regulations found in the cms conditions of participation (cops) for home health agencies (42 cfr 484.36) and the cops for hospices (42 cfr 418.76). the development and implementation of the hcr provided an accessible database that includes all home health and personal care aides who were employed on september 25, 2009 and after.

the workgroup’s efforts have resulted in the revision of the guide to operation of a home health aide training program. effective february 1, 2012, all applicants seeking initial approval as a home health aide training program must meet the requirements in the revised guide. for questions or clarification on this directive, contact the new york state department of health, division of home and community based services at [email protected]

181 home health aide instructor jobs available on apply to home requirements. nursing: 2 years. major revisions to the requirements for operating a home health aide the training program must designate at least one approved nurse instructor to be responsible for the coordination of training learn about the job description and duties, and read the step-by-step process to start a career in health, hha instructor course, hha instructor course, home health aide instructor manual, home health aide training program application, home health aide training manual. u’ TRAINING REQUIREMENTS A HHATP must include classroom and supervised practical training. The aide trainee must receive a minimum of 75 hours of training including a minimum of 59 hours classroom and 16 hours of supervised practical training. Required testing and competency evaluation are not included in the 75 hours.Jul 1, 2013

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This page provides basic information about being certified as a Medicare and/or Medicaid home health provider and includes links to applicable laws, regulations, and compliance information.

A Home Health Agency (HHA) is an agency or organization which:

  • Is primarily engaged in providing skilled nursing services and other therapeutic services; Has policies established by a group of professionals (associated with the agency or organization), including one or more physicians and one or more registered professional nurses, to govern the services which it provides;
  • Provides for supervision of above-mentioned services by a physician or registered professional nurse;
  • Maintains clinical records on all patients;
  • Is licensed pursuant to State or local law, or has approval as meeting the standards established for licensing by the State or locality;
  • Has in effect an overall plan and budget for institutional planning;
  • Meets the federal requirements in the interest of the health and safety of individuals who are furnished services by the HHA; and
  • Meets additional requirements as the Secretary finds necessary for the effective and efficient operation of the program.

For purposes of Part A home health services under Title XVIII of the Social Security Act, the term “home health agency” does not include any agency or organization which is primarily for the care and treatment of mental diseases.

The healthcare industry grows and progresses rapidly. In the midst of it, you can find home health care as one of the most in-demand, fast-growing areas. The team at the US Bureau of Labor Statistics has looked into the future and predicts that home health aide (HHA) careers are continuing to grow and grow and grow!. People who work in this industry take a great deal of importance in the lives of those who need medical assistance the most. In plain words, they are aging baby boomers. In plain terms, HHAs are pretty awesome.

What is a Home Health Aide?

A home health aide is one of the most prevalent career paths in the field of in-home health care. People who take HHA jobs are passionate about caring for and helping others. A home care aide provides care to patients who need help for any variety of reasons that range from illnesses and cognitive impairment to disability and advanced age.

HHA duties (link to the other article) can be really different between employers. These duties depend on the types of clients (e.g., child versus adult) and why they need help in the first place. People in need of a home health aide may need assistance with the most basic care tasks such as eating, bathing, moving around, or even going to the bathroom. They might need help with running some errands such as picking up medication, doing grocery shopping, going to medical appointments, and more.

To be more, some of the remaining home health aide duties may include helping with monitoring of the vital signs, as well as performing some basic medical tasks such as assisting the patient with taking medication. Would you enjoy helping people in this way? Being a certified home health aide is more than just a job – it’s a way to help people. Thankfully, it does not require a college degree. However, you will probably need some home health aide training before you get in the field and start looking for a job.

Should I become an HHA?

You might secure a position as an HHA without formal education. Still, to maximize your chance of landing a job, as well as to learn how to become an HHA, you can pursue one of the available training courses and certificates from many institutes. Any training you choose to pursue, and any experience you can get will go a long way into making you an effective caregiver.

Naturally, to land the best home health aide jobs and get the necessary training, you need to know where to find such classes and how to choose the right program.

HHA Classes

Just know that your training requirements will be different depending on what each particular employer wants. To work for a Medicare or Medicaid funded agency, you must meet the minimum standards of HHA training. The rules require 75 hours of training, sixteen hours of practical and supervised work, and a passing of the state certification program’s competency evaluation.

For formal training, you may look to HHA training programs offered by postsecondary institutions such as community colleges. Such HHA classes usually last a semester and require that you complete a physical examination, state-mandated blood tests, as well as a background check to enroll.

HHA Training and How to Pay for It

First, let’s see what your options are for home health aide training:

  • Community colleges
  • Eldercare programs
  • Home health care agencies
  • Night courses at high schools
  • Online training courses

Generally speaking, a typical training program for an HHA takes between two and six weeks to complete. The program includes lectures, quizzes, tests, and in some cases, hands-on experience at a health care facility.

HHA training can cost anywhere between $100 and $1000. If this is more than you can afford, you will be happy to hear that there are some great alternatives. If you’re looking for free training, there are some options. Many agencies actually offer HHA classes for free, or you can get on-the-job training provided by nursing assistants, licensed nurses, or more experienced aides.

Many local home health aide agencies offer free training in return for your commitment. In other words, you can look at some CHHA jobs that offer free training beforehand but be ready to work with them for a specified time.

Getting Hired as a Home Health Aide

The average salary for an HHA is around $25,000 at this moment, with over 797,000 employed home health aides in the United States at the moment. Home care agencies hire more than half of the home health aides, while the rest work for assisted living or retirement communities, family services, and nursing homes.

If you have obtained the home health aide training and are searching for a job, do not worry. This career is in high demand. You need minimal HHA training to land most jobs. And, if you were dedicated enough to take extra HHA classes or have some experience behind you, your odds at a high income are even more significant.

Have you been asking: what are the best HHA jobs near me? If you have, go online and look for job posts on Caregiver Jobs Now. If you don’t have your HHA certification yet, you can look for “Caregiver” jobs that may not require any kind of certification at all. This will give you some practices before you start your HHA training program!