Home health aide certification is not one national credential.
What qualifies you as a home health aide is the federal rule for Medicare-certified home health agencies: at least 75 hours of training, a competency evaluation performed by a registered nurse, and 12 hours of in-service education every 12 months.
States add their own rules on top: different training hours, registries, and — in Texas, for example — qualification routes built on prior experience or registry listing rather than a new training program.
What is HHA certification?
"HHA certification" is shorthand for meeting the aide qualification rules in 42 CFR 484.80.
Medicare-certified home health agencies may use only home health aides who meet them (42 CFR 484.80(a)(1)).
CMS sets those rules nationally, and they define qualified status — not a national certificate.
Federal rules recognize four routes to qualified status:
- Complete a home health aide training and competency evaluation program.
- Complete a competency evaluation program on its own.
- Complete a state-approved nurse aide program while listed in good standing on the state nurse aide registry.
- Qualify through a state licensure program the rule recognizes.
The nurse aide route deserves a close read if you already hold a CNA credential.
Under 42 CFR 484.80(a)(1)(iii), a person who completed a state-approved nurse aide training and competency evaluation program and is in good standing on the state nurse aide registry meets the federal home health aide training qualification, subject to the 24-month rule covered below.
The qualification tracks a defined job.
The same rule lists aide duties as hands-on personal care, simple procedures extending nursing or therapy, help with ambulation or exercise, and help with medications ordinarily self-administered (42 CFR 484.80(g)(3)).
What that work looks like across a full week of visits is the territory of the home health aide career guide.
Everything beyond the federal baseline is state territory, and the states use that freedom in very different ways.
That is why "how do I get my HHA certification" has a different answer in Austin, Albany, Chicago and Tallahassee.
Federal minimum requirements
The qualifications are anchored in section 1891(a)(3) of the Act as implemented at 42 CFR 484.80, and the home health agency compliance standards cross-reference them directly: a home health aide must meet those qualifications (42 CFR 484.115(d)).
In plain terms, a Medicare-certified home health agency may use only aides who do.
Training is the first requirement.
Classroom and supervised practical training must total at least 75 hours, and a minimum of 16 hours of classroom training must come before a minimum of 16 hours of supervised practical training (42 CFR 484.80(b)(1)-(2)).
The curriculum is specified, not improvised.
Federal rules require coverage of 14 subject areas, including communication, observation and documentation, reading and recording temperature, pulse and respiration, infection prevention, personal hygiene and grooming, safe transfers, range of motion and positioning, nutrition and skin changes (42 CFR 484.80(b)(3)).
The instructor requirement is specified too.
HHA training instructors must be RNs with at least 2 years of nursing experience, at least 1 year of it in home health care (42 CFR 484.80(e)).
Keep the scope straight: this floor binds Medicare-certified home health agencies.
It is not a national HHA credential, and it does not tell you what a state requires of aides in settings the federal rule does not reach.
How states differ
The federal floor is national; everything layered on it is not.
States decide whether home health aides get a dedicated training program, a registry listing, a state test — or whether qualification runs through agency licensing rules and the nurse aide credential instead.
New York sets its own HHA training requirement.
Home health aides there must complete core training of at least 75 hours through a New York State Department of Health-approved HHA Training Program, and DOH also approves PCA-upgrade and CNA-transition training for workers moving between those roles.
New York then documents the workforce.
The state's Home Care Registry provides limited public information on the home health aides and personal care aides who completed state-approved training programs.
The CNA-transition track is the detail that matters most for career changers.
New York's DOH-approved HHA Training Programs are approved to provide CNA Transition as a distinct program, alongside Core Training and PCA Upgrade — a dedicated route for CNAs moving into home health aide work (NY DOH).
Illinois keys certification to the setting instead.
Nursing assistants working in licensed or certified skilled nursing facilities, intermediate care facilities and home health agencies must be certified there, per the Illinois Department of Public Health.
Illinois also runs a Health Care Worker Registry that lists individuals with a background check conducted under the Health Care Worker Background Check Act (225 ILCS 46).
It shows CNA and other training, and displays administrative findings of abuse, neglect or misappropriation (IDPH).
Florida runs a shorter, test-flexible route at licensed home health agencies: at least 40 hours of training or a pass on the AHCA Home Health Aide Competency Test, with skills demonstrated in person even when the training itself is online or hybrid.
Medicare- and Medicaid-certified agencies in Florida may still require the federal 75-hour program.
Under 26 TAC §558.701, a licensed home health agency in Texas may use an aide with one year of full-time direct-care experience, a training-and-competency or competency-evaluation program pass, qualifying nursing student status, or HHSC Nurse Aide Registry listing with no abuse, neglect or misappropriation finding.
Where a training program is the route, it has its own floor.
Texas home health aide training programs must include at least 75 hours, with at least 16 hours of clinical experience.
At least 16 classroom hours must come before clinical work with clients — matching the federal 42 CFR 484.80 floor.
State rules move
The HHA competency evaluation
Training hours are only half of the qualification on the training route.
The other half is a competency evaluation, and 42 CFR 484.80(c) is prescriptive about who gives it and how it is scored.
The evaluation must be performed by a registered nurse.
Five subject areas have to be evaluated by watching the aide work with a patient or a pseudo-patient: communication, vital signs (temperature, pulse and respirations), personal hygiene, safe transfers and ambulation, and range of motion.
The remaining subjects may be evaluated in writing, orally or by observation.
Scoring has a bright line: an aide rated unsatisfactory in more than one of the required areas has not passed.
An aide rated unsatisfactory in a single required area has not failed the evaluation, but that rating restricts the work right away.
The aide must not perform that task without direct supervision by a registered nurse until they have been retrained in it and have successfully completed a subsequent evaluation (42 CFR 484.80(c)(4)).
This page's research names two separate tests.
Credentia — the company that acquired the nurse aide credentialing (NNAAP) program from Pearson VUE in April 2021 — lists a Home Health Aide exam program only for the District of Columbia on its HHA page, as of October 2026.
Florida's AHCA Home Health Aide Competency Test, covered above, is an alternative to the 40 training hours at licensed home health agencies there.
Registry and renewal
Where the credential is recorded depends on the state.
Federal registry rules give states an option: a state nurse aide registry may also list home health aides who passed a state-approved HHA competency evaluation, as long as the registry keeps HHAs distinct from nurse aides (42 CFR 483.156(a)(3)).
New York runs a dedicated list instead — the Home Care Registry covered above, with limited information on the HHAs and personal care aides who completed state-approved training.
Illinois folds its direct-care workforce into one Health Care Worker Registry maintained by IDPH.
Qualification is not permanent.
An aide who goes 24 consecutive months without furnishing covered services for compensation is no longer considered to have completed a program, and must complete another one before providing services again (42 CFR 484.80(a)(2)).
While you are working, in-service training is a continuing requirement.
Home health aides must receive at least 12 hours of in-service training in each 12-month period, supervised by an RN — and that training may happen while the aide is caring for a patient (42 CFR 484.80(d)).
That is the federal picture end to end.
What your own state adds is the remaining question, and the table below collects the state rules this page's research supports directly.
The 24-month clock
HHA rules by state
Each row below is that state's rule alone — a rule from one state tells you nothing about what another requires.
Every row also sits on top of the federal floor for Medicare-certified agencies, which applies nationally.
| Where | What applies |
|---|---|
| Federal floor (Medicare-certified home health agencies) | At least 75 hours of classroom and supervised practical training, with at least 16 classroom hours before at least 16 supervised practical hours, plus a registered nurse-run competency evaluation (42 CFR 484.80). |
| New York | Core HHA training of at least 75 hours through a DOH-approved HHA Training Program. DOH also approves PCA-upgrade and CNA-transition training, and the state Home Care Registry lists HHAs and personal care aides who completed state-approved training. |
| Illinois | Nursing assistants working in home health agencies — alongside skilled nursing and intermediate care facilities — must be certified. IDPH maintains the Health Care Worker Registry of background-checked workers. |
| Florida | At licensed home health agencies: at least 40 hours of training or a pass on the AHCA Home Health Aide Competency Test, with skills demonstrated in person. Medicare- and Medicaid-certified agencies may require the federal 75-hour program. |
| Texas | Under 26 TAC §558.701, a licensed home health agency may use an aide with one year of full-time direct-care experience, a training-and-competency or competency-evaluation program pass, qualifying nursing student status, or HHSC Nurse Aide Registry listing with no abuse, neglect or misappropriation finding. State HHA training programs run at least 75 hours, with at least 16 hours of clinical experience. |
| District of Columbia | Credentia lists a Home Health Aide exam program for DC — the only jurisdiction on its HHA page — as of October 2026. This page's research adds no DC-specific training-hour or registry rule to the federal floor. |
Read the rows as a range of approaches, not a ranking.
New York pairs dedicated training with a state registry, Illinois keys certification to the setting, Florida allows a shorter hours-or-test route, Texas builds experience-based routes into agency licensing, and DC is the one jurisdiction where Credentia lists an HHA exam program.
If your state is not in the table, the definitive source is the state agency that licenses home health agencies and approves aide training.
Two questions settle the path before you enroll anywhere: whether the state requires a separate home health aide credential, and which training programs it approves.
When your qualification is in hand, home health aide jobs on CaregiverHires list openings from home health and hospice providers, home care agencies, assisted living communities and nursing homes.
Career information, not licensing, legal, medical, benefits or tax advice. Home health aide requirements come from CMS and from state agencies, and they change — confirm the current rules with your state's home health or home care licensing agency before you enroll, test or apply.