Certified Home Health Aide (CHHA)

A Certified Home Health Aide (CHHA) assists people who need help with daily living activities under the supervision of a nurse or other healthcare professional. Individual state regulatory agencies oversee CHHA credentials. The federally required minimum training hours for CCHAs in Medicare-certified home health agencies is 75, but some states require more. Most states require home health aides to be at least 18 years old, but some allow them to be 16. This certification is provided by the National Center for Competency Testing (NCCT).

Completion Time: Training course varies / 3 hours for the NCCT CHHA exam

Cost: CHHA course cost varies / $29 exam fee

Becoming a CCHA begins with training. Federal legislation requires Medicare-certified home health agencies that employ home health aides to be trained and evaluated through training programs approved by the state where the agency is located. Federal regulations require these training programs to include a minimum of 75 hours of training, including at least 16 hours of supervised practical or clinical training and 12 hours of continuing education per each 12-month period. However, the National Academy of Medicine recommends raising this minimum to 120 hours.

States determine their own minimums. According to the latest data available from PHI, 33 states only require the 75-hour federal minimum. Of the remaining 17 states and the District of Columbia that exceed the federal minimum, only 6 states and the District of Columbia meet the 120-hour minimum suggested by the National Academy of Medicine.

Federal regulations also list the specific subject areas and skills that must be taught during training and the competency evaluation process. Once a candidate completes the required training, they must pass a competency exam consisting of a written knowledge test and a skills test.

• Written Knowledge Exam: Assesses candidate’s understanding of home health aide responsibilities and best practices, typically has multiple-choice questions. 

• Skills Exam: Evaluates candidate’s clinical skills in a real-life setting, such as proper hand washing, taking blood pressure and transferring patients. 

The passing score varies by state but typically requires a score of 70% to 80%. Many states accept the nationally recognized National Center for Competency Testing’s (NCCT) CHHA exam. To be eligible for testing, you must meet one of five pathways: 

High school student or graduate of an NCCT-authorized high school within the past 5 years

• Current student in a postsecondary Home Health Aide program at an NCCT-authorized school

• Graduate of a postsecondary Home Health Aide program from an NCCT-authorized school within the past 5 years

• 6 months of verifiable full-time experience as a Home Health Aide within the past 5 years with 2 or more clients or 1 year of verifiable full-time experience as a Home Health Aide within the past 5 years

• Completion of Home Health Aide program or equivalent during U.S. Military service within the past 5 years

The NCCT’s CHHA exam has 125 socred questions and 25 unscored questions, with 3 hours allowed to complete the exam. The question breakdown is as follows:

• 15 - Infection Prevention

• 26 - Direct Client Care

• 25 - Client Safety and Transfers

• 25 - Activities of Daily Living

• 15 - Special Populations

• 19 - Law and Ethics

Prospective testing sites must apply to NCCT for approval to serve as official test administration sites for NCCT certification exams. Some independent testing centers may charge an additional fee for sitting for the exam there, but this fee can’t exceed $50.

Requirements vary by state but usually include:

• Meeting the state’s minimum age standards

• Completing a state-approved training program

• Passing written and skills exams

• Apply online (some states may have paper applications)

• Submit proof of training, exam results and any required documents

• Meeting any other state requirements

To maintain an active CHHA certification, the NCCT requires holders to complete continuing education (CE) annually and pay an annual recertification fee.

Renewal Fee:

• $89 to recertify a single NCCT certification

• $118 when recertifying 2 or more certifications at the same time

The credential remains valid for five years from the certification issue date. If you do not complete the annual requirements for five consecutive years, the certification becomes invalid.

Annual CE/CEU requirement:

• CHHA requires 12 contact hours (CH)

• If CHHA is held with TS-C credential, the annual CH defaults to 14

• If CHHA is held with any other NCCT credential that is not TS-C, the requirement remains 12 CH

NCCT allows CHHA certification holders to complete the required CE hours either through NCCT’s complimentary online CE library (not subject to audit) or by submitting outside CE opportunities (subject to audit).

• NCCT Certified Home Health Aide Detailed Test Plan

• NCCT Test Site & Program Eligibility

• NCCT Guide to Recertification

• NCCT Certified Home Health Aide

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