One of the most common paths we see here at Florida CNA Online is Home Health Aides (HHAs) who wish to become Certified Nursing Assistants (CNAs). In this article, we will discuss the differences between an HHA and a CNA, and how an existing HHA can obtain a CNA certification.

What is an HHA?

An HHA is Home Health Aide, and as the name implies, are authorized to work assisting patients in their homes. HHAs generally help with a patient's daily activities such as eating, getting dressed, and their daily hygiene tasks.

What are the main differences between HHAs and CNAs?

HHAs and CNAs are both employed in the field of caregivers, and their main job is to assist patients with their daily activities. The main difference by far is that HHAs work exclusively in a patient’s home, while a licensed CNA can work in either a patient’s home or in an organizational setting such as a hospital or nursing home.

HHAs generally have some training, but no specific medical training, while CNAs do learn some basic medical skills which they can perform under the supervision of a nurse. Some tasks CNAs carry out which are outside of scope for HHAs are measuring pulse and respirations, tracking a patient’s symptoms and reporting findings to the charge nurse.

What is better for me? HHA vs. CNA

In most cases, we recommend to students who are considering a career in the field to obtain their CNA certification. This is because, in simple terms, a CNA can legally do everything an HHA can, but an HHA cannot do everything a CNA can. In addition to this, becoming a CNA and obtaining a CNA license provides greater flexibility since the license can be transfered to another state if you ever move from Florida or decide to work as a traveling CNA. Since there is no state licensinge for HHAs in Florida, there is no such easy transfer for HHA, and you would have to check with each state individually for their own rules.

What is the difference between a PCA and an HHA?

The term Personal Care Assistant (PCA) varies by state, but in the state of Florida it is generally used to refer to someone who assists in caregiving duties, but is not licensed as a CNA and can not perform licensed duties. For more information on PCAs, visit our article on the differences between PCAs and CNAs.

Requirements to work as an HHA in Florida

It is important to understand that HHAs are regulated by a different agency than the one that regulates CNA licensing. HHAs are regulated by the Agency for Healthcare Administration, while CNAs are regulated by the Florida Board of Nursing. This is significant because there is no state licensing or certification of home health aides in Florida. There are, however, a set of requirements to work as an HHA in Florida, which vary depending on where the HHA works. Below we detail the requirements for various cases.

How to become a Home Health Aide in Florida

  • To work as an HHA at a Home Health Agency
    • Must complete at least 75 hours of training if it is a Medicare or Medicaid agency (40 hours if it is a licensed-only agency) and/OR
    • Successfully complete a competency evaluation given by the Home Health Agency
  • To work as an HHA at a Nurse Registry
    • Provide proof of completion of at least 40 hours of home health aide training by:
      • A public vocational technical school OR
      • A private career education school licensed by the Florida Department of Education or a Home Health Agency, if the HHA was formerly employed by that Home Health Agency.

Do HHAs have any advantages when becoming a CNA?

Yes, generally HHAs do have a leg up on the general population when going through the process of obtaining their CNA license. Many of the tasks performed by CNAs are already performed by HHAs on a daily basis and as a consequence of that they usually breeze through the clinical portion of the exam. Not only that, but most working HHAs will already have had a background check performed for their current employment, and will not need to get another one before taking the state exam. Finally HHAs are required to be CPR certified, which is often required by CNA employers before allowing the CNA to work; though it is not required for the state exam and for obtaining a CNA license.

What if I've worked as a caregiver informally, but never as an HHA?

If you've worked as an informal caregiver, but never as an HHA, then most of the advice on this page will still apply to you, but we recommend you read our specific article on going from an informal caregiver to CNA for more information on your specific situation.

Can I take the CNA state exam directly if I am an HHA?

This is a subject that causes much confusion in Florida, but the answer is yes, you can take the state exam directly without any preparation. That being said, we strongly recommend you take our online CNA course for a refresher, as there are some things which HHA training does not cover. We particularly find that HHAs who take the test directly struggle with the written exam. The written exam is not difficult, but it can be very tricky if you have not taken any practice exams or prepared in advance for the material on the test.

One other very important thing to understand is that since there is no central testing authority or certification for HHAs, each Home Health Agency will provide the standard AHCA test for their HHAs, and there can be variations in the way these agencies will provide the tests. The test you took as an HHA may or may not be very similar to the CNA test. The clinical portion of the CNA exam will test you on randomly assigned skills. You may get lucky and be tested only on skills that overlap with your HHA duties, or you may get unlucky and have only CNA exclusive duties on your test. It is important to be prepared for all prior to attending your exam.

Do you offer an HHA online course?

Unfortunately, at this moment we only offer a CNA class for the state of Florida. Under Florida law, a CNA can work as an HHA with no further certification; therefore we recommend prospective students that qualify to take our course regardless of whether they are targeting a job as an HHA or CNA. There is really no HHA online certification in Florida. If you are exclusively interested in HHA jobs, you have several options available. The best option tends to be to apply for a job with a Home Health Agency directly as many will provide you and cover the cost of HHA training. You can also check out a list of non-public adult schools which offer HHA programs in Florida here. Regardless of your choice, we wish you the best of luck on your medical career!


Discutiremos las diferencias entre una HHA y una CNA, y cómo una HHA existente puede obtener una certificación CNA.