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What is hha in healthcare

If you’re the kind of person who loves helping people, you may be drawn to becoming a home health aide (HHA) or a certified nursing assistant (CNA). Do you know the differences between HHA and CNA training and job duties?

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The job description for both HHA and CNA means being a personal care assistant for clients who need some kind of help or companionship, many of whom are elderly, chronically ill, disabled, or in various stages of dementia. Both career paths can be highly challenging and deeply rewarding, but they aren’t the same.

A home health aide leads her patient down a hallway.

We want to help you understand how a home health aide and a certified nursing assistant are similar in their job opportunities to provide important care and make a meaningful difference in people’s lives, as well as the differences between an HHA and a CNA in their education and training requirements.


Home health aide duties and responsibilities

On the most basic level, being a good home health aide means being a compassionate caregiver helping another person. Home health aides provide basic, personal care to clients. An HHA may assist with bathing, dressing, and other self-care and hygiene needs. As needed, an HHA also may:

  • shop for groceries
  • prepare meals
  • help clients eat
  • perform light housekeeping duties, such as laundry
  • provide occasional transportation where state regulations allow

Although an HHA job description focuses on providing non-medical care only, some states allow home health aides to administer medications and check vital signs if supervised by a nurse or other licensed health care professional.     

CNA duties and responsibilities

Like HHAs, certified nursing assistants working in the home setting provide companionship and help clients with household duties, activities of daily living, and personal care such as eating, bathing, and dressing.

In some care settings in certain states, CNAs can perform a few job duties not performed by an HHA, such as:

  • transfers in and out of a bed, chair, or wheelchair
  • monitoring vital signs
  • administering medications
  • documenting changes in health condition
  • reporting to doctors or nurses.

In nursing homes and other long-term care facilities, CNAs are often the primary caregiver and have more contact with the patient than any other staff member.

Home health aide training

In nursing homes and other long-term care facilities, CNAs are often the primary caregiver and have more contact with the patient than any other staff member.

If you love helping people, you could be qualified to become a home health aide. The US Bureau of Labor Statistics notes that while many HHAs have a high school diploma or a GED, formal education generally is not required to be an HHA. Some states do offer a training and certification process to become a certified home health aide, or CHHA.

CNA certification

CNAs, however, must pass a state licensing exam to be certified. This requires a formal training program offered by community colleges and vocational and technical schools. Candidates must learn basic principles of nursing care and complete several hours of supervised clinical experience.

HHA: primarily in-home care

As their job title suggests, a home health aide usually cares for clients in their own home, with the remote supervision of a nurse manager. In the home setting, you get to work with one person at a time, giving you the opportunity to develop meaningful, personal relationships and provide companionship and friendship in addition to your professional care services. Depending on your chosen schedule, it’s possible to visit several clients in a single day.

CNA: many health care settings

Certified nursing assistants, on the other hand, tend to work in a wider variety of health care settings. CNAs can be part of a care team in home health care, a doctor’s office, hospital, surgical center, retirement community, nursing home, hospice, or other care facility. In a facility setting, CNAs work with multiple patients in one shift, helping to administer medications, control and prevent infections, and document patient care while reporting in person to a supervising nurse.

Home health aide as a career

As a leading provider of comprehensive home health care services, BAYADA offers our own classroom and hands-on training programs for home health aides to learn how to provide specialized care for certain client populations, such as people with Alzheimer’s disease and other forms of dementia.

In some states, HHAs can pursue additional training and pass a national medication aide certification exam (MACE) to become a certified medication aide, allowing them to administer medication and monitor patients for adverse reactions in a hospital or long-term care facility.

Certified nursing assistant as a career

Because of the wider variety of health care settings employing CNAs, you may find greater opportunity for career advancement by either pursuing advanced certification or moving into an administrative role.

Home health aide sits on couch with her client.

Whatever path you choose, the job opportunity is real. The US Bureau of Labor Statistics expects demand for HHAs and CNAs to grow much faster than other occupations. A great place to take advantage of that opportunity is BAYADA. Work here, and you’ll love what you do.

Home Health Care Jobs

December 27, 2022

Section 4137 of the Consolidated Appropriations Act of 2023 extends the rural add-on policy by providing an increase of 1 percent of the payment amount made for home health services provided in the ‘‘Low population density’’ category for CY 2023. CMS is not updating the CY 2023 impact file as there is no change in the rural add-on value between CY 2022 and CY 2023 and the overall impacts for CY 2023 has not changed. A correction notice to CR 12957 will be published reflecting the changes for CY 2023.

Learn What’s New for CY 2023

CMS issued a CY 2023 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Requirements final rule to update Medicare payment policies and rates for home health agencies. See the fact sheet for provisions effective January 1, 2023.

Report to Congress: Unified Payment for Medicare-Covered Post-Acute Care

Section 2(b)(2)(A) of the Improving Post-Acute Care Transformation (IMPACT) Act of 2014 requires a report to Congress (PDF) on unified payment for Medicare post-acute care (PAC).  Medicare PAC services are provided to beneficiaries by PAC providers defined as skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), long-term care hospitals (LTCHs), and home health agencies (HHAs).  Each PAC provider setting has a separate Medicare fee-for-service (FFS) prospective payment system (PPS). A goal of unified PAC payment is to base the payment on patient characteristics instead of the PAC setting. 

The Centers for Medicare and Medicaid Services (CMS) and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) contracted with Research Triangle Institute (RTI) to provide analysis for this study and report.  RTI convened external technical expert panel meetings to obtain input on the study and report.  In the report, the framework applies a uniform approach to case-mix adjustment across Medicare beneficiaries receiving PAC services for different types of PAC providers while accounting for factors independent of patient need that are important drivers of cost across PAC providers.  The unified approach to case-mix adjustment includes standardized patient assessment data collected by the four PAC providers.  The report does not include legislative recommendations, as additional analyses would need to be done prior to testing or universal implementation of a unified PAC payment system.  See Unified PAC Report to Congress Appendices (ZIP).

Implementation of New International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) Diagnosis Codes, Effective April 1, 2020:

The Center for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) has implemented two new ICD-10-CM diagnosis codes, effective April 1, 2020:

CMS finalized a new case-mix classification model, the Patient-Driven Groupings Model (PDGM), effective beginning January 1, 2020. The PDGM relies more heavily on clinical characteristics, and other patient information to place home health periods of care into meaningful payment categories. One case-mix variable is the assignment of the principal diagnosis to one of 12 clinical groups to explain the primary reason for home health services.

Both U07.1, COVID-19 and U07.0, Vaping-related disorder will be assigned to the Medication Management, Teaching and Assessment-Respiratory (MMTA-Respiratory) clinical group for purposes of case-mix adjustment under the HH PPS. Additionally, U07.1, COVID-19, will be added to a new comorbidity subgroup, Respiratory 10, and will receive the Low Comorbidity adjustment under the HH PPS case-mix system. The clinical group assignment for U07.1, COVID-19, and Vaping-related Disorder, U07.0, and the Low Comorbidity adjustment for COVID-19, U07.1 will be included in the Home Health Patient-Driven Groupings Model (HH PDGM) Grouper software package, v01.1.20, available for download on the HH Grouper Software webpage. It is effective for home health claims with From Dates on or after April 1, 2020.

  1. In response to the national emergency that was declared concerning the COVID-19 outbreak, NCHS is implementing a new diagnosis code, U07.1, COVID-19, into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) and;
  2. In response to recent occurrences of vaping related disorders, the NCHS is implementing a new diagnosis code, U07.0, Vaping-related disorder, into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), for reporting vaping-related disorders.

Home Health, Hospice and DME Open Door Forum

For questions about home health payment policy, send your inquiry via email to: [email protected].

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