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HHA vs CNA: 15 Key Differences in 2025

Introduction

It gets asked a lot, yet continues to remain one of the top questions of those considering a career in the healthcare industry:

When it comes to home aide services for older adults, there is a plethora of options. Home Health Aides (HHA) and Certified Nursing Assistants (CNA) can both assist in the daily lives of their clients but differ in the type of training, credentials, and care they provide. The difference between an HHA vs CNA is in their duties. A CNA can perform a variety of medical tasks.

What’s the difference between a HHA and CNA?

The reason for the question is that while Home Health Aides (HHAs) and Certified Nursing Assistants (CNAs) play very similar roles in patients’ lives, there are many more differences than folks think.

TO THE POINT

HHA’s will be assigned greater responsibilities in 2025 such as administering medicine, giving insulin injections, etc. And  CNA’s will be taking on added roles as well.

The pandemic has highlighted the value of HHA’s and CNA’s.

Learn more about the differences between CNA’s and HHA’s; and if your state allows you to administer medications to clients.

The Difference Between a Home Health Aide and a Certified Nursing Assistant

You may be looking for a new career in the medical/healthcare industry and considered being a nurse. Then, you realize that obtaining a Registered Nurse (RN) or Licensed Practical Nurse (LPN) certification can be a long and very expensive process.

If you are looking to start quickly and with very little time and money invested, you should consider becoming a Home Health Aide or a Certified Nursing Assistant – or BOTH!

Knowing the contrasts between these two positions will help you now and as you head down the path of your training and entry into the workforce. Some of the lines between the two fields can be blurry and confusing as you look further at individual state requirements for HHA’s and CNA’s.

See also becoming a HHA for a family member.

What is a Home Health Aide?

A home health aide (HHA) typically works in the homes of a patients. The patient may be chronically ill, elderly and in need of supervision, or they may be an otherwise healthy individual recovering from an illness or surgery.

He/she can be responsible for basic healthcare tasks that can include checking vital signs, helping with medications, or helping patients use wheelchairs, walkers, or other mobility aids.

Their job is to help the patient remain at home where they are most comfortable. This often involves helping them with tasks of everyday living that may not be medical in nature. These tasks include bathing, help with laundry, transportation, prepare meals, etc.

What is a Certified Nursing Assistant?

A certified nursing assistant (CNA) works in a wide variety of environments that can include assisted living centers, nursing homes, and hospitals. They perform many of the same duties as the HHA, including assistance with medical devices, helping with medications, bathing and dressing patients, checking vital signs, and reporting any changes in the patient to the medical team.

They may also work with patients who have dementia, who need respite care, or who are in hospice care. CNA’s, unlike HHAs, usually care for a group of people instead of individuals.

What About Training?

These two roles do require unique training. For example, a CNA must go through a formal training program and pass a state exam, while HHAs can be trained on the job by RN’s. Further, passing a test to demonstrate proficiency may not even be required.

Anything else?

Yes, lots!

The graphics below go into more detail about the differentiation between a HHA and CNA. It’s important to know the details of each as you do not want to put down the money for HHA training only to learn that perhaps being a CNA is a wiser choice.

four red arrows

Work Place

cna and hha work place
TO THE POINT: HHA’s work mostly at clients’ homes while CNA’s are mostly employed at hospitals and nursing homes.

HHA: agencies for home care provide services. CNAs work at client homes, retirement homes, hospitals, rehab centers, hospice care centers, assisted living facilities, adult daycare centers, and more.

Where do CNA’s work?

  • Hospitals
  • Long term residential facilities
  • Nursing homes (also known as skilled nursing facilities)
  • Rehabilitation centers
  • Centers for adult daycare

Nursing homes and assisted living facilities are some of the most common venues for nursing aides. Nursing aides aren’t as likely to work in healthcare facilities, but it does occasionally happen.

Workload

cna vs hha workload
TO THE POINT: HHA’s deal with one patient at time while CNA’s jump from one to another.

Certified nurse assistants have the option of working full time or part time. Because the majority of facilities require those that are willing to work full-time hours, nurse aides typically work 40 or more hours per week, including weekend, holiday, and overtime hours.

Nurse aides’ shifts usually last 8 to 10 hours. They may take advantage of various breaks according to each person’s employer’s schedule. Weekends and holidays usually follow the rotation schedule.

Job Responsibilities

cna and hha responsibilities
THE POINT: The job description for a HHA is mostly activities of daily living compared to a CNA who deals with vital signs and medical equipment.

Medical Tasks

hha and cna medical tasks
TO THE POINT: HHA’s are increasing their medical care tasks but CNA’s perform these on a more consistent basis.

Confused About HHA Tasks?

Training Differences

hha and cna training
TO THE POINT: Training is mandatory for all HHA’s and CNA’s.

There are several training programs necessary to become an HHA, including an educational program that includes classroom time and on-the-job training. Various assessments also are required, including an test administered by a registered nurse. These tests measure your level of competence and identify in case you are capable of carrying out the duties for a HHA.

Every CNA needs to have a state-issued license to provide care. The specifics vary by state, but most states require training and completion of supervised care. Training typically covers standard responsibilities and the fundamentals of nursing. Some CNAs may also have classes on specialized skills such as dementia care that they may need to develop for their elderly patients.

Training Sources

hha and cna training sources
TO THE POINT: Either HHA or CNA, you can find the training abundant as there is great demand for all positions.

Training to be a HHA or CNA?

  • CNA: Certified nursing assistants (CNAs) need no firm medical training; however, they sometimes need a minimum education. You can earn a CNA certification or diploma from a course that includes elements such as training in patient care, disease prevention, vital signs, communication, mental health, and other direct care.
  • HHA: Though strongly advised for those hoping to practice in the field, a home health aide training program can prove essential for certification on the state and federal levels and provide the training necessary for obtaining important skills. We recommend selecting free HHA training classes near you for the best value and to begin working immediately as a certified home health aide.

Training Expense

hha and cna training expense
TO THE POINT: Shop around – you should not pay for HHA training; CNA free training may be tougher.

CNA: On average, you can expect to pay about $1,400 in order to become a CNA certified. The cost could vary depending upon the college you go to and the course. There are now numerous CNA training programs available online. The cost of an online CNA program can vary, depending on the institution or course, but the average cost of an online CNA program typically ranges from $700 up to $1,500.

HHA: The expenses of a home health aide program vary based on the school, course, whether it is online, and the state where the school is located. The median cost of an HHA certification is between $100 and $1,000. The courses with clinical hours and online courses are less expensive. You owe it to yourself to consider free HHA training classes near you for the best value; do not overpay for HHA training when it may be offered for free!

Examinations

hha and cna examination
TO THE POINT: Both HHA’s and CNA’s need to pass a competency test.

CNA: Once students have successfully completed their training as nursing assistants and submitted the correct paperwork, they will have to sit for the main portion of the state’s CNA certification examination. This portion of the exam consists of two parts  the written and oral portion (held in a group setting) and the clinical study portion (held one-on-one).

HHA: Am I Required to Get Certified as a Home Health Aide?

Certifications

hha and cna certification
TO THE POINT: HHA’s (should) and CNA’s (mandatory) need to be certified and licensed.

HHA: Home Health Aides may not need a certification to carry out their duties. Certified Nursing Assistants must have a certification and a license for performing their duties, and some states require specific ones.

Am I Required to Get Certified as a Home Health Aide?

CNA: A CNA certification program typically lasts 2 years. The program must be renewed every year by paying the renewal fee and ongoing employment requirements or hours to complete the job (these may vary by state).

High School?

hha and cna hs diploma
TO THE POINT: While not required overall, you should have your high school diploma to be a HHA or CNA.

CNA: The majority of certified nursing assistant programs require candidates to have a high school diploma or a GED equivalent and be able to provide their school transcript. Some schools and programs will also require candidates to pass an examination and a criminal background test.

HHA: No, but some agencies do insist on a high school diploma for their employees.

HHA Minimum Requirements: Everything You Need to Know

Minimum Age

hha and cna minimum age
TO THE POINT: Candidates for HHA and CNA jobs should be at least 18 years old.

CNA: To become a certified nursing assistant in the majority of states, you must be at least 18 years old. CNA classes usually do not have a minimum educational prerequisite, but the majority of states do require a high school diploma or a GED to begin the course.

HHA: While it is not improbable you can be a home health aide as young as 16 in some states, candidates to be a HHA should be at least 18 years old considering the requirements of a HHA.

Salaries

hha and cna salaries
TO THE POINT: CNA’s earn more than a HHA salary as the training and experience is greater than a HHA.

Advancement

hha and cna career advancement
TO THE POINT: CNA’s will most often find more opportunities in the medical field than HHA’s.

HHA: There is no conventional medical training for HHA qualifications, so there may be little upward mobility. It’s not impossible to utilize HHA expertise to ascend into an administrative role, but there are a great deal of studies and classes involved. CNA: Since CNAs spend a lot of time in medical settings, like hospitals, they’re usually esteemed as professionals hierarchically.

Job Growth

hha and cna job growth
TO THE POINT: The job growth is greater for HHA’s as higher turnover and aging in place increases.

Jobs

hha and cna number of jobs
TO THE POINT: The number of HHA’s is more than double the number of CNA’s.

Summary of HHA vs CNA

HHAs and CNAs more often than not provide similar assistance for patients and customers, but which option is the best will depend on your needs. Both aid with creating day-to-day living simpler. However, if you want extra assistance with recovering from illness or injury, a CNA’s help is likely to work best.

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