Home Health Aide vs. Certified Nursing Assistant: Requirements, Duties, & Salary

Home health aides (HHAs) and certified nursing assistants (CNAs) are both entry-level, in-demand caregiving jobs. Both provide stable and meaningful work that is critical to patients.

However, they are different roles. Each has its own training requirements, skill set, and work environments.

HHAs primarily assist clients with personal care in their homes and may perform basic health monitoring and documentation. 

CNAs also provide help with activities of daily living, but are trained to do more clinical tasks and more often works in a hospital or nursing home.

Both jobs are good choices if you want to start working in healthcare quickly without spending a lot on training. 

Neither role requires more than a high school diploma or GED and a few weeks or months of training to get started. And they are both great stepping stones to higher-paying clinical jobs like medical assisting or nursing.

So, which one is right for you?

This guide gives detailed information that will help you decide which path may be better for you. We cover the differences between HHAs and CNAs, including their duties, training, pay, and work settings. 

Home Health Aide vs. Certified Nursing Assistant Overview

Before going into the details, here’s a quick comparison of the two roles:

Salary figures in this chart show the national mean annual wages for home health and personal care aides and nursing assistants, as reported by the U.S. Bureau of Labor Statistics (BLS) as of May 2025.

Home Health Aide Overview

A home health aide is a trained caregiver who helps clients with daily tasks and basic health needs at home. Most clients are older adults, people with chronic illnesses or disabilities, or people recovering after a hospital stay or surgery. 

The main goal is to help clients stay safe and comfortable at home, so they do not have to move into a hospital or skilled nursing facility.

Typical HHA responsibilities include:

• Assisting with bathing, dressing, and grooming
• Helping clients move safely between a bed, chair, or wheelchair
• Checking and recording vital signs like blood pressure and pulse
• Reminding clients to take medication
• Preparing meals, light housekeeping, and running errands
• Providing companionship and reporting changes to a supervising nurse

Most HHAs work in private homes, but some work in assisted living, group homes, or hospice care facilities. Their schedules range from part-time to full-time and even live-in positions.

While training to become an HHA is somewhat shorter than it is for CNAs, there are still federal and state requirements to meet. 

Federal rules say that agencies certified by Medicare or Medicaid must employ HHAs that have done at least 75 hours of training, including 16 hours of classroom instruction followed by at least 16 hours of supervised, hands-on practice. 

States may add additional requirements.

Since HHAs usually work with one client at a time in a home, this job is suited to people who prefer a less hectic environment and more personal time with clients.

Certified Nursing Assistant Overview

A certified nursing assistant provides hands-on care to patients, often older adults, in nursing and residential care facilities and hospitals. 

CNAs are part of a healthcare team and usually work with multiple patients every shift. They support the licensed and registered nurses who supervise them.

Typical CNA responsibilities include:

• Cleaning and dressing patients
• Helping patients eat and use the bathroom
• Helping patients move around or transfer between beds and wheelchairs
• Measuring and recording vital signs
• Listening to patients' health concerns and reporting them to a nurse
• Dispensing medication; additional certification required in some states

Federal rules say CNAs must complete at least 75 hours of training, including 16 hours of supervised practice, just like HHAs. However, most states require more, often between 75 and 150 hours, and a competency exam.

Since CNAs are part of a bigger nursing team, this job is a good fit for people who enjoy teamwork, a faster-paced setting, and the opportunity to learn from the nurses they support.

Key Similarities Between Home Health Aides & Certified Nursing Assistants

Even though they are different, HHAs and CNAs have a lot in common. Both are hands-on caregiving jobs with affordable training paths. 

They also have these things in common:

• Low barrier to entry: Both roles typically only require a high school diploma or GED and a short training program to get started.
• Overlapping duties: Both help clients with personal care tasks like bathing, dressing, feeding, and mobility, and both can check vital signs.
• Directed and supervised work: Both work under the supervision of a licensed healthcare professional, usually a nurse, and execute a care plan written by a patient’s care team.
• Career advancement opportunities: Both roles are common starting points for people who want to move on to higher-paying clinical careers.
• Physical demands: Both jobs involve a lot of standing, walking, and helping to lift or move clients, so physical stamina is important in both roles.
• Interpersonal skills: Both jobs require compassion, patience, good communication, and the ability to connect personally with patients.

Key Differences Between Home Health Aides & Certified Nursing Assistants

The two jobs are different in several important ways, especially in where they work and how they are supervised.

• Work setting: HHAs mostly work in private homes and are the only provider present. CNAs mostly work in nursing homes and hospitals, where they're part of a larger care team.
• Level of clinical tasks: CNAs generally perform more clinical tasks and work more closely alongside licensed nurses. HHAs focus more on personal care and daily living support.
• Supervision: HHAs often work alone in a client's home with a nurse checking in periodically. CNAs typically work on-site alongside nurses for their entire shift.
• Length of training: The federal minimum is the same for both, but state CNA requirements tend to be longer.
• Schedule: HHAs tend to have more scheduling options because there are full-time, part-time, and even live-in options. CNAs are more likely to work fixed 8- or 12-hour shifts, including nights, weekends, and holidays.
• Number of patients: A CNA may be responsible for several patients at once during a shift. An HHA usually focuses on one client at a time.
• Pay ceiling: CNAs tend to earn more on average than HHAs. They also have more opportunities to add specialty certifications that can boost pay.

Salary & Job Growth: Home Health Aides vs. Certified Nursing Assistants

Both roles offer steady work and decent pay and have positive long-term job outlooks. However, the growth rates for these jobs differ dramatically over the next ten years.

Home Health Aides

The most recent data shows that home health and personal care aides made an average salary of $36,120 per year, or $17.36 per hour, as of May 2025. 

Of course, what an HHA earns depends on where they are located in the country, whether their employer is a private employer or an agency, their experience level, and other factors.

For example, the BLS shows that the top 10% of earners made an average of $45,040 per year, with Washington, Oregon, Rhode Island, DC, and Vermont being the highest-paying states.

But the best news for HHAs is the job growth rate. The BLS projects that this HHA jobs will grow 17% from 2024 to 2034. That is significantly higher than the 3% average for all jobs. 

That growth rate translates into about 765,800 job openings each year, on average, over the decade. 

This growth is mainly because the population is aging and more people prefer to live in home and community-based settings now. Another positive factor is that home health services cannot be automated, replaced by AI, or sent offshore.

Certified Nursing Assistants

CNAs earn slightly more on average than HHAs. The BLS reports that nursing assistants earned an average of about $42,700 per year, or $20.53 per hour, as of May 2025. Pay for CNAs also varies depending on experience, geographic location, and employer.

The top 10% of nursing assistants made an average of $51,980 per year, with Oregon, Washington, New York, New Hampshire, and DC topping the list of highest-paying states.

While the opportunity for a higher salary is better for CNAs, the job growth rate is much lower. The BLS expects only 2% growth from 2024 to 2034, which is slightly below the average for other jobs. This is explained by the financial pressure on nursing homes, which are being asked to deliver more for less money.

However, even with a limited growth rate, there should be about 211,800 job openings each year over the next decade. And CNAs have many opportunities to move up the career ladder by adding special certifications or gaining additional skills.

In fact, so many continue their training after working as CNAs that Stepful has created are a caregiver training path especially for them. CNAs often go on to become medical assistants or nurses, like LPNs or RNs. 

Training & Certification Requirements: Home Health Aides vs. Certified Nursing Assistants

Requirements for both jobs depend on the state, but federal rules set a minimum for agencies that take Medicare or Medicaid.

Home Health Aide Requirements

• You must be 18 years old to be eligible for most training programs, with a high school diploma or equivalent commonly required.
• You must complete a training program that meets the federal minimum of 75 hours of training, including at least 16 hours of supervised, hands-on practice, to be eligible to work for agencies certified by Medicare or Medicaid. These can take a few weeks to a few months to complete.
• You must pass a state and federal criminal background check, which may include fingerprinting.
• You must pass a competency evaluation administered by your program or employer.
• Some states and/or home health agencies require medical screenings, immunizations, and/or CPR certification.
• In most states, you must be listed on your state’s registry of certified home health aides.

Stepful’s HHA training program offers the classroom portion completely online. It includes topics like patient rights, infection control and safety, communication skills, basic health monitoring, and documentation. 

After you complete the coursework and hands-on skills practice, you will be ready to pass your certification exam. Stepful also provides one-on-one career coaching to help you land a full-time job.

CNA Requirements

• You must be 16 to 18 years old, depending on the state, with a high school diploma or equivalent usually required.
• You must complete a state-approved training program that meets the federal minimum of 75 hours of training for Medicare- or Medicaid-certified nursing facilities, including 16 hours of supervised practical training. These usually take 6 to 12 weeks.
• You must pass a state and federal criminal background check, which may include fingerprinting.
• You must pass a state-administered two-part competency exam covering both written knowledge and hands-on clinical skills.
• Some states and/or employers require medical screenings, immunizations, and/or CPR certification.
• You will be placed on your state’s registry of certified nursing assistants, where employers can verify your credentials.

A Day in the Life: Home Health Aides vs. Certified Nursing Assistants

When deciding whether to become a home health aide or a certified nursing assistant, it is helpful to imagine what a typical workday would look like.

A Day in the Life of a Home Health Aide

An HHA’s day usually begins by arriving at the client’s home and checking notes from the last visit or shift. Then, the aide helps with personal care tasks such as bathing, dressing, and grooming. They may also prepare meals and do light housekeeping.

During the visit, the aide will spend time talking with the client and possibly doing an activity together. The aide will provide companionship but also use this time to observe changes in the client’s condition. They can then report anything important to the supervising nurse or leave notes for the next caregiver visit.

Since most HHAs work with one client at a time, the job usually has a steadier pace than working in a facility. This allows more time to build a personal relationship and adjust to the client’s routines and preferences.

A Day in the Life of a CNA

A CNA’s shift usually starts by getting a report from the previous shift about each patient’s needs and any safety issues. Then, the CNA checks on several patients, takes vital signs, and helps with feeding and bathing.

CNAs work closely with nurses during their shift, reporting any changes in a patient’s condition and supporting the nurse’s care plan. Since facilities need staff at all times, CNAs are more likely than HHAs to work nights, weekends, or holidays.

One CNA may care for just a few or even dozens of patients during a shift, depending on the facility and staffing. This means things move a little faster, but it also provides more learning opportunities since there are a variety of challenges happening every shift.

Choosing Between a Home Health Aide and a Certified Nursing Assistant Career

Now that you know all the details, you can start thinking through which path might suit you best. Both jobs are in demand, offer decent pay, and make a difference in the lives of others. 

Here are some questions that might help you decide which way to go:

• Do you prefer working independently or as part of a team? If you like to work independently and prefer to help one client at a time, HHA work may suit you better. If you enjoy being part of a larger care team with multiple patients, CNA work is a better match.
• Do you want to help people with their basic needs, or are you more interested in learning clinical work? CNA training goes deeper into hands-on clinical skills. CNAs also work more closely with nurses, so there are opportunities to learn more nursing skills. HHA work leans more heavily on daily living support and companionship.
• Do you like the idea of working in someone’s home, or would you prefer to be in a hospital or nursing facility? A client’s home isn’t guaranteed to be calm and quiet, but it is typically less hectic than a hospital or nursing home. If you like the idea of being in someone’s home each day, being an HHA would suit you. If you prefer the hustle and bustle of a healthcare environment, being a CNA might suit you better.
• Do you prefer a set schedule, or are you open to shift work that may include nights and weekends? HHAs tend to have more options for working part-time, full-time, or even live-in. They can work the same set of hours every week. CNAs are more likely to work shifts because hospitals and nursing facilities run on shift work. That means your hours may rotate and sometimes include nights, weekends, and holidays.
• Do you have a long-term goal of becoming a nurse? Both roles can lead to further healthcare careers, but CNA experience is often viewed as a better on-ramp to nursing. You will work directly with nurses, see their job up close, and learn more clinical skills.

FAQs: Home Health Aide vs. Certified Nursing Assistant 

Can a CNA work as a home health aide?

Yes. CNAs usually complete more training and are allowed to do more for patients than HHAs, so they can typically work as an HHA with little additional training. 

There may be state requirements for HHAs, such as medical screenings or CPR certification, that a CNA would need to complete to switch jobs, but it depends on the state.

Is a CNA the same as a home health aide?

No. Both are entry-level caregiving roles, but CNAs usually work in hospitals and nursing homes as part of a nursing team. In contrast, HHAs mostly work in private homes without a supervisor present and focus on personal care.

Which pays more, a home health aide or a CNA?

CNAs typically earn more. The most recent data published by the BLS show that the mean annual wage for nursing assistants was about $42,700, compared with about $36,120 for home health and personal care aides. 

Which is easier to become, an HHA or a CNA?

HHA certification is usually faster because federal rules set a 75-hour training floor, and many state programs stay close to it. 

CNA programs share that same federal minimum, but states often add more training on top of that. CNAs also have a more involved two-part competency exam to pass before they can start work.

Can a home health aide become a CNA?

Yes, though it usually requires additional training hours and passing a state competency exam. Many people use HHA experience as a stepping stone toward a CNA credential or another clinical career, such as becoming a medical assistant.

Do CNAs or HHAs work more nights and weekends?

CNAs are more likely to work night, weekend, and holiday shifts, since hospitals and nursing facilities need round-the-clock coverage. HHA schedules tend to be more flexible and can include part-time or live-in arrangements.

Do I need a license to become an HHA or a CNA?

These are not licensed healthcare roles in the same way that doctors and nurses are. However, both jobs do require state certification. This usually means completing an approved training program, passing a competency exam, and getting listed on a state registry.

Which role offers a better path to becoming a nurse?

Both roles can lead to LPN or RN nursing careers. However, CNA experience is often seen as better preparation, since the job involves more clinical, hands-on work. CNAs work as part of a nursing team, so they can learn from nurses firsthand and see what a nursing career looks like up close.

Do HHAs or CNAs need more physical stamina?

Both roles are physically demanding and involve a lot of standing, walking, and assisting clients with moving. CNAs may face slightly more physical strain overall, since they often assist more patients per shift.