The Differences Between a CNA and HHA

Jan 19, 2022 · 7 minutes to read

Smiling carer and elderly person

Home healthcare is a growing industry, as baby boomers continue to age and create their healthcare plans for retirement and beyond. This means that there are many work options if you are thinking about a career in the field.

Two popular career choices in this area are Certified Nursing Aides and Home Health Aides. A Certified Nursing Aide (CNA) and a Home Health Aide (HHA) provide in-home healthcare for the elderly, patients with disabilities, and the chronically ill. Both provide in-home care to patients that can include some form of medical aid, albeit to various degrees.

Let’s explore the differences between CNAs and HHAs to give you a better idea of which role might best fit your home healthcare career goals.

Responsibilities of a Home Health Aide and a Certified Nursing Assistant

Both CNAs and HHAs provide patients with basic care, which includes activities like:

  • Changing soiled bedding
  • Assisting with toileting
  • Bathing and everyday grooming (i.e., brushing teeth, combing hair, etc.)
  • Dressing

These and other similar tasks may be difficult for some patients to do on their own. By helping them with these daily activities, CNAs and HHAs can help their patients live comfortably and safely in their own homes.

A Home Health Aide or a Certified Nursing Assistant may give important in-home support to help make everyday living as pleasant as possible, whether the patient is a senior, a stroke victim, someone recuperating from an injury or illness, or an individual with a handicap. In-home healthcare is critical, especially if the loved one lives independently, to assist him or her to maintain a high quality of life.

What is the difference between a CNA and an HHA?

While both CNAs and HHAs help patients with their basic care needs, each typically performs other tasks as part of their job.

Home Health Aides often do more around the house and may even act as a companion to their patients. Grocery shopping, doing laundry, helping prepare meals, and escorting patients on walks are some of the common things that the HHA may assist with. Depending on the state where you work, an HHA may also provide medicine to a patient under the oversight of a physician or other healthcare practitioner.

Certified Nursing Aides provide somewhat more sophisticated medical care to their patients. Under the supervision of a licensed nurse or doctor, a CNA may check oxygen levels and vital signs, provide medications ordered by a doctor, dress sutures, and change wound dressings. The CNA can also assist with the patient’s living environment, such as maintaining the room’s cleanliness and sanitation, or feeding a patient during meals.

The CNA must work under the supervision of a registered nurse or a licensed practical nurse, to whom they must report their patients’ status and progress. Due to legal and liability concerns, CNAs are unable to conduct some medical procedures.

CNAs often develop a strong relationship with their patients and are typically the first point of contact a patient has in their medical team. CNAs are in a good position to observe variability in clients’ physical condition and variations in their emotional state. As such, they can be relied upon to relay this information to higher levels of the healthcare team and contribute to the patient’s treatment plan and healing.

Working Environments

There are many environments where Home Health Aides may work. HHAs are frequently hired by senior care firms to work in customers’ homes, but can also work in senior day programs, independent living and retirement complexes, assisted living facilities, and senior group homes. HHAs often work with just one or two patients at a time and can get to know their clients very well. Your workdays might follow a set schedule, but you should also be flexible and able to adapt to changes as they happen.

Certified Nursing Aides may also be employed in a variety of settings. These include clients’ homes, day programs, long-term care institutions, rehabilitation centers, and assisted living facilities. CNAs’ workloads can be stressful, demanding, and fast-paced. Yet, the chance to assist individuals with medical needs, as well as the satisfaction they gain from delivering such services to enhance the lives of those who are ill, provide daily inspiration and a sense of fulfilment.

Why do families need HHAs and CNAs?

Home Health Aides and Certified Nursing Assistants are often essential for working families who are also responsible for a loved one’s care. You will provide important assistance and skills that allow patients to remain in the comfort of their own homes and live as freely and safely as possible. You also allow the patient’s family to continue working and living their lives with fewer disruptions.

A HHA can help families that are too busy or unable to maintain the day-to-day monitoring of loved one. Professional staff will visit with the patient and their family to learn more about their care needs and then design an appropriate program to assist with everyday tasks.

HHAs often work for home care agencies, which offer a variety of services to clients. This may include things like:

  • A fall prevention evaluation of the client’s home
  • Transportation to appointments
  • Domestic duties
  • Flexible arrangements to accommodate any schedule discrepancies

Home health aides can be sent to people’s homes on any day of the week, at any hour, and for any amount of time, depending on the client’s needs. If necessary, they can provide 24-hour live-in care. Working families benefit greatly from such flexibility.

CNAs can help families with medical care that they are likely not trained to do or may be uncomfortable performing. Families may need assistance dressing their loved one’s wounds, administering medications by injection, or completing other medical tasks that are essential to their loved one’s recovery. You may also need to accurately take and record vital signs and report these back to a doctor on behalf of the patient.


The training you will need to work as a Home Health Aide or Certified Nursing Assistant varies from state to state. It is advisable to check the laws in your area to learn what sort of education or training requirements you may need to meet.

HHAs are generally not obliged to have any formal schooling beyond a high school diploma. Before being recruited by an in-home healthcare business, HHAs usually must complete hands-on training, pass a competence evaluation, and pass standardized writing examinations in the presence of a certified nurse. Home Health Aide training is typically obtained through vocational institutions and community colleges or directly through your employer.

If you’re interested in pursuing a career as a Certified Nursing Assistant, you will find that a range of medical institutions and community colleges offer certification programs. All CNAs must have a state-issued license, and some states may allow you do certain medical procedures (such as taking blood) if you have the necessary training. In some states, the degree of training a CNA has completed might limit the jobs they are allowed to perform.

Working together

In situations in which a senior is recovering from surgery, both a Home Health Aide and a Certified Nursing Assistant may work together to perform an array of services for the same patient.

For example, a patient recovering at home after a hospitalization may require advanced medical care, which a qualified CNA can provide. At the same time, an HHA could offer more basic care, such as performing general housekeeping, driving them on errands or to doctor’s appointments, or assisting with grocery shopping. Basically, any day-to-day tasks with which the patient will likely need help with until they are back on their feet.

Protecting yourself on the job

Working so closely with patients can expose HHAs and CNAs to many unique risks. An innocent mistake or accident could impact a patient negatively. If you are found liable, you may need to compensate the patient or their family for financial losses that they experienced due to your negligence. This is where home health aide insurance can help. These policies are designed to protect HHAs and CNAs from common on-the-job risks you may face.

Learn more about insurance for HHAs and CNAs. We can help you find, compare, and buy business insurance in minutes.

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