Federal Home Health Aide training requirements

by admin on September 1, 2019

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The U.S. Federal Government has guidelines for home health aides whose employers receive reimbursement from Medicare. In practice, the majority of jobs are with agencies or institutions who receive reimbursement from Medicare.  This means that if you are considering becoming a Home Health Aide, it is quite possible you will need to meet these federal requirements before providing care to a patient.

Many Home Health Care Agencies provide this training to their employees.  If you are looking to become a Home Health Aide, it can be a real advantage to already be certified.  Read on to learn what is required to become certified.

Federal Law

Federal law requires home health aides to pass a competency test covering a wide range of areas. A Home Health Aide may receive training before taking the competency test.

These federal regulations (Title 42 of the United States Code dealing with Public health – 42 CFR 484.1) outline specific requirements that Agencies must follow when employing Home Health Aides:

1.   Home Health Aide employee selection criteria

Home Health Aides must be selected on the basis of such factors as

  • a sympathetic attitude toward the care of the sick,
  • ability to read, write, and carry out directions,and
  • maturity and ability to deal effectively with the demands of the job

2.  Employee supervision

Home Health Aides must be closely supervised to ensure their competence in providing care.  This is particularly important because most Home Health Aides conduct their work in the homes of patients, on their own.

The Home Health Aide is assigned to a specific patient by a registered nurse. Written patient care instructions for the Home Health Aide must be prepared by the registered nurse or other appropriate professional who is responsible for the supervision of the Home Health Aide.

3.  Home Health Aide employee training and evaluation


The aide training programme must address key subject areas through classroom and supervised practical training totalling at least 75 hours.  At least 16 of those hours need to be supervised practical training.  ‘Supervised practical training’  is training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or licensed practical nurse.  The individual being trained must complete at least 16 hours of classroom training before beginning the supervised practical training.

13 key subject areas

1.  Communications skills
2.  Observation, reporting and documentation of patient status and the care or service furnished
3.  Reading and recording temperature, pulse, and respiration
4.  Basic infection control procedures
5.  Basic elements of body functioning and changes in body function that must be reported to an aide’s supervisor
6.  Maintenance of a clean, safe, and healthy environment
7.  Recognizing emergencies and knowledge of emergency procedures
8.  The physical, emotional, and developmental needs of and ways to work with the populations served by the Home Health Agency, including the need for respect  for the patient, his or her privacy and his or her property
9.  Appropriate and safe techniques in personal hygiene and grooming that include:

  • Bed bath
  • Sponge, tub, or shower bath
  • Shampoo, sink, tub, or bed
  • Nail and skin care
  • Oral hygiene
  • Toileting and elimination

10.  Safe transfer techniques and ambulation
11.  Normal range of motion and positioning
12.  Adequate nutrition and fluid intake
13.  Any other task that the Home Health Agency may choose to have the home health aide perform

Instructor qualifications

The training of Home Health Aides must be performed by or under the general supervision of a registered nurse who possesses a minimum of 2 years of nursing experience, at least 1 year of which must be in the provision of home health care.  Other individuals may be used to provide instruction under the supervision of a qualified registered nurse.


An individual can only become a Home Health Aide for a Medicare funded agency after that individual has successfully completed a competency evaluation program.  The evaluation program will test each of the thirteen key subject areas listed above.  This evaluation programme must be done every 12 months.  The home health aide must receive at least 12 hours of additional ‘on-the-job’ training during each 12-month period.

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