The HHA Competency Exam, Explained (2026)
There is no single national home health aide exam, but there is a single national subject list. Here is what is the same everywhere, and what changes from state to state.
Exam facts
| Federal training minimum | 75 hours, including at least 16 hours of supervised practical training; at least 16 classroom hours must come first (42 CFR 484.80) |
| Who evaluates competency | A registered nurse, with other skilled professionals as appropriate. Hands-on skills are observed on a patient or a pseudo-patient |
| Written test, DC example | 70 multiple-choice questions in 2 hours, given by Credentia (the handbook's outline page says 75) |
| Skills test, DC example | 5 randomly selected skills in 25 minutes; all 5 must be rated satisfactory |
| Fees, DC example | Written exam $55; skills evaluation $110 |
| Retakes, DC example | 3 attempts, passed within 12 months; after a third failure, retraining is required |
| Passing score | Set by each state or program. Indiana's written test requires 88%; many programs use 70% to 80%. This site scores you against 80% |
| Keeping it | 12 hours of in-service training every 12 months; a 24-month gap in paid work means retraining |
Official content outline — where the points are
The weights below are the District of Columbia Board of Nursing's published HHA written outline: Role of the Home Health Aide 25%, Physical Care 50%, Psychosocial Care 13%, Personal and Household Maintenance 12%. We split Physical Care and the aide's role into drillable domains whose weights add up to each published area.
See where you stand before you pay
Take the free practice examCommon questions
How hard is the HHA test?
The material is practical, but the bar varies: some programs pass at 70%, Indiana requires 88% on its written test. Candidates who struggle usually underestimate Physical Care, which is half of DC's exam, and the exact-value questions: vital sign ranges, food temperatures, positioning angles.
What is on the written test?
The federal subject list: communication, observation and reporting, temperature, pulse and respiration, infection control, body changes to report, a safe environment, emergencies, the needs of the people served, personal hygiene, transfers, range of motion and positioning, nutrition and fluids, and skin changes. DC adds household tasks like shopping and safe meal preparation.
What happens if I fail?
It depends on the state. In DC you get three attempts and must pass within 12 months; after a third failure you must complete a training program again. Federal rules also say an aide rated unsatisfactory in more than one required area has not passed the competency evaluation.
Which subject should I study first?
Physical Care: personal hygiene, transfers and positioning, infection control, safety and emergencies. It is 50% of DC's exam. After that, the aide's role and reporting, which together are another 25%.