# How to become a hospice aide

There is no hospice aide license. Federal rules give four ways to qualify, and the longest is 75 hours of training plus a nurse-run competency check.

- **Author:** MedJobList Team
- **Published:** Jul 26, 2026

## What a hospice aide does

A hospice aide gives hands-on personal care to patients in the last months of life, usually in the patient's own home and sometimes in a nursing facility. A registered nurse from the hospice interdisciplinary group assigns you to a patient, and the nurse who supervises you writes your care instructions. The federal duty list names hands-on personal care, simple procedures that extend nursing or therapy services, help with ambulation and exercises, and help with medications the patient would normally take alone ([42 CFR 418.76](https://www.law.cornell.edu/cfr/text/42/418.76)). You report changes in the patient's condition back to that nurse.

The job goes by several titles. One agency often runs home health and hospice together, so it lands in our listings as a combined home health and hospice aide, and our board also indexes it under hospice CNA. The family is part of the job description: the federal standard tells the supervising nurse to assess whether you build successful relationships with the patient and family, alongside the clinical tasks.

## How long it takes to become a hospice aide

How long depends on the route: no additional training at all if you already hold a CNA, or about 3 months of evening classes from zero. There is no hospice aide license and no national hospice aide exam. Federal rules name four ways to qualify, and your calendar depends on which one you enter through.

| Field | Value |
| --- | --- |
| You already hold a CNA | A state-approved nurse aide training and competency program qualifies you, as long as you are currently listed in good standing on the state nurse aide registry. The federal rule asks for no further course (42 CFR 418.76(a)(1)(iii)). |
| You have aide experience but no certificate | A competency evaluation on its own, with no training program attached, qualifies you. A registered nurse runs it, and any organization may offer it, so it does not have to be the hospice that hires you (42 CFR 418.76(c)(2)-(3)). |
| You are starting from zero | at least 75 hours of classroom and supervised practical training, then the competency evaluation. At least 16 classroom hours have to be finished before the 16 hours of supervised practical training begin. |
| Your state's own rules | A state licensure program is the fourth route. States can also be narrower than the federal floor: Texas licensing rules for hospice agencies list only two routes, training plus evaluation or evaluation alone, and the nurse aide registry is not one of them ([26 Tex. Admin. Code 558.843](https://www.law.cornell.edu/regulations/texas/26-Tex-Admin-Code-SS-558-843)). |
| Calendar | Rockland Community College in New York ran its 2026 home health aide course over two evenings a week, April 7 to July 2. All Care in Lynn, Massachusetts runs the same 75 hours free of charge and asks for at least 600 paid hours of work afterwards. |
| If you stop working | 24 consecutive months in which you furnish no aide services for pay cancels your program completion, and you have to complete a qualifying program again before you can work as an aide. |

The federal rule counts hours, never weeks, so your calendar comes from the schedule you enroll in. Rockland's two evenings a week stretch the 75 hours across nearly 3 months.

## The 75 hours of training

The federal training program is at least 75 hours of classroom and supervised practical instruction, with at least 16 classroom hours finished before the 16 practical hours start (42 CFR 418.76(b)). The practical hours are performed on a person under the direct supervision of a registered nurse, or an LPN who reports to one. The training has to be run by a registered nurse with at least 2 years of nursing experience, 1 year of it in home care, or by other people working under that nurse's general supervision.

The rule names 12 subject areas: communication skills; observation, reporting and documentation of patient status; reading and recording temperature, pulse and respiration; basic infection control; body functioning and the changes you have to report; maintaining a clean, safe and healthy environment; recognizing emergencies and knowing the procedures; the physical, emotional and developmental needs of the people the hospice serves, including respect for privacy and property; personal hygiene and grooming, down to a checklist that names bed baths, tub and shower baths, hair shampoo, nail and skin care, oral hygiene and toileting; safe transfer techniques and ambulation; range of motion and positioning; and nutrition and fluid intake. A thirteenth line covers any other task the hospice wants an aide to perform, and the hospice has to train you for it.

Price depends on who runs the course. Rockland Community College charges $1,400 for its 75-hour certified home health aide program, which ends in a certificate of completion issued through the New York State Home Care Worker Registry. All Care, a Massachusetts agency, charges its trainees nothing and asks for at least 600 paid hours of work after the course. Ask the hospices and home health agencies near you before you pay a college, because the rule expects hospices to be able to train their own aides and makes them keep the documentation that proves the standard was met.

If you are still choosing which entry-level role to train for, our guide to [healthcare jobs with no experience](/guides/healthcare-jobs-no-experience) compares this work against the other roles that hire without a degree.

## Passing the competency evaluation

A registered nurse performs the competency evaluation, in consultation with other skilled professionals where that is appropriate. Five of the subject areas have to be judged by watching you do the task with a patient or a pseudo-patient: communication; temperature, pulse and respiration; hygiene and grooming; safe transfers and ambulation; and range of motion and positioning. The rest can be written or oral, or observed during a simulation.

Scoring runs task by task. One unsatisfactory rating leaves you competent everywhere else, though you cannot perform that task without direct supervision from a registered nurse until you retrain and pass a second evaluation on it. An unsatisfactory rating in more than one area means you have not completed the evaluation. Any organization may offer the evaluation, apart from home health agencies with specific compliance failures in the previous 2 years.

The nurse aide route has its own rules that this article does not cover. State training hours and program calendars are in our guide to [becoming a CNA](/guides/how-to-become-a-cna), and the exam, renewal and registry lookup are in the [CNA certification guide](/guides/cna-certification). For the home health aide route, see the [HHA certification guide](/guides/hha-certification).

## The rules that follow you after you are hired

You have to receive at least 12 hours of in-service training in every 12-month period, supervised by a registered nurse, and it can happen while you are caring for a patient.

A registered nurse also has to visit the patient's home at least every 14 days to assess the care you are giving, and you do not have to be present for that visit. Once a year a nurse comes to watch you work. If the supervising nurse notes a concern, the hospice sends someone to observe you with the patient. If the hospice confirms the concern during that visit, you have to be re-evaluated on the deficient skill and every skill related to it.

There is one voluntary credential on top of all this. HPCC certifies experienced hospice aides as a Certified Hospice and Palliative Nursing Assistant, and eligibility, cost and renewal are in our [CHPNA certification guide](/guides/chpna-certification).

## Step by step

1. Check what you already hold. A current CNA listing in good standing on your state registry satisfies the federal rule on its own.
2. Check your state's hospice licensing rules next, because they can be narrower than the federal ones. Texas, for one, does not accept the registry route for hospice aides.
3. Call the hospices and home health agencies near you and ask whether they train and evaluate their own aides. Agency training can cost you nothing.
4. If you need the course, enroll in a 75-hour aide training program and finish the 16 classroom hours before the supervised practical hours.
5. Sit the competency evaluation with a registered nurse. Five areas are scored by observation with a patient or pseudo-patient.
6. Apply to hospice agencies. Many run home health alongside hospice and post one aide job covering both.
7. Book your 12 hours of in-service training for the year, and keep working: a 24-month gap sends you back to a qualifying program.

## What hospice aides earn

BLS publishes no separate wage for hospice aides. The closest published occupation is home health and personal care aides, where the median wage was $17.21 an hour, or $35,800 a year, in May 2025 (BLS Occupational Employment and Wage Statistics). The lowest 10% earned under $13.00 an hour and the highest 10% over $21.65. The estimate covers 4,305,810 jobs.

## Where hospice aides are hiring now

Right now 2 active US openings match our hospice aide filter. When we checked in July 2026, they came from home health and hospice agencies in Texas, both hiring for combined home health and hospice aide work and both asking for a home health aide credential. You can see the current set on our [hospice aide jobs](/hospice-aide-jobs) page.

## FAQ

### How long does it take to become a hospice aide?

It depends on the route. If you already hold a CNA and are listed in good standing on your state nurse aide registry, the federal rule asks for nothing more. Check your state, though: Texas does not accept the registry route. Starting from zero, you need a 75-hour training program: Rockland Community College in New York ran its 2026 session over about 3 months at two evenings a week.

### Do you have to be a CNA to be a hospice aide?

Not under federal rules. 42 CFR 418.76 accepts four routes: a 75-hour training program with a competency evaluation, a competency evaluation on its own, a state-approved nurse aide program with a current registry listing, or a state licensure program. State rules can be narrower. Texas licensing rules for hospice agencies list only the first two, so a registry listing alone does not qualify you there.

### Is there a hospice aide certification?

There is no required hospice aide certificate or national exam. On the two routes that start from training or evaluation, the federal rule requires a competency evaluation performed by a registered nurse, and the hospice keeps the documentation. HPCC offers a voluntary credential for aides already working in the field, the Certified Hospice and Palliative Nursing Assistant, covered in our CHPNA certification guide.

### How much does hospice aide training cost?

Anywhere from nothing to about $1,400. Rockland Community College charges $1,400 for its 75-hour aide program in 2026. All Care in Lynn, Massachusetts charges trainees nothing for the same 75 hours and asks for at least 600 paid hours of work afterwards. Agencies are allowed to train their own aides, so ask the ones near you first.

### What is the difference between a hospice aide and a home health aide?

The training standards are close to identical. Home health aides work under 42 CFR 484.80 and hospice aides under 42 CFR 418.76, and both set the same floor: at least 75 hours, with a minimum of 16 classroom hours before a minimum of 16 supervised practical hours, the same subject areas, and a nurse-run competency evaluation. The difference is the patient: hospice aides care for people at the end of life and work from a plan of care set by the hospice interdisciplinary group. The supervision rules are close too, though a hospice aide is always assessed by a registered nurse, while a home health aide can be assessed by a therapist. Agencies often run home health alongside hospice and hire for both in one posting.

### How much do hospice aides make?

BLS does not publish a hospice aide wage. For home health and personal care aides, the median was $17.21 an hour, or $35,800 a year, in May 2025, with the lowest 10% under $13.00 an hour and the highest 10% over $21.65 (BLS Occupational Employment and Wage Statistics).

Source: https://medjoblist.com/guides/how-to-become-a-hospice-aide