CNA vs Home Health Aide (HHA): What's the Difference?
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CNA vs Home Health Aide: Key Differences in Duties, Training, and Pay
CNAs and home health aides (HHAs) do much of the same hands-on care, such as bathing, dressing, and helping people move, but they do it in different places. Most CNAs work in nursing homes and hospitals, while HHAs care for clients in their own homes. CNAs earn more, with a median of $42,260 a year in May 2025 against $35,800 for home health and personal care aides. Jobs for home health and personal care aides are growing much faster, though, at 18% vs 3% from 2025 to 2035.
Federal rules set the same 75-hour training minimum for both roles at nursing homes and Medicare-certified home health agencies, and a CNA in good standing can work as an HHA at one of those agencies without repeating the training. The rest of the choice comes down to where you want to work and how much clinical responsibility you want.
Pay and Job Outlook
CNA vs HHA pay comes down to setting. CNAs earn more at the median, but the gap shrinks inside home health. In May 2025, BLS reported these figures:
- Nursing assistants: $42,260 median, from under $33,940 (lowest 10%) to over $51,980 (highest 10%)
- Home health and personal care aides: $35,800 median, or $17.21 an hour, from under $27,040 (lowest 10%) to over $45,040 (highest 10%)
Since BLS combines the two aide roles, the $35,800 covers both. Inside home healthcare services, the gap narrows to under $2,000: $38,040 for nursing assistants vs $36,230 for home health and personal care aides.
Location moves pay too. Oregon has the highest state median for nursing assistants ($49,830), and Washington has the highest for home health and personal care aides ($47,730), based on BLS state wage data for May 2025. For the full picture of CNA pay by state and setting, including hourly and annual breakdowns, our CNA salary guide has every state.
Growth runs the other way. BLS projects 18% growth for home health and personal care aides from 2025 to 2035, with about 760,500 openings a year. Nursing assistants and orderlies are projected to grow 3%, with about 203,300 openings a year.
The two roles also work in different places:
- Nursing assistants: nursing care facilities (36%), hospitals (32%), assisted living and continuing care retirement communities (11%), home healthcare services (5%), and government (3%)
- Home health and personal care aides: individual and family services (51%), home healthcare services (23%), residential facilities for people with intellectual and developmental disabilities (6%), and assisted living and continuing care retirement communities (6%)
Which Should You Choose?
Choose CNA if you want:
- Higher median pay and a job in a nursing home or hospital
- A credential that also qualifies you for HHA jobs at Medicare-certified agencies
- A first step toward becoming an LPN or RN
The path is short. Our guide to how to become a CNA covers training, the exam, and the registry in three steps, and you can compare CNA classes near you by location and format.
Choose HHA if you want:
- One-on-one care in clients' homes
- Faster job growth (18% for home health and personal care aides vs 3% for nursing assistants)
- Ongoing work with one or a few clients
Start by comparing home health aide schools near you, and if cost or speed is the deciding factor, the fastest and cheapest HHA programs are worth a look first.
Frequently Asked Questions
Is a CNA higher than a home health aide?
There is no formal ranking, but the CNA credential goes further. A CNA in good standing qualifies for HHA work at Medicare-certified agencies, while an HHA has to complete a state-approved nurse aide program or competency evaluation to keep working as a nurse aide in a nursing home past 4 months. CNAs also earn more at the median.
Is it better to be a CNA or HHA?
It depends on where you want to work. CNA pays more and opens more settings, including HHA jobs at Medicare-certified agencies. HHA work offers one-on-one care in clients' homes and much faster job growth, so it suits people who already know they want home-based care.
Who pays more, CNA or HHA?
CNAs. Nursing assistants earned a $42,260 median in May 2025, compared with $35,800 for home health and personal care aides. Inside home healthcare services, though, the gap narrows to $38,040 vs $36,230. By the hour, the overall medians work out to about $20.32 vs $17.21.
Can a CNA work as an HHA in New York?
Yes. A CNA listed on the New York State Nurse Aide Registry does not repeat training, but an approved home health aide training program must confirm their skills first. It then adds home-care topics, such as help with medications, handling a client's money, and home safety, before issuing an HHA certificate.
What is the difference between a CNA, HHA, and PCA?
CNAs give hands-on care, mostly in nursing homes and hospitals. HHAs give similar care in clients' homes and, under a nurse's direction, may give medication or check vital signs. Personal care aides "are generally limited to providing nonmedical services," according to BLS, such as companionship, cooking, cleaning, and driving.
Starting Out as a CNA or Home Health Aide
If you are still torn, CNA training keeps both options open. The same credential that lets you work in a nursing home or hospital also qualifies you for home health aide jobs at Medicare-certified agencies. HHA training is the more direct route if you already know you want to care for clients at home.
Dreambound lists CNA and home health aide programs by location and format, so you can see what is offered near you before choosing a path.
