CNA vs HHA vs PCA: Which Caregiver Role Does Your Agency Need?
Certified nursing assistants, home health aides and personal care aides overlap — but training, settings and requirements differ. Here's how to choose.
Job boards use "caregiver," "aide" and "CNA" almost interchangeably, but the roles are not the same — and hiring the wrong one can leave you out of compliance or paying for credentials you don't need. Here's a practical overview. Requirements vary by state and by payer, so always confirm the rules that apply to your agency.
Personal Care Aide (PCA)
What they do: non-medical help with daily living — bathing, dressing, meals, light housekeeping, companionship and medication reminders.
Training: varies widely. Some states require a set number of training hours; others leave it to the agency or the program funding the care.
Best fit: private-pay companion and personal care, and many Medicaid home and community-based programs.
Home Health Aide (HHA)
What they do: personal care plus some basic health-related tasks, such as checking vital signs, typically under the supervision of a nurse.
Training: aides working for Medicare-certified home health agencies must meet federal training and competency requirements (at least 75 hours, including 16 hours of supervised practical training). Many states add their own requirements.
Best fit: home health agencies and home-care agencies serving clients with more complex needs.
Certified Nursing Assistant (CNA)
What they do: hands-on patient care under nurse supervision, often in facilities but increasingly in home settings too.
Training: a state-approved program (the federal minimum for nursing homes is 75 hours) and a competency exam, followed by listing on the state nurse aide registry.
Best fit: clients with higher care needs, agencies that also staff facilities, and roles where a registry-listed credential is required.
How to decide which to hire for
- Start with your clients' care plans. If clients need companionship and help with daily routines, PCAs may be all you need.
- Check your payers. Medicare home health, Medicaid waivers and private-pay clients can each have different staffing rules.
- Check your state. Licensing rules for home-care agencies often specify minimum aide training.
- Write it into the job post. Stating "HHA or CNA required" or "PCA training provided" up front saves screening time for everyone.
Screening for the right credential
Whichever role you hire for, ask applicants to list their certifications and expiry dates, then verify them with the relevant state registry or training program before making an offer.
Make caregiver hiring easier with Hirecise
Hirecise gives home-care agencies one place to post caregiver roles, collect applications, and see AI-ranked shortlists based on the certifications, care experience and availability you ask for. Hirecise reads what candidates state on their CV — it does not verify certifications with state registries, so that check stays with your team. Try the live demo — no login needed — or start hiring.