What Is a Home Health Aide? CHHA vs CNA vs Nurse Explained
Cut through the alphabet soup — CHHA, CNA, RN, LPN — and understand which role your parent actually needs.
The Three Roles at a Glance
| CHHA | CNA | RN/LPN | |
|---|---|---|---|
| Where they work | Client's home | Nursing homes, hospitals | Hospitals, clinics, home visits |
| What they do | Personal care, companionship | Similar personal care, in facilities | Medical care — assessments, medications, wound care |
| Training | 76+ hours (NJ program) | 90+ hours (NJ program) | 2-4 year degree + NCLEX |
| Can give medications? | No — reminders only | No — reminders only | Yes |
| Hourly rate | $30–$35 | $17–$22 | $40–$75+ |
What a CHHA Does — In Real Life
A Certified Home Health Aide is the person who shows up at your parent's home and helps them through their day — not with medical procedures, but with the things that make daily life possible.
A typical CHHA visit might look like this:
- Arrives at 8 AM, helps your mom get out of bed safely
- Assists with bathing, grooming, and getting dressed
- Prepares breakfast, makes sure she eats
- Reminds her to take her morning medications
- Does a load of laundry, tidies the kitchen
- Walks with her around the block for light exercise
- Drives her to a doctor's appointment
- Prepares lunch before leaving
What a CHHA cannot do:
- Administer medications (they can remind, not give)
- Perform medical procedures (wound care, catheter care)
- Make clinical judgments about health
- Work without nurse supervision
In New Jersey, CHHAs must complete a state-approved training program of at least 76 hours, pass a competency evaluation, and work under a registered nurse through a licensed Health Care Service Firm.
What a CNA Does — and How It Differs
A Certified Nursing Assistant does many of the same tasks as a CHHA — bathing, dressing, feeding, mobility assistance. The key difference is where they typically work.
CNAs primarily work in: nursing homes, hospitals, and rehabilitation centers.
The practical difference for families: If your parent is at home and needs care, the professional coming to their house will be a CHHA — not a CNA. In New Jersey's home care system, the CHHA is the designated aide role for in-home personal care under a licensed agency.
Some people hold both certifications. A CNA who completes additional home health aide training can become a CHHA, adding skills for working in a home environment.
What a Nurse Does — RN vs LPN
Nurses provide medical care. This is the fundamental difference. A Registered Nurse (RN) or Licensed Practical Nurse (LPN) can do everything a CHHA and CNA can do, plus:
- Assess health conditions and create care plans
- Administer medications — including injections
- Perform wound care
- Manage IVs and catheters
- Coordinate with physicians
- Supervise CHHAs and CNAs
When your parent needs a nurse at home: After surgery, during recovery, for wound care, or for medication management requiring clinical skill.
When your parent needs a CHHA at home: For ongoing daily support — bathing, meals, housekeeping, companionship, medication reminders, transportation.
Which Role Does Your Parent Need?
Your parent needs a CHHA if:
- They need help with bathing, dressing, grooming, or toileting
- They're not eating well or can't prepare meals
- They're isolated and need companionship
- They need medication reminders (not administration)
- They need help getting to appointments
Your parent needs a nurse if:
- They're recovering from surgery or hospitalization
- They have wounds that need clinical care
- They need medications administered (injections, IV)
- Their doctor has ordered skilled home health services
Your parent needs both if: They have medical needs AND need daily personal care.
Understanding the NJ System
In New Jersey, home care is regulated through the Health Care Service Firm (HCSF) licensing system:
- The agency must be licensed as an HCSF by the NJ Department of Health
- CHHAs must be certified through an NJ state-approved training program
- A registered nurse must supervise CHHA services and create care plans
- The family has a right to a written care plan, caregiver introductions, and transparent communication
The Cost Comparison
| Role | Typical Cost | Who Pays |
|---|---|---|
| CHHA (through agency) | $30–$35/hour | Medicaid, private pay, LTC insurance |
| CNA (in facility) | Part of facility cost | Medicaid, Medicare (short-term), private pay |
| RN home visit | $40–$75+/hour | Medicare (if physician-ordered), insurance, private pay |
For a detailed breakdown, read our guide on home care costs in NJ.
About OnVerra Health
OnVerra Health is a licensed New Jersey Home Care Service Firm based in Union, NJ, currently pursuing CHAP accreditation. We specialize in Certified Home Health Aide services — personal care, companionship, and daily living assistance for families across Union County and surrounding communities.
Request a free consultation or call us at (908) 718-1948.
FAQ — What Is a Home Health Aide? CHHA vs CNA vs Nurse Explained
Can a CHHA give my parent their medications?
Is a home health aide the same as a caregiver?
Does Medicare pay for a home health aide?
What training does a CHHA need in New Jersey?
My parent has dementia — do they need a CHHA or a nurse?
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Request a Free ConsultationThis article is for informational purposes only and does not constitute medical or financial advice. Consult your healthcare provider for guidance specific to your situation.