Florida Home Health Aide Competency Test: Parts, Passing, and Training

The Florida home health aide competency test is a two-part evaluation you must pass before working for any Medicare- or Medicaid-certified home health agency in the state. It combines a written or oral knowledge exam with a hands-on skills demonstration, and a registered nurse scores both parts against roughly a dozen federally required subject areas.¹ Florida’s Agency for Health Care Administration sets the curriculum standards behind it.²

What the Test Covers

Every question and every skills station maps to the subject areas from the 75-hour training curriculum. No surprise topics. The federally listed areas are:¹

Communication skills, including reading, writing, and verbally reporting clinical information to patients, families, and agency staff
Observation, reporting, and documentation of changes in a patient’s condition
Reading and recording temperature, pulse, and respiration
Infection control, including handwashing and use of personal protective equipment
Basic body functioning and changes that need to be reported
Maintaining a clean, safe, and healthy home environment
Recognizing emergencies and knowing how to respond
The physical, emotional, and developmental needs of the patients you serve, including respect for privacy and property
Personal hygiene and grooming: bed baths, sponge and shower baths, hair shampooing, nail and skin care, oral hygiene, and toileting
Safe transfers between beds, chairs, and wheelchairs, and assisting with ambulation
Normal range-of-motion exercises and proper positioning
Adequate nutrition and fluid intake
Recognizing and reporting skin changes such as pressure sores or rashes

Agencies can add skills beyond this baseline where Florida law permits.

How the Two Parts Work

The knowledge portion is written or oral. The skills portion requires you to perform tasks on a patient or a practice mannequin while a registered nurse observes and scores you.¹

Five subject areas have to be tested by direct observation, not on paper: communication skills, vital signs, personal hygiene and grooming, transfers and ambulation, and range of motion and positioning. The other topics can be assessed through written questions, oral questions, or observation, at the evaluator’s discretion.¹

The evaluation is usually run by the home health agency employing you or by a testing organization the agency designates, with a registered nurse performing or overseeing it.¹ Because agencies run their own evaluations, the exact number of written questions and the specific skills stations vary by employer. The subject areas tested and the pass/fail standard do not.

How You Pass or Fail

Each subject area is scored satisfactory or unsatisfactory. There is no percentage-based passing score. You fail the entire evaluation if you receive an unsatisfactory rating in more than one subject area.¹

One unsatisfactory area is a different situation. You have not failed outright, but you cannot perform that specific task without direct RN supervision until you complete additional training on the skill and pass a follow-up evaluation on it. Two or more unsatisfactory areas means you did not pass, and you have to retrain before retesting.¹

Training You Need Before Testing

You cannot walk in cold. Federal rules require at least 75 total hours of combined classroom instruction and supervised hands-on practice, with a minimum of 16 hours of classroom work done before at least 16 hours of supervised practical training. The practical portion has to be under the direct supervision of a registered nurse, or a licensed practical nurse working under an RN.¹

Programs run through licensed career schools, public vocational-technical centers, and some home health agencies. Tuition for the 75-hour program typically runs a few hundred dollars, though costs vary.

If you already hold an active Certified Nursing Assistant credential and appear in good standing on your state’s nurse aide registry, you may qualify as a home health aide without completing separate HHA training. Federal regulation recognizes CNA certification as an equivalent pathway,¹ and Florida law allows passing the competency test alone to substitute for the full training requirement.²

Background and Health Screening

Training alone will not get you into a testing seat with an agency. Florida requires a Level 2 background screening for anyone working in an AHCA-regulated health care setting, home health agencies included. Screenings are conducted under Chapter 435 and Section 408.809(4) of the Florida Statutes.³

Not every criminal record disqualifies you. Florida Statute 435.04 lists dozens of specific disqualifying offenses, covering violent crimes, sexual offenses, abuse and neglect of elderly or disabled persons, felony fraud, and certain weapons offenses, along with attempts, solicitation, conspiracy, and equivalent crimes from other states.⁴ A criminal history that does not include a listed offense can still be found eligible.

You also need a baseline tuberculosis screening. The CDC recommends four components at hire: an individual TB risk assessment, a symptom evaluation, a TB test (blood or skin), and further evaluation if indicated. A blood test is a single step; a skin test has to be two-step, with the second test given one to three weeks after the first.⁵ Individual employers and Florida’s local health departments may add physical exam requirements, so ask your agency what documentation it wants before your start date.

After You Pass

Passing once is not permanent. To keep working for a Medicare- or Medicaid-certified agency, you must complete at least 12 hours of in-service training during each 12-month period of employment, supervised by a registered nurse. The training can happen while you are actively providing patient care.¹ Common in-service topics include infection control updates, CPR refreshers, and HIV/AIDS education. Your agency is required to keep records showing you completed both the initial competency evaluation and your annual hours.

1
eCFR. 42 CFR 484.80 – Condition of Participation: Home Health Aide Services
2
Florida Senate. Florida Statutes 400.497 – Home Health Aide Training and Competency Test
3
AHCA. Background Screening Information
4
Florida Senate. Florida Statutes 435.04 – Level 2 Screening Standards
5
CDC. Baseline Tuberculosis Screening and Testing for Health Care Personnel