A home health aide, a personal care aide and a certified nursing assistant (CNA) can look alike when they walk through your door, but in Indiana they follow different training rules, work in different settings and are allowed to do different things. If you are arranging care for a parent and searching for a home health aide in Indianapolis, knowing the difference helps you ask for the right kind of help and understand what each caregiver can and cannot do.
Key takeaways
- Home health aides (HHAs) work under a home health agency, usually alongside a nurse or therapist, and are listed on the Indiana Aides Registry after training and testing.
- Certified nursing assistants (CNAs) complete a state-approved 75-hour program and testing and mostly work in nursing homes, hospitals and similar facilities.
- Personal care aides (often called attendants) work for personal services agencies providing non-medical help, and the agency must evaluate their competency for each task.
- None of these roles replaces a nurse. Tasks that require a health professional’s order belong to licensed or supervised clinical staff.
The short version: three roles, three settings
- Home health aide: provides hands-on personal care in the home as part of a home health plan of care, supervised by a registered nurse or therapist.
- Personal care aide: provides non-medical help at home such as bathing, dressing, meals, housekeeping and companionship, without a doctor’s order.
- Certified nursing assistant: provides personal care and basic nursing support, mostly in facilities, under the supervision of nurses.
The tasks overlap a lot. The differences are in training, oversight and where the care fits in a larger medical picture.
What a home health aide in Indianapolis does
A home health aide works for a home health agency and is usually part of a care team that includes a registered nurse and sometimes physical, occupational or speech therapists. Typical duties include:
- Help with bathing, showering, dressing, grooming and toileting
- Assistance with walking, transfers and exercises the therapist has taught
- Observing and reporting changes in the person’s condition to the nurse
- Keeping the immediate care area clean and safe
- Following the written plan of care
When Medicare covers home health, aide visits are part-time and only available while the person is also getting skilled nursing or therapy, as explained on Medicare.gov. When the skilled care ends, those aide visits end too. Many families then switch to private-pay personal care to keep daily help in place.
Indiana training and certification for home health aides
According to the Indiana Department of Health’s home health aide page:
- For federally certified agencies, training must include at least 75 hours, including 16 hours of supervised hands-on practice, with at least 16 hours of classroom instruction completed before practical training begins.
- Aides must pass a competency evaluation. The written test must be passed with a score of at least 88%, and a skills checklist administered by the agency’s RN must be completed with 100% accuracy.
- Aides are added to the Indiana Aides Registry once they pass the test and their application is submitted.
- To stay active, aides must work at least eight hours in nursing-related duties and complete 12 hours of in-service training each year.
- Aides must complete dementia training within 60 days of hire before providing that care, with ongoing dementia training after their first year.
What a certified nursing assistant does
CNAs provide personal care and basic support such as taking vital signs, helping with meals and mobility, and keeping residents clean and comfortable. Most CNAs in Indiana work in nursing homes, hospitals, rehabilitation centers and assisted living settings, under the supervision of licensed nurses.
Indiana training and certification for CNAs
According to the Indiana Department of Health:
- CNAs complete a state-approved nurse aide training program of at least 75 hours, with at least 30 hours of classroom instruction and at least 45 hours of clinical instruction. At least 24 of the clinical hours must take place in a licensed comprehensive long-term care facility.
- They must pass a written test (at least 80%) and a skills test.
- Once they pass, they are listed on the Indiana Aides Registry.
- To stay active, they must work at least eight hours in nursing-related duties every two years.
Being a CNA and being a home health aide are separate listings in Indiana. A CNA who wants to work as a home health aide should check the IDOH requirements for that role rather than assume one certification covers both.
What a personal care aide does
Personal care aides, sometimes called attendants, caregivers or personal care assistants, provide non-medical help at home. In Indiana, many work for licensed personal services agencies. The state describes personal services as attendant care, homemaker tasks (housekeeping, shopping, laundry, meal preparation) and companion services (company, transportation, reading mail, escorting to appointments).
Typical duties include:
- Help with bathing, dressing, grooming and toileting
- Meal preparation and help with eating
- Light housekeeping and laundry
- Medication reminders
- Errands, transportation and companionship
Indiana requirements for personal care aides
Indiana’s personal services agency requirements call for the agency to evaluate each attendant’s competency for every attendant care task it assigns, train and re-evaluate anyone who needs improvement, and confirm competency before the attendant performs a task without direct supervision. Staff with direct client contact must complete a tuberculosis test. The state does not set a fixed number of training hours for attendants in those rules, so it is worth asking any agency how it trains and checks its caregivers.
Personal services do not include services that require the order of a health care professional. If a person’s needs become medical, a home health agency or nurse needs to be involved.
Side-by-side comparison
- Medical oversight: HHA, yes (nurse or therapist plan of care). CNA, yes (nurse supervision, mainly in facilities). Personal care aide, no doctor’s order required.
- Typical setting: HHA, the client’s home. CNA, nursing homes and hospitals. Personal care aide, the client’s home.
- State listing: HHA and CNA, the Indiana Aides Registry after training and testing. Personal care aide, competency evaluated by the employing agency.
- Medicare: HHA visits may be covered as part of skilled home health. Personal care alone is not covered.
Which one does your family need?
Ask a few questions:
- Is there a skilled need right now? After a hospital stay, a new wound, or a change in medications, a home health plan with a nurse and an aide may be the right start. Talk to the doctor about a referral.
- Is the need mostly daily living? If your parent needs help bathing, dressing, cooking and staying safe but is medically stable, a personal care aide is usually the better fit.
- Is the need both? Many families use home health for recovery and personal care for everyday support, sometimes from the same provider.
Our post on home care vs. home health goes deeper on this choice.
Aides from Aken Home Health and Home Care
Aken provides home health aides in Indianapolis as part of our home health services, along with personal care assistance for families who need non-medical help at home. We serve Indianapolis and nearby communities including Carmel, Fishers, Zionsville, Brownsburg, Avon and Greenwood. Interested in working as a caregiver? You can also apply to join our team.
Frequently asked questions
Can a home health aide give medications in Indiana?
Aides generally provide reminders and help with routines set by the nurse. Administering medications is a nursing task. Ask the agency’s nurse what the plan of care allows.
Is a CNA more qualified than a home health aide?
Not necessarily. Both complete training and testing and are listed on the Indiana Aides Registry, but the training focuses on different settings. The best fit depends on where care happens.
How can I check an aide’s certification in Indiana?
You can search the Indiana Aides Registry by name through the state’s MyLicenseOne system.
Do personal care aides need to be certified in Indiana?
Indiana’s personal services agency rules focus on the agency evaluating each attendant’s competency for every task they perform, rather than setting a fixed training-hour requirement. Some personal care aides are also CNAs or home health aides, so ask the agency about each caregiver’s background.
Aken Home Health and Home Care serves Indianapolis and surrounding counties. Call our office at 317-734-3934 (Mon to Fri, 8am to 5pm) or our 24/7 line at 574-320-4705, or request a free consultation.
