Hospice aide jobs: federal training rules, duties and pay

A hospice aide gives personal care to people who are near the end of life and have chosen hospice care. Federal rules for Medicare-certified hospices set a training minimum for aides and require a registered nurse to supervise them. States add their own rules.

BLS does not list hospice aides as a separate occupation. It counts them under home health and personal care aides and notes that an aide may stay with one client "for a specific purpose, such as hospice care."

What hospice aides do

The duties are set out in 42 CFR 418.76, the federal rule for hospice aide and homemaker services. A registered nurse (RN) assigns each aide to a specific patient. The aide:

• gives hands-on personal care;
• performs simple procedures as an extension of therapy or nursing services;
• helps the patient walk or exercise;
• helps with medications that are ordinarily self-administered;
• reports changes in the patient's needs to the RN.

An RN must visit the patient's home at least every 14 days to assess the quality of care, and must make an annual on-site visit to observe each aide, according to the same rule.

Medicare.gov says hospice care is for people with a life expectancy of 6 months or less who accept comfort care instead of treatment to cure their illness. The aide is one part of that plan of care. Medicare.gov says you and your family set up the plan with the hospice care team.

Where hospice aides work

Medicare.gov says hospice care is usually available where the patient lives, which can be their home or a facility such as an assisted living facility or a nursing home. Under certain conditions, patients can also get care in an inpatient hospice facility. See hospice providers in your state.

BLS says aide work is physically and emotionally demanding, and aides must use proper lifting techniques to guard against back injury.

Training and certification

Under 42 CFR 418.76, a hospice aide qualifies by completing one of four routes:

• a training and competency evaluation program that meets the rule;
• a competency evaluation program that meets the rule;
• a nurse aide training and competency evaluation program approved by the state, with the aide listed in good standing on the state nurse aide registry;
• a state licensure program that meets the rule.

The rule sets out these points:

• Classroom and supervised practical training must total at least 75 hours, and at least 16 hours of classroom training must come before at least 16 hours of supervised practical training.
• The program must cover 13 subject areas, including communication, documentation, vital signs, infection control, emergencies, personal hygiene, safe transfers, range of motion and nutrition.
• A registered nurse, in consultation with other skilled professionals, performs the competency evaluation. An aide rated unsatisfactory in more than one required area has not passed.
• A hospice aide must receive at least 12 hours of in-service training in each 12-month period, supervised by an RN.
• After 24 consecutive months with no paid hospice services, an aide must complete a program again.

BLS says aides at certified home health or hospice agencies must complete formal training and pass a standardized test. It also says some states require a license or certification and that aides may need first aid and CPR.

States add their own rules. Carevo does not guess at state requirements. Ask your state board of health, and ask each hospice what it accepts. If you are already a CNA, the CNA page explains the federal nurse aide rules, and the nurse aide route in 418.76 is one of the four routes above.

Hospice aide pay

BLS publishes hospice aides within the home health and personal care aide group (SOC 31-1120). For that group, BLS reports a national median wage of $17.21 an hour, or $35,800 a year, for the May 2025 reference period. These are wages paid to workers, not prices charged by hospices. They are national, so pay in your state and with your employer can be higher or lower.

How to find hospice aide jobs

Hospices hire aides directly. Browse hospice providers and home health agencies in your state, then contact the ones near you. Ask whether they hire aides who have not yet completed a program, what training they provide. If you care for a relative, see paid family caregiver programs.

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