Florida Home Health Aide Competency Test: Format and Scoring

The Florida home health aide competency test is a two-part evaluation that every aide must pass before working for a Medicare- or Medicaid-certified home health agency in the state. One part is a written or oral exam on the subjects covered in your training. The other is a hands-on skills demonstration performed in front of a registered nurse, who grades each task as satisfactory or unsatisfactory.¹ Florida’s Agency for Health Care Administration sets the curriculum standards the test is built on.²

Subjects Covered on the Test

Every question and every skills station maps to the subject list in the federal home health aide regulation. There are no surprise topics. The areas are:¹

Communication skills: 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 personal protective equipment
Basic body functioning and recognizing 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 people you serve, including respect for privacy and property
Personal hygiene and grooming: bed baths, sponge and shower baths, shampooing, nail and skin care, oral hygiene, and toileting
Safe transfers between beds, chairs, and wheelchairs, and assistance 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 may add skills beyond this baseline if Florida law allows it, but these are the subjects you can count on being tested.

How the Test Is Structured

The knowledge portion can be delivered as a written exam or orally. The skills portion requires you to perform tasks on a patient or a practice mannequin while a registered nurse watches and scores you.¹

Five subjects must be scored by direct observation and cannot be handled through written questions alone: communication skills; reading and recording vital signs; personal hygiene and grooming; safe transfers and ambulation; and range of motion and positioning. For every other subject area, the evaluator can choose between written questions, oral questions, or observation.¹

The evaluation is usually run by the home health agency hiring you, or by a testing organization the agency chooses. A registered nurse must perform or supervise it. Because agencies administer their own evaluations, the exact number of written questions and the specific skills stations vary from one employer to the next. The subject areas and the pass/fail rule do not.¹

How Scoring Works

There is no percentage grade. Each subject area is marked satisfactory or unsatisfactory, and your overall result depends on how many areas you miss.¹

Satisfactory in every area: you pass.
Unsatisfactory in exactly one area: you have not failed outright, but you cannot perform that specific task without direct RN supervision until you complete additional training on it and pass a follow-up evaluation of that skill.
Unsatisfactory in two or more areas: you have failed the evaluation and must retrain before retesting.

Passing is not permanent in a practical sense. If a registered nurse or other skilled professional spots a deficiency during a supervisory home visit after you start work, your agency must retrain you and run a new competency evaluation covering the deficient skill and every task related to it.¹ A single on-the-job gap can trigger a broader re-evaluation than the one-area process used during the initial test.

What You Need to Finish Before You Can Test

You cannot sit for the competency evaluation until you have completed an approved training program. Federal rules set the minimum at 75 total hours of combined classroom instruction and supervised hands-on practice, with at least 16 classroom hours completed before you move into at least 16 hours of supervised practical training. The practical portion must happen under the direct supervision of a registered nurse, or a licensed practical nurse who is herself supervised by an RN.¹

Florida offers these programs through licensed career schools, public vocational-technical centers, and some home health agencies. If you already hold an active Certified Nursing Assistant credential and are in good standing on the state’s nurse aide registry, you may qualify as a home health aide without repeating the full HHA course. Federal regulation treats CNA certification as an equivalent pathway, and Florida law allows passage of the competency test alone to substitute for the full training requirement.¹²

Two other requirements sit alongside training. Florida requires a Level 2 background screening for anyone working in an AHCA-regulated setting, including home health agencies. The screening is governed by Chapter 435 and Section 408.809(4) of the Florida Statutes, and Section 435.04 lists the specific crimes that disqualify an applicant, among them violent felonies, sexual offenses, abuse or neglect of elderly or disabled persons, felony fraud, and certain weapons offenses.³⁴ A criminal history that does not include a disqualifying offense will not automatically bar you.

The CDC also recommends a baseline tuberculosis screening at hire for all health care personnel, consisting of an individual TB risk assessment, a symptom evaluation, a TB test (blood or skin), and further evaluation if needed. A blood test can be a single step; a skin test requires two steps, with the second administered one to three weeks after the first.⁵ Individual employers and local health departments in Florida may require additional documentation, so confirm with the hiring agency before your start date.

After You Pass

Passing the competency test lets you work, but keeps you working only if you stay current. To remain eligible at 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 take place while you are actively providing patient care, and common topics include infection control updates and CPR refreshers.¹ Your agency is responsible for keeping records of both the initial evaluation and your annual in-service hours.

One scope boundary is worth knowing before you walk into the skills portion. Home health aides provide personal care and assistance with daily living, not medical treatment. You generally cannot perform medical procedures, give injections, or independently administer medications; you can remind a patient when it is time to take medication and help identify which pills to take. Florida does recognize a narrow exception under which a licensed home health agency can authorize an RN to delegate certain tasks, including medication administration, to an aide when the delegation meets the requirements of Chapter 464 and Chapter 400.⁶ Without that formal delegation, medication administration is outside your role.

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
6
The Florida Legislature. Florida Statutes 400.464 – Home Health Agencies