- CHPNA certification is awarded by HPCC and signals hospice/palliative-specific competency to employers beyond a standard CNA license.
- Eligibility requires 500 hours of hospice/palliative NA practice in 12 months or 1,000 hours in 24 months under RN supervision.
- The exam covers four domains: ADLs, Patient Status/Environment, Psychosocial/Spiritual Care, and Professional Skills.
- Exam fee is $190 for HPNA members and $280 for nonmembers, delivered via PSI in-person or remote proctoring.
The CHPNA Job Landscape
Nursing assistants who work in hospice and palliative settings do fundamentally different work than assistants on a med-surg floor or in a standard long-term care facility. The pace is slower in some ways, heavier in others, and the emotional demands are constant. Employers in this space increasingly look for candidates who hold the Certified Hospice and Palliative Nursing Assistant (CHPNA) credential from the Hospice and Palliative Credentialing Center (HPCC) because it verifies a specific, tested body of knowledge rather than general nursing-assistant competence.
If you're job hunting in this field, understanding exactly what the credential verifies - and how employers use it - matters as much as knowing how to pass the exam itself. For a full breakdown of what the certification actually is, see What Is CHPNA Certification?
Who Hires CHPNA-Certified Nursing Assistants
The demand for CHPNA-credentialed nursing assistants comes from several distinct types of employers, each with slightly different day-to-day expectations:
- Hospice agencies - home-based and inpatient hospice organizations are the most direct employer of CHPNA-certified staff, since the eligibility requirement itself is built around hospice and palliative nursing-assistant hours.
- Palliative care programs within hospitals - many hospital systems now run dedicated palliative consult teams and inpatient units that value staff who understand comfort-focused care distinct from curative care.
- Skilled nursing and long-term care facilities with palliative units - facilities that care for residents with serious or terminal illness often seek certified assistants to staff dedicated comfort-care wings.
- Home health agencies with hospice divisions - agencies providing in-home end-of-life support look for assistants comfortable managing symptoms and family dynamics without direct supervision on every visit.
Because certification requires practice under RN supervision, most CHPNA-credentialed assistants already have a foot in the door with an employer before they certify - but the credential itself opens doors to better shifts, specialty units, and sometimes differentiated pay scales within the same organization.
Key Takeaway
If you're not yet working in hospice/palliative care, start by seeking an entry-level CNA role at a hospice agency or hospital palliative unit - this builds the hours you'll need for CHPNA eligibility while giving you real domain exposure.
What the Job Actually Looks Like Day to Day
CHPNA-certified assistants aren't just doing baths and vitals. The job blends hands-on physical care with close attention to symptom changes and emotional support for patients and families facing terminal illness. Typical responsibilities include:
- Assisting with activities of daily living for patients who may have limited mobility, pain, or fluctuating alertness
- Monitoring and reporting changes in patient status - skin breakdown, breathing patterns, appetite, pain cues - to the supervising RN
- Supporting the emotional and spiritual needs of patients and their caregivers during the dying process
- Maintaining a safe, calm care environment, often in a patient's own home rather than a clinical setting
- Communicating professionally and sensitively within an interdisciplinary hospice team
These are exactly the areas tested by the CHPNA exam, which is why hiring managers treat the credential as a proxy for job readiness. For candidates who want a granular look at each tested area before applying to roles, CHPNA Exam Domains 2026: Complete Guide to All 4 Content Areas breaks down every domain in depth.
How the Exam Domains Map to Real Job Duties
The CHPNA exam is built from a 2024 job analysis, meaning the four domains reflect what certified assistants are actually expected to do on shift - not abstract textbook categories. Understanding this mapping helps both job seekers preparing for interviews and candidates studying for the exam itself.
Domain 1: Patient Care: Activities of Daily Living
Covers bathing, feeding, positioning, mobility assistance, and hygiene for patients whose conditions may change rapidly. On the job, this is the physical core of the role.
- Adapting ADL support to fluctuating energy and consciousness levels
Domain 2: Patient Status and Environment
Focuses on observing and reporting physical changes, and maintaining a safe, comfortable care setting - critical in home hospice where the assistant may be the first to notice a decline.
- Recognizing signs that warrant immediate RN notification
Domain 3: Psychosocial/Spiritual Care of the Patient and Family/Caregivers
Addresses emotional presence, cultural sensitivity, and support for grieving family members - a domain that separates hospice-specific work from general CNA duties.
- Supporting caregivers who are also processing anticipatory grief
Domain 4: Professional Skills
Covers communication within the interdisciplinary team, documentation, boundaries, and professional conduct required in home and facility hospice settings.
- Reporting accurately and collaborating with RNs, social workers, and chaplains
Note that the handbook's roughly 20% recall / 80% application split describes the cognitive level of exam questions, not domain weighting - meaning most questions ask you to apply knowledge to a scenario rather than recite a fact. This mirrors real hospice work, where judgment calls matter more than memorized definitions. For a deeper look at what "hard" really means for this exam, see How Hard Is the CHPNA Exam? Complete Difficulty Guide 2026.
Getting Certified Before You Apply
Before you can sit for jobs that specifically require or prefer CHPNA certification, you need to meet HPCC's eligibility rules and pass the exam itself.
Eligibility
Candidates need 500 hours of hospice and palliative nursing-assistant practice in the preceding 12 months, or 1,000 hours in the preceding 24 months, all performed under registered-nurse supervision in the United States. This is why most people pursuing CHPNA jobs already work as a CNA in a hospice or palliative setting before certifying. Full eligibility details are covered in CHPNA Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Exam Format
The exam contains 110 multiple-choice questions - 100 scored and 10 unscored - with four answer choices each and one best answer. Candidates get 2 hours and 30 minutes, delivered by PSI at a test center or via live remote proctoring. No reference materials are allowed. Passing requires a scaled score of 500 on a 200-800 scale, detailed further in CHPNA Passing Score 2026: Exactly What You Need to Pass.
Cost and Scheduling
Initial exam fees are $190 for HPNA members and $280 for nonmembers. Testing windows run in March, June, September, and December, with online application deadlines of February 15, May 15, August 15, and November 15 respectively. If you don't pass, the reTEST Assured program offers one discounted retake for $135 within one of the next three testing windows. For the complete pricing and scheduling picture, see CHPNA Certification Cost 2026: Complete Pricing Breakdown and CHPNA Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
| Item | Detail |
|---|---|
| Certifying body | Hospice and Palliative Credentialing Center (HPCC) |
| Membership association | Hospice and Palliative Nurses Association (HPNA) |
| Exam delivery | PSI - test center or live remote proctoring |
| Question count | 110 total (100 scored, 10 unscored) |
| Time allowed | 2 hours 30 minutes |
| Passing score | 500 (scale of 200-800) |
| Certification term | 4 years, renewable via exam or HPAR |
Career Path and Advancement
Certification is renewable for four years, and renewal requires either qualifying practice plus successful re-examination, or completion of the Hospice and Palliative Accrual for Recertification (HPAR) pathway, which includes professional-development requirements. One important nuance: if a candidate fails a renewal examination, they must continue through the examination route rather than switch to HPAR for that cycle.
For assistants building a long-term career in hospice and palliative care, certification often functions as a stepping stone - it demonstrates commitment to the specialty and can support moves into senior aide roles, team lead positions, or further education toward nursing credentials. Whether the time and cost investment pays off in your specific market is worth weighing carefully; Is the CHPNA Certification Worth It? Complete ROI Analysis 2026 and CHPNA Salary Guide 2026: Complete Earnings Analysis both dig into that question in more depth.
Preparing for the Exam While Job Hunting
Many candidates study for the CHPNA exam while already working hospice shifts, which means study time is limited and needs to be targeted at the domains that feel least familiar from daily practice. A simple way to structure the final weeks before a testing window:
Domain 1 & 2 Review
- Refresh ADL support techniques and patient-status observation skills you use daily but rarely articulate in exam language
Domain 3 Focus
- Study psychosocial and spiritual care scenarios, since these questions often require applying judgment rather than recalling facts
Domain 4 & Timed Practice
- Review professional communication standards and take full-length timed practice questions to build stamina for the 2.5-hour format
Mixed Review
- Rotate through all four domains with application-style questions and confirm your testing window registration deadline has been met
For a structured resource covering all of this in one place, CHPNA Study Guide 2026: How to Pass on Your First Attempt walks through a fuller preparation plan, and CHPNA Cheat Sheet 2026: One-Page Review of Must-Know Facts is useful for quick review in the final days. You can also build exam-day confidence with realistic timed questions on our practice test platform, which mirrors the four-domain structure and application-heavy question style candidates actually face.
Key Takeaway
Because roughly 80% of questions test application rather than recall, practicing with scenario-based questions on a full-length practice test is more valuable than memorizing definitions alone.
FAQ
Yes - eligibility requires 500 hours of hospice and palliative nursing-assistant practice in the preceding 12 months, or 1,000 hours in the preceding 24 months, under RN supervision. Most candidates certify while already working in the field.
Requirements vary by employer, but hospice agencies, hospital palliative care programs, skilled nursing facilities with comfort-care units, and home health agencies with hospice divisions are the most likely to prefer or require it.
Initial exam fees are $190 for HPNA members and $280 for nonmembers. A discounted retake of $135 is available through the reTEST Assured program if you don't pass on the first attempt.
Testing windows occur in March, June, September, and December, with online application deadlines 15 days before each window begins (February 15, May 15, August 15, and November 15).
Certification lasts four years. Renewal requires qualifying practice plus either successful re-examination or completion of the Hospice and Palliative Accrual for Recertification (HPAR) program, including its professional-development requirements.