- CHPNA stands for Certified Hospice and Palliative Nursing Assistant, credentialed by HPCC.
- The exam has 110 questions (100 scored), a 2-hour, 30-minute limit, and requires a scaled score of 500.
- Eligibility needs 500 hours in the past 12 months or 1,000 hours in the past 24 months under RN supervision.
- Fees are $190 for HPNA members and $280 for nonmembers; a discounted $135 retest is available.
What Is a CHPNA?
A Certified Hospice and Palliative Nursing Assistant (CHPNA) is a nursing assistant who has demonstrated specialized competency in end-of-life and serious-illness care and has earned certification through the Hospice and Palliative Credentialing Center (HPCC). The related professional membership organization, the Hospice and Palliative Nurses Association (HPNA), supports the field but does not itself issue the CHPNA credential - HPCC does. The exam is delivered by PSI, either at a physical test center or through live remote proctoring, giving candidates flexibility in how and where they sit for the test.
This distinction matters because several unrelated credentials share similar-sounding initials in other industries. For hospice and palliative care specifically, CHPNA identifies a nursing assistant - not an RN, not a manager, and not a certification in an unrelated field. If you're still sorting out terminology, the companion piece CHPNA Meaning and the explainer What Does CHPNA Stand For? break down the acronym in more detail.
What a CHPNA Actually Does
Unlike a generic CNA role, the CHPNA's daily work is shaped entirely by end-of-life and serious-illness contexts. Typical responsibilities include:
- Assisting patients with bathing, dressing, feeding, positioning, and mobility as their physical capacity declines
- Monitoring and reporting changes in patient condition - skin integrity, pain behaviors, appetite, breathing patterns - to the supervising RN
- Supporting patients and family members emotionally and spiritually during decline and after death
- Communicating professionally within an interdisciplinary hospice or palliative team
These four buckets of duty map almost exactly onto the four domains tested on the certification exam, which is why understanding the domain structure is the fastest way to understand the job itself. For a deeper breakdown of each domain's weight and content, see CHPNA Exam Domains 2026: Complete Guide to All 4 Content Areas.
The Four CHPNA Exam Domains
The 2026 candidate handbook reflects the 2024 job analysis and organizes exam content into four domains. The distribution most candidates hear about - roughly 20% recall versus 80% application - describes the cognitive level of questions, not how many points come from each domain. In other words, most questions ask you to apply knowledge to a scenario rather than simply recall a fact.
Domain 1: Patient Care: Activities of Daily Living
Covers hands-on personal care tasks adapted to a declining or terminally ill patient - bathing, feeding, toileting, positioning, and mobility assistance performed safely and with dignity.
- Adapting ADL techniques as physical function declines
- Maintaining comfort and safety during transfers and repositioning
- Recognizing when a task requires additional support or escalation
Domain 2: Patient Status and Environment
Focuses on observing, documenting, and reporting changes in the patient's physical condition and surroundings.
- Recognizing signs of pain, distress, or declining status
- Maintaining a clean, safe, and appropriate care environment
- Accurate, timely reporting to the supervising RN
Domain 3: Psychosocial/Spiritual Care of the Patient and Family/Caregivers
Addresses the emotional and spiritual dimensions of hospice work, including support for grieving families and culturally sensitive care.
- Supporting patients and families through anticipatory grief
- Respecting diverse spiritual and cultural practices around death
- Recognizing when to involve chaplains, social workers, or counselors
Domain 4: Professional Skills
Covers conduct, communication, confidentiality, and functioning as part of an interdisciplinary hospice team.
- Maintaining professional boundaries and patient confidentiality
- Effective communication with RNs and the care team
- Understanding scope of practice limits
Key Takeaway
Study each domain as a reflection of real job duties, not an abstract test category - the exam's application-heavy format rewards candidates who can reason through patient scenarios, not just memorize terms.
Who Hires CHPNAs
CHPNA-certified nursing assistants typically work in settings where end-of-life or serious-illness care is central to the mission: hospice agencies, inpatient hospice units, palliative care teams within hospitals, long-term care facilities with hospice partnerships, and home health agencies that serve hospice patients. Employers in these settings often view the certification as evidence that a candidate can be trusted with the emotional and clinical complexity unique to this population. If you're evaluating whether the credential translates into better job prospects or pay, CHPNA Jobs and CHPNA Salary Guide 2026: Complete Earnings Analysis go into more detail, and Is the CHPNA Certification Worth It? Complete ROI Analysis 2026 weighs the broader return on the investment of time and fees.
Eligibility Requirements
Before you can sit for the exam, HPCC requires documented hands-on experience. Specifically, candidates need:
- 500 hours of hospice and palliative nursing-assistant practice in the preceding 12 months, or
- 1,000 hours of that same practice in the preceding 24 months
In both cases, the practice must occur under registered-nurse supervision within the United States. This requirement exists because the credential validates real-world competency, not just classroom knowledge. For a full walkthrough of how to document and verify these hours, see CHPNA Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Exam Format, Fees, and Registration
The CHPNA exam consists of 110 multiple-choice questions - 100 scored and 10 unscored - each with four answer choices and one best answer. Candidates are given 2 hours and 30 minutes to complete the test, and no outside reference materials are permitted during the exam. A passing result requires a scaled score of 500 on a 200-800 scale; the scaled score, not a raw percentage, is what determines pass or fail. For the full mechanics of how scoring works, CHPNA Passing Score 2026: Exactly What You Need to Pass is worth reading before test day.
| Item | Detail |
|---|---|
| Total questions | 110 (100 scored, 10 unscored) |
| Time allowed | 2 hours 30 minutes |
| Passing score | 500 on a 200-800 scale |
| Fee (HPNA member) | $190 |
| Fee (nonmember) | $280 |
| Discounted retake (reTEST Assured) | $135, within one of the next three testing windows |
The reTEST Assured program is worth understanding before your first attempt: if you don't pass, you're eligible for a discounted $135 retake within one of the next three testing windows. This softens the financial hit of a failed attempt but still makes first-attempt preparation the more cost-effective path. A detailed cost breakdown, including how membership status affects your total spend, is available in CHPNA Certification Cost 2026: Complete Pricing Breakdown.
Testing Windows and Deadlines
The exam is offered in four windows each year: March, June, September, and December. Online applications are due on fixed deadlines ahead of each window - February 15, May 15, August 15, and November 15, respectively. Missing a deadline means waiting for the next quarterly window, so building your eligibility hours and application paperwork around these dates matters as much as studying content. CHPNA Exam Dates 2026: Testing Windows, Deadlines & Scheduling lays out a planning calendar if you want to work backward from a target test date.
Certification Length and Renewal
Once earned, CHPNA certification is valid for four years. Renewal requires continued qualifying practice plus one of two paths: successful re-examination, or completion of the Hospice and Palliative Accrual for Recertification (HPAR) program, which includes its own professional-development requirements. One important rule to note: a candidate who attempts and fails a renewal examination must continue through the examination route for that cycle - they cannot switch over to HPAR instead. Planning your renewal strategy early, rather than defaulting to whichever path seems easiest at the last minute, avoids this trap.
Preparing for the Exam
Because the exam leans heavily toward applied scenarios rather than simple recall, preparation works best when it's organized around the four domains rather than a generic study calendar. A simple way to structure a final few weeks of review:
ADLs and Patient Status
- Review Domain 1 and Domain 2 content together, since both involve hands-on observation skills
- Practice scenario questions involving changes in patient condition
Psychosocial/Spiritual Care
- Focus on Domain 3 scenarios involving grief, family dynamics, and cultural sensitivity
Professional Skills and Full Review
- Cover Domain 4 conduct and communication topics
- Take timed practice sets to build stamina for the 2.5-hour exam
Timed practice matters here specifically because the exam's application-based format takes longer to reason through than pure recall questions would. Running full-length practice sessions on our CHPNA practice test platform is one of the most direct ways to get comfortable with that pacing before test day. A more complete week-by-week plan, including how to weight review time across all four domains, is in CHPNA Study Guide 2026: How to Pass on Your First Attempt, and if you're trying to gauge overall difficulty before you commit to a study schedule, How Hard Is the CHPNA Exam? Complete Difficulty Guide 2026 is a useful reality check.
Key Takeaway
Because no reference materials are allowed during the exam, practice under the same no-notes, timed conditions you'll face in the actual test - not open-book review.
If you want a condensed, single-page reference to run through in the final days before your test, the CHPNA Cheat Sheet 2026: One-Page Review of Must-Know Facts collects the numbers and domain names in one place. And for readers who landed here after searching related phrasing, you may also find What Is CHPNA?, What Does CHPNA Mean?, or What Is CHPNA Certification? useful as companion overviews, along with CHPNA Certification and CHPNA Training for background on how candidates typically build the required hours before applying. Running a few practice quizzes on nursingassistantprep.com before you lock in a testing window is a low-risk way to see where your domain knowledge actually stands.
Frequently Asked Questions
The Hospice and Palliative Credentialing Center (HPCC) awards the CHPNA credential. The Hospice and Palliative Nurses Association (HPNA) is the related membership organization, but membership status only affects your exam fee, not who certifies you.
The exam has 110 multiple-choice questions - 100 scored and 10 unscored - with 2 hours and 30 minutes allowed to complete it.
You need a scaled score of 500 on a 200-800 scale. The scaled score accounts for question difficulty, so it doesn't translate to a simple percentage of correct answers.
The reTEST Assured program allows a discounted retake for $135 within one of the next three testing windows following an unsuccessful attempt.
Certification lasts four years. Renewal requires qualifying practice hours plus either a successful re-examination or completion of the HPAR program with its professional-development requirements. Note that if you fail a renewal exam, you must continue through examination rather than switching to HPAR.