- What Is CHPNA, Exactly?
- Who Awards the Credential
- Eligibility Requirements
- Exam Format and Question Style
- The Four Content Domains
- Cost and Registration Mechanics
- Scoring and Passing
- Certification Length and Renewal
- Who Hires CHPNA-Certified Assistants
- Preparing Without the Guesswork
- Frequently Asked Questions
- CHPNA is awarded by the Hospice and Palliative Credentialing Center (HPCC), delivered via PSI.
- The exam has 110 questions (100 scored, 10 unscored) in 2 hours 30 minutes.
- Passing requires a scaled score of 500 on a 200-800 scale.
- Eligibility needs 500 hours of hospice/palliative NA practice in 12 months, or 1,000 hours in 24 months.
What Is CHPNA, Exactly?
CHPNA stands for Certified Hospice and Palliative Nursing Assistant. It's a specialty credential for nursing assistants who work with patients receiving hospice or palliative care under the supervision of a registered nurse. The certification signals that a nursing assistant has demonstrated hours-based practical experience in this specific care setting and has passed a standardized exam covering the practical, physical, and emotional dimensions of end-of-life and serious-illness caregiving.
This is not a general nursing assistant certification and it is not a nursing credential. It sits specifically at the intersection of hands-on personal care and the psychosocial complexity that comes with hospice and palliative populations. If you're comparing this credential to others that share the same letters, make sure you're reading about the right one - this article, and the rest of the content on this site, refers only to the Certified Hospice and Palliative Nursing Assistant credential described above.
For a broader breakdown of the credential itself, see CHPNA Certification, and for quick-reference definitions, check CHPNA Meaning or What Does CHPNA Stand For?.
Who Awards the Credential
The Hospice and Palliative Credentialing Center (HPCC) is the certifying body that awards the CHPNA credential. HPCC works closely with the Hospice and Palliative Nurses Association (HPNA), which is the membership organization for professionals in this specialty - HPNA membership status directly affects what you pay for the exam, which we'll cover below.
The exam itself is delivered by PSI, either at a physical test center or through live remote proctoring. This flexibility matters for candidates in rural areas or those juggling shift work, since it removes the need to travel to a fixed testing location on a fixed schedule.
Eligibility Requirements
Before you can sit for the exam, you need to show qualifying practice hours. There are two paths:
- 500 hours of hospice and palliative nursing-assistant practice within the preceding 12 months, or
- 1,000 hours of the same practice within the preceding 24 months.
In both cases, that practice must occur under the supervision of a registered nurse, and it must take place in the United States. This hours requirement is the gatekeeping mechanism that keeps the credential tied to actual hands-on hospice/palliative experience rather than classroom exposure alone. If you're unsure whether your current role or hour count qualifies, walk through the specifics in CHPNA Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Exam Format and Question Style
The CHPNA exam consists of 110 multiple-choice questions total: 100 are scored and 10 are unscored (used for statistical calibration, though you won't know which is which during the test). You get 2 hours and 30 minutes to complete it. Every question offers four answer choices with exactly one best answer - there's no partial credit, no "select all that apply," and no reference material allowed in the room or on screen.
The 2026 candidate handbook is built on the 2024 job analysis, which is the study HPCC periodically conducts to make sure exam content matches what nursing assistants in hospice/palliative settings actually do day to day. That job analysis also produced a cognitive-level split of roughly 20% recall-based questions and 80% application-based questions. That split describes how questions are written, not how domains are weighted - so don't confuse "cognitive level" with "content domain" when you're planning study time.
Key Takeaway
Because roughly 80% of questions are application-based, memorizing definitions alone won't carry you. You need to practice reasoning through patient scenarios, not just recalling terms.
For a deeper look at how tough the exam actually feels in practice, read How Hard Is the CHPNA Exam? Complete Difficulty Guide 2026.
The Four Content Domains
The exam blueprint is organized into four content domains. Understanding what each one actually covers - not just its title - is the single highest-leverage thing you can do before test day.
Domain 1: Patient Care: Activities of Daily Living
This domain covers the hands-on physical care tasks that make up much of a hospice/palliative nursing assistant's daily work.
- Bathing, grooming, mobility assistance, and positioning for comfort
- Nutrition and hydration support as disease progresses
- Skin integrity and pressure injury prevention in bed-bound patients
Domain 2: Patient Status and Environment
This domain focuses on observation skills and safe environment management.
- Recognizing and reporting changes in patient condition
- Infection control and safety in home or facility settings
- Understanding the physical signs associated with disease progression near end of life
Domain 3: Psychosocial/Spiritual Care of the Patient and Family/Caregivers
This domain tests judgment around emotional, cultural, and spiritual dimensions of care.
- Supporting patients and families through grief, fear, and anticipatory loss
- Respecting diverse cultural and spiritual practices around death and dying
- Communicating appropriately within the scope of a nursing assistant's role
Domain 4: Professional Skills
This domain covers the boundaries, documentation, and teamwork expectations of the role.
- Scope of practice and when to escalate to the RN
- Accurate, timely documentation and communication with the care team
- Ethical conduct and confidentiality standards
For a full walk-through of each domain with sample question angles, see CHPNA Exam Domains 2026: Complete Guide to All 4 Content Areas.
Cost and Registration Mechanics
Exam pricing depends on your HPNA membership status:
| Candidate Type | Initial Exam Fee |
|---|---|
| HPNA Member | $190 |
| Nonmember | $280 |
If you don't pass on your first attempt, the reTEST Assured program offers a discounted retake of $135, usable within one of the next three testing windows following the unsuccessful attempt. This gives you flexibility to regroup and target the domain(s) that gave you trouble rather than rushing back in unprepared.
Testing happens in four windows per year - March, June, September, and December - with online application deadlines set at February 15, May 15, August 15, and November 15, respectively. Missing a deadline means waiting for the next window, so mark these dates well ahead of time. Full scheduling details live in CHPNA Exam Dates 2026: Testing Windows, Deadlines & Scheduling, and a complete cost breakdown is in CHPNA Certification Cost 2026: Complete Pricing Breakdown.
Scoring and Passing
Scores are reported on a scaled range of 200 to 800, and you need a 500 to pass. Because the scale is scaled rather than raw, a 500 doesn't mean "50% of questions correct" - it reflects a statistically adjusted threshold that accounts for question difficulty across versions of the exam. Official 2025 results showed a 79.5% first-time pass rate (232 of 292 candidates) and an 82.5% overall pass rate (316 of 383 candidates, including retakes).
For the exact mechanics of how the scaled score works and how to interpret it, see CHPNA Passing Score 2026: Exactly What You Need to Pass, and for a full statistical picture, read CHPNA Pass Rate 2026: What the Data Shows.
Certification Length and Renewal
Once earned, the CHPNA credential is valid for four years. To renew, you have two options:
- Complete qualifying practice hours and pass a renewal examination, or
- Complete the Hospice and Palliative Accrual for Recertification (HPAR) pathway, which includes its own professional-development requirements.
One important rule to note: if you attempt the renewal examination and fail, you cannot switch over to HPAR afterward - you must continue through the examination route. That makes it worth deciding your renewal strategy early rather than defaulting to "take the test" without considering whether HPAR's professional-development route fits your situation better.
Who Hires CHPNA-Certified Assistants
Hospice agencies, palliative care programs within hospitals, inpatient hospice units, and home health organizations that provide serious-illness support are the primary employers seeking this credential. Because the role requires RN-supervised practice hours to even sit for the exam, most certified assistants already have direct experience in these settings before they test - the credential formalizes and validates skills they're actively using.
Employers value the certification because it demonstrates a nursing assistant has been evaluated specifically on hospice/palliative competencies - not just general nursing assistant skills borrowed from acute or long-term care. If you're weighing whether this credential is worth pursuing for your career path, Is the CHPNA Certification Worth It? Complete ROI Analysis 2026 and CHPNA Salary Guide 2026: Complete Earnings Analysis dig into that question directly. You can also browse open roles and typical job descriptions in CHPNA Jobs.
Preparing Without the Guesswork
Because the exam is heavily application-based rather than pure recall, the most effective prep splits time by domain rather than by generic review. A simple approach: dedicate early study sessions to the domains with the most hands-on physical content (Domain 1 and Domain 2), since those concepts are easiest to visualize and reinforce with scenario practice. Save the psychosocial and professional-skills domains (Domain 3 and Domain 4) for later sessions once you're comfortable with scenario-based question formats, since these domains rely more on judgment calls than memorized facts.
Physical Care Foundations
- Review ADL support and skin/positioning content tied to Domain 1
- Practice recognizing status changes for Domain 2
Judgment-Based Domains
- Work through psychosocial/spiritual scenarios for Domain 3
- Review scope-of-practice and documentation rules for Domain 4
Whichever order you choose, use full-length practice questions that mimic the four-choice, single-best-answer format so you get comfortable with the exam's actual style before test day - you can start with practice questions on our CHPNA practice test platform. For a structured week-by-week plan, see CHPNA Study Guide 2026: How to Pass on Your First Attempt, and for a condensed reference the night before your exam, use the CHPNA Cheat Sheet 2026: One-Page Review of Must-Know Facts.
If you're still building your foundational skills before diving into exam-specific prep, CHPNA Training covers what preparatory coursework typically looks like. And if you landed here searching general definitions, related pages like What Is A CHPNA?, What Does CHPNA Mean?, and What Is CHPNA Certification? answer the same question from slightly different angles.
Frequently Asked Questions
PSI delivers the exam, either at a physical test center or through live remote proctoring, while the Hospice and Palliative Credentialing Center (HPCC) is the body that awards the credential.
There are 110 multiple-choice questions (100 scored, 10 unscored), with four answer choices each, and you're given 2 hours and 30 minutes to finish.
You need a scaled score of 500 on a 200-800 scale.
The reTEST Assured program lets you retake the exam at a discounted rate of $135 within one of the next three testing windows.
Certification lasts four years. Renewal requires qualifying practice hours plus either a passing renewal exam score or completion of the HPAR pathway; if you fail the renewal exam, you must stick with the exam route rather than switching to HPAR.