HHA Scope of Practice: What You Can and Cannot Do
A clear guide to HHA scope of practice — what tasks are within your role, what requires a nurse, and how to handle requests that fall outside your scope.
Understanding scope of practice is one of the most critical concepts for both passing the HHA exam and working safely in the field. Get it wrong on the exam, and you'll lose points. Get it wrong on the job, and you could harm a client or lose your certification.
What Is Scope of Practice?
Scope of practice defines the tasks that a healthcare worker is legally and professionally authorized to perform based on their training, competency, and state regulations. For HHAs, this is a defined set of personal care and supportive services tasks.
What HHAs CAN Do
HHAs are trained and authorized to assist clients with:
Personal Care
- Bathing, grooming, and hygiene assistance
- Dressing and undressing
- Oral care including dentures
- Nail care (except trimming nails of diabetic clients in many states)
- Hair care and shaving
Mobility
- Ambulation assistance
- Transfers (bed to chair, chair to toilet)
- Range of motion exercises (as directed)
- Repositioning in bed
Nutrition
- Meal preparation (following diet orders)
- Feeding assistance
- Encouraging fluid intake
- Recording intake and output
Vital Signs
- Temperature, pulse, respirations, blood pressure
- Weight measurement
Observation and Reporting
- Documenting care provided
- Reporting changes in client condition to a supervisor
- Observing and recording skin condition
What HHAs CANNOT Do
This is where exam questions get tricky. HHAs are not authorized to:
- Administer medications (in most states — some allow simple oral med assistance with training)
- Perform wound care beyond simple dressing changes (without specific delegation)
- Insert or remove catheters
- Perform tube feedings independently
- Adjust medical equipment settings (oxygen flow rate, etc.)
- Make medical judgments or change care plans
- Perform any task not included in the client's care plan
The "What Would an HHA Do?" Questions
These are extremely common on the certification exam. Here's the pattern:
Wrong answers typically involve:
- Doing something outside scope ("The HHA should change the dressing")
- Making an independent medical decision ("The HHA should increase the client's fluids")
- Doing nothing when reporting is required
Correct answers almost always involve:
- Following the care plan
- Reporting to the supervisor
- Asking for clarification before acting
Example: A client's family member asks the HHA to give the client an aspirin for pain. What should the HHA do?
- ❌ Give the aspirin — medication administration is outside HHA scope
- ❌ Refuse without explanation — this isn't client-centered
- ✅ Explain that this is outside the HHA's role and notify the supervisor
When Clients or Families Ask You to Do Something Outside Your Scope
This happens in real practice all the time. The correct response is always:
- Explain (kindly) that you're not authorized to perform that task
- Do not perform the task
- Report the request to your supervisor
Never perform a task outside your scope — even with good intentions. You could harm the client and face legal consequences.
The Bottom Line
Scope of practice isn't about limiting what you can do — it's about protecting clients and protecting yourself. On the exam, when in doubt, the answer is usually "report to the supervisor" or "follow the care plan."
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