Free Maryland HHA Practice Test 2026

In Maryland, as of April 1, 2026, which statement best describes how someone may legally work as a home health aide?

Does Maryland issue a separate Home Health Aide certificate?

No. As of April 1, 2026, Maryland no longer issues a standalone Home Health Aide certificate or any Home Health CNA category designation. Under HB 1125/SB0999 (2024 General Assembly), Maryland restructured nursing assistant certification into CNA-I and CNA-II tiers. Working as a home health aide in Maryland means holding a CNA-I or CNA-II certificate from the Maryland Board of Nursing (MBON). There is no separate HHA exam, no 100-hour HHA-specific program, and no OHCQ HHA Registry — MBON maintains the nursing assistant registry. Federal home health aide training and competency requirements for Medicare-certified agency employees are governed by 42 CFR § 484.80.

How do I become eligible to work as a home health aide in Maryland after the April 2026 redesignation?

New applicants must complete a Maryland Board of Nursing-approved nursing assistant training program of at least 100 hours — 60 hours of classroom and laboratory instruction plus 40 hours of supervised clinical training — then pass the Board-approved nursing assistant competency evaluation to earn a CNA-I certificate. CNA-I holders may practice in any care setting, including home health. CNA-II status (may work in any setting except long-term care, including home health) is reserved for individuals who held a CNA certificate on or before March 31, 2026. Once employed by a Medicare-certified home health agency, the employer must also ensure you meet federal HHA competency requirements under 42 CFR § 484.80.

Is there a state HHA exam in Maryland, and what score do I need to pass?

Maryland does not have a separate standalone HHA examination. The path to working as a home health aide in Maryland runs through nursing assistant credentialing. New applicants complete the Board-approved nursing assistant competency evaluation — currently the Credentia-administered NNAAP, consisting of a 70-question multiple-choice written exam and a skills evaluation (five randomly selected skills, all must be satisfactory) — to earn a CNA-I certificate. The former HHA-specific competency evaluation tied to the old Home Health CNA category designation was eliminated effective April 1, 2026. Because Maryland no longer has a separate HHA credential, there is no HHA-specific passing score — the standard that applies is the one for the CNA-I competency evaluation.

How long does Maryland CNA certification last, and how do I renew it?

Maryland CNA certification (CNA-I or CNA-II) operates on a two-year renewal cycle. Under the rules effective April 1, 2026, all renewal applicants must have completed at least 16 hours of active practice as a nursing assistant within the 2-year period immediately preceding the certificate expiration date. If you have not met the 16-hour active practice requirement: CNA-I holders must take and pass a nursing assistant competency evaluation; CNA-II holders must complete a nursing assistant training program. Contact the Maryland Board of Nursing for current renewal fees and application forms.

Can I transfer my out-of-state CNA certification to Maryland?

Yes. If you hold a current, active CNA certificate in good standing on another state's nurse aide registry and have no findings of abuse, neglect, or misappropriation, you may apply to the Maryland Board of Nursing for endorsement without retaking the nursing assistant competency evaluation. After April 1, 2026, out-of-state applicants are evaluated under the CNA-I/CNA-II framework. Contact MBON for the current endorsement application and to confirm which tier you qualify for based on your out-of-state credentials.

Is CNA training free in Maryland?

Some Maryland employers — particularly home health agencies — offer to pay for or reimburse CNA training in exchange for a work commitment. Tuition-free options also exist through some community colleges, workforce development programs, and Medicaid waiver provider agencies. However, there is no universal free program; cost varies by school and employer. The Credentia exam fee and MBON application fees are separate costs candidates must budget for.