How to become a home health aide in Illinois: training, testing and the registry

Not clinically reviewed. Informational only, not billing, legal or clinical advice. Check the linked primary source and the Illinois Department of Public Health.

To work as a home health aide for an Illinois home health or home nursing agency, you need to be on IDPH's Health Care Worker Registry, finish a state-approved nurse aide training program, or meet a state equivalency such as current registration in another state. Federal rules add a 75-hour training floor and a competency evaluation by a registered nurse.

Key facts (checked Nov. 12, 2026) - Illinois agencies may use an aide who is on the Health Care Worker Registry, finished a state-approved program, or meets an equivalency (77 Ill. Adm. Code 245.70). - Federal training for Medicare home health aides is at least 75 hours, with 16 classroom hours before 16 supervised practical hours (42 CFR 484.80(b)). - Illinois's approved basic nursing assistant programs are at least 120 hours: 62 theory, 18 lab, 40 clinical (77 Ill. Adm. Code 395.150). - The state written exam allows three tries within 12 months (77 Ill. Adm. Code 395.400). - Illinois certification stays active with at least one paid 8-hour shift in 24 months (245.70(d)).

This guide is for people thinking about aide work and for families who want to know what training the aide at the door has had. It sticks to what the rules say. It doesn't name schools, employers or prices, and we couldn't verify fees from a primary source, so none are listed.

What does a home health aide do?

Under Medicare's rule for home health agencies, 42 CFR 484.80(g), a registered nurse or another skilled professional assigns an aide to a specific patient and writes the care instructions. The aide's services must be ordered by the patient's physician or allowed practitioner, be in the plan of care and be allowed under state law.

The training topics in the same rule give a picture of the work. They include personal hygiene and grooming, safe transfers and walking, range of motion and positioning, nutrition and fluids, reading and recording temperature, pulse and respiration, infection control, and recognizing emergencies. If you're wondering how this fits into what Medicare pays for at home, our explainer on whether Medicare covers home health care covers the benefit.

What are the ways to qualify in Illinois?

The Illinois rule for home health and home nursing agencies, 77 Ill. Adm. Code 245.70(a), gives three routes. An agency must make sure each aide:

1. is approved on the Department of Public Health's Health Care Worker Registry,
2. finished a training program approved under the state's aide-training code (77 Ill. Adm. Code 395), or
3. meets one of the equivalencies in 245.70(b).

IDPH's registry page puts it plainly: "Nursing assistants/aides working in licensed and or certified skilled nursing facilities, intermediate care facilities and home health agencies must be certified."

For most people starting out, the usual route is a state-approved nurse aide program followed by the state's written test. That puts you on the registry as a certified nursing assistant (CNA).

What training does federal law require?

If the agency takes Medicare, 42 CFR 484.80 applies. It accepts several kinds of qualification, including a state-approved nurse aide training and competency evaluation program, as long as the aide is "currently listed in good standing on the state nurse aide registry."

For an aide training program, the rule sets these minimums:

• Hours: classroom and supervised practical training "must total at least 75 hours."
• Order: "A minimum of 16 hours of classroom training must precede a minimum of 16 hours of supervised practical training."
• Supervision: practical training happens under a registered nurse, or a licensed practical nurse supervised by one.
• Skills check: an aide may work for the agency "only after" passing a competency evaluation, which "must be performed by a registered nurse." Some skills, including vital signs, personal care, transfers and positioning, must be tested by watching the aide do them with a patient or a stand-in.
• Ongoing training: at least 12 hours of in-service training in every 12-month period.

Illinois's own rule adds a home-setting skills check. Under 245.70(e), an RN at the agency evaluates each aide on 16 subject areas. That list includes understanding dementia and problem solving with people with dementia who show challenging behavior.

What does Illinois's approved training cover?

Illinois's Basic Nursing Assistant Training Program, under 77 Ill. Adm. Code 395.150, is longer than the federal home health floor:

• At least 120 hours of instruction, not counting breaks, meals or orientation.
• 62 hours of theory, 18 hours of lab (skills) and 40 hours of clinical instruction.
• 12 hours on Alzheimer's disease and other dementias, and 4 hours of CPR, with CPR certification before the program ends (with a limited exception in the rules).
• 16 hours before any direct contact with a resident, on communication, infection control, safety and emergency procedures, independence and residents' rights.
• At least four weeks and no more than 120 days, unless a college or other school runs it on a term or semester basis.

IDPH links to a list of approved programs from its registry page.

How does the written competency test work?

Under 77 Ill. Adm. Code 395.400, the exam is a state-approved written test drawn from the program curriculum. It's offered in English and Spanish. A facility may proctor it but can't score it. Only IDPH or its designee does that, and passing is recorded on the Health Care Worker Registry.

You get three chances to pass within 12 months after finishing the program. If you don't pass in three tries or within that year, you have to take the program again. IDPH's CNA Facts page says Southern Illinois University Carbondale (SIU-C) runs the written exam at sites around the state and sends results to the registry electronically. The SIU-C testing site offers a practice exam and study guide.

Can out-of-state, military or nursing-school training count?

Yes, through the equivalencies in 245.70(b). Any one of these works:

• Another state's registry: documentation of current registration from another state.
• Nursing school: a nursing arts course with at least 40 hours of supervised clinical experience in an accredited nurse training program, plus the written part of the state competency test.
• Military: a U.S. military training program that includes the content of Illinois's basic program, shown by a diploma, certificate, DD-214 or other written proof, plus the written test.
• Foreign nursing program: proof of completion, a Social Security card and a visa or proof of citizenship, plus the written test.

Requests go to IDPH with the documents (245.70(c)). The CNA Facts page says someone transferring from another state must have no findings of abuse, neglect or misappropriation, and no disqualifying convictions, on their home state's registry. It also says a nurse with a current, valid Illinois RN or LPN license in good standing can work as a CNA without being on the registry.

Do I need a background check?

Yes. Illinois agencies must follow the Health Care Worker Background Check Act (225 ILCS 46), under 77 Ill. Adm. Code 245.72. IDPH's registry page says the act covers unlicensed workers employed as home health care aides. It also says people with disqualifying convictions can't work in those jobs unless IDPH grants a waiver.

Agencies must also check the registry before hiring. Under 245.70(f), an agency can't employ someone as an aide until it has asked IDPH about any registry findings of abuse, neglect or misappropriation of property.

How do aides keep their status active?

Two clocks apply, and both run on paid work:

• Illinois: to keep CNA certification active, you must work "at least one 8-hour shift within a 24-month period," doing nursing or nursing-related services for pay under a licensed nurse (245.70(d)). IDPH's CNA Facts page says that after 24 straight months without that work, certification is lost, and passing the written test is the way back. It also says employers report hire and separation dates into the registry, which "is what keeps the CNA active."
• Federal: under 42 CFR 484.80(a)(2), a 24-month stretch with no paid aide services means you must complete another qualifying program before working for a Medicare home health agency again.

How can I check the registry?

Use IDPH's public Health Care Worker Registry search. IDPH says the registry lists people who had a background check under the act, shows CNA training information and displays administrative findings. Families can use the same search. For how agencies themselves are rated, see our guide to home health quality reporting and star ratings. For Illinois agency rules and news, see our Illinois page.

Frequently asked questions

How many training hours does a home health aide need? Federal rules for Medicare home health agencies set at least 75 hours for an aide training program, including at least 16 hours of supervised practical training (42 CFR 484.80(b)). Illinois's approved basic nursing assistant programs require at least 120 hours (77 Ill. Adm. Code 395.150).

Can I transfer a CNA from another state to Illinois? 77 Ill. Adm. Code 245.70(b)(1) accepts documentation of current registration from another state as an equivalency, and requests go to IDPH with documentation. IDPH's CNA Facts page adds that the person must have no abuse, neglect or misappropriation findings or disqualifying convictions on their home state's registry.

What happens if I stop working as an aide? Federal rules require a new program after 24 consecutive months without paid aide work (42 CFR 484.80(a)(2)). Illinois requires at least one paid 8-hour shift in 24 months to keep CNA certification active (77 Ill. Adm. Code 245.70(d)).

Where do I check whether someone is on the registry? IDPH's public Health Care Worker Registry search at hcwrpub.dph.illinois.gov. Illinois agencies must check it for findings of abuse, neglect or misappropriation before hiring an aide (77 Ill. Adm. Code 245.70(f)).

Sources

• 42 CFR 484.80, Home health aide services (eCFR)
• 77 Ill. Adm. Code 245.70, Home Health Aide Training
• 77 Ill. Adm. Code 245.72, Health Care Worker Background Check
• 77 Ill. Adm. Code 395.150, Minimum Hours of Instruction
• 77 Ill. Adm. Code 395.400, Competency Examination
• IDPH, Health Care Worker Registry
• IDPH, CNA Facts
• IDPH, Health Care Worker Registry public search

Photo: Feen, via Wikimedia Commons, CC BY-SA 3.0 (resized). File photo; illustration only.

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Sources were opened and checked Nov. 12, 2026. Rules can change; the linked primary sources control. Home Health Brief corrects errors under its published corrections policy.

Not clinically reviewed. Informational only, not billing, legal or clinical advice. Drafted with AI assistance from primary sources. Written and edited by the Home Health Brief newsroom under Monsaur Othman's editorial standards.