A hospice CNA provides comfort-focused care to patients in the final stage of life — typically defined as a terminal diagnosis with 6 months or fewer to live. Unlike hospital or nursing home CNAs, hospice CNAs work in patients' homes, residential hospice facilities, or inpatient units, focusing entirely on comfort, dignity, and quality of life rather than curative treatment. Hospice CNA salary averages $19–$25/hour, with per diem CNA positions often paying 10–20% more for scheduling flexibility.
A hospice CNA (Certified Nursing Assistant) provides direct personal care to terminally ill patients under the supervision of a hospice RN and the patient's care team. The goal is not to cure or extend life — it is to maximize comfort, preserve dignity, and support both the patient and their family during an emotionally intense time.
Core hospice CNA duties include:
What a hospice CNA does NOT do: administer pain medications (that's the RN), perform wound care beyond monitoring, or make clinical decisions. The CNA's role is hands-on physical care and emotional support.
Home hospice CNAs visit patients in their private residences, providing scheduled care visits of 1–2 hours each. This is the most common hospice setting in the US — about 70% of hospice patients receive care at home.
Best for: CNAs who are self-directed, comfortable working alone, and prefer meaningful one-on-one relationships with patients and families.
Inpatient hospice facilities are freestanding residential units or dedicated wings in hospitals/nursing homes for patients whose symptoms cannot be managed at home.
Best for: CNAs who prefer a structured team environment and are ready for higher-acuity end-of-life care.
Per diem CNA positions (Latin: "per day") mean you work as needed — you set your availability and the agency assigns you shifts based on demand. This is distinct from full-time employment.
Per diem CNA employment suits experienced CNAs who value flexibility over benefits stability. New CNAs often start full-time to build skills before moving to per diem.
Continuous care (vigil) shifts are extended assignments — 8–24 hours — assigned when a patient is actively dying and needs around-the-clock presence to maintain comfort.
Best for: Experienced hospice CNAs who have developed emotional resilience and find meaning in being present at end of life.
Hospice CNA pay is competitive with hospital CNA rates — and per diem CNA positions pay even more per hour in exchange for schedule unpredictability:
| Position Type | Hourly Rate (2026) | Annual (full-time equiv.) | Benefits |
|---|---|---|---|
| Home Hospice (FT) | $18–$24 | $37,000–$50,000 | Health, PTO, mileage |
| Inpatient Hospice (FT) | $19–$25 | $39,000–$52,000 | Full benefits + differentials |
| Per Diem CNA (hospice) | $22–$30 | Varies by hours taken | None (or minimal) |
| Continuous/Vigil Shifts | $28–$40 | N/A (as-needed) | Per shift, no benefits |
Geographic factors significantly affect hospice CNA pay: California, New York, Massachusetts, and Washington state pay $24–$32/hour for hospice CNAs. Rural Midwest and Southeast states average $16–$20/hour. How much a hospice CNA makes also depends on years of experience — most agencies add $0.50–$1.00/hour per year of verified hospice-specific experience.
Hospice agencies are actively hiring — the National Hospice and Palliative Care Organization reports a nationwide shortage of trained hospice CNAs. Here's how to break in:
All hospice positions require an active state CNA certification. If you're not yet certified, complete a state-approved accelerated CNA program — most hospice agencies hire new graduates if they demonstrate the right temperament.
While some hospice agencies hire new CNAs, most prefer candidates with at least 6 months of direct patient care experience. Nursing home, hospital, or home health experience all qualify. The clinical skills (repositioning, ADLs, vital signs) must be second-nature before adding the emotional complexity of end-of-life care.
The major national hospice employers include VITAS Healthcare, Amedisys, Compassus, LHC Group, Enhabit, and Gentiva. All maintain job boards with hospice CNA jobs and per diem CNA positions. Also search your local hospital's hospice division and nonprofit community hospice organizations — they often have better staffing ratios and support systems than for-profit agencies.
Hospice hiring managers look for: comfort discussing death openly, experience with dementia or terminal illness patients, emotional stability and self-care habits, and references who can speak to your compassion. Your cover letter should address why you want to work in end-of-life care specifically.
Hospice certification for CNAs is available through the National Board for Certification of Hospice and Palliative Nursing (NBCHPN). The CHPNA (Certified Hospice and Palliative Nursing Assistant) credential requires 2,000 hours of hospice experience and passing an exam. It's not required to work as a hospice CNA, but it signals specialized expertise and often earns a small pay premium ($0.50–$1.50/hour).