Hospice CNA: Duties, Salary, Per Diem Work & How to Get Started
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.
Quick Reference: Review the sections below for a comprehensive guide to CNA — covering exam structure, preparation strategies, and what to expect on test day.
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:
- Personal hygiene care — bathing, oral care, hair care, skin moisturization; for bedbound patients, this is often a bed bath performed with extreme gentleness
- Repositioning and pressure injury prevention — turning patients every 1–2 hours, padding bony prominences, monitoring skin for breakdown
- Vital signs monitoring — tracking temperature, blood pressure, pulse, and respiratory rate; reporting changes such as Cheyne-Stokes breathing patterns to the RN
- Comfort measures — applying warm blankets, adjusting pillows, providing cool cloths for fever, playing calming music, maintaining a peaceful environment
- Nutrition and hydration assistance — helping with meals as tolerated; in late-stage hospice, patients often have no appetite and may only accept sips of water or mouth swabs
- Emotional presence — sitting with patients, holding hands, listening; for patients who are unresponsive, speaking calmly and maintaining a peaceful presence
- Family education and support — teaching family members how to assist with basic care, answering questions about what to expect in the dying process
- Post-mortem care — assisting with body care after death when the RN has confirmed passing; a solemn duty performed with dignity
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.
Hospice CNA Work Settings & Schedules
Hospice CNAs work across several settings — each with different schedules, patient loads, and pay structures:
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.
- Visit schedule: Typically 1–3 visits per week per patient, as ordered by the hospice physician
- Patient load: 5–8 patients per day, driving between homes
- Autonomy: High — you work independently, with RN support by phone and scheduled visits
- Mileage reimbursement: Most agencies reimburse at IRS rate ($0.67/mile in 2026)
- Pay: $18–$24/hour base; per diem positions pay $22–$28/hour
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.
- Shift structure: Standard 8- or 12-hour shifts, similar to nursing home CNA work
- Patient load: Typically 4–8 patients per CNA per shift
- Intensity: Higher acuity than home hospice — patients are more medically complex
- Team environment: Work closely with RNs, chaplains, social workers, and volunteers
- Pay: $19–$25/hour; night/weekend differentials add $1.50–$3.00/hour
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 meaning: Work on a day-by-day, as-needed basis with no guaranteed hours
- Pay premium: Per diem CNA pay is typically 10–25% higher than full-time to compensate for schedule uncertainty (no benefits)
- Flexibility: Maximum — accept or decline shifts as your schedule allows
- Benefits: Usually none (no health insurance, PTO, or retirement from the agency)
- Best use: Supplement a full-time job, semi-retirement, or while in nursing school
- Per diem CNA agencies: Most hospice agencies maintain a per diem pool — call and ask directly
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.
- Trigger: Ordered by the hospice physician when a patient is in "active dying" phase (typically final 24–72 hours)
- CNA role: Provide constant comfort care, monitor symptoms, relay changes to the RN
- Emotional intensity: Very high — you will be present when patients die
- Pay: Typically time-and-a-half or a flat vigil rate; some agencies pay $28–$40/hour for vigil shifts
- Support: Hospice organizations provide bereavement support for staff — use it
Best for: Experienced hospice CNAs who have developed emotional resilience and find meaning in being present at end of life.
Hospice CNA Salary: Full-Time vs Per Diem Pay
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.
How to Get a Hospice CNA Job
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.
2. Get at least 6 months of CNA experience first (recommended)
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.
3. Apply directly to hospice agencies
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.
4. Highlight the right qualities in your application
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.
5. Consider hospice certification (optional but valued)
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).
Is Hospice CNA Work Right for You?
You are comfortable being present with dying patients and their grieving families You can discuss death openly without personal distress or avoidance You practice effective self-care and have healthy emotional outlets outside work You find meaning in comfort and dignity care, even when there is no "getting better" You are comfortable working independently with minimal direct supervision (home hospice) You can set appropriate emotional boundaries — caring deeply without carrying the grief home You are patient and gentle — many hospice patients are in pain, confused, or frightened You are reliable and show up consistently — your patients and families depend on you You handle schedule variability (especially for per diem CNA positions) without stress You are willing to continue learning — hospice care involves ongoing education in palliative care CNA Pros and Cons
Pros
- CNA salary data provides benchmarks that help professionals negotiate compensation and evaluate job offers objectively
- Understanding salary ranges by experience level helps professionals plan career progression and timing of role changes
- Geographic salary variation data helps candidates evaluate relocation decisions with accurate financial context
- Specialty or certification premiums within the field provide clear ROI data for professional development investments
- Published salary data creates transparency that reduces information asymmetry in compensation negotiations
Cons
- Published salary averages may not reflect local market conditions — cost of living differences make national averages misleading in high-cost cities
- Salary surveys may be based on self-reported data from non-representative samples, potentially skewing results
- Entry-level salary data is often less accurate than mid-career data, as entry-level roles vary widely in scope and title
- Benefits, bonuses, and total compensation can vary as much as base salary, making base salary comparisons incomplete
- Salary data ages quickly in high-demand fields — reports more than 1–2 years old may significantly understate current market rates
Hospice CNA Questions and Answers
What is a hospice CNA?
A hospice CNA is a Certified Nursing Assistant who provides comfort-focused personal care to terminally ill patients — typically those with a life expectancy of 6 months or less. Hospice CNAs focus on hygiene, repositioning, comfort measures, and emotional support rather than curative treatment. They work in patients' homes, inpatient hospice facilities, or nursing home hospice wings.
What does per diem CNA mean?
Per diem CNA means working "by the day" — on an as-needed, shift-by-shift basis without a guaranteed schedule. Per diem CNA employment typically pays 10–25% more per hour than full-time positions to compensate for the lack of guaranteed hours and benefits. CNAs in per diem positions set their availability and accept or decline shifts as offered by the agency.
How much does a hospice CNA make?
Full-time hospice CNAs earn $18–$25/hour depending on setting and location. Per diem hospice CNAs earn $22–$30/hour. Continuous care (vigil) shifts pay $28–$40/hour. Annual earnings for a full-time home hospice CNA average $37,000–$52,000. States with higher cost of living (California, New York, Washington) pay significantly more.
Do I need special certification to work as a hospice CNA?
No — a standard state CNA license is all that's required to work in hospice. The optional CHPNA certification (Certified Hospice and Palliative Nursing Assistant) from NBCHPN is available to CNAs with 2,000+ hours of hospice experience, but most agencies hire without it. The certification can earn a small hourly premium and demonstrates specialized commitment.
Is hospice CNA work emotionally difficult?
Yes — hospice CNA work involves frequent exposure to death and grief, which most CNAs find both challenging and deeply meaningful. The key to longevity in this specialty is consistent self-care, peer support, and using the bereavement resources that good hospice agencies provide. Hospice CNAs typically report higher job satisfaction than facility-based CNAs despite (or because of) the emotional demands.
How do I find hospice CNA jobs near me?
Apply directly to major hospice providers: VITAS Healthcare, Amedisys, Compassus, Gentiva, LHC Group, and Enhabit all have national job boards. Also contact local nonprofit hospice organizations, hospital-affiliated hospice programs, and home health agencies. Search "hospice CNA" or "per diem CNA" on Indeed, ZipRecruiter, or your state's job board. Hospice agencies in most areas are actively hiring.
What should I know about hospice hiring cna?
Hospice hiring cna is an important topic for anyone working in or preparing for Hospice CNA. This guide covers the key details — use the table of contents above to navigate to the most relevant section.