- How the Seven-Domain Blueprint Works
- Domain Weights at a Glance
- Domain 7: Human Resource Basic Practices and Law (30%)
- Domain 3: Management Skills (20%)
- Domain 5: Regulatory Processes for Hospices (20%)
- Domains 6 and 1: Financial Management and Leadership (10% Each)
- Domains 2 and 4: Customer Service and Marketing and Sales (5% Each)
- Exam Format, Fees, and Scheduling Mechanics
- Sequencing Your Prep by Domain
- Frequently Asked Questions
- The Certified Hospice Manager exam is built on seven domains, and Human Resource Basic Practices and Law alone carries 30%.
- Management Skills and Regulatory Processes for Hospices each carry 20%, so three domains account for 70% of the exam.
- Expect 80-100 single-answer selected-response questions in 2 hours, closed book, with no guessing penalty.
- Initial certification costs US$598 total: a US$99 application plus a US$499 examination fee.
How the Seven-Domain Blueprint Works
The Certified Hospice Manager (CHM) credential is awarded by the National Board for Home Care and Hospice Certification (NBHHC). Every question on the exam traces back to a published seven-domain blueprint, which means your preparation should be organized around those domains rather than around a generic list of "hospice management topics." If you are still orienting yourself to the credential, start with What Is CHM Certification? and then return here for the content-area detail.
The blueprint is deliberately weighted toward the day-to-day work of a hospice supervisor or manager: hiring, coaching, disciplining, staffing, documenting, and keeping the agency compliant. Marketing and customer service matter, but they are small slices. The exam rewards candidates who can think like a manager making defensible decisions, not candidates who can recite definitions.
This guide walks through all seven content areas in order of exam weight, explains what each one tests, and shows how to turn the weights into a study plan. When you are ready to test yourself, the CHM practice test is organized to mirror these domains.
Domain Weights at a Glance
| Domain | Name | Weight | Priority |
|---|---|---|---|
| 7 | Human Resource Basic Practices and Law | 30% | Highest |
| 3 | Management Skills | 20% | High |
| 5 | Regulatory Processes for Hospices | 20% | High |
| 1 | Leadership Skills | 10% | Medium |
| 6 | Financial Management and Budgeting | 10% | Medium |
| 2 | Customer Service | 5% | Lower |
| 4 | Marketing and Sales | 5% | Lower |
Notice the concentration: Domains 7, 3, and 5 together make up 70% of the blueprint. A candidate who is strong in those three and merely competent elsewhere is in a far better position than one who spreads study time evenly. For a realistic read on how demanding this makes the exam, see How Hard Is the CHM Exam?
Domain 7: Human Resource Basic Practices and Law (30%)
This is the largest domain on the exam, and it is where many clinically trained managers feel least prepared. Nurses and social workers who were promoted into supervision often learned people management on the job, without formal grounding in employment law. The exam tests whether your instincts match legally defensible practice.
What Candidates Must Understand
Expect scenario-based questions that ask what a manager should do first, or which response is most appropriate, in a realistic personnel situation.
- Hiring: job descriptions, structured interviewing, lawful and unlawful interview questions, reference and background checks, and onboarding documentation.
- Coaching and performance management: setting expectations, giving documented feedback, and distinguishing a coaching conversation from formal discipline.
- Discipline and termination: progressive discipline, consistency across employees, documentation standards, and avoiding retaliation.
- Staffing: scheduling, coverage, on-call arrangements, and balancing caseloads with workforce limits.
- Employment law: discrimination, harassment, wage-and-hour concepts, leave, accommodation, and workplace safety.
- Documentation: what to record, when, and how to keep personnel records factual and objective.
If you are building a question bank, devote the largest share of your practice to this area. Our CHM study guide explains how to translate the 30% weighting into hours, and the practice test platform includes dedicated CHM human resources questions so you can drill this domain on its own.
Domain 3: Management Skills (20%)
Management Skills covers how a hospice manager organizes people, work, and information to keep the program running. Where Domain 7 is about the rules governing employment, Domain 3 is about the craft of running a team and a service line.
Core Management Competencies
Questions here tend to present an operational problem and ask for the best managerial response.
- Planning and prioritizing across competing demands, such as admissions, visits, and staffing gaps.
- Delegation: what can be delegated, to whom, and how accountability is retained.
- Problem solving and decision making, including root-cause thinking rather than quick fixes.
- Meeting management, communication flow, and keeping interdisciplinary team members aligned.
- Change management and getting staff buy-in for new processes.
- Quality improvement concepts: measuring performance, identifying trends, and closing the loop on corrective action.
Quality improvement deserves special attention because it bridges Domains 3 and 5. A manager who can explain how data drives a corrective action plan is demonstrating exactly the thinking this domain rewards. Practice describing each QI cycle in plain steps: identify, analyze, act, measure, and sustain.
Domain 5: Regulatory Processes for Hospices (20%)
Regulatory Processes for Hospices is the domain most specific to hospice itself. Candidates from home health or other settings sometimes underestimate it, assuming their general compliance knowledge transfers. It transfers partially, but the exam expects hospice-specific fluency.
Regulatory Topics to Master
Focus on how regulations translate into manager actions: what you must ensure, document, and monitor.
- Hospice Conditions of Participation and what each requires of a manager.
- Admission and certification processes, including the documentation that supports eligibility.
- Plan of care and the interdisciplinary group's role in developing and updating it.
- Patient rights, informed consent, and complaint or grievance handling.
- Compliance programs, internal audits, and how to respond to a survey or deficiency.
- Clinical record requirements and timeliness of documentation.
Because Domains 3, 5, and 7 all lean on documentation, you will find the same habits paying off across 70% of the exam. The CHM cheat sheet is a handy way to keep key regulatory and HR reminders in one place during the final review stretch.
Domains 6 and 1: Financial Management and Leadership (10% Each)
Domain 6: Financial Management and Budgeting
This domain tests whether a hospice manager can read and act on the numbers behind the program. You are not being asked to be an accountant, but you are expected to understand how budgets are built and how variances are interpreted.
- Budget preparation and monitoring, including labor costs, supplies, and visit volume.
- Variance analysis: recognizing when actual results diverge from the budget and deciding what to do.
- Productivity measures and how staffing levels affect cost.
- Reimbursement fundamentals and the link between documentation, billing, and revenue.
- Controlling costs without compromising patient care or compliance.
Managers without a finance background should practice translating a simple variance into a decision. If labor costs exceed budget, what are the possible causes, and what would you check first? That reasoning pattern is more valuable than memorizing formulas.
Domain 1: Leadership Skills
Leadership Skills is distinct from Management Skills in emphasis. Management is about running processes; leadership is about influencing people and shaping culture. In hospice, where staff face emotional strain and moral distress, leadership questions often involve staff morale, vision, and communication.
- Motivating and engaging staff, including recognition and retention.
- Communicating a mission and aligning the team around patient- and family-centered care.
- Conflict resolution within and between disciplines.
- Ethical decision making and modeling expected behavior.
- Supporting staff through compassion fatigue and grief.
The 10% weights here mean each domain is worth meaningful study time, though less than the big three. If you want context on how this sits within the overall difficulty picture, review our CHM pass rate discussion for what is and is not publicly known.
Domains 2 and 4: Customer Service and Marketing and Sales (5% Each)
These two domains together account for 10% of the exam. Do not ignore them, but do not over-invest either. A short, focused review is usually enough.
Domain 2: Customer Service
In hospice, "customers" include patients, families, referral sources, and sometimes the community at large.
- Responding to complaints and service-recovery principles.
- Setting expectations with families and communicating clearly during sensitive moments.
- Measuring satisfaction and using feedback to improve.
- Cultural sensitivity and respectful service across diverse populations.
Domain 4: Marketing and Sales
This is about building referral relationships and community awareness ethically and within regulatory boundaries.
- Developing and maintaining referral source relationships.
- Community education and outreach that stays compliant.
- Understanding the difference between education and improper inducement.
- Basic market awareness and positioning of the hospice's services.
Note how Marketing and Sales questions often intersect with regulatory thinking. A strong answer is one that grows referrals without crossing compliance lines, which is another reason Domain 5 knowledge pays dividends across the exam.
Exam Format, Fees, and Scheduling Mechanics
Knowing the content is only half the preparation. You also need to understand how the exam is delivered and what the administrative path looks like.
Question Format and Time
The NBHHC candidate handbook describes an exam of 80-100 questions with a 2-hour limit. Questions are single-answer selected response, the exam is closed book, results are reported as pass or fail, and there is no penalty for guessing. That last point matters: never leave an item blank. If you are unsure, eliminate what you can and choose the best remaining option.
For a deeper look at scoring, see CHM passing score.
Fees and Application
| Item | Cost |
|---|---|
| Application fee | US$99 |
| Examination fee | US$499 |
| Initial certification total | US$598 |
The optional CAHSAH hospice manager course is priced separately. For a complete breakdown, including renewal costs, see CHM certification cost.
Delivery and Windows
Professional Testing (PTI) coordinates administration, with Pearson VUE computer-based test centers and approved onsite paper testing. Once your application is approved, you receive an Authorization to Test, which you need before scheduling with Pearson VUE. Approval lasts 12 months. The 2026 computer-based testing windows are:
- February 1-28 (application deadline January 20)
- April 14-May 12 (application deadline April 7)
- August 1-31 (application deadline July 21)
- November 1-30 (application deadline October 20)
Plan backward from your window and its application deadline, leaving time for the approval step. Our CHM exam dates guide covers scheduling in more detail, and CHM requirements explains who qualifies, including the experience routes by education level and the three healthcare-industry references.
Sequencing Your Prep by Domain
Because the domains are so unevenly weighted, the order in which you study them matters. The plan below front-loads the heavy domains and leaves lighter ones for efficient review. Adjust the length to fit your chosen testing window.
Domain 7: HR Basics and Law
- Work through hiring, coaching, discipline, and staffing scenarios.
- Drill employment-law concepts and documentation standards with practice questions.
Domains 3 and 5
- Cover management skills and quality improvement cycles.
- Review hospice regulations, patient rights, and survey readiness.
Domains 6 and 1
- Practice budget and variance reasoning.
- Review leadership, conflict resolution, and ethics scenarios.
Domains 2 and 4, then full review
- Skim customer service and marketing compliance.
- Take timed mixed-domain sets and revisit your weakest domain.
Key Takeaway
Let the blueprint set your hours. Spend roughly the biggest share of study time on Domain 7, a strong second block on Domains 3 and 5, and keep Domains 2 and 4 to a short, targeted pass. Use timed practice sets to confirm you can answer scenario questions inside the 2-hour limit.
For a fuller walkthrough of pacing and resources, read the CHM study guide. Candidates weighing whether the effort is justified may also want Is the CHM certification worth it? and the CHM salary guide for career context.
Frequently Asked Questions
The Certified Hospice Manager exam is built on seven domains: Leadership Skills, Customer Service, Management Skills, Marketing and Sales, Regulatory Processes for Hospices, Financial Management and Budgeting, and Human Resource Basic Practices and Law.
Human Resource Basic Practices and Law is the largest at 30%. Management Skills and Regulatory Processes for Hospices each carry 20%, so those three domains together make up 70% of the exam.
The candidate handbook describes 80-100 single-answer selected-response questions with a 2-hour limit. The exam is closed book, results are pass or fail, and there is no penalty for guessing.
Initial certification costs US$598, made up of a US$99 application fee and a US$499 examination fee. The optional CAHSAH hospice manager course tuition is separate.
No. Because the weights are uneven, prioritize Human Resource Basic Practices and Law first, then Management Skills and Regulatory Processes for Hospices. Give Customer Service and Marketing and Sales a brief, focused review.