- What You Are Actually Studying For
- Exam Format and Registration Mechanics
- Domain 7: Where 30% of the Exam Lives
- Management Skills and Regulatory Processes: The 20% Pair
- The Four Smaller Domains
- A Domain-Ordered Study Sequence
- How to Read CHM Scenario Questions
- Choosing Your 2026 Testing Window
- After You Pass: Renewal Planning
- Frequently Asked Questions
- Human Resource Basic Practices and Law is 30% of the blueprint, so it deserves the largest share of your study time.
- The exam is 80-100 single-answer questions in 2 hours, closed book, with no penalty for guessing.
- Initial certification costs US$598: a US$99 application plus a US$499 examination fee.
- You need an Authorization to Test before you can schedule with Pearson VUE, so apply before the deadline.
What You Are Actually Studying For
The Certified Hospice Manager credential is awarded by the National Board for Home Care and Hospice Certification (NBHHC). It targets people who supervise or manage hospice operations: directors, administrators, program managers, and clinical or operational supervisors who are accountable for staff, compliance, and results. If you want the basics of the credential first, start with What Is CHM Certification? and then return here.
This guide is built around the official seven-domain blueprint and the 2024 candidate handbook. The central idea is simple: the exam rewards manager judgment, not memorized definitions. Nearly every question asks what a competent hospice manager should do, say, or document in a realistic situation. Your preparation should therefore be weighted by blueprint percentage and practiced through scenarios.
| Domain | Weight | Study Priority |
|---|---|---|
| Domain 7: Human Resource Basic Practices and Law | 30% | Highest |
| Domain 3: Management Skills | 20% | High |
| Domain 5: Regulatory Processes for Hospices | 20% | High |
| Domain 1: Leadership Skills | 10% | Medium |
| Domain 6: Financial Management and Budgeting | 10% | Medium |
| Domain 2: Customer Service | 5% | Lower |
| Domain 4: Marketing and Sales | 5% | Lower |
For a deeper walkthrough of each content area, see CHM Exam Domains 2026: Complete Guide to All 7 Content Areas.
Exam Format and Registration Mechanics
The NBHHC candidate handbook describes an exam of 80 to 100 questions with a 2-hour limit. Questions are single-answer selected response. The exam is closed book, results are reported as pass/fail, and there is no guessing penalty. That last point matters: never leave an item blank. If you are running short on time, eliminate what you can and answer every question.
Professional Testing (PTI) coordinates administration. Most candidates test on computer at a Pearson VUE test center, and approved onsite paper testing is also available. You do not simply book a seat; the sequence matters.
- Submit the application with education and work-history evidence and three healthcare-industry references (list your current employer first when applicable).
- Wait for approval. Approval lasts 12 months.
- Receive your Authorization to Test. You need it before scheduling with Pearson VUE.
- Schedule inside an open testing window and sit the exam.
What it costs
Initial certification is US$99 for the application plus US$499 for the examination, for a total of US$598. The optional CAHSAH hospice manager course is priced separately, so budget for it only if you choose that route. A full breakdown, including renewal fees, is in CHM Certification Cost 2026: Complete Pricing Breakdown.
Domain 7: Where 30% of the Exam Lives
Human Resource Basic Practices and Law is the single biggest lever on your result. With roughly three in ten questions drawn from it, a weak showing here is very hard to offset elsewhere. Many candidates arrive from clinical backgrounds and have strong instincts about patient care but less formal exposure to employment law, which is why this domain tends to feel hardest. For perspective on difficulty, see How Hard Is the CHM Exam? Complete Difficulty Guide 2026.
Domain 7: Human Resource Basic Practices and Law
Expect scenarios that put you in the manager's seat during ordinary and difficult personnel moments. The tested skill is choosing the lawful, documented, fair action.
- Hiring: job descriptions, structured interviewing, lawful and unlawful interview questions, reference and background checks, and fair selection.
- Coaching and performance: setting expectations, giving feedback, and documenting performance conversations.
- Discipline: progressive discipline, consistency across employees, and what a defensible disciplinary record looks like.
- Staffing: scheduling, coverage, orientation and competency, and matching staffing to patient needs.
- Documentation: why contemporaneous, factual records protect both employees and the organization.
- Employment law: discrimination, harassment, wage and hour concepts, leave, accommodation, and safe termination practices.
A reliable pattern in these questions: the best answer is usually the one that is documented, consistent, and proportionate. Beware options that skip steps, treat similar employees differently, or rely on verbal conversations with no record.
Management Skills and Regulatory Processes: The 20% Pair
These two domains carry 20% each, and together they equal Domain 7's weight. Treat them as a second major block of your preparation.
Domain 3: Management Skills
Management Skills (20%)
This domain covers how a hospice manager runs a team and a program day to day.
- Planning, prioritizing, and delegating work across an interdisciplinary team
- Running effective meetings and communicating up, down, and across the organization
- Problem solving and decision making under competing demands
- Quality improvement: identifying a problem, measuring it, acting, and re-measuring
- Change management and managing conflict among staff
Domain 5: Regulatory Processes for Hospices
Regulatory Processes for Hospices (20%)
This is the compliance backbone of the exam. Focus on the processes a manager must keep functioning, not just on recalling rule names.
- Hospice regulations and the Conditions of Participation that shape operations
- Survey readiness, deficiencies, and how to respond with a corrective plan
- Patient rights, informed consent, and complaint and grievance handling
- Clinical record requirements, plans of care, and interdisciplinary review
- Compliance programs, reporting obligations, and quality assurance and performance improvement
Regulatory items reward precision about who is responsible for what and what must be documented and when. When two answers both sound reasonable, prefer the one that keeps the hospice compliant and the patient protected.
The Four Smaller Domains
Together, Leadership Skills (10%), Financial Management and Budgeting (10%), Customer Service (5%), and Marketing and Sales (5%) make up 30% of the exam. Do not neglect them, but do not over-invest either.
- Leadership Skills: vision, motivation, ethical decision making, mentoring, and building a culture of accountability in a mission-driven setting.
- Financial Management and Budgeting: budget development, variance analysis, understanding revenue and expense drivers, productivity measures, and the financial impact of staffing and census decisions.
- Customer Service: responding to patient and family concerns, service recovery, and relationships with referral partners. Customer here includes families, patients, and the physicians and facilities that refer.
- Marketing and Sales: community education, referral development, and communicating hospice value ethically and accurately.
Key Takeaway
The two 5% domains are the cheapest points on the exam. A short, focused review of customer service and marketing concepts often converts to correct answers faster than another hour on a domain you already know well.
A Domain-Ordered Study Sequence
The only generic planning advice worth following is to sequence by blueprint weight and your own gaps. Here is one eight-week arrangement tied directly to CHM domains. Compress it if you already manage compliance daily, or stretch it if employment law is new to you.
Human Resource Basic Practices and Law
- Cover hiring, coaching, discipline, and staffing end to end
- Work employment-law scenarios and write out why each wrong option fails
- Take a short diagnostic quiz to expose gaps early
Regulatory Processes for Hospices
- Review hospice regulations, survey response, and patient rights
- Trace documentation requirements through a patient's record
- Revisit one HR topic each session to keep it fresh
Management Skills and Leadership Skills
- Practice delegation, conflict, and quality improvement scenarios
- Review leadership and ethics concepts
Finance, Customer Service, Marketing and Sales
- Learn budgeting and variance basics
- Cover service recovery and referral development
Timed Mixed Review
- Complete full-length practice sets within 2 hours
- Rework every missed item, prioritizing HR and regulatory misses
For a compact end-of-study refresher, pair this plan with the CHM Cheat Sheet 2026: One-Page Review of Must-Know Facts.
How to Read CHM Scenario Questions
CHM questions are single-answer selected response, which means one option is best and the others are plausible but flawed. The skill is identifying why the distractors are worse. A few habits help.
- Identify the domain first. Is this really an HR law question, a regulatory process question, or a management judgment call? Naming it narrows the correct reasoning.
- Find the manager's role. The right answer is usually the action a manager should take, not one a clinician or executive would take instead.
- Prefer the documented, policy-aligned step. Answers that follow established procedure and create a record beat improvised or purely verbal fixes.
- Watch absolutes and shortcuts. Options that skip an investigation, bypass a required step, or treat people inconsistently are commonly wrong.
- Answer everything. With no guessing penalty, an educated guess always beats a blank.
Wondering how scoring is reported? Results are pass/fail, and the specifics are covered in CHM Passing Score 2026: Exactly What You Need to Pass and CHM Pass Rate 2026: What the Data Shows.
Choosing Your 2026 Testing Window
Computer-based testing is offered in defined windows with application deadlines that fall before each window opens. Because you need an Authorization to Test before scheduling, the deadline is the date that actually controls your timeline.
| 2026 Testing Window | Application Deadline |
|---|---|
| February 1-28 | January 20 |
| April 14-May 12 | April 7 |
| August 1-31 | July 21 |
| November 1-30 | October 20 |
Work backward from your target window. Allow time to gather transcripts or license evidence, line up three references, and confirm your management experience documentation before the deadline. Then use the weeks after approval for focused study. Full scheduling guidance is in CHM Exam Dates 2026: Testing Windows, Deadlines & Scheduling.
Key Takeaway
Submit your application well ahead of the deadline rather than on it. Approval lasts 12 months, so there is little downside to applying early and a real cost to missing a cutoff and waiting for the next window.
After You Pass: Renewal Planning
Certification lasts 4 years. Renewal requires 50 points, including at least 36 continuing-education contact hours and no more than 14 other points, plus relevant management or leadership work for 12 of the preceding 48 months. Renewal costs US$99 for the application plus US$299 for renewal, totaling US$398, and late renewal within the permitted one-year period adds US$99.
Start logging continuing-education hours early instead of scrambling near the end of the cycle. If you are still weighing the credential, see Is the CHM Certification Worth It? Complete ROI Analysis 2026 and the CHM Salary Guide 2026: Complete Earnings Analysis for how it fits into a hospice management career.
Frequently Asked Questions
Start with Human Resource Basic Practices and Law. At 30% of the blueprint it is the largest domain, and employment law is the area many clinically trained managers find least familiar. Follow it with Regulatory Processes for Hospices and Management Skills, which are 20% each.
The NBHHC candidate handbook gives a range of 80 to 100 single-answer selected-response questions with a 2-hour limit. The exam is closed book, reported as pass/fail, and has no guessing penalty, so answer every item.
Initial certification is US$598, made up of a US$99 application fee and a US$499 examination fee. The optional CAHSAH hospice manager course has separate tuition. Renewal later costs US$398 (US$99 application plus US$299 renewal).
Yes. Your application must be approved first, and you must receive an Authorization to Test before scheduling with Pearson VUE. Approval lasts 12 months, and applications are due before each testing window opens, such as January 20 for the February 2026 window.
No. Certified Hospice Manager is issued by NBHHC for hospice supervisors and managers. Some other credentials share the acronym, so always confirm the certifying body and blueprint. For comparisons with related hospice credentials, see CHM Certification and What Is CHM?.