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HFSA Heart Failure Certification (HF-Cert™)

HFSA has developed the Heart Failure Certification (HF-Cert™) program to recognize providers who have demonstrated advanced-level knowledge and skill to provide competent heart failure services in the United States. 



  Standard Rates
HFSA Member $300
Non-Member $550


The Heart Failure Certification (HF-Cert™) has been developed to recognize providers who have demonstrated advanced-level knowledge and skill to provide competent heart failure services in the United States. Heart failure providers demonstrate proficiency in a variety of settings including but not limited to academic medical centers, hospitals, medical group practices, ambulatory care, long term care, and military treatment facilities.

The HF-Cert professional provides assessment, treatment, and management of the patient with heart failure by ideally, or preferably, utilizing a multidisciplinary team approach in a patient-centered manner. Such a provider could include a cardiologist, internist, hospitalist, emergency physician, intensivist, family practitioner, clinical pharmacist, physician assistant, and a registered nurse with a graduate degree. Look below for more details about the HF-Cert program.

View the HF-Cert Handbook for full program information, requirements, and policies.

Testing Window

The HF-Cert exam will be offered during two testing windows in 2023.

2023 Testing Window Application Deadline Special Accommodations Request Deadline Exam Appointment Scheduling Begins
January 9 –
March 10, 2023
March 9, 2023 6 weeks before the desired testing date CLOSED
August 14 – September 29, 2023 September 28, 2023 6 weeks before the desired testing date Currently open

HFSA will offer a retake attempt at no additional charge during the August/September testing window for those who signed up and took the exam in the January-March 2023 testing window, and were unsuccessful on the first window exam.

Application Fee
  Standard Rates
HFSA Member $300
Non-Member $550

Not a member of HFSA? Click below to join today and receive the member discount!

About the Heart Failure Certification


By passing the HF-Cert examination, heart failure providers not only display their aptitude in each specialized knowledge area, but also present their expertise in heart failure with a HF-Cert credential.

The Heart Failure Certification program:

  • Validates professional expertise
  • Protects the public
  • Distinguishes the heart failure profession
  • Differentiates heart failure providers in a competitive job market
  • Encourages education providers to develop programming that will improve the knowledge and performance of heart failure providers through academic training and professional development opportunities
  • Provides a learning path that recognizes career-long professional development
  • Improves the understanding of heart failure by related disciplines

Professional certification is a process by which an entity grants formal recognition to individuals that meet predetermined, standardized criteria. The certification process involves determination of eligibility, an assessment of demonstration of competence, and requirements for regular recertification. Certification is usually voluntary and established by a non-governmental entity. HFSA’s HF-Cert is a professional certification.

Value of Certification

HF-Cert designees benefit from:

  • Increased recognition by peers and respect of colleagues in the profession
  • Improved opportunities for employability and advancement
  • Greater confidence in their professional competence
  • Increased professional trust from employers or the public
  • Increased autonomy in the workplace
  • Better compensation and career longevity

Patients/Consumers benefit from:

  • Objective, independent, third-party evaluation and assessment of professional competence
  • Commitment to public safety and/or consumer protection
  • Accountability through ethical conduct standards and/or a disciplinary process
  • Recertification requirements for continued or enhanced competence

Employers benefit from:

  • Qualified individuals for employment or advancement
  • Recertification requirements for continued or enhanced competence
  • Commitment to public safety and/or consumer protection
  • Reduced risk of errors, accidents and/or legal liability
  • Reduced employee turnover and increased job satisfaction
  • Justification for potential compensation differential


HFSA has developed eligibility requirements to ensure that the certification application process is fair and impartial. HFSA membership is not a prerequisite for the HF-Cert program.

Eligibility Requirements

All individuals who seek certification must meet the established eligibility requirements in effect at the time of application. Each eligibility requirement has been established to ensure that certified individuals have an acceptable level of knowledge, as evidenced by the examination and education requirements, and skill, as evidenced by the experience requirement, needed to provide heart failure services at an advanced proficiency level.


Applicants must have earned one of the following advanced degrees:

  • Registered Nurse: graduate degree (e.g. MSN, DNP, PhD)
  • Pharmacist: A Bachelor of Science in Pharmacy (BSPharm –graduated on or prior to 2005) or Doctor of Pharmacy (PharmD)
  • Physician: A Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) plus completion of a residency in family medicine or internal medicine
  • Physician Assistant: Master of Science in Physician Assistant or Master of Science in Physician Assistant Studies


Applicants must have one of the following active licenses in good standing, with no current restrictions or pending actions, in the United States:

  • Registered Nurse 
  • Pharmacist
  • Physician
  • Physician Assistant


Applicants must have at least three (3) years of documented experience with a minimum of 1,240 experience hours during the previous two (2) years with a practice focus in heart failure across the HF-Cert content domains.

*Eligible experience is attained after completion of the respective advanced degree. 

Background, Code of Ethics, and Application Accuracy Attestation

Applicants must attest to comply with the HFSA Code of Ethics and report any State Board suspensions. Any State Board suspension must be reported to HFSA within 15 days. Applicants and certificants must abide to practice heart failure specialty in a manner consist with the certification standards and responsibilities set forth in the HFSA’s Code of Ethics. Applicants must attest to the accuracy of information reported within the application.


Applicants must achieve a passing score on the HF-Cert examination.

Eligibility Verification

HFSA reserves the right to verify any information provided on the certification application and/or as part of the application process.

Examination Content and Preparation

How the Examination is Developed

The HFSA Certification Council and Exam Development Task Force (EDTF) participate in and provide oversight for the development and ongoing maintenance of the HF-Cert examination. The Council works in partnership with the testing vendor to ensure the examination is developed and maintained in a manner consistent with generally accepted psychometric principles and education testing practices for certification programs.

Examination Content

The HF-Cert examination consists of 150 multiple-choice questions (125 scored questions and 25 non-scored, pretest questions) across four content domains. Pretest items are interspersed throughout the exam and are not identifiable as pretest items.

All exam content is developed based on practice in the United States.

Candidates will have three (3) hours to complete the computer-based examination. The exam is offered at testing vendor sites across the United States. The HF-Cert exam is offered only in English.

Candidates are encouraged to review the HF-Cert content outline in preparation for the examination.

HF-Cert Exam Content Outline

HF-Cert Examination Content Domain Weight
I. Prevention 19 items
II. Assessment 42 items
III. Management 54 items
IV. Systems of Healthcare 10 items
Total 125 items


I. Prevention (19 items)
A. Understand risk factors and comorbidities and their contribution to heart failure (HF) (e.g. age, Chagas disease, hypertension, renal dysfunction, venous thromboembolism).
B. Educate patients regarding positive health behaviors that promote optimal clinical outcomes (e.g. compliance with medication, diet adherence, flexible diuretic regimen, self-care skills).
C. Educate patients and caregivers regarding risk of HF symptoms.
D. Enhance provider and patient communication in discharge planning and care transitions to reduce hospital readmissions among patients with heart failure.
E. Train transitioning HF patients and caregivers in self-monitoring and record keeping (e.g. blood pressure, edema, heart rate, weight gain).


II. Assessment (42 items)
A. Assess to determine appropriate treatment plan.
B. Evaluate risk of HF decompensation in patients with cerebrovascular and peripheral vascular disease.
C. Evaluate risk of HF decompensation in patients with acute coronary syndrome and valve disease.
D. Evaluate risk of HF decompensation in patients with elevated BP.
E. Evaluate risk of HF decompensation in patients with CAD.
D. Evaluate risk of HF decompensation in patients with atrial fibrillation.
F. Determine needs for HF treatment interventions (e.g., diagnostic tests, medications, palliative, preventive, surgical).
G. Determine differential diagnoses by prioritizing/recognizing urgent and emergent conditions.
H. Determine differential diagnoses by synthesizing and analyzing subjective/objective information.
I. Determine nutritional causes of cardiomyopathy leading to HF (e.g. sodium and fluid balance, thiamine deficiency from chronic alcoholism).
J. Determine criteria for hospital discharge of acute HF decompensation patients.
K. Determine criteria for hospital discharge of acute HF decompensation patients.
L. Evaluate candidacy for cardiac rehabilitation.
M. Evaluate candidacy for referral to advanced care center.
N. Establish final diagnoses by ordering, performing, or interpreting additional diagnostic tests.
O. Establish final diagnoses by performing or interpreting additional physical examinations.
P. Identify relevant changes in clinical status.
Q. Identify contraindicated drugs based on patient specific parameters.
R. Identify lab-based diagnostic tests for diagnosis and identification of disease stage of HF.
S. Interpret multivariable risk scores (e.g. ADHERE, Seattle).
T. Obtain comprehensive HF patient history that includes symptoms, social history, family history, past medical history, medications, allergies.
U. Review and apply the results of cardiac catheterization.
V. Review and apply the results of cardiac imaging (CT, MRI, PET).
W. Review and apply the results of cardiac stress test.
X. Review and apply the results of echocardiography.
Y. Review and apply the results of Holter monitor.
Z. Review and apply the results of laboratory test.
AA. Review and apply the results of X-ray.
BB. Perform a comprehensive physical examination.
CC. Prescribe lab-based diagnostic tests for diagnosis and identification of disease stage.
DD. Provide medication reconciliation.
EE. Review discharge follow-up for errors or discrepancies in medications.
FF. Review prescription history for adverse reactions (recognize and report).
GG. Review prescription history for allergic reactions.
HH. Review prescription history for avoidance of drug interactions and complications.


III. Management (54 items)
A. Advise patient and/or caregiver on guideline directed medical therapy and self-care plan.
B. Demonstrate knowledge of social determinants and barriers to implementation of appropriate HF management.
C. Assess patient eligibility for advanced therapies.
D. Assess patient eligibility for hospice care coordination.
E. Assess patient eligibility for recognition of futility in care.
D. Evaluate risk of HF decompensation in patients with atrial fibrillation.
F. Participate in shared decision-making and advanced directives.
G. Coordinate patient, caregiver, and/or surrogate to implement discharge plan.
H. Coordinate palliative care for HF patients (e.g. counseling, cultural activities, homecare, medication to reduce pain/suffering, patient education, spiritual activities).
I. Determine the effectiveness of the plan of treatment and care based on outcomes by assessing patient response(s).
J. Determine the effectiveness of the plan of treatment and care based on outcomes by collecting additional subjective and/or objective information as needed.
K. Recognize the importance of health-related quality of life (HRQOL) in patients with HF (e.g. cognitive dysfunction, chronic alcoholism, depression, symptom burden, functional status).
L. Establish a patient-centered treatment and care plan that includes considering comorbidities.
M. Establish a patient-centered treatment and care plan that includes making referrals to other health professionals and community resources.
N. Establish a patient-centered treatment and care plan that includes ordering, performing, supervising, or interpreting results of further tests.
O. Establish a patient-centered treatment and care plan that includes prescribing, ordering, or administering non-pharmacologic therapies and/or procedures.
P. Establish a patient-centered treatment and care plan that includes prescribing, ordering, or administering pharmacological therapies.
Q. Establish a patient-centered treatment and care plan that includes providing for appropriate follow-up.
R. Establish a patient-centered treatment and care plan that includes providing relevant education and/or counseling.
S. Evaluate the mechanisms of action, pharmacologic features, and dosing of existing and new agents for treating and managing HF.
T. Identify drug-drug and drug-disease interactions.
U. Recognize appropriate use criteria of specialized procedures specific to a given population(s) (e.g. endomyocardial biopsy, CPX).
V. Provide education and or counseling for HF patients (e.g. diet/fluid intake, self-management, self-monitoring, weight).
W. Utilize in-patient physical and occupational therapy for HF.


IV. Systems of Healthcare (10 items)
A. Demonstrate knowledge of quality, safety, performance, value measures, and ethics in HF.
B. Apply culturally sensitive methods with transitioning HF patients.
C. Comply with Core Measures and best practice standards.
D. Develop administrative roles, policies, and protocols for HF treatment and diagnosis.
E. Participate in the development of formal and informal educational programs for appropriate health care professionals.
Exam Preparation

Applicants are encouraged to review the detailed content outline to familiarize themselves with the content of the exam.
Applicants may review a shortlist of the Exam Reference List for reading materials that may assist in preparing for the exam. Full documents can be found on the HFSA Clinical Documents and HFSA Guidelines pages.

Sample Question

1. The PRIMARY goal of therapy in patients with chronic heart failure and atrial fibrillation is

A. prevention of thromboembolism and symptom control.

B. immediate restoration of sinus rhythm.

C. to control heart rate to a minimum of 70 beats per minute.

D. to prevent worsening heart failure.

Answer: A

The HFSA Certification Council is the certifying body for the Heart Failure Certification program. The Certification Council is responsible for overseeing the development of certification for heart failure providers, implementing policies and procedures for this certification program, and overseeing the development of the certification examination.

The HFSA Certification Council’s role is in developing and administering certification examinations to determine the qualifications of candidates for certification. The HFSA Certification Council does not require, provide, accredit, or endorse any specific study guides, training or review courses, or other examination preparation products. The Certification Council, certification staff, and certification subject matter experts do not have involvement in the creation, accreditation, approval, endorsement or delivery of examination review courses, preparatory materials, educational programs, or training programs/products that prepare candidates for the HF-Cert certification examination. Purchase of review materials is not a requirement for testing, nor does use of any review materials imply successful performance on the HF-Cert certification examination.