Pennsylvania Licenses Facilities Separately

Many families use the terms personal care and assisted living to mean the same thing. In Pennsylvania, these are two distinct types of facilities. The Department of Human Services (DHS) Bureau of Human Services Licensing regulates them under separate rules.

Personal care homes operate under 55 Pa. Code Chapter 2600. Assisted living residences operate under 55 Pa. Code Chapter 2800. The state began licensing assisted living residences separately in January 2011. Under Act 56 of 2007, only a facility with this specific license may use the term “assisted living” in its name or marketing.

The main differences involve privacy, medical staffing, and the ability to age in place. An assisted living residence is designed so residents can stay there even as their health needs increase. Their units are private, similar to a studio apartment. Personal care homes are not required to have medical staff on site. Their bedrooms may be shared by up to four people. DHS inspects both types of facilities annually to ensure they follow state rules. Reviewing these senior living options carefully helps you find the right fit for your loved one.

Comparing Personal Care, Assisted Living, Nursing Homes and Home Care

When choosing how to support an aging relative, you must compare facilities against the option of staying home. Each setting offers different levels of privacy, care, and cost. The CareScout 2025 Cost of Care Survey provides median costs for Pennsylvania, which helps families budget for these services.

Nursing homes provide the highest level of medical supervision. A semi-private room in a Pennsylvania nursing home has a median cost of $393 per day. A private room costs $450 per day. If you choose home care, a non-medical caregiver costs a median of $34 per hour across the state. You can learn more about local pricing by researching the cost of home care in Philadelphia.

Home care agencies supply employees to provide non-medical services in the consumer’s home. These services include personal care, companionship, and respite care. Aides help with bathing, dressing, toileting, and assistance with self-administered medications. They do not perform skilled nursing tasks like wound care or injections. If your loved one requires skilled care, Medicare home health covers part-time physical therapy and nursing for homebound individuals.

Questions to Ask When Touring Facilities

Touring a facility gives you a chance to see the environment and ask specific questions. Always ask to see the latest annual DHS inspection report. This report shows any violations the state found during their visit. You should also ask about the exact room your loved one will occupy. In a personal care home, ask how many other residents will share the bedroom.

Staffing is another critical topic. Ask if the facility employs licensed nurses or only aides. Find out what happens if your loved one’s health declines. Because personal care homes are not designed for aging in place, a resident may have to move if they eventually need skilled nursing. You must understand these limits before signing a contract. Comparing home care vs nursing home settings can clarify what level of daily support is actually required.

If you decide staying home is better than moving, New Century Home Care can help. Call us at 215-974-0000 or fill out our contact form and choose “I am a client” then “I need services”. Our office staff speak English, Russian and Ukrainian.

Staying Home Instead of Moving

Many seniors want to remain in their own homes in Philadelphia rather than move into a facility. You can hire a non-medical home care agency to help with activities of daily living. Caregivers assist with bathing, dressing, meal preparation, and mobility. This allows your loved one to maintain their independence without the strict schedules of a facility.

Paying for home care is a major concern for families. If your loved one needs long-term services and meets financial limits, they can apply for the Community HealthChoices (CHC) waiver. This program is part of Pennsylvania Medicaid. It covers Personal Assistance Services, non-medical transportation, home-delivered meals, and home adaptations. To qualify, an applicant must be at least 21 years old and require the level of care typically provided in a nursing facility.

The CHC waiver application involves an in-person assessment. In Philadelphia, an assessor from the Philadelphia Corporation for Aging (PCA) visits the home. They perform a Functional Eligibility Determination to evaluate your loved one’s ability to handle daily tasks based on the last three days. To meet Group 1 criteria, a person must need hands-on help with three or more activities of daily living, such as bathing, dressing, walking, toileting, or eating. Alternatively, they can qualify under Group 2 by meeting at least three conditions from a specific list. For example, they might need hands-on help with two activities of daily living, have a mild to severe cognitive impairment, and experience memory problems. The assessment ignores the need for supervision or cueing, which means people with cognitive issues are sometimes wrongly denied and should consider an appeal.

If approved, a service coordinator creates a person-centered service plan. This plan dictates exactly which services the waiver will cover and how many hours of care are approved. You can explore the rules for PA Medicaid for home care to see if your relative might qualify.

Financial eligibility for the waiver includes income and resource limits. The 2026 gross income limit is $2,982 per month, which is 300% of the SSI Federal Benefit Rate. Only the applicant’s income counts. An unmarried applicant is limited to $8,000 in countable resources. For married couples, the state uses a spousal impoverishment formula. The community spouse can keep at least $32,532 in resources, while the applicant keeps $8,000. The home the applicant lives in and one motor vehicle are excluded from this total.

The County Assistance Office also enforces a five-year look-back period. They review bank records and tax returns to see if the applicant transferred assets for less than fair market value. Such transfers can cause a penalty period of ineligibility. If your loved one is approved, they will receive their medical coverage through a managed care plan. In the Southeast zone, the options are AmeriHealth Caritas CHC, Pennsylvania Health & Wellness, and UPMC Community HealthChoices.

When evaluating home care vs assisted living, remember that the CHC waiver pays for services at home; ask the County Assistance Office how facility costs are treated. Medicaid participants can switch between CHC plans at any time to find the best provider network for their needs.

New Century Home Care is a licensed non-medical home care agency. We work with the Community HealthChoices waiver, PCA, Keystone First, and AmeriHealth Caritas. We serve Philadelphia, Bucks, Montgomery, Delaware, and Chester counties. Call 215-974-0000 or submit our contact form, selecting “I am a client” and “I need services”.