Pennsylvania Caregiver Laws: What Home Care Workers and Families Should Know
Pennsylvania Caregiver Laws: What Home Care Workers and Families Should Know
Short answer: Pennsylvania regulates non-medical home care agencies under 28 Pa. Code Chapter 611. These state laws set strict rules for caregiver background checks, competency training, consumer rights, and mandatory abuse reporting to protect clients.
- Pennsylvania home care agencies provide non-skilled support and cannot perform medical tasks like wound care or injections.
- Caregiver background checks require a criminal history report, tuberculosis screening, and two non-relative references.
- Community HealthChoices (CHC) waiver participants cannot hire their spouse, legal guardian, or power of attorney as a paid caregiver.
- Under Act 13, employees of facilities such as home health care agencies must immediately report suspected elder abuse to the local Area Agency on Aging.
- Federal law requires Electronic Visit Verification (EVV) for Medicaid personal care services to track shifts accurately.
Home care agency licensing in Pennsylvania
The state regulates non-medical home care agencies under 28 Pa. Code Chapter 611. This law defines a home care agency as a business that supplies, arranges, or schedules employees to provide home care services in a consumer’s residence. Agencies must follow these regulations to maintain their license with the Pennsylvania Department of Health.
Under these Pennsylvania caregiver rules, home care services include personal care, assistance with instrumental activities of daily living (IADLs), companionship, respite care, and specialized care. Personal care covers hands-on help with bathing, dressing, toileting, transferring, and assistance with self-administered medications. Specialized care involves non-skilled services unique to the consumer’s needs that help them live independently safely.
Home care agencies provide non-skilled services. Caregivers cannot perform wound care, administer injections, manage IVs, or conduct nursing assessments. If a person requires those services, they must receive them from a licensed nurse or therapist through a home health agency.
Caregiver hiring rules and background checks
Pennsylvania law sets requirements for anyone hired to provide direct care. Agencies must verify a worker’s background, health, and competency before assigning them to a client. These steps ensure that consumers receive safe support in their homes.
| Requirement | Pennsylvania Law | What It Requires |
|---|---|---|
| Interviews & References | §611.51 | The agency must interview the applicant (two-way video is allowed under Act 96 of 2024). The applicant must provide at least two satisfactory references from former employers or other people not related to them. |
| Criminal Background Checks | §611.52 | Agencies must obtain a criminal history report from within one year prior to hiring. Pennsylvania residents of two or more years need a State Police record. Others need an FBI record and a Department of Aging letter of determination. |
| Provisional Hiring | §611.54 | An agency can hire a worker provisionally while waiting for background checks. This lasts a maximum of 30 days for two-year PA residents, or 90 days for non-residents. The worker cannot be assigned until they meet competency standards. |
| Competency & Training | §611.55 | Workers must hold a valid PA nurse’s license, pass an agency exam, or complete a training program. Topics must include infection control, handling emergencies, confidentiality, and recognizing abuse. |
| Tuberculosis Screening | §611.56 | Caregivers must complete a TB screening for active tuberculosis before having any consumer contact. This screening must be updated every 12 months following CDC guidelines. |
While a Certified Nursing Assistant (CNA) license is not legally required for non-medical direct care workers, agencies must verify that all employees meet the state’s competency standards. You can read more about caregiver hiring and training requirements and Pennsylvania home care training programs to understand exactly what agencies look for.
If you are caring for a loved one and want to work through a licensed agency, New Century Home Care is hiring. Call 215-974-0000 or fill out our contact form (select “I am a caregiver” and “I already have a client”).
Consumer rights and service planning
Pennsylvania law protects the rights of home care consumers. Under §611.57, consumers have the right to be directly involved in their service planning. This ensures the care plan meets their specific daily needs and respects their preferences.
Agencies must provide at least 10 calendar days’ written notice before terminating services, with limited exceptions. This gives families time to arrange alternative care. Furthermore, to prevent conflicts of interest and financial exploitation, no one affiliated with a home care agency may assume power of attorney or guardianship over a consumer of that agency.
Mandatory abuse reporting for home care workers
The Older Adults Protective Services Act (Act 79 of 1987) established protective services for adults aged 60 and older. Act 13 of 1997 added specific reporting mandates. Employees and administrators of home health care agencies who have reasonable cause to suspect abuse of a recipient must report it immediately.
Caregivers make this oral report to the local Area Agency on Aging. In Philadelphia, you call the Philadelphia Corporation for Aging (PCA) 24/7 Helpline at 215-765-9040. Reports can be anonymous and are kept confidential. If someone is in imminent danger, caregivers must call 911. Knowing how to recognize signs of elder abuse is a required part of all home care training.
Paid family caregiver rules under the CHC waiver
Pennsylvania allows family members to get paid for caregiving through the Community HealthChoices (CHC) waiver. However, state and managed care rules restrict exactly who can receive payment. The CHC waiver will not pay for personal assistance services furnished by the participant’s spouse, legal guardian, representative payee, or power of attorney.
During the COVID-19 pandemic, the state allowed temporary, case-by-case exceptions for some of these roles. Those pandemic-era flexibilities ended on May 11, 2023. The Office of Long-Term Living does not expect to make future exceptions. Families should review the rules for spouse or POA caregivers before applying.
Electronic Visit Verification (EVV) tracking
Caregivers working through Medicaid programs must track their time using specific technology. Section 12006 of the 21st Century Cures Act requires states to use Electronic Visit Verification (EVV) for Medicaid personal care services.
Workers clock in and out using a mobile app or a designated phone system at the client’s home. EVV captures the date, location, type of service, and the start and end times of the shift. All agencies providing CHC waiver services must comply with this mandate.
Ready to join an agency that follows all state regulations and supports its team? Contact New Century Home Care at 215-974-0000 or submit our online form, choosing “I am a caregiver” then “I already have a client”.
Frequently asked questions
Can you get paid as a caregiver for a family member in Pennsylvania?
Yes. Pennsylvania allows family members to get paid through the Community HealthChoices (CHC) waiver. However, the participant’s spouse, legal guardian, representative payee, or power of attorney cannot be paid for these services.
What are caregivers not allowed to do?
Non-medical home care workers cannot perform skilled nursing tasks. This means they cannot administer injections, manage IVs, do wound care, or perform medical assessments. They provide personal care, companionship, and help with daily living activities.
What is caregiver guilt?
Caregiver guilt is a common feeling where a person believes they are not doing enough for their loved one or feels bad about taking time for themselves. Support groups and respite care can help manage these feelings.
When to walk away from caregiving?
You might need to step back from caregiving if your own health fails, you experience severe burnout, or your loved one’s needs exceed what you can safely provide at home. Adding agency care, or in some cases moving to a facility, may be the safer option.
New Century hires caregivers across Philadelphia and 4 counties. Weekly pay, $350 signing bonus, paid sick days, free health insurance plan available, 401(k). Call 215-974-0000.
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