Your rights with a home care agency in Pennsylvania

What rights does your family have with a home care agency?

Pennsylvania's home care rules include a section on client protections. It applies to every licensed home care agency and home care registry, whether you pay privately, through long-term care insurance, or through a state program. In short, it gives your family four things:

1. A say in the care. Your parent can help plan the services and can expect reasonable needs and preferences to be respected.
2. Notice before services end. At least 10 calendar days, in writing, with limited exceptions.
3. Money protections. No one connected with the agency can become your parent's power of attorney or guardian, and no one can require your parent to sign checks over to the agency.
4. Information before care starts. A written packet explaining the services, hours, charges, who to call with concerns, caregiver qualifications and whether the caregiver is an employee.

The agency must keep records showing it followed these rules, and the Department of Health can check them during inspections. If you are still choosing an agency, start with our guide to checking a Pennsylvania home care license, which also covers the screening and training every caregiver must have. This guide picks up once care is under way.

What does having a say in the care look like?

It means the care plan is built with your parent, not handed to them. Pennsylvania's rules say a client has the right to take part in planning services and to have individual needs and preferences reasonably accommodated, except where the caregiver's own health and safety would be at risk. Day to day, that looks like:

• Choosing the routine. A shower in the morning or at night, breakfast before or after, which tasks come first.
• Sharing preferences about the caregiver, such as a woman for bathing, someone comfortable with a big dog, or someone who speaks your parent's language, and having them considered in the match.
• Saying no to a task on a given day, or asking for help with something not yet in the plan.
• Asking for a change when the plan stops fitting, and having it updated in writing.
• Including the people your parent chooses, such as a legal representative or a family member.

"Reasonable" does have limits. A non-medical agency cannot provide nursing, and an agency can decline a request that puts the caregiver at risk, such as lifting someone alone who needs two people to move safely. If a request is declined, it is fair to ask for the reason and for another option.

How much notice must an agency give before it stops care?

At least 10 calendar days' written notice. Shorter notice is allowed only in two situations:

• The client has not paid despite notice and is more than 14 days behind.
• The caregiver's health or safety is at risk.

The notice period gives your family time to arrange other help. If you get a notice, ask for the reason in writing, ask whether the problem can be fixed, and call your county Area Agency on Aging for options. If care comes through Community HealthChoices or another program, call the service coordinator right away.

A caregiver calling out sick, or an agency being short for one shift, is not the same as ending services. That is a scheduling problem the agency should be working to solve with you.

The rules do not set how much notice your family must give the agency. That is in your service agreement, so it is worth reading before you sign.

Can a caregiver become your parent's power of attorney?

No. No one may become power of attorney or guardian for a client because of their connection to the home care agency serving that client. The agency also cannot require a client to sign checks over to it. These rules exist because caregivers are in the home, see the mail, and earn trust over time.

A few simple habits add another layer of protection:

• Pay the agency by check, card or bank transfer to its business name, against an itemized invoice.
• Do not give caregivers bank cards, PINs, checkbooks or online banking passwords.
• Put away cash, jewelry, spare checks and medications that are not in daily use.
• If a caregiver asks for a loan, a gift or a change to a will, tell the agency's administrator right away.
• Name a trusted family member or attorney as power of attorney, and give the agency their contact details.

What information should you get before care starts?

Before services begin, the agency must give your parent, or their representative or a responsible family member, an information packet that is easy to read. Here is what it should include and how it can help you:

• The services and who will provide them. Compare it with the care plan, and ask who covers when that caregiver is off.
• The hours. Keep it to compare with invoices.
• The charges, by the hour or week. Keep it with your invoices for insurance and tax records.
• Who to call at the Department of Health about the agency's license.
• The Department's complaint hotline and the local ombudsman's number. Post these by the phone with your other important numbers.
• How caregivers are hired and trained, so you know what screening and training your parent's caregiver has.
• Whether the caregiver is an employee or an independent contractor, and what that means for taxes and insurance. If the caregiver is a contractor, read carefully, because your family may have employer duties.

If you did not get this packet, ask for it. A licensed agency should be able to provide it quickly.

What other protections are there?

Several other safeguards protect your parent:

• Licensing and inspections. The Department of Health inspects agencies before granting or renewing a license, and each office location needs its own license.
• Caregiver screening and training. Agencies must check references, run criminal background checks (including an FBI check where required), obtain child abuse clearance, screen for tuberculosis, and confirm skills at least yearly. Our license guide covers these in more detail.
• Protective services. Pennsylvania's Older Adults Protective Services Act covers people 60 and older. Anyone who believes an older adult is being abused, neglected, exploited or abandoned can report it confidentially, 24 hours a day, to the county Area Agency on Aging or the statewide line at 1-800-490-8505. Adults 18 to 59 with disabilities are covered through the same number.
• Program rights. If Community HealthChoices pays for care, the health plan's member handbook explains your parent's rights to choose providers, raise complaints, and appeal decisions about hours. Our Community HealthChoices guide covers the process.

What should you do if something is not right?

Start with the agency, and go further if that does not work. A helpful order:

1. Talk to your care coordinator about everyday problems: a late caregiver, a missed task, a match that is not working. Most issues are fixed here.
2. Write to the agency's administrator if the problem continues or is serious. Keep a copy, with dates and names.
3. Contact the Pennsylvania Department of Health. The complaint hotline printed in the state's home care rules is 1-866-826-3644, and that is the number agencies must include in your packet. The Department's current complaint page also lists 1-800-254-5164 and an online complaint form. You can ask to keep your name confidential; the Department will still contact you, but the agency will not be told who filed.
4. Call the long-term care ombudsman at your county Area Agency on Aging. The ombudsman helps older adults resolve concerns about long-term care, at home or in a facility.
5. Report abuse, neglect or exploitation to 1-800-490-8505 or your Area Agency on Aging at any time. In an emergency, call 911 first.

How do you reach the ombudsman in your parent's county?

Call the county Area Agency on Aging and ask for the long-term care ombudsman. For the 16 counties we serve:

Our Area Agency on Aging guide explains what else each office can do for your family.

What makes a concern easier to resolve?

Being specific: who, what, when, and what you would like to happen. Include the agency's name, your parent's name, the dates and times, the caregiver or staff involved if you know, what happened, who you already told and what they said, and the outcome you are hoping for. Attach copies of the information packet, care plan, invoices or texts that help explain it. Keep a simple log while the concern is open.

How does It's Your Home Care respect these rights?

It's Your Home Care is licensed by the Pennsylvania Department of Health as a home care agency, and every caregiver is our W-2 employee. Before care begins, families receive the written information Pennsylvania requires, and every client has a written care plan built with the client and family during the in-home consultation.

After care starts, we check in regularly. You can reach our Harrisburg office at (717) 695-2704, Monday through Friday from 9am to 5pm, and active clients have on-call support after hours.

If something is not right, we hope you will tell us first, so we can work to fix it. If we do not, you have every right to take it further, and the numbers are in your packet. For a sense of what the first days of care should feel like, read what to expect in the first week of home care, or reach out to us with any question.