Home Care for an Elderly Parent in Pennsylvania: Options and Costs

Your parent can't live alone anymore, but they don't want a nursing home. You're not alone in this — most families in Pennsylvania face this exact moment, and the system offers more options than the hospital discharge planner probably mentioned.

Here's what's actually available, what it costs, and how to avoid the most expensive mistakes.

Four Ways to Get Home Care in Pennsylvania

Private-pay through an agency. The fastest option. You call a licensed home care agency, they send an aide, and you pay out of pocket. The state median is $34 per hour. No waiting period, no applications, no eligibility requirements. But at 44 hours per week, you're spending $6,480 per month — and that can drain savings in under a year.

Medicaid Community HealthChoices (CHC). If your parent qualifies financially (income at or below $2,982/month, assets under $8,000) and clinically (needs nursing-facility-level care), Medicaid covers home care through one of three managed care plans. No monthly cost cap, no waitlist. This is the most comprehensive public option, but the application takes 45 to 60 days.

The OPTIONS program. For parents aged 60+ who earn too much for Medicaid. No income or asset limits to apply, but services are capped at $765 per month (with rare exceptions up to $1,900). Cost-sharing scales from 0% to 100% based on income. Availability depends on county funding — some counties have waitlists.

Hiring a family member as caregiver. Through Medicaid CHC's Services My Way program, an adult child can be hired as a paid caregiver at $13 to $15 per hour. Spouses and legal guardians are excluded. The OPTIONS program also allows paid family caregiving in some AAA models.

How to Hire a Home Care Aide

Whether you go through an agency or hire independently, Pennsylvania requires specific protections.

Licensed agencies vs. registries. Pennsylvania licenses two types of providers under 28 Pa. Code Chapter 611: home care agencies and home care registries. Agencies directly employ the aides — they handle hiring, training, scheduling, backup coverage, and supervision. Registries act as referral services, connecting you with independent aides. You pay the registry a fee, but the aide is technically your employee, which means you handle taxes and workers' comp.

For most families, an agency is simpler despite the higher hourly rate. If an aide calls out sick, the agency sends a replacement. With a registry or private hire, you're on your own.

Background check requirements. Pennsylvania mandates criminal background checks for all home care workers through licensed agencies and registries. Chapter 611 requires:

• Pennsylvania State Police criminal history check (PATCH)
• Federal FBI fingerprint check
• Child abuse clearance (ChildLine)

These clearances must be completed before the aide provides any unsupervised care. If you hire independently (not through an agency or registry), the state doesn't mandate these checks — but you should run them yourself. The PATCH check costs $22 and returns results within days through epatch.pa.gov.

What to look for in an aide. Beyond clearances, ask about:

• Experience with your parent's specific conditions (dementia, mobility limitations, post-surgical care)
• Availability for the schedule you need, including weekends
• Whether they drive (for appointments and errands)
• References from families with similar care needs

What Non-Medical Home Care Includes

Pennsylvania defines non-medical home care as assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs):

• Bathing, dressing, grooming, and toileting (ADLs)
• Meal preparation, light housekeeping, and laundry (IADLs)
• Medication reminders (not administration — that requires a nurse)
• Mobility assistance, transfers, and fall prevention
• Companionship and cognitive engagement
• Errands and transportation

What aides cannot do: administer medications, provide wound care, perform clinical assessments, or deliver any service requiring a nursing license. For those needs, your parent needs Medicare-certified home health — a separate service that Medicare covers at zero cost-share.

Building a Sustainable Care Plan

Most families end up layering multiple sources:

1. Medicare home health for any clinical needs (physical therapy, wound care) — covered at $0
2. Medicaid CHC or OPTIONS for daily personal care — covered or subsidized
3. Family caregiving for the hours between professional visits — potentially compensated through Services My Way
4. Private-pay to fill any remaining gaps

The key decision comes down to your parent's financial situation. Families who spend down to Medicaid eligibility without planning often lose more than they needed to. Families who assume they can't qualify and pay entirely out of pocket may be overlooking real options.

The Pennsylvania Home Care Navigator helps you map your parent's exact financial position against every available program, build a layered care plan, and navigate the application process for whichever combination makes sense.

See more Pennsylvania guides →