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Home care staff requirements in Pennsylvania

Pennsylvania's Department of Health licenses non-medical home care agencies and home care registries under 28 Pa. Code Chapter 611, and licenses home health care agencies separately under Chapter 601. Direct care workers need a state police or FBI criminal history report, a ChildLine clearance if serving minors, two references, competency training or testing before assignment, an annual competency review, and TB screening before client contact and every 12 months. Provisional hiring is allowed for up to 30 days (90 days for recent out-of-state residents) while background results are pending.

Licenses

• No one may operate a home care agency or home care registry without a Department of Health license, and each physical location needs its own license (28 Pa. Code 611.2(a)).
• Home care services include personal care, help with daily household tasks, companionship and respite (28 Pa. Code 611.5).
• Home health care agencies that provide skilled nursing plus at least one other therapy or aide service are licensed under a separate chapter (28 Pa. Code ch. 601).

Background checks

• Each direct care applicant must submit a criminal history report obtained at application or within the prior year (28 Pa. Code 611.52(a)).
• Applicants who have lived in Pennsylvania for the past two years get a State Police criminal history record; others need an FBI record and a Department of Aging determination letter (28 Pa. Code 611.52(b)-(c)).
• Agencies may not hire or keep a worker whose record shows a conviction listed in 6 Pa. Code 15.143 or whose Department of Aging letter says they are not eligible (28 Pa. Code 611.52(e)).
• Agencies serving clients under 18 must get a ChildLine child abuse clearance for each direct care applicant and may not hire those named as perpetrators (28 Pa. Code 611.53).
• Before hiring, agencies must get at least two satisfactory references from former employers or unrelated people (28 Pa. Code 611.51(a)(2)).
• Provisional hiring is allowed while reports are pending if the applicant has applied, swears in writing they are not disqualified, has met competency requirements, and is monitored through random direct observation and consumer feedback (28 Pa. Code 611.54(a)(1)-(5)).
• Provisional hire may last no more than 30 days for two-year Pennsylvania residents and no more than 90 days for others (28 Pa. Code 611.54(a)(7)).
• The state's older adult protective services rules define home health care agency to include private duty home care, homemaker-home health aide, companion care and registry providers, and list convictions that bar hiring (6 Pa. Code 15.2; 6 Pa. Code 15.143).

Training and competency

• Before assigning a direct care worker, the agency must confirm the worker has a Pennsylvania nursing license, passed an agency competency exam, or completed an approved training program such as an agency program, a federal home health aide program or a nurse aide program (28 Pa. Code 611.55(a)).
• Agency competency exams or training must cover confidentiality, consumer control, household tasks, recognizing changes, infection control, universal precautions, emergencies, documentation, abuse and neglect reporting, and difficult behaviors (28 Pa. Code 611.55(b)).
• Workers giving personal care must also be trained or tested on bathing, grooming, dressing, skin and mouth care, transfers, feeding, toileting and help with self-administered medications (28 Pa. Code 611.55(c)).
• Competency documentation transfers between agencies if the break in work is no more than 12 months (28 Pa. Code 611.55(d)).
• Agencies must review each worker's competency at least once a year, and more often after discipline for a quality of care problem (28 Pa. Code 611.55(e)).
• Home health care agency aides must be trained in topics such as self-reliance, nutrition, aging, infection-safe environments, reporting changes, ethics, confidentiality and recordkeeping (28 Pa. Code 601.35(a)).

Health screening

• Before consumer contact, direct care workers must document TB screening under CDC guidelines showing they are free of active TB, dated no more than one year before the start date (28 Pa. Code 611.56(a)).
• TB screening documentation must be updated at least every 12 months from the last evaluation (28 Pa. Code 611.56(b)).

Also in the personnel file

• Worker files must document the interview date, references, criminal history report, ChildLine verification if needed, competency and health screening (28 Pa. Code 611.51(b)).
• Agencies must hold a face-to-face interview before hiring, though an October 2024 state law partly overrides this requirement (28 Pa. Code 611.51(a)(1) and Editor's Note).
• In home health care agencies, an RN or other professional must make a supervisory visit to the patient's home at least every two weeks (28 Pa. Code 601.35(c)).

Common questions

Some rules for Pennsylvania weren't confirmed from an official source. Check with the state before relying on this page.

Sources

• 28 Pa. Code ch. 611 (home care agencies and home care registries), Pennsylvania Code and Bulletin
• 28 Pa. Code ch. 601 (home health care agencies), Pennsylvania Code and Bulletin
• 6 Pa. Code ch. 15 (protective services for older adults, criminal history), Pennsylvania Code and Bulletin

This page summarizes state licensing rules in plain words, with links to the rules themselves. It is not legal advice, rules change, and your license type decides what applies: check the linked source and your licensing agency. Medicare-certified home health agencies also follow 42 CFR 484.80. Checked October 2026.

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