Private duty home care in Philadelphia, PA: A guide

Private duty home care in Pennsylvania

Private duty home care in Philadelphia, PA: A guide

Our guide helps you understand what private duty home care, or private pay home care, is. Plus, we go into detail about other caregiver questions and answers you may have such as costs and coverage options in this comprehensive guide.

Navigating and understanding the world of “home care” can be confusing. Individuals may hear many different terms used, such home care, home health care, private duty care, nonmedical home care, skilled home care, companion care, live-in care, etc. For families in and around Philadelphia, Pennsylvania it is important to understand the options available. Home health services are increasing due to demographic shifts and a desire to reside and age in one’s own home

If a senior loved one or disabled family member is in need of private duty home care services, learn more about how in-home care can benefit their life. Many older adults enjoy living in the comfort and safety of their own home. Private duty home care allows them the option. We explain in detail what private duty home care is, agencies that offer private duty home care such as Chosen Family Home Care, plus help comparing private pay care to other home care options.

What is Private Duty Home Care?


private pay home care services


Private duty home care (also known as private pay) is a service provided to seniors and disabled individuals who are in need of assistance with day-to-day activities. These services are a part of the caregiving support offered under long term care in America.  A private duty caregiver at home will visit your residence or the residence of your loved one. They help with activities such as meal preparation, housekeeping, and personal hygiene and grooming. Additionally, a private duty home caregiver can also provide companionship services for seniors. Plus, they can offer respite care to give family members who care for their loved ones on a regular basis a much needed break. Private duty services, also known as personal care services, are paid for out of pocket and do not require a doctor’s order.

Private duty caretakers make it possible for seniors to stay safely within their homes. They can then enjoy the comfort and familiarity of a space filled with memories. Private pay home care can also make it possible to transport the elderly to places they wish to go or visit. In some other cases, home care workers may provide therapy services as well. This will depend on the home care agency and their services will vary. Even with the ever shifting healthcare industry, you’ll find that private pay home health will continue to grow across the country. 

What types of workers deliver private pay caregiver services?

For most cases, many individuals will have caregivers whose main responsibilities are to provide personal care and companionship home care. Some private duty caregivers provided enhanced but limited medical services. This includes home health aides, who can help with some medical tasks like vital signs and rehabilitative exercises. A certified nurse aide, or CNA, will have comparable functions. As a general rule, the more advanced a caregivers background and capability, the more expensive the care provided will be. Examples of workers include:

  • Homemakers
  • Caregivers
  • Personal care aides
  • Home health aides
  • Certified nurse aides


home care agencies that are private duty


How do you choose a private duty caregiver at home?

A private duty home care agency, such as Chosen Family Home Care, will work with you to assess the needs of both the client and their family. With this information, they can appropriately match a caregiver based on both experience and personality. Generally, the caregiver will be assigned after an initial meeting. The goals are for caregivers to satisfy emotional, medical, and other needs of the client. Many private duty home caregivers have experience and training to be suited in their roles. In Pennsylvania, they are required to undergo criminal background checks for safety reasons.

Can a senior loved one be safe in the home?

To best assess the individual needs of a family member or loved one, it’s recommended to speak to a nurse or client care professional. Chosen Family Home Care can perform a free evaluation to determine the client’s needs and suitability for home care. If your private duty home caregiver recommends an alternative such as assisted living or other options, your loved one may be safer and happier when not residing at home.

That being said, many seniors and disabled adults are perfectly happy at home with the right mix of home care services as well as other supports. 

What do private duty caregivers do for care recipients?

Private duty home care services will assist individuals with activities of daily living, such as:

  • Maintaining good personal hygiene, including bathing, laundry services, personal grooming, or other similar tasks
  • Reminding seniors to take their medications on time
  • Cooking, grocery shopping, and meal preparation
  • Arranging for transportation to appointments and events
  • Housekeeping and general maintenance around the home

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caregivers at home in philadelphia


Who pays for private duty home care?

Private duty or private pay home care services are out of pocket expenses that are not covered by insurance. Generally speaking, home care is only covered under Medicaid, Veterans Affairs benefits, or with long term care insurance. See our complete guide to Medicaid coverage for home care services.

How much does private duty home care cost?

Private duty home care service costs are provided in depth in our guide to how much home care costs in Philadelphia, PA. In addition to discussing costs locally, we outline the costs of care on average in Pennsylvania as well as in the United States. There may be additional resources to help pay for private pay home health services. 

Should I hire private duty home care workers privately or through an agency?

A large majority of individuals who utilize home care services are those that need several hours per day of assistance. This is opposed to those who may require care around the clock or full-time care. Due to the cost and the increasing shortage of caregivers and home health aides, many families consider hiring in-home privately as opposed to hiring an agency for private duty home care in Philadelphia. This may seem reasonable for some families, particularly those interested in the cost savings of hiring private caregivers. However, it can cause some issues as well as create unexpected liabilities for the family, who then becomes the employer directly.

Tax Matters



As a private employer, the individual or family member will be required to pay Social Security, payroll tax, and unemployment taxes. Some caregivers may represent themselves as independent contractors. This could theoretically relieve the hiring individual of these tax burdens. However, it is the responsibility of the hiring party to make sure that the aide truly is an independent contractor and is therefore paying their own taxes. In most cases, the caregiver will not meet the legal criteria to be classified as an independent contractor. If the caregiver doesn’t meet their tax obligations, the responsibility then falls on the employer. This can be a major concern as it could involve back taxes, plus even interest or civil fines and the potential for criminal penalties. Individuals that are interested in being private employers should seek the counsel of an employment lawyer. They can make sure that appropriate hiring practices are in compliance with federal tax laws.

Exploitation or abuse

If caregivers are not properly screened or monitored, there is a potential for abuse or financial exploitation when home care services are being performed for a senior or cognitively impaired person. Certainly, many people that become caregivers do so with the desire to help others and are compassionate about their care recipients. However, there is always potential for unsuspecting caregivers to take advantage of others if given the opportunity. This potential can increase when the caregiver and the recipient of care are in the home environment with minimal supervision.

Undoubtedly, families and loved ones don’t fail to provide supervision out of purposeful neglect or malice. Supervision can be tough because of a lack of experience or due to distance. In addition, families often lack the time or resources to perform regular criminal background checks or follow up on personal and professional references. A family member or loved one may be appreciative of the care provided by the caregiver so that, too, could be vulnerable being exploited or manipulated

Supervision by a home care agency


home health aides as caregivers


A licensed home care agency has the duty to provide routine supervision of their caregivers and aides. This includes providing the training for caregivers to be successful, work within the scope of their regulations, and navigate conflicts or other work-related issues. When considering private duty home care in Philadelphia, PA, you’ll find Chosen Family Home Care offers extensive supervision.

Home care agency supervision is often just as important to the caregiver as it is for families. Caregivers can work with challenging clients and scenarios in the resident’s home. Plus, it’s vital for patient safety and quality. Issues could arise because of differences in culture or personality, varying expectations of the aide’s responsibilities, or food preferences. The home care supervisor can help to rectify many concerns, clarify the caregiver’s role, as well as the expectations of both the caregiver and the recipient of care or their family. Plus, the home care agency can support the home health aide to set appropriate or legal limits on the type of care that can be offered. For example, a senior could expect a caregiver to assist with wound care or other functions that fall under the scope of a licensed nurse.

In the case of behavioral issues that may arise because of cognitive changes or through a history of navigating tough relationships, a home care agency supervisor can offer guidance to support both caregivers and recipients of care alike. These situations can be tricky, especially when the caregiver is facing situations that they are unfamiliar with or challenging. A supervisor’s training can help the caregiver understand what is part of the disease process and how to cope with behaviors so that the caregiver-client relationship is a successful one. Usually, effective supervision is crucial to making a tough situation work.

Differences between Medicare and Medicaid-Funded home care and private pay home care

There are many differences between caregiving available through a private duty home care agency that of government-funded home care services.

For starters, Medicare and Medicaid-funded home care can be very challenging to qualify for. This is because of the strict eligibility criteria of the programs. For example, Medicaid waiver home care clients may have limited say to who their home health aide is. They will also have little to no ability to dictate the caregiver’s total hours or visit frequency. Often, Medicare and Medicaid home care services are strictly time-limited For clients who require ongoing care they will often need to qualify for services regularly. One exception to this is home care services provided under the PA Medicaid waiver. This is a great option for families and their loved ones. However, eligibility criteria is also very limited in this case. See our full guide to the Medicaid waiver services in Pennsylvania here. You can see further examples and differentiators within home health services in this report too. If one can access these programs, it can be a great option as opposed to private duty home care in Philadelphia, PA.


personal care aide in the home


Because of the limitations of many government funded programs, families and loved ones will have less flexibility when it comes to receiving home care services through them. Home care agencies that receive a bulk of their services provided by government funded programs will have to prioritize delivering services at the lowest possible cost. Because of these challenges for agencies, this often means caregivers may struggle to provide all of the services that a client may need.

This can put a burden on the clients, their families, and caregivers. For starters, Medicaid and Medicare will not pay for basic support services such as assistance with meal preparation or companion care. Unfortunately, these are often vital to the health and well-being of seniors and people with disabilities.

Because of these reasons, many home care agencies can’t work with Medicare and Medicaid clients. They may work with other payer sources, including the Medicaid waiver, VA benefits, or long term care insurance. Conversely, most home care agencies will offer private duty home care as an option.

Benefits of Private Duty vs Government-Funded Home Care for Clients


benefits of private duty home care


For both home care agencies and families alike, working on a private-pay basis provides many advantages. Private duty home care agencies have complete control and flexibility when it comes to both providing care to recipients. It also generally allows them to be more flexible with family members and their loved ones too in regards to scheduling and services offered.

Private pay home care agencies can also freely offer a wider range of non-medical care services to their clients. Examples include homemaking, personal care, and companion care. For starters, they won’t be bound to cases in which care is only authorized when the client is recovering from an injury or illness. This is common with authorizations under government programs. 

Additionally, home care agencies can provide extremely flexible care to its clients. They could offer a variety of shift options as well as more intensive options such as round the clock care or dementia care, among others. This can grant a better level of care for clients receiving home care services and make it an even more appealing alternative to a senior care facility. Agencies that offer private duty home care in Philadelphia, PA can accommodate this. 

Considering home care agencies and other options

When you are one of the millions of Americans that prefers to reside in their own home, then it may be time to consider a future with a supportive caregiver helping you at home. If you’re still not sure about the type of care and home care services you or your loved one might need, a highly skilled and experienced Chosen Family Home Care representative can answer your questions and develop a tailored care plan to best fit your needs. Please call or text Chosen Family Home Care today at 267.457.4122 or send us a message online for more information. Our caring staff is available every day. We look forward to serving you or your family.


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