Caregiver training and TB screening rules in PA

Three ways a caregiver can show competency

Before working with clients, a Pennsylvania caregiver must hold a Pennsylvania nursing license, pass a competency exam, or complete a qualifying training program.

The training option covers an agency's own program, a home health aide program, or the nurse aide certification and training program. That flexibility lets you hire experienced aides without retraining them from scratch, provided you document which route each worker took.

Chapter 611 does not set a number of training hours. What it sets is content, so a program is judged by the topics it covers rather than how long it runs.

Pennsylvania caregivers may show competency through a valid Pennsylvania nurse's license, a competency examination, or a qualifying training program. — 28 Pa. Code § 611.55, Pennsylvania Code, retrieved 2026-09-27

Topics an agency's own training program must cover

An in-house program must cover confidentiality, consumer control and the independent living philosophy, and household tasks; personal care workers add bathing, grooming, dressing and skin care.

The consumer control topic is easy to skip and important to keep. Non-medical care is directed by the client or their representative, and a caregiver who takes over decisions is out of line with the regulation's premise, not just with good manners.

Build the curriculum as a checklist that mirrors the rule, then keep a signed record of each worker's completion. That record is what an inspector reads.

Pennsylvania competency training must address confidentiality, consumer control and the independent living philosophy, and instrumental activities of daily living. — 28 Pa. Code § 611.55, Pennsylvania Code, retrieved 2026-09-27

Training for personal care workers must add bathing, shaving, grooming and dressing, and hair, skin and mouth care. — 28 Pa. Code § 611.55, Pennsylvania Code, retrieved 2026-09-27

The annual competency review

Competency is not a one-time box. Each caregiver's competency must be reviewed at least once a year after it is first established, and the review documented.

Tie the review to a fixed date per worker, such as their hire anniversary, rather than a single annual training day. Staggered reviews are easier to supervise and harder to miss when someone was out sick on the group date.

A worker overdue for review is a finding waiting to happen, so a simple spreadsheet flagging each date 30 days out does the job.

once per yearA competency review must occur at least once per year after a Pennsylvania caregiver's initial competency is established. — 28 Pa. Code § 611.55, Pennsylvania Code, retrieved 2026-09-27

Tuberculosis screening before the start date and every 12 months

Each caregiver must document they are free of active tuberculosis, from screening no more than a year before their start date, and update it at least every 12 months.

The 12 months run from the date of the last evaluation, not from the calendar year. A worker screened in March is due again by the following March, whatever their hire date.

Put the TB date next to the competency review date in the same tracker. Both are yearly, both live in the personnel file, and both are checked at inspection.

1 yearPennsylvania caregivers must be screened for active tuberculosis no more than 1 year before their start date. — 28 Pa. Code § 611.56, Pennsylvania Code, retrieved 2026-09-27

12 monthsTB screening documentation must be updated at least every 12 months, measured from the date of the last evaluation. — 28 Pa. Code § 611.56, Pennsylvania Code, retrieved 2026-09-27

The information packet every client gets before care starts

Before the first visit, the client receives a packet listing the services, the caregiver's identity, hours, fees and total costs, how to reach the Department, and the hiring and competency rules.

The packet also carries the worker-status disclosure: employee or independent contractor, and what that means for tax and insurance. The Department supplies a form for that notice.

Assemble the packet once as a template and tailor the service list and caregiver name per client. Keep the signed copy in the client folder, because the packet is one of the easiest things for a surveyor to check.

Before services begin, Pennsylvania agencies must give consumers a list of services, the identity of the direct care worker, hours, fees and total costs, and Department contact information. — 28 Pa. Code § 611.57, Pennsylvania Code, retrieved 2026-09-27

The consumer packet must also describe the hiring and competency requirements applicable to direct care workers. — 28 Pa. Code § 611.57, Pennsylvania Code, retrieved 2026-09-27

Keep a copy of the rules in the office

Chapter 611 itself requires a current copy of the chapter to be kept at the agency or registry office, which makes it the simplest item on any inspection checklist.

Print it, date it, and replace it when the Department announces a change. Staff who can open the rule and check it answer their own questions faster than a phone call to the Division.

With files in order, the screening side is complete. The checks that come first are in the background check guide, and pay rules for the same workers are on the payroll page. If you are still at the planning stage, start from what the license covers.

Chapter 611Pennsylvania home care agencies and registries must maintain a current copy of 28 Pa. Code Chapter 611 at the agency or registry. — 28 Pa. Code § 611.4, Pennsylvania Code, retrieved 2026-09-27

Questions