Silver Home Care
Acknowledgment of Pennsylvania State Regulations per 35 Pa. Stat. § 448.806b
Financial and Legal Restrictions
Reference: 35 Pa. Stat. § 448.806b (Pennsylvania Home Care Agencies & Registries Statute)
In accordance with Pennsylvania state regulations (35 Pa. Stat. § 448.806b), I acknowledge that:
Check Endorsement: I am not permitted to endorse a check over to a home care agency or registry, including Silver Home Care.
Power of Attorney: I am not permitted to give or assign power of attorney to anyone employed by or affiliated with Silver Home Care.
Guardianship: I am not permitted to give or assign guardianship to anyone employed by or affiliated with Silver Home Care.
I have been provided with the opportunity to ask questions and understand my responsibility to comply with all relevant laws, regulations, and contract provisions. I acknowledge that failure to comply may result in the termination of services provided by Silver Home Care.
35 Pa. Stat. § 448.806b:
"No individual as a result of the individual's affiliation with a home care agency or home care registry may assume power of attorney or guardianship over a consumer utilizing the services of that home care agency or home care registry."
"No consumer may be required to endorse checks over to a home care agency or home care registry."
By signing below, I confirm that I have read, understood, and agreed to the terms outlined above.
Client Name:
Representative Name:
Client/Representative Signature:
Relationship (if Representative):
Date:
Document Version 1.0 | Effective January 27, 2026
Silver Home Care | 680 Lincoln Hwy, Fairless Hills, PA 19030 | (800) 719-6912 | [email protected]
