Your complete guide to becoming a Direct Care Worker at Silver Home Care. Everything you need to know to provide exceptional, person-centered care.
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Mission, values, and who we are
Professional conduct & boundaries
Infection control & protection
Attendance, dress code & policies
Care plans & EVV system
Professional development
Hiring through termination
Glossary & appendices
To improve lives, one visit at a time.
This isn't just a tagline. It's the reason Silver Home Care exists and the standard by which we measure our work.
Silver Home Care is a locally owned, hands-on agency based in Fairless Hills, PA. We aren't a franchise. We're a small team led by people who care about the quality of care provided to our clients.
Since 2016, we have built our reputation on reliability, responsiveness, and respect for both clients and caregivers. We work primarily with older adults and medically complex clients who need support to remain safely and comfortably in their own homes.
Administrator
Oversees day-to-day operations with hands-on leadership
Staff Supervisor
Your main contact for scheduling and support
Billing & Payroll
Handles billing, payroll, and compliance
Office Support
Supports office and field staff operations
Bathing, dressing, grooming, toileting
Light housekeeping, laundry, meal prep
Social interaction and engagement
Temporary relief for family caregivers
Planning and preparing nutritious meals
Errands and medical appointments
At Silver Home Care, our work is guided by the principle of person-centered care. This means we do more than complete a list of tasks—we focus on the client's goals, preferences, and choices. These rights are protected under Pennsylvania regulations (28 Pa. Code § 611.57 and 55 Pa. Code § 52.11) and reinforced through our Participant Rights and Communication Policy. For the full list of client rights, see the Client Handbook.
In practical terms, person-centered care means clients have the right to be treated with dignity and respect, to make choices about their care, and to accept or refuse services. They also have the right to privacy, to participate in decisions about their care plan and daily routines, and to receive services free from abuse, neglect, exploitation, or discrimination.
Respect client preferences around scheduling, routines, and how care tasks are carried out, as long as those preferences are safe and within the care plan.
If a client refuses a task, document it in HHAeXchange and notify the office if the refusal affects safety, required services, or represents a significant change.
Encourage independence whenever possible—even when it takes a little longer—because preserving dignity is part of good care.
Remember when we said we hired you because you're kind, reliable, and have integrity? This is where those qualities show up most clearly. Professionalism at Silver Home Care is about consistency and judgment, not formality. When you enter a client's home, you represent the agency, and the way you speak, act, and carry yourself shapes the client's experience of care.
Professional boundaries are a key part of that. Your role is to provide care and support—not to become personally entangled in a client's private life. Conversations should be respectful, appropriate, and focused on the client. You can be warm and engaged, but the visit should not turn into a space for sharing personal struggles, debating politics or religion, or getting pulled into family conflicts. Those situations can quietly erode trust and make care harder for everyone involved.
Confidentiality fits naturally into this same framework. As a Direct Care Worker, you will learn private details about a client's health, routines, and personal life. That information must stay protected. You may only share it with authorized Silver Home Care staff and only for legitimate care or safety reasons. Client information should never be discussed with friends or family, shared on social media, or talked about in public settings.
If you access care plans or documentation electronically, your device must be password protected. Papers or notes containing private information should never be left where others can see them. Confidentiality is both a legal requirement under HIPAA and Pennsylvania regulations and a basic expression of respect for the people we serve.
Direct Care Workers may never:
When in doubt: If you are ever unsure whether something crosses a boundary, pause and contact your supervisor or the office for guidance. Maintaining clear boundaries protects you, the client, and the agency.
At Silver Home Care, infection control is taken seriously because the clients we serve are often older adults or medically fragile. Something minor for you—like a cold—can pose a serious risk to someone with a weakened immune system. Following infection control practices is one of the most important ways we protect our clients and each other (28 Pa. Code § 611.56(b)(6)).
The foundation of infection control is hand hygiene. You are expected to wash your hands with soap and water before and after every care task, before preparing food, after using the bathroom, after removing gloves, and any time your hands are visibly dirty.
Personal protective equipment (PPE) must be used correctly. Gloves are required when assisting with personal care, toileting, or any task involving bodily fluids. Always follow the care plan and agency instructions.
Wash hands before/after every care task, food prep, and bathroom use
Use gloves for personal care tasks and follow care plan for additional PPE
Never mix cleaning products - know what you're using and store safely
Report unsafe conditions, loose rugs, poor lighting, or other hazards immediately
Watch this video to learn the correct handwashing procedure that all caregivers must follow:
You are legally required to report suspected abuse, neglect, or exploitation
As a Direct Care Worker, you are a mandated reporter under Pennsylvania law (55 Pa. Code § 52.18; OAPSA). This means that if you ever see, hear, or suspect abuse, neglect, or exploitation, you are required to report it.
Abuse may be physical, verbal, emotional, sexual, or financial. Neglect can involve a failure to provide basic needs such as food, hygiene, safety, or medical attention. Exploitation often involves financial or legal manipulation.
Emergencies and critical incidents can occur without warning, and your response can make a significant difference (28 Pa. Code § 611.58).
In a medical emergency—such as a fall with injury, loss of consciousness, difficulty breathing, chest pain, severe bleeding, or a seizure—call 911 immediately. Stay with the client, follow the dispatcher's instructions, and keep the client as comfortable as possible until help arrives. Once emergency services are on the way, notify the office.
Client abandonment is one of the most serious violations of Silver Home Care's standards. Abandonment occurs when a client is left without care during a scheduled visit—whether by not showing up, leaving early without authorization, or leaving without proper coverage or notification.
If you are running late, cannot make it to a shift, or encounter an emergency, you must contact the office immediately. Do not call the client directly and do not attempt to arrange coverage with another caregiver.
If you are with a client, remain until your scheduled shift ends or until a replacement arrives
As a home care worker, you play an important role in protecting the integrity of Medicaid-funded services. Medicaid fraud is a serious violation that can result in criminal charges, fines, and loss of employment.
Common examples of Medicaid fraud include falsifying time records, claiming payment for services not provided, or billing for unauthorized tasks. At Silver Home Care, we use Electronic Visit Verification (EVV) to maintain accurate records and ensure compliance with Medicaid requirements.
Your responsibility: Always clock in and out accurately, provide only the services authorized in the care plan, and report any concerns about fraud or billing irregularities to the office immediately.
Dependability is the foundation of home care. Clients rely on you to be present and on time, and even small disruptions can have a real impact on their safety and routine. Silver Home Care's Attendance and Punctuality Policy (28 Pa. Code § 611.56(b)(5)) exists to protect clients and ensure continuity of care.
In practical terms, this means you are expected to arrive on time and ready to work for every scheduled shift. If something interferes with your ability to do that—running late, transportation issues, illness, or an unexpected emergency—you contact the office immediately. You should never call the client directly to cancel or explain an absence. Repeated lateness, call-outs, or no-shows create risk for clients and may lead to corrective action.
If you are unsure how to handle a situation affecting your attendance, the office is there to help you make the right call in the moment.
Your well-being matters, and breaks are part of maintaining safe, sustainable care. At the same time, many clients rely on you as their sole source of supervision during a visit, so breaks must always be managed with client safety in mind.
If you are working a shift of four hours or more, you are entitled to a break. In most cases, this will be an on-site break. You may rest, eat, or pause while remaining in the home and available to the client. These on-site breaks are paid.
If the care plan allows and the client can be safely left alone for a short period, you may take an off-site break, typically around 30 minutes. Off-site breaks are unpaid. You must clock out and back in using HHAeXchange and notify the office before leaving, even if off-site breaks have been approved in the past.
Smoke breaks are permitted only when the client's care allows it. Smoking is never allowed inside a client's home, even if the client gives permission. If you step outside to smoke, it must be brief, and you must return free of smoke odors. Wearing an extra jacket that can be removed, washing your hands, and using mints or gum before returning are simple steps that help protect clients who may be sensitive to smoke or strong smells.
Direct Care Workers are expected to present themselves professionally at all times. This helps clients feel comfortable and reinforces trust in the care being provided.
At Silver Home Care, professional presentation means wearing the Silver Home Care uniform top while on duty, arriving clean and well groomed, wearing safe closed-toe, non-slip shoes, and avoiding strong odors such as smoke, perfume, or heavy cleaning products. These expectations support both safety and client comfort.
Silver Home Care offers time-and-a-half pay for six major holidays: New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day.
Holiday pay applies only when you are scheduled and work on the holiday itself. If you are already in overtime, you will be paid your overtime rate instead of additional holiday pay.
To request a holiday off, submit your request at least 60 days in advance.
During a visit, your attention needs to be on the client. Phones should be kept on silent and out of sight while you are working. If you need to make or take a call, it should be brief, and you must ensure the client is safe while you step aside.
Earbuds and headphones are not permitted during shifts. They can block sounds such as alarms, timers, or a client calling for help, and they interfere with your ability to stay aware of your surroundings.
Silver Home Care supports every worker's right to report concerns about safety, abuse, fraud, or policy violations without fear of retaliation. If you raise a concern in good faith, you may not be punished or targeted for doing so.
Silver Home Care complies with all applicable non-discrimination laws, including the Americans with Disabilities Act and Title VI. Discrimination based on race, color, religion, sex, age, disability, national origin, sexual orientation, or gender identity is not permitted.
Every client at Silver Home Care has a written care plan prepared by the agency. This plan is your guide to what services you provide, how they should be provided, and any specific needs or precautions for that client. Following the care plan exactly is required for consistency, safety, and regulatory compliance (28 Pa. Code § 611.57; 55 Pa. Code § 52.15).
At the end of every shift, you are responsible for completing your documentation in the HHAeXchange app. This includes confirming tasks that were completed, documenting any tasks the client refused, and writing a clear, professional note that reflects what occurred during the visit.
Documentation must be completed before you leave each shift. It creates an accurate record of care, supports appropriate follow-up, ensures services are billed correctly, and protects you by showing what care was provided.
Silver Home Care complies with the federal 21st Century Cures Act, which requires Electronic Visit Verification (EVV) for all Medicaid-funded home care services. We use the HHAeXchange mobile app to record visits.
You are expected to clock in and out from inside the client's home, after greeting the client and beginning the visit. Clocking in from a car, from outside the home, or before seeing the client is not permitted.
Missed punches are handled through the Missed Punch Form process. The form is not a substitute for EVV; it is a controlled way to document an exception.
Non-compliant exception. Call office immediately and follow Missed Punch Form process.
Compliant exception if reported in real time and backup process followed.
Clock in/out from actual location and complete Missed Punch Form. Never leave client without approval.
Some clients require overnight services. Under Community HealthChoices (CHC) regulations, Direct Care Workers assigned to overnight shifts must remain awake for the entire shift. This requirement exists for client safety.
To verify compliance, Silver Home Care requires overnight check-ins through the employee app at 1:00 a.m., 3:00 a.m., and 5:00 a.m.
Building your skills to provide exceptional care
Before working independently with clients, you must complete Silver Home Care's required competency training program. This training covers essential topics such as infection control, personal care, client rights, and workplace safety. Completion is required under Pennsylvania law (28 Pa. Code § 611.55; 55 Pa. Code § 52.21) and ensures you are prepared for the responsibilities of your role.
Competency requirements include demonstrating skills such as safe transfers, infection control practices, effective communication, and maintaining ethical boundaries. These competencies must be completed under supervision and signed off before you are assigned to provide care independently.
Silver Home Care requires annual refresher training and competency reviews, as mandated by regulation (28 Pa. Code § 611.56; 55 Pa. Code § 52.21).
Topics include:
In addition to annual requirements, Silver Home Care provides monthly trainings that are required to maintain eligibility to work.
These address:
Note: You will receive notification when training is due. Timely completion is expected.
Training at Silver Home Care is not only about compliance. It is also an investment in your professional growth. Each completed training strengthens your skills, confidence, and ability to handle complex situations.
Optional development opportunities may include:
Dementia & Alzheimer's Care
Advanced Transfer Techniques
Cultural Competency
Communication Workshops
Training supports compliance with state regulations, but it also reflects Silver Home Care's mission to improve lives one visit at a time. Well-trained Direct Care Workers provide safer care, build stronger trust with clients, and contribute to a more stable care environment.
Failure to complete required training or demonstrate competency may result in temporary removal from client assignments until requirements are met. Silver Home Care takes training seriously because preparation protects clients, workers, and the agency.
From hiring to grievances—understanding your employment journey
Silver Home Care follows all state requirements for background checks, child abuse clearances, and OIG exclusion checks (28 Pa. Code § 611.51; 55 Pa. Code § 52.19).
In some situations, Direct Care Workers may be hired provisionally while clearances are pending. During provisional employment, you must remain under direct supervision and may not work independently until all final clearances are received.
Pennsylvania regulations require tuberculosis (TB) testing and screening for all Direct Care Workers prior to client contact (28 Pa. Code § 611.53).
Initial TB testing or screening must be completed before your first shift, along with annual TB screening thereafter. Workers who do not provide updated screening documentation will be removed from the schedule until compliance is achieved.
Employment eligibility is verified through I-9 documentation and the federal E-Verify system, as required by law. Silver Home Care also conducts ongoing checks, including regular OIG exclusion reviews and periodic background re-checks, to maintain compliance over time.
These verification processes protect clients, the agency, and the integrity of services by ensuring that only qualified and eligible workers are placed in clients' homes.
Employment or client services may be terminated under certain circumstances. Silver Home Care's Termination of Services Policy outlines this process in compliance with 28 Pa. Code § 611.58.
Silver Home Care wants workers to feel respected, supported, and heard. If you have a concern, the first step is to speak with your supervisor.
If not resolved, escalate to the Administrator or submit a formal complaint. All complaints are reviewed promptly, confidentiality is respected, and retaliation is not permitted.
Direct Care Workers are protected under Pennsylvania's Whistleblower Law (43 P.S. § 1421) when reporting concerns such as safety issues, fraud, or abuse in good faith.
You may report concerns internally or to state oversight agencies. Retaliation for good-faith reporting is prohibited and will not be tolerated.
All Direct Care Workers are required to sign the Orientation Acknowledgment Form. This form confirms that you have:
The signed acknowledgment is maintained in your personnel file, as required by regulation (28 Pa. Code § 611.56; 55 Pa. Code § 52.21).
We hired you because we saw something in you that matters—you're kind, you're reliable, and you understand that treating people with respect and dignity isn't optional. Those qualities are exactly what this work requires.
At Silver Home Care, every visit is more than a task. It is an opportunity to improve someone's life by providing steady, respectful, and thoughtful care in their own home. The work you do makes a real difference—one visit at a time.
By following the guidance in this Orientation Guide, respecting client rights, and maintaining professional standards, you play a direct role in creating safety, dignity, and continuity for the people we serve.
Thank you for choosing this work and for being part of Silver Home Care. We're glad you're here, and we're here to support you every step of the way.
Any action that causes harm, including physical, emotional, sexual, or financial harm. Direct Care Workers are mandated reporters.
Federal law prohibiting discrimination against individuals with disabilities and requiring reasonable accommodations.
A written document outlining approved services, client needs, and specific instructions. All services must follow the care plan.
Leaving a client without care during a scheduled shift. Considered a serious violation that may result in termination.
The demonstrated ability to perform caregiving duties safely and effectively, as required by regulation.
The obligation to protect private client information in compliance with HIPAA and agency policy.
Electronic Visit Verification - federally mandated system to record home care visits through GPS-enabled mobile technology.
The illegal or improper use of a client's resources, property, or person for personal gain.
The mobile application used for EVV, task documentation, and visit notes.
Federal law protecting the privacy and security of health information.
A professional legally required to report suspected abuse, neglect, or exploitation under Pennsylvania law.
A failure to clock in or out in the EVV system. Requires immediate contact with the office.
Personal Protective Equipment - such as gloves or masks used to reduce infection risk.
A worker who reports suspected fraud, abuse, or safety violations and is protected from retaliation.
