Who this applies to
Clients, representatives, and families receiving or considering licensed home care.
What is not automatically guaranteed
This page paraphrases public regulation themes and is not the full Virginia Administrative Code.
Limitations
This page paraphrases public regulation themes and is not the full Virginia Administrative Code. Eden educational resources are not a substitute for official Medicaid, waiver, or health-plan determinations. Rules vary by program, assessment, authorization, and plan. Confirm current details with DMAS, your MCO, and Eden intake.
Plain-English summary
Dignity, privacy, freedom from abuse/neglect/exploitation, care-plan participation, competent staff, and the difference between Virginia home-care regulation, Medicaid provider rules, and Eden internal standards.
Client rights (paraphrased)
Virginia home-care organization regulations expect providers to support dignity, respect, privacy, confidentiality of health information, freedom from abuse, neglect, and exploitation, participation in care planning, the right to refuse services, access to trained, competent staff, and a complaint process.
Three layers of rules
Distinguish Virginia home-care organization regulation, Virginia Medicaid provider requirements, and Eden internal standards. They overlap but are not identical.
Licenses and credentials
Eden describes itself as a licensed home-care organization and publishes awards or certifications only when verified. This site does not invent certificates or expose confidential license IDs.
Caregiver qualifications
Public themes include competency, orientation, training, background screening where applicable, PCA/aide qualifications, LRI aide requirements matching attendant rules, supervision, documentation, EVV, and scope limits (aides are not nurses).
Adult Day
Adult day offers supervised daytime engagement. Only clinical services actually offered should be claimed. Coverage and authorization depend on the program.
Transportation vs NEMT
Eden community or errand transportation, when offered, is not automatically Virginia Medicaid NEMT. Do not assume Eden can book or bill Medicaid NEMT.
Eligibility and applicability
Program rules, assessments, and payer authorization decide what can start. Medicaid enrollment, waiver enrollment, service eligibility, service authorization, and authorized hours are not the same status.
Assessment and documentation
Depending on the program and service, an assessment and supporting documentation may be required. A nurse does not automatically visit first for every request.
Authorization and approval
When authorization is required, the payer or MCO reviews the requested service and hours. Outcomes can include approval, partial approval, a request for more information, or denial. Eden does not approve the benefit.
Hours and limits
Requested, assessed, authorized, scheduled, and EVV-verified hours can all differ. This site does not invent a universal hour number.
How services can interact
Personal care, respite, companion, adult day, and transportation follow separate rules. A plan may authorize one, more than one, or none.
Family caregiver implications
A parent or spouse is not automatically a paid caregiver. Virginia LRI rules apply only in defined relationships and only when the current official policy and authorization allow it.
Agency-directed vs consumer-directed
Agency-directed: a licensed agency is the employer. Consumer-directed: the member or representative is the employer of record, with services-facilitator support where the waiver allows. Eden's typical public role is agency-directed care.
Insurance and MCO implications
Managed-care members usually follow their plan's authorization and appeal process. Fee-for-service members follow DMAS processes. A plan existing on the official roster does not mean Eden is in-network.
What Eden can help with
Explain how to raise a concern with Eden, and point to official complaint channels.
What Eden cannot decide
Eden cannot waive client rights or rewrite DMAS or Virginia Department of Health rules.
Can I refuse a caregiver or a task?
Clients generally may participate in planning and refuse services. Refusing a task does not create a right to unauthorized hours or a guaranteed replacement aide the same day.
Eden educational resources are not a substitute for official Medicaid, waiver, or health-plan determinations. Rules vary by program, assessment, authorization, and plan. Confirm current details with DMAS, your MCO, and Eden intake.
Last reviewed August 23, 2026.
Want help?
Start Care or contact Eden. Submitting a request does not approve services or hours.