PCA, CNA, HHA, LPN & RN — Role Comparison

Limitations

Titles on a job posting, a Medicaid service name, and a Board of Nursing license are different systems. This page will not tell you that a PCA may perform a specific medical task. 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.

Important definitions

Short definitions used on this page. Program manuals may phrase lists slightly differently.

• PCA / personal care aide: A worker who assists with authorized personal care. Programs may also say attendant, personal assistance, or aide. Titles are not interchangeable across every payer.
• Attendant: A common consumer-directed term for the worker hired by the member or representative to provide authorized assistance.

Plain-English summary

Educational comparison of personal care aides, certified nurse aides, home health aides, licensed practical nurses, and registered nurses. This is not a legal scope-of-practice chart and does not replace Virginia licensure rules.

Why this is not a legal-scope grid

A simplified chart that lists medical tasks by title would be easy to get wrong. Delegation, setting, competency, and the care plan all matter. When a task is in doubt, the answer is supervisor or RN — not a website cell.

PCA versus nurse

Personal care supports ADLs and related needs under an RN-developed written plan. Skilled nursing is licensed nursing care. A family request does not turn a PCA into a nurse.

Not ABA and not RBT

Registered Behavior Technician work is behavior-analysis related. Eden Home HealthCare Center does not treat RBT as a home-care PCA role on this site.

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.