Our Care Setup Process: What Happens, Step by Step, and How Long It Really Takes

Starting home care for a parent, spouse, or loved one can feel overwhelming. Most families have never done this before, and the questions pile up fast: Where do I even begin? Who do I call first? How long will this take? Will my loved one have to wait weeks while we figure it out?

At Apple Home Care Services, we believe families deserve straight answers. That’s why we walk every Philadelphia-area family through our care setup process from the first phone call. Some families can have a caregiver in their loved one’s home within 24 to 48 hours. Others — particularly those using the Community HealthChoices (CHC) Medicaid Waiver — should plan for 30 to 45 days. Both paths are normal, and we’ll help you understand exactly which one fits your situation.

Below is how our process works, what happens at each step, and what to expect along the way — including the parts most agencies won’t tell you.

Our 4-Step Care Setup Process

No matter how care is being paid for, every family we work with moves through the same four-step process. Each step is designed to give your family more clarity, more support, and more time to ask the questions that matter.

1. Initial Consultation

We start with a free, no-pressure conversation, either by phone or in your loved one’s home. This is where we listen. We want to understand who your loved one is — their daily routine, the things that bring them joy, the concerns that keep you up at night, and the kind of help that would make the biggest difference. We’ll also explain how home care works in Pennsylvania and the realistic options for your family. You will not be asked to commit to anything during this visit.

2. Custom Care Plan

Once we know your loved one’s needs, we build a personalized care plan that maps exactly what happens during each visit. That can include personal care like bathing and dressing, companion care, light housekeeping, medication reminders, safety monitoring, transportation to appointments, and specialized support for conditions like dementia, Alzheimer’s, Parkinson’s, or post-surgery recovery. Care plans are not one-size-fits-all, and they’re not set in stone. As needs change, the plan changes with them.

3. Caregiver Matching

This is the step that sets a good home care experience apart from a great one. We don’t just send the next available caregiver. We carefully match each client with a caregiver whose personality, schedule, language, and skill set fit your loved one. Every caregiver on our team has cleared FBI and Pennsylvania state background checks, TB and health screenings, professional reference checks, and in-person interviews. We hire for character first because that’s what makes care feel like family.

4. Ongoing Care & Support

Care begins, and our work is just beginning too. Our office team stays in regular contact with your family and your caregiver, monitors how things are going, and adjusts the care plan as needs change. If something isn’t working — a scheduling conflict, a personality mismatch, a new health concern — we want to know right away so we can fix it. You are never on your own.

How Long Does It Actually Take to Start Home Care in Philadelphia?

This is one of the most common questions we hear, and the honest answer is: it depends on how care is being paid for. There are two main paths, and the difference in timing is significant. Knowing which path applies to your family is the single most important thing you can learn before you start calling agencies.

A Closer Look at the 30–45 Day CHC Waiver Process

Here’s what is actually happening behind the scenes during those weeks of waiting, and what your family will be doing at each step.

1. 1
   Day 1

   Free In-Home Consultation

   We come to you. During this visit, we learn about your loved one’s needs, explain how the CHC Medicaid Waiver works, and help you understand whether your loved one is likely to qualify clinically and financially. There is no cost and no obligation. If CHC is the right path, we help you start the application that same week.

2. 2
   Days 2 to 5

   Apply Through the Independent Enrollment Broker (Maximus)

   Pennsylvania uses an Independent Enrollment Broker — currently Maximus — to handle all CHC Medicaid Waiver applications. You will contact them by phone or online to begin. This step is critical and easy to get wrong, so we stay on the phone with you and help your family gather everything you’ll need: proof of income, assets, medical history, and contact information for your current healthcare providers.

3. 3
   Days 7 to 14

   In-Home Functional Assessment

   A nurse from Maximus visits your loved one at home to evaluate their need for help with activities of daily living. This visit determines clinical eligibility for the waiver. It usually lasts about an hour. We coach families before the assessment so you know what to expect and how to make sure your loved one’s real needs are accurately captured. This is one of the most important hours in the entire process.

4. 4
   Days 14 to 21

   Financial Eligibility Review

   While Maximus reviews clinical eligibility, the County Assistance Office (CAO) reviews financial eligibility for Medicaid — looking at income, assets, and other factors. This is often the slowest part of the process and where families feel most stuck. We help you respond quickly to any requests for additional documentation so the file doesn’t sit.

5. 5
   Days 21 to 30

   MCO Enrollment & Service Approval

   Once approved, your loved one will be enrolled in one of three CHC Managed Care Organizations (MCOs): Keystone First Community HealthChoices, PA Health & Wellness, or UPMC Community HealthChoices. You get to choose. We can explain the differences between them and help you pick the one that works best for your family and your current providers.

6. 6
   Days 30 to 45

   Care Plan and First Caregiver Visit

   Your loved one is assigned a Service Coordinator from the MCO, who builds a Person-Centered Service Plan authorizing the hours and types of care your loved one will receive. At this point, Apple Home Care is officially authorized to start. We finalize the caregiver match, schedule the first visit, and care begins.

What Apple Home Care Does for Your Family During the Wait

Many agencies will sign you up, hand you a packet of paperwork, and disappear until you’re approved. We don’t work that way. The 30 to 45 day waiting period is when families feel the most anxious and the most alone — and it’s also when the most things can go wrong. Here’s how we stay engaged through every step:

• Hands-on application support. We sit with you on the phone with Maximus, help you fill out forms, and make sure nothing is missing or incorrect.
• Assessment coaching. Before the in-home functional assessment, we walk your family through what will be asked and how to describe your loved one’s needs honestly and accurately.
• Document help. We provide a clear checklist of every document you’ll need for the financial review and help you gather them.
• Status updates. We follow up on your behalf with Maximus, the County Assistance Office, and the MCO so you’re not the one chasing paperwork.
• Interim private pay options. If your loved one needs help right now and can’t safely wait, we can start a short-term private pay arrangement and transition smoothly to CHC coverage once approved.
• Honest answers. If we think your loved one may not qualify, we’ll tell you and help you understand your other options instead of leaving you to figure it out alone.

Frequently Asked Questions About Starting Home Care