HHA vs. CNA vs. PCA vs. Companion Care: What's the Difference?

The Four Titles, Explained Simply

Families searching for home care in Pittsburgh often encounter four caregiver titles. Each one describes a different scope of training and daily tasks. Understanding the differences helps you choose the right level of support for your mom or dad — without paying for services they do not need, or accidentally under-planning for ones they do.

Home Health Aide (HHA) An HHA has completed a state-approved training program and competency evaluation. In Pennsylvania, HHAs working for licensed home health agencies meet specific hour requirements set by the state. They can assist with personal care activities — bathing, grooming, dressing, mobility support, and basic household tasks. Importantly, an HHA working through a non-medical agency like Mary Angels does not perform nursing tasks, administer medications, or provide wound care. That boundary is set by Pennsylvania law, not the individual caregiver.

Certified Nursing Assistant (CNA) A CNA has completed a longer training program and passed a state competency exam. CNAs often work in nursing facilities and hospitals. When a CNA works for a home health agency (medical), they may assist with a wider clinical scope under a nurse's supervision. However, when a CNA is employed by a non-medical home care agency, their role is the same as an HHA — personal care and daily living assistance. The title tells you about their training; the agency license tells you what they are permitted to do in your home.

Personal Care Aide (PCA) A PCA provides hands-on personal care — help with bathing, dressing, toileting, and transfers — along with light housekeeping and meal preparation. This title is commonly used in Pennsylvania's Medicaid programs, including Community HealthChoices (CHC). At Mary Angels, our caregivers providing personal care in Pittsburgh fill this role: skilled at hands-on assistance, but strictly non-medical.

Companion Caregiver A companion focuses on social connection and light support rather than hands-on personal care. Think of it as a trusted presence: conversation, accompaniment to appointments, light meal prep, light housekeeping, and gentle reminders. Companion care is ideal for a parent who is still largely independent but lonely, at risk of isolation, or needs a watchful eye when family cannot be there. Learn more about companion care in Pittsburgh.

What "Non-Medical" Actually Means — and Why It Matters

Mary Angels Home Care is licensed in Pennsylvania as a non-medical home care agency. This is not a limitation — it is a clear, honest description of what we do.

• We do not provide nursing care, physical therapy, occupational therapy, or any clinical treatment.
• We do not administer or manage medications (though we can remind a client it is time to take their own medications).
• We do provide personal care, companionship, homemaking, transportation, and around-the-clock support for daily living.

If your parent is recovering from surgery and needs wound care or skilled nursing visits at home, they would need a home health agency (medical), often arranged through a hospital discharge planner. Once the skilled nursing visits wrap up, many families continue with a non-medical caregiver for daily living support. These two types of agencies work alongside each other — they are not competitors.

For families navigating a hospital discharge in Pittsburgh, the guide on home care after hospital discharge in Pittsburgh walks through exactly how this handoff works.

Which Type of Caregiver Does My Parent Actually Need?

Here is a quick way to think through it:

Most Pittsburgh families find that their parent needs more than one type of support — for example, morning personal care plus afternoon companionship. A good agency builds a schedule around the real day, not a rigid category.

What Mary Angels Caregivers Do Every Day

At Mary Angels, we match each client in Pittsburgh and Allegheny County with a caregiver who fits their personality and needs. A typical day might include:

• Morning personal care: bathing assistance, dressing, grooming
• Meal preparation and light housekeeping
• Companionship, conversation, and cognitive engagement
• Transportation to appointments, grocery stores, or social activities
• Medication reminders (the client self-administers)
• Overnight or live-in support for families who need peace of mind around the clock

We serve neighborhoods across Allegheny County — from Squirrel Hill and Shadyside to the North Hills, Mt. Lebanon, and communities across the South Hills and East End. For families managing Alzheimer's and dementia care in Pittsburgh, we provide specialized support including routines, redirection, and close supervision — all without medical intervention.

How to Choose the Right Agency in Pittsburgh

The caregiver title matters less than the agency behind them. When you are comparing home care options in Allegheny County, ask these questions:

• Is the agency licensed by the Pennsylvania Department of Health as a home care agency?
• Are caregivers employees of the agency (not independent contractors)? If yes, the agency handles taxes, background checks, and liability.
• Does the agency carry workers' compensation insurance?
• How does the agency handle a call-out — will my parent be left without coverage?
• Is there a care coordinator I can call directly?

Mary Angels Home Care is a PA-licensed, family-owned, women-owned agency. Every caregiver is our employee. We offer a free in-home assessment so you can meet us before making any commitment. Call us at 412-900-9354 or visit our home care consultation checklist to prepare your questions in advance.