How to get a home health care business license (2024)

home health care business
Facundo Bermudez
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Published on 31 May 2024 Time to read 13 min read Last update on 4 Jun 2024

Starting a home health care business can be a fulfilling and profitable endeavor, but navigating the licensing requirements can feel overwhelming. Whether you’re passionate about providing compassionate care to those in need or you’re looking to tap into a growing market, obtaining the proper license is a crucial first step. This article will walk you through the step-by-step process of getting a license for your home health care business, ensuring you’re well-prepared to meet state regulations and operate legally.

In addition, we will also explain whether you need a license to start a home health care business in Florida, California, and Texas. By the end, you’ll know exactly what you need to do to get started legally and successfully.

Do you require a license to start a home health care business?

Starting a home health care business can be a rewarding venture, but one of the crucial steps in this process is understanding the licensing requirements, which vary significantly from state to state.

In some states, a license is required only for personal care services. Personal care services aim to assist older adults with activities of daily living (ADLs), which include essential tasks such as eating, bathing, toileting, walking, and dressing. These services are vital for clients who need help with basic self-care activities. States that require a license for personal care services include Texas, Louisiana, South Carolina, Virginia, West Virginia, New York, Maine, and Rhode Island.

Companionship and personal care services licensing

Other states require a license for both companionship and personal care services. Companion care provides crucial social and emotional support for older adults, focusing on instrumental activities of daily living (IADLs). These activities include light housekeeping, meal preparation, social engagement, running errands, arranging medical appointments, and providing transportation based on the client’s needs. Companion caregivers help improve the quality of life for older adults who may be struggling with loneliness, depression, or a lack of motivation by offering tailored support and companionship. In states that require licensing for both services, you will need to obtain the necessary licenses to legally operate your home health care business.

For some entrepreneurs, starting with a personal care license is a strategic approach. Obtaining a personal care license can be less challenging and allows the business to begin operations while working towards meeting the more stringent requirements for a companionship license. This phased approach enables the business to build a client base and revenue stream, making the process of obtaining the companionship license more manageable over time.

States without licensing requirements

On the other hand, some states do not require a license to provide home health care services. This can simplify the process of starting your business, although it is still essential to comply with any other local regulations and standards to ensure quality care. States that do not require licenses for home health care services include Arizona, New Mexico, Kansas, New Hampshire, South Dakota, North Dakota, Iowa, Missouri, Arkansas, and many more.

When planning to start a home health care business, it’s critical to research the specific licensing requirements in your state. Ensuring compliance with local regulations not only helps in providing legal and high-quality services but also establishes your credibility and trustworthiness with clients and their families. Always check with your state’s health department or licensing board for the most accurate and up-to-date information.

home health care business

What type of license does a home health business need?

You have two primary licensing options:

1. Home Care License:
Provides nonmedical services such as personal care, housekeeping, and companionship.

2. Home Health Care License:
Offers both nonmedical care and skilled nursing services, covering a broader range of health care needs.

How long does it take to get a home health license approved?

The approval time for a home health care license varies by state and depends on the number of applications being processed. It can take anywhere from under three months to as long as 18 months. To get a more accurate timeframe, it’s best to contact your state’s licensing authority directly.

Are license approvals guaranteed?

Approval of your license application is not guaranteed. However, if your application is complete and includes all the required documents, it has a good chance of being approved. If any information is missing, the state will notify you, and you will need to provide the additional information, which may delay the process.

The most common reason for rejection is that the Administrator or Director of Nursing (if required) does not have the necessary qualifications and experience. Ensuring these key roles are filled by qualified individuals can significantly improve your application’s chances of approval.

How to obtain a home health care license

Before applying for a home health care license, there are several important steps to take. Here’s an improved guide to help you through the process:

1. Decide on the legal structure of your business

Determine the legal structure of your home care business, such as a sole proprietorship, partnership, limited liability company (LLC), or corporation. This decision impacts your taxes, personal liability, and registration requirements.

An LLC or corporation generally provides limited liability protection, which can be beneficial in the healthcare industry. Consider consulting a legal advisor or accountant to choose the best structure for your needs.

2. Research state licensing requirements and fees

Visit your state’s Secretary of State website to understand the specific licensing requirements and fees in your area. Each state has different regulations, so it’s essential to know what is expected. Licensing fees can either be a flat rate or based on the number of employees you have.

Familiarize yourself with the types of documentation needed, such as proof of insurance, background checks, and training certifications. Also, take note of any deadlines and ensure you prepare all necessary paperwork ahead of time.

3. Determine if a Certificate of Need (CON) is required

Check with your state’s health department to see if you need a Certificate of Need (CON), especially if you plan to offer services like Medicare and Medicaid. The CON is designed to prevent excessive health care facilities by ensuring that new services meet an actual need in the community.

If required, you will need to complete a detailed application demonstrating the demand for your services and how your business will meet that demand. Apply for the CON first before proceeding with your license application to avoid delays.

4. Set up a secure office location

Establish a secure office location that complies with local zoning laws. This can be a commercial office space or a designated area in your home, provided it meets state requirements. Ensure you have locked cabinets for storing client and staff records securely.

Some states mandate that your office is accessible to staff and the public during business hours. Having a dedicated office space can also enhance your business’s credibility. Include a copy of your lease or proof of ownership with your license application to show that you have a legitimate place of business.

5. Draft a business plan

Prepare a comprehensive business plan outlining your business goals, services offered, market analysis, operational plan, and financial projections. Even if not required for your license application, a solid business plan is crucial for guiding your operations and securing funding.

Detail how you plan to comply with state regulations and address the needs of your target market. A well-crafted business plan can also be a valuable tool for attracting investors or securing loans.

6. Register your business with the Secretary of State

Officially register your business with the Secretary of State and the State Department of Revenue Services. This process usually involves filing your business name and legal structure with state and local governments. You may also need to obtain an Employer Identification Number (EIN) from the IRS if you plan to hire employees.

Completing this step ensures your business is legally recognized and can operate within the state. Keep copies of all registration documents, as they may be required for your license application.

7. Hire appropriate staff

Hire key personnel such as an Administrator (unless you’re managing the agency yourself), a Director of Nursing, and a backup Registered Nurse. Ensure these individuals have the necessary qualifications and experience required by your state. Carefully vet your staff to make sure they meet all regulatory requirements.

In addition to clinical staff, consider hiring administrative support to handle billing, scheduling, and compliance tasks. Having a qualified and experienced team in place is crucial for passing inspections and delivering high-quality care.

8. Check staff screening requirements

Ensure all staff members undergo required screenings, which may include criminal background checks, fingerprinting, and random drug testing. Check with your state’s regulations to determine the specific requirements for your staff.

It’s important to verify nursing licenses with the state board and ensure any Certified Nursing Assistants (CNAs) and Home Health Aides (HHAs) are registered if required. Conducting thorough background checks, even if not mandated, is highly recommended to ensure the safety and integrity of your business.

9. Comply with state training requirements

Follow your state’s specific training requirements for caregivers and nurses. For example, in Florida, caregivers need 40 hours of Home Health Aide training, Alzheimer’s Disease or Related Disorders (ADRD) training, and approved CNA Continuing Education Units (CEUs).

Make sure your staff completes all necessary training and maintains their certifications. Providing ongoing education and training opportunities can help your team stay updated on best practices and improve the quality of care provided.

10. Purchase adequate insurance

Secure comprehensive insurance coverage for your business. At a minimum, you should have Professional Liability Insurance to protect against claims of negligence or malpractice.

Consider getting General Liability Insurance for accidents and property damage, and Cybersecurity Insurance to protect against data breaches. Adequate insurance coverage is essential to protect your business, employees, and clients. Work with an insurance provider who specializes in home health care to ensure you get the right coverage for your needs.

How can we help you?

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Our soft landing solution program is designed to provide thorough planning and seamless execution throughout your relocation journey, ensuring you have everything you need for a smooth transition to the US.

According to our former clients, the process of moving to the US with an E-2 visa typically takes between 3 and 5 months. This time frame includes securing the visa, establishing your business, and relocating. If you’re interested in learning more, request our free guide here.

How to get a home care license in Florida

Getting a home care license in Florida is a detailed and challenging process. Start by submitting a Florida home care license application and paying the required fee, with details available on the Florida Agency for Health Care Administration (AHCA) website.

Preparation is crucial. You must provide comprehensive documentation, including a business plan, and establish policies, procedures, and forms that comply with state regulations. Additionally, hire qualified staff with the necessary training and certifications to meet Florida’s standards.

Understanding state-specific laws and training requirements is essential. While a specific home care certificate is not required, you must understand the necessary policies and procedures to operate legally. This is important as the number of Americans aged 65 and older is expected to rise from 58 million in 2022 to 82 million by 2050, increasing the demand for home care services. Continuous learning and staying updated with industry standards are crucial for compliance.

How to get a home care license in Texas

In Texas, this license is called a Home and Community Support Services Agencies (HCSSA) license. Here’s a step-by-step guide to getting started:

1- Apply for the HCSSA License: Compile a home care license application and submit it to the State of Texas with a fee of $2,625. The initial licensure process can take up to four months.

2- Survey Readiness: After receiving the initial license, your agency has six months to submit for survey readiness, or the license will become void.

3- Research Texas Regulations: Familiarize yourself with the requirements to ensure you are prepared to meet them. Texas mandates that an Administrator and an alternate qualified individual run the home care business. They must have at least a GED, pass a background check, attend eight hours of administrative training, and complete specific modules on the Health and Human Services website.

4- License Renewal: After obtaining the initial license, it needs to be renewed every three years. A state survey of the agency is usually conducted unless the agency becomes accredited through a Certified Accreditation Organization, which can streamline the renewal process.

How to get a home care license in California

California is a top state for employing home health aides. According to the Bureau of Labor Statistics (BLS), it has the highest employment levels for home health and personal care aides and the second-highest concentration of these jobs in the country.

To get a home care license in California, follow the guidelines set by the Home Care Services Branch (HCSB). The HCSB licenses Home Care Organizations, processes applications, responds to complaints, and conducts unannounced visits to ensure compliance. It also manages the Home Care Aide application process and maintains the Home Care Aide Registry.

California’s Home Care Services Consumer Protection Act, effective January 2016, requires Home Care Organizations to be licensed. It also provides an online registry for background-checked Home Care Aides. This law aims to protect elderly and disabled individuals who hire private aides for daily living assistance.

It’s important to distinguish between a home care business and a home health business. A home care business provides nonmedical assistance, like help with daily activities, while a home health business offers medical care. Obtaining a home care license in California allows you to offer nonmedical services. If you want to provide medical services, you will need a different license for a home healthcare business.


Navigating the intricate licensing requirements is a vital step to ensure your business is legally compliant and poised for success. Whether driven by a passion for care or market opportunities, obtaining the appropriate license is essential. Reflecting on the complexities discussed, it is evident that thorough preparation and understanding of state-specific regulations are crucial. If you are considering obtaining a license, consulting with an expert can provide invaluable guidance and streamline the process.

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