Open a Home Health Care Agency21st Century Health Care Consultants specializes in understanding industry standards, regulations, federal, state and Medicare compliance and accreditation requirements.

Our New Agency Start-up Program is designed to assist and provide you with everything needed to open a Home Health Care agency. We enable you to provide a wide range of health and social services to persons recovering from an illness, injury, or persons who are disabled and/or chronically ill. Our start-up program will enable your agency to provide medical services such as nursing, social services, and therapeutic treatments (physical, speech, occupational therapy). We can also assist you with opening a Non Medical Home Health Care Agency providing non-medical personal and companion care services.

The recent and ongoing changes for state licensing standards, regulatory requirements and accreditation standards can make opening a new home health care agency very challenging. At 21st Century, we simplify the process, we have an extensive training program and assist you in all areas required to operate your home health care agency successfully.

Home health care services provide the ideal solution. Professional and non-medical agencies providing in-home care for seniors are currently serving less than one percent of this significant growth group. This offers a tremendous opportunity, 99% of the senior population to be exact, to be served by your home health care agency.

21st Century Health Care Consultants is a premier resource for Home Health Care agency start-ups. Established in 1995, we have assisted well over a thousand home health care agencies. We are experts at taking our client visions and transforming them into compliant, successful, rewarding, and profitable Home Health Care Agencies.Owning a Home Health Care Agency is an extremely rewarding profession. Few businesses offer this level of appreciation from those they serve or the satisfaction of providing a much needed service.

We provide a full range of support services for our Clients, whether an existing or a opening a health care agency, we are the experts in helping individuals open home health agencies, from the corporate or limited liability set up, to the final stages of successfully operating as a Medicare accredited and certified home health care agency. We are also experts assisting our agencies in meeting all required operational standards.

These are highly regulated by the state and federal government. We are well versed in the difficult process of launching a new agency, helping create or re-focus business plans, articulating organizational needs, and the customization of all licensure and procedures so that from start-up, your organization is thriving and moving forward.

Starting Your Own Home Care Agency

Opportunities to open home care agencies continue to grow due to the aging population and preference of many older Americans to be cared for in their homes. Starting a home care agency to meet this great demand for in-home care may potentially be a rewarding business enterprise.

A home health Care business offers helpful services for needing people, especially the elderly. The home health business owner can go to the patient’s home and provide services.

Initially it is very important to understand the distinction between starting a medical skilled home health agency versus a non-medical home care agency. Medical skilled home health agencies as the name implies administer skilled licensed nursing and rehab therapy services under physician’s orders with strict guidelines imposed. Medical home health agencies require extensive licensures that could include Medicare and Medicaid certifications. Basically non-medical home care services include personal care, assistance with daily living activities, meal preparation, housekeeping and transportation. Such services are often vital for folks to remain safe and comfortable in their homes. Private pay rather than 3rd party billing sources are the most common form of payment for non-medical care.

Your next decision is whether to start a homecare business on your own or team up with a home care franchise. By choosing a Franchise company you will be subject to franchise fees and must abide by a franchise operating agreement. This includes re-occurring franchise fees and territory restrictions. Starting a homecare business on your own will have lower start-up costs and right to provide services in all counties permitted in which your state license allows.

Formal training or a medical background is not required for owning and managing a home care agency. Many healthcare workers often find this business endeavor attractive due to their experience but by no means a prerequisite. Strong communication and organization skills with a well planned business strategy are more fundamental to success. Licensure requirements vary widely from state to state for non-medical homecare agencies however are generally not so complex to discourage many from undertaking. Start by contacting your state licensing board to request a package or kit detailing all requirements. See lists of state contacts.

What is Needed to Open a Home Health Care Agency

Starting a home health business is a demanding task, as legal registration and permits for running the business are required. The owner also needs to plan out the services that are offered by the home health business for needing patients or the elderly.

Hiring a Home Health Care Consultant

Consider hiring a Home Care Consultant that is knowledgeable about setting up home health care agencies in your state. A good consultant can simplify the process and can expedite the licensing process, train your personal on how to operate the agency and develop all the manuals that you will need in order to comply with state and federal laws.

Registrations for opening a Home Health Care Agency

The home health business needs to be registered to be a legally operating business in the United States. According to, each state has a set of requirements or rules regarding business registration. While some states require all businesses to be registered with the secretary of state in the given state, others ask that smaller businesses be registered on a county level rather than state. You will need to register the home health business on the level required by the state laws in the given state. Set up the business entity that will best fit your needs. (Sole proprietor, Partnership, Limited Liability Company, S Corporation, C Corporation)

Permits and Licenses required to open a Home Health Care Agency

Permits and home health care licenses are required for a home health business. The permits and home health care license requirements will differ for each state, so contact the secretary of state to get the proper list for the given state. The business also requires local permits, which can include a health permit from the county’s health department and an occupational permit from the county’s building and planning department.

Tax ID and EINs required to open a Home Health Care Agency

To open a home health agency you will need to apply for tax IDs and licenses. Contact the IRS to apply for an employer ID number, also known as an EIN. The business owner also needs a state tax permit, which can be obtained from the secretary of state’s office upon registration. The state tax permit covers income taxes and employment taxes for the business should it require additional assistance.

Office and Communications requirements to open a Home Health Care Agency

Having an office is another thing the home health care business owner may need. The business office has a computer, telephone, e-mailing system, fax machine and patient files so the patients or elderly can contact the home health care during opening hours. Establish as business checking account and credit card account and apply for business loans if required to meet start-up costs. Set up a computerized accounting system. The office is also where the business owner spends time organizing the budget, creating service plans and prepares for visits that must be made for the following day or week on the road. Depending on the services that will be offered, you may need to obtain a lab license or waiver. You may also need to obtain a contract to handle bio-hazardous waste.

Home Health Care Policy and Procedures and all agency operational materials required to open a Home Health Care Agency

We Suggest that you purchase professionally written policy and procedures manuals. These policy and procedures need to be written specifically to include all of your state and federal requirements. If skilled services are provided these policies must include Medicare’s conditions of participation and Accrediting body requirements. You will also be required to have all operational materials such as new patient admission packets, Personal Files, Logs, Forms, In-service Education Plans, Nursing Procedures, Documented minutes for committee meetings, etc.

Hiring Nursing and Caregivers

Find and hire the best Registered nurses and caregivers available as the reputation of your business weighs heavily upon the quality of care delivered. Spend time interviewing prospects and checking references to find most competent, compassionate and resourceful caregivers. Post employment ads on relevant job internet sites, at local community colleges with CNA and local newspapers.

Sources for Patient referrals

Determine best sources for referrals in your area such as connecting with long-term care facilities and hospital discharge social workers. Contact local physicians, senior centers and rehab outpatient centers to reach prospective clients.

Other Suggestions and requirements to open a Home Health Care Agency

Hire a website designer to create a professional with content site directed towards internet savvy adult children of seniors who are responsible for securing home care services. Post your agency listing on established elder care websites with strong internet presence for greatest exposure.

Find a location where care is affordable to population and without excessive competition. Save your money on costly high traffic commercial office space and instead find a cheaper accessible location for your employees.

Be creative with scheduling to manage ever changing balance of employees with client needs. Turning away clients is harmful for future referrals but at same time risking poor care due to lack of staff is equally damaging to a company’s reputation.

Consider joining a your states Home Health Care Association. This is a organization consisting of health care professional that focuses on assisting home health care agencies.

Be resourceful in managing day to day operations. Be thoughtful and respectful to your employees. Be understanding and accommodating with meeting your clients needs. Reflect upon reasons you started your own business in the beginning and when times are tough and take time to savor the small accomplishments along the way.

Our Lifetime Training Support Program

Click here for a description of Our Training Program

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CHAP Community Health Accreditation Program

ACHC Accreditation Commission for Health Care

  • Founded in 1965, CHAP is the oldest community-based accreditation program with the most experience of any other accrediting organization and the oldest national community-based accrediting body.
  • Only community-based standards by and for the industry
  • CHAP standards are relevant to community-based care and aren’t retrofitted from standards created for institutions or facility-based care providers.
  • Medicare Deeming Authority for Home Health and DMEPOS.
  • ACHC standards were written by providers specifically for the services that you provide so they are relevant, realistic and easy to understand.
  • ACHC provides accreditation for a variety of programs.
Community Health Accreditation Program (CHAP)
Phone: 1-800-656-9656
Accreditation Commission for Health Care (ACHC)
Phone: 1-919-785-1214