How Do I Become Licensed to Open a Home Health Care Agency?

Home health agencies are organizations that send trained nurses and other health care providers to care for patients in their homes after they leave the hospital. Hospitals, private clinics or for-profit organizations operate home health agencies; their structure and organization vary, as do state requirements for licensure. Understanding how a home health agency becomes licensed involves getting a clearer picture of requirements and time frames; contact your state department of health for specific details.

Pre-application Requirements

• Although requirements for licensure vary from state to state, there are a few common items that state departments of health generally require from home health agencies before they apply for state licensure. For example, both Texas and Virginia departments of health require that a home health agency completes a certificate of need process. This process proves that the community has a need for the services the agency provides, or that any agencies already operating in the area are not fulfilling the need that exists. A business license and a federal tax identification number are two additional requirements a home health agency will need to obtain before applying for state licensure. Some states--such as Texas--ask that home health agencies schedule a review by an accrediting body like the Joint Commission.

Application Requirements

• States vary on application requirements for licensure of home health agencies, but as a general rule, home health agencies usually must demonstrate financial health, an organizational chart, proof of need (in some states), proof of accreditation (in some states), professional histories of leadership and staff, tax status, a business plan and a detailed explanation of the services the agency plans to provide. For examples of forms available, see references.

Other Requirements

• All states, no matter their stance on other requirements, mandate a site survey of the agency as part of the application process. State department of health staff audit the agency to ensure that its staff have the necessary expertise to provide services as described, and that the organization is healthy and follows applicable laws and regulations. Some states--such as Texas and Virginia--ask for home health agencies to describe how they will maintain staff knowledge through continuing education activities; others, like Pennsylvania, ask for details about what home health agency staff will do should patients they care for require transfer to hospital care.

Time Frames

• Because state requirements vary, the expected time frames that applications will require are widely variable; however, most stages of the application process require anywhere between 30 and 45 days for review and approval. Business licenses, tax identification numbers, certificates of need, and accreditation by outside quality organizations can take longer.