Starting a home health agency: questions, answered

The federal Conditions of Participation set qualifications for roles such as the administrator and the clinical manager. The clinical manager must be a licensed physician, physical therapist, speech-language pathologist, occupational therapist, audiologist, social worker, or registered nurse. The administrator has separate qualification options that can include a physician, a registered nurse, or an undergraduate degree with the required experience. They do not, as we read them, tie ownership itself to a nursing license. Your state may have its own rules; check your state and ask counsel.

Some founders plan for both. Whether that needs separate entities, licenses, policies or staff depends on your state and your structure; check your state and ask counsel.

No. CMS lists home health agencies and hospices as separate provider types, each with its own certification rules. This site covers home health only.

A federal requirement a home health agency must meet to take part in Medicare. The home health conditions are in 42 CFR Part 484.

Medicare.gov says Medicare does not pay for custodial or personal care when that is the only care needed, or for homemaker services unrelated to the care plan.

No. A state Medicaid personal care or waiver program is a separate state path. becomemedicaidprovider.com, also published by Home Care Agency Blueprint, covers enrollment.

Do not assume so. Federal rules say licensure applies as required by the state. Check your current state rules with your state licensing or survey agency.

The Outcome and Assessment Information Set, an assessment instrument CMS uses for home health. Certified agencies report OASIS data; confirm current requirements in CMS materials.

We do not publish timelines. Ask CMS and your state survey agency about the current process.

Home Care Agency Blueprint, which sells courses and coaching to people starting home care agencies. We say so on every page so you can weigh our perspective.