Home care agencies continue to grow in popularity due to our aging population and preference of many older Americans to be cared for in their homes. Starting a home care business to meet this great demand for in-home care may potentially be a rewarding business enterprise.
Skilled home health agency vs. non-medical home care agency
Initially it is very important to understand the distinction between starting a medical skilled home health agency versus a non-medical home care agency. 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 then 3rd party billing sources are the most common form of payment for non-medical care.
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 including Medicare and Medicaid certifications. Most newcomers to this field are more likely to consider the less complicated non-medical home care venture with typically lower start-up costs. The focus here is aimed at this non-medical home care agency start-up.
Starting a non-medical home care agency
Your next decision is whether to start a home care business on your own or team up with a home care franchise. There are pros and cons for both but basically franchise fees provide a business model along with start-up guidance and ongoing support. Launching out on your own usually has lower start-up costs without entry or re-occurring franchise fees, less hand-holding but more independence with business strategies. When electing the independent option, write a detailed plan of how you will start, operate, and grow your business.
Training and medical background
Formal training or a medical background is not required for owning and managing a home care agency. Many healthcare workers find this business endeavor attractive due their experience but it is 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 home care 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 below.
Basic Requirements and Advice
Some basic requirements apply to starting a home care business similar to that of most other businesses including the following:
1. Set up Business Entity
Set up the business entity that will best fit your needs. (Sole proprietor, Partnership, Limited Liability Company, S Corporation, C Corporation) Consult with an attorney and or CPA or research online on your state government website (www.state.(your state initials).us about appropriate business structure, info regarding payroll, sales tax, workers compensation and business liability insurance.
2. Obtain Employer ID Number
Obtain a Federal Employer Identification Number (EIN) from the IRS (IRS form SS-4) similar to your personal social security number to identify your business with regards to tax liability
3. Register with Secretary of State
Register your business with Secretary of State in your state. Decide on a business name and check availability in your state including consideration for domain name for website. When approved have letterhead, business cards, brochures printed.
4. Check on license requirements
Check on requirements for city or county business license and apply as needed
5. Prepare your finances
Establish a 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.
6. Write or buy a Policy and Procedures Manual
Write or purchase a policy and procedures manual to address new client admissions, plan of care, scheduling, employee and payroll records, orientation, in-service training, client billing.
7. Find and hire caregivers
Find and hire the best 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 nursing programs and local newspapers.
8. Connect with referral sources
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.
9. Build a website
Hire a website designer to create a professional website with content 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.
10. Find an office space
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.
11. Be creative with scheduling
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.
12. Attitude is everything!
Be resourceful in managing day to day operations. Be thoughtful and respectful to your employees. Be understanding and accomodating to 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.
About the Author
Clare Absher is a Registered Nurse with 44 years of experience. Most of her experience is in home health serving as a caregiver, educator, patient advocate, and liaison between families and community resources. She has also worked in acute care, assisted living, and retirement settings. She is passionate about helping families care for their elderly loved ones at home.
State Licensing Contacts
Alabama
Alabama Department of Human Resources
Public Information Number: 1-334-242-1310
http://www.dhr.state.al.us/
Alaska
Alaska Department of Health and Social Services
Public Information Number: 1-907-465-3030
http://www.hss.state.ak.us/
Arizona
Arizona Department of Economic Security
Public Information Number: 1-602-542-4791
http://www.de.state.az.us/
Arkansas
Arkansas Department of Human Services (ADHS)
Public Information Number: 1-501-661-2201
http://www.arkansas.gov/dhhs/homepage.html
California
California Department of Social Services
Public Information Number: 1-916-455-6951 or 1-916-654-3345
http://www.dss.cahwnet.gov/
Colorado
Colorado Department of Human Services
Public Information Number: 1-303-866-5700 or 2-1-1
http://www.cdhs.state.co.us/
Connecticut
Connecticut Department of Social Services
Public Information Number: 1-800-824-1508
http://www.ct.gov/dss/site/default.asp
Delaware
Delaware Department of Health and Social Services
Public Information Number: 1-302-577-4502
http://www.dhss.delaware.gov/dhss/
District of Columbia
D.C. Department of Human Services
Public Information Number: 1-202-INFO-211 (1-202-463-6211)
http://www.dhs.dc.gov/
Florida
Florida Agency for Health Care Administration
Public Information Number: 1-850-488-1295
http://www.fdhc.state.fl.us/
Georgia
Georgia Department of Human Resources
Public Information Number: 1-404-651-6314
http://www.dhr.state.ga.us/
Hawaii
Hawaii Department of Human Services
Public Information Number: 1-808-586-4997
http://www.hawaii.gov/dhs
Idaho
Idaho Department of Health and Welfare
Public Information Number: 1-208-334-6558
http://www.healthandwelfare.idaho.gov/
Illinois
Illinois Department of Human Services
Public Information Number: 1-217-557-1601
http://www.dhs.state.il.us/
Indiana
Indiana Family and Social Services Administration
Public Information Number: 1-317-232-7020
http://www.in.gov/fssa
Iowa
Iowa Department of Human Services
Public Information Number: 1-515-281-3147
http://www.dhs.state.ia.us/
Kansas
Kansas Department of Social and Rehabilitation Services
Public Information Number: 1-785-296-3271
http://www.srskansas.org/
Kentucky
Kentucky Cabinet for Health and Family Services
Public Information Number: 1-502-564-7042
http://chfs.ky.gov
Louisiana
Louisiana Department of Social Services
Public Information Number: 1-225-342-7475
http://www.dss.state.la.us/
Maine
Maine Department of Health and Human Services
Public Information Number: 1-207-287-3707
http://www.maine.gov/dhhs/
Maryland
Maryland Department of Human Resources
Public Information Number: 1-800-332-6347 or 1-410-767-7109
http://www.dhr.state.md.us/
Massachusetts
Massachusetts Department of Social Services
Public Information Number: 1-617-748-2000
http://www.mass.gov/dss
Massachusetts Executive Office of Health and Human Services
Public Information Number: 1-617-727-7600
http://www.mass.gov/eohhs
Michigan
Michigan Department of Community Health
Public Information Number: 1-517-373-3740
http://www.michigan.gov/mdch
Minnesota
Minnesota Department of Human Services
Public Information Number: 1-651-296-6117
http://www.dhs.state.mn.us/
Mississippi
Mississippi Department of Human Services
Public Information Number: 1-800-345-6347 or 1-601-359-4480
http://www.mdhs.state.ms.us/
Missouri
Missouri Department of Social Services
Public Information Number: 1-800-735-2466 or 1-573-751-4815
http://www.dss.mo.gov/
Montana
Montana Department of Public Health and Human Services
Public Information Number: 1-406-444-5622
http://www.dphhs.mt.gov/
Nebraska
Nebraska Health and Human Services System
Public Information Number: 1-402-471-9433
http://www.hhs.state.ne.us/
Nevada
Nevada Department of Human Resources
Public Information Number: 1-775-687-4000
http://dhhs.nv.gov/
New Hampshire
New Hampshire Department of Health and Human Services
Public Information Number: 1-603-271-4685
http://www.dhhs.state.nh.us/
New Jersey
New Jersey Department of Human Services
Public Information Number: 1-609-292-5325
http://www.state.nj.us/humanservices
New Mexico
New Mexico Children, Youth and Families Department
Public Information Number: 1-505-827-7602
http://www.cyfd.org/
New Mexico Human Services Department
Public Information Number: 1-505-827-7750
http://www.hsd.state.nm.us/
New York
Office of Children & Family Services
http://www.ocfs.state.ny.us/
New York State Department of Health
Public Information Number: 1-518-474-5422
http://www.health.state.ny.us/
North Carolina
North Carolina Department of Health and Human Services
Public Information Number: 1-919-733-4534
http://www.dhhs.state.nc.us/
North Dakota
North Dakota Department of Human Services
Public Information Number: 1-701-328-2310
http://www.nd.gov/humanservices/
Ohio
Ohio Department of Job and Family Services
Public Information Number: 1-614-466-6282
http://jfs.ohio.gov/
Oklahoma
Oklahoma Department of Human Services
Public Information Number: 1-405-521-3646
http://www.okdhs.org/
Oregon
Oregon Department of Human Services
Public Information Number: 1-800-422-6012 or 1-503-945-5944
http://www.oregon.gov/DHS/index.shtml
Pennsylvania
Pennsylvania Department of Public Welfare (DPW)
Public Information Number: 1-717-787-2600
http://www.dpw.state.pa.us/ServicesPrograms/
Rhode Island
Rhode Island Department of Human Services
Public Information Number: 1-401-462-2121
http://www.dhs.state.ri.us/
South Carolina
South Carolina Department of Health and Human Services
Public Information Number: 1-803-898-2500
http://www.state.sc.us/dss/
South Carolina Department of Social Services
Public Information Number: 1-803-898-7601
Tennessee
Tennessee Office of Licensure
Public Information Number: 1-615-532-6590
http://www.tn.gov/mental
Texas
Texas Health and Human Services Commission
http://www.hhsc.state.tx.us/
Utah
Utah Department of Health
Public Information Number: 1-801-538-6101
http://www.health.state.ut.us/
Utah Department of Human Services
Public Information Number: 1-801-538-4001
http://www.dhs.state.ut.us/
Vermont
Vermont Agency of Human Services
Public Information Number: 1-802-241-2220
http://www.ahs.state.vt.us/
Virginia
Virginia Department of Medical Assistance Services
Public Information Number: 1-804-786-7933
http://www.dmas.virginia.gov/
Virginia Department of Social Services
Public Information Number: 1-804-692-1901
http://www.dss.state.va.us/
Washington
Washington Department of Social and Health Services
Public Information Number: 1-360-902-7800
http://www1.dshs.wa.gov/
West Virginia
West Virginia Department of Health and Human Resources
Public Information: 1-304-558-0684
http://www.wvdhhr.org/
Wisconsin
Wisconsin Department of Health and Family Services
Public Information Number: 1-608-266-9622
http://www.dhfs.state.wi.us/
Wyoming
Wyoming Department of Health
Public Information Number: 1-307-777-7656
http://wdh.state.wy.us/main/index.asp
