Do You Need a License to Run a Non-Medical Home Care Agency?
In most states, yes. How the license depends on the services you offer, what six states actually require, what applications ask for, and how to check your state.
By Caregiver Scheduling Team ·
In most states, yes. Agencies that provide hands-on personal care, such as help with bathing, dressing or toileting, need a state license or registration almost everywhere. Companion and homemaker services are licensed in many states, registered in some, and unregulated in a few. Nursing and other medical services need a separate home health license. The answer depends on your state and on exactly which services you sell.
Which services trigger a license?
Hands-on personal care is the usual trigger.
| Services | Typical requirement |
|---|---|
| Companionship, meals, light housekeeping, errands | Licensed or registered in many states; business license only in some |
| Personal care (bathing, dressing, toileting, transfers) | State license in most states |
| Medication administration, wound care, nursing | Home health agency license, often Medicare certification |
| Referral or registry (family employs the caregiver) | Separate registry license or registration in states that allow it |
Florida shows the split clearly. Its statute defines a homemaker and a companion as people who “may not provide hands-on personal care to a client” (Fla. Stat. 400.462). Companion and homemaker organizations are exempt from licensure but must register with the Agency for Health Care Administration for $50 per biennium (Fla. Stat. 400.509). Hands-on care puts you under the home health agency or nurse registry license.
What do six states actually require?
Every one of these states licenses personal care agencies, and most license companion care too. Fees are initial application fees as published on the state’s own page.
| State | Rule | Who needs it | Initial fee |
|---|---|---|---|
| California | Home Care Organization license, CDSS | Organizations providing non-medical home care; aides must be on the Home Care Aide Registry | $5,603 for two years |
| Texas | Home and Community Support Services Agency license, 26 TAC 558 | Anyone providing “personal assistance services” for pay (558.2) | $2,625 |
| Washington | In-home services agency license, WAC 246-335 | Anyone who employs two or more people to provide home care (246-335-315) | $5,000 per service category for the first 12 months |
| Pennsylvania | Home care agency or registry license, 28 Pa. Code 611 | Agencies supplying personal care, companionship or respite for a fee (611.5) | $100 |
| Florida | Registration for companion and homemaker only; license for hands-on care | See above | $50 per biennium to register |
| Minnesota | Basic or comprehensive home care license, Minn. Stat. 144A.471 | Basic covers bathing, dressing, toileting and medication reminders; comprehensive adds nursing tasks | $2,100 basic, $4,200 comprehensive |
Read the definitions. Washington’s home care services are “nonmedical services and assistance” including personal care (WAC 246-335-410). Pennsylvania puts companionship inside home care services, so companion-only agencies there are licensed. Our agency licensing tool lists every state’s agency, license type and source link with the date it was checked.
Are there states with no license requirement?
A few states do not license private-pay non-medical agencies, and several are debating bills to add one. We list a state as unlicensed only when its own agency says so, so treat any “no license” claim as a prompt to call the state. Medicaid programs, Area Agencies on Aging and long-term care insurers set their own requirements regardless.
What do applications usually ask for?
The same six things in nearly every state, plus a fee and often a survey:
- Business entity documents and ownership disclosure
- Administrator qualifications
- A policies and procedures manual
- Proof of insurance, and a surety or dishonesty bond in some states. Washington asks for $1 million per occurrence of general liability (WAC 246-335-320); California asks for $1 million per occurrence, $3 million aggregate, plus a $10,000 employee dishonesty bond (Health and Safety Code 1796.37)
- Background checks for owners, administrators and caregivers
- Caregiver training or competency requirements. See training requirements by state
How long does licensing take?
From a few weeks for simple registration to several months where there is an on-site survey. Washington gives applicants nine months to finish the steps. See how long it takes to get a license and startup costs.
How do you check your own state?
- Find the agency that licenses home care. It is usually the health department or social services.
- Read the definitions in the regulation: what counts as “personal care” or “home care services”?
- Compare those definitions with your service list, line by line.
- If you are unsure, call the licensing office before you take clients.
Operating without a required license brings fines and stop orders, and insurers, payers and Medicaid will not work with you.
How Caregiver Scheduling handles this
Licensed agencies have to show caregivers were qualified on the day of each visit. Credential tracking records each caregiver’s certifications, background check and training with expiry alerts, and on Growth and up a missing or expired credential blocks assignment. GPS-verified visit records back up your survey file. $199/month for up to 10 caregivers or $299/month for up to 50, free for 30 days.
FAQ
Do I need a license for companion care only? In many states, yes. Florida requires registration instead, and a few states require only a business license. Check your state’s definition of home care.
Is a home care license the same as a home health license? No. Home health covers medical services and is licensed separately, often with Medicare certification.
How much does a home care license cost? From $50 to register in Florida to $5,603 in California. Most states fall between $100 and $5,000, before insurance and bonds.
Can I take clients while my license is pending? Usually not for licensed services. Ask your state.
This article is general information, not legal advice. Check your state’s licensing rules.