Starting a home care business means deciding what kind of care you will offer, meeting your state's licensing rules, hiring and screening caregivers, and finding your first clients. Rules differ a lot by state, so check with your state agency and a lawyer early. This guide is an overview of the decisions, not legal advice.
1. Decide what type of care you will offer
“Non-medical home care usually covers companionship, personal care help, meal preparation, light housekeeping and transportation. Home health care involves medical services and is regulated more heavily. The type you choose changes your licence, insurance and staffing.”
2. Learn your state's rules
Some states license non-medical home care agencies and some do not. Contact your state health or aging department and ask what applies to you. Ask about registration, background checks, training requirements, record keeping and inspections. Do not guess.
3. Choose a business structure and register
Speak to an accountant or lawyer about the structure that suits you, then register the business, get a tax ID and open a business bank account. Keep personal and business money separate from day one.
4. Insurance
Ask an insurance broker who works with home care about general liability, professional liability, workers' compensation and coverage for caregivers' vehicle use. Your state or your clients' payers may require specific coverage.
5. Write the plan and the numbers
List startup costs and running costs using quotes, not guesses. Plan for the time between hiring caregivers and receiving payment. Decide how you will price care hours and who pays: private clients, long-term care insurance, or programs that have their own enrollment requirements.
6. Hire and screen caregivers
Set a screening process: application, interview, references, background checks as required, and training. Write clear policies on schedules, supervision, call-offs and client safety.
7. Set up systems
You will need scheduling, time tracking, client records, billing and secure document storage. Choose software that fits your state's record rules and protects client privacy.
8. Find your first clients
Families search online and ask their doctors and friends. Start with a simple website, a complete Google Business Profile and a referral plan for discharge planners, doctors' offices and senior living communities. See our guide to home care agency marketing for what to build first.
9. Start small and learn
Begin with a limited service area and a few clients so you can fix problems before you grow. Ask families for feedback and keep notes on what to change.
Frequently asked questions
How do I start a home care business?
Choose the type of care, check your state's licensing rules, register the business, arrange insurance, hire and screen caregivers, set up systems and build ways for families to find you.
Do I need a licence to start a home care agency?
It depends on your state and the type of care. Contact your state health or aging department and a lawyer before you take clients.
How do I get my first home care clients?
Through a clear website, a complete Google profile, referral relationships with discharge planners and doctors' offices, and word of mouth.
