How to Start a Home Healthcare Agency in Pennsylvania

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Home healthcare agencies in Pennsylvania make it possible for frail and elderly people to remain in their own homes for as long as possible. The need for home care is increasing as people are living longer and farther away from adult children. Providing care at home is a cost-effective strategy that results in fostering the independence of Pennsylvania's elderly citizens. The state has strict regulations and guidelines to ensure that safe, competent care is provided.

The Commonwealth's health department website  is a rich source of information about starting a home healthcare business.
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Contact the Pennsylvania Department of Health for an Initial Application for Home Care Agency and Licensure as a Home Health Care Agency or Registry packet. The applications are available by mail or can be downloaded from the Pennsylvania Department of Health website.

Request or download the following documents: Consumer Notice of Direct Care Worker Status, Initial Home Care Agency/Registry Licensure Application Checklist, Pennsylvania Disclosure of Ownership form, Pennsylvania Civil Rights Survey form, Information Requested of Health Care Providers Applying for a License form, Home Care Agency/Registry Licensure Survey, and Rules and Regulations for Home Health Care Agencies packets.

Complete the Initial Application for Home Care Agency form and submit it to the Pennsylvania Department of Health. A check or money order for $250 (as of August 2010) must be submitted with the application.

Join the Pennsylvania Home Care Association (PHCA). Membership costs vary. Since you are starting a new business, expect to pay $1,000 for a one-year membership. PHCA can help you develop a comprehensive business plan and assist you during your application process. The U.S. Small Business Administration (SBA) and SCORE also provide excellent free or low-cost services to assist with creation of business plans. Your business plan must include market analyses and marketing plans, financial plans, and information about the structure of the business.

Obtain business permits Contact your county government for assistance with this step.

Obtain financing. Check with your local bank and chamber of commerce. The SBA and local chambers of commerce may also be able to provide assistance regarding loans or grant money for your home health care agency.

Purchase the Pennsylvania Home Care Association program "The Road to Compliance" to guide you through the licensing process. It consists of a book, CD, and sample competency test. The cost is $225 for members or $500 for non-members. Consider hiring a registered nurse consultant to assist you with development of forms and manuals required for licensure.

Determine what services you'll provide. Skilled services include nursing care and medical social work. Physical, occupational, and speech therapies are considered skilled services as well. Home health-aide services are considered unskilled services. Your agency may offer one or all these types of services. Specific regulations govern each type of service provided.

Develop office manuals. Include a mission statement, organizational chart, and procedures for handling client complaints, including exploitation, neglect, and abuse. Develop privacy statements in compliance with federal laws. Create a fee schedule. Contact the county, state, and federal departments of emergency management. You will need to develop a plan for providing care and assessment of client needs in emergencies such as storms and power outages. Create a plan to register clients as directed by your authorities. The health department and the Federal Emergency Management Agency (FEMA) websites provide information about emergency management.

Decide whether the business will function as a home health registry or as an agency. Registries subcontract independent home care providers. Agency workers are employees of the business. DIscuss your options with an attorney and peers in the Pennsylvania Home Care Association.

Complete and submit the Initial Home Care Agency/Registry Licensure Application Checklist, Pennsylvania Disclosure of Ownership form, Pennsylvainia Civil Rights Survey form, and Home Care Agency/Registry Licensure Survey to the health department.

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Prepare a separate packet following instructions provided in the Information Requested of Health Care Providers Applying for a License packet. Submit this packet to the health department's legal team for review. If you are unclear about what is being requested, contact the legal team by phone at 717-783-2500.

Meet with a surveyor from the health department at your place of business to review policies and procedures. These include hiring, infection control, education, abuse, and emergency management protocols. Your business structure will be reviewed. Contact information regarding customer complaints will be examined. This takes from several hours to several days to complete. The reviewer will make recommendations to ensure compliance. When all criteria are met, you will be granted your home health care license.


  • Home care relies heavily on referrals. Initial business may be slow.

    Networking with noncompetitive healthcare providers is essential to increasing your presence in the community.


  • Licensure takes several months of preparation. Delays in obtaining licensure are common. Be flexible about your opening date. If skilled services are offered, specific employees, such as a director of nurses, may be required. If offering skilled services, you need to decide if you'll accept Medicare. If you will, then additional federal regulations will need to be met.


About the Author

Patricia Bratianu has been combining mainstream healing modalities with alternative therapies for more than 30 years. She has has been writing about health and nature for health care professionals as well as the general public for 20 years. A board-certified holistic registered nurse, Bratianu was granted a Ph.D. in natural health with high honors from Clayton College of Natural Health.

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