Starting a New Mexico Home Health or Personal Care Agency?

• New Mexico Home Health Agency — an HCA-licensed provider offering one or more medically directed home health services and, when desired, separately pursuing Medicare certification and Medicaid enrollment.
• New Mexico Personal Care Agency — a private-pay provider limited to non-medically directed services, with separate Medicaid or waiver approval when applicable.

Yes. An agency providing at least one medically directed home health service must obtain a license from the New Mexico Health Care Authority under 8.370.22 NMAC.

The New Mexico Health Care Authority, Division of Health Improvement, administers Home Health Agency licensing and surveys.

The initial submission includes a letter of intent, application and fee, functional program outline, required policies and procedures, and an annotated copy of 8.370.22 NMAC showing where each rule requirement appears in the agency’s policies.

After HCA approves the initial materials, it may issue a temporary license. The agency may then admit patients and must request its initial survey once it is operational with a patient.

The governing body appoints a qualified administrator and written alternate. Professional services must be directed and provided by personnel holding the applicable New Mexico licenses.

The licensed agency separately completes CMS enrollment, federal materials, OASIS readiness, the Conditions of Participation, and an initial certification survey through the state survey agency or a CMS-approved accrediting organization.

No. Medicaid enrollment is separate. The agency must satisfy current provider screening, service authorization, documentation, EVV, managed-care, and billing requirements.

An organization providing only non-medically directed services is excluded from the Home Health Agency definition in 8.370.22 NMAC and therefore does not obtain an HHA license solely for that private-pay scope.

A nonmedical scope commonly includes assistance with grooming, bathing, dressing, mobility, toileting, meals, homemaking, errands, transportation, and companionship. Skilled nursing and therapy require appropriate professional authority and HHA licensure.

Training should match assigned duties and cover client rights, confidentiality, infection control, emergencies, incident reporting, documentation, service plans, safe assistance techniques, and scope limits. Medicaid and waiver programs may impose additional competency requirements.

Yes. A documented assessment and service plan support appropriate staffing, authorized tasks, scheduling, risk controls, emergency contacts, client preferences, supervision, and periodic review. Medicaid programs use their own assessment and authorization processes.

Program-specific screening applies, particularly for Medicaid and waiver services. Agencies should verify all applicable criminal-history, abuse-registry, exclusion, professional-license, payer, and client-safety screening before assignment.

Provide the service agreement, rights and responsibilities, complaint process, fees and payment terms, authorized services, schedule, emergency contacts, privacy information, scope limitations, cancellation terms, and acknowledgment or consent documents.

The agency should use a written supervision schedule based on client risk, worker competency, complaints, incidents, payer contracts, and program standards. Medicaid or waiver participation may establish specific monitoring requirements.

An annual HHA license is valid for one year. The renewal application and fee are due at least 30 days before expiration, and renewal includes an onsite survey.

No. Medicaid and waiver participation require separate provider enrollment or certification, agreements, screening, service authorization, documentation, quality, billing, and other program-specific requirements.

EVV applies to covered New Mexico Medicaid personal care and home health services delivered in the home. Providers must follow current HCA and managed-care requirements for visit capture, exceptions, corrections, documentation, and claims.

Licensed HHAs must maintain the quality, emergency, complaint, patient-safety, and operational systems required by 8.370.22 NMAC. Personal care agencies should also maintain documented quality and emergency procedures, with additional requirements for Medicaid or waiver participation.

• Logo creation, customized WordPress website, one year of hosting, and domain registration.
• 500 business cards and 500 tri-fold brochures.
• New Mexico-specific policies, human-resources documents, admission or client-service documents, and operational forms.
• New Mexico HCA licensure and CMS preparation for the HHA package, or private-pay operational readiness and optional Medicaid or waiver preparation for the Personal Care package.
• Members' area access, customization, ongoing guidance, and applicable updates.

No. Licensing and government fees, required public notices, accreditation, background checks, insurance, local approvals, office, personnel, EVV, survey expenses, software, mailing, and other third-party costs are separate unless expressly included in writing.

Home Health Forms provides customized documents, guidance, and preparation assistance. New Mexico HCA, CMS, Medicaid, managed-care organizations, survey organizations, accreditors, and other payers make their own decisions. Home Health Foms provides guidance and documents that meet regulatory requirements to ensure your success.

Customized policy manuals, forms, and related digital documents are generally emailed within five business days after all customization information is received. Website, printing, shipping, and other components may have separate timelines.

Eligibility depends on work completed, customized materials produced, digital products delivered, third-party expenses paid, printing ordered, and other services already performed.