Starting a Pennsylvania Home Health or Home Care Agency?

This page addresses three principal options:

• Medicare-certified Home Health Agency — a Pennsylvania-licensed skilled home health agency that has also completed federal Medicare certification.
• State-licensed Home Health Agency — provides skilled nursing and at least one other therapeutic service under Chapter 601 but is not Medicare certified solely because it holds a state license.
• Home Care Agency or Home Care Registry — provides or arranges non-medical home care services under Chapter 611.

The Pennsylvania Department of Health, Division of Home Health, licenses Home Health Agencies and Home Care Agencies/Home Care Registries. Home Health Agencies are governed primarily by 28 Pa. Code Chapter 601; Home Care Agencies and Home Care Registries are governed by 28 Pa. Code Chapter 611.

A Home Care Agency supplies, arranges, or schedules its employees to provide home care services. A Home Care Registry supplies, arranges, or refers independent contractors to provide home care services. The Pennsylvania license states whether the provider is licensed as an agency, a registry, or both.

Yes, unless a specific legal exception applies. Chapter 611 prohibits an entity from operating or holding itself out as a Home Care Agency or Home Care Registry without first obtaining a Department of Health license. Each physical location must be separately licensed and is subject to inspection.

Chapter 611 currently specifies a $100 application or renewal fee for each separately licensed Home Care Agency or Home Care Registry location. The fee is not refundable, rebated, or prorated. Applicants should verify the current amount and payment instructions before submission.

The Department implemented an online initial-application process. Its current instructions state that mailed or emailed HCA/HCR initial applications are no longer accepted effective March 31, 2026. Applicants should use the Department's current online application page and follow all portal instructions.

Requirements depend on the applicant's entity, ownership, proposed license type, physical location, personnel, and services. Applicants should expect to provide business and ownership information, the physical location, administrator or contact information, criminal-history information, policies and procedures, service and consumer materials, worker-qualification processes, and other supporting documents requested by the Department.

The applicant remains responsible for supplying complete and accurate company and personnel information.

Chapter 611 home care services include personal care, assistance with instrumental activities of daily living, companionship, respite care, and specialized care. Personal-care examples include assistance with self-administered medications, feeding, oral and skin care, shaving, ambulation, bathing, grooming, dressing, toileting, and transfers.

No. Chapter 611 applies to non-medical home care agencies and registries. It does not independently authorize the provider to operate as a Home Health Agency, furnish skilled home health services beyond the permitted non-skilled scope, or bill Medicare as a certified Home Health Agency.

Chapter 611 does not impose a blanket requirement that every non-medical Home Care Agency or Registry employ an RN solely to hold the license. The provider must remain within the non-skilled scope and ensure that every direct care worker is competent for assigned duties. Medicaid waiver participation, contracts, specialized services, or another program may impose additional clinical or supervisory requirements.

Before assignment or referral, a direct care worker must hold an applicable Pennsylvania nursing license, pass a compliant competency examination, or complete an accepted training program. The required subjects include confidentiality, consumer control, instrumental activities of daily living, recognizing changes, infection control, universal precautions, emergencies, documentation, abuse and neglect reporting, and difficult behaviors. Workers providing personal care need additional competency in the personal-care tasks listed in Chapter 611.

Chapter 611 requires criminal-history checks for direct care workers, office staff, and owners. Individuals who have resided in Pennsylvania for the preceding two years generally obtain a Pennsylvania State Police criminal-history record. Individuals who have not met that residency period generally require a federal criminal-history record and a Pennsylvania Department of Aging letter of determination.

A Home Care Agency or Registry serving consumers under age 18 must obtain the applicable ChildLine verification for direct care workers, office staff, and owners as required by Chapter 611. The provider must retain the required records and may not employ, roster, or retain a person prohibited by the verification.

Before consumer contact, direct care workers and other staff or contractors with direct consumer contact must document screening showing they are free from active tuberculosis. The screening must follow applicable CDC guidance, may not be more than one year old at the start date, and must be updated at least every 12 months.

Pennsylvania defines a Home Health Agency as an organization staffed and equipped to provide skilled nursing care and at least one other therapeutic service—home health aides, physical therapy, speech therapy, occupational therapy, or medical social services—on a part-time or intermittent basis in a person's residence.

No. Pennsylvania state licensure is required for federal Home Health Agency certification, but it is not the same as Medicare certification. An agency seeking Medicare participation must complete the separate federal enrollment, certification, survey, and compliance process.

The Department does not publish a guaranteed completion time for every application. Its Home Health Agency instructions state that timing depends on the accuracy of the information provided. Overall timing can also be affected by application completeness, corrections, background information, inspections, survey readiness, and—when applicable—Medicare or accreditation steps.

• Logo creation and a customized WordPress website.
• One year of website hosting and domain registration.
• 500 business cards and 500 tri-fold brochures.
• Pennsylvania-specific policy manuals, human-resources documents, admission documents, and operational forms.
• Preparation assistance for the applicable Pennsylvania license application.
• Members' area access, document customization, ongoing guidance, and applicable updates.

No. Department of Health fees, background checks, ChildLine clearances, fingerprinting, insurance, rent, utilities, personnel costs, Medicare enrollment, accreditation, and other government or third-party expenses are separate unless expressly included in writing.

Home Health Forms provides customized documents, startup guidance, and application-preparation assistance. The Pennsylvania Department of Health makes state licensing decisions, and the appropriate federal authorities determine Medicare enrollment and certification. Approval and processing times cannot be guaranteed. 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 Home Health Forms receives all company information needed for customization. Website development, printing, shipping, and other package components may have separate timelines.

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