Starting a Virginia Home Health or Personal Care Agency?

This page presents three common startup paths:

• Virginia Medicare Home Health Agency — skilled home health services with Virginia approval and federal Medicare certification.
• Virginia Home Health Agency — skilled home health services without Medicare billing.
• Virginia Home Care Agency Non-Medical — personal care services provided in a client's residence.

Virginia generally regulates these providers as Home Care Organizations, while the services offered and Medicare status determine the additional requirements that apply.

The Virginia Department of Health, Office of Licensure and Certification licenses and inspects Home Care Organizations. Virginia's primary HCO regulations are found in 12VAC5-381.

Virginia Department of Health states that, effective May 22, 2025, the triennial fee for a Home Care Organization license is $1,500. State fees may change, so applicants should confirm the amount before submitting payment.

Requirements depend on the applicant, ownership structure, location, and proposed services. The application process generally requires:

• A completed application and licensing fee.
• Business, ownership, governing-body, and organizational information.
• Identification and qualification information for required personnel.
• Policies and procedures appropriate to the services the agency will provide.
• Information about the agency's office, service area, regular business hours, and 24-hour on-call arrangements.
• Proof of required initial reserve operating funds.
• Required insurance, background-check, and supporting documentation.
• Successful completion of the applicable licensure review and inspection process.

Yes. The governing body must appoint an administrator who has at least one year of training and experience in direct health care service delivery and at least one year, within the last five years, of supervisory or administrative management experience in home health care or a related health program.

The organization must have an operational business location with regular posted business hours, maintain required records, permit VDH access for inspections, and post its current license for public inspection. Whether a residence may be used depends on whether it satisfies state operational requirements and all applicable zoning, lease, deed-restriction, homeowners-association, occupancy, and local requirements.

Processing time varies with application completeness, document review, applicant readiness, inspection scheduling, and correction of deficiencies. Medicare certification or accreditation adds separate steps. Home Health Forms does not guarantee a state or federal processing time.

Personal care services may support a client's health and safety at home and include assistance with activities of daily living, permitted medication assistance or administration, taking and recording vital signs when included in the plan of service, reporting changes in condition, and related instrumental activities of daily living.

Services must be based on a written plan developed by a registered nurse in collaboration with the client and family.

Yes. Virginia requires the organization to designate a registered nurse responsible for supervising personal care services. Supervision must occur as often as the client's needs, the RN's assessment, and agency policy require, but no less frequently than every 90 days. An RN or LPN must also be available during all hours personal care services are provided.

Virginia's HCO regulations do not apply to a provider offering only homemaker, chore, or companion services as those terms are defined by Virginia law and regulation. Once services cross into personal care or home health services, licensure requirements may apply. Providers should evaluate their exact service descriptions and actual practices before relying on an exemption.

Not solely because it holds Virginia licensure. An organization planning to seek federal certification must first obtain Virginia state licensure and then complete the applicable Medicare certification and enrollment process. Medicare-certified agencies must also comply with applicable federal Home Health Conditions of Participation.

Yes. A Virginia HCO must implement written policies and procedures approved by its governing body. They must address the agency's administrative, personnel, client-care, emergency, quality-management, and other applicable operational requirements and be reviewed at least annually. Home Health Foms offers policies and procedures that meet regulatory requirements to ensure your success.

Home Health Forms provides startup guidance, customized documents, and application-preparation assistance. Virginia VDH makes licensing decisions, and the appropriate federal authorities determine Medicare certification.

The applicant is responsible for truthful and complete information, qualified personnel, an appropriate office, financial and insurance requirements, fees, regulator requests, inspections, and ongoing compliance. 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 to complete the customization. Other package components may have separate production timelines.

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