Wisconsin Home Health Agency Complete Startup Package

Wisconsin Department of Health Services, Division of Quality Assurance administers this agency licensing route. The principal requirements are DHS 133 and Wis. Stat. 50.49. This package addresses the Home Health Agency model.

A Home Health Agency license is issued by DHS under Wis. Stat. 50.49 and DHS 133. Wisconsin offers a state-only licensing route as well as a combined state and federal certification process; this package supports the state-only route.

Wisconsin charges a $300 Home Health Agency license application fee. The application process also lists a $15 background-check fee for each covered owner or other person requiring that check. These state charges are separate from our package.

Prepare the agency application, ownership and management information, administrator qualifications, organizational chart, financial materials, background forms, and the required policy checklist. DHS identifies Form F-62674 for the application and F-62536 for the policy review.

The application includes a 90-day operating budget and evidence of funds available to carry out the proposed operation. The business must be financially ready to hire qualified staff and deliver services before revenue is established.

The licensing process can issue an initial three-month provisional license, with extensions subject to DHS approval and the applicable limit. Use only the authority actually granted in the issued license while preparing for the permanent licensing survey.

DHS instructs the agency to demonstrate skilled nursing services to at least ten clients before the permanent licensing survey. Follow the state-only instructions for the selected application route and retain the clinical records needed to demonstrate compliance.

Qualified administration and registered nursing leadership must direct the agency's operation and nursing care. Verify current licenses and qualifications for all disciplines and document supervision, clinical coordination, and coverage.

Document assessments, practitioner orders, individualized care plans, visit notes, treatments, medications, progress, coordination, and discharge. The agency's record system must support safe care and DHS 133 compliance.

Yes. DHS requires the applicable background disclosures and checks for covered owners and other specified individuals. The application guidance lists a $15 fee for each person requiring the state application background check.

Establish written emergency contacts, staff escalation, backup coverage, weather and travel procedures, and instructions for clients when a scheduled visit cannot occur. For an immediate medical emergency, staff should activate emergency services. Keep the response appropriate to the Wisconsin services your agency is authorized to provide.

Provide a clear contact for concerns, record each complaint, assign follow-up, document the response, and review patterns that call for changes. Preserve client confidentiality and follow applicable abuse, neglect, and incident-reporting requirements.

Written policies are required for the licensed services. They should address administration, personnel, client care, supervision, rights, confidentiality, infection prevention, emergencies, and records. Maintain a documented process to review services, complaints, incidents, and record quality, and follow the quality or program-evaluation requirements applicable to this license.

Home Health Forms provides Wisconsin-specific quality improvement and written policies.

• Logo creation and a customized WordPress website.
• One year of website hosting and domain registration.
• 500 business cards and 500 tri-fold brochures.
• Wisconsin-specific policy, human-resources, admission, clinical, and operational documents for skilled medical services.
• Preparation of the Wisconsin Home Health Agency application for your review, signature, and submission.
• Members' area access, document customization, ongoing guidance, and applicable updates.

Home Health Forms provides documents, guidance, and application-preparation assistance. The Wisconsin Department of Health Services, Division of Quality Assurance makes licensing decisions. The applicant remains responsible for qualified personnel, accurate information, insurance, operational readiness, fees, regulator responses, inspections, and ongoing compliance. Home Health Forms 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 information needed for customization is received. Website development, printing, shipping, and other package 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.

Select a payment option. After purchase, complete the company questionnaire linked on the thank-you page. We use your company details to customize the selected documents and coordinate the remaining work.