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Do I Need a License to Start a Home Healthcare Agency?

home healthcare agency regulations

Licensing requirements for home healthcare agencies vary from state to state. However, the vast majority require agencies to pay for a license. Only eight states currently do not require a license:

  • Alabama
  • Iowa
  • Massachusetts
  • Michigan
  • Ohio
  • South Dakota
  • Vermont
  • West Virginia

In addition, 18 states mandate that home healthcare agencies file certificates of need before operating. These certificates are intended to help state authorities curb excess supply in the healthcare market by evaluating local demand before allowing a new agency or facility to open.


As for your staff, all registered nurses and licensed practical nurses must be registered to practice in your state. Training and licensing requirements for non-skilled caregivers (or those that don’t provide medical care) are different for each state, and some have no established training requirements for non-skilled caregivers. Many states are reconsidering their training requirements, given the growing need for home healthcare.

BrightStar Care only hires screened and licensed caregivers, ensuring that patients receive the best possible quality of care. Furthermore, every single BrightStar Care location has a registered nurse overseeing each case. This top-notch quality of care sets BrightStar Care apart from competitors.

Guarding Against Fraud

State regulation of home healthcare agencies helps guard against fraud and protect patients’ best interests. With skyrocketing demand for home healthcare services, many new agencies are popping up to meet that demand, but not all offer quality care and firm ethics.

For example, federal investigators estimate that fraudulent home healthcare providers have billed more than $100 million dollars since 2012.

As more state authorities recognize the prevalence of home healthcare fraud, it will be increasingly important for prospective home care business owners to align themselves with trusted brands. In the face of widespread fraud, consumers will become savvier and seek out agencies with uncompromising standards of care and ethics. Additionally, compliance will become more costly for home care companies without established systems.


BrightStar Care has achieved the highest level of accreditation for a home healthcare business – and we’re the only home health care franchise system to do so. Our elite standards enable our franchisees to become Joint Commission accredited, a nationally recognized healthcare standard held by renowned facilities like the Mayo Clinic. The Joint Commission has named BrightStar Care an “Enterprise Champion for Quality” for six consecutive years, thanks to our unparalleled standards of care.

Do you want to learn more about BrightStar Care? Download our free franchise report here!

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