Starting a Florida Home Health Agency or Homemaker & Companion Services Provider?

This page focuses on three Florida options:

• Licensed and Medicare-certified Home Health Agency — a Florida-licensed agency that also completes federal Medicare certification.
• Licensed Home Health Agency — a state-licensed agency providing the services authorized on its license.
• Registered Homemaker and Companion Services Provider — a provider limited to homemaker and companion services and prohibited from hands-on personal care.

The Florida Agency for Health Care Administration (AHCA) licenses home health agencies and registers homemaker and companion services providers through its health-care licensing program.

Florida uses a registration, rather than a home health agency license, for a provider offering only homemaker and companion services. AHCA states that an individual working alone must generally register unless a statutory exception applies.

AHCA's current home health agency application checklist lists a $1,705 biennial license fee plus a $300 Health Care Trust Fund assessment, for a total of $2,005. AHCA currently lists a $50.75 fee for a two-year Homemaker and Companion Services registration.

Fees can change. Verify the amount and acceptable payment method with AHCA before submitting an application.

Requirements depend on the ownership, services, counties, and application type. The AHCA application and checklist request items such as:

• Provider, ownership, controlling-interest, and corporate information.
• Services, hours of operation, and proposed geographic service area.
• Required personnel and qualification information.
• Proof of liability insurance and financial ability to operate.
• Evidence of the legal right to occupy the office and compliance with local zoning.
• Accreditation information when skilled home health services will be provided.

AHCA requires an application, fee, ownership and controlling-interest information, identification of required management and financial personnel, service-area information, and applicable Level 2 background screening. Additional documents may be required based on the applicant's legal structure and responses.

A home health agency must have a qualified administrator and a written alternate administrator. An agency providing skilled nursing care must also have a qualified director of nursing and an alternate who meets applicable requirements. Other personnel depend on the services offered.

A home health agency must identify and document its licensed location and legal right to occupy it, and it must meet applicable zoning and operational requirements. AHCA states that a Homemaker and Companion Services provider may operate from a Florida residence within its service area, but the address is public and may be inspected if a complaint is received. Applicants should also verify local zoning, lease, deed-restriction, and homeowners-association requirements.

Florida law generally gives AHCA 30 days to notify an applicant of errors or omissions. The applicant generally has 21 days to respond, and AHCA generally must approve or deny a complete application within 60 days. Total startup time can be longer when corrections, background screening, accreditation, surveys, Medicare certification, or other prerequisites are involved.

A properly licensed and staffed home health agency may provide the skilled and/or unskilled services authorized on its license, which can include nursing, home health aide services, physical therapy, occupational therapy, speech therapy, social work, and other permitted home health services. Services must match the agency's license, personnel qualifications, orders, and plan-of-care requirements.

No. AHCA licensure is a Florida requirement. Medicare certification is a separate federal process. A provider that wants to participate in Medicare must satisfy the applicable state licensing requirements and federal requirements, including the Home Health Conditions of Participation in 42 CFR Part 484.

Florida requires a home health agency that provides skilled home health services to obtain and continuously maintain accreditation from an AHCA-recognized accrediting organization. Florida law also establishes documentation and survey timing requirements during the application process.

Not solely because it holds a Florida license. The agency must separately complete Medicare enrollment and certification and remain compliant with applicable federal requirements before billing Medicare for covered services.

A registered provider may offer nonmedical homemaker and companion services, such as housekeeping, meal preparation, shopping, errands, transportation, companionship, and similar assistance that does not involve hands-on personal care.

It may not provide hands-on personal care or nursing services. AHCA identifies prohibited personal-care activities such as bathing, dressing, grooming, toileting, feeding, transferring, skin care, and assistance with self-administered medications. A provider wishing to offer those services must obtain the appropriate authority before doing so.

Background-screening requirements depend on the provider type and role. AHCA states that new Homemaker and Companion Services applicants must obtain Level 2 screening for the managing employee and financial officer, and new homemakers and companions must also satisfy applicable screening requirements. Home health agencies have separate screening obligations for applicable owners and personnel.

Yes. A Homemaker and Companion Services business name may not imply that the provider offers home health, personal care, nursing, medical, or other services outside the registration. Florida also requires applicable license or registration numbers in advertisements. Applicants should have AHCA review the proposed name and follow current advertising rules.

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