5 Tips you need to know to start a home care agency in New York

It has been about two months since the NY state Department of Health announced the lift of the moratorium on the Initial Application to start a Home Care Agency. Business owners, entrepreneurs, and clinicians have been researching and trying to make sense of the complex new process. There is so much more to the new process than filling out an application for home care licensure.

Here are 5 tips you need to know before applying for your New York Home Care Agency License.

1. Is there a NEED?

Many entrepreneurs want to start a home care business in New York but have been prevented due to the moratorium. The state has made the process selective as evidenced by the new certificate of need process. The real question entrepreneurs must ask themselves is “is there a real need” for a new agency in the community that I want to serve? Do I have the evidenced-driven data to confirm that there is indeed a true need? Carefully weighing your odds of approval against the risk is essential. Entrepreneurs are encouraged to prepare a SWOT Analysis to assist them with this decision.

2. Do you meet the Financial and Background REQUIREMENTS?

Gone are those days when starting a home care business in New York meant you only had to have just thousands of dollars and the application fee. You now have to have months of operating costs and be deemed financially capable. Not only do you have to pay the $2,000 non -refundable (the second highest home care application fee after California) the NY DOH wants to know if a license is granted how likely you are to be operating efficiently, effectively, and in compliance. Keep in mind that some bad apple home care agencies have been following regulatory compliance and have been found cutting corners, not paying proper wages and wage parity benefits, and overall being fraudulent; although there has always been character and competency review to ensure that home care owners have not taken part of unethical fraudulent behavior, DOH will review your Background Check State, Federal OMIG Check- for past history of fraud, waste, abuse, conflict of interest and obtain character references.

2. Do you have the management STRUCTURE?

Keep in mind home care is a multi-billion-dollar business. Do not expect to run it without having professional resources in close proximity. Besides having a Director of Patient Service, a Registered Nurse with availability 24 hours 7 days a week on call, you still need a backup Operator/ Administrator, Scheduling Coordinator, Biller, Receptionist/ clerical staff, and Home Care Marketer at the very least. You also need a CPA upfront that will be involved in the initial application process. While operating you will need access to a general counsel, employment, and compliance attorneys to help guide you and seek professional advice. Having assistance from home care business consultants, Home Care Tech Vendors SaaS, and Training and Education providers as well. And not to forget your Quality Assurance Board Members to advise on continuous quality improvement for your agency. Very importantly, having a solid recruitment plan for recruiting and retaining home health aides and registered nurses.

Keep in mind your startup costs. Its also always highly recommended hiring a consultant and consulting firm like Emmanuel Consulting Agency Inc to start a home care agency in New York. Selecting consulting firm that is located in New York, is experienced, reputable, and has a cost-per-phase payment structure can help you ensure your reach your goal of starting a home care agency without wasting money and resources. Having a consulting firm to tap into and receive expert advice specific to the LHCSA will position your agency for success. Finding a home care business consulting firm with a one-of-a-kind LHCSA Administrator and Nurses Training Program to receive training for new and existing home care business owners, Director of patient services is imperative. Training, education, and compliance is essential to keep you functioning and profitable.


Business is a risk and requires a realistic strategic approach. In many other states, home care entrepreneurs may continue to work part-time while growing their business but this is not recommended in order to get your agency off the ground. Home care is highly regulated and requires many hours of work, compliance, and networking. Positioning yourself to grow your business will make it more profitable and sustainable. After all, it is a multibillion-dollar service-based business that can be extremely lucrative when run well.

Have you ANALYZED the market?

Do you know what has occurred in the last 8-10 years in-home care? Noting trends in the market and doing your market research is imperative for the NY market. The New York home care Business market is not like any other state so keep in mind there are complexities within the market. Have you looked into the LHCSA RFO? You can learn more here about the LHCSA RFO. or what it would take if you want to sell your agency in the future or add a partner.

4. Do you have an EFFECTIVE marketing plan?

If you have not started with a home care agency business plan specifically for NY home care businesses, we highly recommend a business plan and marketing to receive patients.

5. Do you have the TIME and RESOURCES to invest?

The process for a Certificate of need can be a lengthy one due to the application and evaluation process where the application must be approved by Public Health Planning Council (PHHPC) which meets bi-monthly. Consider the time it will take for the application process, preparing for your presurvey inspection from the Department of Health, and the time it takes to break even.

If you want to learn more about how to start your own home care agency in New York click here

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