How to start a home care agency
Updated October 14, 2026 · CensusDesk research
The short answer.Starting a non-medical home care agency comes down to five steps: decide your services and who pays (private pay, Medicaid, or both), form your business, get licensed by your state, hire and train your first caregivers, and build a way for families to find you. Licensing is the step that changes the most from state to state: the agency, the training, the fee, and the timeline are all set by your state. Pick yours below.
Licensing guides by state
| State | The license |
|---|
| Florida | AHCA companion registration, or a home health agency license |
| Georgia | Private Home Care Provider license |
| Michigan | No state license for non-medical home care |
| New York | Licensed Home Care Services Agency (LHCSA) |
| Texas | HCSSA license, Personal Assistance Services |
More states every week.
The five steps, in any state
- Decide your services and who pays. Non-medical care (bathing, dressing, meals, companionship) or skilled home health. Private pay, Medicaid, or both.
- Form your business. Register with your state, get an EIN, open a business account, and line up insurance.
- Get licensed. Your state’s agency, training, application, fee, and survey. See your state’s guide.
- Hire and train caregivers. Background checks and training rules are set by your state.
- Build your front door. Families search online first. A website that answers them day or night is how a new agency gets its first clients without paying per lead.
CensusDesk is the digital front desk for home care agencies: a modern website if you don’t have one, a free care report families take on your site day or night, and every new family in your inbox the same minute. We build it before you pay.
See your agency’s front desk