How to start a home care agency in Michigan

Updated October 14, 2026 · CensusDesk research

Michigan at a glance

Rules change. Check LARA’s Home Health Agencies page and MDHHS’s Home Help agency provider pages before you open.

Step 1. Decide what kind of agency you are

Most new agencies start non-medical: help with bathing, dressing, meals, light housekeeping, errands, and companionship. In Michigan, that work doesn’t need a state license. If you plan to offer skilled nursing or therapy, you’re a home health agency instead. Michigan doesn’t license those either, but to bill Medicare you need federal certification, and LARA does the survey. Check with LARA on survey timing before you plan around it. This guide covers the non-medical path.

Decide one more thing early: private pay, Medicaid, or both. Private-pay families pay you directly. In Michigan, Medicaid personal care runs through the MDHHS Home Help program, which has its own enrollment (Step 4). Many owners start private pay because the money comes in faster and the paperwork is lighter.

Step 2. Form your business

Register your business with LARA or, for an assumed name, with your county clerk. Get a federal EIN from the IRS and open a business bank account. Ask your city or county if you need a local business license. Talk to an insurance agent about liability and workers’ compensation coverage now, too. You will want it in place before your first caregiver starts.

Step 3. Set your own standards

With no state license, nobody hands you a rulebook for private-pay care. Families will still ask how you screen and train caregivers. Write down your policies: background checks, training, how you supervise care, and how you handle complaints. It’s what a careful family wants to hear, and it’s a head start if Michigan ever adds a license.

Step 4. If you’ll bill Medicaid, enroll in Home Help

MDHHS’s path for a Home Help agency provider:

1. Get your EIN and register your business with LARA or your county clerk.
2. Get a Type 2 (organization) National Provider Identifier (NPI).
3. Set up a SIGMA vendor account and a MILogin account for CHAMPS.
4. Complete your CHAMPS provider enrollment application (MDHHS says to finish it within 30 days of starting) and get approved.
5. Enroll each caregiver in CHAMPS and link them to your agency after their criminal history check.

You can’t serve Home Help clients or bill until CHAMPS approves you, and a caregiver can’t start until their own enrollment is approved. MDHHS doesn’t publish a processing time on these pages, so check with MDHHS.

Step 5. Serve your first client

For private pay, once your business is set up and insured, you can start serving clients. There’s no state survey to request. For Home Help clients, wait for CHAMPS approval first. Either way, check LARA and MDHHS once a year. If Michigan adds a license, those are the pages that will say so.

What it costs to get licensed

Getting your first clients

A license doesn’t bring families to you. Here’s what the research says about where clients come from, and what that means for a new Michigan agency.

• Referrals lead. Current and past clients are the top referral source for private duty home care, followed by discharge planners, home health, hospice, and rehab. A new agency has no past clients yet, so the referral engine starts slow.
• Families search first. Most families looking for senior care start with a generic search like “home care near me,” and few search an agency by name. If your agency has no website, those families find someone else.
• Directories charge per lead. Lead directories and paid search often run $50 to $150 per lead, and the family may be shopping three agencies at once.
• Speed wins. On average about a third of home care inquiries become clients. A family coming home from the hospital may have only a day or two to decide.

What one client is worth in Michigan

That’s why the first thing a new agency needs after its license is a front door that works when you can’t pick up the phone: a real website, a way for families to get answers at night, and every inquiry in your inbox the minute it happens.

Sources

• Michigan LARA, “Home Health Agencies” (state licensing not required; certification surveys), michigan.gov/lara, read October 14, 2026
• Michigan MDHHS, “A Guide on how to become an enrolled and approved Home Help Agency Provider” (EIN, registration, NPI, CHAMPS steps), read October 14, 2026
• Michigan MDHHS, “CHAMPS Instructions & Information” for Home Help agency providers, read October 14, 2026
• CareScout Cost of Care Survey 2025, median hourly cost of non-medical in-home care by state
• HCAOA Private Duty Benchmarking, via Activated Insights (referral sources)
• Caring.com search behavior figures, via CoreCubed (generic search)
• Home Care Pulse, via Home Health Care News (inquiry conversion benchmarks)
• Sagapixel (directory and paid search cost per lead estimates)