How to start a home care agency in Florida (companion and homemaker registration, 2026)

The rule says: "Before any organization or individual shall directly or indirectly provide homemaker and companion services for elderly or disabled adults, it shall make application for and become registered by the AHCA." (59A-8.025(1), F.A.C.)

• A companion "spends time with or cares for an elderly, handicapped, or convalescent individual and accompanies such individual on trips and outings and may prepare and serve meals to such individual" (F.S. 400.462(8)).
• A homemaker "performs household chores that include housekeeping, meal planning and preparation, shopping assistance, and routine household activities" for an elderly, handicapped or convalescent person (F.S. 400.462(22)).
• Neither may provide hands-on personal care to a client (F.S. 400.462(8), (22)). AHCA puts it this way: "They cannot provide any personal care or nursing according to state law." (AHCA provider page)
• Light help AHCA’s surveyors accept. Rule 59A-8.025 lists no duties. The home health personnel rule, 59A-8.0095(12), lets a homemaker or companion steady a client when walking by holding their arm or hand, give casual cosmetic help such as brushing hair (not clipping nails), and, if the client or their responsible party asks, "verbally remind the client that it is time for the client to take his or her medicine". AHCA’s surveyor set for registrants cites that rule, so our reading is that surveyors will hold your staff to it (see our readings) (59A-8.0095(12); AHCA regulation set, tag I0003).

Personal care, in the same part of the statutes, means "assistance to a patient in the activities of daily living, such as dressing, bathing, eating, or personal hygiene, and assistance in physical transfer, ambulation, and in administering medications as permitted by rule" (F.S. 400.462(27)).

Who does not need the registration

• Licensed home health agencies and nurse registries. "Licensed home health agencies and nurse registries are exempt from registration for provision of homemaker and companion services." (59A-8.025(1))
• Agency for Persons with Disabilities contractors, in one case. "A person under contract with the Agency for Persons with Disabilities which provides companion services only for persons with a developmental disability, as defined in s. 393.063, is exempt from registration." (F.S. 400.509(1))
• Individuals working alone: unclear. AHCA’s 2021 surveyor guidance says individuals who work on their own and hire no one no longer need to register, but the statute says "any person" and the rule says "any organization or individual" must register (AHCA surveyor set, tag I0002; F.S. 400.509(1); 59A-8.025(1)). Confirm with AHCA before relying on the guidance (see our readings).

The general licensing law applies

"Each applicant for registration and each registrant must comply with all provisions of part II of chapter 408." (F.S. 400.509(2)) In that part, a licensee includes an entity "that is issued a permit, registration, certificate, or license by the agency" (F.S. 408.803(9)), so its duties for licensees reach registrants too.

Advertising

"A person that offers or advertises to the public a service for which registration is required must include in its advertisement the registration number issued by the Agency for Health Care Administration." (F.S. 400.509(5)) Offering or advertising services that need a license or registration without one is prohibited, and a provider that does not stop after AHCA’s notice may be fined $1,000 for each day (F.S. 408.812(1), (4)).

• The statute and the form. "The amount of the fee shall be $50 per biennium." (F.S. 400.509(3)) AHCA’s July 2024 form shows $50.75. The general law lets AHCA "annually adjust licensure fees" by no more than the change in the Consumer Price Index (F.S. 408.805(2)); our reading is that this explains the difference. Pay what the current form says.
• No refunds. "Fees are nonrefundable." (F.S. 408.805(4)) State, county and municipal agencies are exempt from the registration fee (AHCA form).
• Late renewals. A renewal filed late carries a $50 per day late fee, but the total may not exceed 50 percent of the license fee or $500, whichever is less: about $25.38 in total on AHCA’s $50.75 form fee (our arithmetic of the statutory cap) (F.S. 408.806(2)(d)). Late change requests under rule 59A-35.040 bring a $500 fine (59A-35.040(3)).
• Screening costs. "The costs associated with obtaining the required screening must be borne by the licensee or the person subject to screening. Licensees may reimburse persons for these costs." (F.S. 408.809(5)) Our sources do not give the fingerprinting amount.
• Insurance and bonds. We found no insurance or bond requirement for companion and homemaker registrants in s. 400.509 or rule 59A-8.025 (our reading). Home health agencies, by contrast, need malpractice and liability insurance of at least $250,000 per claim (F.S. 400.471(3)).

"The agency, registry, or service shall require level 2 background screening for employees or contractors as required in s. 408.809(1)(e) pursuant to chapter 435 and s. 408.809." (F.S. 400.512) Level 2 screening includes "fingerprinting for statewide criminal history records checks through the Department of Law Enforcement, national criminal history records checks through the Federal Bureau of Investigation" (F.S. 435.04(1)(a)).

Who is screened

• Owners and managers. The licensee if an individual, the administrator, the financial officer and every controlling interest are screened through AHCA (F.S. 408.809(1)(a)-(d)).
• Staff. Anyone the authorizing statutes require who is expected to "provide personal care or services directly to clients or have access to client funds, personal property, or living areas". Contractors are covered if they provide personal care or services directly, or work 20 hours a week or more with that access (F.S. 408.809(1)(e)).

Timing

• No client contact until cleared. "An employer may not hire, select, or otherwise allow an employee to have contact with any vulnerable person that would place the employee in a role that requires background screening until the screening process is completed and demonstrates the absence of any grounds for the denial or termination of employment." (F.S. 435.06(2)(a))
• Training can start first. A new hire may begin training and orientation before screening is complete, but "may not have direct contact with vulnerable persons until the screening process is completed" (F.S. 435.06(2)(d)).
• Arrests. If you learn an employee was arrested for a disqualifying offense, remove them from contact with vulnerable people until the arrest is resolved in a way that leaves them eligible (F.S. 435.06(2)(b)).
• Every 5 years. Screened people must be rescreened every 5 years. If their fingerprints are already enrolled in the FBI’s retained print arrest notification program, the rescreen does not need the fingerprints sent to the FBI again (F.S. 408.809(2)).
• After a break. Until fingerprints are enrolled in that FBI program, a person returning to a screened position after a break of more than 90 days must submit to a national screening (F.S. 435.12(2)(b)1.).

The Clearinghouse

AHCA runs the "Care Provider Background Screening Clearinghouse" (F.S. 435.12(1)). Employers "must register with and initiate all criminal history checks through the clearinghouse before referring an employee or potential employee" for fingerprinting (F.S. 435.12(2)(d)), and since January 1, 2024, report a person’s initial status and any change within 5 business days (F.S. 435.12(2)(c)2.).

Offenses

On top of the chapter 435 list, s. 408.809(4) adds offenses such as Medicaid provider fraud, domestic violence and battery when the victim is a vulnerable adult (F.S. 408.809(4)). The application includes an attestation that every employee required to be screened has met level 2 standards or obtained an exemption (AHCA form, section 12).

Employment history

Registrants get the employment or contract history of anyone employed or contracted who will have contact with clients in their homes, by asking for it and verifying it, "unless through diligent efforts such verification is not possible" (F.S. 400.509(4)). The rule counts two documented attempts to verify, or for a disconnected number an attempt to find current contact details, as diligent effort (59A-8.025(7)).

"A person employed, contracted, or referred by a nurse registry or a person registered with the agency to provide companion or homemaker services must complete the training required under s. 430.5025." (F.S. 400.51) Section 430.5025 is the Alzheimer’s Disease and Related Forms of Dementia Education and Training Act. In it, “employee” includes contracted staff and independent contractors employed or referred by the provider who need level 2 screening (s. 430.5025(2)(d)). The similar-sounding s. 400.6045 is the hospice provision: the Department of Elder Affairs says "Hospice providers are not included in section 430.5025, Florida Statutes." (Elder Affairs)

• Companion work counts as personal care here. For this section only, personal care includes "homemaker or companion services" given in person (s. 430.5025(2)(c)). That is different from the licensing definition, under which companions may not give hands-on personal care.
• Keep the record. The provider keeps each employee’s record of completion (s. 430.5025(4)(b)2.). The Department of Elder Affairs says employers keep a copy of the certificate in the personnel file and that "The Agency for Health Care Administration (AHCA) will check for this during routine monitoring visits." (Elder Affairs)
• It travels. An employee who has completed the 1-hour program does not repeat it on moving to another covered provider (s. 430.5025(4)(b)3.).
• Staff hired before July 1, 2023 had until July 1, 2026 to complete the training, and proof of equivalent earlier training substitutes (s. 430.5025(9)).
• Nothing else named. We found no other caregiver training or orientation rule for companion and homemaker registrants in s. 400.509 or rule 59A-8.025. The rule asks you to supply staff "capable of delivering contracted or agreed upon services, including all visits" (59A-8.025(9)); our reading is that how you prove that is up to you.

Florida’s adult protection law starts with "Any person, including, but not limited to, any:" and then lists professions. Any such person "who knows, or has reasonable cause to suspect, that a vulnerable adult has been or is being abused, neglected, or exploited must immediately report such knowledge or suspicion to the central abuse hotline" (F.S. 415.1034(1)(a)). A vulnerable adult is a person 18 or older whose ability to manage daily living or their own care or protection is impaired, including by the infirmities of aging (F.S. 415.102(28)).

Suspected child abuse, abandonment or neglect is also reported immediately to the central abuse hotline (F.S. 39.201(1)(a)).

• The hotline. 1-800-96-ABUSE (1-800-962-2873); TTY 711 or 1-800-955-8771; online and fax reporting too (DCF). "The Florida Abuse Hotline accepts reports 24 hours a day and 7 days a week of known or suspected child abuse, neglect, or abandonment and reports of known or suspected abuse, neglect, or exploitation of a vulnerable adult." (DCF)
• Immediate danger. "If you suspect or know of a child or a vulnerable adult in immediate danger, call 911." (DCF)
• Telling clients. On or before the first day of service, tell each client, and their family or representative if appropriate, of the right to report complaints, abuse, neglect or exploitation, and Medicaid fraud, with toll-free numbers and the statute’s wording, such as “To report abuse, neglect, or exploitation, please call toll-free (phone number).” (F.S. 408.810(5)(a)).

We read s. 400.509, rule 59A-8.025, part II of chapter 408 and rule chapter 59A-35 for written duties that apply to a companion and homemaker registrant. Here is what we found.

Duties we found

• One policy. "Each licensee shall establish appropriate policies and procedures for providing such notice to clients." (F.S. 408.810(5)(b)) That is the notice of the right to report complaints, abuse and Medicaid fraud, described above. The statute does not say the policy must be written, but writing it down is the simple way to show it (our reading).
• A confidential client record with the client’s details, emergency contact, next of kin or guardian, and physician, any contract or service agreement, the services with the length and frequency of visits, dietary restrictions if you handle meals, food allergies, activity limits, and any termination notice (59A-8.025(8)).
• Employment history records, with the verification, or two documented attempts where verification is not possible (59A-8.025(7)). AHCA’s surveyor guidance expects a file for each worker showing their employment history (tag I0011).
• The dementia training record for each employee (s. 430.5025(4)(b)2.).
• A record of services (our reading). The home health personnel rule, 59A-8.0095(12), has a companion keep a chronological written record of services and a homemaker keep appropriate work records. AHCA’s surveyor set for registrants cites that rule, so on our reading surveyors will expect these records too (59A-8.0095(12)).

Standards with no written form set

• Accepting clients. "When a client is accepted, there shall be a reasonable expectation that the requested services will be provided adequately and safely in their residence." (59A-8.025(9))
• Capable staff, every visit. "The homemaker and companion services provider is responsible for obtaining all needed information pertaining to service delivery and for supplying employees or independent contractors capable of delivering contracted or agreed upon services, including all visits." (59A-8.025(9))
• Reporting changes. Changes to application information are reported within 21 calendar days unless a rule sets another deadline (F.S. 408.810(3)); an address change must reach AHCA 21 to 120 days ahead (59A-35.040(2)(b)).
• Closing down. Tell AHCA at least 30 days before you stop, and tell clients. When you stop, surrender the registration, and either forward each client’s records as the client chooses or publish the newspaper notice the statute sets (F.S. 408.810(4)).

Left to you (our reading)

We found no rule for companion and homemaker registrants on supervision of staff (apart from a documented supervision plan for providers registered before July 1, 2015 that serve counties outside their primary area; 59A-8.025(6)), care plans, client contracts, grievances, infection control, emergency plans, staff orientation beyond the dementia training, or a schedule for reviewing policies. That does not mean those things do not matter: clients, families, insurers and payers may ask for them. It means Florida’s registration rules leave the method to you.

What surveyors check

AHCA’s page points to a "State Regulation Set used by surveyors" (AHCA Rules/Survey Standards page). The homemaker and companion set we saved (printed in 2021) has tags for registration, services within the definitions and rule 59A-8.0095(12), no home health services or nurse registry work without a license, the registration number in adverts, and the employment history file (Regulation Set I 1.07, our summary). Its guidance is plain: "HCS should not accept clients that need personal care. HCS can only provide housekeeping, chore, errands, cooking, and companionship" (tag I0005)

Hands-on care with bathing, dressing, toileting or transfers is outside the companion and homemaker registration. Florida has two other routes, both licensed by AHCA.

A home health agency licensed for non-skilled services

• What it is. "“Home health agency” means a person that provides one or more home health services." (F.S. 400.462(15)) Home health services include home health aide services (F.S. 400.462(19)), and a home health aide "provides hands-on personal care" (F.S. 400.462(17)).
• Non-skilled only is possible. AHCA’s application asks: "Does your home health agency plan to offer only non-skilled services which include home health aide, certified nursing assistant, homemaker, and companion services?" (AHCA Form 3110-1011) Licenses issued since July 1, 2018 list each service and whether it is skilled care (F.S. 400.464(1)).
• Still RN-supervised. "An agency that does not provide skilled care is not required to have a director of nursing." (59A-8.0095(2)(i)) But "Each home health agency that provides skilled care or non-skilled care must have an RN provide supervisory visits of unlicensed assistive personnel" (59A-8.0095(3)(c)), and aides and CNAs give personal care assigned by and under the supervision of a registered nurse (59A-8.0095(5)(a)).
• The application. A signed business plan and a balance sheet, income and expense statement and cash flow statement for the first 2 years, compiled and signed by a certified public accountant (F.S. 400.471(2)); malpractice and liability insurance of at least $250,000 per claim (F.S. 400.471(3)); and AHCA’s $1,705.00 license fee plus a $300.00 biennial assessment (AHCA Form 3110-1011). Accreditation applies only to agencies that provide skilled care (F.S. 400.471(2)(g)).
• A survey first. "Home health agencies will be surveyed by AHCA or an accrediting organization as defined in Rule 59A-8.002, F.A.C., pursuant to Sections 400.471(2), 408.806 and 408.811, F.S. Home health agencies will be surveyed prior to initial licensure, and at least every 36.9 months on an unannounced basis thereafter." (59A-8.003(2)(a))
• Written policies. The home health rules name more written policies than the registration’s one, such as on "the availability of a registered nurse supervisor during hours of patient service" for non-skilled agencies (59A-8.003(9)(d)), on advance directives (59A-8.0245(1)), and a written comprehensive emergency management plan (59A-8.027(1)).
• Aide training. Before a home health aide works, the agency needs proof of at least forty hours of training in the listed subjects, or a passed competency test (59A-8.0095(5)(c)).

A nurse registry

• What it is. A registry arranges contracts for nurses, CNAs, home health aides, companions or homemakers "who are compensated by fees as independent contractors" (F.S. 400.462(25)). "A nurse registry is exempt from the licensing requirements of a home health agency but must be licensed as a nurse registry." (F.S. 400.506(1)(a))
• No supervision. "A nurse registry may not monitor, supervise, manage, or train a registered nurse, licensed practical nurse, certified nursing assistant, companion or homemaker, or home health aide referred for contract under this chapter." (F.S. 400.506(19))
• Limits on aide referrals. "A certified nursing assistant or home health aide may be referred for a contract to provide care to a patient in his or her home only if that patient is under a physician’s care." Their tasks are limited to bathing, dressing, toileting, grooming, eating, physical transfer and similar daily routines (F.S. 400.506(6)(b)).
• Fee and procedures. AHCA’s form shows a $2,000.00 license fee (AHCA Form 3110-7004), and each registry sets written procedures for selecting, documenting, screening and verifying the credentials of each contractor it refers (59A-18.005(2)).

Both routes also carry the dementia training (s. 430.5025(4)(c)) and level 2 screening (F.S. 400.512).

• The fee. The statute says $50 per biennium; AHCA’s July 2024 form shows $50.75. Our reading: the yearly Consumer Price Index adjustment in s. 408.805(2) explains it (F.S. 408.805(2)).
• The form the rule names. Rule 59A-8.025(3) still names the December 2014 application; rule 59A-35.060 now incorporates the July 2024 form (59A-8.025(3); 59A-35.060). Our reading: use the current form.
• Two meanings of “personal care”. In the licensing definitions, companions and homemakers may not give hands-on personal care. In the dementia training law, personal care includes homemaker or companion services. Both are right in their own sections (F.S. 400.462(27); s. 430.5025(2)(c)).
• Which rule sets companion duties. Rule 59A-8.025 does not list the tasks a companion or homemaker may do. The duties sit in the home health personnel rule, 59A-8.0095(12), and in the nurse registry rule, 59A-18.009 (59A-8.0095(12); 59A-18.009(2)). AHCA’s surveyor regulation set for registrants cites 59A-8.0095(12) (tag I0003), so our reading is that surveyors will expect a registrant’s staff to stay within those duties. Note the tension: steadying a client when walking sits close to "assistance in ... ambulation", which the statute counts as personal care (F.S. 400.462(27)). Keep to the light help the rule names.
• Individuals working alone. The statute says any person that provides companion or homemaker services must register (F.S. 400.509(1)), and the rule says any organization or individual must register before providing them (59A-8.025(1)). AHCA’s 2021 surveyor guidance says: "Registration of individuals that work independently on their own is no longer required." (tag I0002) If you will work alone and hire no one, confirm with AHCA before relying on that.
• Elder Affairs’ summary is broader than the law. Its page opens: "In Florida, all staff members in licensed care settings that serve adults and older adults must complete specific training requirements for Alzheimer’s disease and related dementias (ADRD)." (Elder Affairs) The statute ties the 1-hour course to staff who give personal care or have regular contact, and the extra 2 hours to staff who give personal care (s. 430.5025(4)(b); (4)(c)). Our reading: follow the statute, and note that written information on hire goes to each employee ((4)(a)).
• The rule is old, but current. Rule 59A-8.025 was last amended in 2016, and the flrules.org page lists no later notice for it (59A-8.025 history). Our reading: no change is in progress as of 8 October 2026.
• AHCA pages. AHCA’s website blocked our automated requests, so the AHCA pages we cite are Internet Archive copies from 2024 and 2025 (AHCA provider page). The forms and rules come from the official Florida Administrative Code site.

On 8 October 2026, AHCA’s FloridaHealthFinder locator listed, by our count of active and open records:

• Homemaker and companion providers: 3,043 records, of which 2,945 registered, 69 in review and 29 in litigation (our count).
• Nurse registries: 1,360 records, of which 1,296 licensed and 64 in review (our count).
• Home health agencies: 2,992 records, of which 2,875 licensed, 116 in review and 1 in litigation. The list does not say which are licensed for non-skilled services only (our count).

For context only: Florida’s Medicaid long-term care plans must cover personal care, among other benefits (F.S. 409.98). That is a program rule for plans and the providers they contract with, not a license rule; this guide does not cover Medicaid enrollment.