Home care licensing requirements by state

Licensed

Companionship is part of personal care. Housekeeping-only organizations are exempt.

6 CCR 1011-1 Ch. 26, 2.10(B)(1)

$2,720.30

Class B initial fee, 2026/27 schedule, non-refundable.

Initial License Application

$1,638.36 a year

Base renewal fee, plus fees per branch and workstation.

Renewal License Application

At the initial survey

All required policies must be ready for review at the initial survey. The earlier fitness review can also look at policies.

Step 66 CCR 1011-1 Ch. 2, 2.7.1(D)

Yes, usually on site

A scheduled initial survey. CDPHE issues the license after a survey with zero deficiencies.

Step 6, Survey Requested & CompletedStep 7, License Issued

No

The supervisor needs personal care training and experience set by agency policy; the rules name no nurse for Class B.

6 CCR 1011-1 Ch. 26, 7.7

Licensed

Companion or sitter work is licensed, so companion-only businesses need a license.

111-8-65-.03(q)

$300 to apply

Plus $250 a year for each service category, up to $750.

111-8-25-.03(8)

$250 a year per service

The license has no expiry date. The annual fee, up to $750, is billed from October to December for the next calendar year.

111-8-25-.03(8)Annual License Fee Payments, p. 1

Ready before you apply

All policies must be in place before you apply, which you confirm in a notarized affidavit, and available on request. DCH checks them at unannounced inspections.

Application Checklist, p. 1Application Checklist, Affidavit of Compliance

On the provisional license

A three-month provisional license to admit at least three clients; request the initial survey before it ends.

Application Checklist, p. 2

Yes, on the application

DCH’s application checklist requires a registered nurse for every initial application, whatever services you offer.

Application Checklist, p. 2

Licensed

Home services include companionship, cleaning, laundry and shopping. An agency that only does housecleaning is not a home services agency.

77 Ill. Adm. Code 245.20210 ILCS 55/2.08

$1,500

Covers the 240-day provisional license; the first full license then runs to one year from the end of the month the provisional license was issued. Not refundable.

Form 445104, page 177 Ill. Adm. Code 245.100(a)(3)(A), (C)77 Ill. Adm. Code 245.100(a)(2)

$1,500 a year

The same fee for a renewal.

Form 445104, page 1

Filed with the application

Copies of seven policy areas go in with the initial application.

77 Ill. Adm. Code 245.90(a)(3)(I)

On the provisional license

IDPH inspects in the last 30 days of a 240-day provisional license, then issues a full license if you substantially meet the rules.

77 Ill. Adm. Code 245.100(a)(3)77 Ill. Adm. Code 245.100(a)(2)

No

The agency designates a person to supervise services; the rule sets no degree or license for the role.

77 Ill. Adm. Code 245.30(f)(1)

Licensed

Personal services include homemaker and companion services.

IC 16-27-4-4(a)

$250

With each license application.

IC 16-27-4-6(d)

$250 a year

A license expires one year after it is issued.

IC 16-27-4-6(d)IC 16-27-4-6(h)

Submitted with the application

IDOH’s application form lists nine policies and procedures to submit.

State Form 53391, Section VIII, items 1-9

Possible

IDOH may conduct an onsite inspection with an initial license or a renewal.

IC 16-27-4-6(e)

No

The statute requires a manager and sets no qualifications, license or experience for the role.

IC 16-27-4-9(a)

Homemaker-only: probably exemptOur reading

KDHE says housekeeping, shopping, laundry and similar tasks need no hands-on care and many are offered by businesses not required to be licensed. Confirm with KDHE.

Questions and Feedback, K.A.R. 28-51-117, p. 36

$250 or $500

$250 under 100 unique clients a year, $500 for 100 or more. Non-refundable.

K.A.R. 28-51-101(a)(1)(B)(iii)K.A.R. 28-51-101(a)(1)(B)(iv)

$100 or $350 a year

$100 under 100 unique clients, $350 for 100 or more.

K.A.R. 28-51-101(b)(2)(C)K.A.R. 28-51-101(b)(2)(D)

Uploaded for a document review

The rule makes your policies part of the initial application. After the fee, you upload them to KDHE’s file transfer system, and KDHE issues the license when every required document meets the requirements.

K.A.R. 28-51-101(a)(1)(C)Instructions, Initial Applications 2Instructions, Initial Applications 4

UnclearOur reading

The statute ties the license to a survey inspection, but KDHE’s application describes a document review only. An on-site survey follows at least every 36 months.

K.S.A. 65-5104(a)K.S.A. 65-5104(b)(2)

No, and no nursing

No registered nurse is required. KDHE’s attestation prohibits nursing of any kind under this license, including nurse supervision.

Two Options, Option 2Attestation Form, p. 2

Homemaker-only exempt; companion probablyOur reading

An agency giving only household support (light housekeeping, meals, shopping and errands) needs no license. By our reading, companion work with no hands-on help is also outside the RSA license; confirm with OHCQ.

COMAR 10.07.05.03BCOMAR 10.07.05.02B(14)COMAR 10.07.05.02B(17)OHCQ announcement of the 2012 RSA rules, "Will there be a significant fiscal impact on providers?"

No fee

OHCQ charges no fee to apply, although COMAR still lists $1,000.

Application, Instructions

No renewalOur reading

The statute no longer provides for renewal, so licenses no longer expire. Confirm with OHCQ.

COMAR 10.07.05.04H

Filed with the application

The application names the document and page for each of the 23 policy items in COMAR 10.07.05.08B.

COMAR 10.07.05.04A(2)(i)Application, Section B, Policies and Procedures

Possible

The Department may inspect on site, announced or unannounced, before approving or denying an application.

COMAR 10.07.05.04D

Yes, for ADL clients

For clients who need skilled services or help with daily living, an RN oversees the care plan, delegation, supervision and training.

COMAR 10.07.05.12E(1)

Homemaker licensed, companion only unclearOur reading

Nevada’s list of nonmedical services includes laundry, shopping, cleaning and transportation, and any business (not a solo individual) providing them in the home to elderly or disabled people needs a license. Companionship alone is not on the list; confirm with HCQC.

NRS 449B.050NRS 449B.465NRS 449B.015(1)

$1,374

Nonrefundable. A surety bond of $5,000 to $50,000, by number of employees, is also filed with each application and renewal.

NAC 449.013(1)(n)NRS 449B.185(1)-(2), (7)

$687 a year

Plus 6% of the renewal fee ($41.22) on issue and each renewal.

NAC 449.013(2)(n)NAC 449.013(3); NRS 449B.210(3)

At the prelicensure survey

HCQC looks at the applicant’s policies and performs a prelicensure survey.

NAC 449.0112(1)

Yes

A prelicensure survey once the application, identity proof and fee are complete.

NAC 449.0112(1)

No

The rules name no nurse; the administrator needs a high school diploma or equivalent, or a Nevada long-term care administrator license.

NAC 449.3973(1), as amended by R089-24 section 58

Probably exempt without hands-on helpOur reading

The license covers nursing, home health aide and personal care (help with hygiene, dressing and feeding). Housekeeping and companion work without that help are not on the list, but homemaker services also include dressing and feeding, so ask DOH.

PHL s. 3605(1)10 NYCRR 700.2(c)(16)10 NYCRR 700.2(c)(19)10 NYCRR 700.2(c)(18)

$2,000

Application fee, not refunded once DOH acknowledges the application. A license also needs Public Health and Health Planning Council approval.

PHL s. 3605(13)FAQ B, Q1PHL s. 3605(2)

No expiry in statute; register yearly

The license has no expiry date in the statute, but the agency registers with DOH every year.

PHL s. 3605-b(1)(a)

Reviewed after PHHPC approval

A paper manual goes to the DOH regional office after contingent PHHPC approval, before the pre-opening survey.

FAQ A, Q3Guidance, Submission item 2

Yes, pre-opening

Once the manual is acceptable, the regional office schedules a pre-opening survey; the license follows a successful survey.

FAQ A, Q3

Yes

Every agency employs at least one RN responsible for directing and supervising all patient care.

10 NYCRR 766.9(h)

A separate license

Companion, sitter or respite care alone is a home assistance service, which needs its own license.

G.S. 131E-136(1b)G.S. 131E-138(a)

$510

Non-refundable. A license lasts one year and expires on December 31.

G.S. 131E-138(c)10A NCAC 13J .0903(b)FAQ 24

$510 a year

The same fee, due by December 31 for the license to run from January 1.

G.S. 131E-138(c)FAQ 26

Desk review before licensing

The initial survey reviews the policies, procedures and personnel documents you send. DHSR’s checklist lists 32 policy items.

Requirements for Establishing a Home Care Agency10A NCAC 13J .0903(a)Initial Survey Checklist, pp. 1-2

A desk review

The initial survey is a review of documents you send, before a license is issued. Unannounced inspections follow every 3 years.

Requirements for Establishing a Home Care Agency10A NCAC 13J .0903(a)FAQ 34-35

Yes, for in-home aide services

An RN must be available for supervision and consultation while aides are working.

FAQ 43

Partly licensed, not settledOur reading

Personal care includes help managing the home, errands, caregiver respite, and homemaker services that are incidental to personal care or essential to the person’s health and welfare. Companionship is not named. Confirm with ODH.

ORC 3740.01(Q)(1)ORC 3740.01(Q)(4)

$250

For a three-year license, not refundable. New agencies also need a $20,000 surety bond.

OAC 3701-60-03(B)(2)ORC 3740.05(A)ORC 3740.03(B)(1)(h)

$250 every three years

A renewal counts as timely if filed at least 90 days before the license expires.

ORC 3740.05(A)OAC 3701-60-03(H)

One named policy with the application

A copy of the written criminal records check policy, plus any policies related to your services, if applicable.

OAC 3701-60-03(B)(3)(g)OAC 3701-60-03(B)(3)(d)

Not for nonmedicalOur reading

The statute requires a site visit only for skilled applicants applying through Medicare certification.

ORC 3740.04

Not covered for the ODH license

For ODA (Medicaid) certification, the aide supervisor must be an RN, or an LPN under the direction of an RN.

OAC 173-39-02.11(C)(4)(a)

Not settledOur reading

Only house-cleaning-only businesses are exempt. The rule lists shopping, errands, laundry and transportation among licensed care tasks, but the statute defines in-home care around help with daily living. Ask DPH.

S.C. Code 44-70-20(3)(b)R.60-122 §700.BS.C. Code 44-70-20(2)

$1,000

Initial license fee.

R.60-122 §103.I

$800 a year

R.60-122 §103.I

One policy with the application

The random drug testing policy goes with the initial and renewal applications. Our sources do not say DPH reviews the other policies before licensing.

R.60-122 §103.F.1-5Form 1307, Additional Documents

Not stated

DPH issues the first license only once you show substantial compliance; the rule does not say whether it checks by visit or by documents. Any provider may be inspected without notice.

R.60-122 §103.BR.60-122 §102.LR.60-122 §202.A

No

The rule does not require a nurse. Medicaid personal care adds an RN or LPN supervisor.

R.60-122 §402.B, §406.APersonal Care Scope, D.1, E.2-3

Household help is licensed

Household help and help to get to community activities are personal support services. Housekeeping-only is exempt, and companionship is not named as an exemption.

0940-05-38-.01(1)0940-05-38-.03(2)(c)

$810 per site

For one category of service, with each initial application.

0940-05-02-.05(1)

$810 a year per site

The same fee with each yearly renewal.

0940-05-02-.05(1)

Electronic desk audit

The initial inspection covers “certain policies and procedures”. TDMHSAS does not publish which.

Step 5What does an Initial Inspection cover?

An electronic desk audit

The initial inspection is done electronically after the paperwork is in and the fee is paid. No fire inspection for a PSSA.

Step 5Step 4

Only for medication assistance or education services

Medication assistance training must be given by, or under the general supervision of, a registered nurse, and education services are consultation by a registered nurse. An agency offering neither needs no nurse for them.

0940-05-38-.08(1)(b)0940-05-38-.01(6)

Exempt

Sitter-companion, chore or household services with no personal care or health-related services need no license.

Tex. Health & Safety Code §142.003(a)(15)

$2,625

For an initial three-year license.

26 TAC §558.3(a)(1)-(2)26 TAC §558.15(b)

$2,625 every three years

The renewal fee is the same.

26 TAC §558.3(a)(1)-(2)

At the initial survey, after licensing

All required policies must be ready when the surveyor arrives.

26 TAC §558.521(d)26 TAC §558.521(a)

After the license

Within six months of the license date, admit at least one client and request the initial survey.

26 TAC §558.521(a)

No

Agencies offering only personal assistance services need no supervising nurse; home health and hospice agencies do.

26 TAC §558.243(c)(1)

Exempt

The HCO regulations do not apply to providers of only homemaker, chore or companion services.

12VAC5-381-30 A

$1,500

For a three-year license, paid with the application and not refundable.

12VAC5-381-70 A12VAC5-381-40 E

$1,500 every three years

The same fee for each renewal application.

12VAC5-381-70 A

Not covered in our sources

Applicants are subject to inspection

OLC offers a prelicensure consultation on the survey process, and the license is issued on finding compliance. Then unannounced inspections at least every two years.

12VAC5-381-40 C12VAC5-381-40 A12VAC5-381-20 B12VAC5-381-80 A

Yes, for personal care

An organization providing personal care designates a registered nurse to supervise it.

12VAC5-381-360 A

Homemaker licensed, companion only unclearOur reading

No exemption covers homemaker-only or companion-only businesses, and housekeeping and shopping are IADLs. Companionship with no ADL or IADL task is less clear.

WAC 246-335-410(5)

$5,000

Per service category, for the first 12-month license.

WAC 246-335-990(1)

$2,400 to $3,700 per 2 years

The standard fee, set by full-time equivalent staff from 5 or fewer to 101 or more. Lower for agencies contracted with and monitored by DSHS or an AAA; each extra county adds a surcharge.

WAC 246-335-990, Table 1WAC 246-335-990(4)RCW 70.127.100WAC 246-335-990(4)(b)(iii), Table 2WAC 246-335-990(3)

Approved before licensing

DOH reviews and approves the policy manual before the license is issued. Its survey office asks for the manual after you apply.

DOH 505-109 (April 2026), Policies and Procedures

Yes, announced

An announced initial survey before licensing; the license is issued only after you pass it.

WAC 246-335-320(3)License Requirements page

Only for optional nursing tasks

No nurse is required on staff. An RN by contract is needed only if you offer nurse delegation or help with vital signs that guide medication.

WAC 246-335-420(14)(b)