How To Start A Home Care Agency | Episode 1 - Getting Started 7 Key Steps

Starting a Home Care Agency: Initial Steps & Research
📌 The initial step for starting a home care agency is researching local regulations via the Department of Health website to understand licensing criteria.
📌 In New York, there are two agency types: LICHAs (licensed, focusing on private payers/long-term care) and CHHAs (certified, allowed to bill Medicare for short-term, skilled services).
📌 States vary significantly; for example, Florida allows agencies to be private duty or private duty/Medicare combined, whereas Michigan reportedly has no state Department of Health oversight for home care agencies.
📌 Always check the Department of Health site for application processes, fee structures, and whether they are currently issuing new licenses (some states, like NY, have moratoriums).

Agency Focus and Application Strategy
📌 After research, determine your area of focus: will you target long-term care, or skilled high-tech nursing services like wound care or intrathecal medication management?
📌 Establishing the agency application can be time-consuming; self-piecing policies took the speaker's initial team one year to complete.
📌 The speaker advises hiring a consultant for nearly $50,000 to handle the application process, viewing it as a time-saver compared to years of manual work and a way to learn business nuances.
📌 Application solutions for required policies are often found directly within the state's home care regulations.

Building the Core Team
📌 A crucial team member is the Director of Nursing (DON) or Director of Patient Services (DPS), responsible for all patient care, regulation knowledge, and interacting with state surveyors.
📌 If you are the DPS, ensure you possess strong administrative, leadership, and management skills; if not, hire someone who does.
📌 The Administrator is a non-medical role, often equivalent to a COO, ensuring the organization operates according to regulations.
📌 Do not neglect the Marketing Director; although often not required on the application, strong marketing experience is vital for growth in the home care market.

Funding and Financial Strategy
📌 A major mistake is being undercapitalized; the speaker's first agency was underfunded with only 5,000$ cash and50,000$ in credit/loans, leading to hiring subpar staff.
📌 Startups often raise significant capital (e.g., 500,000$ to20$ million) to establish an operating budget; aim higher than typical healthcare start-up funds.
📌 Effective funding sources include friends, family, angel investors, or retirement accounts; banks are often too traditional for initial financing.
📌 The speaker is seeding their new Florida company with 100,000$ (per consultant advice) solely for operational expenses, with plans to raise 1$ to afte…" style="color:#cc0000">3$ million after proving the concept.

<strong class="section-heading text-xl font-bold mb-4 inline-block">Execution and Reflection</strong>
📌 Step six is executing the original plan based on your defined agency size (e.g., mom-and-pop vs. $300$ to $1,000$ patients) by creating a detailed roadmap and organizational chart.
📌 Self-reflection is the final, critical step; be prepared to pivot if results deviate significantly from projections (e.g., hitting patient targets too quickly).
📌 Use the pre-service period to review the initial team for performance and synergy, potentially replacing underperforming members before operations begin.
📌 Bonus Insight: Founders should be cautious about arbitrarily distributing equity to partners or talent; utilize vesting schedules and study startup models to avoid giving up too much equity for insufficient capital (e.g., avoid giving up 25% for only25,000$).

Key Points & Insights
➡️ Research State Variance: Always check your local Department of Health website first, as regulations and licensing availability (moratoriums) differ significantly state-to-state.
➡️ Prioritize Key Hires: Secure a competent Director of Nursing/Patient Services with strong administrative and patient care skills, as they are central to compliance and operations.
➡️ Don't Skimp on Capital: Avoid being undercapitalized; secure sufficient operating funds (the speaker suggests at least $$100,000$ for initial proof of concept) to execute your business plan effectively.
➡️ Smart Equity Management: Study startup models to structure partnership agreements and fundraising; never give away significant equity (like 25%) for small amounts of initial cash.

📸 Video summarized with SummaryTube.com on Feb 21, 2026, 21:14 UTC