To operate a home care business in Florida, you need authorization from the Agency for Health Care Administration (AHCA) before serving your first client, and the Florida home care license requirements depend on which of two tracks fits your business: a Home Health Agency (HHA) license if you plan to deliver skilled medical care, or a Homemaker and Companion Services (HCS) registration if you plan to offer non-medical help like housekeeping, meal preparation, shopping, and companionship. The HHA path is the longer, more expensive, and more heavily regulated of the two. Plan on three to six months from business formation to license in hand, longer if your application has gaps or your survey turns up deficiencies.
Pick Your Track First: HHA License or HCS Registration
Florida draws a sharp line between the two categories, and this choice controls the rest of your application.
You need a Home Health Agency license if any of the services you plan to provide must legally be performed by a licensed healthcare professional. That includes nursing, physical, occupational, respiratory, and speech therapy, home health aide services, and dietetics and nutrition counseling.1Florida Senate. Florida Code 400.462 – Definitions2Florida Senate. Florida Code 400.464 – Home Health Agencies to Be Licensed
You need a Homemaker and Companion Services registration if you plan to offer only non-medical assistance. The registration itself is simple and inexpensive: $50.75 for a two-year period, with no financial-viability documentation and no full licensure survey.3Florida Agency for Health Care Administration. General Information – Homemaker and Companion Services Registration
Everything below covers the HHA license. Where the HCS process differs, the difference is called out.
Set Up the Business Before You Touch the Application
Form a Florida LLC or corporation through the Division of Corporations, get a federal Employer Identification Number from the IRS, and complete your Florida tax registrations. If you intend to bill Medicare or Medicaid at any point, apply for a Type 2 (organizational) National Provider Identifier through the NPPES registry. The NPI is free and required under HIPAA for electronic healthcare transactions, and later federal enrollment depends on already having it.
Hire Your Administrator and Director of Nursing
AHCA expects both roles filled and vetted before you submit, not after.
The administrator must be a direct employee. Florida law requires this person to be a Florida-licensed physician, physician assistant, or registered nurse, or someone with at least one year of supervisory or administrative experience in home health care or in a licensed hospital, nursing facility, or assisted living facility.4Online Sunshine. Florida Code 400.462 – Definitions One administrator can run only a single agency, unless several agencies share identical controlling interests, in which case the cap is five.5Online Sunshine. Florida Code 400.476 – Administration and Management
The director of nursing must be a Florida-licensed RN who supervises all personnel providing direct patient care.6Legal Information Institute. Florida Administrative Code Rule 59A-8.0095 – Personnel If your administrator is already a licensed physician, PA, or RN and you have ten or fewer full-time equivalent employees, one person can fill both roles.5Online Sunshine. Florida Code 400.476 – Administration and Management Agencies not providing skilled care do not need a director of nursing at all.
Clear Level 2 Background Screening Early
Every person with direct client contact or access to client information must pass a Level 2 background screening before starting work. Fingerprints are processed through the AHCA Clearinghouse and run against both the Florida Department of Law Enforcement and FBI databases.7Florida Agency for Health Care Administration. Background Screening
Your administrator, director of nursing, and all controlling interests must clear this screening before AHCA will schedule your licensure survey. Build two to four weeks into your timeline and start it as soon as key people are identified. This step is one of the most common causes of delay.
Separately, you must check every employee and contractor against the federal Office of Inspector General’s List of Excluded Individuals and Entities. Hiring someone on the OIG exclusion list exposes your agency to civil monetary penalties, and that person cannot participate in any service reimbursed by a federal healthcare program.8Office of Inspector General, U.S. Department of Health and Human Services. Exclusions The check is free.
Prove You Can Afford to Operate
An HHA application must include a Proof of Financial Ability to Operate package.9Online Sunshine. Florida Code 408.810 – Minimum Licensure Requirements A certified public accountant must compile prospective financial statements covering your first two years: a pro forma balance sheet, a cash flow statement, and an income and expense statement showing that projected revenues will cover liabilities and operating costs.10Legal Information Institute. Florida Administrative Code Rule 59A-35.062 – Proof of Financial Ability to Operate The documents must be compiled and signed by the CPA, not prepared internally. Budget several weeks and roughly $2,000 to $5,000 in CPA fees. HCS registrations skip this package entirely.
Insurance
Every home health agency must carry malpractice insurance and general liability insurance, each with a minimum of $250,000 per claim. Proof of coverage must accompany the initial application and every renewal.11Florida Senate. Florida Code 400.471 – Home Health Agency Licensure Once you have employees, Florida law also requires workers’ compensation coverage for most employers.
Surety Bond If a Controlling Interest Is a Nonimmigrant Alien
This one applies narrowly but matters when it does. If any controlling interest in the agency is a nonimmigrant alien, Florida requires a surety bond of at least $500,000, payable to AHCA, guaranteeing full legal compliance. The requirement covers initial applications, renewals, and changes of ownership.12Florida Senate. Florida Code 408.8065 – Surety Bond If all controlling interests are U.S. citizens or permanent residents, no bond is required.
Establish an Office and Write Your Policy Manual
You need a functional physical office accessible to staff and surveyors during business hours. AHCA requires documentation of the space, typically a lease agreement or deed with a floor plan, and the office must comply with local commercial zoning.
Your policy and procedure manual is the document surveyors scrutinize most closely. It must comply with Chapter 400, Part III of the Florida Statutes and Chapter 59A-8 of the Florida Administrative Code, and it needs to cover patient rights and grievances, infection control, quality assurance, emergency management (including hurricanes), personnel policies, and HIPAA compliance.13Agency for Health Care Administration. AHCA Form 3110-1011 – Home Health Agency Application Surveyors compare your written policies against operational reality, so a template manual pulled off the shelf without customization to your services is a common source of deficiencies.
Submit the Application
HHA applicants use AHCA Form 3110-1011.13Agency for Health Care Administration. AHCA Form 3110-1011 – Home Health Agency Application HCS applicants use a separate, simpler form on AHCA’s website. The complete HHA package includes the application form, ownership and entity documentation, professional licenses and résumés for the administrator, director of nursing, and other key personnel, the CPA-compiled financial documents, proof of insurance, the office lease or deed with floor plan, the policy manual, and the non-refundable application fee.
The initial HHA license fee is approximately $2,255, which covers your first biennial inspection.
AHCA reviews for completeness and issues an omissions letter if anything is missing, and every omissions response adds weeks. Once AHCA considers the application complete, it has 60 days to approve or deny.14Online Sunshine. Florida Code 408.806 – License Applications
Pass the Initial Licensure Survey
After administrative review clears and all controlling interests pass background screening, an AHCA field office schedules an on-site survey. You cannot serve any client until the survey is complete and the license is issued.
Because you have not yet cared for clients, surveyors focus on readiness. They verify the office is operational, confirm required personnel meet qualifications, review the policy manual against regulatory requirements, and inspect record-keeping systems. If they find deficiencies, you generally have ten days to submit an acceptable plan of correction, and a follow-up visit may be required. Failure to correct deficiencies or submit an adequate plan will result in a recommendation to deny. The field office typically takes about two weeks to prepare the survey report after the visit. Once you clear it, AHCA issues your license and you can begin accepting clients.
What Kicks In After You’re Licensed
Florida HHA licenses run on a biennial cycle. You must submit a renewal with current proof of insurance and pay the renewal fee before expiration. AHCA conducts periodic inspections during the license period, and deficiencies can lead to fines, corrective action, or revocation.
If your agency provides personal care or home health services reimbursed by Medicaid, you must use an Electronic Visit Verification system that captures client and caregiver identity, service type, and precise visit timing. Non-compliance leads to claim denials.
Background screening and OIG exclusion checks are ongoing, not one-time. Screen every new hire before they start, and recheck the OIG list periodically for existing staff.8Office of Inspector General, U.S. Department of Health and Human Services. Exclusions If staff perform procedures involving potential blood exposure, you must maintain an Exposure Control Plan under OSHA’s Bloodborne Pathogens standard, provide protective equipment, and document sharps injuries.
State License Is Not Medicare or Medicaid Enrollment
Your AHCA license does not, by itself, let you bill Medicare or Medicaid. Medicare certification is a separate process through the Centers for Medicare and Medicaid Services, requires meeting federal Conditions of Participation, and involves its own federal survey; it can add several months on top of state licensure. Medicaid enrollment is handled through AHCA’s provider enrollment division and has its own credentialing and compliance requirements. Many new agencies begin with private-pay clients while working through federal enrollment. Whichever direction you take, the state license is the foundation everything else builds on.