To start a home health care business in Florida, you need a license from the Agency for Health Care Administration (AHCA), and before you get there you need a registered business entity, a federal tax ID, background clearances for every owner, proof you can fund operations, qualified clinical leadership, and the right insurance. Plan on several months from your first filing to your first patient visit.
Form Your Business Entity First
Everything downstream references the legal entity, so set it up through the Florida Division of Corporations before you touch any health care paperwork. Most owners file either a corporation under Florida Statutes Chapter 607 or an LLC under Chapter 605, both through the Sunbiz online portal.
An LLC filing costs $125, which covers the $100 filing fee and a $25 registered agent fee.1Florida Department of State, Division of Corporations. LLC Fees Corporation filing fees start at $35, with additional required fees bringing the total higher.2Florida Department of State, Division of Corporations. Fees Either structure requires a registered agent with a Florida physical address.
Once the entity is active, pull a Federal Employer Identification Number from the IRS.3Internal Revenue Service. Get an Employer Identification Number You will need the EIN for bank accounts, payroll, and every state and federal application that follows. Then register with the Florida Department of Revenue for state tax obligations including reemployment tax.4Florida Department of Revenue. Account Management and Registration
Get the business name exactly right now. If the name on your Sunbiz registration does not match what you later put on your AHCA application and background screening records, expect delays or rejection. Mismatches between documents are the single most common reason applications stall.
Decide Between a Home Health Agency and a Nurse Registry
Florida Statutes Chapter 400, Part III covers both home health agencies and nurse registries, but they operate on different models.5Florida Legislature. Florida Statutes Chapter 400 Part III – Home Health Services The choice drives your staffing structure, liability exposure, and insurance costs.
A home health agency employs caregivers directly, supervises their work, and bears liability for the care delivered. Agencies can provide skilled nursing, therapy, and non-skilled personal care or companion services, and they can pursue Medicare certification or stay state-licensed only. Florida Administrative Code Chapter 59A-8 sets the operational standards.6Legal Information Institute. Chapter 59A-8 – Minimum Standards for Home Health Agencies
A nurse registry refers independent contractors to patients rather than employing caregivers. There is less clinical overhead and less control over service delivery, with different forms, insurance requirements, and legal obligations. Pick the registry model if you want to run a referral operation; pick the agency model if you want to employ and manage clinical staff.
Build the AHCA Application
This is where the real work sits. Nothing goes in until background clearances, financials, forms, insurance, and named clinical leaders are all lined up.
Level 2 Background Screening
Everyone with a controlling interest must pass a Level 2 background screening through the AHCA Care Provider Background Screening Clearinghouse, including fingerprinting and a criminal history check under Florida Statutes Section 408.806 and Chapter 435. Certain convictions are permanent disqualifiers for owning or managing a Florida health care entity. Start this early. Processing takes weeks, and a disqualifying offense surfacing late will end the application.
Proof of Financial Ability to Operate
Florida Statutes Section 408.810(8) requires initial applicants to prove they can financially sustain operations.7Florida Senate. Florida Statutes 408.810 – Minimum Licensure Requirements You submit AHCA Form 3100-0009 with projected revenues and expenses, a plan for financing cash-flow needs, and documentation of access to contingency funding.8Legal Information Institute. Florida Administrative Code Rule 59A-35.062 – Proof of Financial Ability to Operate AHCA is checking that you will not run out of money in year one.
Application Forms
The main licensing form for a home health agency is AHCA Form 3110-1011.9Legal Information Institute. Florida Administrative Code Rule 59A-35.060 – Licensure Application Process It collects your business structure, physical office location, and the people responsible for daily operations. You also include a signed civil rights affidavit confirming compliance with federal non-discrimination laws. Every field must match your Sunbiz filing and background screening records.
Administrator and Director of Nursing
The application must name a qualified administrator and a Director of Nursing. The administrator handles overall management and must meet the qualifications in Florida Statutes Section 400.462 and Florida Administrative Code Rule 59A-8.0095.10Legal Information Institute. Florida Administrative Code Rule 59A-8.0095 – Personnel The Director of Nursing oversees clinical staff and patient care plans and must be a Florida-licensed registered nurse. Verify both candidates meet the education and experience standards before you put their names on the form; reviewers scrutinize these appointments closely.
Liability Insurance
You must submit evidence of professional and general liability insurance with the application. General liability coverage for home health agencies typically runs $1 million per occurrence and $2 million aggregate. Professional liability limits may need to be higher if you offer skilled nursing or medication management. A small agency usually pays roughly $300 to $1,500 per year, varying with services and staffing.
Submit and Pass the On-Site Survey
Everything uploads through the AHCA Health Quality Services Portal, which requires an account for document submission and status tracking.11Florida Agency for Health Care Administration. Single Sign On Portal You pay a non-refundable licensing fee set by Florida Administrative Code Rule 59A-35.060.9Legal Information Institute. Florida Administrative Code Rule 59A-35.060 – Licensure Application Process
AHCA then runs an omissions review. If there are gaps, you get a notice and a deadline to respond; miss it and the application can be denied. Watch the portal daily during this phase.
The license is not issued until you pass an on-site licensure survey. State inspectors visit your physical office to verify operational policies, personnel files, and administrative records against the standards in Florida Administrative Code Chapter 59A-8.6Legal Information Institute. Chapter 59A-8 – Minimum Standards for Home Health Agencies Pass the survey and you can accept patients.
Medicare and Medicaid Certification
The state license alone lets you serve private-pay and some insurance-covered patients. Billing Medicare or Medicaid requires separate federal and state certification. Skipping Medicare cuts you off from the largest payer in the industry, but the certification process is demanding, and some owners launch state-licensed only and pursue it later.
Medicare Enrollment
Medicare enrollment uses the CMS-855A application, filed on paper or through the Provider Enrollment, Chain and Ownership System (PECOS).12Centers for Medicare & Medicaid Services. CMS-855A Medicare Enrollment Application – Institutional Providers You need a Type 2 National Provider Identifier before applying and must pay a $750 application fee for 2026 to your Medicare Administrative Contractor.13Federal Register. Provider Enrollment Application Fee Amount for Calendar Year 2026
Home health agencies are automatically classified as high-risk providers, which means fingerprinting for all owners and a mandatory site visit.14Centers for Medicare & Medicaid Services. Medicaid Provider Enrollment Requirements Frequently Asked Questions You must also show operating reserves sufficient to cover at least three months of expenses after billing privileges are granted, with the required amount set by CMS based on comparable new agencies in your area.12Centers for Medicare & Medicaid Services. CMS-855A Medicare Enrollment Application – Institutional Providers
Conditions of Participation
Medicare-certified agencies must meet the federal Conditions of Participation in 42 CFR Part 484, which go beyond Florida’s baseline.15eCFR. Part 484 – Home Health Services That includes a quality assessment and performance improvement program, electronic OASIS patient assessment reporting to CMS within 30 days, a documented emergency preparedness plan reviewed every two years, and stricter personnel qualifications. The federal survey requirement can be met through a state survey agency inspection or through accreditation from a recognized body such as the Joint Commission, ACHC, or CHAP.
Florida Medicaid Enrollment
Medicare enrollment does not enroll you in Medicaid. You must enroll separately with the Florida Medicaid program. Federal regulations in 42 CFR Part 455 set minimum requirements, and Florida may add its own.14Centers for Medicare & Medicaid Services. Medicaid Provider Enrollment Requirements Frequently Asked Questions Any restriction or limitation on your nursing license will result in a denial.
Hiring and Workplace Compliance
Once the license is in hand, new owners often get caught by federal and state employer obligations rather than by licensing itself.
Florida requires workers’ compensation insurance for non-construction employers with four or more employees, counting corporate officers and LLC members toward the total.16Florida Department of Financial Services. Coverage Requirements A home health agency will reach that threshold fast. Have a policy in force before employee number four starts.
Every hire completes Form I-9 to verify identity and work authorization. Keep completed I-9s for three years after the hire date or one year after employment ends, whichever is later, and produce them on request for federal inspectors.17U.S. Citizenship and Immigration Services. I-9, Employment Eligibility Verification
Screen every hire against the Office of Inspector General’s List of Excluded Individuals and Entities before hiring and on an ongoing basis. Employing someone on the list exposes the agency to civil monetary penalties.18U.S. Department of Health and Human Services, Office of Inspector General. Background Information – Exclusions Run the check at least monthly for existing staff.
For Medicare-certified agencies, home health aides must complete a minimum of 75 hours of training, including classroom and supervised practical work, before providing patient care. Florida adds requirements for some populations: aides serving medically fragile children need at least 86 hours of specialized training under Florida Administrative Code Rule 59A-8.0099.19Legal Information Institute. Florida Administrative Code Rule 59A-8.0099 – Minimum Training Requirements
If employees may encounter blood or other infectious materials, OSHA’s bloodborne pathogens standard requires a written Exposure Control Plan reviewed and updated annually, proper sharps disposal containers, a sharps injury log, and frontline caregiver input on selecting safety devices.20Occupational Safety and Health Administration. Bloodborne Pathogens – 1910.1030 Because care happens in patients’ homes rather than a clinical setting, the plan has to address that reality.
Patient Rights and HIPAA From Day One
Before any patient receives care, give them written notice of their rights and your agency’s transfer and discharge policies. Explain verbally and in writing what Medicare, Medicaid, or other coverage will pay, what the patient may owe, and how to reach your administrator with complaints.15eCFR. Part 484 – Home Health Services The patient or legal representative signs confirming receipt. If coverage or costs change, communicate the update before the next home visit.
HIPAA’s Privacy Rule protects all individually identifiable health information you handle, whether electronic, paper, or verbal. You must maintain reasonable administrative, technical, and physical safeguards against unauthorized disclosure.21U.S. Department of Health & Human Services. Summary of the HIPAA Privacy Rule For Medicare-certified agencies, this extends to OASIS data, which must stay confidential and cannot be released to the public.15eCFR. Part 484 – Home Health Services Build the privacy practices into your operations from the first patient; retrofitting after a breach is far more expensive than doing it right the first time.