To operate a home health agency in Kansas, you need a license from the Kansas Department of Health and Environment (KDHE) under K.S.A. 65-5101 through 65-5117 and the regulations at K.A.R. 28-51-100 through 28-51-120. Kansas home health agency licensing is a state process, but if you plan to bill Medicare or Medicaid you also have to clear a separate federal certification. Both layers come with ongoing staffing, record-keeping, and inspection requirements you have to keep meeting after the license is in hand.
Who Needs a Kansas Home Health License
Any public or private agency that provides home health services, supportive care services, or attendant care services for a fee must be licensed before operating in Kansas.1Kansas Legislature. Home Health Agencies SB 154 The rule reaches even agencies that only hold themselves out as providing these services, so you can trigger it before your first patient visit.
A few operators are excluded: local health departments that are not federally certified as home health agencies, durable medical equipment companies that deliver services through specialized equipment, and independent living agencies. If your operation fits one of those, the licensing statute doesn’t apply. If it doesn’t, you need the license.
Applying to KDHE
The application goes to KDHE and covers your agency’s organizational structure, ownership, services offered, and staff qualifications. Kansas used to charge a flat application fee, but the legislature moved to a fee set by administrative regulation and calculated on the unduplicated number of patients admitted during the prior licensure year.2Kansas Legislature. Kansas Statutes 65-5104 Because the number can change, check the current schedule with KDHE before you file.
KDHE may inspect your operation on-site before granting the license, looking at the facility, equipment, policies, and general readiness to deliver care. Your governing body also has to meet specific organizational requirements: bylaws or an operating agreement renewed annually, a qualified administrator and alternate administrator, written policies and procedures, and disclosure to the department of every corporate ownership interest of five percent or more.3Cornell Law School. Kansas Administrative Regulations 28-51-103 – Organization and Administration Those pieces need to be in place at application, not after.
Annual Renewal and Reporting Changes
The license runs one year. Renewal requires filing an annual report and paying the current fee. Miss that deadline by more than 30 calendar days and the license is automatically canceled.2Kansas Legislature. Kansas Statutes 65-5104 There is no discretionary grace period beyond that window.
You also have to tell KDHE about significant operational changes as they happen, including ownership transfers and new service lines. Skipping that notification is a separate ground for suspension or revocation, independent of anything found in a survey.
Adding Medicare or Medicaid Certification
A state license lets you operate. It does not let you bill Medicare or Medicaid. For those programs, your agency must meet the Conditions of Participation (CoPs) at 42 CFR Part 484 and pass a federal certification survey.4eCFR. 42 CFR Part 484 – Home Health Services The CoPs govern patient rights, care planning, quality assessment, infection control, clinical records, and personnel qualifications.
Before enrolling with Medicare, your agency needs a National Provider Identifier, the unique 10-digit number required for all HIPAA standard transactions.5CMS. The Who, What, When, Why and How of NPI
The 36-Month Ownership Rule
One federal rule catches buyers of existing agencies off guard. If more than 50 percent of an agency’s ownership changes within 36 months of initial Medicare enrollment or the most recent ownership change, the Medicare provider agreement does not transfer. The new owner has to enroll as a brand-new agency and obtain a fresh state survey or accreditation.6CMS. Incorporation of Recent Provider Enrollment Regulatory Changes – Home Health Prospective Payment System Final Rule An exception applies if the agency has submitted two consecutive years of full cost reports since its last enrollment or ownership change.
All providers and suppliers must also report any adverse legal actions against themselves, their owners, or managing employees within 30 days.7Federal Register. Medicare and Medicaid Programs Calendar Year 2026 Home Health Prospective Payment System Rate Update
Staying Compliant After Licensure
Licensing is the entry point. Keeping the license means meeting continuing standards at both the state and federal level.
Inspections and Surveys
KDHE conducts scheduled and unscheduled inspections, reviewing patient records, interviewing staff and patients, and checking whether daily operations match your written policies. For Medicare-certified agencies, the federal recertification survey must occur no later than 36 months after the previous standard survey.8CMS. State Operations Manual Appendix B – Home Health Agencies Agencies with complaint histories or documented safety concerns are surveyed more often. Any deficiencies require a corrective action plan the agency must actually implement.
Electronic Visit Verification
Kansas requires Electronic Visit Verification (EVV) for Medicaid-funded home health visits. The system records the service type, patient, date and location, caregiver, and start and end times of each visit. Kansas extended EVV from home and community-based services to home health care services effective December 3, 2023.9KanCare. Electronic Visit Verification Claims for home health visits will not process without an approved and validated EVV transaction.
Kansas uses a provider-choice model: the state offers a free EVV application, but agencies may use a third-party system if the state has authorized it.9KanCare. Electronic Visit Verification The mandate comes from Section 12006 of the 21st Century Cures Act, which imposes reductions in the Federal Medical Assistance Percentage on states that fail to implement EVV. For 2026, the reduction reaches 0.75 percent for home health care services, and that reduction flows down to agencies through reduced reimbursement.10Medicaid.gov. EVV Requirements in the 21st Century Cures Act
OASIS Data
Medicare-certified agencies must collect and electronically transmit Outcome and Assessment Information Set (OASIS) data for every patient receiving skilled services. The state designated by CMS instructs agencies on administering, encoding, and transmitting the data set and integrating it into their record-keeping.11eCFR. 42 CFR 488.68 – State Agency Responsibilities for OASIS Collection and Data Base Requirements Errors must be corrected within CMS timeframes, and patient-identifiable OASIS information is confidential.
Patient Records and Care Planning
Each patient must have an individualized plan of care that is reassessed as the patient’s condition changes. K.A.R. 28-51-100 spells out what the clinical record must contain: an admission note, the plan of care, progress notes, records of communication about the patient’s status or treatment, and a discharge summary report.12Cornell Law School. Kansas Administrative Regulations 28-51-100 – Definitions Clients receiving supportive care services rather than skilled services need a parallel client record with similar documentation plus notes on the supportive care provided.
Staffing and Supervision
Kansas sets staff qualifications through K.A.R. 28-51-113. Nurses providing home health services must hold a current license from the Kansas State Board of Nursing. Home health aides follow a two-step path: they must first become a Kansas-certified nurse aide in good standing on the public nurse aide registry, which involves completing a 90-hour training program, and then complete an additional 20-hour home health aide course approved by the department.13Cornell Law School. Kansas Administrative Regulations 28-51-113 – Home Health Aide Qualifications Before enrolling in the 20-hour course, aides must pass a reading comprehension screening at an eighth-grade level.
Once aides are working, federal rules require ongoing supervisory assessments by a registered nurse or other qualified professional, with frequency and format set by 42 CFR 484.80.14eCFR. 42 CFR 484.80 – Condition of Participation: Home Health Aide Services If a supervisory visit confirms a deficiency, the aide must complete retraining and pass a competency evaluation for the deficient skill and all related skills before resuming those duties. Agencies also have to keep staff current on infection control, medication management, patient rights, and emergency response, and document every training activity for inspectors.
Background Checks and Exclusion Screening
K.S.A. 65-5117 requires criminal history record checks for staff who will have direct contact with patients. The agency must keep records showing checks were completed, and those records are reviewed during state surveys.
Medicare or Medicaid participation adds a second screen: every new hire and existing employee has to be checked against the Office of Inspector General’s List of Excluded Individuals and Entities (LEIE). No federal payment will be made for items or services furnished, ordered, or prescribed by an excluded individual, and employing someone on the list in a role touching federally billed services exposes the agency to civil monetary penalties.15HHS Office of Inspector General. Background Information – Exclusions Screening at hire and periodically thereafter is the standard way to stay out of that trap.
What Non-Compliance Costs
KDHE can suspend or revoke a home health agency’s license for regulatory violations, and agencies that fail to correct deficiencies after a survey face escalating enforcement. K.S.A. 65-5114 makes certain violations of the home health agency act a misdemeanor, which opens the door to criminal prosecution.
On the federal side, fraudulent Medicare or Medicaid billing can trigger exclusion from federal health programs, repayment demands, and in severe cases criminal charges carrying imprisonment. Agencies whose patient-safety failures cause harm may also face civil suits from patients or families. Corrective action plans are mandatory when surveyors identify deficiencies, and refusing or failing to implement one is itself grounds for further sanctions up to revocation.