From application to approval, we handle your VDH licensing — then hand you the platform to run your agency from day one. Most consultancies disappear when your license arrives. We keep going.
Want to open a non-medical home care agency in Virginia? You need a Home Care Organization (HCO) License from the Virginia Department of Health. Our estimate: 300–360 days for provisional approval plus an on-site survey. State filing fees total $1,500 and are paid directly to VDH.
Non-medical home care agencies do not require a CON in Virginia.
Medicaid Program
Cardinal Care Managed Care
Plus the CCC Plus Waiver and Managed Care Organizations (MCOs) and Becoming a Medicaid Provider for qualifying providers.
Home Care License Type in Virginia
Virginia regulates home-based care under several license categories. Most new founders start with a HCO License for non-medical care, then add skilled services later if they choose.
NON-MEDICAL
Home Care Organization (HCO) License
Virginia requires a Home Care Organization (HCO) License to provide personal care services.
Personal care and daily living assistance
Companionship and homemaker services
Medication reminders (not administration)
Transportation and errand assistance
Respite care for family caregivers
State fee:
$1,500 Triennial License Fee
Timeline:
10-12 Months for provisional approval
Regulator:
Virginia Department of Health
How to Get Licensed in Virginia
Virginia licensing follows a structured 8-step process through VDH. Our specialists handle all 8 steps in the Launch and Signature packages; in the Licensing Kit, you handle the submission yourself with our expert guidance.
300–360 days from start to provisional approval
1
FOUNDATION
2
POLICIES
3
APPLICATION
4
INSURANCE
5
SURVEY
6
OPERATIONS
1
Form Your Business Entity
FOUNDATION
File an LLC with the Virginia State Corporation Commission (SCC). The filing fee is $100 (Va. Code § 13.1-1005). Get an EIN from the IRS, open a business bank account, and register with the Virginia Department of Taxation.
2
Develop Policies and Procedures
POLICIES
Create written policies covering client rights and responsibilities, personnel management, service delivery procedures, quality assurance, emergency protocols, infection control, and complaint resolution.
3
Hire Your Administrator and Nurse
POLICIES
Your administrator needs at least one year of training and experience in direct health care. They also need one year of supervisory or management work in home health care or a related health program in the last five years (12VAC5-381-170). You must also name a registered nurse to supervise personal care services (12VAC5-381-360).
4
Complete Criminal Record Checks
APPLICATION
Collect a sworn disclosure statement from every applicant. Get a Virginia State Police criminal record report within 30 days of hire. Do not accept a report dated more than 90 days before hire. Keep reports in locked files (12VAC5-381-110).
5
Secure Insurance and Crime Coverage
INSURANCE
Get malpractice insurance, general liability ($1M per occurrence), and third-party crime insurance or a $50,000 blanket fidelity bond. Add workers' comp and auto liability if you drive clients.
6
Submit VDH Application
APPLICATION
Apply through the VDH OLC Portal. New users must first ask for a portal account. The rule says to apply at least 60 days before you plan to open (12VAC5-381-40). Plan for much longer. Include everything asked for and the $1,500 fee. The fee is not refundable. An incomplete application goes inactive after six months.
7
Pass Initial Inspection
SURVEY
VDH reviews your application and then does an on-site inspection (12VAC5-381-40 C). OLC emails you when the inspection is ready to schedule. Fix any problems it finds.
8
Receive License and Begin Operations
OPERATIONS
Once approved, you get your Home Care Organization license. It is renewed every three years. Then you can begin serving clients.
Why Virginia Founders Choose HomeCareAtlas
The biggest difference between us and traditional consultancies isn't the license — it's what happens after the license arrives.
Traditional Consultant
HomeCareAtlas
Pricing
A mystery sales process and hard upsells
Clear packages built for your goals
Policies & Procedures
Generic templates
Built around your state and your service model
Application Filing
You assemble the packet
Done-for-you in Launch and Signature
Survey Day
You're on your own
On-call phone support during your state visit
After License Arrives
Relationship ends
Platform, dashboard, and directory listing go live
Caregiver Onboarding
Not included
Digital onboarding ready for hire #1
Compliance Tracking
You build a spreadsheet
Live compliance dashboard included
Directory Presence
None
Listed on Carezano the day you open
Three Ways to Get Your Virginia Agency Licensed
Pick the level of support that matches how hands-on you want to be. Virginia state fees ($1,500 to VDH) are passed through at cost.
Virginia charges a state application fee, paid directly to the state licensing body. We don't mark it up.
Want to see pricing? We share it on your free 15-minute call. Pick a time →
The Platform That Comes With Your License
Every tier includes free time on Home Care Atlas — the operating system for your new agency. This is the part other Virginia consultancies don't offer.
Virginia Licensing Workspace
Track your application, documents, and deadlines in one dashboard. Your Atlas specialist works in the same view you do.
Custom Virginia P&P Manual
Written around your state's rules, your service model, and your agency — not a generic national template. Survey-ready before you file.
Business Formation
LLC, EIN, NPI, surety bond, and insurance — all tracked and handled in Launch and Signature packages.
Compliance Dashboard
From caregiver #1 onward, every certification, background check, and required document is tracked with automatic expiration alerts.
Caregiver Onboarding
I-9, W-4, direct deposit, and required background-check verifications — all collected digitally.
Carezano Directory Listing
Listed on our public directory the day you open. Local families find you, referral partners find you, you're visible from day one.
Common Questions Before You Book
What license do I need for home care in Virginia?
Virginia requires a Home Care Organization License from the Virginia Department of Health (VDH), Office of Licensure and Certification. You need it to give personal care. The rules are 12VAC5-381.
How much does a Virginia home care license cost?
The VDH fee is $1,500 for each initial and renewal application (12VAC5-381-70, amended May 22, 2025). The license is renewed every three years. We estimate total startup costs at $45,000 to $85,000.
How long does Virginia licensing take?
Plan on about a year. VDH says complete initial applications now take about 10 to 12 months from submission to final approval. That is because so many people are applying. Applications are handled in the order they come in. Business setup time comes on top of that.
What background checks are required in Virginia?
Every job applicant must sign a sworn statement about convictions and pending charges. You must get a Virginia State Police criminal record report within 30 days of hire (12VAC5-381-110). The HCO rule does not ask for fingerprints or FBI checks.
What insurance is required in Virginia?
Virginia requires malpractice insurance, general liability of at least $1M per occurrence, and third-party crime insurance or a $50,000 blanket fidelity bond (12VAC5-381-210). Check Virginia workers' comp law too. Add auto liability if you drive clients. A surety bond is not required.
Is Northern Virginia a good market for home care?
It can be. We estimate Northern Virginia has the highest billing rates in the state ($32-$42/hr). Many federal and military retirees live there. Competition is strong.
How do I get Medicaid clients in Virginia?
First get your VDH license. Then enroll with DMAS as a Medicaid provider. Then contract with the Cardinal Care health plans: Aetna, Anthem HealthKeepers Plus, Humana, Sentara Health Plans, and UnitedHealthcare.
Do I need a license for companion care only?
No. Agencies that provide only homemaker, chore, or companion services do not need the HCO license (12VAC5-381-30). If you already hold an HCO license and switch to companion-only, you file a written exemption request with a $75 fee (12VAC5-381-30 B, -70 D). If you add any personal care, you need the full license.
Virginia Home Care Licensing: What You Need to Know
Virginia requires a Home Care Organization (HCO) License to provide personal care services. Personal care means help with daily activities like bathing, dressing, and eating. The rules are in Code of Virginia Title 32.1, Chapter 5, Article 7.1 and 12VAC5-381. Apply at least 60 days before you plan to open. The license is renewed every three years. The fee is $1,500 for each initial and renewal application (rule amended May 22, 2025). The rules do not apply to agencies that offer only homemaker, chore, or companion services (12VAC5-381-30). A licensed agency that wants an exemption files a written request with a $75 fee. Running an HCO without a license is a Class 6 felony.
The Home Care Organization (HCO) License
Agencies that give personal care must get a VDH Home Care Organization License under 12VAC5-381. The rules do not apply to homemaker, chore, or companion-only agencies (12VAC5-381-30). A licensed agency that switches to companion-only files a written exemption request with a $75 fee. Every job applicant must sign a sworn statement about past convictions and pending charges. You must get a Virginia State Police criminal record report within 30 days of hire (Code of Virginia § 32.1-162.9:1; 12VAC5-381-110). Until it comes back, the worker needs direct supervision by a checked employee to work with clients. Barrier crimes under § 19.2-392.02 bar hiring, with one narrow exception for an old misdemeanor. Virginia requires malpractice insurance, general liability insurance of at least $1 million per occurrence, and third-party crime insurance or a blanket fidelity bond of at least $50,000 (12VAC5-381-210). Check Virginia workers' comp law too. A surety bond is not required. Virginia also requires required administrator certification (typical cost N/A).
Certificate of Need (CON) in Virginia
Virginia does not require a Certificate of Need (CON) for non-medical home care. You can move directly into the licensing process without a separate market-need review.
Medicaid Participation — Cardinal Care Managed Care
Virginia's Medicaid program. Cardinal Care Managed Care combined the CCC Plus and Medallion 4.0 managed care programs, which ended in 2023. New health plan contracts began July 1, 2025. Most home care agencies reach Medicaid clients through these health plans.
The VDH On-Site Survey
VDH Inspections at Least Every 2 Years (12VAC5-381-80). VDH makes unannounced on-site inspections of each licensed Home Care Organization as needed, and at least every two years.
Common Reasons Virginia Applications Are Rejected or Delayed
Generic P&P manuals that don't reflect state-specific regulations
Incomplete administrator documentation
Insurance or surety bond policies that don't meet state minimums
Missing or inadequate quality assurance program documentation
Physical office that doesn't meet site-review standards
Caregiver background checks that miss required state databases
Every one of these is preventable with proper preparation. It's the biggest reason founders choose done-for-you packages over DIY — the cost of a rejection in lost time is almost always higher than the cost of doing it right the first time.
Book a Free Virginia Strategy Call
15 minutes with a home care specialist. We'll map out Virginia licensing for you, your timeline, and your best next step — even if you don't hire us.
Which Virginia license type fits your business model (Home Care Organization)
Your realistic timeline and budget
Whether Cardinal Care Managed Care enrollment makes sense for your plan
No pressure. No obligation. Virginia-specific guidance either way.
Your Future Virginia Clients Are Already Looking for Care.
Every week you spend piecing this together alone is a week you're not serving your first Virginia client. Let's get your agency licensed, launched, and visible — with people on your side who know VDH.
Built exclusively for non-medical home care|Virginia-specific guidance under 12 VAC 5-381 (Home Care Organizations)|Platform & HomeCareAtlas directory on day one
Virginia licensing details verified by HomeCareAtlas on September 1, 2026.
Virginia Home Care License — Done-for-You Licensing
