HomeCareAtlas Team · Updated November 2026
Researched from primary state regulatory sources.
How to Start a Home Care Agency in Pennsylvania
Starting a home care agency in Pennsylvania costs roughly $12,000 - $38,000 and takes 10-20 Weeks. Here's every step, fee, and deadline — sourced directly from Pennsylvania Department of Health (PA DOH, Division of Home Health).
In Pennsylvania, you need a license from the Department of Health (DOH) to run a home care agency. The rules are in 28 Pa. Code Chapter 611. Each office location needs its own license (§611.2(a)). The fee is $100 per location, and the license lasts one year. Since March 31, 2026, DOH only takes applications online. It no longer takes mailed or emailed ones. There are two license types. A Home Care Agency hires its own caregivers. A Home Care Registry refers caregivers who work on their own. Most new owners pick the agency license.
To start a non-medical home care agency in Pennsylvania, you need a Home Care Agency License from the Pennsylvania Department of Health (PA DOH, Division of Home Health). The application fee is $100 (doh license fee (per location)), the process takes approximately 10-20 weeks, and total startup costs range from $12,000 - $38,000. You need a $100 DOH license for each location. Since March 31, 2026, you can only apply online. Mailed applications are not accepted.
- License Required
- Yes — Home Care Agency License
- Regulatory Body
- Pennsylvania Department of Health (PA DOH, Division of Home Health)
- Application Fee
- $100 (doh license fee (per location))
- Timeline
- 10-20 Weeks (our estimate, start to license)
- Total Startup Cost
- $12,000 - $38,000
- Key Requirement
- You need a $100 DOH license for each location. Since March 31, 2026, you can only apply online. Mailed applications are not accepted.
- Last Verified
- November 2026 against Pennsylvania Department of Health (PA DOH, Division of Home Health) regulations
DOH License Fee (per location)
Source: 28 Pa. Code §611.2(e); 35 P.S. §448.807(b) · Checked Oct 2026
Our Estimate, Start to License
This is our best guess. Check with the Pennsylvania Department of Health (PA DOH, Division of Home Health).
Residents Age 70+
Strong Opportunity
How Pennsylvania compares to neighboring states
| State | License Fee | Timeline | Startup Cost |
|---|---|---|---|
| Pennsylvania ← | $100 | 10-20 Weeks | $12,000 - $38,000 |
| New Jersey | $500 | Varies | $55,000 - $100,000 |
| Ohio | $250 | 30-90 Days | $40,000 - $80,000 |
| New York | $2,000 | 9-18 Months | $100,000 - $200,000 |
| Delaware | $250 | 6-9 Months | $40,000 - $75,000 |
In This Article
Pennsylvania Licensing Overview
The Pennsylvania Department of Health (PA DOH, Division of Home Health) oversees all non-medical agencies.In Pennsylvania, you need a license from the Department of Health (DOH) to run a home care agency. The rules are in 28 Pa. Code Chapter 611. Each office location needs its own license (§611.2(a)). The fee is $100 per location, and the license lasts one year. Since March 31, 2026, DOH only takes applications online. It no longer takes mailed or emailed ones. There are two license types. A Home Care Agency hires its own caregivers. A Home Care Registry refers caregivers who work on their own. Most new owners pick the agency license.
You Need a DOH License (Ch. 611)
You need a license before you run or advertise a home care agency (§611.2(a)). Home care includes personal care, help around the house, companionship, and respite. Each location needs its own license.
Background Checks Depend on Where You Lived
Lived in PA for the last 2 years? Get a PA State Police check. If not, get an FBI fingerprint check and a Department of Aging letter (§611.52). Child abuse clearance is only needed if you serve anyone under 18 (§611.53).
Caregivers Must Show Skills, Not Hours
The state sets no hour count for caregiver training. Before work, each caregiver must pass a skills test, finish a training program, or hold a PA nurse license (§611.55). The "40 hours" you may see is not in the DOH rules.
Administrator Certification
Every Home Care Agency License must designate a qualified administrator or agency manager.
- Training Cost:No course required
- Topics:Chapter 611 sets no degree, experience, or training rule for the person who runs your agency. If that person changes, tell DOH in writing within 30 days (28 Pa. Code §51.4(c)). DOH asks for the new person's resume and a background check from the last year.
Source: 28 Pa. Code Ch. 611 · Checked Oct 2026
Estimated Startup Costs (2026)
Budget for $12,000 - $38,000 to ensure 3-6 months of runway.
| Category | Low Est. | High Est. |
|---|---|---|
| DOH License Fee (per location) | $100 | $100 |
| LLC Certificate of Organization (Dept. of State) | $125 | $125 |
| LLC Annual Report (yearly) | $7 | $7 |
| General Liability Insurance (estimate) | $1,800 | $3,500 |
| Professional Liability Insurance (estimate) | $800 | $1,800 |
| Workers' Compensation Insurance (estimate) | $800 | $1,800 |
| Background Checks (owners and first staff; PSP check is $22 each) | $50 | $400 |
| Office Setup | $400 | $2,500 |
| Scheduling & Care Software | $400 | $1,800 |
| Marketing & Website | $1,500 | $4,500 |
| Working Capital (3-6 months) | $6,000 | $22,000 |
We map every cost and file your Pennsylvania license for you.
How to Get a Pennsylvania Home Care Agency License
1-2 Weeks
Form Your Business
File a Certificate of Organization with the PA Department of State. The fee is $125. Veteran-owned and reservist-owned small businesses may not have to pay it. Get a free EIN from the IRS. Sign up for state taxes with the Department of Revenue. Every LLC now files a $7 annual report. It is due between January 1 and September 30 each year.
1-2 Weeks
Write an Operating Agreement
PA does not make you have one. But you should. It says who owns what and who makes choices. It should also say who runs the agency day to day and what happens if an owner leaves. Remember: DOH must hear from you in writing at least 30 days before any transfer of 5% or more of the stock or equity (28 Pa. Code §51.4(a)). Have a lawyer look at it.
2-6 Weeks
Start Background Checks Early
Owners and office staff need checks too, not just caregivers (§611.52(a)). Lived in PA the last 2 years? Get a PA State Police check online at epatch.pa.gov. If not, get FBI fingerprints and a Department of Aging letter. Serving anyone under 18? Also get child abuse clearances from the Department of Human Services (DHS).
1 Week
Pick Your License Type and Location
Choose a Home Care Agency, a Home Care Registry, or both. Each office location needs its own license and its own $100 fee. DOH says there are no branch offices in home care. So plan one location at a time.
3-4 Weeks
Build Your Policies and Forms
Write your policies. Make a client information packet (§611.57). It must list your services, fees, the DOH complaint hotline, and the local Ombudsman number. Set up skills checks, staff files, TB screening, and care plans. DOH inspects you before it issues the license. So have a real system ready, not just paper.
1-2 Weeks
Get Insurance
Chapter 611 sets no insurance amount. Get general and professional liability anyway. Ask a broker what limits fit you. Clients sign a DOH form that says whether you carry liability insurance for the worker. Workers' comp is a separate PA law. Get it before you hire. You can buy it from a private carrier or the State Workers' Insurance Fund (SWIF), (570) 963-4635.
1-2 Weeks
Apply Online to DOH
Apply on the DOH online portal (sais.health.pa.gov). The link is on the DOH home care page. Pay the $100 fee (28 Pa. Code §611.2(e)). The portal tells you which papers to upload. DOH stopped taking mailed or emailed applications on March 31, 2026. Questions about the online process: [email protected].
8-12 Weeks
DOH Inspection and License
DOH inspects your agency before it issues the first license (§611.2(a)). It looks at staff files, your client packet, and your records. Fix any problems fast. DOH does not publish how long this takes. Our guess is 2-3 months, but it can be longer.
We can do all of them for you in Pennsylvania.
New 2026 Legal Mandates
License Required (28 Pa. Code §611.2)
You cannot run or advertise a home care agency or registry without a DOH license. Each location needs its own license. The license says if you are an agency, a registry, or both.
Background Checks (§611.52)
Caregivers, office staff, and owners all need a criminal history report from the last year. Lived in PA the last 2 years? A PA State Police check. If not, an FBI check plus a Department of Aging letter. You may not hire anyone with a banned crime listed in 6 Pa. Code §15.143.
Child Abuse Clearance — Only If You Serve Kids (§611.53)
You only need child abuse clearances if you serve anyone under 18. If you serve only adults, you do not need them under Chapter 611.
Caregiver Skills Check (§611.55)
Before you send a caregiver to a client, they must have one of these: a PA nurse license, a passing score on your skills test, or a finished training program. Programs can be yours, a home health aide program, PA nurse aide training, or a Medicaid program. Check skills again at least once a year. Tests and training must cover 10 set topics.
Hiring While Checks Are Pending (§611.54)
A new hire can start while their check is pending. They must have applied for it, and you must know of nothing that rules them out. They must pass the skills check first. The limit is 30 days for people who lived in PA the last 2 years, and 90 days for others.
TB Screening Before Client Contact (§611.56)
Caregivers and staff who meet clients need a TB screening first. It must be from within 1 year of their start date. Update it every 12 months.
Client Information Packet (§611.57)
Before care starts, give each client a packet. It lists the services, the worker, hours, and fees. It has DOH contact info, the DOH complaint hotline (1-866-826-3644), and the local Ombudsman number. It also says if the worker is your employee or works on their own, and what that means for taxes and insurance.
Online Applications Only (Since March 31, 2026)
DOH takes first-time applications only through its online portal at sais.health.pa.gov. Mailed or emailed papers are no longer accepted. Questions: [email protected].
Ownership and Manager Changes (28 Pa. Code §51.4)
Tell DOH in writing at least 30 days before any transfer of 5% or more of the stock or equity. Tell DOH within 30 days after the person running the agency changes.
Workers' Comp Required; No DOH Insurance Minimum
Chapter 611 sets no insurance amounts. A $1 million policy is common, but it is not the law. Workers' comp is required by a separate PA law once you have employees.
Our Pennsylvania licensing team tracks the law so you do not have to.
Caregiver Mandates
Important Warning
Pennsylvania checks skills, not hours. The "40-hour training" number is not in Chapter 611. Medicaid programs may have their own training rules. DOH inspections look hard at staff files. Make sure each file shows how the caregiver passed the skills check.
- Criminal Background Check: Lived in PA the last 2 years: a PA State Police check. Everyone else: an FBI fingerprint check plus a Department of Aging letter. Child abuse clearance only if you serve anyone under 18.
- Skills Check (Several Ways to Pass): A PA nurse license, your own skills test, a training program, home health aide training (42 CFR 484), PA nurse aide training, or Medicaid program training. Proof moves with the worker to a new agency if the gap is 12 months or less.
- 10 Required Topics: Privacy, client choice, help around the house, spotting changes in the client, infection control, universal precautions, emergencies, record keeping, abuse and neglect, and hard behaviors. Personal care workers also learn bathing, grooming, dressing, moving, toileting, meals, and help with medicines.
- Yearly Skills Review: Review each caregiver’s skills at least once a year (§611.55(e)). Keep records. DOH inspections focus on staff files.
- TB Screening: A TB screening before client contact, dated within 1 year of the start date. Renew it every 12 months.
Regional Billing Snapshots
*Regional rates vary by specialized care needs (Dementia, Parkinson's) and local competition.*
We launch Pennsylvania home care agencies start to finish.
Regional Market Opportunities
Pennsylvania has about 2.8 million adults 65 and older. That is about 21% of the state, and the 5th most of any state (Census, July 2025). Older adults now outnumber children under 18. The 65+ group grew about 13% from 2020 to 2025. The middle pay for home health and personal care aides is $14.14 an hour (BLS OEWS May 2025, series OEUS420000000000031112008). Community HealthChoices (CHC) is the main Medicaid path for home care. The billing rates below are our estimates. Real rates depend on your area and payer.
Philadelphia Metro
The biggest market. Large health systems (Penn Medicine, Jefferson, Temple) send many referrals. It also has the most agencies.
Key: Caregivers who speak more than one language can help you stand out. The suburbs may be easier to start in.
Pittsburgh Metro
The second-biggest market. UPMC is the main health system and a big source of referrals.
Key: Get to know UPMC discharge planners early.
Lehigh Valley (Allentown, Bethlehem, Easton)
St. Luke's and Lehigh Valley hospitals anchor care here. It mixes city and suburbs.
Key: Strong hospitals and fewer agencies than the big cities.
Central PA (Harrisburg, Lancaster, York)
The state capital area. Costs to run an agency are lower. Many CHC Medicaid members live here.
Key: If you want Medicaid clients, start talking to the CHC health plans early.
Scranton / Wilkes-Barre / Northeast PA
Many older adults and lower costs. Geisinger and local hospitals send referrals.
Key: Rates are lower, but so are your costs.
Cost of care in Pennsylvania
What agencies charge clients vs. what caregivers earn in Pennsylvania. The difference is the agency's gross margin per billable hour — before overhead like insurance, admin, marketing, and compliance costs.
$30.5
Avg. hourly rate charged to clients
$19.80
Avg. caregiver hourly wage
$10.70
Gross margin per hour
35%
Gross margin %
What this means for agency owners
In Pennsylvania, agencies keep roughly $10.70 per billable hour after paying the caregiver. That's a 35% gross margin.
This is a typical margin for the industry. You will need to manage overhead carefully, but profitability is achievable with good operations.
Sources: Avg. hourly rate from CareYaya and CareScout 2025 surveys (averaged). Caregiver wage from Care.com. Gross margin is before overhead costs like insurance, admin, marketing, and compliance.
Pennsylvania Medicaid Programs
Community HealthChoices (CHC)
Pennsylvania's Medicaid managed care for adults 21 and older who have both Medicare and Medicaid, or who need long-term help at home. It covers the whole state. Three health plans (MCOs) serve every region: AmeriHealth Caritas, PA Health & Wellness, and UPMC Community HealthChoices. Members can switch plans at any time (DHS).
Old Waivers Now in CHC; LIFE as an Option
People in the old Aging, Attendant Care, Independence, and COMMCARE waivers are now served by CHC. People 55 and older who need nursing-home-level care can pick the LIFE program instead of CHC, if a LIFE provider serves their area (DHS).
How to Take Medicaid Clients (3 Steps)
Step 1: Get your DOH license. Step 2: Enroll as a Medicaid provider with DHS. Step 3: Ask each CHC health plan to add you to its network. A DOH license does not enroll you in Medicaid. Medicaid enrollment does not make a plan take you. Some plan networks may be full.
Private Pay and Medicaid
Many agencies mix private-pay and Medicaid clients. Private pay often pays more and pays faster. Medicaid brings more clients but pays less. Good referral sources are hospital discharge planners, Area Agencies on Aging, senior centers, doctors, and elder law lawyers.
Becoming a Provider
Essential 2026 Tech Stack for Owners
Tiles outlined in teal are areas HomeCareAtlas covers in our platform.
Pennsylvania Licensing FAQ
What license do I need for home care in Pennsylvania?
You need a Home Care Agency License from the PA Department of Health if you hire caregivers yourself. If you refer caregivers who work on their own, you need a Home Care Registry license. The rules are in 28 Pa. Code Chapter 611. Each location needs its own license.
How much does a Pennsylvania home care license cost?
The DOH fee is $100 per location, and you pay it again each year to renew. Our estimate for total startup costs is $12,000 to $38,000. That covers the $125 LLC filing, insurance, background checks, and cash to run. There is no surety bond rule in Chapter 611.
What background checks are required in Pennsylvania?
It depends on where the person lived. Lived in PA the last 2 years? A PA State Police check. If not, an FBI fingerprint check plus a Department of Aging letter. Caregivers, office staff, and owners all need one. Child abuse clearance is only needed if you serve anyone under 18.
How long does Pennsylvania licensing take?
Our estimate is 10-20 weeks in total. That covers forming the business, background checks, writing policies, applying, and the DOH inspection. DOH does not publish a processing time.
Is a surety bond required in Pennsylvania?
No. The state law lets DOH require a bond by regulation (35 P.S. §448.807(c)), but Chapter 611 does not. Some websites list a $50,000 bond. We could not find any PA source for it.
What training do caregivers need in Pennsylvania?
There is no set hour count. Before work, each caregiver needs a PA nurse license, a passing skills test, or a finished training program (§611.55). The "40-hour" number is not in the DOH rules. Medicaid programs may set their own.
Is Pennsylvania a good market for home care?
It is a big market. About 2.8 million Pennsylvanians are 65 or older, the 5th most of any state (Census, July 2025). Older adults now outnumber children. The 65+ group grew about 13% from 2020 to 2025.
What is the difference between a Home Care Agency and a Home Care Registry?
A Home Care Agency hires caregivers and runs the care. A Home Care Registry refers caregivers who work on their own, and it gets a fee. The license says which one you are. Most new owners pick the agency license.
Can I still mail my application?
No. Since March 31, 2026, DOH only takes applications through its online portal. Mailed or emailed papers are not accepted. Questions: [email protected].
Does my DOH license let me take Medicaid clients?
Not by itself. You need three things, in order. Your DOH license. Then Medicaid enrollment with DHS. Then a contract with each CHC health plan (AmeriHealth Caritas, PA Health & Wellness, UPMC). Some plan networks may be full.
Do I need a child abuse clearance if I only serve seniors?
No. Chapter 611 only asks for child abuse clearances if you serve anyone under 18 (§611.53). Many guides get this wrong.
Do I need an operating agreement for my LLC?
PA does not make you have one, but you should. It says who owns what, who makes choices, and what happens if an owner leaves. DOH must hear from you at least 30 days before any transfer of 5% or more of the stock or equity. Banks often ask to see one. Have a lawyer look it over.
Does Chapter 611 require set insurance amounts?
No. Chapter 611 sets no insurance amounts. A $1 million policy is common, but it is not the law. Workers' comp is a separate PA law. Get it before you hire. You can buy it from a private carrier or SWIF.
Where do I file everything?
LLC: PA Department of State ($125). EIN: IRS.gov (free). State Police check: epatch.pa.gov. FBI fingerprints: follow the Department of Aging steps. Child abuse clearance: PA DHS (only if you serve kids). DOH license: online at sais.health.pa.gov ($100). Workers' comp: a private carrier or SWIF, (570) 963-4635. Medicaid: DHS enrollment, then each CHC health plan.
Starting in a Nearby State?
Licensing requirements vary a lot between states. Compare your options:
New Jersey
$500 fee · Varies
Ohio
$250 fee · 30-90 Days
New York
$2,000 fee · 9-18 Months
Delaware
$250 fee · 6-9 Months
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Home care agencies in Pennsylvania
Want to see the competition up close? Look at who is already open, city by city.
- Home care agencies in Philadelphia
- Home care agencies in Pittsburgh
- Home care agencies in Bala Cynwyd
- Home care agencies in Jenkintown
- Home care agencies in Bethlehem
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Where our numbers come from
We check each fact against Pennsylvania's own rules. Tap a source to read it yourself.
- License needed?Yes28 Pa. Code §611.2(a)· Oct 2026
- Who oversees itPennsylvania Department of Health (PA DOH, Division of Home Health)28 Pa. Code §611.2(d)· Oct 2026
- License nameHome Care Agency License28 Pa. Code §611.2(b)· Oct 2026
- The rules28 Pa. Code Ch. 611 (Home Care Agencies & Registries)28 Pa. Code Ch. 611· Oct 2026
- First license fee$10028 Pa. Code §611.2(e); 35 P.S. §448.807(b)· Oct 2026
- License lasts1 year35 P.S. §448.809(a)(1)(i) (Health Care Facilities Act §809)· Nov 2026
- BondNone28 Pa. Code Ch. 611; 35 P.S. §448.806.3· Oct 2026
- Owner/manager trainingNo state minimum28 Pa. Code Ch. 611· Oct 2026
- Caregiver trainingNo state minimum28 Pa. Code §611.55· Oct 2026
- Background checksPA State Police criminal history record (FBI fingerprint check plus Department of Aging determination if a PA resident under 2 years) dated within 1 year of application; ChildLine clearance only if serving clients under 1828 Pa. Code §§611.52, 611.53· Oct 2026
- How long it takes10-20 WeeksBest guess — not confirmed yet
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This guide is for informational purposes only and does not constitute legal, regulatory, or business advice. Licensing requirements, fees, and regulations change frequently. Always verify current requirements with your state's licensing agency before making business decisions. HomeCareAtlas is not responsible for the accuracy or completeness of this information.
Researched and reviewed by
John Helmy, Founder of HomeCareAtlasBuilding tools and resources to help home care agency owners navigate licensing, compliance, and growth.