Medicare Blog

how to start a none medicare certified home health agency

by Dr. Lily Mayert PhD Published 2 years ago Updated 1 year ago
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What is home care?

Home care services are non-medical and usually associated with companionship and assistance with activities of daily living (ADL). Services of this type do not require authorization or approval from a physician. Most often, these are paid for out-of-pocket (i.e. private pay) but can also be covered through a long-term care insurance policy.

Is it easy to start a home health agency?

Starting a home health agency is an exciting opportunity. Home care agencies are in high demand and the industry is growing rapidly, but it’s not easy to get started. There are many things that need to be done before you can open your doors for business.

What is market research?

Your market research will entail collecting, analyzing and interpreting information about your market – or where you will conduct your business. You would not want to start hiring home health aides for a market that has an agency on every block!

How old are the baby boomers?

The demand for home care increases each year. The Baby Boomers are now in their 60’s and 70’s. Even though they’re not as strong, mobile, or active anymore; seniors want to live at home for as long of a time physically possible with the least amount of interruptions.

Who is the most senior medical person?

The most senior medical person on your staff is usually the head nurse, or often referred to as the quality assurance nurse or director of nursing. He/she supervises all the caregivers (i.e. aides) and the scheduling of client visits. There may be a nurse reporting to this person who handles the clinical aspects. The structure of your medical staff (i.e. nurses) varies.

Can franchisors give you a discount?

National vendors may give them a discount and that can be passed on to you.

What is a criminal check?

criminal checks. proof that key staff members are qualified under state regulations. There are fourteen (14) states that do not accept license applications unless it can be proven through a Certificate of Need (CON) application that the need for a home health care agency is pressing.

Below we have outlined some of the key steps to opening a Medicare-Certified HHA

Determine your states requirements concerning a Certificate of Need (CON)

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What is home health agency?

A Home Health Agency (HHA) is an agency or organization which: 1 Is primarily engaged in providing skilled nursing services and other therapeutic services;Has policies established by a group of professionals (associated with the agency or organization), including one or more physicians and one or more registered professional nurses, to govern the services which it provides; 2 Provides for supervision of above-mentioned services by a physician or registered professional nurse; 3 Maintains clinical records on all patients; 4 Is licensed pursuant to State or local law, or has approval as meeting the standards established for licensing by the State or locality; 5 Has in effect an overall plan and budget for institutional planning; 6 Meets the federal requirements in the interest of the health and safety of individuals who are furnished services by the HHA; and 7 Meets additional requirements as the Secretary finds necessary for the effective and efficient operation of the program.

What is a public agency?

Public agency is an agency operated by a State or local government. Examples include State-operated HHAs and county hospitals. For regulatory purposes, “public” means “governmental.”. Nonprofit agency is a private (i.e., nongovernmental) agency exempt from Federal income taxation under §501 of the Internal Revenue Code of 1954.

Why is Medicare denied?

Many Medicare enrollment applications are denied, because providers fill out the wrong forms. Complete the CMS-855A form available in the resources section. References. Centers for Medicaid and Medicare Services: Medicare Enrollment for Institutional Providers, CMS-855A.

What is home health agency?

Home health care agencies employ nurses, certified nursing assistants (CNAs) and home health aides, who take care of the elderly in their homes. If you are compassionate, hardworking and have business sense, opening a home health care agency will not be difficult. Before you open your agency, make sure you obtain Medicare certification.

What age does Medicare cover?

Medicare serves people 65 or older, people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant), according to the U.S. Department of Health and Human Services. 00:00. 00:04 08:24. GO LIVE.

Who is Theresa Bruno?

Writer Bio. Theresa Bruno began her writing career as a librarian in 2008. She published an article in "Indiana Libraries" and has written many book reviews for "American Reference Book Annual" and "Reference and User Services Quarterly.".

What is home health agency?

Home Health Agency (HHA) Licensing and Certification Program. The Indiana Department of Health (IDOH) licenses agencies that provide nursing services, physical therapy, occupational therapy, speech therapy, medical social worker, home health aide, and other therapeutic services to the patient at the patient's temporary or permanent residence.

What is incident report form?

The Incident Report Form is for health care facilities to notify the Indiana Department of Health of a reportable incident pursuant to the IDOH Reportable Unusual Occurrence Policy. The Incident Report Form is also for health care facility staff (nursing homes, intermediate care facilities, and hospice agencies) to report a reasonable suspicion ...

What is a QIO?

Quality Improvement Organization Information - A Quality Improvement Organization (QIO) is a group of health quality experts, clinicians, and consumers organized to improve the care delivered to people with Medicare.

What is a home health agency?

A Home Health Agency (HHA) is an agency or organization that is primarily engaged in providing skilled nursing services and other therapeutic services, and that has policies established by a group of professionals (associated with the agency or organization), including one or more physicians and one or more registered professional nurses, to govern the services which it provides. Home Health Agencies are not licensed or registered by the Ohio Department of Health and Home Health Agencies that are certified by the Centers for Medicare and Medicaid Services (CMS) are regulated under 42 CFR 484 . Ohio requires criminal records checks for all Home Health Agency staff who provide direct care to patients; these criminal records check rules are set forth in Chapter 3701-60 of the Ohio Administrative Code.

Does Ohio require criminal records checks?

Ohio requires criminal records checks for all Home Health Agency staff who provide direct care to patients; these criminal records check rules are set forth in Chapter 3701-60 of the Ohio Administrative Code.

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Introduction

  • Starting a home health agency can be a very exciting opportunity – even more so in 2022! It’s even more exciting as the demand for home care is skyrocketing – especially as we find our way (slowly) out of the COVID pandemic. Who wants to be in a nursing home and take a risk, pay more and live in a place that would remind anyone of a hospital – most people want to age in their ho…
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Why Now?

  • You hear it all the time. We are an aging population as almost 10,000 Americans turn 65 years old every day. That turns out be about 72 million people 2025. Here’s a shocker: more than 90% of us prefer to remain at home for as long as possible. Home care service is much cheaper compared to facility care. And healthcare payers (e.g. Medicare, Medicaid, etc.) encourage home care beca…
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Covid-19 Impact on The Industry

  • What have we learned about the pandemic? Aside from the devastating toll on lives, it created demands on our health care system that we never experienced. And not just those with the virus but the entire [world] population. COVID-19 has been particularly harmful to seniors and those who have chronic medical conditions such as asthma, diabetes, and heart disease. More telling, …
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from The Ground Up Or existing?

  • Now that we’ve made the case for the demand for home health agencies based on the desire to stay at home to recover and the aging society, it’s time to focus on opening or starting such a business. They come in many flavors, so to speak. There are many factors to consider but the very first one is: do you buy an existing business, start one from scratch or consider a franchise…
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The Necessary Steps to Starting Your Home Health Care Agency

  • Step 1: Your Business Plan
    How much can you make owning a home health agency? Home health care may be unique, but the one thing it has in common with every other new business venture is that a lack of planning is a sure way to undercut its potential success. Your business may never get off the ground withou…
  • Step 3: Staffing and Management of the Agency
    You will have supplies as part of your inventory such as masks, wipes, first aid kit, sanitary personal protective equipment, etc. but your number one product is your staff. They are the ones that provide the service to your client/patient base. And the ones who are the source of your rev…
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Home Health Agency Start-Up Costs

  • The costs depend on greatly on the type of agency (i.e. start from scratch, franchise or purchase an existing business). Private home care agencies are the least expensive to open as they don’t require expensive licensure and certification. They require between $50,000 and $120,000 to get going depending on the scale of the operation and services offered. Home health agencies, thos…
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Summary

  • No matter how, when or where you start a home health agency it requires careful planning starting from the very first question: Am I ready to start a business and do I have the support and resources to do so? In summary: 1. It is a ripe environment to start an agency 2. Good leadership and people skills are more imperative than a medical background 3. Plan everything and be cons…
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