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The Cost of a Home Health/Home Care Agency Start-Up

financial paperThroughout the years, Kenyon HomeCare Consulting has had the privilege of assisting successful start-up home health agencies across the country. Although many thoughtful questions are asked, we have noticed that only 10% of those individuals requesting assistance have projected out the assumed cost of starting up. The remaining 90% have given little consideration to the cost of starting a home health agency. If they have thought about it, they tend to grossly underestimate the revenues needed for the first year of operation.

Costs of a start-up home care agency vary by state, as well as by the type of home care agency that an individual may wish to start. The least expensive is the non-skilled home care agency, followed by the licensed skilled home care non-Medicare. The most expensive start-up is Medicare/Medicaid home health and hospice.

One of the major reasons new home care businesses fail is because of lack of working capital for the start-up phase of the business. The estimated cost to start-up a non-skilled private-pay home care agency runs about $40,000 to $80,000, Licensed home health non-Medicare $60,000 to $100,000, and Medicare-certified agencies $150,000 to $350,000, depending on the state in which you start your home health agency. Much of the cost is incurred around licensing issues and regulations requiring licensed personnel, computer software, and hardware; patient care costs that are paid out of the owner’s pocket and are not recoverable; commercial space for the office; and the length of time the state is out until initial review or survey. Additionally, many states now require that all Medicare start-up agencies go through an accreditation organization, which also adds cost and time to the start-up phase.

Anyone thinking about starting up a home care/health agency must first develop a working budget for the first year. There are some basic costs that all home care start-ups share depending on the type of agency and the state and federal rules: name and logo development, policy and procedure development if in a licensed state or going for Medicare, computer software and hardware, sales and marketing, recruitment and retention, office furniture, supplies, and equipment, office space rental, plus telephones, and personnel costs. For the Medicare agency start-up costs, the requirement of paid clinical staff to care for a minimum of 10 patients has to be added into the start-up budget cost. Those monies, considered part of the start-up costs, are not recoverable from the Medicare. In addition, Medicare and the states will require a specified amount of money in a bank account to prove the financial viability of the new organization. All of these elements must be included in the start-up budget.

There is one last budget element that must be added: payment to the new owner. This is the most commonly missed budget line. Starting a business is a full time job! The time and energy invested in starting up a home care agency is considerable and requires a line item for reimbursement. Some of the estimated start-up costs stated above are the reimbursement that the owner will need to survive financially while the agency is getting started. Failure to include this expenditure leads many aspiring home care agency owners to work outside the start-up to generate income while they simultaneously try to start the business. This is a sure recipe for failure.

Are you starting up a health/home care agency, have the working capital, and need some assistance in developing your budget?  Visit our online system at  Kenyon HomeCare Consulting to schedule a consultation now.

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Category: Agency Startups & Diversification

13 responses to “The Cost of a Home Health/Home Care Agency Start-Up”

  1. Maria Trejo says:

    My interest is to provide occupational therapy services to children and adults via home health services.

  2. Maria Trejo says:

    I would like to know if you provide assistance to start up this business.

  3. Ginny Kenyon says:

    yes we do. you can contact me by making an appointment by going to

  4. SteIve Street DO says:

    I am a pain management physician that has an independent clinic and manages 100 implanted pump patients. I am considering setting up a home health care service for home pump refills. There are only a few insurance companies that pay for this service but pay well. It would be ran out of my office by myself and a RN. I don’t know anything about home health care regulations and would need a lot of help. Do you offer this kind of help?

  5. Ginny Kenyon says:

    We do offer that service. please go to this will take you to my calendar. please pick a day and time that works for you and make an appointment. That way I can be sure that we will have uninterrupted time to talk. I look forward to talking to you. Ginny

  6. Sharon Gail Livingston RN/DON says:

    I have a home health company and we would like to work with you to service your home bound oain patients with nursing to refill their pain pumps and assessment them for you between office visits. Please contact me.

  7. Ginny Kenyon says:

    the best way to have time to talk to me is to go to that will take you to my calendar and you can make an appointment to talk on a day and time that works for you. I look forward to talking to you.

  8. Maria says:

    I need to find out how much it cost to start a home care business in Ohio

  9. Ginny Kenyon says:

    the cost will depend on where you are in your state and any other business regulations. the range for start up of a non skilled is between $40,000 to $60,000.

  10. Susie says:

    Hello I currently own a hospice in a state that has a moratorium . I purchased last year have gone though the creditialing phase with Medicare and Medicaid approved . Illness has in family needs me to go back home if at all possible my husband is handling alone . I was wondering does your company know how much a new license and NPI is worth in Mississippi . Thank you

  11. Ginny Kenyon says:

    no it would really depend on so many factors. you would do best to call a merger and acquisitions company to get that invormation

  12. Ginny Kenyon says:

    Your comment was unclear have you started a new home health agency and want some help?

  13. Ginny Kenyon says:

    Thanks we will check it out

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