If you do not have work experience in the healthcare industry then we recommend that you get experience volunteering in your local community – for such organizations as Alzheimer Association or at your local hospital, skilled nursing facility, assisted living community, or senior center. Volunteering will give you a sense for the senior care industry and whether or not you enjoy working with seniors. If you really enjoy volunteering then you are likely to have the passion we require to join our organization. If you don’t enjoy volunteering then we recommend that you choose another industry as you will likely not find fulfillment in the home care industry.

Agency owners who have a passion for the industry are always the most successful in this industry – all things being equal outside of that. Home Health and Personal Care at Home are very different. Home Health is providing skilled nursing, physical therapy, and occupational therapy care to seniors in their homes. This requires a Home Health License from the state, accreditation from an accrediting body like CHAP, Joint Commission, etc. and a Medicare/Medicaid Provider License. The average time frame for this process is 1.5 years and average costs range from $150,000 to $350,000 depending on the state you are in. Much of the cost is due to office space, software, personnel, patient care costs (that are paid out of owner’s pockets and not recoverable from Medicare) during the application process.

The application process also requires that an agency get and maintain 10 clients for a minimum of two months in order for Medicare to come in and test the care scores of these patients to verify the agency met the regulatory and care minimum standards. Keep in mind that each client only last two months and then their care episode ends and they are no longer your client. If you don’t get to having 10 clients all at once Medicare will not schedule your on-site care outcomes inspection. You also need to have a Director of Nursing (licensed RN in your state) and a licensed MD on your board of directors.

So, there is a lot of time, effort, risk, and cost with starting a home health business. Add that to the fact that the President of the National Association of Home Care and Hospice recently said that Home Health Agencies will need to diversify into providing personal care (non-medical) services in order to maintain profit margins due to Medicare cutting Home Health billing rates consistently year over year and projected to continue that way into the future. In addition, due to Obama Care (Affordable Care Act) hospitals are in pilot programs (that could go nationwide in the not too distant future) to require Medicare to pay the hospital a lump sum of money and they then get to decide how a patient gets the care they need for all of their ongoing services (home health included).

Given that hospitals are getting Medicare cuts in certain areas of their operations, they are more than motivated to make up those losses in other area’s which is leading them to cut out losing profits to a 3rd party home health agency and instead hire their own RN’s directly to go out and do the home health visits – effectively cutting out the home health agency altogether. Please do your research on the home health industry before making a leap in that direction – there is more to it than initially meets the eye.