Florida is one of the most attractive states in the country to open a home care agency. It has one of the highest shares of residents aged 65 and over, and demand for care at home keeps growing. But the licensing path confuses a lot of first-time founders, mostly because “home care license” can mean four different things in Florida. Here it is in plain English.
Who licenses home care in Florida
Home care in Florida is regulated by the Agency for Health Care Administration (AHCA), under Chapter 400, Part III and Chapter 408, Part II of the Florida Statutes. Every initial application now goes through the AHCA Online Licensing System. Paper applications are no longer accepted.
Pick the right path: four options
- Homemaker and Companion Services registration. For non-medical help only: light housekeeping, meal preparation, transportation and companionship. Staff can’t bathe clients, help with medication or give any hands-on personal care. The fee is $50.75 for two years.
- Home Health Agency (HHA) license. Needed as soon as you offer hands-on personal care, skilled nursing or therapy, and required for Medicare or Medicaid. The current initial fee is $2,005 (a $1,705 licensure fee plus a $300 processing component).
- Nurse Registry license. A referral model that matches clients with independent contractor nurses, aides and companions. It avoids the employment model of an HHA, but it can’t bill Medicare.
- Hospice license. The longest road. You need a Certificate of Need before you can even apply for the license.
The most common mistake is picking the companion registration because it’s cheap, then offering personal care anyway. If your caregivers will help with bathing, dressing or toileting, you need the Home Health Agency license.
Good news: no Certificate of Need for home health
Florida home health agencies have never been subject to the state’s Certificate of Need program, and that hasn’t changed. A new HHA needs an AHCA license and, separately, Medicare or Medicaid enrollment if it wants to bill them.
Hospice is different. A hospice CON goes through AHCA’s competitive batching cycles, which open twice a year. The application fee is $10,000 plus 1.5% of the proposed spend, up to $50,000. From the first letter of intent to the first patient, 12 to 18 months is common.
What AHCA will ask for
- Level 2 background screening (FDLE and FBI fingerprints through the AHCA Clearinghouse) for owners with 5% or more, officers, administrators and direct-care staff
- CPA-prepared pro forma financials for your first two years, plus a contingency reserve of at least one month’s projected operating expenses (for a Home Health Agency)
- Liability and malpractice insurance of at least $250,000 per claim
- A qualified administrator and director of nursing, available during set business hours and reachable within an hour of an unannounced AHCA visit
- Accreditation from an AHCA-recognized body (CHAP, ACHC, The Joint Commission or DNV) for agencies providing skilled care
- An on-site AHCA survey before the Home Health Agency license is issued
Three traps that delay Florida applications
- The 21-day cure clock. When AHCA finds a deficiency, you get 21 days to fix it. Miss that window and the application is denied. Missing or weak financials are the usual cause, including projections that show a first-year operating margin of 15% or more in any month.
- Your business name. If you’re registering as a homemaker-companion provider and your company name includes words like “health”, “nursing” or “medical”, AHCA may treat it as implying services you aren’t licensed for. A fictitious name registration on SunBiz fixes this.
- Mixing up the license and Medicare. Your AHCA license and Medicare enrollment are separate processes with separate timelines. One doesn’t give you the other.
How long it takes
A Homemaker and Companion registration usually takes 30 to 45 days from a complete application. A Home Health Agency license typically runs 60 to 90 days from a complete, deficiency-free application, and preparing the financials, policies and screening can add two to three months before that.
The Medicare timing note
On May 13, 2026, CMS froze new Medicare enrollment for home health agencies and hospices nationwide for six months. It’s scheduled to end on November 13, 2026, unless CMS extends it. The freeze doesn’t touch your Florida license: you can be fully licensed by AHCA and serve private-pay clients now. You just can’t bill Medicare until enrollment reopens. We explain what to do with that window in our guide to the freeze.
How we help in Florida
We prepare and submit the full AHCA application at a fixed price: $2,495 for a Homemaker-Companion registration and $3,495 for a Home Health Agency license. For the full picture, see our Florida licensing guide and the Florida cost breakdown.
Not sure whether you need the registration or the full license? Book a free discovery call, tell us the services you plan to offer, and we’ll tell you which Florida path fits.
This article is general information, not legal advice. Florida rules and fees change; we confirm the current requirements as part of every project.
