It depends on your state, the license you need and how complete your application is when you file. A few regulators set a deadline for their own review. Most publish none. And in some states, certain licenses can’t be issued right now at all without a Certificate of Need or a finding that more agencies are needed. Below is what each regulator actually says for the 10 states and Washington, DC we work in, with a link to the source for each.
The short answer, state by state
| State | What the regulator publishes |
|---|---|
| Texas | Up to 45 days to check your application, then up to 45 days to issue the license |
| Florida | A decision within 60 days of a complete application (hospice needs a Certificate of Need first) |
| Georgia | 30 business days for a private home care provider review, then a 3-month provisional license |
| Louisiana | A need review within 90 days; no published time for the license itself |
| Michigan | No state license for home health agencies |
| Missouri | None for a home health license; about 9 months for an In-Home Services contract |
| North Carolina | None; you have 12 months to complete the requirements |
| Ohio | None published |
| Pennsylvania | None published |
| Washington, DC | About 6 months for a Certificate of Need, then the license |
| California | None for a home care organization; new home health licenses paused |
State by state
Texas
Home care, home health and hospice agencies all need a Home and Community Support Services Agency (HCSSA) license from HHSC. HHSC has two clocks: up to 45 days from when you submit and pay the fee to tell you whether the application is complete, and up to 45 days from a complete application to issue or deny the license. After the license, you must admit your first client and request the initial survey within six months.
Sources: 26 TAC §558.31; HHSC: how to become a licensed HCSSA provider. See Texas licensing steps and Texas license costs.
Florida
For a home health agency license, and for a homemaker and companion registration, AHCA must approve or deny within 60 days after it receives a complete application. A new hospice needs a Certificate of Need before it can be licensed, and AHCA publishes no overall time frame for that route.
Sources: s. 408.806, F.S.; s. 408.036, F.S. See Florida licensing steps and Florida license costs.
Georgia
For a private home care provider (PHCP) license, DCH says its initial review takes 30 business days from submission. You then get a three-month provisional license. In that time you must admit at least three clients and request your survey, or the provisional license is voided. A new home health agency needs a Certificate of Need, and DCH is not accepting new home health applications now; its next assessment of need is due on or around March 31, 2027.
Sources: DCH PHCP application checklist; DCH home health batching notice, September 30, 2026. See Georgia licensing steps and Georgia license costs.
Louisiana
Home and community-based service providers (including personal care) and hospices first go through a Facility Need Review. LDH reviews the initial application within 90 days. Once approved, a home and community-based provider must be licensed within six months, with one 90-day extension possible. LDH publishes no processing time for the license review itself.
Source: LAC 48:I, Chapter 125 (Facility Need Review). See Louisiana licensing steps and Louisiana license costs.
Michigan
Michigan’s licensing agency, LARA, says state licensing is not required for home health agencies. To bill Medicare, an agency still needs certification, and LARA says it is not conducting initial surveys until higher-priority work is done, so most new agencies plan on accreditation instead.
Source: LARA: home health agencies. See Michigan steps and Michigan startup costs.
Missouri
DHSS lists the steps for a home health license but publishes no processing time. For non-medical In-Home Services paid by Medicaid, providers contract with the state instead, and the Missouri Medicaid Audit and Compliance unit says to allow about nine months before provider numbers are issued and services can start.
Sources: DHSS: home health state licensure; MMAC: In-Home Services proposal information. See Missouri licensing steps and Missouri license costs.
North Carolina
A home care agency license needs no Certificate of Need, and DHSR publishes no review time. It does give you a deadline: you must complete all requirements within 12 months of submitting your application and fee. Home health agencies and hospices need a Certificate of Need, and the state’s review of those applications takes 90 days, which can be extended by up to 60 more.
Sources: DHSR: requirements for establishing a home care agency; G.S. 131E-185. See North Carolina licensing steps and North Carolina license costs.
Ohio
Ohio licenses skilled and non-medical home health services under Revised Code Chapter 3740. The Ohio Department of Health publishes no processing time for either license.
Source: ODH: home health agency licensure. See Ohio licensing steps and Ohio license costs.
Pennsylvania
The Department of Health publishes no processing time for a home care agency or registry license, or for a home health license.
Source: Pennsylvania DOH: home care. See Pennsylvania licensing steps and Pennsylvania license costs.
Washington, DC
A home care agency (home health) needs a Certificate of Need from the State Health Planning and Development Agency first. DC Health says to allow six months from your letter of intent to the final decision. You then apply for the license at least 60 days before you plan to open. For a non-medical home support agency, no processing time is published.
Sources: DC Health: how to obtain a Certificate of Need; 22-B DCMR §3102. See Washington, DC licensing steps and Washington, DC license costs.
California
CDSS publishes no processing time for a home care organization license. New home health agency licenses have been paused since June 29, 2026, under SB 164, until no later than 90 days after CDPH’s revised home health regulations take effect. New hospice licenses fall under a separate pause in the Health and Safety Code, and new hospice applicants must show an unmet need.
Sources: CDSS: home care organization application process; CDPH AFL 26-28; CDPH AFL 25-04. See California licensing steps and California license costs.
What adds time in every state
- Background checks. Owners, administrators and staff usually need criminal background checks, and some states require fingerprints. Results that come back late hold up the file.
- Need reviews. Some licenses need a Certificate of Need or a similar review before the license application can even start.
- The initial survey. Many states inspect a new agency before or soon after it opens. In some, the survey can only happen once you are serving clients.
- Policies that don’t match the rules. Reviewers check that your written policies cover what the state’s rules require. Gaps mean questions, or a file sent back.
- Medicare. Billing Medicare is a separate federal step that starts after the state license (more on this below).
Where the clock starts, and what restarts it
Where a state publishes a review time, it usually runs from the day the regulator has a complete application. A missing document, an unsigned form or an unanswered request for more information can stop the clock or send the application back. The fastest route is a complete file the first time.
How to keep your own timeline short
- Pick the right license first. Applying for the wrong license type usually means starting again.
- Start background checks early. Owners and key staff can often begin while you prepare the rest of the file.
- Write your policies to your state’s rules before you file. Many states review the policy manual as part of the application or the first survey.
- Answer every request quickly. Some states give you a short window to respond before the file is closed.
- Know when your survey happens. Plan staffing and your first clients around it.
Medicare is a separate clock
A state license lets you operate under state law. To bill Medicare, a home health agency or hospice also enrolls with CMS and passes an initial survey, by the state or by an accrediting organization such as ACHC, CHAP or The Joint Commission. That comes after the state license and adds months to the plan. New Medicare enrollment for home health agencies and hospices has been under a nationwide CMS moratorium in 2026; see our post on the moratorium and our guide to accreditation.
Questions owners ask
Can I start serving clients before my license is issued?
Not in a state that requires a license for the services you offer. The license comes first. In some states the initial survey then happens after you start serving clients.
Are there states with no home care license?
Some. Michigan’s licensing agency says state licensing is not required for home health agencies, though Medicare rules still apply if you bill Medicare. See our post on states with no home care license.
Can a consultant make the state review faster?
No one can speed up a regulator’s own review. What good preparation does is keep your application from being sent back, which is where most of the lost time comes from.
Want a plan for your state? Our team prepares license applications for a fixed price in all 11 places above. Book a free discovery call (or send us a message) or see how our licensing support works.
This is general information, not legal advice. Review times are the ones each regulator publishes as of November 2026. They change, so check the source links before you plan.
Ready-made policy manuals from our Policy Portal
Our Policy Portal, Cura Core, has ready-made policy and procedure manuals for home care, home health and hospice agencies in 11 states. Each button opens those manuals on curacore.app, where you pick your state and can read three policies from any manual free. Every policy cites the rules behind it, and staff sign-off is built in.
Home Care Policy and Procedure Manuals
For: non-medical home care and personal care agencies
Open on curacore.appHome Health Policy and Procedure Manuals
For: skilled home health agencies
Open on curacore.appHospice Policy and Procedure Manuals
For: hospice agencies
Open on curacore.app
