Northeast
Pennsylvania Home Care, Home Health & Hospice Licensing
No Certificate of Need — but a brand-new online-only portal, a training-program competency mandate for direct care workers, and an active federal Medicare enrollment moratorium make expert guidance essential.
RegulatorPA DOH
Typical timelineFor Home Care Agency and Registry licenses: two to three months from a complete, accurate application submission is the typical DOH processing window, though some applicants report four to six months when deficiency letters require multiple correction cycles. Pre-application setup (business registration, policy development, background clearances) adds another four to six weeks. For Home Health Agency and Hospice licenses: state licensure follows a similar two-to-three-month pattern; Medicare certification adds additional time after licensure, and as of June 2026, the active CMS moratorium means new Medicare enrollment applications will not be processed until at least mid-November 2026.
License routes4
Delivery100% Virtual
Licensing in Pennsylvania
Pennsylvania does not impose a Certificate of Need (CON) requirement for home care, home health, or hospice providers, making it more accessible than many competing states. All three service types require a state license issued by the Pennsylvania Department of Health (PA DOH) Division of Home Health before operations begin, with the application process now conducted exclusively through the SAIS online portal for Home Care Agency and Registry applications (effective March 31, 2026, paper and email submissions are no longer accepted for those license types). A critical federal overlay: as of May 13, 2026, CMS imposed a nationwide six-month moratorium on new Medicare enrollment for home health agencies and hospices, meaning new providers can obtain state licensure but cannot submit a CMS-855A for Medicare certification until the moratorium lifts or is not extended.
Your regulator
Pennsylvania Department of Health, Division of Home Health (PA DOH)
Official licensing page →License routes we cover in Pennsylvania
Home Care Agency (HCA) License
For businesses that employ direct care workers to provide non-skilled personal care, assistance with activities of daily living, companionship, respite care, or specialized care in a client's residence; governed by 28 Pa. Code Chapter 611.
Home Care Registry (HCR) License
For businesses that refer (rather than employ) independent direct care workers to clients for the same non-skilled services covered under Chapter 611; carries distinct disclosure and consumer notification obligations distinct from the HCA model.
Home Health Agency (HHA) License
For organizations providing skilled nursing care plus at least one therapeutic service (physical therapy, occupational therapy, speech therapy, medical social services, or home health aide services) on a part-time or intermittent basis; governed by 28 Pa. Code Chapter 601.
Hospice License
For organizations providing palliative care, pain management, and supportive services to terminally ill patients and their families; state licensure under the Health Care Facilities Act is required before any federal Medicare certification survey can be requested. Pennsylvania has not yet finalized its own substantive hospice regulations; in the interim, the Federal Medicare Conditions of Participation (42 CFR Part 418, Subparts C, D, and E) serve as the operative standards for licensed hospice organizations.
How we get you licensed
- 1Organize your business entity and secure a physical office
Register as an LLC or corporation with the Pennsylvania Department of State and obtain a federal EIN. Secure a physical office address — P.O. boxes are not accepted and DOH surveyors inspect the premises before issuing any license.
- 2Develop your policies, procedures, and compliance documentation
Build a comprehensive manual aligned with the applicable chapter: 28 Pa. Code Chapter 611 for HCA/HCR, Chapter 601 for HHA, and — for hospice — the interim standards set by 42 CFR Part 418 (Subparts C, D, and E) under the Health Care Facilities Act, since Pennsylvania has not yet finalized its own hospice-specific chapter. Cover client rights, personnel management, infection control, emergency procedures, training plans, and the required consumer disclosure package.
- 3Obtain all required background clearances and health screenings
All owners, office staff, and direct care workers must obtain a PA State Police criminal history record (Act 34). Staff without two consecutive years of Pennsylvania residency must also obtain a Federal criminal history record and a letter of determination from the Pennsylvania Department of Aging. Child Abuse History Clearances (Act 151) are required for all staff with direct consumer contact. TB screening within the past year is required for workers and office staff who have consumer contact. Allow four to six weeks for clearance turnaround.
- 4Submit the initial license application through the SAIS online portal
Use the PA DOH SAIS portal at sais.health.pa.gov/CommonPOC/Licensing/IPA-DHH/Login.aspx. Effective March 31, 2026, paper and email submissions are no longer accepted for HCA/HCR applications. Mail the required application fee separately to the PA DOH Division of Home Health, 2525 N. 7th Street, Harrisburg, PA 17110. HHA and hospice initial applications are currently submitted by email to ra-dhhhandhosinitial@pa.gov with the fee mailed separately.
- 5Respond to deficiency notices and pass the pre-licensure inspection
DOH reviewers may issue deficiency notices requiring corrected or additional documentation. Once the application is accepted as complete, DOH schedules an on-site inspection of your office space and records. Most applications are decided within two to three months of a clean submission; correction cycles can extend this to four to six months.
- 6Pursue Medicare certification after state licensure is granted (HHA and hospice only)
State licensure must be in hand before submitting CMS enrollment forms. Submit Form 855A to your Medicare Administrative Contractor and supporting CMS forms to DOH. As of May 13, 2026, a CMS nationwide six-month moratorium blocks new HHA and hospice Medicare enrollments; monitor CMS guidance for the moratorium expiration (projected around November 13, 2026) before filing. State licensure can and should be pursued now so the provider is ready to enroll in Medicare as soon as the moratorium lifts.
Key Pennsylvania requirements
- Physical office location with inspectable premises required — P.O. boxes are not accepted by DOH.
- Comprehensive policies and procedures manual aligned with 28 Pa. Code Chapter 611 (HCA/HCR) or Chapter 601 (HHA), covering client rights, personnel, infection control, emergency procedures, and training; hospice providers must follow the interim federal standards at 42 CFR Part 418 pending final Pennsylvania regulations.
- All direct care workers must demonstrate competency before providing unsupervised care; for HCAs, this means completion of an approved training program (which may be agency-developed, a home health aide program, nurse aide certification, a Medicaid Waiver program, or a Department-approved alternative) covering personal care, nutrition, infection control, safety, emergency procedures, and client rights, with annual competency reviews thereafter.
- Criminal background checks for all owners, office staff, and direct care workers under Act 34 (PA State Police); individuals without two consecutive years of Pennsylvania residency must also obtain a Federal criminal history record and a letter of determination from the Pennsylvania Department of Aging; Child Abuse History Clearance (Act 151) for all staff with direct consumer contact.
- TB screening within the past year required for all direct care workers, contractors, and office staff who have direct consumer contact.
- Written consumer disclosure package provided at service initiation, covering the service plan, direct care worker identity, hours, fees, employment or referral status, tax obligations, and a minimum 10-calendar-day advance notice policy before service termination.
Traps that catch new owners
- Submitting paper or emailed applications for HCA/HCR licensure after March 31, 2026: the SAIS online portal is now the only accepted channel, and non-portal submissions are rejected outright rather than held for correction, causing applicants to lose their place in queue and restart the process.
- Confusing Home Care Agency (non-skilled, Chapter 611) with Home Health Agency (skilled, Chapter 601): the two license types have different fee structures, different staffing and training standards, and different Medicare certification pathways — applying under the wrong category delays approval and may require a full restart.
- Underestimating the federal Medicare enrollment moratorium for HHA and hospice: state licensure and Medicare certification are separate tracks, and the active nationwide moratorium (effective May 13, 2026, through approximately November 13, 2026) means providers who receive state licensure today cannot immediately bill Medicare — business projections that assume prompt Medicare revenue will need revision.
Pennsylvania licensing packages
Fixed price, agreed in writing before any work begins. Each package is prepared and submitted for you, fully online.
Pennsylvania licensing FAQs
Does Pennsylvania require a Certificate of Need to open a home care, home health, or hospice agency?
No. Pennsylvania does not impose a Certificate of Need requirement for any of these service categories, which removes a barrier that exists in states such as New York (which requires CON approval for Certified Home Health Agencies). Any qualified applicant who meets the DOH licensing standards may apply.
Can my new home health agency or hospice start billing Medicare as soon as the state issues my license?
Not immediately under current conditions. State licensure is a prerequisite for Medicare certification, but as of May 13, 2026, CMS imposed a six-month nationwide moratorium blocking new home health agency and hospice Medicare enrollment applications. New providers should pursue state licensure now, then monitor CMS guidance for the moratorium lift date — currently projected around November 13, 2026 — before submitting the CMS-855A enrollment package.
What is the difference between a Home Care Agency license and a Home Care Registry license in Pennsylvania?
Both license types cover non-skilled personal care, companionship, and related services under 28 Pa. Code Chapter 611. The key distinction is the employment model: a Home Care Agency employs direct care workers directly and bears full employer responsibilities. A Home Care Registry refers independent contractors to clients and must clearly disclose the contractor relationship to consumers, including the consumer's own tax and insurance obligations. The DOH licenses each model separately, and applicants must correctly identify their model at the time of application.
Ready to launch in Pennsylvania?
Book a free discovery call and we’ll map exactly what your Pennsylvania licensing will take — and what it will cost.
Book a Free Discovery Call
