Federal District
Washington, DC Home Care, Home Health & Hospice Licensing
DC has two home care licenses, a Certificate of Need for skilled agencies, and a 2026 Medicare enrollment freeze.
RegulatorHRLA
Typical timeline3 to 12 months
License routes3
Delivery100% Virtual
Licensing in Washington, DC
DC Health's Health Regulation and Licensing Administration (HRLA) licenses home care under DC Law 5-48. Skilled home health agencies also need a Certificate of Need (CON) from SHPDA first; non-medical and hospice providers do not. Since May 13, 2026, CMS has paused new Medicare enrollment for six months, but the DC license stays available.
Your regulator
DC Health, Health Regulation and Licensing Administration (HRLA)
Official licensing page →License routes we cover in Washington, DC
Home Care Agency License
Agencies giving skilled nursing plus another therapy at home. DCMR 22-B, Chapter 39.
Home Support Agency License
Only non-medical personal care, no skilled nursing. No CON. DCMR 22-B, Chapter 99.
Hospice License
Palliative care for terminally ill people. No CON. DC Code § 44-501, DC Law 5-48.
How we get you licensed
- 1Pick Your License Type and CON Status
Skilled services need a CON; personal care and hospice do not. Get the CON before your license. Contact SHPDA at (202) 442-5875.
- 2File the Certificate of Need (Home Care Agencies Only)
Send a letter of intent, post a public notice, and wait 60 days. Fee: greater of 3% of capital or $5,000 (max $300,000). SHPDA reviews in 90 days; CONs last up to three years.
- 3Set Up Your Business and Office
Register with DLCP (replaced DCRA October 1, 2022) and get an EIN. Keep a DC office open eight hours a day, Monday to Friday. No P.O. boxes.
- 4Hire Staff and Prepare Documents
Name a Director who is a physician, RN, or has at least one year of supervisory experience in home health. Prepare governing, personnel, patient-rights, care-plan, records, and admissions policies.
- 5Apply Online Through HRLA
Apply online at dchealth.dc.gov (no paper since May 3, 2023) and pay the $600 fee. Show malpractice insurance ($1,000,000 per incident) and general liability ($1,000,000 per occurrence).
- 6Pass the Pre-Opening Inspection
HRLA inspects your site before the first license. DC Code § 44-505(a) requires it; accreditation cannot replace it now. At renewal, § 44-505(b) lets CHAP or ACHC accreditation count instead.
How long does it take?
Typical time to a live license in Washington, DC. Times assume a complete, accurate application; missing items add time.
- Home Support Agency (non-medical)
- 3 to 5 months
- Home Care Agency (needs a CON)
- 6 to 12 months
- Hospice
- Similar to Home Care, without the CON step
Key Washington, DC requirements
- A CON is required before a Home Care Agency license. SHPDA takes 90 days, and the 60-day letter-of-intent wait makes this track at least five months. Not required for Home Support or hospice.
- Keep a DC office staffed eight hours a day, Monday to Friday; no P.O. box or virtual address.
- Director must be a physician, RN, or have one year of supervisory home health experience (DCMR 22-B § 3904).
- Carry malpractice insurance of $1,000,000 per incident and general liability of $1,000,000 per occurrence (DCMR 22-B § 3901).
- Initial fee is $600; renewals run $400 (1–150 patients) to $1,300 (1,251+ patients) by census (DCMR 22-B § 3902).
- All applications must be filed electronically; paper has not been accepted since May 3, 2023.
Traps that catch new owners
- Don't chase Medicare certification blindly: since May 13, 2026, CMS paused new HHA and hospice enrollment for six months. You can still get the DC license, but not Medicare, until it lifts.
- Don't skip the CON. Filing with HRLA before CON approval means denial. The fee is nonrefundable, and saturated areas risk denial.
- Accreditation (CHAP/ACHC) replaces the survey only at renewal under § 44-505(b); the § 44-505(a) pre-opening inspection is mandatory.
- DC Health rejects names implying care your license doesn't cover; a Home Support agency using clinical terms may face objections.
- Don't use the old DCRA name. Business registration moved to DLCP on October 1, 2022; mail to DCRA gets misdirected.
Washington, DC licensing packages
Fixed price, agreed in writing before any work begins. Each package is prepared and submitted for you, fully online.
Washington, DC licensing FAQs
Do I need a Certificate of Need for a non-medical home care agency in DC?
No. The CON under DC Code § 44-406 applies only to skilled agencies (Home Care Agency, DCMR 22-B Chapter 39). Home Support Agencies (DCMR 22-B Chapter 99) are exempt and apply directly to HRLA.
Can I get a DC Home Care Agency license and take Medicare patients now?
You can get the state license anytime; it's separate from Medicare. But since May 13, 2026, CMS has a six-month nationwide moratorium on new home health Medicare enrollment. New agencies must wait until it lifts; those who applied before that date are unaffected.
Will DC Health accept a CHAP or ACHC survey instead of a state inspection?
Only at renewal. DC Code § 44-505(a) requires an on-site inspection before initial licensure; accreditation can't waive it. Later, § 44-505(b) lets DC Health accept an approved survey at renewal. Report survey dates within five days and submit documents within five days of completion.
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