Last verified: October 2026. Rules and fees change, so confirm every figure with the Pennsylvania Department of Health before you file.
Pennsylvania has one of the lowest licensing fees in the country, but it licenses more than most states do: even companion-only businesses need a license. This guide covers what it takes to open a non-medical home care agency in Pennsylvania, the steps in order, what it costs, and what your caregivers need.
Quick facts: Pennsylvania home care licensing
| License name | Home Care Agency (you employ caregivers) or Home Care Registry (you refer independent caregivers) |
| Issued by | Pennsylvania Department of Health, Division of Home Health |
| Governing law | Health Care Facilities Act (35 P.S. §448.101 et seq.); 28 Pa. Code Chapter 611 |
| License fee | $100 initial, $100 renewal, nonrefundable |
| Apply through | The DOH SAIS online portal |
| Inspection | On-site, before the license is issued |
| Companion-only license? | Yes, companionship counts as home care |
Do you need a license for home care in Pennsylvania?
Yes, for almost any paid in-home help. Chapter 611 defines home care services to include personal care, help with household tasks and companionship, so a companion-only business still needs a license. You choose between two license types:
- Home Care Agency: you hire caregivers as employees and supervise them.
- Home Care Registry: you refer independent caregivers to clients.
One business can hold both. Each physical location needs its own license.
Step-by-step: how to open a home care agency in Pennsylvania
- Form your business and get owner criminal history reports; the rules require them on file.
- Write your policies, consumer notices (including the direct care worker status notice) and your caregiver competency program.
- Apply online in the DOH SAIS portal. Paper and emailed applications are no longer accepted.
- Mail the $100 fee by check, payable to the Commonwealth of Pennsylvania.
- Pass the on-site inspection. If you run from home, DOH inspects your home office.
- Submit a plan of correction if DOH finds anything, then receive your license.
- Enroll in Medicaid (optional) once licensed.
Pennsylvania has no certificate of need and no moratorium on new home care agencies.
How much does it cost?
- DOH license: $100, and $100 at each renewal (renewal due at least 60 days before expiration).
- Business formation, insurance, background checks and TB screening for staff.
- Changing your administrator later requires a resume and a background check under a year old.
Budget separately for insurance, payroll for your first caregivers before clients pay, software, and marketing. Licensing is rarely the biggest line. See what it really costs to start a home care agency.
Caregiver requirements in Pennsylvania
- Before assignment, each caregiver must hold a PA nursing license, pass your competency exam, or complete approved training (your program, a home health aide program, a CNA program, or Medicaid waiver training).
- No minimum hours are set, but training must cover topics like confidentiality, infection control, emergencies and abuse reporting, plus bathing, transfers and toileting for personal care.
- Competency is reviewed every year.
- Two references, a PA State Police background check (FBI check if they have lived in PA under 2 years) and TB screening before client contact, then yearly.
- Provisional hiring is allowed while checks are pending, with monitoring.
How long does it take?
Plan on roughly 3 to 6 months, driven mostly by how quickly DOH schedules your inspection.
Medicaid in Pennsylvania
Medicaid personal assistance for older adults and adults with physical disabilities runs mostly through Community HealthChoices, a managed care program. The path is your DOH license, then Pennsylvania Medicaid provider enrollment, then contracts with the Community HealthChoices plans.
Comparing states? See the home care license requirements for every state.
Want the full playbook?
I built and run a licensed home care agency in California. The licensing steps differ state to state, but getting clients, hiring good caregivers and managing cash flow work the same way in Pennsylvania. The Home Care Agency Blueprint covers that side in 49 lessons. You can see the syllabus, start with the $29.99 Startup Workbook, or book a free call to map out your Pennsylvania launch.
FAQ
Do I need a license for companion care in Pennsylvania?
Yes. Pennsylvania counts companionship as home care, so companion-only agencies need a Home Care Agency or Registry license.
What is the difference between a home care agency and a registry?
An agency employs caregivers and handles payroll, taxes and supervision. A registry refers independent caregivers to clients. Both are licensed under the same chapter.
Do I need an office?
No specific office type is required. If you operate from home, the inspection happens at your home.