Last verified: October 2026. Rules and fees change, so confirm every figure with the Virginia Department of Health before you file.
Virginia licenses personal care agencies as Home Care Organizations (HCO) through the Virginia Department of Health. Companion-only agencies are exempt, but once you add hands-on personal care you need the license, an experienced administrator and an RN supervisor. This guide covers the details.
Quick facts: Virginia home care licensing
| License name | Home Care Organization (HCO) |
| Issued by | VDH Office of Licensure and Certification |
| Governing law | Va. Code §32.1-162.7 et seq.; 12VAC5-381 |
| License fee | $1,500 initial or renewal ($50 late renewal) |
| License term | Renews every 3 years |
| File by | At least 60 days before you plan to open |
| Companion-only license? | No, homemaker, chore and companion-only providers are excluded |
Do you need a license for home care in Virginia?
Yes, if you provide personal care. Personal-care-only agencies are not exempt. Providers of only homemaker, chore or companion services are excluded from licensure (a formal exemption request costs $75).
Accredited agencies can be exempt from routine licensing, but only after initial licensure. You cannot skip the first license by getting accredited.
Step-by-step: how to open a home care agency in Virginia
- Form your LLC with the State Corporation Commission, get an EIN and register for state taxes.
- Appoint a qualified administrator and an RN supervisor and write your policies.
- Submit the OLC application and $1,500 fee at least 60 days before your planned opening. Incomplete applications go inactive after 6 months.
- Request a prelicensure consultation if you want one (optional).
- Pass the OLC inspection.
- Receive your license.
- Enroll with Medicaid and credential with the Cardinal Care health plans.
How much does it cost?
- VDH license: $1,500, and $1,500 at each 3-year renewal.
- Salary or contract cost for a qualified administrator and an RN supervisor.
- Background checks and TB screening for aides.
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 Virginia
- Criminal record clearance within 30 days of hire; no unsupervised client contact until it arrives. Virginia’s barrier-crimes list bars some hires.
- At least 12 hours of in-service training a year, and an annual competency evaluation.
- RN supervisory visits at least every 90 days for personal care, with an RN or LPN available during service hours.
- Medicaid aides at non-licensed providers need a 40-hour curriculum before assignment; aides at licensed agencies follow the 12-hour in-service rule.
How long does it take?
The legal minimum is filing 60 days before opening; in practice plan for about 4 to 6 months.
Medicaid in Virginia
Virginia Medicaid long-term services now run through Cardinal Care managed care (formerly CCC Plus). Medicaid personal care providers must be VDH-licensed, VDH-certified or accredited, then enroll with DMAS and credential with the health 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 Virginia. 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 Virginia launch.
FAQ
Can I get accredited instead of licensed?
Not at first. The accreditation exemption applies only after your initial license.
Do companion-only services need a license in Virginia?
No. But adding any hands-on personal care triggers HCO licensure.
Do I need a nurse?
Yes, for personal care. An RN must supervise, with visits at least every 90 days.
What experience does the administrator need?
At least one year of training and experience in direct health care delivery, plus at least one year of supervisory or management experience in home health or a related program within the last five years.
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