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Home Care license in your State

Registering: Certificate Of Need required Do not need license to run home care business Approval from the State Health Planning and Development Agency Approval from Alabama Department of Public Health and CMS https://www.alabamapublichealth.gov/index.html https://www.cms.gov/Center/Provider-Type/Home-Health-Agency-HHA-Center Contact: Alabama Bureau of Licensure and Certifications +1-800-252-1818 http://www.alabamapublichealth.gov/providerstandards/

There are several steps in obtaining an assisted living home license. If you are interested in obtaining a license you can download and print a New Home Application Packet below and submit the completed packet to our office. Your application will be reviewed by a supervisor and assigned to a specialist, who will work closely with you to ensure your application meets all of the licensing requirements. An onsite inspection will also be scheduled as part of the new home application process. Contact: State of Alaska Division of Senior and Disability Services +1-907-269-3666 http://dhss.alaska.gov/dhcs/Pages/hflc/home_health.aspx https://www.alaskahomecare.com/ https://dhss.alaska.gov/dhcs/Pages/cl/ALH%27s/Becoming-Licensed.aspx?fbclid=IwAR1VUPvH_uNDme_OvoEeZKG6LUnl3Lhr7mHhQqVhx2wloNapky-E8Qm_TY4 Opportunities with a Home Care License in Alaska As the number of seniors who need home care rises in Alaska and all parts of the country, now is the best time to seize this opportunity. Starting your own home care agency to fulfill this extraordinary need for in-home care in Alaska, will be a rewarding business opportunity for you. Also keep in mind you will need help in obtaining a home care license in Alaska, and Amaka Consulting, Inc. Consultants can help with this. Before Obtaining a Home Care License in Alaska At first it is imperative to comprehend the differences between starting a non medical home care business versus a skilled medical home care business in Alaska. Skilled Medical Home Care Agencies as the name infers requires a physicians order and the care is given by actual skilled nurses. Non Medical home care agencies in Alaska offers non medical care such as companion and personal care. Fundamentally non-medical home care in Alaska help with every day living exercises, dinner arrangement, housekeeping and transportation. Such home care agencies are regularly indispensable for people to stay protected and happy in their homes. Private compensation as opposed to 3rd party pay sources are the most well-known type of payment for non-medical home care in Alaska. Amaka Consulting, Inc. had the most experience with the Alaska Home Care and Home Health Care License processes, call us today for a free consultation. No Home Care Training Needed to Obtain a Home Care License for Alaska Formal medical training or a clinical foundation isn't required for obtaining a home care license in Alaska, to start a home care business. A lot of medical professionals do start their own home care business, but having a medical background is not a requirement to obtain a home care license and starting a rewarding career in home care. There are many requirements in opening a Skilled Home Health Care Business in Alaska Beginning a Skilled Home Health Business in Alaska is a difficult task, as enrollment and licenses for maintaining the Skilled Home Health Business are required. The business owner needs to develop a plan the services that the agency will provide to patients who need it or the elderly in the community. Consider Hiring a Home Health Care Consultant Consider partnering with a Home Care Consultant that is experienced in setting up Skilled Home Health Care Businesses in Alaska. An experienced consultant can streamline the process and expedite the approval of the home care license for Alaska and becoming a Medicare provider by one of the following accreditation bodies: Accreditation for Home Health Care (ACHC) Community Health Accreditation Partner (CHAP) The Joint Commission When you choose your consultant, make sure they can provide you will all the necessary tools to successfully operate a home care business. This includes paperwork for all documentation that is required to operate. Operation Requirements for opening a Skilled Home Health Care Business in Alaska In order to operate a Skilled Home Health Care Business in Alaska, the business needs to be registered as a legal operating entity. The first step is to incorporate the Skilled Home Health Care Business in Alaska. The next step is to apply for a Tax ID and NPI number. Amaka Consulting, Inc. Health Care Consultants will complete all these steps for you so you don't have the stress of doing this all on your own. If you would like to be able to bill Medicare for services that your agency will be providing, you will need to be certified. Amaka Consulting, Inc. Health Care Consultants will guarantee that you be Medicare Accredited agency. We will come to your location and perform a mock survey so when the real survey comes you will be fully prepared and pass with no deficiencies. Applying for a Tax ID and EIN number are required to open a Skilled Home Health Care Business in Alaska To open a Skilled a Home Health Care Business in Alaska you will need to apply for Tax ID, EIN, NPI numbers and licenses. We will contact the IRS to apply for an employer ID number, also known as an EIN. The business owner also needs a state tax permit, which we will obtain from the secretary of state’s office upon registration. The state tax permit covers income taxes and employment taxes for the business should it require additional assistance. Leasing or Purchasing an Office in Alaska Having an office is another thing a Skilled Home Health Care Business owner may need in Alaska. The business office has a computer, telephone, e-mailing system, fax machine and patient files so the patients or elderly can contact the agency during opening hours. A Skilled Home Health Care Business will also establish a business checking account and credit card account and apply for business loans if required to meet start-up costs in Alaska. The business owner and their personnel will spend their time budgeting, creating service plans, and preparing for visits that are scheduled for the following day and the weeks to come. Other Requirements for opening a Skilled Home Health Care Business in Alaska If your agency will be providing services for glucose monitor you will need to obtain a CLIA Waiver. You may need to obtain a contract to handle bio-hazardous waste materials. Amaka Consulting, Inc. Consultants can help you with these requirements in Alaska. Policy and Procedures are required to open a Skilled Home Health Care Business in Alaska When you purchase policy and procedures make sure they are professionally written and specifically include all of Alaska's, State and Federal requirements. A Skilled Home Health Care Business policy and procedures must in Medicare's conditions of participation and Accrediting body requirements. Operational materials such as new patient admission packets, Personal Files, Logs, Forms, In-service Education Plans, Nursing Procedures, and Committee Minutes are also required. Yes, You May Need Help, and We Are Here For You It is not recommend to start a home care agency on your own, but the truth of the matter is, most home care agencies are backed by dedicated home care consultants or a home care franchise company. Amaka Consulting, Inc. Health Care Consultants will make the process of obtaining a home care license for Alaska easy because we do the work for you. With the help of Amaka Consulting, Inc., you will have "Peace of Mind" in knowing that we have been in business for over 25 years and helped over 4000 clients start their own home care agencies. Amaka Consulting, Inc. Health Care Consultants are the largest and most successful group of home care consultants in the industry.

Registering: To get started on the process, contact the Bureau of Medical Services and Licensing https://www.azag.gov/seniors/resources-for-seniors Contact: Arizona In-Home Care Association Arizona Hospital and Healthcare Association Arizona Department of Health Services, 150 North 18th Avenue Phoenix, Arizona 85007 (602) 542-1025 Fax: (602) 542-0883 Opportunities with a Home Care License in Arizona As the number of seniors who need home care rises in Arizona and all parts of the country, now is the best time to seize this opportunity. Starting your own home care agency to fulfill this extraordinary need for in-home care in Arizona, will be a rewarding business opportunity for you. Also keep in mind you will need help in obtaining a home care license in Arizona, and Amaka Consulting, Inc. Consultants can help with this. Before Obtaining a Home Care License in Arizona... At first it is imperative to comprehend the differences between starting a non medical home care business versus a skilled medical home care business in Arizona. Skilled Medical Home Care Agencies as the name infers requires a physicians order and the care is given by actual skilled nurses. Non Medical home care agencies in Arizona offers non medical care such as companion and personal care. Fundamentally non-medical home care in Arizona help with every day living exercises, dinner arrangement, housekeeping and transportation. Such home care agencies are regularly indispensable for people to stay protected and happy in their homes. Private compensation as opposed to 3rd party pay sources are the most well-known type of payment for non-medical home care in Arizona. Amaka Consulting, Inc. had the most experience with the Arizona Home Care and Home Health Care License processes, call us today for a free consultation. No Home Care Training Needed to Obtain a Home Care License for Arizona Formal medical training or a clinical foundation isn't required for obtaining a home care license in Arizona, to start a home care business. A lot of medical professionals do start their own home care business, but having a medical background is not a requirement to obtain a home care license and starting a rewarding career in home care. There are many requirements in opening a Skilled Home Health Care Business in Arizona Beginning a Skilled Home Health Business in Arizona is a difficult task, as enrollment and licenses for maintaining the Skilled Home Health Business are required. The business owner needs to develop a plan the services that the agency will provide to patients who need it or the elderly in the community. Consider Hiring a Home Health Care Consultant Consider partnering with a Home Care Consultant that is experienced in setting up Skilled Home Health Care Businesses in Arizona. An experienced consultant can streamline the process and expedite the approval of the home care license for Arizona and becoming a Medicare provider by one of the following accreditation bodies: Accreditation for Home Health Care (ACHC) Community Health Accreditation Partner (CHAP) The Joint Commission When you choose your consultant, make sure they can provide you will all the necessary tools to successfully operate a home care business. This includes paperwork for all documentation that is required to operate. Operation Requirements for opening a Skilled Home Health Care Business in Arizona In order to operate a Skilled Home Health Care Business in Arizona, the business needs to be registered as a legal operating entity. The first step is to incorporate the Skilled Home Health Care Business in Arizona. The next step is to apply for a Tax ID and NPI number. Amaka Consulting, Inc. Health Care Consultants will complete all these steps for you so you don't have the stress of doing this all on your own. If you would like to be able to bill Medicare for services that your agency will be providing, you will need to be certified. Amaka Consulting, Inc. Health Care Consultants will guarantee that you be Medicare Accredited agency. We will come to your location and perform a mock survey so when the real survey comes you will be fully prepared and pass with no deficiencies. Applying for a Tax ID and EIN number are required to open a Skilled Home Health Care Business in Arizona To open a Skilled a Home Health Care Business in Arizona you will need to apply for Tax ID, EIN, NPI numbers and licenses. We will contact the IRS to apply for an employer ID number, also known as an EIN. The business owner also needs a state tax permit, which we will obtain from the secretary of state’s office upon registration. The state tax permit covers income taxes and employment taxes for the business should it require additional assistance. Leasing or Purchasing an Office in Arizona Having an office is another thing a Skilled Home Health Care Business owner may need in Arizona. The business office has a computer, telephone, e-mailing system, fax machine and patient files so the patients or elderly can contact the agency during opening hours. A Skilled Home Health Care Business will also establish a business checking account and credit card account and apply for business loans if required to meet start-up costs in Arizona. The business owner and their personnel will spend their time budgeting, creating service plans, and preparing for visits that are scheduled for the following day and the weeks to come. Other Requirements for opening a Skilled Home Health Care Business in Arizona If your agency will be providing services for glucose monitor you will need to obtain a Waiver. You may need to obtain a contract to handle bio-hazardous waste materials. Amaka Consulting, Inc. Consultants can help you with these requirements in Arizona. Policy and Procedures are required to open a Skilled Home Health Care Business in Arizona When you purchase policy and procedures make sure they are professionally written and specifically include all of Arizona's, State and Federal requirements. A Skilled Home Health Care Business policy and procedures must in Medicare's conditions of participation and Accrediting body requirements. Operational materials such as new patient admission packets, Personal Files, Logs, Forms, In-service Education Plans, Nursing Procedures, and Committee Minutes are also required. Yes, You May Need Help, and We Are Here For You It is not recommend to start a home care agency on your own, but the truth of the matter is, most home care agencies are backed by dedicated home care consultants or a home care franchise company. Amaka Consulting, Inc. will make the process of obtaining a home care license for Arizona easy because we do the work for you. With the help of Amaka Consulting, Inc, you will have "Peace of Mind" in knowing that we have been in business for over 18 years and helped over 175 clients start their own home care agencies. Amaka Consulting, Inc. are the largest and most successful group of home care consultants in the industry.

The Health Services Permit Agency, with direction from a nine-member Health Services Permit Commission, is responsible for issuing Permits of Approval (POAs) for Nursing Facilities, Residential Care Facilities, Assisted Living Facilities, Home Health and Hospice Agencies, Psychiatric Residential Care Facilities and Intermediate Care Facilities for the Intellectually Disabled. Registering: https://www.healthy.arkansas.gov/programs-services/topics/arkansas-health-services-permit-agency/ Permit of Approval Rulebook: https://www.healthy.arkansas.gov/images/uploads/pdf/HSPA_Rulebook_.pdf Health Home Application Form: https://www.healthy.arkansas.gov/images/uploads/pdf/HOME_HEALTH_CARE_SERVICES_Application.pdf Contact: Arkansas Health Services Permit Agency 906 Broadway - Suite 200 Little Rock, AR 72201501-661-2509

Registering: https://www.cdss.ca.gov/inforesources/community-care/home-care-services/home-care-org-application-process Requires Program Design Contact: Community Care Licensing Division Home Care Services Bureau 744 P Street MS 9-14-90 Sacramento, CA 95814 Phone: (877) 424-5778 Fax: (916) 651-5600 HCSB@dss.ca.gov 1. Find a qualified, certified Administrator. The first and most important step. Without having a qualified, certified administrator on your team, none of the rest can follow. In all likelihood, you’re probably intent to become certified yourself, but how do you go about doing that? To become certified you must first take the DSS-required 80 hour Certification Course, and then take and pass the DSS-administered 100 question test with a minimum passing score of 70%. This test must be taken within 60 days of you completing the 80-hour course, after which you must submit the required paperwork and fee within 30 days of passing the test. Not everyone is qualified to be an administrator of your facility. The general requirements call for a high school diploma or equivalent and being at least 21 years of age. For a 16-49 bed facility, you must have passed at least 15 college units and have at least 1 year of experience working in an RCFE or equivalent. To be an administrator of a 50+ bed facility, you’ll need to have a minimum of 2 years of college under your belt, and have at least 3 years of experience working in an RCFE or equivalent. Are you qualified, and ready to take the DSS-required RCFE initial certification course for administrators? 2. Secure the physical plant. It will sound obvious in hindsight, but you can’t be the administrator of a residential facility for the elderly if you don’t have the actual facility part locked down. In order to submit a license application for your facility, you must show “control of property” — that is, proof that you either own the property outright, that you are either in the process of buying the property or that you will be leasing/renting the property. 3. Contact your local fire marshal for a pre-inspection. The sooner you do this, the better! It’s possible that the fire marshal will charge you a nominal fee, but this inspection will let you know early on if you will need to make costly modifications to your home/facility in order to be compliant with local fire codes and state regulations. Money well spent! If you don’t make these modifications, you won’t be able to get the maximum number of non-ambulatory rooms or apartments out of your facility. You’ve already come this far! Maximize your investment by making these modifications, or find another location! 4. Take the online Orientation course with DSS. You must take the DSS RCFE course. You only need to take this course once. The DSS RCFE orientation course falls into two categories: adult care and senior care. There is a registration fee and access to the courses is limited to 30 days once the fee is purchased. This is all done through the DSS website. When finished submit a copy of your orientation certificate. The orientation is the beginning of the process. Stay informed about future regulation changes and updates through a certified regulation service. 5. Submit a license application to DSS. Now we’re getting to the fun stuff. The next step in this process is to prepare and submit an RCFE license application for DSS, including parts A and B, along with the applicable fee. We won’t sugarcoat it: this is not like filling out an application for a driver’s license. The Applications Instructions alone are 22 pages in length, and all told you’re looking at hundreds of pages to gather information for, prepare, and fill out. Attempting this on your own is a recipe for disaster — just one error could delay your facility’s opening by months! Instead, it’s smart to consider having yours completed by a professional. Our team has licensed hundreds of small and large RCFE’s, and worked with DSS licensing personnel for over 15 years. We have never had an application rejected due to error! Do you have the required 3 months’ of operating costs in the bank? You must open a bank account in your facility name and deposit at least 3 months’ operating costs into it. The DSS will verify this in the process of reviewing your application. Be patient. This process may take 4-5 months. 6. Market your Facility. Congratulations, you’ve submitted your application! Now it is time to start meeting with the potential residents who fill your facility once you are licensed. You are NOT allowed to move residents into your facility until you secure the license from DSS. But DO start looking for residents. Don’t wait until you secure the license, because that will just be time lost! In our post detailing 6 Steps for a Successful RCFE we talked about the importance of choosing your residents wisely. Remember, your first resident is your benchmark and will set the tone for your facility in ways you might not expect. 7. DSS will schedule a Component II (face to face) meeting at their office. This is step two in a three-part component process that must be completed by all new licensees. Once your application has been reviewed, you will be contacted by the DSS for a one-on-one with the the reviewing analyst. Component I was the orientation course you took in #4 on this list, and Component III involves “category specific training and discussion in areas not often understood by new licensees intended to promote successful facility operation.” Both components II and III will be done once DSS accepts your license application, but prior to actual licensure. These are all essential aspects of the license application process. 8. DSS will schedule a pre-licensing visit to inspect your facility. You’re so close! You’re almost there! A pre-licensing inspection is by the DSS as the last step in the RCFE license application review process. DSS will send you a checklist for you to complete prior to this visit. Make sure you complete this checklist fully, and have it available for their review when they come to visit. Note: the DSS will NOT conduct a pre-licensing until your fire marshal grants their approval. 9. Hire staff and train them accordingly. Putting together your team and training them accordingly is arguably the most important step in this entire process. You aren’t just looking for warm bodies to fill these important caretaking positions. You want a passionate team of people who want to come in every single day intent one making the lives of your residents better. Remember, you don’t want to wait until you are licensed to build your team, because you will not be able to move in and care for residents without staff! Once you’ve found the right people, make sure that they are properly trained and meet all the state requirements. And don’t forget the importance of ongoing CEU training for RCFE administrators and staff as well! 10. DSS issues you a facility license. You did it! Yes, you! Let that feeling of pride wash over you. You are now the proud administrator of a fully licensed RCFE. This is everything you’ve worked so hard toward, and it’s time to open your doors. Now you can move in your residents that are on your waiting list! The process to opening an RCFE facility in California may be long, but it’s rewarding. It’s okay if it takes you a year or more to get your facility off the ground — it’s not a race, and in the end it will all be worth it. The senior care industry is among the fastest growing industries in the country, and California is no different. We must be prepared to meet the needs of seniors with the best care possible. More growth, means more new facilities. Update for 2020 RCFE Regulations & Operations During COVID-19 Given the population’s nature of an RCFE facility, the threat of contracting and spreading the coronavirus proves a tremendous challenge. Beyond the “new normal” operating procedures of enforced social distancing, mask and glove wearing, and ongoing temperature checks to better protect the residents, the staff must also take even greater precautions for their own protection. At the end of May, 2020, the Center for Disease Control released enhanced guidelines for every RCFE administrator and staff member to follow in the face of the pandemic. These include: New regulations about visitor restrictions and updated outlines on group activities, especially as some facilities start to relax their previously mandated restrictions. In addition, new information was released regarding the best practices for tracking infections and preventing infection of others in a systematic way. This current contagion of COVID-19 presents unprecedented challenges both for aspiring RCFE administrators and long-standing ones. But never has the need for dedicated RCFE workers been more urgent. Getting your RCFE license now will go a long way to helping our senior population today and tomorrow. The need is there. Are you ready to provide it?

Registering: https://www.colorado.gov/pacific/cdphe/home-care-agencies https://www.colorado.gov/pacific/cdphe/home-care-agencies-provider-resources https://www.homecareofcolorado.org/ Colorado Department of Public Health and Environment Colorado Home Care Association Colorado Home Care Consultants Starting a Home Care Business in Colorado Contact: Bureau Association of Health Services: 3035621924 CHOOSE A NAME Choose a name for your home care business that makes sense. A common issue with starting a home care business and getting it licensed in the state of Colorado is the choice in name. If you use words that relate to medical terminology it can hurt your ability to market and give consumers the wrong opinion about what services, your home care business is offering and can offer. Transparency is the best marketing strategy for your home care business. Be clear and concise on what you are trying to convey to the consumer (i.e. Using words like Health or Medical or services such as nursing or therapies). This can also cause issues with licensing your home care business further down the line and depicts that your business is not what it seems (Home Care and Home Health Care are not the same – If you would like to learn more about starting a home health care business or would like to know the difference between the two, call us today for more information.) Make it unique! The constantly growing home care market is saturated with common names that use words such as: always, best, caring, first, and hands (to name a few). There are other barriers that can also prevent you from registering your name. As with many great ideas, there is a chance someone thought of it first. Names that are matching other business names cannot be registered and names that are too alike can also be rejected. Researching to see if the name is available is always required and this is done with a search on the Colorado Secretary of State website. CREATE A BUSINESS PLAN Create a brightly lit path that can help you pave the way to success by knowing the ins and outs of what to expect when your dream becomes your reality. Otherwise, it may turn into a nightmare. Researching the market and determining that there is a need for your type of home care business can seem overwhelming. That’s when utilizing a home care business consultant might become a good idea. There are many barriers to entry. The owners of the agency must be able to pass a background check. There are fees associated with the formation of the Agency and licensing. Researching the census and local competition in Colorado is very important. Determining your pay sources are important as well as there are Medicaid Programs available for Colorado and they prefer you apply for it at time of initial application, determining referral sources, etc. Furthermore, your home care business must have enough capital to get the business started and run it for at least 6 months. REGISTER Colorado Secretary of State Formation, Employer Identification Number, State Tax ID, and a National Provider Identification number will be needed to get your home care business started. You will need a tangible address to start the agency (P.O. Boxes are not acceptable). This is where a little help from a home care business consultant will come in handy. We do all of this for you. INSURE YOUR NEW BUSINESS The State of Colorado requires the following for home care licensure in Colorado: The State of Colorado requires that the business be covered by both General/Professional liability and Workman’s Compensation to operate. Additionally, they also require a Surety Bond with CDPHE as the Certificate holder to be presented at time of application. Please give us a call to learn more. OBTAIN LICENSE To start your home care business, you will need to apply for your home care license in Colorado. A home care license is also known as a Class B Home Care Agency license. A home care license application will need to be compiled and submitted with a $2,200 fee to the state. Initial Licensure application review can take up to 3 months for initial review. A one (1) Year provisional license is granted if the agency passes the survey. Let us take the stress off handling this long and complicated process with our team of professionals. Researching the Colorado regulations is a must when starting this process of applying for your home care license in Colorado. Colorado also requires an Administrator and Alternately qualified individual to run the home care business. This person is required to attend a specialized Administrative Training to gain the knowledge, experience, and ability to effectively manage the agency. All staff and owners must be able to pass a Criminal Background Check. The Home Care License is not permanent in the state of Colorado but there is an annual renewal process to keep the status of the license active. This is not an easy task, professional assistance will most likely be required to navigate the process and keep the business running smoothly. Our home care license and home care business startup consultants can help. Call us today.

Registering: Find the application here: https://portal.ct.gov/DCP/License-Services-Division/License-Division/Homemaker-Companion-Agency-Registration A home care agency is known in Connecticut as a home maker companion agency Companion services mean: "...nonmedical, basic supervision services to ensure the well-being and safety of a person in such person's home." Contact: https://www.cthealthcareathome.org/ Connecticut Home Care Program for Elders (CHCPE) Providers who wish to enroll as CHC Service Providers must be credentialed by Allied Community Resources (860-627-9500) and must fill out the enrollment application online at www.ctdssmap.com ---Provider---Enrollment. All required information must be submitted to complete the application. Paper enrollment applications are no longer accepted. The provider manual can be accessed at www.ctdssmap.com ----Publications----Provider Manuals. Information about changes for providers can be found on the home page of www.ctdssmap.com under Publications, Provider Bulletins and Important Messages. Provider may also access free provider billing training sessions conducted by HP. Provider Email Address: Providers with billing problems or claim concerns may email the Community Options Unit at HomeandCommunityBasedServices.dss@ct.gov.

RESOURCES Delaware Department of Public Health https://dhss.delaware.gov/dhss/dph/index.html Delaware Association for Health Services at Home https://dahcc.org/ Delaware Department of Health Medicaid Helpline Delaware Home Health Care Licensing Division Important Links for Home Health Care Agencies in Delaware National Home Care Facts & Statistics National Hospice Facts & Statistics Telehealth in Delaware Reporting Fraud and Abuse -OIG Filing Complaint against a Home Health Care Agency Hiring Private Home Care Workers Home Care Acronyms Accreditation Organizations Accreditation Commission for Health Care, Inc. (ACHC) Community Health Accreditation Program (CHAP) Joint Commission on Accreditation of Hospital Organizations Federal Government Agency for Healthcare Research and Quality (AHRQ) Americans with Disabilities Act (ADA) Centers for Disease Control and Prevention (CDC) Centers for Medicare and Medicaid Services (CMS) National Patient Safety Foundation Office of Civil Rights https://firststeps.delaware.gov/home_health_agencies/#:~:text=Home%20Health%20Agencies%20(HHA)%20are,services%20or%20home%20health%20aide https://www.dhss.delaware.gov/dhss/dhcq/ohflcmain.html Contact: http://www.dahcc.org/ There is a growing need for home care and home health care businesses in Delaware due to the ever increasing rate of the elderly population. Imagine starting a home care or home health care business in Delaware. Imagine the unlimited growth and potential of owning your own home care business in Delaware. Can you envision yourself owing your very own home care business? If so, call our Delaware home health care consultants today and we will get started on your home care license in Delaware and provide you with everything you need for success! Now is the best time ever to start your very own home care or home health care business in Delaware There is more than just one way to grow your home care or home health care business in Delaware. Our Delaware Home Care Consultants will help you to start a home care or home health care business with a business model that allows you to take on not just non-medical personal care and companion care patients, but home health care patients in need of skilled nursing and therapy services as well. Whether you want to bill home care and home health care business services to Medicaid, Medicare, Private Insurance, or simply Private Pay, our Delaware Home Care Consultants will help you to achieve your goals. What other types of home care businesses can Certified Homecare Consulting help me start in Delaware? Here are some of the home care and home health care businesses, as well as other businesses models Certified Homecare Consulting can help you start in Delaware. Companion Care Personal Care Private Duty Medicare Hospice Lifetime support for your home care business in Delaware Amaka Consulting, Inc. has offered lifetime consulting and training to all of our clients since we helped to start our first home care business in Delaware. We provide the best home care and home health care operational and marketing training and education in the industry. It’s not even a competition. We own home care and home health care business, and it shows in our expertise. Want to start a home care or home health care business in Delaware but don’t know what to do next? Choose Certified Homecare Consulting and start your home care business in Delaware the right way! We provide a dedicated account manager who will coach you and hold your hand through the entire process of starting your home care business in Delaware. Understanding the home care and home health care license process in Delaware We leave no stone unturned, completing all of the home care and/or home health care licensing requirements in Delaware on your behalf. We complete the Delaware home care license requirements, provide your agency with Delaware home care policies and procedures, and provide all of the other forms and documents you will need to get a home care license or a home health care license in Delaware. We guarantee your home care and home health care license in Delaware. If you would like more information on how this works, call us today. Home care policy and procedure manuals for your Delaware home care business Our home care and home health care policy and procedure manuals and completely customized for your agency and written and prepared by our team of home health care consultants. Our home health care consultants understand Delaware regulations and know what it takes to get a home care license in Delaware and start a successful home care business. We guarantee our home care and home health care policies and procedures manuals will not only meet your needs, but pass all state license scrutiny in Delaware. Best of all, we are always just a phone call away if you have any questions. Private Duty for home care and home health care or Medicare Certification and Accreditation for your Home Health Care Business in Delaware Unless your vision for your Delaware home care business is strictly a private pay home care business, you will want to achieve Private Duty or Medicare Certification and Accreditation. The reason for achieving accreditation is that most Medicaid Programs and third party payers require some form of accreditation as a prerequisite for credentialing as a service provider. If you want to bill Medicare, your home health care agency must be just that, a health care agency providing skilled nursing services. Medicare does not apply to non-medical home care and a home care agency is not able to bill Medicare. If you would like to start a home health care agency in Delaware and bill Medicare, you will need to achieve Medicare Certification and Accreditation. Certified Homecare Consulting can help. Compliance Audits, Licensure, & Accreditation Preparation Have peace of mind knowing that Certified Homecare Consulting will go above and beyond to make sure your home care or home health care business is licensed and accredited. Our consultants review everything your agency has completed up until the point of survey and mock survey your agency prior to the actual license and accreditation surveys. Not only have we been consulting new home care and home health care businesses for many years, but we have been and continue to operate successful home health care agencies today in Massachusetts and Pennsylvania. How will your home health care business get paid as a provider? Medicaid Medicaid Waiver Programs Medicare Long and Short Term Insurance Workers Compensation VA Programs Private Pay Grants – Coal Miners, Peat Lung, etc. Third Party Insurance -BCBS, CCA, Aetna, etc. Home Health Care Training in Delaware We bring our home care and home health care training to Delaware by way of ongoing training and consulting telephonically, and by video. Of course, you are always welcome to visit us onsite at our office. If you are achieving Medicare Accreditation it is vital that we visit your Delaware home health care agency in person to conduct a hands on mock accreditation audit. Our process is tried and true, and our home health care training is top notch. Home Health Care Training and Clinical Support Our nurses are here for you. Imaging having a home health care consulting firm and a team of nurses on call any time you need them. This is who we are and all for just one small fee. You pay us just one time for our services and our clinical support and training is a tool for your home health care business to use now and forever. Give us a call today to learn more. Specialty Programs like Telehealth and Fall Prevention will give you the upper hand Telehealth is a simple, cheap solution to give your home care or home health care agency a cutting edge. These types of programs help your agency to appeal to and attract not only patients, but their families and referral sources. Imaging walking into an outpatient facility with brochures detailing your telehealth program, fall prevention program, and others. You will not just be another Delaware Home Care Business, you will be the best home health care business in Delaware! Marketing your home health care business in Delaware As owners of home health care agencies, let us tell you the honest truth. YOU NEED GOOD MARKETERS!!! For many of you, you will be your first marketer. There is no way around this. No consultant, franchise, or anyone else can replicate, duplicate, or mimic the success your home health care business will have in Delaware with a home health care marketer that knows the area in Delaware that you live in. If you are in Dover, you need a marketer with connections to referral sources and others in Dover. If you are in Sussex – same thing, and etc., etc. Aside from having amazing talent to market to the local community door to door, there are other important factors to marketing to help you achieve the success you are looking for. All of these factors are covered in our world class home care and home health care marketing training. In our home care and home health care marketing training, you will learn where to go, what to say, who to say it to, how to say it, and so much more. Aside from our home care and home health care marketing training, your home health care business will receive printed and electronic materials, a website, and promotional items to market your home health care business in Delaware. All of these items are customized for your agency. We are going to: Create your name, brochures, and business cards Brand your business Build your website Create an internet presence Show you how to market Show you where to market Show you how to succeed

Registering: https://www.flrules.org/gateway/ruleNo.asp?id=59A-8.025 Contact: http://homecarefla.org/ Operation Requirements for Opening a Home Care Business in Florida To run a home care business in Florida, the corporation must be registered as a legal operating business. A home care business in Florida will need to apply for a Tax Number and NPI Number. Certified Homecare Consulting will do this for you, so you do not have to do it all on your own. Contact Us For immediate assistance, call us now at 347-443-9636 Applying for a Tax ID and EIN Number to Open a Home Care Business in Florida To open a home care business in Florida, you need to apply for a Tax ID Number, Employer Number (EIN), NPI Numbers, and licenses. Certified Homecare Consulting will contact the IRS to request the EIN. The business also needs a state tax pass, which we will get from the Secretary of State’s office upon registration. This all seems like a scary set of tasks, as applying for all these ID Numbers is confusing and frustrating. This is why Amaka Consulting, Inc. exists and is here to help you. Additional Requirements for a Home Care Business in Florida Some services your home care business in Florida will require additional contracts. For example, to monitor blood pressure, you will need a waiver from the CLIA for the monitoring machine. Also, you will need a waiver to handle hazardous blood waste. Consider Hiring a Home Care Consultant Consider partnering with a home care consultant with experience building a professional home healthcare business in Florida. An experienced home care consultant can simplify the process, speed up approval of a home care license in Florida, and if you choose to become private duty accredited for home care, or a Medicare Certified home health care business, they will fast track your accreditation with one of the following: Accreditation of Home Healthcare (ACHC) The Joint Commission Community Health Certification Partner (CHAP) When choosing a home care consultant or home health care consultant, confirm they can provide you with all the tools you will need to successfully run a home care business in Florida. This should include everything you need for operation – as well a home care license guarantee. Get Trained to Open a Home Care Business in Florida With so many requirements to open and run a home care business in Florida its no surprise why so many people choose Certified Homecare Consulting. At Certified Homecare Consulting we give you the tools for success! We have helped many people just like you start a home care businesses in nearly every state across the country. Certified Homecare Consulting is one of the largest and most successful home care consulting groups in the United States. Even if you are still on the fence about starting your home care business in Florida, call today. In just ten minutes that one phone call will help clarify if you are indeed ready to start a home care business and if not, it will identify what you will need to start your home care or home health care business in Florida. Call us today for a non-binding consulting session, 347-443-9636

Registering: In the state of Georgia Home Care agency is called: “Private home care provider” https://dch.georgia.gov/sites/dch.georgia.gov/files/PHCP-InitialLicensurePacket-3-21-16.pdf Licensing is a two part process: Submit your application and wait for approval (which takes around 6 months). Upon approval you will get a provisional license which is good for 1 year and within 1 year you need to become operational by getting 2 clients and having “on site survey for regular license” { more info in link above} Contact http://www.gahha.org/ http://www.gaccp.org/ HOME HEALTH AGENCY INITIAL LICENSURE PACKET The Health Care Section of the Office of Healthcare Facility Regulation (HFR) is responsible for licensing HHAs under Georgia State Law and for assisting the Centers for Medicare/Medicaid Services (CMS) in performing the certification function for those HHA providers wishing to participate in the Medicare Program. O.C.G.A. § 31-7-150 et seq. requires agencies to obtain a Georgia state license prior to providing home health services. A state license is also a prerequisite to obtaining Medicare certification. Certificate of Need (CON) Requirement Before receiving a license to operate a home health agency, you must have a Certificate of Need (CON) issued by the Department of Community Health, Division of Health Planning. To apply for a CON, contact: Department of Community Health, Division of Health Planning 2 Peachtree Street, NW, 5th Floor Atlanta, GA 30303-3142 (404) 656-0655 State Licensure Application Process After you obtain a CON from the Department of Community Health, Division of Health Planning, you may begin the application process to obtain a home health agency license. Before an initial licensure survey can be conducted, the following must be received by the Healthcare Section, Healthcare Facility Regulation’s Office: 1. Certificate of Need (CON) – copy 2. APPLICATION FOR A LICENSE TO OPERATE A HOME HEALTH AGENCY 3. Cashier’s check or money order for $200. payable to: Department of Community Health 4. Affidavit Re: Personal Identification for Licensure/Registration Submit to: Home Care Unit Healthcare Facility Regulation Healthcare Section 2 Peachtree Street, Suite 31-447 Atlanta, GA 30303 If any essential documents are determined to be absent or incorrect, the application will be considered incomplete; the application and documents will be returned to you along with information identifying the missing or incorrect documents. At that time the application will be considered to be voluntarily withdrawn, but you may reapply when you have assembled all of the required documents. Once the application packet has been determined by HFR staff to be complete, you will be contacted by HFR about your initial licensure inspection. Initial Licensure On-site Survey During the initial state licensure survey, you will be checked for compliance with the Georgia-Rules and Regulations for HOME HEALTH AGENCIES, O.C.G.A., Chapter 290-5-8. If no deficiencies are cited during the survey, a license will be issued, effective the date of the survey. If deficiencies are cited, it will be necessary for you to submit an acceptable plan of correction. Enclosures: 1. Georgia Rules and Regulations for Home Health Agencies, Chapter 290-5-8 2. Application for a Licensure to Operate a Home Health Agency 3. Affidavit Re: Personal Identification for Licensure/Registration

Registering: https://health.hawaii.gov/ohca/state-licensing-section/hcal/ Home Care Agency Licensing Application Form and Instructions Hawaii Licensed Home Care Agencies Home Care Agency Complaint Form Hawaii Administrative Rules, Chapter 11-700, Home Care Agencies Hawaii Administrative Rules, Chapter 11-103, Licensure and Certification Fees for Health Care Facilities and Agencies Contact: http://www.hah.org/ HOME CARE AGENCY INFORMATION What is a Home Care Agency? Home Care Agency is defined as a public or proprietary agency, a private, nonprofit organization, or a subdivision of an agency or organization, engaged in providing home care services to clients in their residence. The term Home Care Agency does not apply to an individual, including an individual who is incorporated as a business or is a volunteer. What Services are Included in Home Care? Home care services include but are not limited to: Personal care, including assistance with dressing, feeding, and personal hygiene to facilitate self-care; Homemaker assistance, including housekeeping, shopping, meal planning and preparation; or Respite care and assistance and support provided to the family. What Services are Not Included in Home Care? Personal care or homemaker assistance do not include the management of the client’s money or finances, or the balancing of the client’s checkbook; or Nursing services or other clinical professional services normally provided by home health agencies or private duty nursing services. How Do I Know if an Agency is a Licensed Home Care Agency? A list of licensed home care agencies is posted on the Department’s website. For information purposes only, agencies already in existence prior to the adoption of section 11-700, Hawaii Administrative Rules (HAR) who have submitted applications for a license are also listed and are noted as pending. Any agency not listed is not licensed nor have they applied for a state license. Where Can I Find More Information on the State’s Requirements on Home Care Agencies? For more detailed information on the licensing requirements on home care agencies, read section 11-700. How Do I Report a Possible Unlicensed Home Care Agency or File a Complaint Against a Licensed Agency? To file any complaint, click here to download the complaint form. Fax the completed form to (808) 692-7414, or email it to DOH.OHCALicensing@doh.hawaii.gov. LICENSE APPLICATION INFORMATION How do Agencies Apply for a License? License application instructions and an application form can be found here. Agencies are advised to become very familiar with licensure requirements by reading HAR 11-700. Chapter 11-700 are the regulations on home care agencies, and include terms and definitions, scope of services and service plan requirements, policies and procedures, administration and standards, and other important items. In addition, all licensed Home Care Agencies are subject to unannounced inspections to ensure safe levels of care in the recipient’s home. Existing agencies must apply for their state license immediately and may continue to operate during the license application process. New agencies must be licensed prior to providing services to clients. The Department may begin to take enforcement action against any agency which does not apply for a license within three months of the start of the licensing program. Hawaii Revised Statutes (HRS) section 321-14.8 establishes the authority of DOH to license home care agencies and enforce administrative rules. Are Agencies Required to Pay a Licensure Fee? Yes. Pursuant to Chapter 11-103, HAR, an initial licensure fee of $1,200 is due prior to issuance of the new license. Refer to Chapter 11-103, HAR, for more information. The Office of Health Care Assurance performs all state licensing activities on healthcare facilities, agencies and organizations in Hawaii. This includes conducting all on-site state licensing surveys or inspections and Medicare certification surveys or inspections on behalf of the U.S. Centers for Medicare and Medicaid Services (CMS).

Registering: Licensing & Certification: (208) 364-1959, ALC@dhw.idaho.gov https://healthandwelfare.idaho.gov/Medical/LicensingCertification/tabid/124/Default.aspx This state does not need licensing Contact: Idaho Bureau of Occupational Licenses- (208) 334-3233 Home Health Agencies A Home Health Agency is an agency providing skilled nursing services and at least one of the following other therapeutic services: physical therapy, speech language pathology, occupational therapy, medical social services, or home health aide services in the place of residence used as the patient’s home. To establish State licensure and Centers for Medicare/Medicaid Services (CMS) Medicare certification of an HHA, an applicant must request, complete, and submit an application packet. Application materials are located below, or requested through the Bureau of Facility Standards at 208-334-6626. Application process and forms The application packet includes what must be submitted, reviewed, and approved (Items #1-6) prior to an initial survey and resource information related to HHAs (Items #7-12): An HHA license is required to serve patients. To obtain a license, complete the HHA license Application and develop and submit, to this office for review and approval, the information on the HHA Licensure Checklist. You may use this Personnel Review Form to track compilation of personnel documents to be submitted. An HHA license will be issued only after the information has been received, reviewed, and approved by this office. Health Insurance Benefits Agreement - CMS 1561 Form (two signed originals required) Fiscal year ending date Form, Home Health Agency Survey and Deficiencies Report - CMS 1572a Form Complete sections 1-22 of the form CMS requires all new applicants for HHAs to complete the form CMS-855A, Medicare Application for Health Care Providers that will Bill Fiscal Intermediaries, and forward it to the Regional Home Health Intermediary (RHHI). This may be accomplished either by submitting a hardcopy or electronically. Submit the hardcopy to: The RHHI for Idaho is: National Government Services Provider Enrollment P.O. Box 7143 Indianapolis, IN 46207-7143 805-367-0734 www.ngsmedicare.com The internet-based Provider Enrollment, Chain and Ownership System (Internet-based PECOS) may be used in lieu of the Medicare enrollment application (i.e., paper CMS-855A). Information regarding this option may be found at: PECOS 6. “Office of Civil Rights Clearance for Medicare Certification” (OCR), Assurance of Compliance Portal This compliance may be completed and submitted on line, via https://ocrportal.hhs.gov/ocr/aoc/instruction.jsf The submission will go directly into the OCR intake queue, and the provider will receive an e-mail from OCR stating that the provider completed the civil rights submission. The e-mail will contain an OCR number, which is critical to OCR’s ability to access the provider’s submission from the OCR intake queue. The provider will submit a copy of this e-mail to the SA, and the SA will submit it to the CMS Regional Office in lieu of the completed civil rights package. 7. Appendix Q, Guidelines for Determining Immediate Jeopardy, 8. CMS State Operations Manual (SOM) – Chapter 2, Provider Certification (§2180 through §2186), 9. Home Health Agency Regulations, Survey Protocols, & Interpretive Guidelines, SOM Appendix B, 10. State Rules, IDAPA 16.03.07, Rules for Home Health Agencies in Idaho, 11. Initial Surveys for New Medicare Providers, CMS S&C Letter 08-03, 12. Revised HHA Initial Certification Process CMS S&C Letter 12-15 Become a Medicaid provider To become an Idaho Medicaid provider, you must submit an Idaho Medicaid provider enrollment application to DXC Technology, Idaho’s Medicaid Management Information Systems (MMIS) vendor. To submit an Idaho Medicaid provider enrollment application, go to www.idmedicaid.com and register for a trading partner account. A step-by-step user guide can be found by selecting Reference Material, User Guides, New Provider Enrollment Guide. Additional provider enrollment help is available by contacting your Provider Relations Consultant or Provider Services. Contact information can be found at www.idmedicaid.com or call 866-686-4272. Applying to be an Idaho Medicaid provider is a separate process from federal certification and state licensure. Medicare/Medicaid reimbursement is not retroactive and usually becomes effective only after your enrollment application is approved, the survey is completed, and you are in compliance with all regulations or have submitted an acceptable plan of correction.

Registering: Rules and Regulations : https://www.ilga.gov/commission/jcar/admincode/077/07700245sections.html Initial Application: https://www.dph.illinois.gov/sites/default/files/forms/coos-hha-home-nursing-home-services-and-placement-initial-licensure-061217.pdf Contact: http://www.idoahomecare.org/ http://www.ilhomecare.org/ What is the process to obtain a license? The applicant shall review the Home Health, Home Services and Home Nursing Agency Code Adm. Code 245 to determine which license reflects the services that the agency /business will provide. The applicant shall complete the initial licensing application located in the Forms. The Department has 60 days to conduct an initial review of the application and will contact the applicant for revisions to be submitted for an acceptable application. Upon approval of the application the Department will send a letter requesting, a letter from the applicant as to the agency’s readiness for on onsite. The Department will schedule an on onsite survey with the applicant to ensure the agency meets the regulations under Home Health, Home Services and Home Nursing Agency Code Adm. Code 245. Rules and Regulations: Home Health Rules and Regulations Initial Application: Home Health, Home Services, Home Nursing and Placement Agency Licensing Initial Application Can an agency apply for multiple licenses (i.e. Home Health, Home Services, Home Nursing and or Placement agencies)? Yes the applicant shall complete the initial application and select all of the licenses the agency is applying for on page 2 of the application and shall pay the higher of the licensure fees applicable. A home nursing agency or a home service agency shall pay a licensure fee not to exceed $1500. The fee is not refundable. A home nursing placement agency or home services placement agency shall pay a licensure fee not to exceed $500. The fee is not refundable. Home Health Agencies. For a single home health agency license only, each initial and renewal application shall be accompanied by a license fee of $25. The fee is not refundable. What is the process for an agency to expand the geographical service area to service clients/patients? The agency must seek approval from the Department prior to caring for clients in a new county. The agency shall submit the information outlined on the Forms “Home Health Agency Add or Remove Geographic Service Area” to the Department contact information below. Branch Office – a location or site from which an agency provides services within a portion of the total geographic area served by the parent agency. The branch office is part of the agency and is located sufficiently close to share administration, supervision and services in a manner that renders it unnecessary for the branch to be independently licensed. To apply for a branch office complete the “Home Health Agency Questionnaire” under the forms and submit to the Department the contact information on this page. Forms Medicare Intermediary Information Facility Information Change Form Home Health Agency Medicare Certification Home Health CHOW Information Home Health, Home Services, Home Nursing and Placement Agency Licensing Initial Application Home Health, Home Services, Home Nursing and Placement Agency Licensing Renewal/Change of Ownership Application Home Health Agency Add or Remove Geographic Service Areas Home Health Agency Administrator Qualifications Review - Attachment A Home Health Agency Agency Supervisor Qualifications Review - Attachment B Home Health Agency Social Worker/Worker Assistant Qualifications Review - Attachment D Home Health Agency Manager Qualification Review - Attachment E Home Health Agency Management Status Form Home Health Agency Questionnaire Instructions - Addition of Services Instructions - Making Changes to your HHA License Laws & Rules Home Health, Home Services, and Home Nursing Agency Licensing Act (210 ILCS 55) IDPH Administrative Code Medicare HHA Manual Health Care Worker Background Check Act (225 ILCS 46) Health Care Worker Background Check (Code 955)

Registering Personal Services agency https://www.in.gov/isdh/20119.htm https://www.in.gov/isdh/files/AC_PSA_Initial_Application_Instruction_Letter.pdf Notes: make sure you look into the letter of instruction and after reviewing you can call this number: 317-233-7492 You need to have an address and physical location to register Contact Indiana State Department of Health Division of Acute Care 2 North Meridian Street, 4A Indianapolis, IN 46204 (317) 233-7474 (Acute Care Receptionist) (317) 233-1325 (ISDH Main Switchboard) Applications: Applying for Initial Licensure or Change of Ownership Review all applicable information PRIOR to submission of application to the Department. Initial Application To apply for an initial license to operate a home health agency complete the “APPLICATION FOR LICENSE TO OPERATE A HOME HEALTH AGENCY” (SF 4008) and submit with $250.00 licensure fee and other required information to the Indiana Department of Health. Initial Licensure Application Instruction Letter Application for License to Operate a Home Health Agency (State Form 4008) Submit all documentation requested on application. Forms to be completed and returned with the application: FOR STATE LICENSE AND STATE LICENSE SEEKING MEDICAID: Notice of Affiliation Home Health Agency Survey Report (CMS-1572) Home Health Agency Survey Report State License Only Home Health Agencies/Hospice Agencies Geographic Area Served Clinical Laboratory Application (HCFA-116). If applicable. Copy of the Articles of Incorporation or Certificate of Assumed Business Name signed by the Secretary of State for doing business in Indiana. SS-4 or comparable document from the Internal Revenue Service that reflects the corporation name and EIN number. $250.00 Licensure Fee Copies of current valid Indiana licenses, limited criminal history checks and resumes on staff. Please refer to Criminal History Check Information. FOR MEDICARE: Initial Certification for Medicare Letter CMS LETTER Medicare Provider/Supplier Enrollment Applications (Form CMS-855A) Letter Process of Initial Medicare Certification CMS-Approved Accreditation Organization Contact Information Medicare Forms: Medicare Form Instruction Letter Health Insurance Benefit Agreement (Form CMS-1561) Civil Rights Certification for Medicare Provider Applicants Please make sure to complete and submit the “Data Request Checklist” Medicare Provider/Supplier Enrollment Application (Form CMS-855A)

Contact https://dhs.iowa.gov/ime/about/contacts/member-services https://dhs.iowa.gov/ime/members/medicaid-a-to-z/hcbs/home-health There are no state-mandated training requirements for nonmedical in-home caregivers in Iowa, although agencies that employ homemakers often require that staff has basic first aid training. Home-Delivered Meals: Contact your local Area Iowa Department on Aging: 1-800-532-3213 Long-Term Care Ombudsman: 515-725-3308 Home Health Services The Home Health Services (HHS) program provides in home medical services by Medicare-certified home health agencies. A member does not have to be determined homebound in order to receive HHS services. HHS does not include medical needs that can be met by a family member, significant other, friend, neighbor, community or other unpaid resources. A physician must certify that a member has a medical need for HHS through a face to face encounter. The physician must, also, review and sign the HHS plan of care (POC) every 60 days. The physician’s signature on the plan of care authorizes the service(s) as an assessed medical need(s). To prevent duplication of same or similar services and to ensure that the member’s comprehensive needs are met, the HHS POC must include all services, regardless of funding source, and unpaid supports provided to the member. These goals require that the HHS provider coordinate and communicate with caregivers, legal representatives or unpaid sources, providers of other services; and/or a DHS service worker or case manager, who may be assigned to a member. HHS providers are reimbursed per visit. The per visit rate is a fee schedule that is based on the low utilization payment adjustment (LUPA) methodology.

Registering https://www.kdheks.gov/bhfr/home_health_agencies/Kansas_HHA_Packet.pdf Contact https://www.kdheks.gov/bhfr/index.html Kansas Department of Health and Environment 1000 SW Jackson, Suite 330 Topeka, Kansas 66612-1365 Phone: 785-296-0127 FAX: 785-559-4250 Opening a Home Care Agency in Kansas If you are interested in opening an agency in Kansas, the following information and links may assist you in getting started... Kansas Dept. of Health and Environment (KDHE) State ACH Licensure Forms Kansas Dept. of Health and Environment (KDHE) contact is Lois Wilkins, 785/296-1258, lois.wilkins@ks.gov She can provide you with additional information on home health agency licensure procedures. Kansas Health Occupations Credentialing Website To Become Medicare Certified... Medicare Provider Enrollment Website: CMS information for providers and suppliers to facilitate their enrollment into the Medicare program. Provider Enrollment Packet: by CGS to assist providers in correctly completing the Medicare Enrollment Application: Form CMS 855A. National Provider Identifier Standard (NPI) Application Information: CMS instructions for obtaining a NPI. Additional links that may be helpful to you as you begin this process... Kansas Nurse Practice Act from the Kansas State Board of Nursing Kansas State Board of Nursing KDADS Home Health Aide Information KDADS Criminal Record Check Program Information KDHE Health Care Provider Directory - Note: To access the directory, you must read restrictions and click "I Agree" to continue.

Registering Check out this link for all the information needed to register https://chfs.ky.gov/agencies/os/oig/dhc/Pages/ltcapplications.aspx Contact Kentucky Cabinet for Health and Family Services Phone:(502) 564-7963 Mailing Address: 275 E. Main St. 5E-A Frankfort, KY 40621Division of Health Care (OS) Applications for Health Care and Long-Term Care Long Term Care Facilities Kentucky Administrative Regulations and Revised Statutes Prior to licensure, long term care facilities must have a certificate of need with the exception of family care homes which do not require a certificate of need. Application for long term care facility license License Fee Schedule for long term care facilities Family Care Home Application for Family Care Home License Family Care Home License Fees: $42 Personal Services Agency Application for Personal Services Agency Certification PSA Initial Application Checklist PSA License Fees: $500 for initial certification $350 for annual recertification $350 for a change in an ownership interest of more than 25 percent Other Health Care Facilities Kentucky Administrative Regulations for Health Care Facilities Prior to licensure, many of the facilities listed below must have a certificate of need or fire marshal approval. Please contact our office before submitting your application to determine whether these requirements apply to your facility. Applications for license to operate health care facilities: Abortion Facility Application Adult Day Health Application Alcohol or Drug Treatment Entity Application Checklist for AODE License Application Alcohol or other Drug Abuse Prevention Agency Application Alternative Birthing Center Application Ambulatory Infusion Agency Application Ambulatory Surgical Center Application Behavioral Health Services Organization Chemical Dependency Treatment Service Application Community Mental Health Center Application End Stage Renal Dialysis Application ESRD Incident or Accident Report Form Freestanding or Mobile Technology Application Home Health Agency Application Hospice Non Residential Application Hospice Residential Application Hospital Application (includes all types) Hospital-owned Pain Management Clinic Application Medical Laboratory Application MR/DD Group Home Application Outpatient Health Care Center Application Prescribed Pediatric Extended Care Application Private Duty Nursing Application Psychiatric Residential Treatment Facility Application Residential Crisis Stabilization Unit Application Specialty Intermediate Care Clinic Application License Fee Schedule for Other Health Care Facilities

Registering https://ldh.la.gov/index.cfm/page/3786 https://ldh.la.gov/index.cfm/page/427 https://ldh.la.gov/assets/medicaid/hss/docs/HHA/HH_LAC_48_2_Chapter_91_042020.pdf Contact Louisiana Department of Health Program Manager Marian Tate, RN, BSN Phone: 225-342-6446 Fax: 225-342-0157

Register All info here: https://www.maine.gov/sos/cec/rules/10/144/144c119.doc Contact https://www.maine.gov/dhhs/ How to Apply To apply to have a facility licensed or renewed, complete the appropriate application and submit with the required documentation and fees as detailed in the application form. These application forms are "fillable." Please save the form to your computer and complete it by typing the required information into the fields provided. You can then print your completed form, sign, and submit via mail. Adult Day Program Application (Initial & Renewal) (PDF) Residential Care & Assisted Living Application (Initial & Renewal) (PDF) Infection Prevention and Control New rule adopted on June 4, 2021. This rule applies to all settings licensed under Chapter 113. 10-144 CMR. 113 Assisted Housing Infection and Control (PDF). Assisted Living Programs An Assisted Living program is a facility that offers services to residents in private apartments. There are two types of Assisted Living programs. Type I provides only medication administration, and type II provides medication administration and nursing services. Assisted Living Program Rules (Word) Residential Care Facilities A Residential Care Facility is a facility that offers services to residents in private, or semi-private, bedrooms. Some Residential Care Facilities that receive MaineCare funding are known as Private Non-Medical Institutions (PNMIs) and are governed by a separate set of rules. There are four levels of Residential Care Facilities: a facility with a licensed capacity of one (1) to two (2) residents. Level I Rules (Word) PNMI Level I Rules (Word) a facility with a licensed capacity of three (3) to six (6) residents. Level II Rules (Word) PNMI Level II Rules (Word) a facility with a licensed capacity of three (3) to (6) residents and which employs three (3) or more persons who are not owners and are not related to the owner. Level III Rules (Word) PNMI Level III Rules (Word) a facility with a licensed capacity of more than six (6) residents Level IV Rules (Word) PNMI Level IV Rules (Word) Adult Day Programs An Adult Day Program offers therapeutic activities and supervision of adults in group settings. Adult Day Rules (Word) Water Testing Requirements Due with Applications All facilities or agencies / locations or sites with private wells are required to complete the Basic Safety Test (TSA) of their well water prior to filing an initial or renewal application. A copy of the test results should be submitted to DLC with their applications. Water test kits can be ordered from the Health and Environmental Testing Laboratory at the following web site: https://apps1.web.maine.gov/cgi-bin/WebShop/public/index?store_id=10/ Waivers Facilities can apply for a waiver of specific regulations that are not mandated by state or federal law, and do not violate resident rights by submitting a waiver request application. Request for Waiver Application (PDF) Changes to an Existing Facility License Changes to a facility license, such as a change of administrator, or a change in the capacity of the facility require an application and approval by the Division of Licensing & Certification. Change of Administrator Application AD or AH (PDF) Assisted Housing Program Change in Licensed Capacity Application (PDF)

Registration https://health.maryland.gov/mmcp/longtermcare/Pages/Home.aspx Contact Maryland Department of Health Herbert R. O'Conor State Office Building 201 W. Preston Street Baltimore, MD 21201 877-463-3464 410-767-6500 GUIDELINES FOR ESTABLISHING A HOME HEALTH AGENCY Interested in establishing a home health agency in Maryland? The following addresses some of the most frequently asked questions In order to be eligible to seek licensure and subsequently to be eligible to apply for Medicare certification, an applicant must first obtain a Certificate of Need (CON) from the Maryland Health Care Commission (MHCC). A CON is required to establish a new home health agency or to expand the services of an existing home health agency into a jurisdiction that the agency does not currently serve. To obtain a CON, an application must be filed with the MHCC in accordance with an established schedule. The MHCC will only grant a CON to an applicant if it finds that the project proposed is needed and that it is consistent with the applicable State Health Plan standards and CON review criteria. The standards which a prospective applicant must meet are set forth in the State Health Plan (COMAR 10.24.08) and may be found at: http://www.dsd.state.md.us/comar/SubtitleSearch.aspx?search=10.24.08.* Within this regulation, review rules may be found at COMAR 10.24.08.09 and 10.24.08.10; the methodology for projecting need may be found at 10.24.08.11. Additional background information and data on home health agencies may be found under Supplement 1 and need projections to 2010 may be found under Supplement 2 at: State Health Plan The CON review criteria and the rules regarding review of the application may be found in COMAR 10.24.01., which is available on the Certificate of Need page on the MHCC website. The current schedule for accepting CON applications for review can also be found on the CON page of the MHCC website. The schedule will identify, on the basis of each jurisdiction you propose to serve, the deadline for filing a letter of intent and a CON application. The CON procedural rules, the process, the schedule for reviews, and the CON application form may be found at: on the Certificate of Need home page PLEASE NOTE: that a valid letter of intent must include the following information: A. The identity of each person on whose behalf the letter of intent is filed, including: 1). The name and address of each such person; and 2). In the case of a letter of intent filed on behalf of a person that is not a natural person, the date the entity was formed, the business address of the entity, and the identity and percentage of ownership of all persons having an ownership interest of 5 percent in the entity; B. A description of the proposed project; C. The quantity and types of beds or health services involved [in this case, home health agency services]; and D. The specific location and each jurisdiction in which services will be provided, according to the relevant planning region in the State Health Plan for that facility or service [For home health agency services, the relevant planning region is the county or the independent city of Baltimore]. Information regarding licensure * as a Maryland Home Health Agency is provided under the Department of Health and Mental Hygiene’s Office of Health Care Quality For more information on the federal requirements governing Medicare-Certified home health agencies (42 CFR 484) and on the Conditions of Participation as a Medicare agency, information is provided at www.cms.hhs.gov/center/hha.asp

Register https://www.mass.gov/orgs/division-of-health-care-facility-licensure-and-certification https://www.thinkhomecare.org/page/starting-an-agency Contact Division of Health Care Facility Licensure and Certification 67 Forest St., Marlborough, MA 01752(617) 753-8000 State Regulations You don't have to apply to the Department to open a home health business. Massachusetts laws for the Department of Public Health do not include licensure of home health agencies. The Massachusetts Department of Labor Standards licenses certain home health agencies under its regulations for employment agencies. This licensure is a state requirement for conducting a home health business. For more information, call (617) 626-6970. A home health agency is required to report employee misconduct toward persons receiving services to the Department. This regulation applies to any home care agencies whether is it Medicare certified on not. Medicare HHA Program Regulations The agency must provide skilled nursing and at least one other qualifying service (i.e. physical therapy, occupational therapy, speech/language pathology, medical social services, home health aides). Agency employees must provide at least 1 qualifying service. All other services may be provided by contract with a third party. Application Instructions If you wish to apply for Medicare certification, complete all steps included in the HHA Application Instructions. Required forms Home Health Agency Medicare Deemed Status Certification Checklist CMS-1561 Health Insurance Benefit Agreement (PDF) 3 copies, all of which must be fresh-ink originals CMS-1572 Home Health Agency Survey & Deficiencies Report Omit numbers 7, 8, 11, 21, 22 HHS-690 Assurance of Compliance Either a fresh-ink original copy or an email receipt from an online submission OMB 0990-2043 Civil Rights Information Request Form Either printed with signed checklist and attachments or an email receipt from an online submission See the CMS Technical Assistance Regarding Civil Rights Resources See a list of CMS accrediting agencies Obtain a National Provider Identifier (NPI) CMS tech assistance regarding civil rights Medicaid Enrollment In order for your agency to participate in the Massachusetts Medicaid program, it first must be certified as an HHA in the Medicare program. To pursue Medicaid enrollment, contact MassHealth Provider Enrollment at (800) 841-2900. Processing and Medicare provider number According to CMS protocol, the Division of Health Care Facility Licensure and Certification will process these materials to the CMS Regional Office (CMS-RO). Subsequently, CMS-RO will assign a Medicare provider number to your agency.

Register https://www.michigan.gov/documents/ag/FINAL_Non-Medical_Home_Care_Agency_Checklist_498832_7.pdf Contact Call the Licensing and Regulatory Affairs Department at 517-335-9700 https://www.michigan.gov/lara/0,4601,7-154-89334_72600---,00.html Home health agencies that provide skilled nursing services may apply for certification to participate in the Medicare/Medicaid programs. The Centers for Medicare and Medicaid Services (CMS) contracts with LARA to evaluate compliance with the federal regulations by conducting certification surveys and complaint investigations. For initial certification or change of ownership: Complete Provider Enrollment Application (CMS-855A) and submit to Medicare Administrative Contractor (MAC)/Federal Fiscal Intermediary (FI). Complete and submit to BCHS: An e-mail confirming a successful electronic submission of your Civil Rights Clearance for Medicare Provider Certification from the Office for Civil Rights (OCR) Two (2) signed originals Health Insurance Benefit Agreement (CMS-1561) One (1) signed original HHA Survey and Deficiencies Report (CMS-1572A - Only complete numbers 1-10 and 12-20.) Contact Accrediting Organization (AO) to schedule survey (initial only) For address/location changes: Complete Provider Enrollment Application (CMS-855A) and submit to MAC/FI within 90 days of the move * Note-address/location changes should remain within the approved geographic area For branch site application (one application packet per site): Complete Provider Enrollment Application (CMS-855A) and submit to MAC/FI. Complete Branch Application (BCHS-SHCS-803) and submit to BCHS. Note: Branch site applications must be completed for all proposed sites, including relocations of previously approved sites and newly requested sites. For a change in administrator, please email the following: Facility name, address, and provider # New administrator full name Effective start date of administrator For submitting correspondence or application documents, please email BCHS_FedDivision@michigan.gov. Federal Reciprocal Agreements - For a federally certified provider in Michigan to provide services in another state, the provider must be federally certified in the other state or the provider must be recognized under a CMS-approved Reciprocal Agreement between the State of Michigan and the other applicable state. Michigan has no reciprocal agreement with Indiana or Ohio for home health agency services. In short, federally certified home health providers in Michigan cannot offer services within these states unless certified as a provider within these states. Michigan does have an agreement with Wisconsin. This agreement recognizes only the following certified Michigan providers: 23-7292 and 23-7093. Contact Information Michigan Department of Licensing and Regulatory Affairs Bureau of Community & Health Systems - Federal Certification 611 W. Ottawa Street PO Box 30664 Lansing, MI 48909 Phone: 517-284-8953 FAX: 517-241-3354

Register All the information is here: https://www.health.state.mn.us/facilities/regulation/homecare/starting.html Contact https://survey.vovici.com/se/56206EE31B4AC36F Department of Health: 651-201-5000 Phone 888-345-0823 Toll-free Minnesota laws require individuals and agencies that offer home care services be licensed. Home care services may not be offered nor provided without a valid license (unless the provider is exempted or excluded from licensure as addressed below). Information about licensure is provided on this website. MDH encourages parties interested in becoming licensed to review all sections of the Home Care website to become familiar with the requirements of licensure. Applicants and licensed providers must understand Minnesota home care laws. The home care laws can be accessed for free electronically and may also be purchased as a bound book or a digital (PDF) file. Home Care Laws Minnesota has two types of home care licenses. The license a home care provider holds depends on the types of services offered. Download the following documents to see the services that are allowed under the basic and comprehensive home care licenses. Statement of Services: Basic Home Care License (PDF) Statement of Services: Comprehensive Home Care License (PDF) To be eligible for a home care license, applicants must have agency-specific policies and procedures in place that address all requirements of Minnesota home care statutes. Review information about MDH’s expectations for policies and procedures, as well as other important and helpful information at these links: Expectations for Agency-Specific Policies and Procedures for Home Care Providers Applications Forms for Home Care Providers Background Studies All owners, managerial officials, and the named RN or licensed health professional on home care license applications must complete and pass background studies prior to the issuance of a home care license. What is the typical processing time for a temporary home care license? The time it takes to obtain a license is dependent upon how complete an application is when received by MDH. In addition to the application and the fee, there are many documents that are required to make a complete application. Review the application closely, including the checklist, to be sure you are providing all materials. Home care laws require that MDH review each application to determine the applicant’s knowledge of and compliance with Minnesota home care regulations. We may request additional information or a telephone or in-person meeting with applicants to make this assessment. Once an application is deemed complete MDH has 60 days to issue or deny the temporary license. Medicare Certification Licensed home care providers may apply to become Medicare certified home health agencies (HHAs) after being found in substantial compliance with the initial full survey and receiving a comprehensive home care license. Temporary licensees are not eligible for Medicare certification, nor are basic licensees. Refer to Federal Certification Process for Home Health Agencies on the MDH website for more information. Integrated License: Home and Community-Based Services Designation Some providers of home care services may choose to hold an integrated license: home and community-based services (HCBS) designation on their home care license. This designation allows the licensee to provide basic support services as identified under Minnesota Statutes, section 245D.03, subdivision 1, paragraph (b). For more information, review the following documents: Questions and Answers: Integrated Licensing and the HCBS Designation Related Statute: Minnesota Statute 144A.484 Home Management Registration Home management services are different from home care services. Home management includes only these three services: Housekeeping Meal preparation Shopping If an individual or an agency is providing at least two of those services to a person who is unable to perform these activities due to illness, disability, or physical condition, these providers must be registered with the Minnesota Department of Health. In addition, they must comply with the provisions of the home care bill of rights, and they must attend an orientation session that provides training on the home care bill of rights and on the aging process and the needs and concerns of elderly and disabled persons. Related Statute: Minnesota Statute 144A.482 Who is excluded or exempt from home care licensure? Some types of providers are not required to hold a home care license to provide home care services. Those which are exempted from home care licensure are regulated by other laws and/or licensed under separate licensing bodies. Those which are excluded are either not providing direct home care services or otherwise meet the specific conditions as outlined in statute for exclusion. Review Minnesota Statutes, section 144A.471 to see who must hold a home care license. Information about exempt and excluded providers can be found in subdivisions 8 and 9 of this statute. 144A.471 Home Care Provider and Home Care Services Exempt providers must comply with the applicable provisions of the home care bill of rights in section144A.44. Excluded individuals and businesses are not required to provide the home care bill of rights. For More Information Individuals and businesses interested in starting a home care agency are encouraged to review all sections of the Home Care website, including the FAQs for Consumers/Families/Caregivers and the FAQs for Current Providers before submitting an application. If you have questions call 651-201-4200 or submit an inquiry via the contact us button at the right.

Resource https://msdh.ms.gov/msdhsite/_static/resources/264.pdf https://aspe.hhs.gov/sites/default/files/private/pdf/110516/15alcom-MS.pdf Contact Department of Health Central Office Phone 601-576-7400 (8am-5pm) Toll-free: 1-866-458-4948

Register https://health.mo.gov/safety/homecare/appsforms.php https://health.mo.gov/safety/homecare/ Contact Bureau of Home Care and Rehabilitative Standards Missouri Department of Health and Senior Services PO Box 570 Jefferson City, MO 65102-0570 Phone: 573-751-6336 Fax: 573-751-6315 Home Health/Hospice Hotline: 800-392-0210 (to be used for filing complaints) Email: info@health.mo.gov

Register https://dphhs.mt.gov/qad/licensure/healthcarefacilitylicensure/lbfacilityapplications/lbhomehealthagency Contact https://mt.gov/

Register http://dhhs.ne.gov/licensure/Pages/Home-Health-Agencies.aspx Initial Licensure application http://dhhs.ne.gov/licensure/Documents/HHAInitialAppNonfillable.pdf Contact DHHS Licensure Unit Attn: Home Health Agencies PO Box 94986 Lincoln NE 68509-4986 (402) 471-4967

Register Called a Personal Care Agency http://dpbh.nv.gov/Reg/HealthFacilities/HF_-_Non-Medical/Agency_to_provide_personal_care_services_in_the_home_(personal_care_agency)/ Contact http://dpbh.nv.gov/contact/Contact/ Division of Public and Behavioral Health (DPBH) 4150 Technology Way, Carson City, NV 89706 Phone: 775-684-4200 | FAX: 775-684-4211 Email: dpbh@health.nv.gov Business Hours: 8 a.m. to 5 p.m.

Register https://www.nhcarepath.dhhs.nh.gov/home-care/index.htm Contact https://www.dhhs.nh.gov/ New Hampshire Department of Health and Human Services 129 Pleasant Street | Concord, NH | 03301-3852

Register Useful Guide: https://www.state.nj.us/humanservices/doas/documents/ltc_guide_6.pdf Contact New Jersey, 1996-2020 Department of Health P. O. Box 360 Trenton, NJ 08625-0360

Register https://www.nmhealth.org/about/dhi/hflc/prop/stli/ 505-476-9025 Phone http://164.64.110.134/parts/title07/07.001.0007.html Contact https://www.nmhealth.org/contact/staff/

Register https://www.health.ny.gov/forms/doh-1056.pdf Contact https://www.health.ny.gov/ New York calls this type of Agency a “Licensed Home Care Services Agency” [LHCSA]. This hands-on license will require an application to be compiled and submitted digitally to the New York Department of Health with a fee of $2,000. A Nurse Supervisor is needed to oversee the Home Health Aides. Home health agencies must be certified to operate in New York State. This certificate is from the NYS Department of Health (NYSDOH). There is a moratorium until 2020 on most new applications. The information provided here is for reference. Contact the NYSDOH for more information. Home health agencies provide long-term, part-time medical care at patients' homes. For certification, agencies must provide at least these services: nursing services; home health aide services; medical supplies; equipment; and appliances for use at home. The agency must also provide at least one other service. These include: physical therapy; occupational therapy; speech pathology; nutritional services; or medical social services. Agencies also need a Certificate of Need. This proves that the agency meets a public need, is run by qualified people, and is financially solvent. For the operating certificate, the agency must prove that the facilities meet all legal requirements. Home Care Professionals Complaints about care? Call 1-800-628-5972. Training and Educational Materials DAL HBCS 11-11: Aide Training Requirements for Veterans with Medical Training - November 9, 2011 Certified Home Health Agency Charity Care Report DAL 07-13: Charity Care Charity Care Sample Letter (PDF, 97KB, 3pg.) Home Care Curriculum (PDF, 282KB, 173pg.) (Revised January 2007) Home Care Health Related Tasks Curriculum (PDF, 161KB, 85pg.) (Revised January 2007) The Personal and Skilled Care Outcomes (PESO) Data Set DAL NH 12-02: Personal Care Aide Training Programs Re-approvals Advisory: April 12, 2012 - Home Care Registry Pre-2008 PCATP DAL HCBS 12-01: Operation of a Home Health Aide Training Program Attachment A: HHATP Address Verification (DOC, 69KB, 1pg.) HHTAP Training Materials Frequently Asked Questions and Answers

Register https://info.ncdhhs.gov/dhsr/ahc/flohc.htm Contact https://info.ncdhhs.gov/dhsr/requests.htm https://www.ncdhhs.gov/divisions/dhsr/dhsr-contact-form

Register https://www.ndhealth.gov/hf/North_Dakota_Home_Health_Agencies.htm Contact 1-800-545-8256 Home Health Hotline

Register https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/home-health-agencies/homehealthagencies Contact Ohio Department of Health Bureau of Regulatory Operations, HHA 246 North High Street Columbus, OH 43215 Telephone: (614) 995-7466 Fax: (614) 564-2475 E-mail: community@odh.ohio.gov A new Ohio law mandating licensure for home health agencies and providers will go into effect July 1, 2022. This law will be codified at O.R.C. § 3740.01 et seq., and comes from Ohio House Bill 110 affecting both “home health agencies” and “individual non-agency providers.” Home health agencies are those persons or government entities that provide skilled home health services or nonmedical home health services at a patient’s home. Individual non-agency providers are natural persons who are self-employed to provide skilled home health services or nonmedical home health services. Beginning on July 1, 2022, home health agencies must have valid licenses to provide either skilled home health services or “nonmedical home health services” through one or more employees. Non-agency providers must also have a license to provide skilled or nonmedical home health services. Under the new law, nonmedical home health services include, but are not limited to, bathing assistance, meal preparation, assisting with dressing, and other personal services. Skilled home health services include skilled nursing care, physical therapy, occupational therapy, speech-language pathology, medical social services, and home health aide services. Applications for licenses for home health agencies and nonagency providers seeking to provide skilled home health services require the following documentation: Proper evidence of certification for participation in the Medicare program Evidence of accreditation by a national accreditation organization approved by the Centers for Medicare and Medicaid Services Evidence of certification by the Department of Aging to provide such services Evidence of past provision of direct care (i.e., the provision of home health services in a patient’s home or that require routine access to a patient’s personal property or financial documents); or, in the absence of evidence showing the prior provision of past care, a surety bond in the amount of $50,000 An application fee of $250 Copies of fingerprints of the primary owner or the agency, if applicable, or the non-agency provider Copies of any filings with the Ohio Secretary of State Copies of an agency’s criminal record check A notarized affidavit confirming the applicant’s identity Other additional documents outlining the agency or provider’s operations, such as a description of services to be provided, an address of the agency or provider’s place of business, and days and hours of operation. Issued licenses are valid for three years and are renewable upon payment of a renewal fee and continued compliance with licensure requirements. A home health agency or non-agency provider who holds a skilled home health services license can provide nonmedical home health services. However, a home health provider or non-agency provider who holds a license to provide nonmedical home health services cannot perform skilled home health services without holding a valid skilled home health services license. Prior to the effective date of the bill, the Ohio Department of Health will promulgate rules providing further details on the provision of these licenses. Home Health Agency Licensure The requirements of Chapter 3740. of the Ohio Revised Code (ORC) included in House Bill 100 of the 134th General Assembly, pertaining to the licensing of Home Health Agencies and Nonagency Providers are currently under development. Section 3740.02 ORC requires implementation of licensure beginning one year after the effective date of the legislation, which was September 30, 2021. The Ohio Department of Health will be scheduling stakeholder meetings as part of the rule development process. To be contacted when these stakeholder discussions are scheduled, please submit your contact information to Selina.Jackson@odh.ohio.gov

Register https://www.ok.gov/health/Protective_Health/Medical_Facilities_Service/Home_Services_Division/Licensure_Applications_and_Forms/index.html https://www.ok.gov/health2/documents/Home%20Care%20Application%20Guidance%20Letterhead.pdf Contact OSDH - Medical Facilities Service Attn: Home Services Division 1000 NE 10th Street Oklahoma City, OK 73117-1299 Telephone: 405-271-6576 Fax: 405-271-1141 Email: medicalfacilities@health.ok.gov

Register https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/HEALTHCAREPROVIDERSFACILITIES/HEALTHCAREHEALTHCAREREGULATIONQUALITYIMPROVEMENT/Documents/IHCApplication.pdf https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/HEALTHCAREPROVIDERSFACILITIES/HEALTHCAREHEALTHCAREREGULATIONQUALITYIMPROVEMENT/Documents/IHCInitialAgencyPacket.pdf Contact Health Facility Licensing and Certification 800 NE Oregon Street, Suite 465 Portland, Oregon 97232 971- 673-0540 971 (phone) 673-0556 (Fax)

Register https://www.health.pa.gov/topics/facilities/home-care/Pages/Home%20Care.aspx https://www.health.pa.gov/topics/Documents/Facilities%20and%20Licensing/HCAapp.pdf Contact https://www.health.pa.gov/About/Pages/Contact.aspx

Register https://health.ri.gov/licenses/detail.php?id=204 Contact CONTACT Department of Health 3 Capitol Hill Providence, RI 02908 Phone: 401-222-5960 After Hours Phone: 401-276-8046RI Relay 711

Register Called a Health Facility https://scdhec.gov/health-regulation/healthcare-facility-licensing Licensed State Different than most states: quite detail oriented Contact Online – Use our Constituent Services form. Email – Send an email to info@dhec.sc.gov. Mail – Send a letter to: Constituent Services SC Department of Health and Environmental Control 2600 Bull Street Columbia, SC 29201 Phone –(803) 898-3432

Register https://doh.sd.gov/providers/licensure/homehealth.aspx https://doh.sd.gov/providers/licensure/facility-license.aspx Contact Submit written request for information to license and/or certify specific facility type to: Chris Qualm, Administrator Office of Health Care Facilities Licensure & Certification 615 E. 4th Street Pierre, SD 57501-1700

Register https://www.tn.gov/health/health-program-areas/hcf-professionals/applications.html https://www.tn.gov/content/dam/tn/health/program-areas/hcf/PH-3506HHS.pdf Contact https://www.tn.gov/health/health-contact-information.html

Register https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/home-community-support-services-agencies/how-become-a-licensed-hcssa-provider Contact https://hhs.texas.gov/about-hhs/find-us Texas Health and Human Services licenses, certifies and surveys home and community support services agencies for compliance with state and federal laws and regulations. Through these regulatory activities, HHS protects Texas citizens receiving home health, hospice and personal assistance services. What is HCSSA/Hospice? Click here to learn more. Becoming Licensed in Texas HCSSAs must be licensed to operate in Texas. To become licensed, an agency must: Complete the pre-survey, computer-based training. Properly complete the license application. Upload all required documents. Pay the required license fee(s). Be registered with and be in good standing from the State Comptroller of Public Accounts. Be registered with and be in good standing from the Secretary of State of Texas. Be approved by HHS/HCSSA Licensure and Certification Unit. Types of Applications Initial An initial application is an application that has never been issued an HHS license number to operate in Texas. Changes of ownerships are also considered an initial application. Change of Ownership A change of ownership happens when the agency changes the tax identification number. Renewal A renewal application for a current license holder must be submitted on or before the licensure expiration date. A late fee can apply. Any application submitted after the licensure expiration date will not be accepted. Changes of Information If certain information provided on an initial or renewal application changes after HHS issues the license, an agency must report the change to HHS/HCSSA Licensing unit. The agency must report the change using the appropriate Home and Community Support Services Agency License Application, (Form 2021, 2024 and 2025), found in the Texas Uniform Licensing Information Portal (TULIP). To avoid a late fee, a change must be reported within the time frame specified for the type of change. Licensing Fees HHS is phasing in a three-year license term. Below are the licensing fees: Initial licensing fee for three-year license: parent agency, branch, or change of ownership: $2,625 alternate delivery site: $1,000. Renewal licensing fees: For two-year license: parent agency or branch: $1,750 alternate delivery site: $600. For three-year license: parent agency or branch: $2,625 alternate delivery site: $900. Renewal licensing late fees (in addition to the renewal licensing fee) if the renewal application is submitted less than 45 days before the license’s expiration date: For two-year license: parent agency or branch: $875 alternate delivery site: $300. For three-year license: parent agency or branch: $1,312.50 alternate delivery site: $450. A late fee of $250 for each license, in addition to the licensing fee, will be assessed if the change-of-ownership application is submitted less than 30 days before the effective date of the change of ownership. All HCSSAs must pay a $30 standard fee when reporting most changes to HHS/HCSSA Licensure Unit. If a HCSSA does not report a change of information in a timely manner to the HHS/HCSSA Licensure Unit, the HCSSA must pay a late fee of $100, if applicable. This late fee is in addition to the $30 fee, if applicable. Category of Services Licensed and Certified Home Health Must accept a person for home health services based on a reasonable expectation that their medical, nursing and social needs can be met adequately in their residence. Certified home health agencies must comply with the requirements of the Social Security Act and the regulations in Title 42 of the Code of Federal Regulations, Part 484. Licensed Home Health Must accept a person for home health services based on a reasonable expectation that the their medical, nursing and social needs can be met adequately in their residence. Licensed and Certified Home Health with Home Dialysis Designation Must accept a person for home health services based on a reasonable expectation that their medical, nursing and social needs can be met adequately in the client's residence. For a residence to receive a home dialysis designation, it must meet the licensing standards specified in Texas Administrative Code §558.405. Certified Home health agencies must comply with the requirements of the Social Security Act and the regulations in Title 42 of the Code of Federal Regulations, Part 484. Licensed Home Health with Home Dialysis Designation Must accept a person for home health services based on a reasonable expectation that their medical, nursing and social needs can be met adequately in their residence. For a residence to receive a home dialysis designation, it must meet the licensing standards specified in 26 TAC §558.405. Hospice Services, including those provided by unlicensed personnel under the delegation of a registered nurse or physical therapist, provided to the person in care or their family as part of a coordinated program. These services include palliative care for terminally ill people and support services for them and their families. Hospice services are available 24 hours a day, seven days a week. Certified hospice providers must comply with the requirements of the Social Security Act in Title 42 of the Code of Federal Regulations, Part 418. Personal Assistance Services Routine ongoing care or service required by a person in a residence or independent-living environment that enables them to engage in the activities of daily living or to preform functions required for independent living, including respite. Time Frames for Applications An application from an agency for an initial, renewal and change of ownership: parent, branch office or alternate delivery site license is processed in accordance with three general time frames: Upon receipt of a thoroughly complete application in TULIP, the HHS/HCSSA Licensing unit has up to 45 days to process the application. If HHS/HCSSA Licensing unit receives an incomplete application, the HHS/HCSSA Licensing unit will notify the HCSSA via TULIP of any deficient items in the application. The applicant must respond with complete and correct information within 30 days from the date of notification or the application will be denied. Upon receipt of the application deficiency response in TULIP, the licensing unit will issue or deny the license within 45 days unless other matters prevent the approval or denial of the application, for example a pending survey or enforcement recommendation. NOTE: After an initial license is issued, the agency must notify the HHS regional office upon enrolling its first person under their care (If more than one category, the agency must enroll and provide surveys to the highest category) and request an initial health survey using the HHSC Form 2020, Notification of Readiness for Initial Survey. This survey request must be completed within six months of the issuance of the initial license. After an agency is issued a new change-of-ownership license, the agency must notify the HHS regional office within six months of the effective date of their new license. After an initial license is issued for an alternate delivery site with or without an inpatient unit, the hospice agency must notify the HHS regional office upon enrolling its first person under their care and request an initial health survey. Changes of Information Click here for instructions on how to submit Changes of Information for a HCSSA. Forms Parent, Branch, Alternate Delivery Site and Medicare Branch Applications Visit the TULIP website to access the applications and instructions page. Form 2021, Home and Community Support Services Agency Application for Parent (initials, renewals, change of ownership and changes of information to the parent agency), fees are non-refundable. Form 2023, Home and Community Support Services Agency Application for Initial Medicare Certified Branch, fees are non-refundable. Form 2024, Home and Community Support Services Agency Request for an Alternate Delivery Site License (initials, renewals, change of ownership and changes of information to the alternate delivery site, to include In-patient unit), fees are non-refundable. An Inpatient Hospice unit must contact the HHS Architectural Unit at 512-438-2311 to request a Life Safety Code survey before approval and an Impatient Hospice unit must notify their HHSC regional office upon enrolling its first person under their care and request an initial health survey. Form 2025, Home and Community Support Services Agency Request for a Branch License, (initials, Renewals, Change of Ownership and Changes of Information to the branch office), fees are non-refundable. Statutes and Rules HCSSA providers are responsible for reading and understanding the HCCSA regulations before becoming a licensed provider. Click here to see all Rules and Statutes. Medicare Certification Participation in the state and federal Medicaid program and federal Medicare program is voluntary. However, each agency must be certified for the appropriate Medicare program before serving people who are eligible. As of January 30, 2019, there are no active Medicare Provider Enrollment Moratoria in Texas. An existing home health or hospice provider seeking Medicare certification should refer to the following provider letters, respectively. Provider Letter No. 15-09, Direction from the Centers for Medicare & Medicaid Services (CMS) on Prioritization of Initial Medicare Certification Surveys (Home Health) [PDF] (Note: This provider letter has not been updated to note the expiration of the moratorium) Provider Letter No. 15-10, Direction from the Centers for Medicare & Medicaid Services (CMS) on Prioritization of Initial Medicare Certification Surveys (Hospice) [PDF] related to requirement to use an Accrediting Organization for initial certification surveys. The application will not be considered completed until verification of an initial certification survey is received from an AO or conducted by HHSC Survey Operations. Due to CMS workload prioritization directives, no initial certification surveys are being performed by HHSC Survey Operations. Existing Licensed Providers seeking to add Medicare certification should submit an application through the TULIP system (Form 2021, Home and Community Support Services Agency License Application: Change-Update Category of Service), including the following documents to be uploaded into the application: CMS 1561: Health Insurance Benefit Agreement CMS 417 Request for Hospice certification, as applicable Verification of Office of Civil Rights Submission New home health and hospice providers seeking licensure and Medicare certification should submit an application through the TULIP system (Form 2021, Home and Community Support Services Agency License Application: Initial). For a list of required documents, see the required documents for Medicare certification below. Accreditation Agencies Community Health Accreditation Partner The Joint Commission Accreditation Commission for Health Care, Inc. Required Documents for Medicare Certification These documents are required if the agency is seeking certification or is currently certified through the Medicare program. Printed CMS 855A Home Health Enrollment Application (PDF) [Please read the instructions for how to submit this form to the fiscal intermediary]. Online CMS 885A Home Health Enrollment Application. CMS 1561 Health Insurance Benefit Agreement (PDF) [with original signatures, completing the entire top half and signing under "Accepted for the provider of services by"]. Civil Rights Clearance for Medicare Provider Applicants (copy of evidence of successful electronic submission through HHS Assurance of Compliance portal). CMS 417 Hospice Request for Certification in the Medicare Program (PDF) [with original signatures] only if requesting the category of certified hospice. Attention: Home health and Hospices agencies that are (1) initially enrolling in Medicare, (2) adding a branch or multiple location, or (3) revalidating their enrollment information, must submit with their CMS 855 application: Verification of the application fee in an amount prescribed by CMS and/or A letter for a request for a hardship exception to the application fee. The provider must pay the application fee electronically through Pay.gov, with a credit or debit card. The application fee applies to CMS 855 applications that the agency's Regional Home Health Intermediary/Medicare Administrative contractor. The following links provides additional information and the current application fee process: CMS Home Health Center CMS Hospice Center Implementation of Provider Enrollment Provisions (PDF) Medicare Enrollment Application Hospice Request for Certification in the Medicare Program (PDF) Health Insurance Benefit Agreement for Medicare Home Health (PDF) Medicare Conditions of Participation for Home Health and Hospice Office for Civil Rights Email the Oasis Help Desk Texas Department of Public Safety HCSSA Training Classes Board of Nursing Taxable Entity Search

Register https://health.utah.gov/all-licensing http://health.utah.gov/hflcra/ Contact Utah Department of Health 1-888-222-2542 Cannon Health Building 288 North 1460 West Salt Lake City, UT 84116 License health care facilities required by state law to hold a license and regularly inspect these facilities for compliance with state laws and regulations; Work with the Health Facilities Committee, whose members are appointed by the Governor, to develop and revise state regulations to govern the building, operation, and quality of care in licensed facilities. Review the architectural plans of new building and remodeling projects of licensed providers to assure compliance with building and safety standards; Perform regular on-site inspections of Utah health care providers participating in the Medicare and Medicaid programs to ensure compliance with federal health, treatment and safety standards; See that every Medicaid-funded nursing home and institutional patient in the state meets standards of medical need before admission and throughout their stay; Conduct background screenings on all direct care staff in certain health care industries, as required by law. Investigate complaints from the public about poor care or unsafe conditions in all licensed and/or certified facilities or providers. Assure facility correction through requiring Plans of Correction, follow up inspections, use of sanctions, (fines, bans on admissions, closure) and on-site monitoring. Toll Free: (800) 662-4157 Salt Lake Area: (801) 273-2994 jhoffman@utah.gov

Register https://dail.vermont.gov/regulations-designation-operation-hha https://www.healthvermont.gov/sites/default/files/documents/2016/12/REG_home-health-agency-personal-care-services.pdf https://dail.vermont.gov/sites/dail/files/documents/Res_Care_Hom_Licensing_Regulations_2000.pdf https://dail.vermont.gov/sites/dail/files/documents/Regulations_Designations_operations_Home_Health_Agencies.pdf Contact https://dail.vermont.gov/contact-us Phone: (802) 241-2401 Fax: (802) 241-0386 Address: Department of Disabilities, Aging and Independent Living HC2 South, 280 State Drive Waterbury VT 05671-2020 Start a Home Care Business Regardless of what stage you are at with starting a home care business, by working with Amaka Consulting, you are guaranteeing your success! When you make the choice to work with us, we guarantee your home care business will get its home care license in your State, as well as accredited if this is something you are looking to achieve. Whether you want to provide care for patients paying out of pocket, through Medicare (Medicare only applies to Home Health and Hospice), Medicaid, Private Insurance, Managed Care, or the Veterans Administration, we are the most reliable home care consultants to connect you with that goal. And best of all, we practically do the work for you and provide everything your home care business needs for operation – customized and catered to meet the needs of your unique home care business. All you pay us is a small 1-time fee which you can choose to have broken down into even smaller payments, paid over time. We are not a home care franchise; you own your home care business with zero ongoing points, fees, or royalties due to us. Amaka Consulting has been in business for nearly 15 years, starting hundreds (literally, hundreds) of successful home care businesses in the process for people just like you. Other companies boast of having started 4000+ home care businesses, what they don’t tell you is how many of those thousands of home care businesses remain in business and are supported today. We haven’t just helped others; we helped ourselves, by starting many healthcare businesses of our own, many of which we still own and operate today. So you can make your decision with confidence, knowing that our team has been there. We know what it’s like to go through the process of starting a home care business from scratch, preparing for home care licensure, accreditation, and certification, and balancing expenses while we build our client base. There is no substitute for firsthand experience, and we have it. Start a home care business today with Amaka Consulting.

Register https://townhall.virginia.gov/l/GetFile.cfm?File=C:%5CTownHall%5Cdocroot%5CGuidanceDocs%5C601%5CGDoc_VDH_4271_v3.pdf Virginia Home Care Contact https://www.vdh.virginia.gov/contact-us/ Requirements and Instructions for Initial Home Care Licensing This checklist has been developed to provide applicants with the information necessary to obtain a license to operate a home care organization in Virginia. For an initial license, an on-site survey must be conducted by the Home Care Licensing staff of the Virginia Department of Health. It is the responsibility of the applicant to be prepared and to provide all necessary assistance to the surveyor. Failure to provide appropriate and timely assistance will result in denial of the license and reapplication and payment of the licensing fee. Step I Thoroughly read and familiarized yourself with the Rules and Regulations for the Licensure of Home Care Organizations (12VAC5-381). Copies of the Rules and Regulations can be downloaded from the Internet at: http://www.vdh.virginia.gov/OLC/Laws/index.htm. All policies and procedures contained in the regulation, all employee personnel and client medical record forms must be developed and ready for surveyor review. This checklist can assist with identifying the necessary items needed for initial licensure. Step II Once employee personnel and client medical record forms and the policies and procedures have been completed, the applicant can submit: 1. A completed application and $500 fee 2. A written statement of the applicant’s knowledge or experience in operating a home care program 3. The proposed organizational chart 4. A copy of the organization’s emergency preparedness plan (12VAC5-381-150) 5. A listing of governing body members and meeting minutes (12VAC5-381-160) 6. Evidence of indemnity coverage (12VAC5-381-210) 7. A copy of the business plan, the working budget and balance sheet 8. The organization’s client rights policies and procedures (12VAC5-381-230); and 9. The job description, qualifications and specific responsibilities of the Administrator, the nursing director, and the financial manager. to: Home Care Licensure Office of Licensure and Certification Virginia Department of Health 9960 Mayland Drive, Suite 401 Henrico, Virginia 23233 Pursuant to §32.1-162.9, a nonrefundable license fee of $500 is charged for each license application. Payment may be check, money order or certified check made payable to: The Virginia Department of Health. The law prohibits a license from being issued if the fee has not been paid. Therefore, no license is issued until the check has cleared the bank. Step III Upon receipt of the completed application and fee, the applicant will be notified of the next available prelicensure conference. These conferences are not mandatory; however, applicants are encouraged to attend. The primary reason applicants are denied licensure is because they fail to comply with the instructions contained in this guideline and the licensure regulations. These are minimal requirements; failure to comply will result in additional preparation time. Therefore, it is recommended that applicants fully prepare for the initial survey. Step III The applicant is notified of the time and date of the initial survey. Failure to be fully prepared will result in cancellation of the initial survey. Should that occur, the license is denied and the applicant cannot reapply for 120 days. Policy/Procedures and Forms Checklist To ensure compliance with the Rules and Regulations for the Licensure of Home Care Organizations (12VAC5-381) and to prepare for the initial survey, new providers are advised to have the following items ready for review prior to the on-site arrival of the surveyor. NOTE: Replication of the cited regulation does not satisfy the intent of this checklist or the applicable regulation. I. Administrative policies and procedures – including, but not limited to: □ The existence of the premises where the agency will operate (i.e., lease agreement or ownership documentation) □ The geographic service areas (localities) to be served by the organization □ Contract services (12VAC5-381-220) □ Billing practices and financial resources (12VAC5-391-190) □ Infection control (12VAC5-381-260) □ The annual quality improvement program (12VAC5-381-250) II. Client care policies and procedures – including but not limited to: □ Scope of service and applicable service policies Skilled care Personal care Therapy services Pharmacy services □ Client rights (12VAC5-381-230) □ Client complaint policy (12VAC5-381-240) □ Admission and discharge (12VAC5-381-180) □ Coordination of care with other community services or home care agencies, including applicable sample forms □ On-call services □ Copies of all client record forms, including but not limited to: (i) admission, (ii) client medical history, (iii) initial needs assessment, (iv) plan of care, and (v) medication sheets. III. Personnel policies and procedures – including, but not limited to: □ Employment application □ Standards of conduct □ Employee and contractor orientation policy □ Screening employees for TB, alcohol abuse and drug usage □ In-service training policy and records of curriculum □ Employee annual performance evaluation □ Personnel records, content, access, storage, retention policy □ Competency evaluation processes □ Job descriptions of nursing and home attendant staff, including criminal record check (12VAC5-381- 200) □ Copies of all personnel record forms, including, but not limited to: (i) application, (ii) license or certification verification, (iii) competency evaluation, and (iv) reference checks or verification of previous employment and professional licensure/certification, if applicable. □ Personnel records for: (i) administrator), (ii) nursing director, and (iii) two complete personnel records for each service/discipline offered. Frequently Asked Questions: Initial Licensure Question: Is my business required to have a home care organization license? Answer: Businesses requiring licensure as a home care organization include the following: ● Those intended to offer more than one health care professional discipline including but not limited to: (i) nursing, (ii) therapies, (iii) home attendant services, and (iv) personal care services; ● A home care professional and: (i) one or more home care attendants, (ii) one or more certified nursing assistants, or (iii) a home care attendant and a certified nursing assistant working together and intend to offer services in the home; or ● Those offering home care services, including hands on personal care, but not skilled services Home care services include the following: • Nursing • Physical, occupational, respiratory, or speech therapy • Home care attendant services • Personal care services Question: What is the difference between a home care organization, a nurse registry, and homemaker or companion services? Answer: Home Care organizations: • Provide services that are privately paid for or paid for by insurance or other means to clients in their home or place of residence • Provide staff to do services in assisted living facilities, schools, or other business entities on a temporary or school year basis proving a contract is in place • Can qualify for Medicare and Medicaid reimbursement • Hire employees or contract with independent contractors to provide services • Provide at least one home care service Nurse registries: • Provide services that are privately paid for or paid for by insurance or other means to clients in their home or place of residence • Provide staff to do services in assisted living facilities, schools, or other business entities on a temporary or school year basis proving a contract is in place • Use registered nurses, licensed practical nurses, and other direct care workers as independent contractors • Cannot qualify for Medicare or Medicaid reimbursement, but may participate in the Medicaid Waiver program Homemaker companion services: • Hire or contract with homemakers that do household chores that include housekeeping, cooking, shopping assistance, laundry, and other routine household activities • Hire or contract with companions to provide companionship for the client such as keeping the client company at home or going with the client on outings or to appointments • Cannot provide any hands-on personal care to a client. Personal care, such as assistance with the activities of daily living (i.e., bathing, dressing, eating, or toileting, or assistance with physical transfer, ambulation or administering medication), cannot be provided by homemaker or companion services Question: Can I have a nurse registry, home care organization and homemaker/companion agency under one license? Answer: In Virginia, nurse registries and homemaker/companion services do not require licensure. Question: How long does it take to get licensed? Answer: It can take up to 60 days from the date the initial application is received by the VDH/OLC Home Care Unit. The applicant cannot begin providing services until receipt of the license. The process includes the following steps: • Initial application and fee is received • The application is reviewed for completeness; incomplete applications are returned • Applicant is notified of the next available licensure pre-conference session • A licensure pre-conference is conducted • Applicant is notified of the intended initial survey • Initial survey/inspection is conducted • Surveyor prepares a deficiency report based on deficiencies identified during the survey/inspection • Applicant has 15 days to correct any cited deficiencies and submit an acceptable Plan of Correction • The Plan of Correction is reviewed and approved; if unacceptable the applicant is notified • A license is issued Question: What is the cost of home care licensure? Answer: The licensure fee, which must accompany the application, is $500 per year and is nonrefundable. Checks, money orders or certified checks are accepted. At this time, it is not possible to pay on-line. Question: How much funding should I have to start a home care organization? Answer: There is no standard amount that could be used as a funding start point as each applicant’s services and staff to be hired will be different. It is recommended that applicants contact a CPA and prepare a business plan. Resources for beginning a small business are available on the OLC web site at: http://www.vdh.virginia.gov/OLC/Laws/index.htm NOTE: The revenue from Medicare or Medicaid does not begin until the program completes the federal certification process, which can only occur after the program has been licensed by the state, and can take 5 to 6 months or longer. Therefore, relying on Medicare or Medicaid revenue during the first months as a licensed program is not feasible. Question: What is the required personnel to start a home care organization? Answer: There are four administrative positions required to start a home care organization: (i) an administrator, (ii) and alternate administrator, (iii) a nursing director, and (iv) a financial manager. The administrator and nursing director may be the same individual if appropriately qualified. Question: What are the required qualifications for the administrator and alternate administrator? Answer: The requirements for administrator and alternate administrator are located in Section 12VAC5381-170 of the Rules and Regulations for the Licensure of Home Care Organizations. Question: Is it necessary to have a financial manager? What are the qualifications for the financial manager? Answer: Yes, Even with the availability of computerized bookkeeping or financial management programs, the organization needs to have an individual responsible for financial operations. There are no educational or experience requirements for this position. The individual needs to clear the criminal background checks as required by law. Any of the other required positions listed above may also serve as the financial manager, if they are appropriately qualified. Question: If my organization is only going to offer non-skilled or personal care services and will not be Medicare or Medicaid certified, do I need a nursing director? Answer: No. Home care organizations that offer only non-skilled or personal care services, and that will not be Medicare or Medicaid certified, do not require a nursing director. However, they do need to have a registered nurse to supervise the care provided as stated in 12VAC5-381-360. This individual does not have to be full time and may be a contract employee. Question: Does my emergency preparedness plan need to be reviewed before my organization can be licensed? Answer: Yes, The emergency preparedness plan must be developed prior to the initial survey and must accompany the initial application and required fee.

Register https://www.doh.wa.gov/LicensesPermitsandCertificates/FacilitiesNewReneworUpdate/HomeCareAgencies https://www.doh.wa.gov/LicensesPermitsandCertificates/FacilitiesNewReneworUpdate/HomeCareAgencies/ApplicationsandForms https://www.doh.wa.gov/portals/1/Documents/Pubs/505052.pdf Contact General questions about public health or if you have questions about where to send mail 360-236-4501 or 800-525-0127 Home care agencies provide non-medical services to people with functional limitations. Examples of non-medical services include: Activities of daily living, such as assistance with ambulation, transferring, bathing, dressing, eating, toileting, and personal hygiene to facilitate self-care; Homemaking such as assistance with ordinary housework, essential shopping, meal preparation, and travel to medical services; and Respite care such as assistance and support provided to the family; The Department of Health licenses home care agencies to ensure care is provided within health and safety standards established by statute and rule. The department enforces the standards by periodically conducting unannounced on-site surveys of these agencies. Some home care agencies contract with the Department of Social and Health Services (DSHS) to provide services to Medicaid-eligible people in need of home-based services. These contracted agencies are surveyed by Area Agency on Aging (AAA) staff members using standards equivalent to the departments for evaluating the care and services provided. For more information on contracting with DSHS, please contact your local AAA at 1-800-562-3263 or the Division of Developmental Disabilities at 1-800-562-3022. License Requirements For home care agency licensing, submit the following: Copy of In-home Services Orientation Class “certificate of completion.” Applications will not be processed unless a certificate of completion has been submitted. Completed in-home services application (PDF), along with the initial licensing fee. Proof of current commercial general liability insurance according to WAC 246-335-320(2)(b). Disclosure statements for the on-site administrator and director of clinical services according to WAC 246-335-320(2)(d) dated within three months of the application date. Criminal history background checks processed through the Washington State Patrol for the on-site administrator and director of clinical services according to WAC 246-335-320(2)(d) dated within three months of the application date. Copy of any and all current government-issued business licenses for each office location; this may include state, county, or city licenses. Completed full-time equivalent worksheet. A description of the agency’s organizational structure listing; for example, the names of the officers, administrator, director of clinical services, and other key positions. A description of how the agency will provide management and supervision of hospice services throughout all requested service areas. A description of the services the agency will offer directly and those offered under contract. Submit all of the above to the address shown in the application packet above. After review and acceptance of the application materials, the department’s Office of Investigation and Inspection will contact the applicant and schedule an initial survey. Applicants must pass the survey process in order for their license to be issued. Important notice: According to WAC 246-335-320(4), the department may close out an application, with no refund of licensing fees being issued, if an applicant has not completed all steps required for licensure within nine months. For the federal Medicare-certified hospice agency application, continue on to the Department of Health’s website.

Register http://dhhr.wv.gov/bms/Provider/Documents/Manuals/bms_manual_%29Chapter_508_Home_Health%202015.pdf Virginia Department of Health Virginia Home Care Association Starting a Home Care Business in Virginia Contact West Virginia Department of Health and Human Resources: Office of the Secretary One Davis Square, Suite 100 East Charleston, West Virginia 25301 Phone: (304) 558-0684 Fax: (304) 558-1130 Email: DHHRSecretary@wv.gov CERTIFICATE OF NEED APPLICATION PROCESS A. Determination of Reviewability: Organizations planning relocation of offices, service changes, acquisitions, and/or addition/deletion of any new services need to submit a request to the HCCRA for a determination of reviewability prior to initiating any action. That request should be concluded with a notarized verification of the signature of the person authorized by the provider organization to sign in its behalf pursuant to W. Va. C.S.R. 65-7-25. Additional offices within an existing approved service area may be added without undergoing certificate of need review; the HCCRA should be notified of these additional offices by the organization submitting a request for a determination of reviewability. B. Letter of Intent: The initial step in the Certificate of Need Process is the submission to the HCCRA of a letter of intent. The letter should include: 3 1. Name and brief description of the entity applying for the certificate of need; 2. Brief description of the proposed project, including anticipated individuals to be served and services to be provided; 3. Identifying the county(ies) in the proposed service area; 4. Estimate of anticipated capital expenditure associated with the project; and, 5. Signature of individual authorized to sign for the organization. C. Application: The HCCRA reviews the letter of intent and determines the type of application which is appropriate. An application form and certain data and materials which should be helpful in its completion are sent to the applicant. The receipt by the HCCRA of a completed application and accompanying application filing fee initiates the CON application review process. For details on time frames, notices, hearings and appeal processes, refer to W. Va. Code §16-2D-1 et seq. and 65 C.S.R. 7. D. Decisions: Decisions of the HCCRA are issued in the form of orders which outline the details of applications, the HCCRA analysis, findings and conclusions, the decision and opportunities for reconsideration and/or appeals. No decision will be issued to an entity which is not in full compliance with the Health Care Financial Disclosure Act (West Virginia Code §16-5F-1 et seq.). E. Public Notices: Actions of the HCCRA, including receipt of letters of intent, applications declared complete, decisions of the Board, scheduled hearings and time frames for hearing requests appear in the "Health Care Cost Review" newsletter published weekly by the HCCRA, in the State Register, and in the Charleston newspapers every Saturday

Register https://www.dhs.wisconsin.gov/regulations/hha/application.htm https://www.forwardhealth.wi.gov/kw/pdf/home_health.pdf Contact DIVISION OF HEALTH CARE FINANCING Jim Doyle Governor Helene Nelson Secretary State of Wisconsin Department of Health and Family Services WISCONSIN MEDICAID AND BADGERCARE PROVIDER SERVICES 6406 BRIDGE ROAD MADISON WI 53784 Home Health Agency: Application for State Licensure and Federal Certification As a result of 2017 Wisconsin Act 59(link is external) (PDF) (page 222) home health agencies (HHAs) in Wisconsin can now utilize outside accrediting organizations approved by both the Division of Quality Assurance (DQA) and CMS for combined initial licensure and Medicare certification surveys. These changes mean that, whereas HHAs previously had to go through a state licensure survey and then seek a Medicare certification survey from an outside accrediting organization, that process can now be completed as a part of a single streamlined process. HHAs that will be seeking both state licensure and Medicare certification should follow the process under the "Combined Application" tab below. HHAs that do not plan to seek Medicare certification should follow the process under the "State Licensure Application" tab. General information and definitions The definition of a home health agency in Wis. Stats. § 50.49(1)(a)(link is external) is an organization that "Primarily provides skilled nursing and other therapeutic services." Refer to Defining "Skilled Care" for Wisconsin Home Health Agency (HHA) Licensure, P-01212 (PDF) for more information on what constitutes skilled nursing care. Do not complete a home health agency application if the intent is to provide only personal care services that include assistance with activities of daily living, housekeeping activities, and/or accompanying client to medical appointments. If you are interested in personal care agency information please visit Personal Care Agencies (PCAs). Medicare certified and state licensed HHAs will need to meet all regulations listed below. Please review these regulations before preparing your application: Wisconsin Admin. Code ch. DHS 133(link is external) Home Health Agencies Wisconsin Stats. § 50.49(link is external) Licensing of home health agencies 42 CFR 484(link is external) Code of Federal Regulations for home health services LICENSURE APPLICATION You must complete the state licensure process at the same time or before you complete the Medicare and Medicaid certification processes. Similarly, you must complete the Medicare certification at the same time or before you complete the certification process for Medicaid. The issuance of a license to operate a home health agency in the state of Wisconsin is not part of the Medicare provider enrollment process and therefore will not automatically assure either certification in the Medicare program or Medicare payment. Provisional License As a home health agency applicant, you are required to complete an application, pay fees and submit supporting documentation in the form of policies and procedures that will demonstrate your compliance with Wis. Admin. Code ch. DHS 133(link is external) for home health agencies before a license will be issued. The following must be submitted to DQA as part of the state licensure process: Letter of intent with a detailed description of the proposed home health agency, including credentials showing the administrator and substitute administrator meet the requirements for these positions detailed in Wis. Admin. Code § DHS 133.06(link is external). Wisconsin Home Health Agency License Application, F-62674 (Word) completed in its entirety. HHA application fee ($300). Entity Caregiver Background Checks completed online including $10 per individual. Organizational chart identifying any other entities owned by the organization. Financial reference, which could include: letter of reference from HHA's financial institution bank statement evidence of stock ownership verification of outside employment or other income A proposed operating budget for the first 90 days of operation using Model Balance Sheet, F-62674A Copy of the Internal Revenue Service (IRS) Employer Identification Number (EIN) letter. Organizational documents: Corporation: provide copy of articles of incorporation Limited liability company (LLC): provide copy of articles of organization and operation agreement Limited liability partnership (LLP): provide copies of partnership agreement Policies and Procedures: Demonstrate, via submission of agency policies and procedures and patient care documentation, your compliance with Wis. Admin. Code ch. DHS 133(link is external) for Home Health Agencies. Also, demonstrate via submission of agency policies and procedures, your compliance with Wis. Admin. Code ch. DHS 13(link is external) Reporting and Investigation of Caregiver Misconduct. Refer to Chapter 6 of the Wisconsin Caregiver Program Manual, P-00038 (PDF). Once all of the requested application materials are received an application is considered complete. Wisconsin has a two-step application review process. The first review determines whether an applicant is fit and qualified(link is external) and includes an analysis of a variety of factors including financial solvency, personnel qualifications, criminal background clearance, payment of required fees, history of operating health care agencies in other states, and documentation that demonstrates the provision of the following required services to patients in their homes: Skilled nursing, and Therapeutic Services (physical therapy, speech therapy, occupational therapy, medical social services or home health aide). Following a determination the applicant meets the fit and qualified criteria, the second review is completed by a Registered Nurse (RN) who will review the applicants policies and procedures to determine whether they meet Wis. Admin. Code chs. DHS 133(link is external) and DHS 13(link is external). The RN will consult with the applicant during this review process if needed. Once DQA has approved the prospective HHA, provisional state licensure will be granted. While Wisconsin provisional licensure is good for three months, it is extendable up to three times, for a total of one year. Please send a letter to DQA requesting these extensions as necessary The now-provisional HHA should begin serving clients. Once the HHA has served ten clients requiring skilled nursing care (seven of whom are still active) they should send a letter, along with ten patient care plans, to DQA. This will trigger an unannounced Wisconsin licensure survey by state surveyors. Once this survey process is complete, including any necessary corrections, permanent HHA licensure can be granted by DQA. MEDICARE CERTIFICATIOIN If you are seeking Medicare certification, you are advised to submit application materials and supporting documentation at the same time you seek Wisconsin state licensure. You must complete the state licensure process at the same time or before you complete the Medicare and Medicaid certification processes. Similarly, you must complete the Medicare certification at the same time or before you complete the certification process for Medicaid. The issuance of a license to operate a home health agency in the state of Wisconsin is not part of the Center for Medicare and Medicaid (CMS) Medicare provider enrollment process and therefore will not automatically assure either certification in the Medicare program or Medicare payment. Medicare Certification (Optional) In order to become certified in the Medicare Program, a home health agency must first meet State of Wisconsin licensing requirements and obtain a provisional license. Steps to obtain Medicare certification: Review the following CMS Medicare information for home health agencies: Federal Conditions of Participation for Home Health Agencies, 42 CFR 484(link is external). CMS State Operations Manual (SOM) Chapter 2 – The Certification Process(link is external) (PDF). Refer to Section 2202 for OASIS requirements and review 2202.10 A through F for initial certification. OASIS Information SOM Appendix B – Guidance to Surveyors: Home Health Agencies(link is external) (PDF) CMS Home Health Prospective Payment System(link is external) CMS Home Health Center(link is external) Complete a CMS-855 submitted to Wisconsin's assigned Medicare Administrative Contractor (MAC), which is currently National Government Services (NGS). Once the MAC has approved this form, they will send a copy to DQA. Please also provide a copy of this CMS-855 approval letter to your chosen accrediting agency. They will need this document before your final certification and licensure survey can be performed. Contact a CMS Approved Accrediting Organization(link is external) (PDF) to perform the Medicare Certification survey (this is separate from the Wisconsin state licensure survey). Submit a signed CMS-1561 Health Insurance Benefits Agreement(link is external) (PDF) to DQA. Once DQA has issued your HHA license and has copies of your CMS-855 form, full accrediting agency survey report, and signed CMS-1561, DQA will provide these documents to CMS and recommend Medicare certification approval. MEDICAID CERTIFICATION Medicaid Certification (Optional) In order to become Medicaid certified, a home health agency must first meet State of Wisconsin licensing requirements and obtain a provisional license. If you are interested in becoming a certified provider with Wisconsin Medical Assistance (Medicaid) Program, you are encouraged to apply at the same time that you apply to Medicare. See Wisconsin Medicaid provider certification on the Wisconsin ForwardHealth website(link is external). Refer to Medicaid Contacts for additional contact information.

Register https://health.wyo.gov/aging/hls/facility-types/home-health-agency-wyoming-licensure-information/ Home Health Agency Rules Chapter 10 (Licensure) – 11-01-2001 Chapter 9 (Program Administration) – 10-15-2001 Healthcare Facility Construction Rule Chapter 3 – effective 04-03-2008 Chapter 3 Guidelines State Initial-CHOW License Application Instructions State Initial-CHOW License Application State Licensure Checklist A license permits an applicant to operate a healthcare facility in Wyoming. It does not enroll or certify a provider or supplier of healthcare services to participate in federal certification programs (Medicare/Medicaid). Contact Healthcare Licensing and Surveys 2300 Capitol Avenue, Suite 510 Cheyenne, WY 82002 (307) 777-7123 Fax: (307) 777-7127 wdh-ohls@wyo.gov

The classes you need to meet Georgia’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Assisting with Ambulation Basic First Aid Bathing Client-Specific Issues CPR Dressing Emergency Procedures Grooming Housekeeping Infection Control Instrumental Activities of Daily Living (IADLs) Mouth Care Nutrition & Meal Preparation Positioning Safety Precautions Shaving Toileting Transfers Vital Signs Working with an Aging Population ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Oregon’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Assisting with Self-Administered Medication Behavior Management Clients’ Rights & HIPAA Emergency Procedures Infection Control Modified Diets Nutrition & Meal Preparation Observation Reporting & Documentation Role of a Caregiver Safety Precautions SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

Required Initial Training Topics Required initial training topics are mandated by the state and require approval as part of the Home Care Aide 75-hour certification training. Required Annual Training Topics Required annual training topics are intended to promote professional development and increase a caregiver’s skills. Topics may not be repeated unless the subject is advancing on previous education or a need is presently based on the caregiver’s annual competency evaluations. Additionally, caregivers may repeat up to five hours of the following topics: ​ Bloodborne Pathogens Infection Control CPR Training First-Aid Training Food Handling Training Health Insurance Portability and Accountability Act (HIPAA) Medication Assistance Disaster Preparedness Aging Sensitivity Client Rights and Safety Abuse and Neglect Identification Mandatory Reporting START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet California’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Emergency Procedures Infection Control Role of a Caregiver Safety Precautions Required Annual Training Topics Activities of Daily Living (ADLs) Assisting with Transportation Clients’ Rights & HIPAA Elder Abuse Prevention Instrumental Activities of Daily Living (IADLs) START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Nevada’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Behavior Management Clients’ Rights & HIPAA Communication, Elder Abuse Prevention Emergency Procedures Infection Control Instrumental Activities of Daily Living (IADLs) Mobility & Safety Equipment Modified Diets Nutrition & Meal Preparation Observation Reporting & Documentation Role of a Caregiver Safe Patient Handling (Back Safety) Safety Precautions Skin Care Toileting Transfers Working with an Aging Population Required Annual Training Topics Client-Specific Issues Clients’ Rights & HIPAA Elder Abuse Prevention START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Wyoming’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics CPR OSHA SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Utah’s caregiver training requirements are included in SkilledUp. ​ Required Initial Training Topics Basic First Aid Bathing Clients’ Rights & HIPAA Denture Care Dressing Elder Abuse Prevention Instrumental Activities of Daily Living (IADLs) Activities of Daily Living (ADLs) Assisting with Self-Administered Medication Assisting with Transportation Introduction to First Aid Mouth Care Nutrition & Meal Preparation Role of a Caregiver Toileting Transfers Vital Signs Required Annual Training Topics Elder Abuse Prevention START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Colorado’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Basic First Aid Behavior Management Communicating with a Person with Dementia Fire Safety Instrumental Activities of Daily Living (IADLs) Nutrition & Meal Preparation Observation Reporting & Documentation Role of a Caregiver Safety Precautions Assisting with Self-Administered Medication Clients’ Rights & HIPAA Communication Elder Abuse Prevention Emergency Procedures Housekeeping Infection Control Required Annual Training Topics Behavior Management Basic First Aid Client Independence Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Introduction to First Aid Safety Precautions START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Oklahoma’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Clients’ Rights & HIPAA Emergency Procedures Infection Control Nutrition & Meal Preparation Observation Reporting & Documentation Safety Precautions SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Minnesota’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Assisting with Self-Administered Medication Clients’ Rights & HIPAA Communication Bathing Cultural Competency Denture Care Dressing Emergency Procedures Hair Care Infection Control Instrumental Activities of Daily Living (IADLs) Mobility & Safety Equipment Modified Diets Mouth Care Nutrition & Meal Preparation Observation Reporting & Documentation Professionalism Range of Motion Role of a Caregiver Safety Precautions Toileting Vital Signs Working with an Aging Population Required Annual Training Topics Child Abuse Clients’ Rights & HIPAA Elder Abuse Prevention Housekeeping Infection Control START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) ​ SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Illinois’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Assisting with Self-Administered Medication Clients’ Rights & HIPAA Communication Elder Abuse Prevention Emergency Procedures Infection Control Instrumental Activities of Daily Living (IADLs) Mobility & Safety Equipment Observation Safety Precautions Reporting & Documentation Required Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Wisconsin’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Clients’ Rights & HIPAA Emergency Procedures Infection Control Safety Precautions Communication SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

Required initial training topics are mandated by the state and require approval as part of the Certified Home Health aide 76-hour certification training. Best Practice standards also mandate initial training in the following topic areas in addition to the 76-hour certification training initial & annual: Required Initial Training Topics Bloodborne Pathogens Child Abuse Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Pain Management Workplace Safety Required Annual Training Topics Activities of Daily Living (ADLs) Child Abuse, Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Pain Management Role of a Caregiver Safety Precautions Workplace Safety START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Maryland’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics CPR Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Observation Reporting & Documentation Activities of Daily Living (ADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Washington DC’s caregiver training requirements are included in SkilledUp. SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) Required Annual Training Topics Caring for Persons with Disabilities START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Delaware’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Caring for Persons with Disabilities Clients’ Rights & HIPAA Communicating with a Person with Dementia Communication Infection Control Instrumental Activities of Daily Living (IADLs) Introduction to Dementia Nutrition & Meal Preparation Observation Reporting & Documentation Role of a Caregiver Safety in Dementia Housekeeping Mobility & Safety Equipment Modified Diets Safety Precautions Working with an Aging Population SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

Required Initial Training Topics Infection Control Activities of Daily Living (ADLs) Assisting with Self-Administered Medication Clients’ Rights & HIPAA Communication Elder Abuse Prevention Emergency Procedures Instrumental Activities of Daily Living (IADLs) Nutrition & Meal Preparation Observation Reporting & Documentation Role of a Caregiver Safety Precautions Safe Patient Handling (Back Safety) ​ Required Annual Training Topics Clients’ Rights & HIPAA Emergency Procedures Infection Control Child Abuse Elder Abuse Prevention START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Kentucky’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Assisting with Self-Administered Medication Communication Elder Abuse Prevention SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Pennsylvania’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Behavior Management Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Instrumental Activities of Daily Living (IADLs) Nutrition & Meal Preparation Observation Reporting & Documentation Safety Precautions SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet North Carolina’s caregiver training requirements are included in SkilledUp. SkilledUp Recommended Initial Training Topics Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Tennessee’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Assisting with Self-Administered Medication Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Observation Reporting & Documentation Safety Precautions SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Florida's caregiver training requirements are included in SkilledUp. ​ Required Initial Training Topics Activities of Daily Living (ADLs) Assisting with Self-Administered Medication Clients' rights & HIPAA Communicating with A Person with Dementia Communication Cultural Competency Denture Care Emergency procedures HIV?AIDS Housekeeping Infection Control Instrumental Activities of Daily Living (IADLS) Introduction to Dementia Mobility & Safety Equipment Nutrition & Meal Preparation Range of Motion Safety Precautions Vital Signs Working with an Aging Population SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

SkilledUp Recommended Initial Training Topics Role of a Caregiver Clients’ Rights & HIPAA Elder Abuse Prevention Emergency Procedures Infection Control Safety Precautions Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

The classes you need to meet Arkansas’s caregiver training requirements are included in SkilledUp. Required Initial Training Topics Activities of Daily Living (ADLs) Alzheimer’s & Dementia Assisting with Ambulation Bathing Clients’ Rights & HIPAA Communication Dressing Emergency Procedures Ethical Considerations Fire Safety Housekeeping Infection Control Mouth Care Nail Care Nutrition & Meal Preparation Observation Reporting & Documentation Range of Motion Role of a Caregiver Safety Precautions Toileting Transfers Workplace Safety SkilledUp Recommended Annual Training Topics Clients’ Rights & HIPAA Elder Abuse Prevention Infection Control Emergency Procedures Communication Cultural Competency Working with an Aging Population Assisting with Oral Hygiene Nutrition & Meal Preparation Introduction to Dementia Care START A FREE TRIAL ON OUR TRAINING WEBSITE

A state-by-state analysis of training requirements for home health aides in regards to the federally-required minimum of 75 hours:

Federal legislation (42 CFR 484.36) requires that Medicare-certified home health agencies employ home health aides who are trained and evaluated through training programs approved by their states. Federal regulations require that these training programs consist of at least 75 hours of training, including at least 16 hours of supervised practical or clinical training and 12 hours of continuing education per each 12-month period. Federal regulations also list the subject areas and skills to be taught, outline the qualifications for approved trainers, and define the competency evaluation process. In its recent report on the adequacy of the healthcare workforce for older Americans (Retooling for an Aging America, 2008), the National Academy of Medicine (formerly the Institute of Medicine) recommends that “federal requirements for the minimum training of certified nursing assistants (CNAs) and home health aides should be raised to at least 120 hours and should include demonstration of competence in the care of older adults as a criterion for certification” (Recommendation 5-1).

State Regulations On Training Requirements Alabama: Follows the Federal Code of Regulations: CFR Title 42, Vol. 3, 484. Alaska: Alaska Administrative Code, Title 7, 12.519. Arizona: Arizona Revised Statutes, Title 36, Article 2, 36.2939 (B.2.a). Arkansas: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484. California: California Code of Regulations, Title 22, Division 5, Chapter 6, §74747. Colorado: Code of Colorado Regulations, 10 CCR 2505‐10 8.525. Connecticut: Connecticut Department of Public Health Regulations, Public Health Code, Title 19‐13‐D69. DC: District of Columbia Municipal Regulations, Title 17, Chapter 93, §9327.3. Delaware: Delaware Administrative Code, Title 16, §4406. Florida: Florida Administrative Code, Rule Chapter 59A‐8.0095. Georgia: Follows Federal Code of Regulations: CFR Title 42, Vol.3, 484. Hawaii: Hawaii Administrative Rules, Title 11, Chapter 97, Section 1. Idaho: Idaho Administrative Code, IDAPA 16.03.07. Illinois: Illinois Administrative Code, Title 77, §245.70; 77 IL Admin. Code §395.150. Indiana: Indiana Code 16‐27‐1.5‐1 Iowa: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484. Kansas: Kansas Administrative Regulations 28‐51‐100. Kentucky: Follows Federal Code of Regulations: CFR Title 42, Vol.3, 48 Louisiana: Follows Federal Code of Regulations: CFR Title 42, Vol.3, 484. Maine: Code of Maine Rules, 10‐144, Chapter 119. Maryland: Code of Maryland Regulations, Title 10.39.01.08. Massachusetts: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484. Michigan: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484. Minnesota: Minnesota Administrative Rules, 4664.0260. Mississippi: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484. Missouri: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484. Montana: Montana Department of Public Health and Human Services, Policies and Procedures, State Certification of Competency for Home Health Aides. Nebraska: Nebraska Administrative Code, Title 175, 14‐006.04G5. Nevada: Nevada Department of Health & Human Services, Medicaid Service Manuals, 1403.8. New Hampshire: New Hampshire Code of Administrative Rules, Chapter He‐W 553. New Jersey: New Jersey Administrative Code, Title 13:37‐14.4. New Mexico: New Mexico Administrative Code, 7.28.2.30.C. New York: New York Codes, Rules, and Regulations (NYCRR), Title 10, § 700.2., New York State Department of Health North Carolina: Division of Medical Assistance, Medicaid Clinical Coverage Policies and Provider Manuals, Clinical Coverage Policy No.: 3A (6.2). North Dakota: North Dakota Administrative Code, 33.03.10.1.18. Ohio: Ohio Administrative Code, 5160-12-03. Oklahoma: Oklahoma Administrative code, Title 310, 677-9-4. Oregon: Oregon Administrative Rules, 410‐127‐0020. Pennsylvania: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484. Rhode Island: Rhode Island Rules and Regulations, R23‐17‐HNC/HC/PRO. South Carolina: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484. South Dakota: South Dakota Administrative Code, 67‐16:05:01. Tennessee: Rules of the Tennessee Department of Health, Board of Licensing Health Care Facilities, Chapter 1200.08.26. Texas: Texas Administrative Code, Title 40, Part 1, Chapter 97, Sub-Chapter D, §97.701. Utah: Utah Administrative Code, Rule R432-700-22. Vermont: Regulations for the Designation and Operation of Home Health Agencies, Part X, 10.1. Virginia: Virginia Administrative Code, Title 12, Agency 30, Chapter 50, Section 160. Washington: Washington Administrative Code, 246- 335-015-23. West Virginia: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 484. Wisconsin: Wisconsin Administrative Code, Chapter DHS 129, Certification of Programs for Training and Testing Nurse Aides, Medication Aides and Feeding Assistants, Subchapter II. Wyoming: Wyoming Department of Health, Aging Division, Rules for Program Administration of Home Health Agencies, Chapter 9.