Key Steps to Opening a Medicare-Certified Home Health Agency

Mar 23, 2018 9:38:04 AM / by ACHC

While starting a new skilled home health agency (HHA) can be exciting and rewarding, it can also be a long and time-intensive process. Although there is a growing need for HHAs with the population of people age 65 and older expected to reach 19.6 percent by 2030, CMS in recent years has imposed significant financial and operational barriers that HHAs must navigate.

Because ACHC was created by home care providers, we understand these unique challenges that you face. Our goal as your partner in accreditation is to offer resources and education to help you through this process and fully prepare you for accreditation. One of these resources that ACHC has recently developed is a free On-Demand Home Health Start-Up Webinar that walks you through the process of starting an HHA in more detail. This webinar can be found on

Below we have outlined some of the key steps to opening a Medicare-Certified HHA.

  1. Determine your states requirements concerning a Certificate of Need (CON)
  2. Determine if state licensure is required in the state where you want to operate
  3. Must meet requirements of CMS State Operations Manual, Chapter 2, Section 2180C
    • Provide Skilled Nursing services and other therapeutic services
    • These services are supervised by a physician or RN
    • Have established policies & procedures
    • Maintain clinical records on all patients
    • Have an overall plan and budget
    • Meet the Medicare Conditions of Participation (CoPs)
    • Meet capitalization requirements
  4. Complete and submit an 855A application to CMS
    • Once approved, submit approval letter to ACHC
  5. Complete a successful test OASIS transmission
  6. Develop patient caseload
    • Must have 10 patients served with 7 active at the time of survey
    • Must meet the definition of CMS skilled care per the Medicare Benefits Policy Manual Chapter 7
  7. Download and review ACHC Accreditation Standards
  8. Submit your ACHC Accreditation application and Preliminary Evidence Report (PER) Checklist
  9. ACHC will complete an on-site survey within 60 days of HHA’s stated readiness


IACHC_Certified-Consultant_Sealf you would like more help with getting your agency off the ground, or preparing for accreditation, you may be interested in reaching out to an ACHC Certified Consultant. Our Certified Consultants have been trained in ACHC Accreditation Standards, survey approach, and processes to better prepare healthcare clients for the accreditation survey. Find a Certified Consultant on

Topics: ACHC Today, Home Health


Written by ACHC

Subscribe to Email Updates

Recent Posts