How to Start a Home Health Agency in Michigan (2025 Checklist)

Starting a home health agency (HHA) in Michigan is a rewarding venture that meets a critical community need. However, navigating the state's specific licensing and federal certification requirements can be complex. This guide provides a clear, step-by-step checklist to launch your agency successfully in 2025.

This guide is for you if you plan to:

• Provide skilled nursing, physical therapy, or other clinical services.
• Bill Medicare and Medicaid for your services.
• Operate a fully licensed and certified HHA in Michigan.

Michigan Home Health Care Licensure: Key Facts

• Governing Body: The primary authority is Michigan’s Department of Licensing and Regulatory Affairs (LARA), Bureau of Community and Health Systems.
• License Needed: You need a Home Health Agency License to operate.
• Certificate of Need (CoN): Michigan is a CoN state. You MUST obtain a Certificate of Need from the Michigan Department of Health and Human Services (MDHHS) before you can apply for a license to become a Medicare-certified HHA. This is one of the biggest hurdles for new agencies.
• Accreditation: While not mandatory for state licensure, accreditation from an organization like ACHC, CHAP, or The Joint Commission is required for Medicare certification.

Step-by-Step Guide to Starting Your Agency

Step 1: Obtain a Certificate of Need (CoN)

This is your non-negotiable first step for a Medicare-certified agency. The CoN process demonstrates that there is a need for a new HHA in your proposed service area. The application is complex, data-intensive, and highly competitive. You must project patient volume and prove your financial viability. Plan for this process to take significant time and investment.

Step 2: Establish Your Business Entity

Before you can apply for licenses, you need a legal business structure.

• Choose a Structure: Form an LLC or S-Corporation for liability protection. Consult a lawyer for the best choice for your situation.
• Register Your Business: Register with the Michigan Department of Licensing and Regulatory Affairs (LARA).
• Get an EIN: Apply for an Employer Identification Number (EIN) from the IRS website. This is your federal tax ID.

Step 3: Develop Your Policies and Procedures

Your agency must have comprehensive policies and procedures that meet both state (LARA) and federal (CMS) regulations. These are not just documents; they are the operational blueprint for your agency. They must cover:

• Patient Rights and Responsibilities
• Clinical Protocols and Service Delivery
• Emergency Preparedness Plan
• Hiring, Training, and Supervising Staff
• Infection Control and HIPAA Compliance
• Billing and Financial Management

This is a time-consuming but critical step. Using a pre-built, Michigan-specific manual, like the ones offered by CarePolicy.US, can save hundreds of hours and ensure compliance from day one.

Step 4: Apply for State Licensure with LARA

Once your CoN is approved and your policies are in place, you can apply for your Home Health Agency license. The application will require you to submit your business documentation, proof of financial stability, and your complete policy and procedure manual for review.

Step 5: Hire Key Personnel

You must have a qualified Administrator and a Director of Nursing (DON) before you can be licensed. LARA has specific experience and credentialing requirements for these roles. Your DON must be a Registered Nurse (RN) with experience in home health care.

Step 6: Secure Accreditation and Medicare Certification

• Choose an Accreditor: Select either ACHC, CHAP, or The Joint Commission. Their review process involves a thorough survey of your operations, from policies to patient care.
• Submit Medicare Enrollment (CMS 855A): Once accredited, you can formally apply to become a Medicare provider by submitting the CMS 855A application through the PECOS system. You will also need to obtain your National Provider Identifier (NPI) from the NPPES website if you don't have one.
• Pass the Certification Survey: LARA surveyors will conduct an unannounced on-site survey on behalf of CMS to ensure you are compliant with all federal Conditions of Participation (CoPs).

Step 7: Enroll as a Michigan Medicaid Provider

To serve Medicaid clients, you must enroll separately with Michigan's Medicaid program. This is done online through the Community Health Automated Medicaid Processing System (CHAMPS). This process requires your state license and Medicare certification details. Our Medicare and Medicaid Compliance Manual can guide you through these specific enrollment requirements.

Step 8: Staff Up, Market, and Launch

With your licenses and certifications in hand, you can begin hiring your field staff (RNs, LPNs, therapists, aides), marketing your services to referral sources like hospitals and physician offices, and finally, admitting your first patients.

How CarePolicy.US Accelerates Your Launch

The licensing and certification process in a Certificate of Need state like Michigan is daunting. We provide the specific tools and expertise to get it right the first time.

• Michigan-Specific Policy Manuals: Don't start from scratch. Our turn-key packages are 100% compliant with LARA and CMS regulations, complete with the forms and procedures you'll need for your survey.
• CoN & Licensing Consulting: We provide expert guidance on the CoN application process and help you assemble a perfect state license application packet.
• Enrollment Services: Our team can manage your CMS 855A Medicare enrollment and CHAMPS Medicaid applications, ensuring accuracy to avoid costly delays.

Frequently Asked Questions

Q: Can I start a non-medical home care agency instead?
A: Yes. Michigan distinguishes between licensed Home Health Agencies (skilled care) and unlicensed agencies that provide only non-skilled companion or personal care services. This guide focuses on the licensed, skilled model.

Q: How much does it cost to start a home health agency in Michigan?
A: Startup costs can range from $80,000 to $150,000 or more, factoring in CoN application fees, licensing, accreditation, staffing, and operational capital for the first six months.

Q: How long does the entire process take?
A: Due to the CoN requirement, expect the process to take 12-18 months, or even longer, from business formation to seeing your first patient.

Your Next Step

Starting a home health agency in Michigan is a marathon, not a sprint. The key to success is meticulous planning and expert guidance.

If you're ready to take the next step, book a free consultation with a CarePolicy.US expert. We'll help you build a clear road map for your agency's successful launch.