Medical home care agencies require an Administrator, a Director of Nursing and a licensed nursing staff. Non-medical staffing consists of an Administrator, a Client Care Coordinator and trained nurse aides or home care aides.
Financing the Home Health Agency
In addition to the standard start up costs of a small business, financing an independent home health care agency includes health care licensing and certification cost, bonding for employees, medicare and insurance billing software and clerks, and administrative and direct care staffing.
Methods of Payment for Services
Medicare and/or independent insurance billing are options.
- Phone and fax numbers are listed on the backs of independent health insurance benefit cards.
- Medicare and/or Medicaid contracts are governed by the law of HIPAA (Health care Portability and Accountability Act). Billing for Medicare and Medicaid funds, the rules and the process for filing for Medicare contracts are different on a state by state basis. A form for filing a CMS855a enrollment application is available from the Centers for Medicare and Medicaid Services website.
Private pay billing is sent directly to the client or family caregiver.
Local Area Agency on Aging and other Aging Issues or Disability Agencies contract, and offer referrals for clients and payment for those services.
Local Area Agency on Aging information websites are referenced by city and state. Phone numbers and addresses will be listed on the site.
The Community Health and Human Services Department or Area Agency on Aging are the local consultants for applying for state grant funding contracts.
Legal Documents and Services
Home Care Businesses need legal representation and documents.
A lawyer should be retained on a continuum basis for all legal transactions and advice. A lawyer may advise filing of a state Articles of Incorporation for protections, such as, name, judgments against the company, and debts. Articles of Incorporation are filed through the state's Secretary of State office.
For a list, see the Federal site for the area state office at mycorporation.com/learning center/secretary-of-state.jsp or call 1-800-692-6772 for state contact information.
An EIN (Employer Identification Number), essential for all small businesses, can be obtained on the Internet at the IRS website or by calling the toll free Business and Specialty Tax line at 1-800-829-4933, faxing a completed SS-4 tax form to (859) 669-5760 or sending the completed information document by mail at:
Internal Revenue Service
Attn: EIN Operation
Cincinnati, OH 45999
Hiring Documentation
In addition to background checks and drug tests, health care businesses require current and negative T.B. Tests for all employees. If the care aide will be transporting clients, a copy of current automobile insurance is required to be on file.
Training Requirements
Orientation, and monthly in-service training are required by the government. Home health training should be relevant to job specific details and be organized according to current concerns of the organization.
- HIPAA Health Insurance Portability and Accountability Act is a training topic for all organizations.
- Safety and first aide training for in home services can be contracted with the local fire department or an EMS (Emergency Medical Service) ambulance training center.
- Training for range of motion (mobility) and safe ambulation can be arranged with a physical therapist agency.
The Bureau of Labor Statistics offers a manual at www,bls.gov/oco/ocos327.htm#training.
Tips for starting an in home care agency
Employee Hiring Tips for Small Business.
Employee Screening Tips for Small Business
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