start up home health agency
I worked home health for years. I don't know much from the administrative end but I will share what I know. Yes you will need a lisence and insurance. If your nurses do something wrong, or get acused of stealing from a patient --you need liability. The department of health controls everything so I imagine if you get in touch with the California Dept of Health, they probably have a long list of regulations for you. You will need to decide if you are going to do medicare patients or private insurance cases because the paper work is very different. Medicare has a strict set of requirements in paper work. I understand that now there are rules for how long a nurse has to spend with a patient. If you have never worked in the field, it would probably be helpful if you took a job for awhile working in the field. Some hospitals have their own home health services. Home Health Corp of America is a big national company. You will need someone to supply your equipment. If you are going to do IV infusions as will, you need a pharmaceutical company to work with you. A delivery service to deliver supplies to the patients home or a large office so you can keep supplies for the nurses to get and charge for as needed. You will need people to work with the insurance companies to get them to pay for what the field nurse says the patient needs--so insurance companies will deny the claim. And of course you will need field nurses. You have to set up your policies--just like the policy manuel in the hospital--standards to regulate the frequency of wound measurement. How much you will pay per visit, will you pay for mileage? I worked for an infusion company in Florida and they paid per visit starting when you walked in the patients house and mileage. That same company in Missouri paid from the time you left your house to the time you got back home and mileage. So in Missouri if I had a patient needing an IVPB who lived 1 hr away, I was paid $120 plus mileage, but for that same visit in Florida, I made $40 plus mileage. Florida tried to say we were making too much money in mileage at $0.35/mile and tried to decrease our rate. I went thru 6 months of records documenting drive time, gas bought, car maintenance to make them leave our mileage rate alone. Of course after I went to Missouri and back to Florida and told them what I made in Missouri, I quit after they did not raise our rates. I worked for a company that did all working age patients and I made $20,000 per month. You will need good nurses that will look at a patients family situation and evaluate their needs. Example: A patient had surgery to remove some fat. She was sent home with a foley and open wounds. A nurse went in and taught her husband to do the wound care and signed off the case. I went in because she called to say her catheter had been pulled on and she thought it was out. I talked to her and her family. She was bed bound, had several infected non healing deep wounds where that had removed fat from her abdomen and both thighs, her husband worked 12 hrs/day, a daughter in college, a retarted son. The nurse expected this husband to work all day, come home cook for his family, bathe his wife and do her wound care. It wasnt being done and she got infected. I called in and said she needs daily wound care, a special hospital bed--they would not give her one because they couldnot weigh her. I found a place for her to be weighed, got her a motorized chair, taught her and her husband how to cook low calorie cheap meals for the family--they were eating mostly meat--got her antibiotics, got her physical therapy for strenghtening so she could get up and out, psychological conseling so she would go out, daily nursing assistant for bath, and daily wound care. I could not believe the nurse before me had left this family in this sad situation--all it took was a few questions to understand their situation and it eventually cost her insurance a bundle because the first nurse got it wrong.
So hope this helps

Thanks jhals for taking the time to respond and provide the information you did. I really do appreciate hearing what you and others have to offer. It sounds like you have the knowledge to start your own home health agency.

Chauncey

not even interested. Also remember insurance companies are very slow paying their bills. You have to have enough cash available to pay your nurses until you get your money. Many companies go bankrupt because they do not have enough funds, nurses payroll checks bounce etc. I worked for a company that never had money to pay their nurses on time. They always said they were good for the money but had to wait for the insurance check to come in. I made $20,000/month off them so I put up with it for awhile. They were notorious for bouncing the last pay check when a nurse got fed up. Most nurses walked away from their cash. They owed me $10,000 and 6 months later I still didnt have my money. I started a law suit and they paid me.

Re: Starting a Home Health Business in California

you could just buy a house and take only pt who walk and are private pay. There is a limit but I have No idea how many (I think 5, I lied) and you wont be regulated by the state. Pay someone to live with them and put the rest of the money in your pocket after you pay bills and groceries. You could charge whatever your local NH is charging for daily rate. The truth is they would rather pay for a smaller setting and nicer house.

Re: Starting a Home Health Business in California
Chuck, I wish you well in this pursuit. Though I'm not a nurse, but a medical transcriptionist from Michigan, I used to work in a nursing home as an activity therapist and saw a few folks come in, who were hired as health aids to short-term patients. I'd ask a nursing home administrator if they could tell me or where to find out, under which state agency health aid businesses are registered. Or, I'd call the equal to State Social Services and ask them. Or, find a private home aid provider via the phone directory and ask them.
I suppose there are requirements that need to be satisfied and look at those carefully before venturing to far into this.
Wish you the best, and glad to see some guys posting..
David

Thank you David and everyone else who has replied to the post so far. I appreciate all of the input. I have done some research and know that you have to get a HHA registered with the state department of health services here in California. Medicare is a whole other task. If you accept medicare cases, you have to first get certified by JACHO.

I am still trying to find out what type of insurance I need to purchase, and what is the best way of procuring contracts or clients. I see so many HHA listed in the Yellow pages and on the internet, so I wonder who do they get their business. I also wonder how difficult it is retaining staff in this business.

A former nursing instructor of mine suggest I also look into something a little less risky like an Adult Day Healthcare Center.

Chauncey aka Chuck

hhagency
have you considered purchasing a branch of an existing agency. They would have most of that set up for you. I got a card from home health corp of america a few days ago, they are recruiting nurses. You may check to see if they have a branch in LA and if not contact them and ask about starting an office in LA. The number on my card is Donna Russo at 1 800 273 7547 or email [email protected]

Jhals, I did look at the hhcainc.com website. They mainly operate out of the southeast part of the country. If I inquired about opening an office here in California it would be like a franchise. I have checked out a couple of franchise for HHA, but I came to the conclusion that I can take the royalty payment and use that for my own marketing. Franchises in general aren't really bad, but in this case I realize that you are paying the franchise to do your marketing for you. I can find a way to do that on my own. I just have to start making contacts or research the best way to procure clients.

Chauncey

I'm an LVN, I have never work for a home health agency. I was reading your response to chuckdeezee and saw that you stated you made 20,000 dollars per month working for a home health agency; please can you give me more information on how to make that much money per month? What agencies pay that kind of money? I thought that agencies pay hourly..

Hello,
I want a home health care service for my mom. She is living alone in home.
So can you suggest me best health care service?
Thanks

Where is your mom living? What kind of care does she need?

hey I am starting a home health care agency. I know some steps to having one.

Set up the business element that will best fit your needs. (Sole proprietor, Partnership, Limited Liability Company, S Corporation, C Corporation) Consult with a lawyer as well as CPA or research online on your state government site (www.state.(your state initials).us about fitting business structure, data in regards to finance, deals charge, laborers remuneration and business risk protection.

Hello,
I started to have a home health agency in California. To now, I registered my agency with the state and I filled out the formes. This week I gonna apply for NPI & EIN. Can you help me with some questions? I really appreciate your time.