HOME HEALTH SERVICES PROVIDER IN CALIFORNIA

Fatumata Kaba
1 day ago
4 min read

DELIVERING SKILLED NURSING, THERAPEUTIC CARE, AND PERSONAL SUPPORT TO INDIVIDUALS IN THEIR OWN HOMES

Home Health Services in California provide short-term, intermittent medical care and support in a participant’s home under a physician’s direction. These services are authorized through California Medicaid (Medi-Cal), Medicare, Managed Care Plans, and some Home and Community-Based Services (HCBS) Waivers. They are essential for individuals who are homebound, recovering from illness, or managing chronic conditions.

1. GOVERNING AGENCIES

Agency: California Department of Public Health (CDPH) – Licensing & Certification Division

Role: Licenses and monitors Home Health Agencies (HHAs) under Title 22 and federal Medicare Conditions of Participation

Agency: California Department of Health Care Services (DHCS)

Role: Administers Medi-Cal reimbursement and enrollment for certified HHAs

Agency: Centers for Medicare & Medicaid Services (CMS)Role: Provides federal oversight and issues Medicare certification

Agency: California Managed Care Plans (e.g., LA Care, Anthem Blue Cross)

Role: Contract with HHAs for covered home health services under Medi-Cal managed care

2. HOME HEALTH SERVICE OVERVIEW

Home Health Services are ordered by a physician and delivered by licensed professionals to individuals who are homebound or need assistance recovering from illness or injury.

Approved providers may deliver:

Skilled nursing (e.g., wound care, injections, chronic condition monitoring)
Physical, occupational, and speech therapy
Home Health Aide (HHA) assistance (bathing, mobility, hygiene)
Medical social work and patient education
Medication management, coordination with physicians
Comprehensive care planning and progress documentation

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the California Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Apply for a Home Health Agency License through CDPH
Pass pre-licensure survey and meet building, staffing, and documentation standards
Obtain Medicare Certification from CMS (optional but often required for Medi-Cal billing)
Enroll with DHCS and Medi-Cal managed care plans (if applicable)
Hire clinical staff including RNs, therapists, and HHAs
Maintain general and professional liability insurance

4. PROVIDER ENROLLMENT PROCESS

Step 1: CDPH Home Health Agency Licensing

Submit application with program plan, staffing structure, infection control policy, and proof of ownership
Undergo facility survey and comply with Title 22 regulations
Receive State License Number upon approval

Step 2: CMS Medicare Certification (optional)

Apply for CMS certification (Form CMS-855A)
Undergo federal survey and obtain CMS provider number

Step 3: Medi-Cal Enrollment

Apply through the California DHCS PAVE portal
Submit licensure, Medicare number (if applicable), NPI, and ownership info
Enroll with managed care plans for additional client referrals

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Fictitious Business Name (FBN)
IRS EIN Letter
NPI confirmation
CDPH Home Health Agency License
Medicare certification (if applicable)
Medi-Cal provider enrollment documentation
Policy & procedure manual including:
- Physician order intake and care coordination protocols
- Skilled nursing, aide, and therapy care plans
- HIPAA compliance and patient rights documentation
- Infection control, quality assurance, and adverse event protocols
- Visit logs, treatment plans, and progress notes
- Emergency preparedness and staff safety protocols
- Staff hiring, credentialing, and supervision plans

6. STAFFING REQUIREMENTS

Role: Administrator / Director of Patient Care Services (DPCS)

Requirements: RN with 1+ year supervisory experience in home health care

Role: Registered Nurse (RN)

Requirements: California RN license, CPR certification, home health experience preferred

Role: Licensed Vocational Nurse (LVN)

Requirements: Works under RN supervision, licensed in California

Role: Certified Home Health Aide (HHA)

Requirements: CDPH-certified HHA with background clearance and TB test

Optional Staff:

Physical Therapist (PT)
Occupational Therapist (OT)
Speech-Language Pathologist (SLP)
Medical Social Worker (MSW)

Training Requirements for All Staff:

Client confidentiality, ethics, and HIPAA
Infection control and emergency procedures
Annual skills competency checks and CEUs

7. MEDICAID WAIVER SERVICES

Home Health Services are reimbursed under:

California Medi-Cal State Plan
Medi-Cal Managed Care Plans
HCBS Waivers (for dual eligibility and medically fragile populations)
California Children's Services (CCS) & EPSDT Supplemental Benefits

Approved providers may deliver:

In-home skilled nursing and therapy as ordered
Personal care and assistance via HHAs
Coordination with physicians, waiver case managers, and discharge planners
Thorough documentation of services for audit compliance

8. TIMELINE TO LAUNCH

Phase: Business Formation

Timeline: 1–2 weeks

Phase: CDPH Home Health Licensing

Timeline: 90–150 days

Phase: CMS Certification (if applicable)

Timeline: 60–90 days

Phase: DHCS Medi-Cal Enrollment & MCO Contracting

Timeline: 45–90 days

9. CONTACT INFORMATION

California Department of Public Health (CDPH) – Licensing & Certification

Phone: (916) 558-1784

Website: https://www.cdph.ca.gov

California Department of Health Care Services (DHCS)

Email: providerEnrollment@dhcs.ca.gov

Website: https://www.dhcs.ca.gov/services/medi-cal/Pages/PEB.aspx

California PAVE Provider Portal

Website: https://pave.dhcs.ca.gov

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

HOME HEALTH SERVICES PROVIDER IN CALIFORNIA

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — CALIFORNIA HOME HEALTH SERVICES PROVIDER

We help home health agencies launch fully licensed and Medicaid-compliant Home Health Services in California, from licensing to Medicare/Medi-Cal enrollment and documentation readiness.

Scope of Work: