Open a care business regulators approve and families trust.
We guide founders through licensing, Medicaid enrollment, policies, staffing and first clients for home care, healthcare staffing, medical transportation and residential programs.
- Entity & insurance
- Policies & procedures
- State license application
- AHCCCS enrollment
- First five clients
- Nonmedical home care
- PAS home care
- Home health agency
- Healthcare staffing
- Nonemergency medical transportation
- Medical courier
- Independent living services
- Shared living
- Sober living homes
An LLC is not a license. A license is not a paycheck.
Most failed care startups skip a link. Each step below has to be active before you deliver or bill the related service. We build the whole chain in order.
- 01
Entity
LLC, EIN, bank account and operating agreement.
≠ Not a license to serve anyone
- 02
License
State authorization for the exact service and setting.
≠ Not LLC formation
- 03
Enrollment
Registration with Medicaid or Medicare under the right provider type.
≠ Not a contract with every plan
- 04
Credentialing
Verification of ownership, staff, insurance and compliance.
≠ Not guaranteed network entry
- 05
Contracting
Signed agreement with a payer, agency, facility or program.
≠ Not a referral
- 06
Authorization
Approval for a named client, service, units and dates.
≠ Not permission to bill any amount
- 07
Clean claim
Payment after a correct claim is adjudicated.
≠ Not guaranteed revenue
Policies, an NPI or a submitted application do not authorize services. Marketing language has to match what you are actually licensed and contracted to provide.
Ten care business models. One disciplined method.
Each model has a different regulator, payer and scope boundary. We start by naming yours precisely, because the classification decides everything that follows.
Nonmedical home care
Companion, homemaker and safety-presence services kept inside a lawful nonclinical scope.
Private pay · LTC insurancePAS home care
Personal assistance with bathing, dressing, mobility and respite under Medicaid waiver and private pay.
Medicaid waiver · Private pay · VAHome health agency
Skilled nursing and therapy under a plan of care, built for state licensure and Medicare certification.
Medicare · Medicaid · CommercialHealthcare staffing
W-2 clinical and support staffing for facilities, with credentialing, bill rates and payroll float planned.
Facility contractsNonemergency medical transportation
Passenger trips to covered care, including AHCCCS PT 28 enrollment and broker contracting.
AHCCCS · Managed care · FacilitiesMedical courier
Specimen, pharmacy and supply delivery with chain of custody, privacy and vehicle controls.
Lab · Pharmacy · Hospital contractsIndependent living services
Skill building and community supports through the DDD Qualified Vendor pathway or private pay.
DDD HCBS · Private payShared living
Adult developmental homes, licensed through a contracted agency, with home study and resident safety.
DDD · Licensed provider homesSober living homes
Recovery housing that meets Arizona ADHS licensing, zoning and house-rule standards before opening.
Resident fees · Program partnersStartup & compliance
Entity, licensing order, payer enrollment and compliance calendars for any care model in any state.
All 50 statesFive phases, each with a gate you must clear.
- PHASE 1
Foundation
Entity, EIN, bank, accounting, insurance, employer registrations and legal review.
Advance whenYou are legally able to operate and employ.
- PHASE 2
Market choice
One service area, a narrow service list, the first payer and validated rates.
Advance whenDemand, wages, rates and margin hold up on paper.
- PHASE 3
Licensing & enrollment
Applications, policies, forms and survey readiness filed in the correct order.
Advance whenApproval letters and enrollment IDs are in hand.
- PHASE 4
Workforce readiness
Recruiting funnel, background checks, training, competency files and scheduling.
Advance whenNo worker starts with an incomplete file.
- PHASE 5
Controlled launch
First five clients or facilities, weekly reviews, billing and collections tracking.
Advance whenCash flow, quality and incident response are stable.
Projected openings each year in U.S. healthcare occupations, 2024 to 2034.
Source: U.S. Bureau of Labor StatisticsDays many facilities take to pay a staffing invoice, while workers are paid weekly. We plan that payroll float up front.
Planning assumption in our staffing packageLinks in the authorization chain. Every one must be active before you deliver or bill a service.
Our first rule of compliance
Policies, forms and files a surveyor can actually check.
You receive controlled manuals and working forms customized to your state, license type and payer, not a generic binder.
- Policy and procedure manuals with governing-body approval and annual review fields
- Client intake, service agreements, care plans and incident reports
- Personnel files, background check logs, competency and training records
- EVV, billing, privacy and compliance calendars
Questions founders ask first
Will Medicare pay for my nonmedical home care agency?
Generally no. Medicare does not pay for most long-term custodial care or ordinary nonmedical support. Nonmedical agencies usually start with private pay and build a separate Medicaid waiver pathway. We help you confirm the right payer before you spend on marketing.
Can a staffing agency bill Medicaid for the workers it places?
Not ordinarily. A staffing company invoices the facility or agency that receives the labor. Medicare and Medicaid pay the enrolled provider for covered services. We build your rate card from fully burdened labor cost so the margin holds.
Do sober living homes in Arizona need a license?
Yes, when the home meets Arizona's statutory definition of a sober living home, ADHS requires licensure before operations begin. Zoning and occupancy need to be clear before you sign a long lease.
How long until I can take my first client?
It depends on the model, state and payer. A private pay companion agency can move far faster than a Medicare-certified home health agency, which also needs certification and survey. Your roadmap gives a realistic sequence with dependencies, not a promise.
Find out exactly what your state requires before you sign a lease or buy a van.
A 45-minute strategy call maps your business model, payer, licensing pathway and startup budget.