How to start a home care agency in Colorado and reach your first client faster
Colorado licenses nonmedical home care, and its definition is broad: companionship and medication reminders count as personal care, so most new agencies need a CDPHE Class B license before the first client. That takes months: a letter of intent, an application at least 90 days before opening, CBI fingerprints and a zero deficiency survey. Health First Colorado adds a second CDPHE survey and HCPF enrollment, and home health now meets a federal Medicare pause. We put all of it in the right order for you.
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- Christine OchimasRN, LMFT, MBA
- All three care typesNonmedical, home health, hospice
- Written to Colorado rules6 CCR 1011-1 Chapters 2 and 26 and HCPF rules in 10 CCR 2505-10
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Updated November 2026 · Reviewed by Christine Ochimas, RN, LMFT, MBA
Answer two questions. See exactly what Colorado requires.
Personal care for Community First Choice members
- State license
- CDPHE Class B or Class A home care agency license, then CDPHE certification for Personal Care/Homemaker services
- Who you deal with
- CDPHE, the Department of Health Care Policy and Financing (HCPF) and members' case management agencies
- Must haves
- Home care agency license, a letter of intent to add Personal Care/Homemaker, CDPHE survey and Certification and Transmittal, HCPF provider enrollment, EVV, the HCBS base wage, caregiver checks and training
- Realistic time to first client
- Several months after the license
Orientation for Colorado only. We confirm your exact path on the free call.
Three places new Colorado agencies lose months
Each one keeps you paying rent, insurance and payroll while no clients arrive.
Starting companion care without a license
Owners plan a companion or homemaker business and assume it needs no license. Colorado's statute lists companionship, medication reminders, personal laundry and housekeeping as personal care services. Only businesses that provide housekeeping alone are left out, so most companion agencies need a Class B license.
What it costs: Clients and caregivers on hold while you restart under a license, plus exposure to CDPHE enforcement.
A license queue measured in months
CDPHE wants the application at least 90 days before your start date and says full processing typically takes 3 to 12 months, with home care applications running longer because of volume. The license is issued only after a zero deficiency initial survey, and survey dates come from a queue.
What it costs: Months of rent, insurance and a manager's pay carried before the first client, longer with every incomplete document.
The license does not open Medicaid
To serve Community First Choice members, a licensed agency files a second letter of intent to add Personal Care/Homemaker services. CDPHE surveys again and issues a Certification and Transmittal, which you attach to your HCPF enrollment. HCPF has also capped personal care and homemaker hours in 2026 and is weighing more limits.
What it costs: A second wait with staff on payroll, and a revenue plan built on hours a member may no longer be authorized for.
What does a delay cost your agency?
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Home care vs home health vs hospice in Colorado
The three sound alike and are regulated differently. The one you choose decides your regulator, staffing, startup capital and timeline.
| Topic | Nonmedical home care | Home health (skilled) | Hospice |
|---|---|---|---|
| What your staff do | Personal care, homemaking, companionship, medication reminders, respite | Skilled nursing, certified nurse aide and therapy services | Comfort care for people who are terminally ill, and support for their families |
| State license | CDPHE Class B home care agency license (6 CCR 1011-1 Chapter 26, Part 7) | CDPHE Class A home care agency license (6 CCR 1011-1 Chapter 26, Part 6) | CDPHE hospice license (6 CCR 1011-1 Chapter 21) |
| Certificate of Need | No | No Certificate of Need step | No Certificate of Need step |
| Main payers | Private pay, Health First Colorado through Community First Choice and HCBS waivers, long term care insurance | Medicare, Health First Colorado, commercial insurance | Medicare hospice benefit, Health First Colorado, commercial insurance |
| Medicare | Not covered | State survey or accreditation, then Medicare enrollment; check the CMS moratorium | State survey or accreditation, then Medicare enrollment; check the CMS moratorium |
| Key staff | Agency manager with supervisory experience and the 8 hour manager course, supervisors, trained and competency tested caregivers | Administrator, physician or RN nursing supervisor with two years of nursing experience, licensed and certified clinical staff | Administrator, physician medical director, RN directing nursing care, interdisciplinary group, volunteers |
| Startup capital | Lowest, but carried through a licensing wait of several months | Higher: clinical payroll and larger insurance minimums before Medicare revenue | Highest: interdisciplinary team before revenue |
| Time to first client | Several months (license), longer for Community First Choice | Longest: license, survey, Medicare enrollment | Longest: license, survey, Medicare enrollment |
Many Colorado owners start with a Class B license, build cash flow and a caregiver team, then move into skilled care. Plan the class carefully: a Class B agency that wants to become Class A files a new initial application and pays the initial fee again. We plan both from day one so your policies, insurance and hiring grow with you instead of being rewritten.
Colorado requirements at a glance
| Licensing agency | Colorado Department of Public Health and Environment (CDPHE), Health Facilities and Emergency Medical Services Division |
|---|---|
| License types | Class B home care agency (personal care only) and Class A home care agency (any skilled service, plus personal care); hospice license under Chapter 21 |
| Governing law | C.R.S. 25-27.5-101 et seq.; 6 CCR 1011-1, Chapter 26 (home care agencies) with Chapter 2 (general licensure standards) |
| Application | Letter of intent, then the application, documents and fee in the COHFI portal at least 90 days before your start date; zero deficiency initial survey before the license is issued |
| Insurance | Liability insurance or a surety bond: Class B $100,000 per occurrence and $300,000 aggregate; Class A $500,000 per occurrence and $3,000,000 aggregate |
| Background checks | CBI fingerprints for owners, managers and administrators; a criminal history check within 90 days before hire; a CAPS check before any direct care; DORA license verification |
| Caregiver training | No set hour count: interactive initial training and a competency evaluation with visual observation before care, then four (homemaker) or six (personal care) topics a year |
| Medicaid | Health First Colorado, run by HCPF; personal care and homemaker moved into Community First Choice on July 1, 2025 |
| Electronic visit verification | Required since August 3, 2020 for personal care, homemaker, IHSS, home health and other services; free State EVV Solution or a provider choice system |
| Entity and tax filing | Colorado Secretary of State; wage withholding and unemployment insurance through MyBizColorado; FAMLI registration |
Summary of Colorado requirements as of November 2026. Rules change; confirm with each agency before filing.
Step by step: launching a home care agency in Colorado
The order matters. Steps 4 and 5 should be finished before step 6, because CDPHE reviews your documents and then surveys policies, background checks and manager training on site. Step 8 starts only after the license is issued.
Form the business and register as an employer
File your LLC or corporation with the Colorado Secretary of State, get an EIN, and register for wage withholding and unemployment insurance through MyBizColorado. Register with FAMLI and build Colorado paid sick leave into payroll: at least one hour for every 30 hours worked, up to 48 hours a year.
You do this; we give you the checklistChoose your license class, payers and counties
Class B if you will provide only personal care, Class A if you will provide any skilled service. Decide on private pay, Community First Choice or both, and list the contiguous counties you can actually staff. Use the path finder above.
Decided on your free consultationSet up the office, insurance and manager
Every agency needs a physical business office in Colorado. Buy liability insurance that meets the minimum for your class for the whole license period, plus workers' compensation. Hire a manager who is at least 21, has a year of supervisory experience in personal care or the education alternative, and completes the 8 hour agency manager course.
You do this; we specify what is requiredWrite policies to Chapter 26
Adopt policies for consumer rights and disclosures, service plans, complaints, emergency preparedness, personnel, training and competency, supervision, records and quality management, written to 6 CCR 1011-1 Chapter 2 and Chapter 26, Parts 5 and 7.
We write this for youBuild the caregiver screening and training system
Run a criminal history check that includes at least a Colorado search no more than 90 days before hire, and complete a CAPS check before anyone provides direct care. Deliver interactive initial training and a competency evaluation with visual observation, and schedule supervision at least every three months.
We set up the system and trackerSubmit the letter of intent and application
Send CDPHE's letter of intent form to get COHFI access, then file the application, required documents and the nonrefundable fee at least 90 days before your start date. Owners and managers submit CBI fingerprints with the application. Answer any defect notice within 14 days.
We prepare the applicationPass the initial survey
Once the application is complete, CDPHE schedules an initial survey, usually on site. Have manager training records, personnel files with background checks, all policies and your quality management plan ready. The license is issued in COHFI after a survey with zero deficiencies.
We get you ready for the surveyAdd Community First Choice
Submit a letter of intent to add Personal Care/Homemaker services, pass the CDPHE survey, then attach the Certification and Transmittal to your HCPF provider enrollment. Set up EVV before your first visit and pay caregivers at least the HCBS base wage.
We prepare and manage it
Caregiver training, CAPS checks and supervision
Chapter 26 does not set a fixed number of training hours for Class B caregivers. It sets topics, competency testing before care and a supervision schedule, and CDPHE surveyors check all three. Background checks come from Part 5 and the statute.
- Agency manager: At least 21, a high school diploma or GED and a year of supervisory experience in personal care, or a degree with health care work experience instead. Completes an 8 hour agency manager course and 12 hours of related training every year.
- Homemakers: Interactive initial training, in person, online or hybrid, and a competency evaluation with visual observation before working alone. At least four training topics every 12 months, prorated for part of a year.
- Personal care workers: Everything homemakers need, plus a skills validation with visual observation before care and a proof of competency check by the manager or supervisor before assignment. At least six topics every 12 months.
- Supervision: Supervision at least every three months, covering consumer satisfaction and worker competence. Quarterly visits may be by telehealth, but the annual supervision must be in person.
- Tasks personal care workers may not do: Skilled services, medication setup, nail trimming, inserting or removing catheters, suppositories or enemas, suctioning, tube feedings, and transfers when the consumer cannot assist.
- Criminal history and CAPS checks: A criminal history check that includes at least a Colorado search, no more than 90 days before hire (C.R.S. 25-27.5-107), and a Colorado Adult Protective Services (CAPS) check before anyone provides direct care. Licensed staff are verified with DORA.
- Owner and manager fingerprints: Each owner, manager and administrator submits fingerprints to the Colorado Bureau of Investigation with the application, and within 10 days of any change in those roles.
- Class A staff: Direct care staff of a skilled agency complete at least 12 training topics every 12 months. Uncertified aides are observed in the home weekly in their first month.
- HCBS base wage: Since January 1, 2026, direct care workers delivering personal care, homemaker, IHSS and other HCBS services must earn at least $17.00 an hour, $19.29 in Denver and $18.17 in Edgewater. Providers attest every year.
Six mistakes that slow Colorado agencies down
We look for every one of these in the first week of an engagement.
Opening a companion care business without a license
- What it costs
- Companionship is a personal care service in Colorado, so the business is operating unlicensed from its first visit.
- How we prevent it
- Your first call ends with the right license class and the order to get it in.
Using an old background check or skipping CAPS
- What it costs
- A criminal history check older than 90 days or a missing CAPS check is a survey deficiency, and the license waits for a clean survey.
- How we prevent it
- A hiring tracker that dates every check and blocks scheduling until both are on file.
Missing quarterly supervision
- What it costs
- Supervision every three months and an annual in person visit are surveyed for every caregiver; gaps lead to a plan of correction.
- How we prevent it
- Supervision dates scheduled automatically for every caregiver from the day of hire.
Assuming the license lets you bill Medicaid
- What it costs
- Without the Personal Care/Homemaker survey and Certification and Transmittal, HCPF enrollment cannot be completed and Community First Choice referrals go elsewhere.
- How we prevent it
- We file the second letter of intent as soon as the license is issued and prepare the HCPF packet in parallel.
Pricing below the HCBS base wage
- What it costs
- Paying a caregiver under $17.00 an hour, or under $19.29 in Denver, risks audits, payment holds and recoupment.
- How we prevent it
- A rate and wage plan built on the current base wage for every county you serve.
Counting on Medicaid home health as a quick start
- What it costs
- HCPF requires Medicare enrollment first, and CMS paused new Medicare home health enrollment in May 2026.
- How we prevent it
- We plan a Class B start or a timed home health launch around the current CMS status.
In a free 30 minute call we confirm your Colorado path, flag the mistakes that apply to your plan, and give you a fixed price to handle the rest.
Colorado launch packages
Three fixed price packages, matched to the path you choose. Your exact price is quoted in writing after your free call, before any work starts.
Private pay launch
For nonmedical agencies serving families who pay privately.
- Colorado path and a dated launch plan
- Policy and procedure manual written to 6 CCR 1011-1 Chapters 2 and 26 and HCPF rules in 10 CCR 2505-10
- Service agreement, client rights and care plan forms
- Caregiver hiring and screening workflow
- Google Business Profile setup
Community First Choice ready agency
Everything in Private pay launch, plus the Medicaid route.
- Policies aligned to Community First Choice requirements
- Caregiver training and background check tracker
- Medicaid provider enrollment
- Credentialing packets for HCPF, after the CDPHE Personal Care/Homemaker survey
- Survey and audit readiness
- Colorado city pages for local search
Home health and Medicare
For skilled home health. Hospice is scoped separately.
- Staffing and capital timeline
- Policies written to CDPHE rules and the Medicare Conditions of Participation
- License application and inspection readiness
- Accreditation survey preparation
- Medicare and Medicaid enrollment support
Every package: one fixed price agreed in writing · you own 100% of your agency · no franchise fees or royalties.
On your own vs a franchise vs Lunaria
| Topic | On your own | Home care franchise | With Lunaria |
|---|---|---|---|
| Who owns the business | You | You, under the franchisor's brand and rules | You, 100% |
| Ongoing fees | None | Royalties and brand fees, usually a share of revenue | None. One fixed project fee |
| Knowing what Colorado requires | Pieced together from manuals and forums | A national playbook, adapted | Confirmed on your first call, then in writing |
| Policy manual | A template, often from another state | The franchisor's standard manual | Written to 6 CCR 1011-1 Chapters 2 and 26 and HCPF rules in 10 CCR 2505-10 |
| Medicaid credentialing | One application at a time | Varies by franchisor | Packets for HCPF, after the CDPHE Personal Care/Homemaker survey prepared together |
| Your brand and marketing | Up to you | The franchisor's brand, with territory limits | Your brand, plus local search set up for you |
The Colorado home care startup checklist
Every Colorado step in order: business setup, your payer path, policies, caregiver screening and training, Medicaid enrollment and getting found. The items to start first are starred.
- Choose your license class (Class B or Class A), payers and contiguous counties
- Form your LLC or corporation with the Colorado Secretary of State
- Get an EIN; register for wage withholding and unemployment insurance through MyBizColorado
- Register with FAMLI and set up paid sick leave (one hour per 30 hours worked, up to 48 hours)
- Lease a physical business office in Colorado
- and 16 more steps
Christine Ochimas, RN, LMFT, MBA
Christine founded Lunaria Care Consulting to give nurses and caregivers a direct route from "I want my own agency" to a compliant business with clients. She reads state requirements the way a reviewer does and writes policies the way a nurse would actually use them.
- We serve owners in all 50 states and DC, with a plan written for Colorado
- We help through enrollment and survey readiness, not just the application
- We tell you what we cannot promise: no one can guarantee a state or health plan decision
Have these ready for your consultation
- The care you want to provide and the clients you want to serve
- The Colorado cities or counties you plan to cover
- Where you are now: idea, business formed or already operating
- Who you expect to pay: families, Community First Choice, Medicare
- Your target opening month and rough budget
No client or patient records. We never need them for a first call.
What it costs to start a home care agency in Colorado
| Item | Notes |
|---|---|
| CDPHE initial license | For applications filed July 1, 2026 to June 30, 2027: $2,720.30 for Class B and $3,709.49 for Class A. CDPHE posts a new fee schedule by March 1 each year for July 1, and fees are nonrefundable. |
| Yearly renewal | Base fee of $1,638.36 (Class B) or $1,916.58 (Class A) for 2026 to 2027, plus branch, workstation and volume fees based on prior year admissions. |
| Hospice license | CDPHE initial hospice license fee is $8,231.33 for July 1, 2026 to June 30, 2027. |
| CBI fingerprints and CAPS checks | CBI fee for each owner, manager and administrator; CAPS and criminal history check fees for each caregiver. Check current fees with CBI and CDHS. |
| Insurance | Liability insurance or a surety bond at the Class B or Class A minimum, plus workers' compensation and auto coverage |
| Office and manager | A physical Colorado office, the manager's pay during the licensing wait, and the 8 hour manager course |
| Medicaid and Medicare enrollment | HCPF lists a $750 enrollment application fee for institutional providers in 2026; check whether it applies to your enrollment type. Medicare uses the same 2026 fee. |
| EVV and scheduling software | The State EVV Solution is free; a provider choice system is paid by the agency |
| Accreditation (home health, hospice) | Accrediting organization application and survey fees if you choose accreditation over a CDPHE certification survey |
| Operating reserve | Covers payroll, rent and insurance through the licensing wait, the Medicaid survey and enrollment |
Fees change. Confirm current amounts with each agency before budgeting.
How long it takes in Colorado
Several months: application at least 90 days before opening, with CDPHE reporting 3 to 12 months for full processing and the initial survey.
Longer: after the license, a second CDPHE survey for Personal Care/Homemaker, the Certification and Transmittal, then HCPF enrollment and EVV setup.
Longest: CDPHE license, certification survey and Medicare enrollment, subject to the CMS moratorium. Medicaid home health follows Medicare enrollment.
Most demand and most competing agencies sit along the Front Range, from Fort Collins through Denver and Aurora to Colorado Springs and Pueblo. Denver and Edgewater have higher minimum wages, which raise the HCBS base wage there, so price and pay plans must follow the counties you list. Western Slope and mountain communities are spread out, which makes supervision visits and backup coverage harder; your license service area must be contiguous counties you can actually staff. Many families search by city and county for a parent, which makes a strong Google Business Profile and clear pages for each community you serve matter.
Frequently asked questions
Do you need a license to start a nonmedical home care agency in Colorado?
Yes, in most cases. Colorado treats companionship, medication reminders, personal laundry and housekeeping as personal care services, so an agency that provides them needs a CDPHE Class B license. Businesses that provide only housekeeping, and placement agencies that only refer caregivers for a fee, are not home care agencies.
What is the difference between a Class A and Class B license?
A Class B agency provides only personal care and may not provide any skilled service. A Class A agency provides any skilled service by a licensed professional, such as nurses, certified nursing assistants and therapists, and may also provide personal care. Class A has higher insurance minimums, and moving from B to A takes a new initial application.
How much does a Colorado home care license cost?
For applications filed from July 1, 2026 to June 30, 2027, the CDPHE initial license fee is $2,720.30 for Class B and $3,709.49 for Class A. Fees change each July 1, and insurance, fingerprints, office and payroll costs come on top.
How long does it take to get licensed in Colorado?
CDPHE asks for the application at least 90 days before your start date and says full processing typically takes 3 to 12 months. The license is issued only after a zero deficiency initial survey, so a complete application and survey ready files matter most.
Can a Class B agency serve Health First Colorado members?
Yes. Since July 1, 2025, personal care and homemaker run through Community First Choice, and personal care requires a Class A or B license. A licensed agency submits a letter of intent to add Personal Care/Homemaker, passes a CDPHE survey and enrolls with HCPF.
Do Colorado caregivers need a certificate?
Not for Class B work. Each caregiver completes the agency's interactive initial training and passes a competency evaluation with visual observation before providing care, then completes four (homemaker) or six (personal care) training topics a year. HCPF also offers free Colorado Direct Care Training modules.
Does Colorado require a Certificate of Need for home health or hospice?
No. CDPHE's licensing process for home care agencies and hospices has no Certificate of Need or need review. Licensure, a certification survey and Medicare enrollment still apply.
Can a new home health agency enroll in Medicare right now?
CMS put a nationwide moratorium on new Medicare enrollment of home health agencies and hospices from May 13, 2026, for six months. It may have ended or been extended by the time you read this, so check its status before you plan. Health First Colorado home health also requires Medicare enrollment first.
How much does Colorado home care consulting cost?
Lunaria charges one fixed price per engagement, based on your path: private pay, Community First Choice or home health and Medicare. You receive the price in writing after a free 30 minute consultation. There are no hourly charges.
Is a franchise a better way to start a home care agency in Colorado?
A franchise gives you a brand and playbook in exchange for fees and ongoing royalties. Starting independently with Lunaria costs one fixed price, and you own 100% of your agency with no franchise fees or royalties.
Sources checked for this guide (37)
- CDPHE Home Care Agencies page (definitions, Class A and Class B, fees, initial licensing guidance)
- CDPHE Facility fees page (2026/2027 fee schedules effective July 1, 2026)
- CDPHE Home Care Agencies fee schedule 2026/2027 (published spreadsheet)
- CDPHE Hospices fee schedule 2026/2027 (published spreadsheet)
- CDPHE Process and requirements for health facility licensure (LOI, CHOW, HCBS certification)
- CDPHE Initial Health Facility/Agency Licensing, Guidance and Instructions (90 days, 3 to 12 months, survey)
- CDPHE HCBS Waiver Services Medicaid Certification Guidance (Personal Care/Homemaker 666, IHSS 656)
- CDPHE Medicare and Medicaid certification for health care facilities
- CDPHE Hospices page (Chapter 21)
- 6 CCR 1011-1 Chapter 26, Part 4, Department oversight (Cornell LII, effective 7/1/2025)
- 6 CCR 1011-1 Chapter 26, Part 5, General requirements (Cornell LII)
- 6 CCR 1011-1 Chapter 26, Part 6, Skilled care (Cornell LII)
- 6 CCR 1011-1 Chapter 26, Part 7, Nonmedical and personal care (Cornell LII)
- 6 CCR 1011-1 Chapter 21, Section 1, Hospices statutory authority (Cornell LII)
- 6 CCR 1011-1 Chapter 21, Section 4, Hospice administration (Cornell LII)
- 6 CCR 1011-1 Chapter 21, Section 6, Hospice patient care services (Cornell LII)
- C.R.S. 25-27.5-102, definitions (colorado.public.law)
- C.R.S. 25-27.5-107, criminal history checks (colorado.public.law)
- C.R.S. 8-13.3-403, paid sick leave accrual (colorado.public.law)
- HCPF Community First Choice Option
- HCPF Medicaid Sustainability and Colorado's LTSS System (2026 caps, rate changes, proposals)
- HCPF Direct Care Workforce Base Wage (2026)
- HCPF Direct Care Worker Training
- HCPF Electronic Visit Verification
- HCPF EVV Overview (required services, hybrid model)
- HCPF Provider Enrollment (2026 application fee, processing times)
- HCPF Home Health Billing Manual (provider qualifications)
- HCPF Long-Term Home Health Program
- HCPF Long-Term Services and Supports Programs (waivers, case management agencies)
- Colorado Department of Revenue, wage withholding accounts
- Colorado FAMLI, employers
- Colorado Secretary of State, business
- Federal Register 2026-09717: nationwide moratorium on Medicare enrollment of home health agencies
- Federal Register 2026-09718: nationwide moratorium on Medicare enrollment of hospices
- CMS Provider Enrollment Moratoria
- 42 CFR Part 484, home health Conditions of Participation (Cornell LII)
- 42 CFR Part 418, hospice care (Cornell LII)
This guide is general information and reflects Colorado requirements as we understood them in November 2026. Requirements change. Confirm current rules, fees and procedures with the Colorado Department of Public Health and Environment, HCPF and CMS before filing. Lunaria Care Consulting provides professional consulting services and does not provide legal advice.
Other states: see all state guides. What we do: licensing, compliance, Medicaid enrollment and local search marketing.