How to start a home care agency in Georgia and reach your first client faster
Georgia licenses nonmedical home care, and the license comes with clocks most new owners do not see coming. You need an RN to apply, even for companion care. A provisional license gives you three months to admit three clients and call for your survey. CCSP and SOURCE only accept new agencies in September, after about a year of full licensure. Home health needs a Certificate of Need that DCH is not currently accepting. We put all of it in the right order for you.
- Guides reviewed by Christine Ochimas, RN, LMFT, MBA
- One fixed price, agreed in writing
- You own 100%. No franchise fees or royalties
Get your free Georgia launch plan
A 30 minute call. No obligation.
- Christine OchimasRN, LMFT, MBA
- All three care typesNonmedical, home health, hospice
- Written to Georgia rulesRule 111-8-65 and the EDWP (CCSP and SOURCE) provider manuals
- Local search marketingGoogle Business Profile and local search
- All 50 states and DCExpand beyond Georgia with us
Updated November 2026 · Reviewed by Christine Ochimas, RN, LMFT, MBA
Answer two questions. See exactly what Georgia requires.
Personal support services for CCSP and SOURCE members
- State license
- Private Home Care Provider license, full and without restriction (Rule 111-8-65)
- Who you deal with
- DCH Healthcare Facility Regulation Division, the DCH EDWP (CCSP and SOURCE) unit, Area Agencies on Aging and care coordinators
- Must haves
- At least 12 months of licensed operation, information session, September enrollment window, $1 million liability and workers' compensation coverage, 40 hour trained aides, RN supervision, EVV
- Realistic time to first client
- Longest nonmedical path: a year of licensure first
Orientation for Georgia only. We confirm your exact path on the free call.
Three places new Georgia agencies lose months
Each one keeps you paying rent, insurance and payroll while no clients arrive.
The provisional license clock
Once DCH approves a new Private Home Care Provider application, it issues a provisional license that lasts three months. In that time you must be operating, admit at least three clients and ask DCH for your initial survey. Miss it and the license is voided, and you start over with a new application.
What it costs: A second application, a second fee and months of rent and payroll with no license to show for it.
The CCSP and SOURCE calendar
DCH only enrolls new personal support providers for the Elderly and Disabled Waiver once a year, from September 1 to 30, after a required information session. You need a full Private Home Care Provider license and at least 12 months in business first, and DCH limits new providers to ten counties. Agencies that miss the window wait for the next September.
What it costs: A full year added to your Medicaid start, and a denial bars you from reapplying for a year.
A home health Certificate of Need that is not open
Georgia requires a Certificate of Need before a new home health agency can apply for a license. In its September 30, 2026 notice, DCH said it will not accept new or expanded home health applications this cycle, and its next need assessment is around March 31, 2027. Owners who plan a Medicare home health start without checking this lose months.
What it costs: Clinical hires, leases and capital committed to a license you cannot apply for yet.
What does a delay cost your agency?
Enter your own numbers. Nothing is stored or sent.
Home care vs home health vs hospice in Georgia
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 | Companion or sitter tasks, personal care tasks such as bathing and dressing, and nursing services if your license includes them | Skilled nursing, therapy and home health aide services ordered by a physician | Palliative and supportive care for people who are terminally ill, and their families |
| State license | Private Home Care Provider license (Rule 111-8-65), by service category | DCH home health agency license (O.C.G.A. 31-7-150 et seq.; Rule 111-8-31) | DCH hospice license (O.C.G.A. 31-7-170 et seq.; Rule 111-8-37) |
| Certificate of Need | No | Yes; DCH is not accepting new applications this cycle | No; O.C.G.A. 31-7-179 says a licensed hospice needs none |
| Main payers | Private pay, CCSP and SOURCE (EDWP), Independent Care Waiver, long term care insurance | Medicare, Georgia Medicaid and its health plans, commercial insurance | Medicare hospice benefit, Georgia Medicaid |
| Medicare | Not covered | Accreditation or state survey, then Medicare enrollment | Accreditation or state survey, then Medicare enrollment |
| Key staff | Administrator and an RN to apply; supervisors for 92 day personal care and 122 day companion visits | Administrator, group of professional personnel including a physician and RN, clinical staff | Administrator, medical director, RN, social worker and counselor in the interdisciplinary team |
| Startup capital | Lowest, but carry a year of private pay before Medicaid | Higher: clinical payroll before Medicare revenue, plus Certificate of Need costs | Highest: interdisciplinary team before revenue |
| Time to first client | Months (private pay); more than a year (CCSP and SOURCE) | Longest: Certificate of Need, licensure, survey, enrollment | Longest: licensure, survey, enrollment |
Most Georgia owners start with a Private Home Care Provider license, build private pay clients and a caregiver team during the year DCH requires before Medicaid enrollment, then apply for CCSP and SOURCE. Because the home health Certificate of Need is closed for now, some owners add the nursing services category to their Private Home Care Provider license to offer private duty nursing, which a licensed RN or LPN must provide. That is not Medicare home health. We plan your categories from day one so your policies and hiring grow with you instead of being rewritten.
Georgia requirements at a glance
| Nonmedical home care license | Private Home Care Provider license from the DCH Healthcare Facility Regulation Division (O.C.G.A. 31-7-300 et seq.; Ga. Comp. R. & Regs. 111-8-65) |
|---|---|
| Service categories | Companion or sitter tasks, personal care tasks and nursing services. Each is listed on the license and has its own annual fee. |
| Who you need to apply | An administrator and a Georgia licensed RN, even if you only offer companion care. One RN may also be the administrator and owner. |
| Home health and hospice | Home health: Rule 111-8-31 and a Certificate of Need under Rule 111-2-2-.32. Hospice: Rule 111-8-37, no Certificate of Need. |
| Medicaid home care route | Elderly and Disabled Waiver Program (EDWP), made up of CCSP and SOURCE, run by DCH. Area Agencies on Aging are the entry point for members. |
| Caregiver training | Personal care assistants: CNA, an approved exam or program, or a 40 hour agency program (20 hours before serving clients). Eight hours of training a year after the first year. |
| Background checks | Fingerprint checks through the DCH Georgia Criminal History Check System (GCHEXS) for owners with 10% or more, administrators and direct access staff (Rule 111-8-12) |
| Electronic visit verification | Required for Medicaid personal support services and, for dates of service from September 14, 2026, Medicaid home health services. DCH offers a state system from Netsmart. |
| Developmental disabilities | NOW and COMP waivers, operated by the Department of Behavioral Health and Developmental Disabilities (DBHDD) |
| Entity filing | Georgia Secretary of State, Corporations Division, plus a city or county business license that DCH asks to see |
Summary of Georgia requirements as of November 2026. Rules change; confirm with each agency before filing.
Step by step: launching a home care agency in Georgia
The order matters. Hire your RN and start fingerprint checks before you apply, and plan your first three clients before the provisional license starts, because DCH gives you three months to reach your initial survey. The CCSP and SOURCE clock starts only when your full license does.
Form the business and get a local business license
File your LLC or corporation with the Georgia Secretary of State, get an EIN, register for withholding with the Department of Revenue through the Georgia Tax Center and for unemployment insurance with the Georgia Department of Labor. DCH asks for a current city or county business license with your agency's name and address.
You do this; we give you the checklistChoose your service categories and payer mix
Companion or sitter, personal care, nursing, or a mix. Every task your staff perform must fall inside a category on your license. If CCSP and SOURCE are in your plan, you need the personal care category and a year of full licensure first.
Decided on your free consultationHire your administrator and RN and run owner checks
DCH requires an administrator and a Georgia licensed RN for every initial application. Owners with 10% or more and the administrator need a satisfactory GCHEXS fingerprint determination dated within 12 months of the application, and the administrator must complete the orientation in Rule 111-8-65-.09.
You do this; we specify what is requiredWrite policies to Rule 111-8-65
Policies must cover your scope of services, service agreements (signed by the second visit or within seven days), client rights and complaints, service plans, supervisory visits, staff qualifications and training, health and TB screening, incidents and records kept for five years. You sign an affidavit that they are in place.
We write this for youApply through GAHLES
Submit the application in the DCH GAHLES portal with notarized affidavits, a photo ID, your business license, Secretary of State evidence, the owner form, GCHEXS letters, the administrator's job description and orientation, the RN's license and the fees. DCH says initial review takes 30 business days.
We prepare the applicationBuild the caregiver pipeline
Each caregiver needs a satisfactory GCHEXS determination before serving clients, TB screening before work, orientation and a job description. Personal care assistants need a CNA, an approved exam or program, or your 40 hour program under an RN. Companions need training in the topics the rule lists.
We set up the system and trackerOpen on the provisional license and pass the initial survey
The provisional license lasts three months. Admit at least three clients, keep supervisory visit notes, and email DCH to request your initial survey before the three months end. After you pass, DCH issues your permanent permit. Relicensure surveys follow about every 18 to 24 months.
We get you ready for the surveyEnroll in CCSP and SOURCE when you qualify
After at least 12 months in business on a full license, attend the August information session, then apply in GAMMIS between September 1 and 30 for both CCSP and SOURCE. Expect a credentialing review, a possible site visit, new provider training, $1 million liability and workers' compensation coverage, RN supervision and EVV.
We prepare and manage it
Caregiver training and background checks in Georgia
Rule 111-8-65-.09 sets staff qualifications for each service category, and the EDWP personal support services manual adds its own standards for aides who serve CCSP and SOURCE members. Every task must be within the category the worker is trained for and the agency is licensed for.
- Personal care assistants: One of: nurse aide training and competency under federal rules, a nurse aide competency exam or credentialing program recognized by DCH, or a 40 hour agency training program run under an RN. Twenty hours come before serving clients and the other twenty within six months.
- Companions or sitters: Must read and write and complete reports, and be trained or show competency in client needs, meal preparation, escort services, housekeeping and sanitation, home safety, medical emergencies and infection control.
- Nursing services: Only Georgia licensed RNs or LPNs, supervised by a Georgia RN.
- Orientation and yearly training: Orientation on your policies, duties, reporting and TB and hepatitis exposure before working with clients, then at least eight clock hours of training a year after the first year, plus a yearly written evaluation.
- Supervisory visits: Personal care: a home visit at least every 92 days, with an RN or LPN supervising care for medically frail clients. Companion care: at least every 122 days. CCSP and SOURCE require RN or LPN visits every 62 or 92 days, depending on hours.
- Fingerprint checks: Owners with 10% or more, administrators and direct access employees need a satisfactory GCHEXS determination under the Georgia long term care background check program. Licensed nurses in good standing are exempt.
- Portability: A determination stays valid while the person works for you. A new hire needs one issued within the past 12 months unless their fingerprints are kept in the Rap Back system.
- TB screening: Every employee is screened for TB before starting work.
Six mistakes that slow Georgia agencies down
We look for every one of these in the first week of an engagement.
Applying without an RN
- What it costs
- DCH requires a Georgia licensed RN on every initial application, even for companion care, so the application cannot move.
- How we prevent it
- We plan your RN role on the first call, including whether one RN can also be administrator or owner.
Letting the provisional license expire
- What it costs
- Without three clients and a survey request within three months, the license is voided and you reapply from the start.
- How we prevent it
- A launch plan with your first clients lined up and the survey request on the calendar.
Licensing for companion care, then doing personal care
- What it costs
- Bathing or toileting help outside your categories is a licensing violation, even when the caregiver is a CNA.
- How we prevent it
- Clear service definitions in your policies and service agreements, and the right categories on your license.
Missing the September enrollment window
- What it costs
- CCSP and SOURCE accept new personal support providers only in September, so a missed window costs a full year.
- How we prevent it
- We track your 12 month date, book the August information session and prepare your packet in advance.
Planning home health before checking the Certificate of Need
- What it costs
- Leases, hires and capital committed while DCH is not accepting new home health applications.
- How we prevent it
- We check the latest DCH notice and your options before you spend on a home health start.
Supervisory visits on paper only
- What it costs
- Surveyors look for documented 92 day and 122 day home visits. Missing notes lead to citations and plans of correction.
- How we prevent it
- A tracker that flags supervisory visits, training hours and screenings for every client and caregiver.
In a free 30 minute call we confirm your Georgia path, flag the mistakes that apply to your plan, and give you a fixed price to handle the rest.
Georgia 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.
- Georgia path and a dated launch plan
- Policy and procedure manual written to Rule 111-8-65 and the EDWP (CCSP and SOURCE) provider manuals
- Service agreement, client rights and care plan forms
- Caregiver hiring and screening workflow
- Google Business Profile setup
CCSP and SOURCE ready agency
Everything in Private pay launch, plus the Medicaid route.
- Policies aligned to CCSP and SOURCE requirements
- Caregiver training and background check tracker
- Medicaid provider enrollment
- Credentialing packets for the DCH EDWP (CCSP and SOURCE) unit
- Survey and audit readiness
- Georgia city pages for local search
Home health and Medicare
For skilled home health. Hospice is scoped separately.
- Staffing and capital timeline
- Policies written to DCH 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 Georgia 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 Rule 111-8-65 and the EDWP (CCSP and SOURCE) provider manuals |
| Medicaid credentialing | One application at a time | Varies by franchisor | Packets for the DCH EDWP (CCSP and SOURCE) unit 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 Georgia home care startup checklist
Every Georgia 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 service categories and payer mix (private pay, CCSP and SOURCE, or both)
- Form your LLC or corporation with the Georgia Secretary of State
- Get an EIN, register for withholding (Georgia Tax Center) and unemployment insurance (Georgia Department of Labor)
- Get a city or county business license with your agency name and address
- Buy general and professional liability, workers' compensation and auto coverage
- and 15 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 Georgia
- 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 Georgia cities or counties you plan to cover
- Where you are now: idea, business formed or already operating
- Who you expect to pay: families, CCSP and SOURCE, 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 Georgia
| Item | Notes |
|---|---|
| Application processing fee | $300 for a new Private Home Care Provider, home health or hospice application, per the DCH Schedule of Licensure Activity Fees. Not refundable. |
| Private Home Care Provider license | $250 a year for each service category (companion sitting, personal care, nursing). The initial license fee is paid before the license is issued, and annual fees are due October 1 to December 31, with a $150 late fee after that. |
| Home health or hospice license | $1,000 a year for each, plus Certificate of Need costs for home health. Check current fees with DCH. |
| Fingerprint checks | DCH's background check FAQ lists $51.50 per person; check the current amount. The agency decides whether it or the applicant pays. |
| Entity formation and local license | Secretary of State filing fee plus your city or county business license |
| Insurance | Liability, workers' compensation and auto coverage. CCSP and SOURCE require at least $1 million per occurrence and $3 million aggregate general liability. |
| Training | Your 40 hour personal care program under an RN, or CNA status checks, plus yearly in service hours |
| EVV and scheduling software | The DCH state EVV system is free for personal support providers; an alternate system is at your cost |
| Operating reserve | Covers payroll, rent and insurance through the provisional period and the year before Medicaid enrollment |
Fees change. Confirm current amounts with each agency before budgeting.
How long it takes in Georgia
Months: DCH's initial review (30 business days by its own estimate), a three month provisional license with your first clients, then the initial survey.
More than a year: at least 12 months in business on a full license, the September enrollment window, then credentialing review and new provider training.
Longest. Home health waits on a Certificate of Need that DCH is not accepting this cycle. Hospice needs licensure, survey and Medicare enrollment.
Metro Atlanta has the most agencies competing for private pay families, and many win on a specific niche such as dementia care, overnight care or a language. Outside the metro area, reliable staffing across long drives is often the selling point, and your license lists the counties you serve, so plan expansion counties early. CCSP and SOURCE members reach agencies through Area Agencies on Aging and care coordinators, so those relationships matter once you enroll. Many families search for care for a parent from out of state, which makes a strong Google Business Profile and clear city pages for Atlanta, Savannah, Augusta, Columbus, Macon and your other communities matter.
Frequently asked questions
Do you need a license to start a nonmedical home care agency in Georgia?
Yes. Agencies that provide companion or sitter tasks, personal care tasks or nursing services in a client's home need a Private Home Care Provider license from the DCH Healthcare Facility Regulation Division under Rule 111-8-65. A provider may not operate without a license or provisional license.
Do I need a nurse to open a Georgia home care agency?
Yes. DCH requires an administrator and a Georgia licensed RN for every initial Private Home Care Provider application, regardless of the services you offer. One RN may also serve as the administrator and owner.
How does the Georgia provisional license work?
After DCH approves your application, it issues a provisional license that lasts three months. You must be operating, admit at least three clients and request your initial survey in that time. After you pass the survey, DCH issues your permanent permit.
How much are Georgia home care license fees?
DCH charges a $300 application processing fee and $250 a year for each Private Home Care Provider service category: companion sitting, personal care and nursing. Home health agencies and hospices pay $1,000 a year. Check the current schedule with DCH before you apply.
How do Georgia home care agencies serve CCSP and SOURCE clients?
By enrolling as personal support services providers in the Elderly and Disabled Waiver Program. You need a full Private Home Care Provider license, at least 12 months in business, an information session and an application filed in GAMMIS between September 1 and 30. Members are referred through care coordinators.
What training do Georgia personal care aides need?
Nurse aide certification, an approved competency exam or credentialing program, or a 40 hour agency training program run under an RN, with 20 hours before serving clients and 20 within six months. After the first year, every employee needs eight hours of training a year.
Does Georgia require a Certificate of Need for home health or hospice?
Home health, yes. A new home health agency needs Certificate of Need approval before it can apply for a license, and DCH said in September 2026 that it is not accepting new home health applications this cycle. Hospice, no: O.C.G.A. 31-7-179 says a licensed hospice needs no Certificate of Need.
Can a new home health agency or hospice enroll in Medicare right now?
Not while the federal pause lasts. On May 13, 2026, CMS began a six month nationwide moratorium on new Medicare enrollment of home health agencies and hospices, including new branches and practice locations. It is set to end around November 13, 2026, but CMS can extend it in six month increments, so it may have ended or been extended by the time you read this. Agencies already enrolled are not affected. It covers Medicare only. Each state decides whether to pause its own Medicaid enrollment, so check with Georgia Medicaid before you plan around it.
Do Georgia caregivers need fingerprint background checks?
Yes. Owners with 10% or more, administrators and direct access employees need a satisfactory fingerprint determination through the DCH Georgia Criminal History Check System (GCHEXS) before serving clients. Licensed nurses in good standing are exempt.
How much does Georgia home care consulting cost?
Lunaria charges one fixed price per engagement, based on your path: private pay, CCSP and SOURCE, or home health and Medicare. You receive the price in writing after a free 30 minute consultation. There are no hourly charges, and you own 100% of your agency with no franchise fees or royalties. We work in all 50 states and DC.
Sources checked for this guide (37)
- DCH Private Home Care Provider Application Checklist (GAHLES, RN requirement, provisional license, July 2026 file)
- DCH Private Home Care Program page
- DCH Rules 111-8-65-.03, .05 and .09, final adoption document (July 2026 file)
- DCH notice of intent and synopsis, Rules 111-8-65 amendments
- Ga. Comp. R. & Regs. 111-8-65-.10, supervision of services (Cornell LII)
- Ga. Comp. R. & Regs. 111-8-65-.09, administration and organization (Cornell LII)
- DCH HFRD Schedule of Licensure Activity Fees (October 2024)
- DCH HFRD Annual Licensing Fee Information (October 2024)
- DCH HFRD payment portal page
- DCH Home Health Agency Application Checklist (Certificate of Need, administrator qualifications, July 2026 file)
- DCH Certificate of Need batching notice for home health services, September 30, 2026
- DCH Certificate of Need batching notice for home health services, April 1, 2026
- DCH Certificate of Need fact sheet
- DCH Certificate of Need program page (HB 1339)
- Ga. Comp. R. & Regs. 111-2-2-.32, home health Certificate of Need review (Cornell LII)
- Ga. Comp. R. & Regs. 111-8-31-.03, home health Certificate of Need review (Cornell LII)
- Ga. Comp. R. & Regs. 111-8-31-.05, home health inspections (Cornell LII)
- Ga. Comp. R. & Regs. 111-8-37-.04, hospice licensure procedures (Cornell LII)
- O.C.G.A. 31-7-179, hospice Certificate of Need not required (FindLaw code copy)
- O.C.G.A. 31-7-350, Georgia long term care background check program (FindLaw code copy)
- DCH Georgia Criminal History Check System (GCHEXS)
- DCH Long Term Care Background Checks FAQ
- DCH Georgia Caregiver Portal FAQ
- Georgia Medicaid, Part II Policies and Procedures for EDWP (CCSP and SOURCE) General Services, October 2026
- Georgia Medicaid, Part II Policies and Procedures for EDWP (CCSP and SOURCE) Personal Support Services, October 2026
- GAMMIS provider manuals list
- DCH Elderly and Disabled Waiver Program fact sheet (2025)
- Georgia Medicaid waiver programs page (NOW, COMP, EDWP, ICWP)
- Georgia Medicaid Electronic Visit Verification page (HHCS revised timeline, applicable codes)
- Georgia Department of Revenue, register a new business
- Georgia Department of Labor, register a business (georgia.gov)
- CMS accreditation and approved accrediting organizations
- CMS-855A Medicare enrollment application, institutional providers
- 42 CFR Part 484, home health Conditions of Participation (Cornell LII)
- 42 CFR Part 418, hospice care (Cornell LII)
- Federal Register 2026-09717, CMS nationwide temporary moratoria on Medicare enrollment of home health agencies (published May 15, 2026)
- Federal Register 2026-09718, CMS nationwide temporary moratorium on Medicare enrollment of hospices (published May 15, 2026)
This guide is general information and reflects Georgia requirements as we understood them in November 2026. Requirements change. Confirm current rules, fees and procedures with the Georgia Department of Community Health, Georgia Medicaid 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.