How to start a home care agency in Illinois and reach your first client faster
Illinois licenses nonmedical home care, and it calls it home services. New owners lose months by applying for the wrong one of five license types, sending caregivers out before their first five hours of training and competency test, or building a plan around Community Care Program referrals that Illinois rules do not allow in year one. Home health and hospice add separate IDPH licenses and Medicare on top. 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 Illinois rules77 Ill. Adm. Code 245 and, for CCP, 89 Ill. Adm. Code 240
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Updated November 2026 · Reviewed by Christine Ochimas, RN, LMFT, MBA
Answer two questions. See exactly what Illinois requires.
Nonmedical home care for Community Care Program participants
- State license
- IDPH home services agency license, then Department on Aging certification as a CCP In-home Service provider (89 Ill. Adm. Code 240)
- Who you deal with
- Illinois Department on Aging, Illinois Department of Healthcare and Family Services, HealthChoice Illinois health plans
- Must haves
- Three years running a home care business (one in Illinois), assets covering 90 days of operating expenses, five independent references, an office in each area served, 24 hour homecare aide training, EVV
- Realistic time to first client
- Longest path: years of operating history first
Orientation for Illinois only. We confirm your exact path on the free call.
Three places new Illinois agencies lose months
Each one keeps you paying rent, insurance and payroll while no clients arrive.
Five license types and one right answer
The Illinois Act covers home health, home services, home nursing and two kinds of placement agency. A home services agency employs and supervises its workers; a home services placement agency places workers with consumers. Each has its own fee, training rules and paperwork, and owners who pick the wrong one start over.
What it costs: Months lost and a second application fee, because IDPH fees are not refundable.
The Community Care Program is not a year one plan
Department on Aging rules say a new CCP In-home Service provider needs at least three years of business operations providing home care services, one of them in Illinois. It must also show assets covering 90 days of operating expenses and keep an office in each area it serves. Owners who budget for CCP referrals from opening day run out of cash.
What it costs: A business plan built on clients you cannot serve yet, and years of private pay growth you did not plan for.
Caregivers who cannot take an assignment
Under 77 Ill. Adm. Code 245.71, each home services worker needs five hours of training and a passed competency evaluation before the first assignment, then five more hours within 30 days. Fingerprint checks through the Health Care Worker Registry run alongside. Agencies that hire first and train later have clients waiting and nobody cleared to send.
What it costs: Lost first clients and caregivers who take another offer while they wait.
What does a delay cost your agency?
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Home care vs home health vs hospice in Illinois
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, meals, housekeeping, companionship, medication reminders, errands | Skilled nursing plus at least one other home health service, such as therapy or aide services | Palliative and supportive care for people who are terminally ill, and their families |
| State license | IDPH home services agency license (210 ILCS 55; 77 Ill. Adm. Code 245) | IDPH home health agency license (210 ILCS 55; 77 Ill. Adm. Code 245) | IDPH hospice program license (210 ILCS 60; 77 Ill. Adm. Code 280) |
| Certificate of Need | No | No Certificate of Need step | No Certificate of Need step |
| Main payers | Private pay first; Community Care Program and health plans after the required operating history | Medicare, Illinois Medicaid and HealthChoice Illinois plans, commercial insurance | Medicare hospice benefit, Illinois Medicaid |
| Medicare | Not covered | Accreditation or state survey, then Medicare enrollment | Accreditation or state survey, then Medicare enrollment |
| Key staff | Agency manager, a supervisor available to workers at all times, trained home services workers | Administrator, RN who supervises home health aides, clinical staff, registry approved aides | Administrator, medical director, RN, interdisciplinary team |
| Startup capital | Lowest | Higher: clinical payroll before Medicare revenue | Highest: interdisciplinary team before revenue |
| Time to first client | A few months for the license; years before CCP | Longest: licensure, survey, enrollment | Longest: licensure, survey, enrollment |
Many Illinois owners start with a home services agency, build private pay revenue and a trained caregiver team, and use those years of operation to qualify for the Community Care Program. One entity can hold more than one IDPH license type, but each license needs its own application and fee, and an agency that both employs and places workers must run each as a separate entity. We plan the whole path from day one so your policies and hiring grow with you instead of being rewritten.
Illinois requirements at a glance
| Nonmedical home care license | Home services agency license from the Illinois Department of Public Health (IDPH). A home services placement agency license applies if you only place workers with consumers. |
|---|---|
| Governing law | Home Health, Home Services, and Home Nursing Agency Licensing Act (210 ILCS 55) and 77 Ill. Adm. Code 245 |
| Home health and hospice | IDPH home health agency license under the same Act (two year license); hospice program license under the Hospice Program Licensing Act (210 ILCS 60) and 77 Ill. Adm. Code 280 |
| Certificate of Need | None for home health or hospice. The Health Facilities Planning Act (20 ILCS 3960) does not list them. |
| Caregiver training | 10 hours for new home services workers (5 before the first assignment, 5 within 30 days) with competency evaluations, then 10 hours every year |
| Background screening | Fingerprint based checks under the Health Care Worker Background Check Act (225 ILCS 46), recorded on the IDPH Health Care Worker Registry |
| Medicaid home care | Department on Aging Community Care Program (89 Ill. Adm. Code 240), which requires three years of home care business experience |
| Electronic visit verification | Required for CCP home care services; HHAeXchange is the state aggregator and its portal is the no cost option |
| Insurance | Certificate showing liability coverage of at least $1 million per occurrence and $3 million aggregate, filed with the license application |
| Medicare (home health, hospice) | Accreditation by a CMS approved organization or a state survey, then Medicare enrollment |
Summary of Illinois requirements as of November 2026. Rules change; confirm with each agency before filing.
Step by step: launching a home care agency in Illinois
The order matters. The license application needs your policies, insurance certificate and Health Care Worker Registry access in place, and every caregiver needs a cleared check and five hours of training before the first visit, so steps 3 to 5 start well before step 6.
Form the business with the Illinois Secretary of State
File your LLC or corporation, get an EIN, register for state payroll withholding and unemployment insurance, and check your city's business license rules.
You do this; we give you the checklistChoose your license type and payer mix
Most owners need the home services agency license, because they employ and supervise caregivers. Plan for private pay first: the Community Care Program requires three years of home care business experience. Use the path finder above.
Decided on your free consultationSet up insurance and employment basics
The IDPH application needs a certificate showing at least $1 million per occurrence and $3 million aggregate liability coverage. Add workers' compensation and auto coverage, and build paid leave into payroll: the Paid Leave for All Workers Act gives one hour for every 40 hours worked, unless a local paid leave ordinance covers you instead.
You do this; we specify what is requiredWrite policies to 77 Ill. Adm. Code 245
The application must include policies on complaints, employee health and safety, infection control, background checks, supervisory visits, records and training, plus your client contract and service plan forms and a list of tasks your workers may not do.
We write this for youRegister for the IDPH systems
Register on the IDPH web portal and get Health Care Worker Registry access. The application asks for proof of both, and you use the Registry for every hire.
We walk you through setupApply for the IDPH home services agency license
Submit the application with ownership, services, service area, charges, staff and policies, and pay the fee. IDPH issues a provisional license within 90 days of a complete application, valid for 240 days, and inspects the agency in the 30 days before it ends.
We prepare the applicationBuild the caregiver pipeline
Check the Health Care Worker Registry, start fingerprint checks after a conditional offer, deliver five hours of training and a competency evaluation before the first assignment, five more hours within 30 days, and 10 hours every year. Plan an on site supervisory visit at least every 90 days.
We set up the system and trackerPlan your route into Medicaid
Once you have three years of home care business experience, one in Illinois, apply to the Department on Aging for CCP certification. Expect a financial review, references, management training and an HHAeXchange EVV setup before your first CCP participant.
We prepare and manage it
Home services worker training and background checks
77 Ill. Adm. Code 245.71 sets the training rules for home services workers, last amended in March 2025. Training covers personal care, dementia, infection control, emergencies, confidentiality, and abuse and neglect, and a worker cannot take an assignment until they pass a competency evaluation.
- Initial training: At least 10 hours for a home services agency worker: five hours before the first assignment and five more within the first 30 days of employment, with a competency evaluation after each part.
- Prior training: You may accept proof of training completed at another licensed home services agency within the past 365 days, or a CNA approved on the Health Care Worker Registry. A competency evaluation is still required before the first assignment.
- Annual training: At least 10 hours every year, including client rights, disaster procedures, infection control, abuse and neglect, and help with daily living tasks. The first year's initial training counts.
- Supervision: A supervisor must be available to workers at all times. Each client gets an on site supervisory visit at least every 90 days, and each worker an on site visit every year.
- Fingerprint checks: Under the Health Care Worker Background Check Act, check the Registry first. If the person has no prior check, start a fingerprint based check through a livescan vendor after a conditional offer. You may employ them for up to three months while results are pending, with adequate supervision.
- Disqualifying offenses: A worker with a disqualifying conviction cannot work until IDPH grants a waiver. Some offenses can be cleared only through an appeal.
- Registry upkeep: Record each hire and separation on the Registry within 30 days and update every employee's record at least once a year.
- Community Care Program aides: CCP adds its own rules: 24 hours of training before working alone with a participant, two hours of dementia training, 12 hours of training every year, and Adult Protective Services registry and exclusion list checks.
Six mistakes that slow Illinois agencies down
We look for every one of these in the first week of an engagement.
Applying for a placement agency license when you will employ caregivers
- What it costs
- The wrong license, a second application and a second nonrefundable fee.
- How we prevent it
- Your first call ends with your exact Illinois license type and the order to do it in.
Counting on Community Care Program clients in year one
- What it costs
- CCP certification requires three years of home care business experience, so a plan built on CCP referrals stalls.
- How we prevent it
- We plan a private pay launch and map the years and records you need for CCP later.
Sending caregivers out before training and competency
- What it costs
- A worker without five hours of training and a passed competency evaluation cannot take an assignment, and the gap shows up at inspection.
- How we prevent it
- A tracker that flags training hours, competency evaluations and the 30 day deadline for every hire.
Filing without the insurance certificate
- What it costs
- An incomplete application can be denied, and the 90 day clock for a provisional license only starts on a complete one.
- How we prevent it
- We specify the coverage before you buy it and assemble a complete application.
Skipping the Health Care Worker Registry
- What it costs
- Hiring someone with a disqualifying offense, or missing the 30 day hire and separation entries, is a licensing violation.
- How we prevent it
- Registry checks, fingerprinting and annual verification built into your hiring checklist.
Missing the renewal window
- What it costs
- Renewals are due 60 to 90 days before the license expires, and late filing can bring a fine.
- How we prevent it
- We calendar renewals, supervisory visits and annual training from the day your license is issued.
In a free 30 minute call we confirm your Illinois path, flag the mistakes that apply to your plan, and give you a fixed price to handle the rest.
Illinois 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.
- Illinois path and a dated launch plan
- Policy and procedure manual written to 77 Ill. Adm. Code 245 and, for CCP, 89 Ill. Adm. Code 240
- Service agreement, client rights and care plan forms
- Caregiver hiring and screening workflow
- Google Business Profile setup
Community Care Program ready agency
Everything in Private pay launch, plus the Medicaid route.
- Policies aligned to Community Care Program requirements
- Caregiver training and background check tracker
- Medicaid provider enrollment
- Credentialing packets for the Illinois Department on Aging and HealthChoice Illinois health plans
- Survey and audit readiness
- Illinois city pages for local search
Home health and Medicare
For skilled home health. Hospice is scoped separately.
- Staffing and capital timeline
- Policies written to IDPH 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 Illinois 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 77 Ill. Adm. Code 245 and, for CCP, 89 Ill. Adm. Code 240 |
| Medicaid credentialing | One application at a time | Varies by franchisor | Packets for the Illinois Department on Aging and HealthChoice Illinois health plans 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 Illinois home care startup checklist
Every Illinois 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 type (home services agency or placement agency) and payer mix
- Form your LLC or corporation with the Illinois Secretary of State
- Get an EIN and register for state payroll withholding and unemployment insurance
- Check your city or county business license rules
- Buy liability coverage of at least $1 million per occurrence and $3 million aggregate, plus workers' compensation and auto
- and 13 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 Illinois
- 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 Illinois cities or counties you plan to cover
- Where you are now: idea, business formed or already operating
- Who you expect to pay: families, Community Care Program, 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 Illinois
| Item | Notes |
|---|---|
| IDPH license | 77 Ill. Adm. Code 245.95 caps the home services agency fee at $1,500 a year and the placement agency fee at $500 a year. A home health agency pays $1,500 for a two year license. Fees are not refundable. Check the current amount with IDPH. |
| Entity formation and city license | Illinois Secretary of State filing fee plus any municipal license |
| Liability insurance | Required at application: at least $1 million per occurrence and $3 million aggregate. Add workers' compensation and auto coverage. |
| Fingerprint checks | Illinois State Police processing fee plus the livescan vendor's charge for each worker without a current check |
| Caregiver training | Trainer time and materials for 10 initial and 10 annual hours per worker |
| Paid leave | A real labor cost under the Paid Leave for All Workers Act or your local ordinance |
| Scheduling and EVV software | Needed for CCP visits later; the HHAeXchange portal is offered at no cost for CCP |
| Accreditation (home health, hospice) | Accrediting organization application and survey fees |
| Operating reserve | Covers payroll, rent and insurance until private pay revenue builds; CCP later asks for 90 days of operating expenses in assets |
Fees change. Confirm current amounts with each agency before budgeting.
How long it takes in Illinois
A few months: IDPH issues a provisional license within 90 days of a complete application, and hiring and training can run at the same time.
Years: CCP certification requires three years of home care business experience, one in Illinois, before the application and management training.
Longest: IDPH licensure and inspection, a certification survey and Medicare enrollment.
Most Illinois demand sits in Chicago, suburban Cook County and the collar counties, where families compare many agencies and search by suburb and neighborhood. The Community Care Program is organized by county outside Cook, by township in suburban Cook and by subareas within Chicago, so the areas you choose now shape where you can serve CCP participants later. Downstate cities such as Springfield, Peoria, Rockford and Champaign, and rural southern and central counties, have fewer agencies spread over longer drives, which makes reliable staffing your selling point. Many families search for care for a parent from another city or state, so 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 Illinois?
Yes. Agencies that employ workers to provide home services need a home services agency license from the Illinois Department of Public Health under 210 ILCS 55 and 77 Ill. Adm. Code 245. Agencies that only place workers with consumers need a home services placement agency license.
What is the difference between a home services agency and a placement agency?
A home services agency employs, trains and supervises its workers. A placement agency places workers with consumers. Each is a separate IDPH license with its own fee and training rules, and an agency holding both must run each as a separate entity.
Who licenses home health and hospice agencies in Illinois?
The Illinois Department of Public Health. Home health agencies are licensed under 210 ILCS 55 and 77 Ill. Adm. Code 245, with a $1,500 two year license. Hospices are licensed under the Hospice Program Licensing Act (210 ILCS 60) and 77 Ill. Adm. Code 280.
Does Illinois require a Certificate of Need for home health or hospice?
No. The Illinois Health Facilities Planning Act covers hospitals, nursing homes, surgery centers, dialysis centers and some equipment and services, but not home health agencies or hospices. Licensure, survey and Medicare enrollment still apply.
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 HFS before you plan around it.
How much training do Illinois home services workers need?
At least 10 hours when hired: five hours before the first assignment and five more within 30 days, with a competency evaluation after each part. After that, at least 10 hours every year. Placement agency workers need at least eight hours before their first assignment.
How do background checks work for Illinois caregivers?
Under the Health Care Worker Background Check Act, you check the Health Care Worker Registry first. If the person has no current check, you start a fingerprint based check through a livescan vendor after a conditional offer. A worker with a disqualifying offense cannot work until IDPH grants a waiver.
Can a new agency serve Community Care Program clients?
Not right away. Department on Aging rules require a new CCP In-home Service provider to have at least three years of business operations providing home care services, one in Illinois, plus assets covering 90 days of operating expenses, five independent references and an office in each area served.
Is a franchise a better way to start a home care agency in Illinois?
A franchise gives you a brand and playbook in exchange for fees and ongoing royalties. IDPH still requires a separate license for each franchise business. Starting independently with Lunaria costs one fixed price, and you own 100% of your agency with no franchise fees or royalties.
How much does Illinois home care consulting cost?
Lunaria charges one fixed price per engagement, based on your path: private pay, the Community Care Program or home health and Medicare. You receive the price in writing after a free 30 minute consultation. There are no hourly charges. We work in all 50 states and DC.
Sources checked for this guide (34)
- 77 Ill. Adm. Code 245.71, home services worker training (Cornell LII, amended 3/25/2025)
- 77 Ill. Adm. Code 245.95, license fees (Cornell LII, amended 8/5/2024)
- 77 Ill. Adm. Code 245.90, license application (Cornell LII)
- 77 Ill. Adm. Code 245.100, provisional license (Cornell LII)
- 77 Ill. Adm. Code 245.80, licensure required (Cornell LII)
- 77 Ill. Adm. Code 245.40, staffing and supervision (Cornell LII)
- 77 Ill. Adm. Code 245.70, home health aide requirements (Cornell LII)
- 77 Ill. Adm. Code 245.72, Health Care Worker Background Check (Cornell LII)
- 77 Ill. Adm. Code Part 955, Health Care Worker Background Check Code (Cornell LII)
- 77 Ill. Adm. Code 955.165, fingerprint based checks (Cornell LII, amended 5/22/2025)
- 77 Ill. Adm. Code 955.145, employment verification on the Registry (Cornell LII)
- 77 Ill. Adm. Code 280.1015, hospice licensure applicability (Cornell LII)
- 89 Ill. Adm. Code 240.1505, CCP provider certification requirements (Cornell LII, amended 7/16/2024)
- 89 Ill. Adm. Code 240.1525, CCP in-home service provider standards (Cornell LII)
- 89 Ill. Adm. Code 240.1530, CCP in-home staffing and EVV (Cornell LII)
- 89 Ill. Adm. Code 240.1510, CCP personnel and background checks (Cornell LII)
- 89 Ill. Adm. Code 240.1535, CCP homecare aide training (Cornell LII)
- 89 Ill. Adm. Code 686.200, DHS Home Services Program homemaker providers (Cornell LII)
- IDoA letter to CCP in-home providers on HHAeXchange EVV, October 29, 2025
- HHAeXchange Illinois DoA and DRS info hub (go live March 2, 2026)
- 210 ILCS 55/4, home health license fee and term (FindLaw, current as of 1/1/2025)
- 210 ILCS 55/2.08, home services agency definition (FindLaw)
- 210 ILCS 55/2.04, home health agency definition (FindLaw)
- 210 ILCS 55/6.3, home services agency fees set by rule (FindLaw)
- 20 ILCS 3960/3, Health Facilities Planning Act definitions (FindLaw)
- 820 ILCS 192/15, Paid Leave for All Workers Act (FindLaw)
- 805 ILCS 180/5-1, LLC articles of organization filed with the Secretary of State (FindLaw)
- 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)
- Blue Cross and Blue Shield of Illinois news release, June 15, 2026 (HealthChoice Illinois award; secondary, pointer only)
This guide is general information and reflects Illinois requirements as we understood them in November 2026. Requirements change. Confirm current rules, fees and procedures with the Illinois Department of Public Health, the Illinois Department on Aging, the Illinois Department of Healthcare and Family Services 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.