How to start a home care agency in Kansas and reach your first client faster
Kansas has no separate home care license, so many owners assume a companion business needs none. It does. Since 2017 the home health agency law covers nonmedical supportive care, and no services may start before KDHE issues the license after a survey. KanCare attendant care needs a different license level with RN coverage, then KMAP enrollment and a contract with each health plan. Hospice cannot even use the name without Medicare certification. We put all of it in the right order for you.
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- All three care typesNonmedical, home health, hospice
- Written to Kansas rulesK.A.R. 28-51 home health agency regulations and KanCare health plan provider manuals
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Updated November 2026 · Reviewed by Christine Ochimas, RN, LMFT, MBA
Answer two questions. See exactly what Kansas requires.
Attendant and personal care for KanCare HCBS members
- State license
- KDHE home health agency license, Skilled Services level, which covers HCBS (K.A.R. 28-51-104 and 28-51-118)
- Who you deal with
- KDHE, KDADS (HCBS waivers and record checks), KMAP and each KanCare health plan: Healthy Blue, Sunflower and UnitedHealthcare
- Must haves
- Skilled Services license, administrator who meets the HCBS standard, RN available during all personal care hours, RN or other qualified health professional home visit every 60 days, KDADS criminal record checks, KMAP enrollment, health plan credentialing, EVV
- Realistic time to first client
- Several months
Orientation for Kansas only. We confirm your exact path on the free call.
Three places new Kansas agencies lose months
Each one keeps you paying rent, insurance and payroll while no clients arrive.
Opening a companion business without a license
The license is called a home health agency license, so owners of companion and personal care businesses assume it is for nurses. Since July 1, 2017, K.S.A. 65-5102 has required a license for any agency that provides supportive care for a fee, and K.A.R. 28-51-101 bars any services before the license is issued. KDHE issues it only after a survey inspection.
What it costs: Clients you cannot serve yet, and fines under K.S.A. 65-5102 if you start anyway.
The wrong license level for KanCare
The Non-Medical Supportive Care Services license does not include HCBS. KDHE issues HCBS under its Skilled Services license, which brings a stricter administrator standard, a registered nurse available during all personal care hours and a professional home visit every 60 days. Only then come KMAP enrollment and credentialing with each KanCare health plan.
What it costs: Months lost relicensing and rewriting policies before your first KanCare referral.
An application packet KDHE sends back
KDHE reviews each section of the packet separately through its file transfer system. Policies must carry your agency's own name and show governing body approval, the administrator and alternate must live within 200 miles of the office, and KDHE asks for up to 10 complete personnel files. A blank, generic or "see attached" item stalls the review.
What it costs: Weeks of rent and payroll while missing items go back and forth.
What does a delay cost your agency?
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Home care vs home health vs hospice in Kansas
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 | Supportive care: help with bathing, dressing, eating, medication reminders, transfers, walking and toileting, plus chore and companionship services | Nursing, physical, occupational, speech and respiratory therapy, home health aide and medical social services | Palliative and supportive care for people who are terminally ill, and their families |
| State license | KDHE home health agency license: Non-Medical Supportive Care Services, or Skilled Services for KanCare HCBS | KDHE home health agency license, Skilled Services level (K.A.R. 28-51) | No state license; Medicare certification required to use the name hospice (K.S.A. 65-6202) |
| Certificate of Need | No | No; Kansas repealed its Certificate of Need law in 1997 | No; Kansas repealed its Certificate of Need law in 1997 |
| Main payers | Private pay, some private insurance; KanCare HCBS waivers with the Skilled Services license | Medicare, KanCare health plans, commercial insurance | Medicare hospice benefit, KanCare |
| Medicare | Not covered | Accreditation or state survey, then Medicare enrollment, once the CMS moratorium ends | Accreditation or state survey, then Medicare enrollment, once the CMS moratorium ends |
| Key staff | Administrator and alternate, a manager who supervises supportive care workers; for HCBS, a registered nurse available during personal care hours | Administrator and alternate, registered nurse directing nursing and aides, certified home health aides, therapists as offered | Administrator, physician medical director, registered nurse, interdisciplinary team |
| Startup capital | Lowest | Higher: clinical payroll before Medicare revenue | Highest: interdisciplinary team before revenue |
| Time to first client | Weeks to months (private pay) to several months (KanCare HCBS) | Longest: licensure, survey, enrollment | Longest: Medicare certification before you can open |
Many Kansas owners start with a Non-Medical Supportive Care Services license, build a caregiver team and cash flow, then move to the Skilled Services license to add KanCare HCBS or skilled home health. Each license level has its own administrator standard and policies, and an agency may offer only the services listed on its application, so we plan the second step from day one instead of rewriting everything later.
Kansas requirements at a glance
| Nonmedical home care license | Required. KDHE home health agency license at the Non-Medical Supportive Care Services level (K.S.A. 65-5101 et seq.; K.A.R. 28-51-117) |
|---|---|
| License for KanCare HCBS | Skilled Services license, which covers skilled home health, HCBS and supportive care (K.A.R. 28-51-104 and 28-51-118) |
| Licensing agency | Kansas Department of Health and Environment (KDHE), Bureau of Facilities and Licensing, Health Facilities Program |
| Hospice | No state license. Only a Medicare certified hospice may call itself a hospice (K.S.A. 65-6202); a certified hospice serving only hospice patients is exempt from home health licensure (K.S.A. 65-5112) |
| Certificate of Need | None. Kansas repealed its Certificate of Need program for health facilities in 1997 (1997 H.B. 2182) |
| Medicaid | KanCare, run by KDHE with HCBS waivers administered by KDADS; enroll with KMAP and credential with Healthy Blue, Sunflower Health Plan and UnitedHealthcare Community Plan |
| Caregiver training | Competency checks before working alone and every year for supportive care and HCBS workers; home health aides must be certified nurse aides who complete a 20 hour course and pass a state test |
| Background checks | KDADS criminal record check and registry review for every worker with direct access (K.S.A. 65-5117); 60 day provisional employment while results are pending |
| Electronic visit verification | Required for HCBS and home health visits; Kansas offers its AuthentiCare EVV system at no charge or an approved third party system |
| Medicare (home health, hospice) | Accreditation or a state survey, then Medicare enrollment; new enrollment paused by a CMS moratorium from May 13, 2026 |
Summary of Kansas requirements as of November 2026. Rules change; confirm with each agency before filing.
Step by step: launching a home care agency in Kansas
The order matters. Your office, administrator, policies and first personnel files must exist before you apply, because KDHE reviews them and surveys you before any client is served. KanCare enrollment follows the license.
Form the business with the Kansas Secretary of State
File your LLC or corporation, get an EIN, register for Kansas income tax withholding with the Department of Revenue and for unemployment insurance with the Department of Labor, and keep your entity in good standing: KDHE asks for a Certificate of Good Standing at renewal.
You do this; we give you the checklistChoose your license level
Non-Medical Supportive Care Services for private pay clients, or Skilled Services if you want KanCare HCBS attendant care now or soon. Your agency may offer only the services listed on its application. Use the path finder above.
Decided on your free consultationSet up the office and leadership
K.A.R. 28-51-100 requires a parent office with a local street address and phone number, staffed during posted hours, and no post office box. Appoint an administrator and alternate who meet K.A.R. 28-51-103 and live within 200 miles of the office, and a manager to supervise caregivers.
You do this; we specify what is requiredWrite policies to K.A.R. 28-51
Bylaws, personnel, criminal record checks, abuse, neglect and exploitation reporting, client rights, admission criteria, plans of care, written assignments, supervision, medication reminders, records and the supportive care scope limits in K.A.R. 28-51-117. Add K.A.R. 28-51-118 policies for HCBS. All must be in your agency's name and approved by the governing body.
We write this for youBuild the caregiver pipeline
Request a KDADS eligibility determination for every hire, check references, collect a health history, a health assessment and a two step tuberculosis test, train on abuse, neglect and exploitation, and document competency. KDHE asks for complete personnel files with the application.
We set up the system and trackerApply to KDHE
Submit the application for your license level, pay the fee online through PayIt, then upload each required section to the KDHE file transfer system. KDHE issues the license after reviewing the packet and completing a survey inspection.
We prepare the applicationEnroll with KMAP and the KanCare health plans
For HCBS, apply through the KMAP Provider Enrollment Wizard and select Healthy Blue, Sunflower Health Plan and UnitedHealthcare Community Plan in the same application so each can credential and contract with you. KanCare plans deny payment to providers not actively enrolled with KMAP.
We prepare every plan's packetSet up electronic visit verification
EVV is required for HCBS visits and home health visits, and EVV claims go through AuthentiCare. Kansas offers its EVV application at no charge, or you can use a third party system the state has approved. Set it up before your first KanCare visit.
We walk you through setup
Caregiver competency, health screening and criminal record checks
Kansas does not set a fixed number of training hours for supportive care or HCBS workers. Instead, K.A.R. 28-51-117 and 28-51-118 require each worker to show competency before working without a supervisor present, be reevaluated every year and receive ongoing training. KDADS runs the criminal record check program under K.S.A. 65-5117.
- Supportive care workers: Competency in 10 areas, including communication with clients who have dementia or hearing loss, infection control, emergencies, client rights and safe personal care, before working alone and every year after.
- HCBS workers: Competency before providing personal care without a supervisor present, yearly reevaluation and ongoing training matched to the services provided, all documented in a training record.
- Home health aides: Must be Kansas certified nurse aides in good standing on the registry, complete a 20 hour home health aide course approved by the state and pass the state test. A trainee has one 90 day period to finish.
- Supervision: A manager or supervisor available at all times, and an on site supervisory visit for each supportive care or HCBS worker at least every three months.
- Health screening: A self reported health history, a health assessment by a physician, nurse practitioner, clinical nurse specialist, physician assistant or registered nurse, and a two step tuberculosis skin test before working with clients, then a new assessment at least every two years.
- Criminal record checks: Request a KDADS eligibility determination for each applicant. A new hire may work provisionally once, for up to 60 days, supervised by fully trained staff. If KDADS asks for fingerprints, the applicant has 20 days to submit them or the application is withdrawn.
- Disqualifying offenses: K.S.A. 65-5117 bars workers with adverse registry findings or listed convictions. Some offenses allow work after six years or a KDADS waiver, which must be requested within 30 days of the prohibition notice.
- Abuse, neglect and exploitation: Training at hire and every year, and a written reporting policy that includes the KDHE complaint hotline, 1-800-842-0078.
Six mistakes that slow Kansas agencies down
We look for every one of these in the first week of an engagement.
Starting companion care before the license arrives
- What it costs
- K.S.A. 65-5102 lets the state fine an unlicensed agency, and K.A.R. 28-51-101 bars any services before licensure.
- How we prevent it
- Your first call sets the license level and the order of steps, so you open only after the KDHE survey.
Billing KanCare on a supportive care license
- What it costs
- HCBS is not covered by the Non-Medical Supportive Care Services license, so the agency must relicense before serving waiver members.
- How we prevent it
- We match your license level to your payer plan before the application goes in.
An administrator who does not meet the standard
- What it costs
- KDHE checks degrees, experience and that the administrator and alternate live within 200 miles. A gap stops the application.
- How we prevent it
- We check both candidates against K.A.R. 28-51-103 for your license level before you appoint them.
Letting provisional employment run out
- What it costs
- A new hire can work provisionally only once and only for 60 days while KDADS results are pending.
- How we prevent it
- A tracker that flags record check results, fingerprint deadlines, competencies and supervisory visits for every caregiver.
Losing in operation status or missing renewal
- What it costs
- Renewal requires serving at least five clients in the past 12 months and one in the last three, and a license not renewed within 30 days of expiration is canceled.
- How we prevent it
- We plan your first clients and file the annual report and attestation at least 30 days before expiration.
Planning a private pay hospice
- What it costs
- Under K.S.A. 65-6202 only a Medicare certified hospice may call itself a hospice, and new Medicare enrollment is paused while the CMS moratorium lasts.
- How we prevent it
- We check the moratorium status and map the Medicare certification path before you commit capital.
In a free 30 minute call we confirm your Kansas path, flag the mistakes that apply to your plan, and give you a fixed price to handle the rest.
Kansas 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.
- Kansas path and a dated launch plan
- Policy and procedure manual written to K.A.R. 28-51 home health agency regulations and KanCare health plan provider manuals
- Service agreement, client rights and care plan forms
- Caregiver hiring and screening workflow
- Google Business Profile setup
KanCare HCBS ready agency
Everything in Private pay launch, plus the Medicaid route.
- Policies aligned to KanCare HCBS requirements
- Caregiver training and background check tracker
- Medicaid provider enrollment
- Credentialing packets for KMAP and each KanCare health plan (Healthy Blue, Sunflower Health Plan and UnitedHealthcare Community Plan)
- Survey and audit readiness
- Kansas city pages for local search
Home health and Medicare
For skilled home health. Hospice is scoped separately.
- Staffing and capital timeline
- Policies written to KDHE 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 Kansas 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 K.A.R. 28-51 home health agency regulations and KanCare health plan provider manuals |
| Medicaid credentialing | One application at a time | Varies by franchisor | Packets for KMAP and each KanCare health plan (Healthy Blue, Sunflower Health Plan and UnitedHealthcare Community Plan) 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 Kansas home care startup checklist
Every Kansas 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 level: Non-Medical Supportive Care Services or Skilled Services
- Form your LLC or corporation with the Kansas Secretary of State
- Get an EIN and register for Kansas withholding tax and unemployment insurance
- Buy workers' compensation, general and professional liability, and auto coverage
- Lease a staffed office with a local street address and phone number (no post office box)
- and 14 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 Kansas
- 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 Kansas cities or counties you plan to cover
- Where you are now: idea, business formed or already operating
- Who you expect to pay: families, KanCare HCBS, 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 Kansas
| Item | Notes |
|---|---|
| KDHE initial license fee | Under K.A.R. 28-51-101: $250 for supportive care only with fewer than 100 unique clients ($500 with 100 or more); $500 for home health services or HCBS with fewer than 100 ($750 with 100 or more). Nonrefundable, paid online through PayIt. Check current fees with KDHE. |
| KDHE annual renewal fee | $100 for supportive care only with fewer than 100 unique clients ($350 with 100 or more); $350 for home health services or HCBS with fewer than 100 ($600 with 100 or more). |
| Entity formation | Kansas Secretary of State filing fee and annual report fees |
| Criminal record checks | The employer pays the KDADS fee for each applicant; any fingerprint collection fee is paid at the collection site |
| Administrator course | Tuition for a KDHE approved home health administrator course, if a supportive care administrator qualifies that way |
| Health screening | Health assessments and two step tuberculosis tests for each worker |
| Insurance | Workers' compensation, liability, auto coverage |
| EVV and scheduling software | The state AuthentiCare application is free; a third party system is paid by the agency |
| Accreditation (home health, hospice) | Accrediting organization application and survey fees |
| Operating reserve | Covers rent, payroll and insurance through KDHE review, KanCare credentialing or Medicare enrollment |
Fees change. Confirm current amounts with each agency before budgeting.
How long it takes in Kansas
Weeks to months: office, administrator, policies and screened staff first, then KDHE review and survey before the first client.
Several months: Skilled Services licensure, then KMAP enrollment and credentialing with each KanCare health plan.
Longest: KDHE licensure for home health, certification survey and Medicare enrollment once the CMS moratorium allows it. Hospice needs Medicare certification before it can open.
Kansas demand is concentrated in the Kansas City suburbs of Johnson and Wyandotte counties, in Wichita and Sedgwick County, and around Topeka, Lawrence and Manhattan, where agencies compete on reliability and referral relationships. Western and rural Kansas covers long distances, and a license lets you serve only within 200 miles of your parent office, so where you put that office shapes your whole service area. Many families search for care for a parent from out of state, so a complete Google Business Profile and a clear page for each city you serve matter.
Frequently asked questions
Do you need a license to start a nonmedical home care agency in Kansas?
Yes. Any agency that provides supportive care services for a fee must hold a KDHE home health agency license, at the Non-Medical Supportive Care Services level, under K.S.A. 65-5101 et seq. and K.A.R. 28-51. Services may not start until KDHE issues the license after a survey inspection.
Which license do I need to serve KanCare HCBS members?
The Skilled Services license, which KDHE says covers skilled home health, HCBS waiver services and supportive care. HCBS agencies must keep a registered nurse available during personal care hours and have a qualified professional visit each personal care client every 60 days. You then enroll with KMAP and credential with Healthy Blue, Sunflower Health Plan and UnitedHealthcare Community Plan.
How much is the Kansas home health agency license fee?
K.A.R. 28-51-101 sets initial fees from $250 (supportive care only, fewer than 100 clients) to $750 (home health or HCBS, 100 or more), and renewal fees from $100 to $600. Fees are paid online through PayIt. Check the current amount with KDHE before you file.
Does Kansas license hospices?
No. Kansas has no state hospice license, but K.S.A. 65-6202 allows only a Medicare certified hospice to call itself a hospice or licensed hospice. A certified hospice that serves only hospice patients is exempt from home health agency licensure under K.S.A. 65-5112.
Does Kansas require a Certificate of Need for home health or hospice?
No. Kansas repealed its Certificate of Need program for health facilities in 1997 (House Bill 2182). Home health still needs KDHE licensure, and both home health and hospice need Medicare certification to bill Medicare.
What training do Kansas caregivers need?
Supportive care and HCBS workers need documented competency before working without a supervisor present, yearly reevaluation and ongoing training, but no set number of hours. Home health aides must be certified nurse aides on the Kansas registry who complete a 20 hour home health aide course and pass the state test.
How do criminal record checks work for Kansas home care agencies?
The agency requests an eligibility determination from KDADS under K.S.A. 65-5117 and pays the fee. A new hire may work provisionally once, for up to 60 days, while results are pending. Workers with adverse registry findings or listed convictions cannot work, though some offenses allow a waiver request.
Can a new home health agency or hospice enroll in Medicare right now?
CMS put a nationwide six month moratorium on new Medicare enrollment of home health agencies and hospices starting May 13, 2026. It can be extended in six month steps, so it may have ended or been extended by the time you read this. Check its current status with CMS before you plan Medicare revenue.
How much does Kansas home care consulting cost?
Lunaria charges one fixed price per engagement, based on your path: private pay, KanCare HCBS or home health and Medicare. You receive the price in writing after a free 30 minute consultation. There are no hourly charges.
Do you only work in Kansas?
No. Lunaria works with owners in all 50 states and DC, so you can add the Missouri side of the Kansas City metro or another state with the same team.
Sources checked for this guide (36)
- K.S.A. 65-5101, home health agency definitions (amended L. 2025, ch. 85)
- K.S.A. 65-5102, license required; temporary license; fines
- K.S.A. 65-5103, application and fee
- K.S.A. 65-5104, license issuance after survey, annual report, cancellation, bordering states
- K.S.A. 65-5112, exemptions including Medicare certified hospices
- K.S.A. 65-5115, home health aide course and examination
- K.S.A. 65-5117, criminal record checks for home health agencies
- K.S.A. 65-6202, only Medicare certified hospices may hold out as hospice
- 1997 Session Laws of Kansas, ch. 16 (H.B. 2182), repeal of the certificate of need program
- KDHE Non-Medical Supportive Care Services (license, application, renewal, PayIt, record checks)
- KDHE Skilled Services (license scope including HCBS, application, renewal)
- KDHE Non-Medical HHA Application Submission Requirements and Instruction Guide (rev. 03/2024)
- KDHE 2025 Home Health Agency Regulations Summary of Changes Guide (draft, September 8, 2025)
- K.A.R. 28-51 article list (Cornell LII)
- K.A.R. 28-51-100, definitions: parent office, service area, in operation (Cornell LII)
- K.A.R. 28-51-101, licensing procedure and fees (Cornell LII)
- K.A.R. 28-51-103, organization, administrator qualifications, personnel records (Cornell LII)
- K.A.R. 28-51-104, home health services, HCBS and supportive care services (Cornell LII)
- K.A.R. 28-51-113, home health aide qualifications (Cornell LII)
- K.A.R. 28-51-117, supportive care services (Cornell LII)
- K.A.R. 28-51-118, HCBS (Cornell LII)
- KDHE news, KanCare MCO contracts January 1, 2025 to December 31, 2027 (May 14, 2024)
- KanCare Become a Provider (KMAP enrollment, MCO selection), Internet Archive copy April 2025
- KanCare Electronic Visit Verification, Internet Archive copy July 2026
- KDADS Frail Elderly waiver page, Internet Archive copy July 2026
- Kansas Register Vol. 45, No. 3 (January 15, 2026), KDADS Frail Elderly waiver amendment request for comments
- Kansas Secretary of State, business filings
- Kansas Business Center, employer requirements (withholding, unemployment, workers' compensation)
- CMS Provider Enrollment Moratoria (last modified 08/27/2026)
- CMS Home Health and Hospice Nationwide Moratorium Q&As (revised 7/09/26)
- Federal Register 2026-09717, nationwide moratorium on Medicare enrollment of HHAs (effective May 13, 2026)
- Federal Register 2026-09718, nationwide moratorium on Medicare enrollment of hospices
- CMS accreditation and approved accrediting organizations
- 42 CFR Part 484, home health Conditions of Participation (Cornell LII)
- 42 CFR Part 418, hospice care (Cornell LII)
- HPPR, Kansas waitlist coverage, August 27, 2026 (secondary, pointer only)
This guide is general information and reflects Kansas requirements as we understood them in November 2026. Requirements change. Confirm current rules, fees and procedures with the Kansas Department of Health and Environment, the Kansas Department for Aging and Disability Services, KanCare 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.