How to start a home care agency in Maine and reach your first client faster
Maine replaced personal care agency registration with a real license in 2024, and older guides still describe the registration rules. The Division of Licensing and Certification says it is running months behind on processing and inspections, it requires a physical office site in Maine, and every caregiver needs an MBCC background check and a PSS training clock that starts at hire. MaineCare enrollment is a separate step after that. 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
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- Christine OchimasRN, LMFT, MBA
- All three care typesNonmedical, home health, hospice
- Written to Maine rules10-144 CMR Chapter 129 and MaineCare Benefits Manual Sections 19 and 96
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Updated November 2026 · Reviewed by Christine Ochimas, RN, LMFT, MBA
Answer two questions. See exactly what Maine requires.
Nonmedical home care for MaineCare members
- State license
- Personal Care Agency license (22 M.R.S. § 1717; 10-144 CMR Chapter 129), then MaineCare enrollment
- Who you deal with
- DHHS Division of Licensing and Certification, Office of MaineCare Services, Office of Aging and Disability Services
- Must haves
- Personal Care Agency license, MaineCare provider enrollment, Section 19 and Section 96 provider rules, PSS training of at least 50 hours, MBCC checks, supervisory visits, electronic visit verification
- Realistic time to first client
- Several months or more
Orientation for Maine only. We confirm your exact path on the free call.
Three places new Maine agencies lose months
Each one keeps you paying rent, insurance and payroll while no clients arrive.
A licensing office running months behind
The Division of Licensing and Certification posts that it is running 6 to 9 months behind its typical processing and inspection timelines because the number of personal care agencies grew quickly. The rule gives DLC 90 working days to decide on a complete application, and an application still incomplete 60 calendar days after DLC receives it becomes void.
What it costs: Months of rent and insurance before your first client, and a fresh start if a missing document voids the application.
The Maine office site rule
Chapter 129 requires a physical site in Maine: a nonresidential building zoned for business, or a separate and distinct room in a home with confidential space and locked record storage. DLC guidance from August 2025 says virtual sites and sites shared with another agency do not qualify. A 2025 bill to drop the site rule died in the Legislature.
What it costs: A rejected or delayed application for owners who planned to run a Maine agency from out of state or from a shared office.
The PSS training clock starts at hire
Every caregiver who gives hands on personal care must be an active CNA, have finished Personal Support Specialist training or another approved program, or enroll within 60 calendar days of hire and finish within nine months. New workers also need an on site supervisory visit at least every 30 days during their first three months.
What it costs: Caregivers who must stop personal care if the nine month deadline passes, and survey findings for missed visits.
What does a delay cost your agency?
Enter your own numbers. Nothing is stored or sent.
Home care vs home health vs hospice in Maine
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 | Help with activities of daily living such as bathing, dressing and transfers, plus meals, shopping, light housework and communication | Skilled nursing and other therapeutic services in the client's home | Palliative and supportive care for people who are terminally ill, and their families |
| State license | Personal Care Agency license (22 M.R.S. § 1717; 10-144 CMR Chapter 129) | Home health care provider license (22 M.R.S. Chapter 419; 10-144 CMR Chapter 119) | Hospice program license (22 M.R.S. Chapter 1681; 10-144 CMR Chapter 120) |
| Certificate of Need | No | No Certificate of Need step | No Certificate of Need step |
| Main payers | Private pay, MaineCare Section 19 waiver and Section 96 personal care, state funded OADS programs | Medicare, MaineCare Section 40 and Section 19, commercial insurance | Medicare hospice benefit, MaineCare Section 43 |
| Medicare | Not covered | Accreditation or state survey, then Medicare enrollment. A CMS moratorium on new enrollment took effect May 13, 2026. | Required for a Maine hospice license. A CMS moratorium on new enrollment took effect May 13, 2026. |
| Key staff | Administrator, qualified supervisor (RN, LPN, CNA or experienced PSS), PSS trained caregivers | Administrator with home health experience, Director of Nursing, RNs, CNAs and home health aides | Administrator, physician medical director, registered nurse, interdisciplinary team |
| Startup capital | Lowest, but plan for a long licensing wait | Higher: clinical payroll before Medicare revenue | Highest: interdisciplinary team before revenue |
| Time to first client | Several months (private pay) to longer (MaineCare) | Longest: licensure, survey, enrollment | Longest: Medicare certification comes before the state license |
Most Maine owners start with a Personal Care Agency, build a caregiver team and cash flow, then decide on home health. Hospice is different in Maine: the law makes Medicare certification a condition of a hospice license, except for volunteer hospices, so the CMS enrollment moratorium affects the whole hospice path. We plan your path from day one so your policies and hiring grow with you instead of being rewritten.
Maine requirements at a glance
| Nonmedical home care license | Personal Care Agency license, required since July 1, 2024 (22 M.R.S. § 1717; 10-144 CMR Chapter 129, adopted August 20, 2024) |
|---|---|
| Licensing agency | Maine Department of Health and Human Services (DHHS), Division of Licensing and Certification (DLC) |
| License types | Provisional (3 to 12 months) for new agencies, full (two years), conditional (up to one year) for enforcement |
| Office site | A physical site in Maine: a nonresidential building zoned for business, or a separate room in a home with confidential space and locked record storage |
| Home health and hospice | Licensed by DHHS DLC under 22 M.R.S. Chapter 419 and 10-144 CMR Chapter 119 (home health) and 22 M.R.S. Chapter 1681 and 10-144 CMR Chapter 120 (hospice) |
| Caregiver training | Active CNA, or Personal Support Specialist (PSS) training of at least 50 hours, started within 60 days of hire and finished within nine months |
| Background screening | Maine Background Check Center (MBCC) checks for all employees, owners and administrators, including the Maine Registry of Certified Nursing Assistants and Direct Care Workers |
| Medicaid program | MaineCare, run by the Office of MaineCare Services; Section 19 waiver and Section 96 personal care, with assessments by Maximus as the Assessing Services Agency |
| Electronic visit verification | Required by MaineCare for personal care services and for Section 40 home health visits; a state EVV system or a connected third party system |
| Entity filing | Maine Secretary of State |
Summary of Maine requirements as of November 2026. Rules change; confirm with each agency before filing.
Step by step: launching a home care agency in Maine
The order matters. Insurance, the Maine site and owner criminal checks must be ready before you apply, because an application that stays incomplete for 60 days becomes void and DLC is already running months behind.
Form the business with the Maine Secretary of State
File your LLC or corporation, get an EIN, register for Maine income tax withholding with Maine Revenue Services and for unemployment insurance with the Maine Department of Labor, and register on the Maine Paid Leave Portal for paid family and medical leave contributions.
You do this; we give you the checklistDecide your payer mix
Private pay, MaineCare or both. MaineCare enrollment comes after the license, so many agencies open with private pay clients while they enroll. Use the path finder above.
Decided on your free consultationSecure your Maine site and insurance
Lease a nonresidential space zoned for business, or set up a separate, lockable room in a home that no one else uses. Set up a dedicated phone line and email, posted office hours, and general and professional liability insurance, because the application asks for proof of coverage.
You do this; we specify what is requiredWrite policies to Chapter 129
Adopt policies for client contracts, service plans, agency expectations given to each client, grievances answered in writing within seven days, abuse and neglect reporting, supervision, annual training, a data driven quality improvement plan and records kept at least five years.
We write this for youApply for the Personal Care Agency license
Apply online through the DLC Personal Care Agency application with the $500 fee, your payer sources, proof of insurance, administrator details and State Bureau of Identification criminal checks for all owners run no more than 30 days before you submit. New agencies receive a provisional license.
We prepare the applicationBuild the caregiver pipeline
Run MBCC background checks on every employee, owner and administrator, check the CNA and Direct Care Worker registry and protective services findings, and enroll each non CNA caregiver in PSS training within 60 days of hire. Schedule supervisory visits every 30 days for each new worker's first three months.
We set up the system and trackerEnroll with MaineCare
Get an NPI, then enroll through the MaineCare provider enrollment application, which moved to the new MaineCare Partner Portal in October 2026. Meet the Section 19 and Section 96 provider rules, including PSS training, orientation and supervisory visit schedules.
We prepare and manage itSet up electronic visit verification
MaineCare requires EVV for personal care services. Use the state EVV system or a third party system connected to MaineCare; MaineCare says connecting a third party system takes at least eight weeks.
We walk you through setupGet ready for the DLC survey
A provisional license lasts 3 to 12 months. DLC surveys agencies as they reach the end of provisional licensure, and a full license of up to two years depends on showing you meet every part of Chapter 129.
We get you ready for the survey
PSS training, supervision and background checks
10-144 CMR Chapter 129 sets the staffing rules for every licensed personal care agency, whoever pays. MaineCare Sections 19 and 96 add their own training, orientation and supervision rules for agencies that serve MaineCare members.
- Who may give personal care: An active CNA on the Maine registry, a worker who has finished Personal Support Specialist (PSS) training or another approved personal care program, or a worker who enrolls within 60 calendar days of hire and finishes within nine months.
- PSS course length: MaineCare rules require an approved PSS course of at least 50 hours, covering personal care procedures, first aid, emergencies and mandatory reporting.
- When PSS training is not needed: Workers whose duties are limited to meals, managing money, shopping, light housework and communication do not need PSS training. Any help with bathing, dressing, toileting or transfers does.
- MaineCare orientation: Under Section 96, a PSS who has not yet finished training needs an eight hour orientation before delivering services; job shadowing can count for up to two hours.
- Background checks: All employees, owners and administrators must be cleared through the Maine Background Check Center, which includes the Maine Registry of Certified Nursing Assistants and Direct Care Workers. You must also confirm there are no substantiated Adult or Child Protective Services findings.
- Owner checks at application: The license application needs a State Bureau of Identification criminal check for every owner, completed no more than 30 calendar days before you submit.
- Qualified supervisor: An LPN or RN, a CNA, someone with the approved personal care course and a year of experience, or someone with five years of related education or experience.
- Supervision: An on site visit at least every 30 days during each new worker's first three months, while they give care, plus an annual performance review. Section 96 adds a home visit before services start and quarterly or six monthly visits by level of care.
- Annual training: Every employee, every year: mandated reporting, abuse and neglect policy, grievances, agency expectations, infection control, emergencies and confidentiality.
Six mistakes that slow Maine agencies down
We look for every one of these in the first week of an engagement.
Following the old registration rules
- What it costs
- An agency built on outdated guidance that does not meet Chapter 129 when DLC surveys at the end of the provisional license.
- How we prevent it
- Your first call ends with your exact Maine path, written to the 2024 rule.
Planning a virtual or shared office
- What it costs
- DLC guidance says virtual sites, shared sites and rooms open to common access do not meet the Maine site rule.
- How we prevent it
- We check your site against the rule and DLC's August 2025 guidance before you sign a lease.
Submitting an incomplete application
- What it costs
- An application still incomplete after 60 days becomes void, and owner criminal checks older than 30 days must be redone.
- How we prevent it
- We assemble every document, insurance proof and owner check so the application is complete on day one.
Missing the PSS deadlines
- What it costs
- A caregiver not enrolled within 60 days or not finished within nine months cannot keep giving personal care.
- How we prevent it
- A tracker that flags PSS enrollment, completion, MBCC checks and annual training for every caregiver.
Skipping early supervisory visits
- What it costs
- Missed 30 day on site visits in a new worker's first three months are survey findings that can delay a full license.
- How we prevent it
- We build the visit schedule and documentation form into your policies and tracker.
Planning hospice or home health without checking Medicare
- What it costs
- Capital spent on a clinical agency that cannot enroll in Medicare while the CMS moratorium lasts, and in Maine a hospice cannot be licensed without Medicare certification.
- How we prevent it
- We check the CMS moratorium status and the Maine hospice rules before you commit capital.
In a free 30 minute call we confirm your Maine path, flag the mistakes that apply to your plan, and give you a fixed price to handle the rest.
Maine 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.
- Maine path and a dated launch plan
- Policy and procedure manual written to 10-144 CMR Chapter 129 and MaineCare Benefits Manual Sections 19 and 96
- Service agreement, client rights and care plan forms
- Caregiver hiring and screening workflow
- Google Business Profile setup
MaineCare ready agency
Everything in Private pay launch, plus the Medicaid route.
- Policies aligned to MaineCare requirements
- Caregiver training and background check tracker
- Medicaid provider enrollment
- Credentialing packets for the Office of MaineCare Services and OADS
- Survey and audit readiness
- Maine city pages for local search
Home health and Medicare
For skilled home health. Hospice is scoped separately.
- Staffing and capital timeline
- Policies written to DHHS DLC 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 Maine 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 10-144 CMR Chapter 129 and MaineCare Benefits Manual Sections 19 and 96 |
| Medicaid credentialing | One application at a time | Varies by franchisor | Packets for the Office of MaineCare Services and OADS 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 Maine home care startup checklist
Every Maine 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 care type and payer mix (private pay, MaineCare, or both)
- Form your LLC or corporation with the Maine Secretary of State
- Get an EIN and register for Maine withholding and unemployment insurance
- Register on the Maine Paid Leave Portal and give new hires the paid leave notice within 30 days
- Secure a Maine site: nonresidential space zoned for business, or a separate lockable room at home
- 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 Maine
- 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 Maine cities or counties you plan to cover
- Where you are now: idea, business formed or already operating
- Who you expect to pay: families, MaineCare, 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 Maine
| Item | Notes |
|---|---|
| Personal Care Agency license | $500 initial application fee. Renewal fees depend on employee count: $200 (1 to 5), $500 (6 to 10), $1,000 (11 to 20), $1,500 (21 to 50), $2,000 (51 or more). Name, site or location changes cost $10. No fee is refunded. |
| Home health and hospice licenses | $300 a year for a home health license under 10-144 CMR Chapter 119; $200 initial and $200 a year for a hospice license under Chapter 120. Check current fees with DLC. |
| Maine office site | Rent for business space, or setup of a separate lockable room at home with secure record storage |
| Entity formation | Maine Secretary of State filing fees |
| Background checks | State Bureau of Identification checks for owners and MBCC fees for each employee, owner and administrator. Check current fees before budgeting. |
| PSS training | Course tuition and paid training time for caregivers who are not CNAs |
| Insurance | General and professional liability (proof required with the application), workers' compensation, auto coverage |
| MaineCare enrollment | MaineCare charges an application fee ($750 in 2026) to the provider types on its fee list; home health agencies also post a surety bond |
| Operating reserve | Covers rent, insurance and payroll during the licensing wait and MaineCare enrollment |
Fees change. Confirm current amounts with each agency before budgeting.
How long it takes in Maine
Several months. DLC decides within 90 working days of a complete application, and it reports running 6 to 9 months behind its typical processing and inspection timelines.
Longer: the Personal Care Agency license first, then MaineCare enrollment, EVV setup and Section 19 or Section 96 referrals.
Longest: state licensure, certification survey and Medicare enrollment, subject to the CMS moratorium that began May 13, 2026. A Maine hospice needs Medicare certification before its license.
Maine's home care demand is spread across a mostly rural state. Southern Maine around Portland and York County has the most agencies and the most competition for caregivers, while families in Aroostook, Washington and other rural counties face long drive times that make reliable staffing your strongest selling point. DHHS reported 362 licensed personal care agencies in August 2025, 77 of them with a primary site outside Maine. Many families search for care for a parent from out of state, so a strong Google Business Profile and clear pages for Portland, Lewiston, Bangor, Augusta and the towns you serve matter.
Frequently asked questions
Do you need a license to start a home care agency in Maine?
Yes. Since July 1, 2024, any business that employs workers to help clients with activities of daily living or instrumental activities of daily living at home needs a Personal Care Agency license from Maine DHHS, Division of Licensing and Certification, under 22 M.R.S. § 1717 and 10-144 CMR Chapter 129. Operating without one can bring civil penalties of $500 to $10,000 a day.
How much does a Maine Personal Care Agency license cost?
The initial application fee is $500. Renewal fees run from $200 for 1 to 5 employees to $2,000 for 51 or more, and name, site or location changes cost $10. No fee is refunded.
How long does it take to get licensed in Maine?
Chapter 129 gives DLC 90 working days to decide on a complete application, but DLC currently says it is running 6 to 9 months behind its typical processing and inspection timelines. New agencies receive a provisional license of 3 to 12 months, then a full license of up to two years if they meet the rule.
Can I run a Maine home care agency from another state?
Not without a Maine site. Chapter 129 requires a physical site in Maine, either a nonresidential building zoned for business or a separate, distinct room in a home with locked record storage. DLC guidance says virtual sites and sites shared with another agency do not qualify.
What training do Maine caregivers need?
Caregivers who give hands on personal care must be active CNAs, have finished Personal Support Specialist training or another approved program, or enroll within 60 days of hire and finish within nine months. MaineCare rules set the PSS course at no less than 50 hours. Workers limited to meals, money management, shopping, light housework and communication are exempt.
How do Maine agencies get MaineCare clients?
After licensing, you enroll as a MaineCare provider with the Office of MaineCare Services. Members qualify for programs such as the Section 19 waiver for older adults and adults with disabilities and Section 96 personal care after an assessment by Maximus, Maine's Assessing Services Agency.
Does Maine require a Certificate of Need for home health or hospice?
No. Maine's Certificate of Need law defines the health care facilities it covers, and home health agencies and hospices are not among them. Both still need a DHHS license, and a Maine hospice must be Medicare certified to be licensed, except volunteer hospices.
Is the CMS Medicare moratorium still in effect?
CMS paused new Medicare enrollment of home health agencies and hospices nationwide on May 13, 2026, for six months. It was due to end around November 13, 2026 unless CMS extended it in six month steps, and it may have ended or been extended since. Check the CMS moratoria page before you plan a home health or hospice agency in Maine.
Is a franchise a better way to start a home care agency in Maine?
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.
How much does Maine home care consulting cost?
Lunaria charges one fixed price per engagement, based on your path: private pay, MaineCare or home health and Medicare. You receive the price in writing after a free 30 minute consultation. There are no hourly charges, and we work in all 50 states and DC.
Sources checked for this guide (42)
- 22 M.R.S. § 1717, licensing of personal care agencies
- 10-144 CMR Ch. 129 § 1, purpose and definitions (Cornell LII)
- 10-144 CMR Ch. 129 § 2, licensing and fees (Cornell LII)
- 10-144 CMR Ch. 129 § 3, administration (Cornell LII)
- 10-144 CMR Ch. 129 § 4, staffing (Cornell LII)
- 10-144 CMR Ch. 129 § 5, quality measures, supervision and training (Cornell LII)
- 10-144 CMR Ch. 129 § 7, agency expectations and grievances (Cornell LII)
- 10-144 CMR Ch. 129 § 8, services (Cornell LII)
- Maine DHHS DLC, Personal Care Agencies page (processing delay, application link)
- DLC Personal Care Agency online application
- DLC guidance: Site requirements for Personal Care Agencies (August 11, 2025)
- DLC and OADS PCA Oversight Provider Listening Session slides (August 2025)
- OADS PCA Licensing Initiative
- LD 1442 (132nd Legislature), Resolve Regarding Personal Care Agency Licensing Rules, status
- OADS home care programs (Maximus as Assessing Services Agency)
- MaineCare Benefits Manual Section 19.01, definitions including PSS 50 hour course (Cornell LII)
- MaineCare Benefits Manual Section 19.04, covered services (Cornell LII)
- MaineCare Benefits Manual Section 96.07, policies and procedures (Cornell LII)
- Office of MaineCare Services, enrolling with MaineCare
- OMS bulletin: New MaineCare Partner Portal MFA requirements (October 6, 2026)
- OMS bulletin: Application Fee for 2026 Reminder, CR 136579
- Office of MaineCare Services, electronic visit verification
- Maine Background Check Center
- 22 M.R.S. § 9054, Background Check Center
- 22 M.R.S. Chapter 419, home health services
- 22 M.R.S. § 2142, home health care provider definition
- 22 M.R.S. § 2143, home health license required
- 10-144 CMR Ch. 119, Ch. 2, home health licensing application procedures (Cornell LII)
- 10-144 CMR Ch. 119, Ch. 5, home health administration (Cornell LII)
- 10-144 CMR Ch. 119, Ch. 6, home health paraprofessional qualifications (Cornell LII)
- 22 M.R.S. § 8622, licensing of hospice programs
- 10-144 CMR Ch. 120 § 2.C, hospice license fees (Cornell LII)
- 22 M.R.S. § 328, Certificate of Need definitions
- 22 M.R.S. § 329, projects requiring a Certificate of Need
- Maine Department of Labor, Paid Family and Medical Leave for employers
- Maine Revenue Services and Department of Labor tax registration application
- CMS provider enrollment moratoria page (updated August 27, 2026)
- Federal Register 2026-09717, nationwide moratorium on enrollment of home health agencies
- Federal Register 2026-09718, nationwide moratorium on 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)
This guide is general information and reflects Maine requirements as we understood them in November 2026. Requirements change. Confirm current rules, fees and procedures with the Maine Department of Health and Human Services, MaineCare 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.