How to start a home care agency in Wisconsin and reach your first client faster
Wisconsin has no license for private pay nonmedical home care, but billing Medicaid is a different story. DQA personal care agency certification comes with a catch: you must serve at least five personal care clients before DQA will survey you, then enroll with ForwardHealth and contract with Family Care MCOs. Caregiver Law background checks apply from your first hire, and EVV applies to every Medicaid visit. 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 Wisconsin rulesWis. Admin. Code DHS 105.17 and DHS 107.112, ch. DHS 12 and 13, and MCO provider standards
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Updated November 2026 · Reviewed by Christine Ochimas, RN, LMFT, MBA
Answer two questions. See exactly what Wisconsin requires.
Personal care for Wisconsin Medicaid and Family Care members
- State license
- DQA personal care agency certification (Wis. Admin. Code DHS 105.17 and DHS 107.112)
- Who you deal with
- DHS Division of Quality Assurance, ForwardHealth (Wisconsin Medicaid), Family Care MCOs, IRIS fiscal employer agents
- Must haves
- DQA application through the DHS DQA Provider Portal, qualified administrator, RN supervisor, cash for 60 days of operating expenses, five clients served before the survey, ForwardHealth enrollment, MCO contracts, EVV
- Realistic time to first client
- Several months or more
Orientation for Wisconsin only. We confirm your exact path on the free call.
Three places new Wisconsin agencies lose months
Each one keeps you paying rent, insurance and payroll while no clients arrive.
Waiting for Medicaid before serving anyone
DQA approves a personal care agency application first, then expects the agency to serve at least five personal care clients before the onsite survey, with care shown for at least two clients on survey day. Medicaid pays nothing until DQA recommends you after that survey. Owners who planned to open with Medicaid clients find they need private pay clients first.
What it costs: Months of payroll and rent with no Medicaid revenue, and a stalled certification.
The nine month survey deadline
DHS 105.17 gives an approved applicant nine months to send DQA a written request for the onsite survey. Miss it and the application is no longer valid. The approval itself lasts one year from the date your complete application was submitted.
What it costs: A lapsed application, a new fee and starting the process again.
Certified, but still no Family Care referrals
Most Wisconsin adults who need long term care at home get it through Family Care, Family Care Partnership or IRIS. Since the end of 2025, providers of these waiver services must be enrolled with Wisconsin Medicaid through the ForwardHealth Portal, and each Family Care MCO contracts with you separately.
What it costs: A certified agency with caregivers on payroll and no referrals while enrollment and MCO contracts are pending.
What does a delay cost your agency?
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Home care vs home health vs hospice in Wisconsin
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 (bathing, dressing, eating, walking), supportive home care, companionship, homemaker tasks, respite | Skilled nursing and therapy under a plan of care from a physician, physician assistant or advanced practice nurse | Palliative and supportive care for people with a terminal illness, and their families |
| State license | None for private pay; DQA personal care agency certification (DHS 105.17) to bill Medicaid | DQA home health agency license (Wis. Stat. 50.49; ch. DHS 133) | DQA hospice license (Wis. Stat. 50.92; ch. DHS 131) |
| Certificate of Need | No | No Certificate of Need step | No Certificate of Need step |
| Main payers | Private pay, Family Care and Partnership MCOs, IRIS, Medicaid fee for service and Medicaid HMOs | Medicare, Wisconsin Medicaid and MCOs, commercial insurance | Medicare hospice benefit, Wisconsin Medicaid |
| Medicare | Not covered | Accreditation or DQA survey, then Medicare enrollment (paused for new agencies from May 13, 2026) | Accreditation or DQA survey, then Medicare enrollment (paused for new hospices from May 13, 2026) |
| Key staff | Administrator meeting DHS 105.17 education and experience rules, substitute administrator, RN supervisor, trained personal care workers | Administrator and substitute administrator, RN supervision, home health aides on the Wisconsin Nurse Aide Registry, clinical staff | Administrator, medical director, RN, social worker, counseling and bereavement staff, volunteers |
| Startup capital | Lowest; DQA wants proof of cash for 60 days of operating expenses | Higher: proof of funds for 90 days and clinical payroll before Medicare revenue | Highest: resources for at least 90 days and an interdisciplinary team before revenue |
| Time to first client | Weeks (private pay) to many months (Medicaid certification) | Longest: provisional license, 10 skilled patients, survey, enrollment | Longest: licensure, survey, enrollment |
Many Wisconsin owners start with private pay nonmedical care, which also builds the five client record DQA wants before a personal care survey. Once certified, DHS 105.17 applies to every client of the agency, not only Medicaid members, although private pay clients may waive the 60 day RN supervisory visit in a written agreement. We plan the private pay start and the Medicaid application together so your policies are written once.
Wisconsin requirements at a glance
| Nonmedical home care license | None for private pay. DQA personal care agency certification under Wis. Admin. Code DHS 105.17 is required to bill Wisconsin Medicaid for personal care. |
|---|---|
| Licensing agency | Wisconsin Department of Health Services (DHS), Division of Quality Assurance (DQA), through the DHS DQA Provider Portal |
| Home health and hospice | DQA licenses home health agencies (Wis. Stat. 50.49; ch. DHS 133) and hospices (Wis. Stat. 50.90 to 50.98; ch. DHS 131) |
| Medicaid agency | DHS, through ForwardHealth (Wisconsin Medicaid, BadgerCare Plus) |
| Long term care programs | Family Care and Family Care Partnership (through managed care organizations), PACE and IRIS (self directed) |
| Personal care workers | At least 16, trained in each assigned skill with a demonstration to a qualified trainer under the RN supervisor, TB screening within 90 days before client contact |
| Background checks | Caregiver Law (Wis. Stat. 50.065, ch. DHS 12): Background Information Disclosure F-82064 and a DOJ caregiver check through WORCS at hire and at least every four years; misconduct reporting under ch. DHS 13 |
| Electronic visit verification | Required for Medicaid personal care and supportive home care (hard launch May 1, 2023) and home health care services (hard launch October 1, 2024); DHS provides Sandata at no cost |
| Medicare and Medicaid pause | CMS moratorium on new home health and hospice Medicare enrollment from May 13, 2026; ForwardHealth stopped approving new home health and hospice agencies the same day |
| Entity filing | Department of Financial Institutions, through One Stop Business Registration with the Department of Revenue and DWD |
Summary of Wisconsin requirements as of November 2026. Rules change; confirm with each agency before filing.
Step by step: launching a home care agency in Wisconsin
The order matters. Private pay clients come before the DQA survey, because DQA needs proof you served at least five personal care clients. Start background checks, policies and the DQA application early.
Form the business and register as an employer
Use One Stop Business Registration to form your LLC or corporation with the Department of Financial Institutions and register with the Department of Revenue for withholding and the Department of Workforce Development for unemployment insurance. Get an EIN first.
You do this; we give you the checklistDecide your payer mix
Private pay only, or private pay now and Medicaid personal care later. If Medicaid is the goal, plan to serve private pay clients under the DHS 105.17 rules from the start, since DQA counts those clients toward the survey. Use the path finder above.
Decided on your free consultationHire the administrator and RN supervisor
DHS 105.17 requires an administrator who is at least 21 with an associate degree in a health care field (or a bachelor's degree plus a year in health care) and a year of supervisory experience in home health or personal care, a substitute administrator, and a Wisconsin RN supervisor with a year of supervisory experience.
You do this; we specify what is requiredWrite policies to DHS 105.17 and DHS 107.112
DQA's RN surveyor reviews your policies with the application: plan of operation, personnel and training, client rights, service agreements, RN assessments and 60 day plan of care reviews, infection control, grievances, discharge, a quality committee that meets quarterly and caregiver misconduct reporting under ch. DHS 13.
We write this for youBuild the caregiver pipeline
Have each worker complete form F-82064, run a DOJ caregiver check through WORCS, review the Nurse Aide and Misconduct Registry, screen for TB within 90 days before client contact, and document training and a skills demonstration for every assigned task. Repeat background checks at least every four years.
We set up the system and trackerApply to DQA for personal care agency certification
Submit the application, fee, policies and owner background checks through the DHS DQA Provider Portal, with proof of cash for 60 days of operating expenses and a GAAP accounting system. Review starts only when the application is complete; DQA decides within 90 days.
We prepare the applicationServe clients and request the survey
Serve at least five personal care clients during the approval year, then send DQA a written survey request within nine months of approval. At the survey you show care for at least two clients. DQA recommends you to Wisconsin Medicaid within 90 days after it.
We get you ready for the surveyEnroll with ForwardHealth and contract with MCOs
After DQA's recommendation, enroll as a Wisconsin Medicaid provider through the ForwardHealth Portal. Then apply to each Family Care and Partnership MCO serving your counties and accept IRIS referrals through fiscal employer agents.
We prepare every plan's packetSet up electronic visit verification
Medicaid personal care and supportive home care visits need EVV. Use the free DHS Sandata system or an alternate system that integrates with the Sandata aggregator, and train caregivers before the first Medicaid visit.
We walk you through setup
Personal care worker training and Caregiver Law background checks
Wisconsin sets no fixed training hours for personal care workers in certified agencies. DHS 105.17 requires orientation before the first client and training in each assigned skill, proven by a demonstration to a qualified trainer under the RN supervisor. The Caregiver Law applies to agencies that employ people to give personal care, whether or not they bill Medicaid.
- Orientation: Before serving any client: agency policies, job duties, how staff work together, health and safety in the home, infection control, emergencies, ethics, confidentiality and client rights.
- Skills training: Training for each assigned skill, with a successful demonstration documented by the RN or qualified trainer. Only an RN may train workers on a delegated nursing act.
- Worker qualifications: At least 16 years old, not a legally responsible relative of the client, and able to do the job. Workers report in writing to the RN supervisor on each assignment.
- Health screening: Written certification of TB and communicable disease screening by a physician, physician assistant or RN within 90 days before first client contact, then periodic screening.
- RN supervision: The RN assesses each client, writes the plan of care, reviews it at least every 60 days and observes the worker giving care in the home. Private pay clients may waive the 60 day supervisory visit in writing.
- Background checks: Form F-82064 from each worker and a DOJ caregiver check through WORCS ($15 online), with registry and credential results from DHS, at hire, after any arrest or conviction, and at least every four years.
- Misconduct reporting: Certified agencies must report and investigate caregiver misconduct allegations under ch. DHS 13 and check the Wisconsin Nurse Aide and Misconduct Registry.
- Home health aides: Aides in licensed home health agencies must be on the Wisconsin Nurse Aide Registry. Medicare requires at least 75 hours of aide training, including 16 hours of supervised practical training, and 12 hours of in service training a year.
Six mistakes that slow Wisconsin agencies down
We look for every one of these in the first week of an engagement.
Missing the nine month survey request
- What it costs
- An approved application that is no longer valid, and starting over with a new application.
- How we prevent it
- We set the survey request date the day DQA approves you and track your client count against it.
Waiting for Medicaid before serving anyone
- What it costs
- No way to reach the five clients DQA needs before the survey, so certification stalls.
- How we prevent it
- A private pay launch plan that runs under the DHS 105.17 rules from day one.
Hiring an administrator who does not qualify
- What it costs
- DQA can find the agency out of compliance with DHS 105.17, delaying approval.
- How we prevent it
- We check education and supervisory experience against DHS 105.17 before you hire.
Letting four year background checks lapse
- What it costs
- Caregiver Law violations on survey and caregivers you cannot schedule.
- How we prevent it
- A tracker that flags every caregiver's four year check, TB screening and skills checkoffs.
Taking Family Care or IRIS referrals before ForwardHealth enrollment
- What it costs
- Adult long term care providers not enrolled with Wisconsin Medicaid risk unpaid visits.
- How we prevent it
- We file ForwardHealth enrollment as soon as DQA recommends you, before MCO contracting.
Buying an agency without a new application
- What it costs
- A change of ownership ends the old Medicaid contract, and the new owner must apply and pass the initial survey again.
- How we prevent it
- We plan the DQA application and survey into any purchase timeline.
In a free 30 minute call we confirm your Wisconsin path, flag the mistakes that apply to your plan, and give you a fixed price to handle the rest.
Wisconsin 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.
- Wisconsin path and a dated launch plan
- Policy and procedure manual written to Wis. Admin. Code DHS 105.17 and DHS 107.112, ch. DHS 12 and 13, and MCO provider standards
- Service agreement, client rights and care plan forms
- Caregiver hiring and screening workflow
- Google Business Profile setup
Family Care ready agency
Everything in Private pay launch, plus the Medicaid route.
- Policies aligned to Family Care requirements
- Caregiver training and background check tracker
- Medicaid provider enrollment
- Credentialing packets for each Family Care MCO serving your counties, after ForwardHealth enrollment
- Survey and audit readiness
- Wisconsin city pages for local search
Home health and Medicare
For skilled home health. Hospice is scoped separately.
- Staffing and capital timeline
- Policies written to DQA 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 Wisconsin 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 Wis. Admin. Code DHS 105.17 and DHS 107.112, ch. DHS 12 and 13, and MCO provider standards |
| Medicaid credentialing | One application at a time | Varies by franchisor | Packets for each Family Care MCO serving your counties, after ForwardHealth enrollment 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 Wisconsin home care startup checklist
Every Wisconsin 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 now, Medicaid personal care later, or both)
- Get an EIN and form your LLC or corporation through One Stop Business Registration
- Register with the Department of Revenue for withholding and DWD for unemployment insurance
- Buy workers' compensation, general and professional liability, and auto coverage
- Document cash for 60 days of operating expenses and set up GAAP accounting
- 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 Wisconsin
- 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 Wisconsin cities or counties you plan to cover
- Where you are now: idea, business formed or already operating
- Who you expect to pay: families, Family Care, 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 Wisconsin
| Item | Notes |
|---|---|
| DQA personal care agency certification | Nonrefundable application fee and an annual fee with the annual report, both set by DQA. Check current amounts with DQA. Veterans may qualify for a fee waiver. |
| Home health license | $300 nonrefundable application fee, then a yearly fee of 0.25% of patient fee revenue, at least $500 and at most $2,500 (DHS 133.03). |
| Hospice license | Application and annual fees set under Wis. Stat. 50.93. Check current fees with DQA. |
| Background checks | $15 per person for an online DOJ caregiver check through WORCS ($20 by mail), for each caregiver and each owner |
| Entity formation | Department of Financial Institutions filing fee |
| RN supervisor | Salaried or contracted time for assessments, 60 day plan of care reviews and supervisory visits |
| Insurance | Workers' compensation, liability, auto coverage |
| EVV | The DHS Sandata system is free; an alternate EVV system is paid by the agency |
| Operating reserve | DQA requires proof of cash for 60 days of operating expenses for a personal care agency and 90 days for a home health agency or hospice |
Fees change. Confirm current amounts with each agency before budgeting.
How long it takes in Wisconsin
Weeks, once the business, insurance, background checks and caregiver training are in place.
Many months: up to 90 days for DQA to decide a complete application, time to serve five clients, the survey, up to 90 days for DQA's recommendation, then ForwardHealth enrollment and MCO contracts.
Longest: provisional license, 10 skilled patients before the home health survey, then Medicare and Medicaid enrollment, both paused for new agencies from May 13, 2026.
Families searching for home care in Wisconsin look by city and county, from Milwaukee, Madison and Green Bay to the Fox Valley and smaller communities. Private pay demand is easiest to build in the larger metro areas, which also helps a new agency reach the five clients DQA wants before its survey. In northern and rural counties, distances are long and reliable staffing is your selling point, and Family Care MCO contracts can matter more than private pay. Many adult children search for care for a parent from out of state, so a strong Google Business Profile and clear city pages help.
Frequently asked questions
Do you need a license to start a nonmedical home care agency in Wisconsin?
Not for private pay. Wisconsin has no license for private pay nonmedical home care. To bill Wisconsin Medicaid for personal care, you need DQA personal care agency certification under Wis. Admin. Code DHS 105.17. Agencies that employ people to give personal care must still follow the Caregiver Law background check rules.
How does Wisconsin personal care agency certification work?
You apply through the DHS DQA Provider Portal. DQA decides a complete application within 90 days. You then serve at least five personal care clients, request an onsite survey within nine months of approval, and show care for at least two clients at the survey. After a successful survey DQA recommends you to Wisconsin Medicaid, and you enroll through ForwardHealth.
Who licenses home health agencies and hospices in Wisconsin?
The Department of Health Services, Division of Quality Assurance. Home health agencies are licensed under Wis. Stat. 50.49 and ch. DHS 133, and hospices under Wis. Stat. 50.90 to 50.98 and ch. DHS 131. Surveys can be done by DQA or an accrediting organization approved by DQA and CMS.
Can a new home health agency or hospice enroll in Medicare or Wisconsin Medicaid right now?
CMS put a nationwide moratorium on new Medicare home health and hospice enrollment in place on May 13, 2026, for six months, and it can be extended in six month increments. ForwardHealth stopped approving new Wisconsin Medicaid home health and hospice agencies the same day. The moratorium may have ended or been extended, so check the current status before you plan.
Does Wisconsin require a Certificate of Need for home health or hospice?
No. Wisconsin's approval and bed limit rules in Wis. Stat. ch. 150 cover nursing homes, facilities for people with intellectual disabilities and hospital and psychiatric beds, not home health agencies or hospices. Licensure, surveys and enrollment still apply.
Do personal care workers need certification in Wisconsin?
No state certificate or fixed hour count is required for personal care workers. They must be at least 16 and trained and checked off on each assigned skill under the RN supervisor. Home health aides in licensed home health agencies must be on the Wisconsin Nurse Aide Registry.
How do Wisconsin home care agencies get Family Care and IRIS clients?
By enrolling with Wisconsin Medicaid through the ForwardHealth Portal, then contracting with the Family Care and Partnership MCOs that serve their counties, such as Community Care, Inclusa, Lakeland Care or My Choice Wisconsin, depending on the region. IRIS participants choose providers, and payment runs through fiscal employer agents.
Is a franchise a better way to start a home care agency in Wisconsin?
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 Wisconsin home care consulting cost?
Lunaria charges one fixed price per engagement, based on your path: private pay, Medicaid personal care certification 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 Wisconsin?
No. Lunaria works with owners in all 50 states and DC, so you can expand into a second state with the same team.
Sources checked for this guide (21)
- Wis. Admin. Code ch. DHS 105 (DHS 105.16 home health, DHS 105.17 personal care providers), Register April 2026
- DHS DQA: Personal Care Agencies, Application and Certification Process (revised December 10, 2025)
- ForwardHealth Provider Enrollment Criteria (alert: no new home health or hospice agencies from May 13, 2026)
- Wis. Stat. ch. 50 (50.065 Caregiver Law, 50.49 home health agencies, 50.90 to 50.98 hospices)
- Wis. Admin. Code ch. DHS 133, home health agencies
- Wis. Admin. Code ch. DHS 131, hospices
- Wis. Stat. ch. 150, regulation of health services (table of contents)
- DHS DQA: Home Health Agencies, Application for State Licensure and Federal Certification
- DHS DQA: Hospice, Application for State Licensure and Federal Certification
- DHS: Employee and Contractor Background Check Process (revised February 24, 2026)
- DHS: Electronic Visit Verification (revised October 20, 2026)
- DHS: IRIS Participant Toolkit for Adult Long-Term Care Provider Enrollment
- DHS: Family Care MCO key contacts and counties (02/2026)
- Wisconsin Department of Revenue: Starting a Business (One Stop Business Registration)
- CMS Provider Enrollment Moratoria (HHAs and hospices, May 13, 2026; last modified 08/27/2026)
- Federal Register 2026-09717, moratorium on Medicare enrollment of home health agencies
- Federal Register 2026-09718, moratorium on Medicare enrollment of hospices
- 42 CFR 484.80, home health aide qualifications (Cornell LII)
- 42 CFR Part 484, home health Conditions of Participation (Cornell LII)
- 42 CFR Part 418, hospice care (Cornell LII)
- CMS-855A Medicare enrollment application, institutional providers
This guide is general information and reflects Wisconsin requirements as we understood them in November 2026. Requirements change. Confirm current rules, fees and procedures with the Wisconsin Department of Health Services, Division of Quality Assurance, ForwardHealth 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.