In Pennsylvania, adults over the age of 65 comprise a significant portion of the population at over 2.2 million people. Many of them are opting to stay in their homes as they seek to age in place rather than move to a retirement community. Yet, despite their desire for independence, many still eventually require assistance with many activities of daily living and medical care. If you're a business-minded Pennsylvania resident, this creates an opportunity for you to provide a much-needed service while operating a successful company. But be sure to research all the legal and financial details before starting a home health agency in Pennsylvania.

Define the Scope of Your Company

Home Health Care Agency (Medical)

Terms can be tricky when it comes to home care, so be sure you understand what type of company you wish to form. In Pennsylvania, a home health care agency is one that provides skilled nursing services that require the supervision of a physician or registered nurse as well as rehabilitative services such as physical occupational and speech therapy.

Consider pursuing certification as an approved participant in the Medicare and Medicaid benefit programs. Becoming a Medicare/Medicaid approved agency means that clients who rely financially on these benefits will now be able to utilize your company's services. The approval process consists of a detailed, formal application and an on-site survey by the state survey agency to assess the company for compliance with the many Conditions of Participation. Information can be found on the Centers for Medicare and Medicaid Services website.

Home Care Agency (Non-medical)

If you're looking to provide only non-medical services, you'd pursue opening a home care agency. This type of agency assists with activities of daily living such as bathing, dressing, meal preparation and companionship.

Create a Business Entity

Before you can start your Pennsylvania home health care agency, you'll need to form an official business entity. A lawyer can help with the details and proper structure for your situation. You'll also need a federal tax ID number (EIN), a state employer number and insurance to cover worker's compensation and liability.

Consider Financing Options

If you don't have funds available to start your agency, you'll need to secure a loan. The Small Business Administration (SBA) can help you find funding as well as provide assistance in managing the particulars of writing a business plan and running your business. A business plan will show the bank that you've researched your industry, organized your business and are a reasonable risk for them.

Another option for home care agencies is a process called "factoring". While you may have the resources to get your business up and running, you may find it difficult to meet your payroll regularly while you're waiting for payments from individual clients or insurance companies. Instead, a company that provides factoring services buys your accounts receivable and gives you the cash right away, keeping a small portion as their fee.

Acquire Certifications and Licenses

Additionally, you'll need to apply for a license from the Department of Health before starting a home health agency in Pennsylvania or providing any services. Along with a $100 fee, the application must include child abuse clearances, criminal record background checks and evidence of health screenings for TB (tuberculin skin test) for all employees or rostered workers. You'll also need to describe your employee training program and how you test for skill competency regarding the care of clients.

Hiring and Training Staff

As a home health care agency, you'll need skilled nurses and therapy practitioners on your payroll in addition to nursing aides to do personal care. You'll need a physician or registered nurse to supervise the staff and make sure that all health department regulations are being followed and that employees are trained to follow company procedures.

Once you have everything in place, advertise your company to local physicians, hospitals and rehabilitation facilities throughout the region. Introduce yourself in person and ask for referrals for your home health services.