How to work with a home care nursing agency

Home care is a health service provided in the patient’s home to promote, maintain, or restore health or lessen the effects of illness and disability. Services may include nursing care; speech, physical and occupational therapies; home health aide services and personal care services.

Please be advised that New York State Public Health Law requires that an organization must be licensed or certified as a home care agency by the New York State Department of Health in order to provide or arrange for home care services in New York State.

Certified Home Health Agencies (CHHAs) provide part-time, intermittent health care and support services to people who need intermediate and skilled health care.

Licensed Home Care Services Agencies (LHCSAs) offer home care services to people who pay out of pocket (with their own funds) or have private insurance coverage.

To view information on specific Certified Home Health Agencies and Licensed Home Care Service Agencies, including available quality measures, please visit the Home Health and Hospice Profiles

The Home Care Registry provides limited information about individual Home Health Aides and Personal Care Aides that have successfully completed state approved training program. To access the Home Care Registry, please visit:

Managed long-term care (MLTC) is a system that streamlines the delivery of long-term services to people who are chronically ill or disabled and who wish to stay in their homes and communities.

In Home Aid, Nursing Pool, Medical Social Worker, Speech Therapy.

Home Care StartUp

For specifically any new startup in Home Care ownership

Home Care Nursing

Nursing Services, Infusion Nursing, Skilled Nursing

Wisdom health Academy consulting services can help your organization to receive your license in Home Care or Home Health. Our team of consultants will work with you to understand your state requirements in the development of your agency policies and procedure manual. Wisdom health Academy will work with you during the licensure process and provide resources for any plan of corrections.

Wisdom Health Academy will work toward completing any plans for correction and provide you with education regarding the licensure process. For more information on the different programs, Contact us today at (800) 280-3758

How to Start a Home Care Business

Home care agencies are created as more seniors want to remain in their homes. Beyond your strong desire to start a business in-home care, building a home care agency can be fulfilling and profitable.

In the process to decide on how to start , you can do it on your own, or buy into a home care franchise or get help with a home care consultant. In the last two options, Wisdom Health Academy can assist you. If you choose a home care franchise , know you are joining a family of business owners with ongoing support and related fees. Starting on your own can be possible, but you face competition with years of experience in the industry and strong presence. At Wisdom Health Academy, we lay the options for you to choose. We offer everything you need to start a home care agency of your choice. Depending on your choice, you can have a lifetime training and support for you and your staff.

Home Health Care Agency

If you’re considering owning a business in the home health care industry, you might be wondering “Where do I start?” business. Before we get into the necessary steps for starting a home health care agency, choose what type of services you want to provide.

We provide care to meet advanced needs for your loved ones at home to improve their health and happiness.

Traditional in-home care allows your loved one to get the help he or she needs without giving up independence. If your loved one is healthy, you might be able to meet his or her needs on your own or hire a caregiver to help provide the assistance they need.

However, there are times when care needs are more advanced, we can help through our uplifting private duty nursing care services. A private duty nurse from Comfort Keepers ® offers loved ones the level of care they need where they want it – not in a nursing facility or hospital, but in the comfort and safety of home.

What is Private Duty Nursing?

Unlike traditional in-home care services, private duty nurses provide one-on-one medical care. They are qualified to offer this care in the comfort of the patient’s own home, or in a facility such as a hospital or nursing home. They can offer advanced care, working in tandem with the family. Our goal is to provide the customized care needed by our clients, all from one source.

Next-Level Home Care for Your Family Member

We hire highly trained, qualified staff to provide specialized care. Our private duty nurses are either licensed practical nurses (LPNs) or Registered Nurses (RNs).

And, our nurses can work in conjunction with traditional in-home caregivers to provide the same uplifting care services that make Comfort Keepers a provider of choice. We believe that every client, no matter their age or acuity, can experience more connection, purpose and hope with quality care from a Comfort Keepers care team.

Private duty nurses are highly trained and certified to perform the following advanced medical tasks:

  • Oral medication set up
  • Non-injectable or injectable medication administration
  • Insulin syringe filling
  • Ostomy and catheter hygiene
  • Removal/replacement of aseptic dressings
  • Skin management, skin condition monitoring, and wound care
  • Oral cavity suctioning and tube feeding
  • Bowel care
  • Core training for family members
  • General health assessments and care coordination

Please discuss your needs with us as services vary by location and state.

How Comfort Keepers can help

Our private duty nurses are available whenever you need them. From scheduled nursing visits to hourly care, someone is there to help 24 hours a day, seven days a week. We work with your loved one’s medical team to offer the professional support he or she needs.

Comfort Keepers provides in-home care that makes a difference in the lives of seniors and other adults. For over twenty years, clients and their families have entrusted their care to us in hundreds of local communities. Whether personal care services or private duty nursing services, we provide the support and services that help to ensure the best care solutions for your loved one.

* Private Duty Nursing is not available in all locations, only those with LPNs or RNs on staff. Check your local Comfort Keepers website to see if they offer the service. You’ll find it listed under the “Care Services” tab. If your local office does not offer this specialized care, contact us. We’ll check if another nearby Comfort Keepers does.

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We understand choosing an in-home care provider can be a difficult decision, and we want to make your journey as easy as possible. We’re here to support you by providing helpful senior care tips and information on in-home care and senior health and wellbeing topics.

Usually, a home health care agency coordinates the services your doctor orders for you.

Medicare doesn’t pay for:

  • 24-hour-a-day care at home
  • Meals delivered to your home
  • Homemaker services (like shopping, cleaning, and laundry), when this is the only care you need
  • Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need

Who’s eligible?

All people with Part A and/or Part B who meet all of these conditions are covered:

  • You must be under the care of a doctor, and you must be getting services under a plan of care created and reviewed regularly by a doctor.
  • You must need, and a doctor must certify that you need, one or more of these:
    • Intermittent skilled nursing care (other than drawing blood)
    • Physical therapy, speech-language pathology, or continued occupational therapy services. These services are covered only when the services are specific, safe and an effective treatment for your condition. The amount, frequency and time period of the services needs to be reasonable, and they need to be complex or only qualified therapists can do them safely and effectively. To be eligible, either: 1) your condition must be expected to improve in a reasonable and generally predictable period of time, or 2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition. The home health agency caring for you is approved by Medicare (Medicare certified).

    You’re not eligible for the home health benefit if you need more than part-time or “intermittent” skilled nursing care . You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult day care.

    Home health services may also include medical supplies for use at home, durable medical equipment, or injectable osteoporosis drugs.

    • $0 for home health care services.
    • 20% of the Medicare-Approved Amount for durable medical equipment (dme) [glossary] .

    Before you start getting your home health care, the home health agency should tell you how much Medicare will pay. The agency should also tell you if any items or services they give you aren’t covered by Medicare, and how much you’ll have to pay for them. This should be explained by both talking with you and in writing. The home health agency should give you a notice called the Advance Beneficiary Notice” (ABN) before giving you services and supplies that Medicare doesn’t cover.

    If you get services from a home health agency in Florida, Illinois, Massachusetts, Michigan, or Texas, you may be affected by a Medicare demonstration program. Under this demonstration, your home health agency, or you, may submit a request for pre-claim review of coverage for home health services to Medicare. This helps you and the home health agency know earlier in the process if Medicare is likely to cover the services. Medicare will review the information and cover the services if the services are medically necessary and meet Medicare requirements.

    Your Medicare home health services benefits aren’t changing and your access to home health services shouldn’t be delayed by the pre-claim review process. For more information, call us at 1-800-MEDICARE.

    To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

    • Other insurance you may have
    • How much your doctor charges
    • Whether your doctor accepts assignment
    • The type of facility
    • Where you get your test, item, or service

    Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

    During the COVID-19 pandemic, nurse practitioners, clinical nurse specialists, and physician assistants can now provide home health services, without the certification of a physician.

    by How to work with a home care nursing agency adireen

    How to work with a home care nursing agency

    How to work with a home care nursing agency

    How to work with a home care nursing agency

    How to work with a home care nursing agency

    How to work with a home care nursing agency


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    As the demand for nurses rapidly increases in the United States, due to the bulk of the population aging, a substantial portion of nurses reaching retirement age, and now a global pandemic, nurses from outside the U.S. may consider working here temporarily or permanently. It is common for nursing recruitment agencies to steadily hire foreign-trained nurses to mitigate the nursing shortage.

    List of International Healthcare Staffing Agencies

    Below is a list of healthcare staffing agencies that assist foreign-trained registered nurses with finding a job in the United States. Likewise, hospital recruiters seeking nurses to assist with their facility’s nursing shortage can contact the staffing agency.

      – full-service agency. – assist with placement in various countries. – assist with NCLEX, IELTS or TOEFL prep, no agency fees. – no recruitment fees. – affiliated with Cross Country, offers full-service assistance. – full-service agency, placements also in Australia and UK. – full-service agency, placing top healthcare professionals into positions within the best healthcare organizations in the US. – full-service agency, assist with filing application. – full-service agency, focuses on cultural transition program. – #1 recruiting agency for African and Caribbean trained nurses. – reimburses cost of exams, immigration, & travel, focus on Indian RN. – provides U.S. healthcare assimilation courses and an orientation. – full-service agency, over 450 nurses placed in the US. – full-service agency, CGFNS required, unique Vanderbilt training. – full service international recruiting agency. – full-service agency that includes a training program to pass the English proficiency and NCLEX-RN exams. – full-service agency, reimbursement of immigration fees, travel, etc. – full-service agency, over 25 years of experience in recruiting. – agency with per diem, travel and international recruitment programs. – full service international recruiting agency since 1999. – agency with travel, permanent & international recruitment programs. – agency with travel and international programs. – agency specializing in hospice care placements. – full service international recruiting agency. – full service international agency specializing in recruiting RNs from India. – full-service agency since 1973. Full benefits package. – full service international recruitment agency since 1996. – full service international recruitment agency. agency with domestic & international recruitment programs. – full service international recruitment agency.


    The first step for foreign-trained nurses to obtain work in the United States is to pass the NCLEX-RN exam in the state that the nurse intends to be employed. Be sure to look into states that are part of the Nursing License Compact (NLC) and provide a multi-state license. To determine if a foreign-trained nurse is ready to take and pass the NCLEX-RN exam, the Commission on Graduates of Foreign Nursing Schools (CGFNS) offers a prescreening test so that the nurse can determine if they need a refresher course. Many international nursing staffing agencies offer refresher courses.


    Non-U.S. citizens are required to have an employer-sponsored visa to work in the United States. The international staffing agencies are generally well-versed in sponsoring visas for the foreign-trained nurses and can walk interested international nurses through the process. The most common route for visa procurement is to apply for a permanent work visa, otherwise known as a green card. However, there are other types of visas such as the TN visa for Canadian and Mexican nurses, and a temporary H-1B visa for certain nursing specialties in underserved areas. An international nurse is eligible to apply for a VISA after the NCLEX-RN is passed.

    English Language Proficiency Tests

    Depending on the native country of the nurse, the international nurse will have to pass either the Test of English as a Foreign Language (TOEFL), the Test of English for International Communication (TOEIC) or the International English Language Testing System (IELTS). The sponsoring international staffing agency will assist the nurse in determining which test to take, and the results are sent directly to the state nursing board. Nurses originating from the United Kingdom, Australia, Canada (except Quebec), Ireland, and New Zealand are exempt from passing an English Language Proficiency Test.

    Other Requirements

    • Only nurses who have a four-year nursing degree from an accredited nursing school are eligible for licensure and work in the United States.
    • Some states require foreign-education nurses to take a Foreign Educated Nurses (FEN) refresher course that consist of classroom and clinical hours.
    • Foreign-educated nurses must have also had at least two years of nursing experience in their home country prior to applying for work in the United States.
    • Those who are NOT eligible for work in the United States as a registered nurse include:
      1. Nurses with less than two years of experience.
      2. Nurses who do not have a four-year nursing degree.
      3. Nurses who have committed a crime.
      4. Nurses who are not sponsored (visa) by a reputable, credentialed nursing staffing agency.

    Final Thoughts

    While there are many steps to take for international nurses to become a Registered Nurse in the United States, the healthcare staffing agency will provide guidance along the way. Best of luck to you and your new career as a registered nurse in the United States!

    Home care nursing (HCN) services are nursing services that a physician orders for a member whose illness, injury, physical or mental condition requires more individual and continuous care by a registered nurse (RN) or licensed practical nurse (LPN) than can be provided in a single or twice-daily skilled nurse visit and that requires greater skill than a Home Health Aide (HHA) or Personal Care Assistant (PCA) can provide.

    Eligible Providers

    Individual RN’s and LPN’s must have an active nursing license. If an enrolling individual LPN cannot attest to all statements on the Home Care Nurse – Individual LPN or RN Applicant Assurance Statement (DHS-7099) (PDF), the LPN must obtain a comprehensive homecare license.

    HCN Relative Hardship Waiver

    The HCN Relative Hardship Waiver allows certain relatives to receive reimbursement for providing services to an MA member. The relative must be currently licensed in the State of Minnesota as an RN or LPN and must be one of the following:

    To qualify for a HCN Relative Hardship Waiver, at least one of the following criteria must be met:

    In the case of a HCN Relative Hardship Waiver, the provider agency is responsible for:

    For a member who is enrolled in a managed care organization (MCO), the MCO is responsible for reviewing and approving or denying the HCN Hardship Waiver Application.

    Paid services and review under the hardship waiver

    Eligible Recipients

    Members must be eligible under one of the following programs:

    Authorization Requirements

    Assessment Requirements

    Home care nursing is based on an assessment of the member’s medical or health care needs. This service includes ongoing professional nursing observation, monitoring, intervention, and evaluation. This level of care provides continuity, intensity, and the length of time required to maintain or restore optimal health. Professional nursing is defined in the MN Nurse Practice Act.

    Covered Services

    HCN services can be classified regular or complex.

    Regular Home Care Nursing

    Regular HCN is provided to a member who requires more individual and continuous care than can be provided during a skilled nurse visit or whose cares are outside of the scope of services than can be provided by a home health aide or personal care assistant.

    Complex Home Care Nursing

    Complex HCN is provided to members who meet the criteria for regular home care nursing and require life-sustaining interventions to reduce the risk of long-term injury or death.

    Noncovered Services

    The following are not covered under HCN:


    Complex Reimbursement Rates

    A complex care reimbursement rate is only available when the member is receiving one-to-one (1:1) HCN services. A complex care rate is not available when the member is receiving shared (1:2) HCN services. This means members can share HCN services if they are authorized complex care, but the agency will only receive the complex rate during the hours the member is receiving the 1:1 services.

    Shared HCN Option

    This option allows two members to share HCN services in the same setting at the same time from the same private duty nurse. All regulations pertaining to home care nursing services also apply to the shared care option. A setting includes:

    Shared HCN cannot be provided to two members in separate apartments in the same building. HCN cannot replace or supplement required staff at a licensed facility.

    Required documentation
    Include a copy of each of the following in the member’s chart when service is shared HCN:

    Changing or discontinuing shared HCN
    The member or legal representative must notify the provider in writing if the member chooses to make a change in his or her shared care. Changes include:

    The written revocation or change must be maintained in the member’s file. For more information, refer to the Quick Reference Tool.


    Plan of care – PCA: See Service Plan.

    Home care nursing agency: An agency holding a comprehensive home care license and that is enrolled with the Department of Human Services to provide home care nursing services.

    Service plan – PCA: (Also called PCA plan of care.) A written description of the services needed by the member based on an assessment. The service plan must include a description of the home care services, the frequency and duration of services, member’s functional level, medications, and treatments, and the expected outcomes and goals.

    Home health agencies are increasingly becoming a bigger part of the overall health care equation, leading to more interest not only from investors, but also from other organizations looking to partner across the care continuum.

    This rings true especially for hospitals, which are more closely scrutinized federally based on lengths of stay, readmissions and total cost of care. So in order to meet certain guidelines, hospitals are looking to home health agencies, which can better transition patients from hospital to home.

    But for agencies looking to stand out from the crowd and earn more referrals, their best shot is to cultivate relationships with hospital discharge planners.

    Just ask Jacqueline Bechtold Gordon, who has been a hospital discharge planner for more than 30 years and understands the importance of face time when it comes to generating referrals.

    Holding a list of post-hospital care (including home health care, home care and senior housing) in the hospital’s area, Gordon becomes a key influencer, helping patients and their families decide where to go next — like a gatekeeper of referrals.

    And she says getting on a discharge planner’s good side can bump an agency up to the top of that list.

    Gordon, who works in the emergency room at Adventist Medical Center-Portland, explains exactly how the discharge process works (and how to push your way up the list) in a Q&A with Sharon Brothers, CEO of the Institute for Professional Care Education (IPCed), during a recent webinar hosted by the institute.

    Sharon Brothers: It used to be skilled nursing was the only option for discharge. Well, if it’s the right setting a person could go home with 24-hour home care, or they could go to assisted living and have a skilled nurse from a home health agency visit them. There are more options today, don’t you think?

    Jacqueline Bechtold Gordon: There’s lots of options today. And I might mention that in the emergency room, we do all of it. We don’t just do the [senior housing] placements. We do home care, home health care, hospice, because we’re the only ones there to do that, especially in after-hours.

    SB: How does the referral process work in the ER?

    JBG: The doctor comes to me and says that this patient has a need. It’s not working out at home, either they don’t have enough care in the home and the patient or family would like to increase the care in the home, or they may need to go into a facility of some type.

    I take a look at the [patient’s] history and physical. I go in and talk to the person and family, just finding out what has been happening at home, what their needs are and what they want to do. … Money is always a big issue. So I need to know whether they have Medicare or Medicaid. I assess the situation and find out what they want to do and start working on it and coming up with a solution.

    Recommended HHCN+ Exclusives

    SB: You’ve done the assessment phase and know what their financial capabilities are; what’s the next step?

    JBG: It depends on what I’m doing. [If] it’s home care, then we would give the family a list of home care agencies and have them choose one that they want to work with. Either they or we will make a call to the agency and see if they’ll provide what the family needs. If it’s home health, we’ll give them a list of home health agencies or ask if they have a home health agency they want to use.

    For a nursing facility I give them — depending on their insurance — the list that’s appropriate and ask them to come up with at least three options. In the emergency room, I just want them to come up with one option because it has to be done very quickly. Then I’ll get the information to those places and see which place can take them, and whoever it works out the quickest with is usually the one where that patient goes.

    SB: So providers’ responsiveness and speed are really important in the ER. For the regular units, how important is responsiveness?

    JBG: It’s important there too. We need to know quickly who is available and who isn’t to take this patient. It’s not like in the ER, where I’m working with one person. On the floors, you’re typically working with three placements at one time or more. So you need to know what the options are for that person.

    SB: If I were a provider and gave you my cellphone number and you knew that I would respond right away, would that be a big deal to you?

    JBG: That’s huge. The quicker we can get to a provider, the quicker they can respond to us and come up with a quality solution to meet the discharge need. They’re going to be at the top of the list.

    SB: The list — it feels like a magical list. How does an agency get on the list and how many agencies are on it? In the area where you work, I would imagine there are a lot of options.

    JBG: There aren’t hundreds and hundreds [on the home care list]. It’s probably about 20. Any agency can be on our list. Our [hospital] secretary is the one that makes up the list. It’s just from known agencies — whoever we know about will be put on that list. So if somebody isn’t on that list they just need to call the hospital and talk with the secretary and let them know that they have a home care agency and ask to be put on the list.

    We want them on the list. The list needs to be as comprehensive as possible.

    As far as nursing homes go, all the nursing homes in the area are on the main list. And then for each insurance company, all the nursing homes that they cover/pay at, are on those lists.

    SB: I imagine you don’t tell the patients and their families, “Call all these 20 agencies.” How does a provider get a leg up? I assume that you say, “Here’s the list, but check out some of these folks”?

    JBG: I pretty much have to. You know who you’ve worked with in the past and who’s been able to give you really good service. Are they really timely? How responsive are they to your needs and how well do they work with the families? Are they willing to drop what they’re doing and come out to the hospital and talk to the families, themselves?

    SB: How important are relationships? I think about lists and names and contact information, and it’s very impersonal. Does it matter if you know who those providers are?

    JBG: Realistically, absolutely. Just handing over a list or just looking at a list of a bunch of vacancies, how would you know which [to suggest]? Developing a relationship with somebody from the agency [or community] of course is going to make a difference.

    SB: If you knew that I had a home care agency and had caregivers certified in dementia care, would that help you be able to filter and say, I know these guys have caregivers that specialize in this?

    JBG: That would be wonderful. Anytime you have somebody specializing in something, that’s better than a general [care service]. Having a specialty is good. If your loved one has Alzheimer’s and the people are trained to know how to care for that, then they are going to be invaluable.

    SB: How can a provider build a stronger relationship with a discharge planner?

    JBG: Just talking to the individual person [the discharge planner] and letting them know what they have that might make them stick out. Do they have a specialty? Do they have specialty training? Anything to make them stick out and not just be a name on a list is going to be helpful.