Start a Home Health Care Business

Medical team of Doctors and male nurse

Home Healthcare Business Consultants

Opportunities to start a home healthcare agency continue to grow due to the elderly population and preference of most retired Americans to be cared for in their homes. Starting a home healthcare agency to meet this great demand for home care and home health care services is both rewarding and profitable. Our home healthcare agency consultants will help you start a home healthcare agency without the franchise or royalty fees.

In a May 7, 2012 article, USA Today News said that the home healthcare agency is one of the top five most profitable businesses in the United States. The article also cited high owner satisfaction and nearly immediate returns on investments made in the home healthcare agency with newer home healthcare agencies typically averaging 12% to 15% in net profits and an average annual revenue of $248,000. Thanks to high demand, the low overhead and respectable return on investment, home health care, specifically for senior care, is prospering.

Our home healthcare agency consultants will help to assure that your home healthcare agency startup grows to be successful.

A home healthcare agency offers services to the disabled and elderly population. The home healthcare agency will go to the patient’s home to provide home care or home health care services. Our home healthcare agency consultants will provide home healthcare agency training to your home healthcare agency and staff to help understand how to market to and care for our elderly and disabled population.

Initially, it is very important to understand the distinction between starting a home healthcare agency versus starting a non-medical home care business. Our home healthcare agency consultants will help you to better understand this difference and which home care business startup is right for you. Our home healthcare agency consultants can help you start a home care business or a home healthcare agency.

A home healthcare agency will administer skilled, licensed nursing and rehab therapy services under physician’s orders with strict guidelines imposed. A home healthcare agency will require extensive home health care licensing and home health care accreditation for Private Duty or Medicare Accreditation. Our home healthcare agency consultants will get your home healthcare agency accredited for Private Duty or Medicare Accreditation. Once your home healthcare agency is Medicare Accredited your home healthcare agency will be able to bill Medicare, Medicaid and private insurance companies.


A non-medical home care business will offer personal care and/or companion care services. A companion care business offers assistance with daily living activities, meal preparation, housekeeping and transportation.

A personal care business is similar to a companion care business, but the personal care business can also touch the client; changing diapers, bathing and performing other hands-on activities. The home care businesses are vital for the elderly and disabled population to remain safe and comfortable in their homes. Private pay rather than 3rd party billing sources are the most common form of payment for non-medical home care business, although, a home care business may find opportunity billing Medicaid and other state programs as well as long-term care insurance companies.

A non-medical home care business license will typically allow you to take part in Medicaid programs in your state. When a home care business license is not required CHAP Accreditation may be required to take part in Medicaid programs. CHAP Medicare Accreditation is not available to a non-medical home care business. A home care business is not able to bill Medicare as Medicare Accreditation only applies to the skilled nursing offered by a home healthcare agency. If you do wish to bill medicare, please ask our home healthcare agency consultants how your home healthcare agency can achieve CHAP Medicare Accreditation.

CHAP Medicare Accreditation

To remain competitive, home healthcare agency’s must often revisit their home healthcare agency mission to improve the quality of services and maintain their fiscal viability. To do this effectively, we suggest you consider the benefits of CHAP Medicare Accreditation using the CHAP Accrediting Body for your home healthcare agency. We have had the privilege of helping more than a thousand home healthcare agencies achieve both Private Duty and CHAP Medicare Accreditation using the CHAP accrediting body.


Twenty First Century Home Health Care Consultants was originally formed in June 1996, to assist home health care agencies with the Medicare Accreditation process. With our many years of experience, we’ve helped more than 1,500 clients find personal and professional success and satisfaction. Accomplishing our client’s goals along with providing the very best home care consulting start-up program, having in depth resources and the industries only lifetime training and support program are some of the reasons for our client’s success.

Our founder, Rosina McFadden, is known as pioneer in the home care industry. She has both a Bachelors and Master’s degree in Nursing and was an early leader in promoting the advantages of Home Care as an alternative to long term hospital stays, while providing her expert testimony before both State and Federal Legislatures. She was a senior Home Health Care site surveyor for the Community Health Accreditation Program for over 15 years and is known as an expert in the industry for home health care accreditation. All of our Registered Nurse consultants have been certified by both the Community Health Accreditation Program (CHAP) as well as the Accreditation Commission for Home Care (ACHC).

We have grown dramatically since our early days and now offer what we believe to be the Broadest Product offering, the most significant resources available, best value and highest quality of service in the industry.

The home health care licensing process can be quite complicated and varies state by state. Our home care business consultants understand each states specific licensing requirements. Our team of 6 licensing specialists pride themselves in their abilities to complete state and federal Home Health Care license applications quickly, without error as well as successfully preparing their clients for their home care license inspections.


The clinical team at 21st Century consisted of 6 Registered nurses, a Medical Social Worker and a Certified Medical Coder. Our team’s experiences include areas such as Personal Care Services, Private Duty home care, Medicare home care, Pediatric home care, Infusion therapy in the home setting, Hospice home care, Assisted Living Facilities, and a chart auditing and medical coding program.

We are extremely proud of the value and quality we provide to each of our new agency entrepreneurs. We are sure that our business model provides the Best Size, Scope, Value, and Quality in Home Health Care Today.

• We specialize in Non-Medical, Companion Care, Personal Care, Skilled Medical, Private Duty & Medicare Accreditation along with Hospice consulting services.

• We have 23 full time Employees to assist you with every aspect of your business.

• We offer the most affordable solution for your successful startup and ongoing accomplishments without excessive fees and/or restrictions.

• Lastly, our quality of services are second to none. We provide the knowledge, resources, in depth education, training, and support services to assure error free performance and success.

We are well versed in the difficult process of launching a new home health care agency, helping create or refocus business plans, articulating organizational needs, and the customization of all licensure and procedures so that from the startup, your organization is thriving and moving forward.

We are one of, if not the only company that writes its own home health care policy and procedure manuals. They are written to meet your home health care agency’s needs. Completely customized, they will meet all of your states operational requirements and any others, such as Medicare’s conditions of participation and accrediting body standards of excellence.

21st Century Health Care Consultants are the providers of Home Care University, We are the only Home Care Consulting and Home Health Care Consulting Company to offer a Lifetime Training and Support Program. Our goal is to have you leave our Training seminars ready to hit the ground running and launch your very own Home Health Care Agency.

We are experts, taking our clients vision and transforming them into compliant, successful, rewarding and profitable Private Duty Home Health Care Agencies. We provide a full range of support services for our clients, whether an existing Private Duty Home Health Care Agency or opening a new Private Duty Home Health Care Agency.

Call any of our clients and see for yourself why our reputation has stood the test of time and ask them how we helped prepare them for success. We invite you to join our growing home health care agency Network that consists of over 1,500 leaders in the Home Health Care industry.

New Agency Startups

2015 Accreditation Photos
Click here for our
2015 Accreditation Photos
21st Century Health Care Consultants
Thank you, 21 Century for your help and support throughout this process.  Your staff, each and everyone  has been awesome.  What a wonderful organization! We'll remember to recommend you highly to others.
Lifetime Training Program

Startup Agency Boot Camp at our Corporate Headquarters
Click here for our
upcoming training dates!
Advanced Marketing and Business
Development Training Course
Coding and Oasis Training Course
dscn3094  dscn3310
Click here for a description and schedule of our Boot Camp training courses and advanced training seminars.
boot camp group picture 8212-2

Why Accreditation is important for New and Existing Agencies
chaplogo goldsealfinal4c-1- achc12
Home Care Certification or Medicare Certification and Accreditation using the CHAP Accrediting Body is regarded as one of the key benchmarks for measuring the quality of a Home Health Care Agency, along with its products and services. In the US, standard setting by industry leaders with peer review is widely accepted.
*First Name:  
*Last Name:  
Street Address:  
*Interested in:  

Clinical Speaking…

Medical Review Additional Development Request (ADR) Process

WHAT IS AN MR ADR? – When a claim is selected for medical review, an additional development request (MR ADR) is generated requesting medical documentation be submitted to ensure payment is appropriate. Documentation must be received by the intermediary within 45 calendar days for review and payment determination.

WHY AN MR ADR? – Any claim submitted to the intermediary may be selected for medical review, and generate an MR ADR. Claims may be selected when elements on the claim match the parameters of a pre-payment edit established by the intermediary. Additional information about the types of edits, and a current list of widespread edits, can be accessed from the “Overview of Medical Review” Web page.

The information below will help ensure that necessary steps are taken to submit documentation timely, and avoid having claims denied as a result the MR ADR process.

CHECKING FOR MR ADRs – When a claim is selected for an MR ADR, the claim is moved to a Fiscal Intermediary Standard System (FISS) status/location. Providers are encouraged to use FISS Option 12 (Claim Inquiry) to check for ADRs at least once per week. You will not receive any other form of notification for an ADR.

Your agency should have an internal process established to monitor claims selected for an ADR, and to ensure the documentation is submitted within the required timeframe. If the requested documentation is not received timely by the intermediary, the claim will be automatically denied.

For more information look at:

Call for a Free No Obligation Consultation, so we may provide you with the information you need to open your own agency!