How to Start a Home Care or Home Health Business in Georgia: DCH Licenses, Fees and CON

October 29, 2026

Starting a home care business in Georgia means working with the Georgia Department of Community Health (DCH), specifically its Healthcare Facility Regulation division. DCH licenses two different kinds of in-home businesses, and they follow different rules, different fees and different paths. Choose the wrong one and you can spend months on an application that cannot deliver the services you planned to offer. This guide walks through the decision first, then the fees, the Certificate of Need question, and the business setup that comes after the license.

Informational content only: This article is not legal, tax or regulatory advice. Licensing rules, fees and review timelines change. Confirm every figure with the agency named in each step, and consult a healthcare attorney and a CPA before you commit money or sign a lease.

Materials and Information You Need Before You Apply

Gather these items before you open the DCH application. Missing one is the most common reason applications stall.

• Entity formation documents: Articles of Organization for an LLC or Articles of Incorporation for a corporation, filed with the Georgia Secretary of State (eCorp).
• A service list: a written list of each service you plan to offer, sorted into nursing services, personal care tasks, and companion or sitter tasks.
• Owner records check application: DCH uses this to run a criminal history check on the owner.
• Staff credentials: current Georgia RN or LPN licenses for any nursing staff, plus records showing your administrator and employees meet the qualifications in the rules.
• Client service agreement template: a written agreement listing services, frequency, charges and client rights.
• Written policies: the operating policies DCH expects to see for each service category.
• A physical location: the address of the office you will license, since each location needs its own license.
• Payment method: for the $300 application processing fee and the initial license fee.
• Accreditation documents (optional): if you hold or plan to pursue accreditation from a national body DCH recognizes.
• Federal employer identification number (EIN) and payroll records, once you plan to hire.

Step 1: Choose the Right DCH License

This decision shapes every later step, so make it first.

Private Home Care Provider (PHCP). Governed by DCH Rules chapter 111-8-65, a PHCP provides nursing services, personal care tasks, or companion and sitter tasks through its own employees or contractors. The license is issued per service category, so you license only what you will actually deliver.

• Personal care tasks cover help with bathing, toileting, grooming, dressing, eating and similar daily activities.
• Companion or sitter tasks cover transport and escort, meal preparation, and household tasks essential to the client's cleanliness and safety.
• Nursing services must be delivered by a licensed RN or LPN working under a supervisor.

Home Health Agency (HHA). This is a separate license for skilled home health care. It is the path that runs into the Certificate of Need program in Step 2.

If your business is a non-medical companion or personal care service, you are almost certainly looking at a PHCP. If your model involves skilled clinical visits ordered by a physician, you are looking at an HHA. Do not apply for a PHCP while planning skilled home health, because you will have to redo the application later.

Also decide whether you are running a home care business or a residential facility. Personal care homes and assisted living have their own rules and their own page: see how to start a personal care home business in Georgia. This article does not cover them.

Step 2: Confirm Whether a Certificate of Need Applies

A Certificate of Need (CON) is not required to license a private home care provider, as long as the business does not operate as a licensed home health agency or a personal care home (DCH Rule 111-8-65-.07).

A new home health agency, or an expansion of an existing one into a new service area, goes through the CON program under O.C.G.A. 31-6-1 and following, and through DCH's home health review cycles. DCH has run these reviews in batches rather than accepting applications year-round. At the last check, no new-application window was open. Before you spend money on an HHA plan, contact DCH Healthcare Planning and ask:

• Is a review cycle open for my service area?
• When is the next application window?
• What documentation will the review require?

Treat the CON question as a gate. If you start an HHA without confirming the review window, you may have leases, staff and marketing costs running while you wait.

Step 3: Budget the DCH Fees

DCH fees come from Rule 111-8-25-.03, as amended effective March 10, 2025. Use the table below as your starting point, then read the full fee schedule on the DCH website at dch.georgia.gov.

Fee	Amount	When it is due	Notes
Application processing fee	$300	Paid on submission	Not refundable except in extraordinary circumstances
PHCP annual license fee	$250 per service offered	Initial fee is paid with the application; annual fee after that	Services are companion or sitter, personal care, and nursing. Maximum of $750
HHA annual license fee	$1,000	Initial fee is paid with the application; annual fee after that	Applies only to home health agencies

The initial license fee equals the annual fee for that license, and you submit it together with the $300 application processing fee. Here is the arithmetic:

• PHCP offering one service: $300 plus $250 equals $550 to start.
• PHCP offering all three services: $300 plus $750 equals $1,050 to start.
• HHA: $300 plus $1,000 equals $1,300 to start, before any CON costs.

Two more points matter for your budget:

• Accreditation discount: a 25% discount applies to these licenses when the provider is accredited by a national accrediting body DCH recognizes and you submit the accreditation decision with your application.
• Other charges: DCH can charge late fees and follow-up visit fees. These are not in the table above, so check the schedule before you assume your costs are fixed.

Older guides list a $350 application fee for private home care. That figure is out of date. The current structure is the $300 processing fee plus the annual license fee for each service.

Step 4: Form the Business Entity

Before or alongside the DCH application, form your legal entity. Most small home care owners choose an LLC. For the full process, read how to start an LLC in Georgia. The key numbers:

• Articles of Organization (LLC): $110 total, which is the $100 filing fee plus a $10 service charge. You can file online or on paper.
• Articles of Incorporation (corporation): also $110 total.
• Processing time: online filings take about 7 to 10 business days, and paper filings about 15 business days.
• Expedited review: $120 for 2 business days, $275 for same-day service if received by noon, or $1,200 for one-hour review on business days.
• Name reservation: $35 for 30 days.

An LLC name must include a limited liability company designator such as LLC, and it must be distinguishable on the Secretary of State's records. Check the name rules before you file. Your business name also has to match what you put on the DCH application.

If you operate under a name different from your entity name, you need a trade name (DBA) filing. Trade names are filed with the Clerk of Superior Court of the county where the business is chiefly carried on, not with the Secretary of State. Expect a clerk fee of about $165, plus a newspaper publication charge, since notice runs once a week for two weeks. Confirm the exact amount with your county clerk. See the Secretary of State business FAQ for more.

Annual registration is $60 ($50 plus a $10 service charge), filed between January 1 and April 1 each year. An LLC files its first annual registration in the year after it forms, and a new corporation files within 90 days of incorporating. Check the Secretary of State for the current window and any late penalty.

Georgia levies no franchise tax on a typical single-member or partnership LLC. Corporations, and LLCs taxed as corporations, pay a net worth tax of $0 to $5,000 depending on net worth. For income tax, read Georgia business taxes.

Step 5: Clear the Owner Records Check and Staff Qualifications

The owner must submit a records check application so DCH can run a criminal history check. DCH cannot issue a license if the owner has a covered crime under the rules, including murder, aggravated assault, child or elder abuse or exploitation, rape, or armed robbery (Rule 111-8-65-.05). If you have any of these in your history, speak with a healthcare attorney before you invest in the application.

Next, confirm that your administrator and employees meet the qualifications the rules define for each service you will offer. Nursing services require a licensed RN or LPN working under a supervisor. Keep copies of licenses, training records and background documentation in one organized file, because DCH will ask for them during review and inspection.

Step 6: Write Client Service Agreements and Policies

Every client must have a written service agreement. It must list the services provided, how often they will be provided, the charges, and the client's rights. Draft this with your attorney, because the agreement is both a regulatory requirement and your main protection when a client disputes a charge or a service.

Also plan around three location rules:

• The license is not transferable. Check with DCH before any sale or change of ownership.
• Each location needs its own license.
• DCH needs 15 days' notice before you change location.

Step 7: Submit the DCH Application and Prepare for Review

File your application through the DCH GAMMIS portal and pay the $300 processing fee and the initial license fee at submission. Initial review typically takes about 60 business days. Treat that as an estimate, not a promise, and confirm current timing with DCH before you set your opening date.

After licensing, DCH inspects providers periodically. Keep your records current so an inspection does not turn into a list of corrections. DCH may exempt a provider from certain inspection requirements if it holds approved accreditation. Examples of accrediting bodies to ask about include The Joint Commission, ACHC and CHAP. Confirm with DCH which accreditors it recognizes and what the exemption covers, because the accreditation discount and the inspection exemption are separate questions.

Step 8: Get the Local Occupation Tax Certificate

Georgia does not issue a general statewide business license. The Secretary of State issues none, and registering with the Department of Revenue for sales tax is not a business license. The local license you need is an occupation tax certificate, often called a business license, under O.C.G.A. Title 48, chapter 13. It is issued by the city if your business is inside city limits, or by the county for unincorporated areas. A business inside a city pays the city, not the county. More than half of Georgians live outside any city, so for many home care owners the county is the issuer.

Each of Georgia's 159 counties and about 537 cities and towns sets its own formula, deadlines and prerequisites. Call or check the website of your city or county before you assume the process is the same as elsewhere. For more detail, see Georgia business license requirements.

If you have more than 10 employees, the local certificate requires an E-Verify affidavit (O.C.G.A. 36-60-6). Read Georgia E-Verify requirements for business licenses before you apply.

Step 9: Register for Taxes, Hire Staff and Carry Workers' Compensation

Register with the Georgia Department of Revenue through the Georgia Tax Center if you have employees, since you will need to withhold state income tax. Registration for sales tax purposes is free, but home care services are generally not subject to sales tax. Confirm that treatment with the Department of Revenue for your specific services before you assume it.

When you make your first hire, follow the steps in hiring your first employee in Georgia. Register for withholding before the first payroll.

Workers' compensation insurance is required once you have three or more workers, including part-time workers. Read Georgia workers' compensation insurance requirements before your third hire. Georgia has no state paid sick leave or family leave mandate, but your DCH-licensed operations still need written policies for staff.

Step 10: Plan for Medicaid Enrollment and Electronic Visit Verification

Medicaid enrollment is a separate process from your DCH license. It runs through DCH and the Medicaid program, and it has its own requirements. Ask DCH and the Medicaid program when to start it.

If you plan to serve Medicaid clients, ask about electronic visit verification (EVV) before you choose scheduling or billing software. Medicaid-funded home care uses EVV to confirm when and where services happen. A scheduling system that does not work with the required verification process can create billing problems that are expensive to fix later.

Tips and Common Mistakes to Avoid

• Applying for the wrong license. A PHCP and an HHA are different licenses with different fees and different CON exposure. Settle the service model first.
• Assuming a state business license exists. You will look for one that does not exist. Your local occupation tax certificate is the license you need from the government, along with your DCH license.
• Believing a CON applies to every home care business. A PHCP does not need one under Rule 111-8-65-.07. An HHA may, so check DCH Healthcare Planning before spending money.
• Using an outdated fee. The current application processing fee is $300, not $350. The annual license fee is $250 per service offered.
• Planning around the wrong timeline. Initial review is typically about 60 business days, but confirm current timing with DCH before you sign a lease or hire.
• Opening a second location without a second license. Each location needs its own license, and DCH needs 15 days' notice before a location change.
• Hiring before registering for withholding. Register with the Department of Revenue before your first payroll.
• Mixing home care with residential care. If you plan to house clients, you are in a different licensing category. See starting a personal care home business in Georgia.
• Skipping the service agreement. Generic agreements that omit services, frequency, charges or client rights can create compliance and billing problems.

What Results to Expect

A complete, accurate application gives you the best chance of a smooth review, but no outcome is guaranteed. Licensing decisions depend on DCH's review of your documents, your owner and staff history, and the service model you describe. The most time-consuming steps may be gathering staff credentials and drafting policies rather than paying fees. Once licensed, a provider may be able to begin serving clients within the scope of the services listed on its license, and it may qualify for a discount if it holds recognized accreditation. Whether those outcomes apply to your situation depends on your plan, your location and DCH's decision.

Next Steps

Start with the license decision, confirm the CON position with DCH, and then work through entity formation, the owner records check and the local certificate. If your plan involves skilled home health or Medicaid clients, budget extra time for those steps. The Georgia Small Business Development Center at the University of Georgia offers free guidance on business planning, and you can find it at georgiasbdc.org.

Disclaimer: This article is informational only and is not legal, tax or regulatory advice. Fees, review timelines and rules change, so verify each figure with the Georgia Department of Community Health, the Secretary of State, the Department of Revenue or the local agency before you act. Consult a qualified healthcare attorney and a CPA for your specific situation.