Starting a home health agency in Iowa can be a lucrative and rewarding business venture for those interested in providing high-quality medical and non-medical care services to clients in their homes. With the significant role that home health businesses play in providing healthcare services to Iowa residents, it is important to understand the market and the regulatory requirements before starting a home health care business.

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In this article, we’ll guide you through the key steps involved in starting a home health care business in Iowa. From conducting market research and meeting regulatory requirements to creating a business plan, we’ll provide you with the information and resources you need to succeed.

Whether you’re starting your own business or considering a franchise, this guide will help you navigate the process and build a thriving home health business in Iowa.

Understanding the Home Healthcare Industry in Iowa

A report from the AARP found that 95% of seniors in Iowa prefer to receive care in their own homes rather than in a nursing home or assisted living facility. This highlights the importance of home care services in Iowa, as they allow seniors to age in place and maintain their independence while still receiving necessary care and support.

Along with that, according to the U.S. Census Bureau, the population of Iowa aged 65 and older is projected to increase from 16.7% in 2020 to 22.6% by 2050. This demographic shift highlights the growing need for home care services and other healthcare resources to support older adults in Iowa.

Home health agencies offer a convenient and cost-effective way for individuals to receive medical and non-medical care in the comfort of their own homes. This is especially important for older adults who wish to age in place and maintain their independence.

Home health agencies can help patients manage their health conditions more effectively and avoid costly hospitalizations and emergency room visits by providing a range of services, including skilled nursing care, therapy, personal care, and companion care.

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Types of Services

Home care care businesses provide various services to help individuals live comfortably and independently in their homes. Services can include:

Conducting Market Research for a Home Health Care Business

Before starting a home health care business in Iowa, it’s essential to conduct market research. Identify your target market, analyze your competition, and determine the need for the type of services needed in your area. This will help you tailor your services to meet the needs of your community.

Identify the Target Market

In Iowa, your target market could include seniors who want to maintain their independence while receiving medical care at home, clients with chronic health conditions, or those needing ongoing medical care after being discharged from a hospital.


By identifying your target market, you can customize your services to meet their specific needs and preferences, such as offering seniors personal care, medication management, and companionship to ensure their comfort and support while receiving care at home.

Analyzing Competition

Analyzing your competition is a critical step in understanding the market in Iowa and starting a successful home care business. You will want to identify other home health care agencies in your area and evaluate their services, pricing, and quality of care. By understanding what your competitors are offering and how they are positioning themselves in the market, you can develop a strategy to differentiate your services and stand out in the market.

For example, you may want to focus on offering specialized services that your competitors do not offer, or you may want to focus on providing high-quality, personalized care to differentiate yourself in the market.

Determining the Need for Home Health Services

To compete in the healthcare market effectively, it’s crucial to understand the needs of your community. Gathering data on healthcare trends in your area, such as chronic health conditions, seniors aging in place, and hospital readmissions can help you determine what services are in high demand.

Meeting Regulations and Licensing Requirements

Home health agencies in Iowa are regulated by the state and federal governments. You’ll need to obtain licenses and certifications, such as a Medicare provider number and a state license.

State and Federal Regulations for Iowa Home Health Agencies

The Iowa Department of Inspections and Appeals regulates home health businesses in the state, and they have specific requirements that agencies must meet to obtain a home health care license. Some of these requirements include:

  • Maintaining a physical office in Iowa
  • Having a designated administrator with at least two years of experience in healthcare administration
  • Conducting background checks on all employees
  • Providing ongoing training and education to staff members
  • Creating policies and procedures for patient care and safety

In addition to state regulations, home health businesses must also comply with federal regulations, such as those set forth by the Centers for Medicare and Medicaid Services (CMS). These regulations cover areas such as patient rights, quality of care, and billing and reimbursement.

Applying for Licenses and Certifications

Once you understand the regulations and requirements for a home health care business in Iowa, it’s time to apply for the necessary licenses and certifications. This process can be complex, so working with a knowledgeable and experienced attorney or a partner like Nurse Next Door or is important.


To become a Medicare-certified home health business in Iowa, you must apply for a Medicare provider number through the CMS. This process involves:

  1. Completing an application
  2. Providing documentation of your compliance with state and federal regulations
  3. Undergoing a site visit from a CMS surveyor

In addition to obtaining a Medicare provider number, you’ll also need to apply for a state license through the Iowa Department of Inspections and Appeals. This process involves completing an application, providing proof of compliance with state regulations, and paying a licensing fee.

Working with a partner like Nurse Next Door can help streamline the licensing and certification process and ensure that your agency meets all of the necessary requirements to operate legally and effectively in Iowa.

Creating a Business Plan

Creating a comprehensive business plan is crucial to starting a successful home health care business in Iowa. Identify your business goals and objectives, determine your target client population, and consider any unique selling points that your agency can offer.

After that, you’ll want to develop a marketing strategy to promote your services and attract clients and consider partnering with healthcare providers in your community to gain referrals. Additionally, you’ll need to develop a budget and financial projections to understand your start-up costs and revenue potential.

Nurse Next Door can provide resources and tools to help you create a successful business plan, from goal setting to financial planning and marketing strategy development.

Staffing and Training

One of the most important factors in the success of your home care business is hiring qualified employees and providing them with proper training. When hiring staff you’ll want to look further than just those that can offer skilled nursing services, it’s essential to look for individuals with the right qualifications and experience, such as registered nurses, licensed practical nurses, non-medical caregivers, home health aides, and companions.

Communication and interpersonal skills are also critical in building strong relationships with clients and their families.


Once you’ve hired your staff, providing them with adequate training and education is important. This includes training on your agency’s specific services and general healthcare training. Ongoing training and education are also important to ensure your staff stays updated on the latest healthcare practices and regulations.

Starting Your Own Business vs. Buying a Franchise

If you’re interested in starting a home health agency in Iowa, you have two main options: starting your own business or buying a franchise. Each option has its own set of pros and cons to consider before making a decision.

Starting Your Own Business

Starting your own business gives you complete control over the business, allowing you to customize your services and operations to your preferences.

You also won’t have to pay franchise fees or royalties and can build your own brand and reputation. However, you’ll need to create your own business model and plan, build your own systems and processes, and won’t have the support and resources of an established franchise.

Buying a Franchise

Buying a franchise has the benefit of an established brand and business model, access to support and resources from the franchisor, and the ability to benefit from the franchisor’s marketing and advertising efforts. Additionally, a franchise business has a higher likelihood of succeeding than starting your own business. However, you’ll need to pay franchise fees and royalties, and you may have less control over the business operations and services, and you’ll need to follow the franchisor’s rules and regulations.

According to a study by the International Franchise Association, 91% of franchise businesses were still operating after four years, compared to only 47% of independent businesses.

When deciding whether become a business owner of your own business or buy a franchise, it’s important to consider your personal preferences and business goals, budget, experience, and resources. Nurse Next Door is a franchise option that provides the benefits of an established brand and business model. Ultimately, the decision comes down to what will work best for your situation.

To Wrap Up

Starting a home health care agency in Iowa can be a rewarding and profitable venture if done correctly.

It’s important to conduct thorough research, create a comprehensive business plan, comply with state and federal regulations, and provide high-quality care to your patients. By following these steps and seeking guidance from industry experts, you can successfully launch and grow your home health business.

If you’re looking for support and resources to help you start your own home health business, Nurse Next Door can help. Our experienced team provides comprehensive training and ongoing support to help you succeed, from marketing and advertising assistance to operational guidance.

Contact Nurse Next Door today to learn more about our franchising opportunities and start your journey towards entrepreneurship and providing compassionate care to your community.