Starting a home health care business in Virginia could very well be the rewarding venture you’ve always dreamed of pursuing. If assisting and supporting people through their health journey and business is your passion, establishing a home health agency in the state of Virginia may be the perfect opportunity for you!

Virginia Skyline

Starting a business in this field requires navigating Virginia’s licensing and regulatory requirements and considering the costs associated with launching a business of this caliber, including staffing, licensing, insurance, and marketing.

In this article, we’ll guide you through the process of starting a home health agency in Virginia, including the licensing and regulatory requirements, the costs associated with starting a home health business, and the necessary steps to establish your policies and procedures.

How Profitable is Owning a Home Health Care Business in Virginia?

This is the number one question people ask when considering starting their own business. Profit and autonomy are significant drivers for potential business owners. Knowing whether you’re profitable will likely determine whether or not to venture off on your own.

You can be confident that the home health care industry is growing at a rapid pace. According to the U.S. Bureau of Labor Statistics, “Healthcare occupations and those associated with healthcare account for most of the 20 fastest growing occupations from 2019 to 2029.” [01] This is exciting for home healthcare business newcomers. The home health care industry is even projected to reach a market value of $173 billion by 2026.

Senior population

Virginia’s aging population is also growing at a steady rate. In fact, the Virginia Department for Aging and Rehabilitative Services (DARS) reported that from 2000 to 2020, the state’s population of individuals aged 60 and older increased by 72.5%. This growing demographic is expected to continue expanding, driving the demand for home health care services.

Of course, the profitability of your home health agency in Virginia will likely depend on several factors, including the size of your business, the types of health services you provide, and your pricing strategy.

However, it also comes down to your reason for starting a home care business. Owning a home health care business is one that blends profit and purpose, making this a great way towards a prosperous and fulfilling career!

Steps to Starting a Home Health Care Agency in Virginia

There are many steps to the startup process (read our step-by-step guide on how to start a home care business in 2023). We’ve listed seven essential steps to help you start a home health care agency in Virginia.

1) Create a Business Plan

Developing a solid business plan is the first step to starting a home health agency. This comprehensive document outlines the company description, business goals, operational plan, strategies, operational procedures, services, target market, competitive analysis, financial projections, and marketing plans.

A well-crafted business plan serves as a roadmap, providing a clear vision of the agency’s objectives and strategies, helping identify potential challenges and opportunities, and enabling informed decision-making. It also acts as a blueprint for owners and investors, illustrating the business’s viability and potential for success.

For more information on structuring and creating the perfect home health care business plan, visit this article.

2) Choose a Business Structure and Register Your Business

In order to do business in Virginia as a home health or non medical home care agency, you will need to register your business by choosing an appropriate legal structure and getting a Tax ID Number and NPI Number.

Business legal structures are important to protect yourself legally. There are different types of legal business structures to choose from. Most companies use an LLC structure (limited liability corporation), corporation, or sole proprietorship. The simplest legal and ownership structure to set up is a sole proprietorship, as it is the most affordable. The downfall of a sole proprietorship is that it does not offer personal liability protection. When starting a home health agency, getting personal liability protection and seeking legal structures that reflect this is highly recommended.

We recommend consulting with a lawyer or accountant when selecting a legal structure for your home health agency in Virginia. They can provide you with valuable advice and assist you with setting up the best structure for your healthcare agency here.

3) Obtain the Proper Licensing

To operate a home health care business in Virginia, you’ll need to obtain the appropriate license. Here are the simplified steps to follow:

  1. Research licensing requirements: Virginia has strict licensing requirements, so familiarize yourself with the process. If you need assistance, consider contacting Nurse Next Door franchising support team at 1-855-737-6803.
  2. Identify the type of license needed: Licenses vary depending on the type of home health care business you plan to operate. Refer to the Virginia Department of Health’s Office of Licensure and Certification for guidance.
  3. Review the Home Care Initial Survey Checklist: Use this resource before applying for a home care license to ensure you meet all requirements.
  4. Prepare to pay fees: Initial application fees are $600, with annual renewal fees of $450.
  5. Submit policies and procedures: Include these with your application, along with other requirements listed in the application checklist.
  6. Consider Medicaid certification: If you plan to accommodate Medicaid clients, research the certification process.

4) Get the Right Insurance

Insurance is a major factor to consider when you’re a business owner. Liability insurance coverage can prevent you from being liable for accidents or injuries on the job with clients or your own staff.

Insurance in the health care field is essential when offering medical services to individuals. You want to ensure all your bases are covered and protect your business.

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5) Develop Policies and Procedures and Other Requirements

Before applying for your home health care license in Virginia, one thing to consider is developing appropriate policies and procedure manuals. These manuals are essential for your staff, the state’s office (Virginia, department of health and policies), and your own home care business.

Defined by the Virginia Department of Health, “a policy is a principle or a predetermined course of action to guide decision making. A procedure describes a method to carry out a policy and often includes a series of steps. The policies and procedures submitted by the agency represent a sampling of the policies and procedures necessary to direct all administrative, personnel, and client care operations of the agency as required by Virginia regulations. The policies and procedures reflect an assurance of compliance.”

6) Hire Staff

As a home health care agency business startup, it’s essential to know when to hire staff. Since many clients require 24/7 personal care services, you cannot handle the workload independently. Hiring reliable staff becomes crucial to support you when you need a break or are too busy to manage the workload.

Generally, consider hiring staff when you have more clients than you can handle, ensuring that you provide the best quality of care to potential clients while keeping up with the demand for your services. You may also want to hire staff if you plan to expand your service offerings or take on larger contracts.

Before hiring staff, make sure you have the necessary resources, including a solid financial plan, appropriate insurance coverage, and a comprehensive training plan. Hiring the right people at the right time can help you develop your home health care agency while providing high-quality care to your clients.

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7) Market Your Home Health Care Agency

Marketing is essential for the success of home health care agencies. Develop a clear marketing plan that includes:

  • Building a strong online presence with a professional website and active social media profiles.
  • Networking with local healthcare providers, attending healthcare events, and conferences to introduce your services.
  • Participating in community events to raise awareness about your agency and services.
  • Leveraging referral marketing by encouraging satisfied clients to refer others and establishing referral relationships with healthcare providers.
  • Consistently providing high-quality care and excellent customer service.

By implementing these strategies, you can establish your home health care agency as a trusted and reliable provider in Virginia. For a complete guide on home care marketing, you can refer to resources like this article on marketing strategies.

To Franchise or Not to Franchise, That Is the Question

It requires years of hard work and effort to grow home health agencies. Starting from scratch may not always be the best option for potential business owners. It takes a lot of time and money to invest in strategy, marketing, brand development, policies, procedures, etc. That’s where franchising comes in.


Franchising is a great alternative for those business owners who want an established and well-recognized brand to lean on. There are many perks to owning a franchise, especially owning a Nurse Next Door franchise. Is a franchise right for you? Read this article to find out!

There are several advantages to joining Nurse Next Door’s franchise, one of which is the continuous support throughout your journey with the company. You’ll receive thorough training, ongoing support and assistance, and access to various tools and resources that can help you operate your business effectively. With a well-established brand reputation, Nurse Next Door can also help you attract new clients that much easier, further contributing to the success of your own business operations.

Of course, there are always risks involved with starting any business, including franchising. For information, read the steps to owning a home care franchise with Nurse Next Door here:

Steps To Own A Nurse Next Door Home Care Business

Whether or not you choose to franchise, a career in the home health industry is rewarding,  meaningful, and full of purpose.

If your values are the same as Nurse Next Door’s core values, including Admiring People, WOW Customer Experiences, Finding Better Ways, and being Passionate About Making A Difference, then perhaps franchising with Nurse Next Door is for you!

Founded in 2001 with a mission to make senior citizens’ lives better, Nurse Next Door provides compassionate and personalized in-home health care services to seniors.

Learn more about franchising opportunities in Virginia today!