Brooklyn Home Care License Lawyer

Home Care Licensing Attorney Serving Brooklyn, NY

Brooklyn is the most populated borough in New York City and one of the largest markets for home health care services in the state. The aging population in neighborhoods like Borough Park, Bensonhurst, Brighton Beach, Flatbush, and Sheepshead Bay drives strong demand for personal care aides, home health aides, and skilled nursing services delivered in the home. If you are starting a home care agency, acquiring an existing LHCSA, or dealing with a DOH compliance matter, our firm provides legal representation throughout the licensing process.

A Licensed Home Care Services Agency (LHCSA) license from the New York State Department of Health is required for any organization that provides nursing, home health aide, or personal care services in a patient's home. The LHCSA application process involves demonstrating public need, financial feasibility, and the character and competence of the proposed operator. Our attorneys prepare and file LHCSA applications, represent clients before the Public Health and Health Planning Council (PHHPC), and handle change of ownership transactions for existing agencies.

Our Lower Manhattan office is easily reached from Brooklyn via the 2, 3, 4, 5, A, C, F, or R trains. We work with home care operators, investors, and healthcare entrepreneurs throughout Kings County. Schedule a free consultation to discuss your home care licensing needs.

Home Care Licensing Services for Brooklyn Clients

LHCSA License Application

Brooklyn has one of the largest home care patient populations in New York City, driven by dense residential neighborhoods, an aging population in Bay Ridge and Bensonhurst, and a significant Medicaid-eligible population. Obtaining a new LHCSA license requires a Certificate of Need (CON) application submitted to the Department of Health. The application must address three criteria: public need for home care services in your proposed service area, the financial feasibility of the agency, and the character and competence of the applicant. For Brooklyn applicants, demonstrating public need can be challenging given the number of existing LHCSAs already licensed to serve Kings County. Our attorneys evaluate whether a new application is viable, identify potential grounds to overcome the public need presumption, and prepare thorough applications that address every element the DOH and PHHPC review.

LHCSA Change of Ownership

Brooklyn's home care market has seen active acquisition activity as larger operators seek to expand their patient base and geographic coverage. Whether you are buying or selling a Brooklyn LHCSA, the DOH change of ownership process requires careful planning. Acquiring an existing LHCSA is often the most practical path to operating a home care agency in Brooklyn. A change of ownership transaction requires DOH approval and PHHPC review, but buyers are not required to demonstrate public need if the agency being acquired is actively serving at least 25 patients and has been licensed for a minimum of five years. Our firm handles every aspect of the acquisition: conducting due diligence on the target agency, reviewing financial records and compliance history, negotiating the purchase agreement, preparing the change of ownership application, and representing the buyer through the regulatory approval process.

DOH Compliance and Regulatory Matters

Brooklyn home care agencies face ongoing DOH compliance requirements including periodic surveys, plan of correction submissions, and quality reporting, with additional expectations around culturally competent care for the borough's diverse population. The Department of Health conducts periodic surveys of LHCSA operations and investigates complaints from patients, staff, and other parties. If a survey identifies deficiencies, the agency must submit a plan of correction within 10 days. Serious or repeated violations can result in enforcement actions, fines, or license revocation. Our firm assists Brooklyn home care agencies with responding to deficiency findings, preparing plans of correction, defending against enforcement actions, and implementing compliance programs to prevent future violations.

Medicaid Managed Care Contracting

Brooklyn agencies typically need contracts with multiple managed care organizations to serve the borough's large Medicaid population concentrated in neighborhoods like Flatbush, East New York, Brownsville, and Sunset Park. Brooklyn home care agencies typically need contracts with multiple managed care organizations (MCOs) to serve the borough's large Medicaid population. The dominant MCOs in Brooklyn include plans with significant enrollment in Flatbush, East New York, Brownsville, and Sunset Park. Most Brooklyn LHCSAs provide services to Medicaid beneficiaries through contracts with Managed Long Term Care (MLTC) plans. These contracts govern reimbursement rates, service authorization procedures, billing requirements, and dispute resolution. Our attorneys review and negotiate MLTC contracts on behalf of home care agencies, advise on Medicaid billing compliance, and assist with disputes over denied claims or contract termination. We also help new LHCSA operators navigate the process of enrolling as a Medicaid provider and securing their first managed care contracts.

Administrative Licensure Amendments

Brooklyn agencies expanding their service area, adding new service categories, or changing their operating address within the borough must file administrative amendments with the DOH. LHCSA operators may need to amend their license for various reasons: expanding their approved service area to additional counties, adding or closing a site, changing the agency's name, or updating ownership information that does not rise to the level of a change of ownership. As of August 2025, the DOH revised its administrative amendment process, requiring all amendments to be submitted to the Bureau of Home and Community Based Services Licensing Unit for approval. Our firm prepares and files these amendments and ensures compliance with the updated procedures.

What Brooklyn Home Care Operators Should Know

Kings County has one of the highest concentrations of LHCSA-licensed agencies in New York State. The large elderly and immigrant populations in Brooklyn, particularly in the Russian-speaking communities of Brighton Beach and Sheepshead Bay, the Orthodox Jewish communities of Borough Park and Williamsburg, and the Caribbean communities of Flatbush and East Flatbush, create consistent demand for culturally competent home care services. Many Brooklyn LHCSA operators serve patients who require aides fluent in Russian, Yiddish, Haitian Creole, Spanish, or Chinese.

Because of the high number of existing agencies, new LHCSA applicants in Brooklyn face a significant hurdle: the public need presumption. If five or more LHCSAs are actively serving patients in Kings County, there is a rebuttable presumption that no additional agency is needed. Applicants must present data-driven evidence of an access gap, such as underserved populations who cannot obtain services from existing agencies due to language barriers, cultural needs, geographic limitations within the county, or specialized care requirements. Our attorneys evaluate whether a viable public need argument exists before you invest in the application process.

For operators considering an acquisition, Brooklyn offers a large inventory of existing LHCSAs, but due diligence is critical. Buyers should carefully review the target agency's DOH compliance history, survey results, Medicaid billing records, staffing levels, managed care contracts, and financial statements. Agencies with unresolved deficiencies, pending enforcement actions, or a history of complaints present significant risk. Our firm conducts comprehensive due diligence and structures transactions to protect the buyer's interests.

Why Brooklyn Clients Choose Agarunov Law Firm

Agarunov Law Firm represents home care operators, investors, and healthcare entrepreneurs from our Lower Manhattan office. We understand the regulatory framework that governs LHCSA licensing in New York and provide practical guidance at every stage of the process.

• Experienced in LHCSA applications, change of ownership transactions, and DOH compliance
• Due diligence, purchase agreement negotiation, and PHHPC representation for LHCSA acquisitions
• Medicaid managed care contract review, negotiation, and billing compliance
• Accessible from Brooklyn via multiple subway lines to our Financial District office
• Licensed in both New York and New Jersey for operators serving patients in both states

How Our Home Care Licensing Process Works

• Step 1: Consultation. We discuss your goals, whether you plan to start a new LHCSA or acquire an existing agency, your proposed service area, and your financial resources. This initial consultation is free.
• Step 2: Feasibility Assessment. We evaluate whether a new LHCSA application is viable in Kings County based on the current public need landscape, or identify acquisition targets if purchasing an existing agency is the preferred approach.
• Step 3: Application or Acquisition. For new applications, we prepare the CON application including public need analysis, financial projections, and character and competence documentation. For acquisitions, we conduct due diligence, negotiate the purchase agreement, and prepare the change of ownership application.
• Step 4: Regulatory Review. We manage communications with the DOH, respond to any requests for additional information, and represent you before the PHHPC when the application is reviewed for approval.
• Step 5: Post-Approval Compliance. After licensure, we assist with Medicaid enrollment, managed care contracting, policy and procedure development, and ongoing regulatory compliance.