Long Island Home Care License Lawyer

Home Care Licensing Attorney Serving Long Island, NY

Long Island has one of the largest aging populations in the New York metropolitan area. Nassau and Suffolk counties are home to hundreds of thousands of seniors who prefer to age in place rather than relocate to assisted living or nursing facilities. The suburban character of Long Island, with its predominantly single-family housing, means home care agencies must manage larger service areas and longer travel times between patient visits compared to agencies operating in the five boroughs. If you are starting a home care agency on Long Island, acquiring an existing LHCSA, or dealing with a DOH compliance matter, our firm provides experienced legal counsel.

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

Our Manhattan office is accessible from Long Island via the LIRR to Penn Station or Atlantic Terminal. We represent home care operators, investors, and healthcare entrepreneurs throughout Nassau and Suffolk counties. Schedule a free consultation to discuss your home care licensing needs.

Home Care Licensing Services for Long Island Clients

LHCSA License Application

Long Island's aging population in Nassau and Suffolk Counties drives significant demand for home health care. LHCSA applicants serving Long Island must account for suburban geography and distance between patients. 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 Long Island applicants, demonstrating public need can be challenging given the number of existing LHCSAs already licensed to serve Nassau and Suffolk counties. 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

Long Island home care agencies are active in the acquisition market, particularly agencies with established managed care contracts and patient volumes in Nassau and Suffolk Counties. The DOH change of ownership process must account for the agency's specific service area approvals. Acquiring an existing LHCSA is often the most practical path to operating a home care agency in Long Island. 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

Long Island agencies face DOH requirements consistent with city agencies but must also address operational challenges of suburban service delivery, including travel time and aide deployment. 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 Long Island 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

Long Island agencies contract with MCOs active in Nassau and Suffolk Counties, where the managed care landscape differs from the five boroughs and requires familiarity with county-specific plans. Long Island home care agencies contract with managed care organizations active in Nassau and Suffolk Counties. The MCO landscape on Long Island differs from the five boroughs, and agencies need contracts with plans that have significant Long Island enrollment. Most Long Island 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

Long Island agencies expanding their service area, adding clinical services, or making changes to their corporate structure must file amendments with the DOH before implementation. 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 Long Island Home Care Operators Should Know

Long Island's home care market differs from the city in several important ways. The suburban geography means agencies must account for greater distances between patient homes, which affects staffing models, transportation logistics, and operational costs. Nassau and Suffolk counties each constitute a separate service area for LHCSA licensing purposes, so operators who want to serve both counties must be approved for each one. The predominantly English-speaking population also includes growing Spanish-speaking, Haitian Creole, and South Asian communities that need linguistically competent home care services.

The public need analysis for Long Island applicants is evaluated at the county level. If five or more LHCSAs are actively serving patients in Nassau County, the presumption of adequate access applies to Nassau specifically, and the same analysis applies separately to Suffolk County. Applicants may find it more feasible to demonstrate public need in Suffolk County, where the population is more spread out and certain communities in the eastern part of the county may be underserved by existing agencies.

For operators considering a LHCSA acquisition on Long Island, the market includes agencies that serve one or both counties. Due diligence should evaluate the target agency's county-level patient census, managed care contract portfolio, compliance history, staffing infrastructure, and operating costs. Long Island agencies often face higher aide recruitment costs due to competition from healthcare facilities and the cost of living. Our firm conducts detailed due diligence and structures acquisitions to protect the buyer's interests.

Why Long Island 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 Long Island via LIRR to Penn Station or Atlantic Terminal
• 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 Nassau and Suffolk counties 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.