Manhattan Home Care License Lawyer

Home Care Licensing Attorney Serving Manhattan, NY

Manhattan is home to a diverse population of seniors and individuals with complex health care needs who require home-based nursing, personal care, and home health aide services. The Upper West Side and Upper East Side have large concentrations of older residents in co-ops and condos, while Washington Heights, East Harlem, Chinatown, and the Lower East Side serve significant immigrant populations who need culturally competent care. If you are starting a home care agency in Manhattan, acquiring an existing LHCSA, or addressing a DOH compliance matter, our firm provides experienced legal representation.

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 application requires demonstrating public need, financial feasibility, and character and competence. Our attorneys prepare LHCSA applications, represent clients before the Public Health and Health Planning Council (PHHPC), and handle change of ownership transactions for agencies operating in New York County.

Our office is located at 30 Broad Street in the Financial District, making it convenient for Manhattan-based clients. We represent home care operators, investors, and healthcare entrepreneurs throughout New York County. Schedule a free consultation to discuss your LHCSA licensing needs.

Home Care Licensing Services for Manhattan Clients

LHCSA License Application

Manhattan's home care market includes both high-acuity Medicaid patients and private-pay clients. LHCSA applicants targeting Manhattan should understand the borough's mixed payer environment. 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 Manhattan applicants, demonstrating public need can be challenging given the number of existing LHCSAs already licensed to serve New York 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

Manhattan LHCSA acquisitions can involve significant transaction values given the borough's patient density and payer mix. The DOH change of ownership process must be managed carefully to avoid disruption to patient care and managed care contracts. Acquiring an existing LHCSA is often the most practical path to operating a home care agency in Manhattan. 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

Manhattan agencies operate in a heavily regulated environment with active DOH oversight, requiring comprehensive compliance programs addressing patient safety, aide supervision, and quality metrics. 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 Manhattan 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

Manhattan agencies may contract with both Medicaid MCOs and private insurance plans, reflecting the borough's mixed payer population and varying needs by neighborhood. Manhattan home care agencies may contract with both Medicaid managed care organizations and private insurance plans, reflecting the borough's mixed payer population. MCO contracting strategy in Manhattan depends on the agency's target patient population. Most Manhattan 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

Manhattan agencies adding service categories, expanding into other boroughs, or making significant operational changes must file amendment applications 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 Manhattan Home Care Operators Should Know

New York County presents a unique home care market. Manhattan's density, high cost of living, and diverse population create both strong demand for services and intense competition among existing agencies. The borough has significant numbers of seniors on the Upper West Side and Upper East Side who can afford private-pay home care, alongside large Medicaid-dependent populations in East Harlem, Washington Heights, and the Lower East Side who rely on managed long term care plans for their home health services.

Manhattan has a substantial number of existing LHCSAs, and new applicants face the same public need presumption that applies across New York State. Applicants proposing to serve Manhattan must demonstrate an access gap if five or more LHCSAs are actively serving patients in New York County. Specialized services targeting underserved populations, such as Mandarin-speaking patients in Chinatown, Spanish-speaking seniors in East Harlem, or patients with complex medical needs requiring skilled nursing visits, may provide grounds to overcome the presumption.

For operators looking to acquire an existing LHCSA that serves Manhattan, the market includes agencies of varying size and sophistication. Some Manhattan-based agencies serve a predominantly private-pay clientele, while others focus on Medicaid-funded care through MLTC contracts. Due diligence should evaluate the agency's payer mix, managed care contract portfolio, compliance record, staffing infrastructure, and financial stability. Our firm conducts comprehensive due diligence to help buyers make informed acquisition decisions.

Why Manhattan 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
• Located in the Financial District at 30 Broad Street for convenient access
• 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 New York 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.