New York Home Care License Lawyer

Home Care Licensing Attorney Serving New York, NY

New York State has one of the largest home health care markets in the country, driven by its aging population, high rate of chronic illness, and a Medicaid program that funds a significant portion of home-based care through managed long term care plans. Whether you are planning to launch a new home care agency in the five boroughs, acquire an existing LHCSA on Long Island or in Westchester, or resolve a DOH compliance issue for an agency operating anywhere in the metro area, our firm provides legal representation at every stage of 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. Since the LHCSA moratorium expired in 2020 and the DOH released its updated application in 2022, the licensing landscape has changed significantly. Our attorneys stay current with DOH policy changes, PHHPC decisions, and the evolving regulatory environment to provide clients with accurate and practical guidance.

Our office at 30 Broad Street in the Financial District serves home care operators, investors, and healthcare entrepreneurs throughout the New York metropolitan area. Whether your agency serves patients in one borough or across multiple counties, we can help. Schedule a free consultation to discuss your home care licensing needs.

Home Care Licensing Services for New York Clients

LHCSA License Application

New York's home care industry serves hundreds of thousands of patients annually. The LHCSA application process is complex, and the DOH maintains strict requirements for new applicants. 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 New York applicants, demonstrating public need can be challenging given the number of existing LHCSAs already licensed to serve the New York metropolitan area. 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

The New York home care market includes frequent acquisition activity as operators buy, sell, and merge agencies. The DOH change of ownership process is a regulated transaction that requires advance approval before the transfer can close. Acquiring an existing LHCSA is often the most practical path to operating a home care agency in New York. 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

New York home care agencies are subject to ongoing DOH oversight including periodic surveys, quality reporting, and complaint investigations that require proactive compliance programs. 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 New York 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

New York home care agencies must establish contracts with Medicaid managed care organizations to serve Medicaid patients. The managed care landscape varies significantly by borough and county, and agencies need contracts with the plans dominant in their service area. Most New York 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

Licensed agencies seeking to expand their service area, add new service types, or make structural changes must obtain DOH approval through the administrative amendment process. 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 New York Home Care Operators Should Know

The New York LHCSA market varies significantly by geography. New York City boroughs have high concentrations of existing agencies, making the public need presumption a substantial hurdle for new applicants. Suburban counties like Westchester, Nassau, and Suffolk may present more favorable conditions depending on the number of agencies actively serving patients in each county. The DOH evaluates public need at the county level, so an applicant who cannot establish need in the New York metropolitan area might have a viable argument in a less saturated county.

For entrepreneurs and investors entering the home care market, acquiring an existing LHCSA is often the most efficient path. The change of ownership process requires DOH approval and PHHPC review but does not require demonstrating public need if the target agency is actively serving 25 or more patients. New York's market includes a wide range of acquisition targets, from small single-county agencies to larger multi-county operations with extensive managed care contract portfolios. The key to a successful acquisition is thorough due diligence covering compliance history, financial performance, staffing levels, and managed care relationships.

Operators who hold or acquire a LHCSA in New York must also navigate the state's complex Medicaid managed care environment. Most home care services for Medicaid beneficiaries are delivered through Managed Long Term Care (MLTC) plans, which control service authorizations, reimbursement rates, and billing requirements. Securing and maintaining managed care contracts is essential to the financial viability of most LHCSAs. Our firm advises on MLTC contracting, Medicaid compliance, and dispute resolution across the metro area.

Why New York 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 statewide
• Due diligence, purchase agreement negotiation, and PHHPC representation for LHCSA acquisitions
• Medicaid managed care contract review, negotiation, and billing compliance
• Centrally located in Lower Manhattan, accessible from all five boroughs and suburbs
• Licensed in both New York and New Jersey for operators serving patients across state lines

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 the New York metropolitan area 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.