Staten Island Home Care License Lawyer

Home Care Licensing Attorney Serving Staten Island, NY

Staten Island has a rapidly aging population and a growing need for home health care services. The borough's suburban layout, with its single-family homes and lower-density neighborhoods spread across the North Shore, Mid-Island, and South Shore, creates unique operational challenges for home care agencies compared to the more densely populated boroughs. Neighborhoods like Tottenville, Great Kills, New Dorp, and St. George are home to seniors who prefer to age in place rather than move to assisted living or nursing facilities. If you are starting a home care agency on Staten Island, acquiring an existing LHCSA, or addressing a DOH compliance issue, our firm provides the legal support you need.

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

Our Lower Manhattan office is accessible from Staten Island via the Staten Island Ferry to Whitehall Terminal, a short walk from our Financial District location. We work with home care operators and healthcare entrepreneurs serving Staten Island and the surrounding area. Schedule a free consultation to discuss your home care licensing needs.

Home Care Licensing Services for Staten Island Clients

LHCSA License Application

Staten Island's geography and aging population create consistent demand for home care services, though the borough's suburban character means agencies must plan service delivery for a more dispersed patient base. 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 Staten Island applicants, demonstrating public need can be challenging given the number of existing LHCSAs already licensed to serve Richmond 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

Staten Island LHCSA acquisitions require particular attention to the agency's managed care contracts and relationships with local referral sources, which may be more concentrated than in larger boroughs. Acquiring an existing LHCSA is often the most practical path to operating a home care agency in Staten 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

Staten Island agencies maintain DOH compliance while managing the logistical challenges of serving a geographically dispersed patient base across the borough. 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 Staten 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

Staten Island agencies contract with MCOs active in Richmond County, where the managed care landscape is smaller than in other boroughs, making relationships with key plans particularly important. Staten Island home care agencies contract with managed care organizations active in Richmond County. The MCO landscape in Staten Island is smaller than in other boroughs, which means agency relationships with key plans are particularly important. Most Staten 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

Staten Island agencies expanding operations beyond Richmond County or adding new service categories must file DOH amendments before implementing the changes. 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 Staten Island Home Care Operators Should Know

Richmond County's demographics present both opportunity and challenge for home care operators. Staten Island has a significant population of older residents, many of whom live in private homes rather than apartment buildings. This means home care agencies must plan for longer travel times between patient visits and factor transportation logistics into their staffing models. The borough's Italian-American and growing immigrant communities, including Russian, Albanian, and Sri Lankan populations, also create demand for culturally competent and language-specific home care services.

Compared to Brooklyn or Queens, Staten Island has fewer existing LHCSAs, which may make the public need argument somewhat more favorable for new applicants in Richmond County. However, applicants must still present evidence-based data if five or more agencies are already serving the county. Demonstrating that existing agencies are not adequately covering the South Shore or that specific populations lack access to linguistically competent aides can strengthen an application.

For operators interested in acquiring an existing LHCSA on Staten Island, the pool of available agencies is smaller than in the more populated boroughs. Buyers should evaluate managed care contract coverage, patient census and service area, compliance history, and the agency's staffing infrastructure. Our firm conducts thorough due diligence and manages the change of ownership process from the initial letter of intent through PHHPC approval.

Why Staten 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 Staten Island via the Ferry to Whitehall, near 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 Richmond 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.