Westchester Home Care License Lawyer

Home Care Licensing Attorney Serving Westchester, NY

Westchester County has a significant and affluent aging population, and demand for home health care services continues to grow across the county's diverse communities. From the densely populated southern Westchester cities of Yonkers, Mount Vernon, and New Rochelle to the suburban towns of Scarsdale, Bronxville, and Rye, seniors and individuals with chronic health conditions rely on home care agencies for personal care, skilled nursing, and home health aide services. If you are starting a home care agency in Westchester, acquiring an existing LHCSA, or addressing a DOH regulatory matter, our firm provides legal guidance throughout the 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 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 serving Westchester County.

Our Manhattan office is accessible from Westchester via Metro-North to Grand Central Terminal. We work with home care operators, investors, and healthcare entrepreneurs throughout Westchester County. Schedule a free consultation to discuss your home care licensing needs.

Home Care Licensing Services for Westchester Clients

LHCSA License Application

Westchester County's growing senior population creates steady demand for home care in communities like White Plains, Yonkers, New Rochelle, and Scarsdale. 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 Westchester applicants, demonstrating public need can be challenging given the number of existing LHCSAs already licensed to serve Westchester 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

Westchester LHCSA acquisitions involve the same DOH change of ownership process as agencies in the five boroughs. Buyers should pay particular attention to the agency's managed care contracts, service area, and relationships with Westchester medical providers. Acquiring an existing LHCSA is often the most practical path to operating a home care agency in Westchester. 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

Westchester agencies maintain the same DOH compliance standards as city agencies while addressing the characteristics of serving patients across the county's urban, suburban, and semi-rural areas. 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 Westchester 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

Westchester agencies contract with MCOs serving the county's Medicaid population, which includes some of the same plans active in the Bronx and Manhattan but with different enrollment patterns. Westchester home care agencies contract with managed care organizations serving the county's Medicaid population. The MCO landscape in Westchester includes some of the same plans active in the Bronx and Manhattan, but enrollment patterns differ. Most Westchester 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

Westchester agencies expanding into the five boroughs, adding new service categories, or modifying their corporate structure must file DOH amendments before making operational 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 Westchester Home Care Operators Should Know

Westchester County's home care market reflects the county's demographic and economic diversity. The affluent communities of the lower and central county have a significant private-pay market for home care, while the cities of Yonkers, Mount Vernon, and Peekskill have large Medicaid-dependent populations. Home care agencies serving Westchester must be prepared to navigate both the private-pay and Medicaid managed care landscapes, which requires different operational and compliance approaches.

The public need analysis for Westchester County follows the same statewide framework. If five or more LHCSAs are actively serving patients in the county, new applicants must overcome the presumption of adequate access. Westchester applicants who can demonstrate unmet need in specific communities, such as the growing Latino population in Yonkers and Port Chester or underserved areas in northern Westchester, may have viable grounds for a new application.

For operators considering a LHCSA acquisition in Westchester, due diligence should evaluate the target agency's payer mix (private-pay vs. Medicaid), managed care contracts, geographic coverage within the county, compliance record, and staffing infrastructure. Westchester agencies often face higher aide recruitment and retention costs due to the county's higher cost of living. Our firm conducts comprehensive due diligence and structures transactions to protect the buyer.

Why Westchester 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 Westchester via Metro-North to Grand Central 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 Westchester 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.