Home Services Division Licensure Applications and Forms 2026

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  1. Click ‘Get Form’ to open the Home Services Division Licensure Application in the editor.
  2. Begin with the 'Aide Identification' section. Fill in the full name, residential address, city, county, state, zip code, phone number, date of hire, social security number, date of birth, RHHA registration number, and CNA registration number.
  3. Proceed to the 'Record of Competency/Skills Check' section. Enter the name of the organization conducting the competency check along with its city, state, zip code, facility number, supervisor's name conducting the check, and the date completed.
  4. Complete the 'Agency Identification' section by providing the program director’s name, home health agency name, street address, city, county, zip code, facility number, and agency telephone number.
  5. Finally, ensure that the program director signs and dates the application at the bottom of this section.

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Medicare will cover 100% of the costs for medically necessary home health care, provided that care is part time or intermittent. The care needed must be less than 28 hours per week. The average cost of home health care in 2024 is $29.50 per hour, but it can vary greatly by state.
Apply Now Go to our online PALS site and sign in or create an account. Select the board to apply to, and plain-language questions will appear to help you get started. Carefully review the license application, which will feature a checklist, required uploads, and prompts. Review all your information and edit as needed.
License Renewal Home care agency licenses in Pennsylvania must be renewed periodically. The renewal process involves: Submitting a Renewal Application: Complete the renewal application form provided by the Department of Health. Paying the Renewal Fee: Submit the required fee along with your application.
Depending on the location of your home healthcare agency, the estimated start-up costs run as follows: Private Pay Home Care agency: $40,000 to $80,000. Licensed Home Health non-Medicare agency: $60,000 to $100,000. Medicare Certified agency: $150,000 to $350,000.
Applications for non-medical licenses must include a check/money order for $100, made payable to Commonwealth of PA. Youll also need to complete several other forms, including: Identifying Information of Home Care Agency/Registry.

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