Last updated: November 2026
A Florida home health agency provides one or more home health services and needs a license or registration from the Agency for Health Care Administration (AHCA), unless exempt under section 400.464(6). Integral Healthcare Solutions (IHS) prepares start-up and expanding agencies for that license: we assess gaps, map the evidence, draft the application packet and the policies, and run a mock survey. The owner and administrator approve the work and file.
This page reads section 400.464, Florida Statutes, and the rules behind it.
What is a Florida home health agency license?
It is the state authorization to operate a home health agency in Florida. Section 400.464 (2026 Florida Statutes, page opened 2026-11-05) requires an AHCA license or registration unless an exemption applies. Section 400.462 defines home health services as health and medical services and supplies furnished to an individual in the individual's home or place of residence, including nursing care, therapies, home health aide services, dietetics and nutrition, and physician-prescribed drugs and biologicals. A single service is enough to make a person a home health agency.
- A license issued on or after July 1, 2018 must specify the home health services the licensee may perform and indicate whether each is skilled care. Providing or advertising a service requiring licensure under this part that is absent from a license issued on or after July 1, 2018 is unlicensed activity under section 408.812.
- Each related office outside the health service planning district of the main office must be separately licensed.
- A home infusion therapy provider must be licensed as a home health agency or nurse registry.
- An advertisement for a licensed service must carry the license number. The fine for leaving it off is not less than 100 dollars, and 500 dollars for a second or later offense.
How the application and review clock runs
Rule 59A-35.060 (effective 11/4/2026) lists paper Form 3110-1011 and online Form 3110-1011OL, both April 2026. The paper application requires the July 2025 application addendum, Form 3110-1024; the online form incorporates that information. Renewals must be filed online. Section 408.806 sets the clock.
- Within 30 days after receipt, AHCA notifies the applicant in writing of apparent errors or omissions.
- Omitted information, other than an inspection, is due within 21 days after AHCA asks, or the application is deemed incomplete and withdrawn and the fees are forfeited.
- Within 60 days after receipt of a complete application, AHCA approves or denies it.
Under that rule, an application is complete only with all required documents and fees, all required background screening results and, if required, a satisfactory inspection. AHCA's Rule 59A-8.003 (effective 1/26/2026) calls for a survey by AHCA or an accrediting organization before initial licensure and at least every 36.9 months afterward, unannounced. Licenses are biennial unless the license category specifies a shorter period.
Who needs it and what triggers it
Anyone who plans to operate a home health agency in Florida needs the license before operating, unless an exemption in section 400.464(6) applies. These situations usually start the work:
- A new agency is being formed, or an out-of-state operator is entering Florida.
- An owner adds an office outside the main office's planning district, or moves to a geographic service area not on the license, which needs an initial application under section 400.471(7).
- A home infusion company learns it needs the license.
Section 400.464(6) lists exemptions in paragraphs (a) through (p). Rule 59A-8.005 says an entity becomes a home health agency, and must file a license application, when its services no longer meet any exemption qualification. A certificate of exemption is voluntary.
What happens if an agency operates without a license?
Section 400.464 declares an unlicensed agency a nuisance, and AHCA or any state attorney may seek an injunction. An owner who, after AHCA notification, fails to cease operation and apply for a license commits a second-degree misdemeanor, with each day a separate offense. Section 408.812 allows a fine of 1,000 dollars for each day of noncompliance after notification. Section 408.8065 makes offering skilled services that require licensure under part III of chapter 400 without a valid license a third-degree felony.
How IHS helps
- Gap assessment against sections 400.464 and 400.471 and the AHCA rules.
- Evidence map of each document the application needs and who produces it.
- Drafting of the application packet and policy set, with clinical content for the agency's clinicians to review, change and approve.
- Mock survey with a findings list and drafted corrections.
Settle the service list before drafting: the license names the services, and Rule 59A-8.008(4) requires the application to identify services provided by employees and, where used, contracted personnel; the agency must provide at least one service directly to patients.
The client supplies ownership documents, the administrator and director of nursing, staffing and credentials, insurance and financial records, and clinical sign-off. The owner's CPA prepares and signs the financial statements. IHS is led by its founder, Thomas G. Goddard, JD, PhD, formerly URAC's Chief Operating Officer and General Counsel. IHS has three practice lines: accreditation consulting, compliance services and program development.
The real limit: AHCA decides whether to license an agency. IHS does not file, contact or act as liaison to AHCA, and it gives no legal conclusions. The owner or administrator files.
What to have ready
- The services the agency will perform, each marked skilled care or not, identifying employee-provided and contracted services and at least one service the agency will provide directly to patients (section 400.464, 2026 Florida Statutes; Rule 59A-8.008, effective 5/5/2026; page opened 2026-11-05).
- The counties to serve; the agency shall not serve patients residing in a county not on its license (Rule 59A-8.007, effective 7/8/2026; page opened 2026-11-05).
- For initial, change-of-ownership or added-skilled-care applications: staff numbers and disciplines, a signed business plan covering patient acquisition and staff recruitment and retention, and each controlling interest's other health care ownership interests (section 400.471(2), 2026 Florida Statutes; page opened 2026-11-05).
- For those applications: a two-year balance sheet, income and expense statement, and cash-flow statement showing sufficient assets, credit and projected revenues to cover liabilities and expenses; prepared under generally accepted accounting principles, compiled and signed by a CPA, with no projected operating margin of 15 percent or greater in any first-year month (section 400.471(2)(e), 2026 Florida Statutes; page opened 2026-11-05).
- For initial licensure, including a change of ownership: estimated startup costs and funding sources through break-even, covering startup costs, working capital and contingency financing, with at least 3 months of average projected expenses, including at least 1 month for contingency funding. For initial, renewal or change-of-ownership licenses, applicants and controlling interests who are nonimmigrant aliens as described in 8 U.S.C. 1101 must file a bond of at least 500,000 dollars payable to AHCA, guaranteeing lawful operation (section 408.8065, 2026 Florida Statutes; page opened 2026-11-05).
- Malpractice and liability insurance of not less than 250,000 dollars per claim, with proof at initial application and renewal (section 400.471(3), 2026 Florida Statutes; page opened 2026-11-05).
- For initial, change-of-ownership or added-skilled-care applications: documentation of accreditation or an accreditation application from an AHCA-recognized organization. Within 120 days after AHCA receives the licensure application, provide nonconditional, nonprovisional accreditation and that organization's survey demonstrating compliance with part III of chapter 400, part II of chapter 408 and applicable rules. Maintain accreditation continuously to retain licensure; agencies without skilled care are exempt from this paragraph (section 400.471(2)(g), 2026 Florida Statutes; page opened 2026-11-05).
- An administrator and director of nursing, or alternates, available to the public for any eight consecutive hours between 7:00 a.m. and 6:00 p.m., Monday through Friday, excluding legal and religious holidays (Rule 59A-8.003, effective 1/26/2026; page opened 2026-11-05).
A free introductory call can help scope the work still needed.
How it compares
| Item | What it is | Where to read more |
|---|---|---|
| State license | The authorization the statute requires to operate in Florida, issued by AHCA. | Section 400.464 link above. |
| Accreditation | Accreditation by an AHCA-recognized organization, supported by a compliance survey; section 400.471(2)(g) sets the skilled-care application requirements. | Section 400.471; IHS's home health and hospice and ACHC home health pages. |
| Medicare participation | A federal condition: if state or local law provides licensing of home health agencies, the agency must be licensed. | 42 CFR 484.100 (current through 2026-11-04). |
What it costs
- Section 400.471 says the license fee is established by rule, not to exceed 2,000 dollars per biennium, with state, county and municipal applicants exempt; section 408.805 says fees are nonrefundable. We did not find the current initial fee amount in the statutes and rules opened for this page (page opened 2026-11-05). Verify current fees with AHCA.
- Consulting fees depend on scope. IHS scopes each engagement after a free introductory call.
What this is not
- It is not legal advice. IHS is a consulting firm, not a law firm.
- It is not a guarantee that AHCA will issue a license. AHCA decides.
- It is not a filing service. IHS does not submit to AHCA or contact it for you.
Frequently asked questions
Does a Florida home health agency need a state license?
Yes. Section 400.464, Florida Statutes, says a license or registration issued by the agency is required in order to operate a home health agency in Florida. Exemptions in section 400.464(6) are the exception.
Who is exempt from home health agency licensure in Florida?
Section 400.464(6) lists exemptions in paragraphs (a) through (p), such as a professional licensed under one of the listed chapters or parts, acting alone within that license's scope to provide care in patients' homes. An exempt entity may voluntarily apply for a certificate of exemption, valid for not more than 2 years and not transferable. Counsel can advise whether an exemption applies.
What must the license say about services and skilled care?
A license issued on or after July 1, 2018 must specify the home health services the licensee may perform and indicate whether each is skilled care. For such a license, providing or advertising a service requiring licensure under this part that is not specified on its face is unlicensed activity.
Do related offices need their own license?
A related office outside the health service planning district of the main office must be separately licensed. Under Rule 59A-8.003, a satellite office in the main office's geographic service area that shares its administration, fiscal management, supervision and service provision is not separately licensed, but opening or closing it requires submission of the Health Care Licensing Application under paragraph (8).
Does a home infusion provider need a home health license?
Section 400.464 says a home infusion therapy provider must be licensed as a home health agency or nurse registry.
How much does a Florida home health agency license cost?
Section 400.471 caps the rule-established license fee at 2,000 dollars per biennium and exempts state, county and municipal government applicants. We did not find the current initial amount in the texts opened for this page, so verify current fees with AHCA. IHS scopes each engagement after a free introductory call.
What happens if an agency operates without a license?
Section 400.464 calls it a nuisance, and AHCA or any state attorney may seek an injunction. After AHCA notification, failing to cease operation and apply for a license is a second-degree misdemeanor, and section 408.812 allows a fine of 1,000 dollars for each day.
Is a state license the same as accreditation or Medicare enrollment?
No: AHCA licensure, accreditation and Medicare participation are distinct. Section 400.471(2)(g) requires accreditation or an accreditation application from an AHCA-recognized organization for initial, change-of-ownership and added-skilled-care applications, exempting agencies without skilled care. Under 42 CFR 484.100, a Medicare-participating home health agency must be licensed if state or local law provides for licensing.
What does a consultant prepare for a Florida home health license?
IHS drafts a gap assessment, the application packet and evidence map, and the policy set for clinicians to approve, then runs a mock survey. The owner and administrator approve and file.