Connecticut home health care agency license: DPH rules, staffing and the inspection

Three Connecticut licenses that look alike

Connecticut splits in-home care across three credentials, and the services you plan to offer decide which one you need.

A home health care agency provides professional nursing plus at least one of these: home health aide services, physical therapy, speech therapy, occupational therapy or medical social services. The services must be available 24 hours a day in the patient’s home. The agency itself must provide nursing and at least one other service with its own staff. Anything else may be provided directly or through contract. The agency must also be able to enroll new patients seven days a week, 24 hours a day.⁠¹ That 24/7 intake duty is the main operating difference between this license and the others. It shapes your on-call schedule from the first day.

A home health aide agency (DPH calls it a homemaker-home health aide agency, or HHHA) provides hands-on supportive care under a registered nurse’s supervision: help with hygiene, dressing, feeding, and household tasks tied to that care. It is a separate DPH license with its own initial worksheet.⁠¹⁠¹⁰ Choose it if you want to provide aide care without offering skilled nursing visits.

A homemaker-companion agency registers with the Department of Consumer Protection, not DPH. The registration fee is $375. The law that creates this registration expressly excludes home health care agencies and home health aide agencies.⁠¹⁵ Companion and homemaker work is covered in Connecticut homemaker-companion agency registration.

If you plan to serve residents of a managed residential community, the relevant license is the assisted living services agency license. See Connecticut assisted living services agency license.

No certificate of need, but the agency must be Connecticut-based

You do not need a certificate of need. Conn. Gen. Stat. 19a-638(b)(6) lists home health agencies among the providers exempt from it.⁠¹² The limits Connecticut does impose are about where the agency is based:

• Office location. Your central office, and any office that serves Connecticut residents, must be inside Connecticut and accessible to the public.⁠⁹ An out-of-state agency cannot serve Connecticut patients from a home base across the border.
• Control. Full authority over the agency must rest with a corporation chartered in or qualified to do business in Connecticut, or with people who will live in Connecticut for the whole license period.⁠⁸
• Space. The office must have adequate, safe space for staff work before and after visits, supervisory conferences and meetings with families. It also needs storage for equipment and supplies, and lockable file cabinets for administrative, financial and clinical records.⁠⁹ It needs a communication system that can take referrals, receive patient calls and stay in contact with staff while they are in patients’ homes.⁠⁹
• Satellite offices. Each satellite patient service office adds $100 to the license fee.⁠¹ Each additional office must meet the regulations, and you must put the lines of authority between it and the central office in writing.⁠⁸

Staff you must hire before DPH will license you

Connecticut does not let you get licensed first and hire later. DPH’s initial worksheet says an agency is not eligible for licensure until the administrator, the registered nurse supervisor, and the full-time primary care nurse who supervises aides are all employed. You must also have enough trained aides available and an acceptable written plan for responding to referrals.⁠¹¹

Administrator

The administrator must be full time.⁠³ To qualify, the administrator needs one of these:⁠²

• a master’s degree in nursing, an active Connecticut nursing license and 1 year of supervisory or administrative experience in a health care facility or program that cared for sick people;
• a master’s in public health or administration with a concentration in health services administration, plus 1 year of that experience;
• a bachelor’s in nursing, an active Connecticut license and 2 years of that experience;
• a bachelor’s in administration with a health services administration concentration, plus 2 years of that experience;
• a Connecticut-licensed physician with 1 year of that experience.

You must report the administrator’s name to DPH within 3 days of appointment, and report a departure within 48 hours. An absence longer than one month must also be reported.⁠³

Supervisor of clinical services

The supervisor of clinical services must be a registered nurse with an active Connecticut license and one of these:⁠²

• a master’s degree plus 1 year of full-time clinical experience in home health or community health;
• a bachelor’s in nursing plus 3 years of full-time clinical nursing experience, at least 1 of them in home health or community health;
• a diploma or associate degree plus 3 years of clinical experience within the past 5 years, at least 1 in home health. This route also requires American Nurses’ Association certification as a community health nurse, or 6 college credits earned within 2 years in community health nursing theory or health care management.

You need one full-time supervisor of clinical services for every 15 or fewer full-time-equivalent professional direct service staff. In an agency with 6 or fewer such FTEs, the supervisor may also serve as administrator.⁠³ The worksheet says a person doing both jobs must meet the supervisor-of-clinical-services requirements only.⁠¹¹ It describes the small-agency threshold as fewer than 6 FTEs, while the regulation says 6 or fewer, so confirm the count with DPH if you are at the line. You must also designate in writing a registered nurse with at least 2 years of home health agency experience to act whenever the supervisor is absent, and report any supervisor absence longer than one month to DPH.⁠³

Therapy and social work supervisors

If you offer therapy or social work, the supervisor of that service must have 3 years of clinical experience. Therapy supervisors must be Connecticut-licensed physical therapists, occupational therapists or speech pathologists. The social work supervisor must hold a master’s in social work from a program accredited by the Council on Social Work Education.⁠²

Governing authority and professional advisory committee

The agency needs a formal governing authority with bylaws. The bylaws must include a conflict-of-interest policy, and the governing authority must meet at least once a year with dated, signed minutes. Every year it reports to DPH the names and addresses of its officers and members and of every owner holding 10% or more.⁠³ It appoints a professional advisory committee of at least one physician, one public health nurse, one therapist and one social worker. Members must be in active practice or have been within the last five years, and no member may be an owner, stockholder or employee of the agency (employees may sit as non-voting ex officio members).⁠³ The committee meets at least twice a year and reviews the agency’s clinical policies.⁠³ The worksheet asks for proof that the committee has already met and approved your patient care policies before DPH inspects.⁠¹¹

Staffing ratios in the Public Health Code

These ratios are written into the regulations. DPH checks them at inspection, and the worksheet asks for evidence of the supervisor ratio.⁠¹¹

A registered nurse must be reachable by phone, and available for a home visit at any hour, including nights, weekends and holidays, whenever aides are on assignment.⁠⁴

Aide training, nurse visits and in-service hours

Aides working for a home health care agency must have completed a DPH-approved training and competency evaluation program of at least 75 hours.⁠⁴ The competency evaluation must be done by a registered nurse with at least 2 years of nursing experience, 1 of them in home health care.⁠⁴ Some people count as already trained. For example, a nurse aide who completed Connecticut’s nurse-aide training counts as trained but must still pass the homemaker-home health aide competency evaluation. Anyone deemed trained gets 10 hours of orientation from the employing agency before working as an aide.⁠⁴ An aide who goes 24 consecutive months without paid nursing or nursing-related work must complete a new competency evaluation.⁠⁴

Once you are operating, the following rules apply:

• A registered nurse must visit and assess every patient who receives aide services as often as the patient’s condition requires, and at least every 60 days. The nurse must do the assessment while the aide is working in the home.⁠¹⁠⁴
• In-service education must average at least 1 hour per month for each employee who serves patients. Aides must attend.⁠⁶
• Each employee needs a physical examination, including a tuberculin test and a statement that they are free of communicable disease, before any patient care.⁠⁶
• Each direct service staff member, including contract staff, needs a written clinical competence report 6 months after hire and every year after that.⁠⁷
• Every contract for services must specify an annual check of clinical competence and may not run longer than one year.⁠⁵

Filing with the Licensure Processing Unit

DPH’s Facility Licensing and Investigations Section handles initial applications through its Licensure Processing Unit. Initial application forms are not posted for download. You request them by email at [email protected] and submit them to the same address. The main FLIS line is 860-509-7400.⁠¹⁰ The worksheet sets the order:

1. Request the application packet

   Email the Licensure Processing Unit for the initial home health care agency application, and download the worksheet, ownership forms and the attestation from the FLIS page.⁠¹⁰

2. File the core package

   This includes the application, an organizational chart, certificates of insurance, the ownership forms that apply, the additional information form, the clinical supervisor’s résumé (plus the hospice form if you plan hospice) and a list of the towns you will serve.⁠¹¹ The 2016 worksheet asks for a notarized application, while Conn. Gen. Stat. 19a-491(a) says a license application need not be notarized.⁠¹⁠¹¹ DPH does not post the initial application, so the worksheet is the only published instruction. Ask the Licensure Processing Unit which form version it will send and whether it still wants notarization.

3. Send the evidence package to the DPH home health nurse before the inspection

   This includes governing authority minutes approving policies and appointing the administrator and advisory committee, and the advisory committee’s first meeting. It also includes signed appointment letters, résumés and job descriptions for the administrator, the clinical supervisor and the aide supervisor, plus written plans for who covers their absences. Add executed contracts for any contracted services, Connecticut licenses and aide training records for staff, and a continuity of operations plan for emergencies.⁠¹¹

4. Complete the attestation

   Next to each Public Health Code section, identify the policy that meets it.⁠¹¹

5. Sign the pre-licensure consent order

   Both the entity and DPH sign it before the license is issued.⁠¹¹ The statute allows DPH to require a consent order as a condition of licensure.⁠¹

6. Pass the scheduled on-site inspection

   DPH issues an initial license only after a scheduled inspection and investigation.⁠¹ Have bylaws, policies, personnel records, plan of care forms, quality assurance committee records and your public information materials on hand. Each policy must be labeled with the regulation section it meets. You must be ready to provide every service you applied for on inspection day.⁠¹¹

The worksheet warns that if you fail the licensure inspection, DPH shreds the application and you start over. It also says the application and attachments must be completed within 9 months, or the file is destroyed unless you have made other arrangements.⁠¹¹ DPH does not publish a processing time for initial home health licenses.

The worksheet requires your brochure and other public materials to say “Not Medicare Certified” while that is true. The regulation behind it requires any licensed agency without Medicare certification to say so clearly in its consumer information.⁠¹¹⁠⁸

Fees and insurance as published

The license fees are set in statute and were checked on 2026-10-12:⁠¹

Scroll the table sideways to see every column.

You may not operate a home health care agency without professional liability insurance or other indemnity of at least $1 million per person per occurrence, with a $3 million aggregate.⁠¹ The application package includes certificates of insurance, and DPH posts an example certificate on its forms list.⁠¹⁰⁠¹¹

Medicare and Medicaid in 2026

Medicare. Effective May 13, 2026, CMS imposed a six-month nationwide moratorium on Medicare enrollment of new home health agencies.⁠¹⁴ The notice bars enrollment of new home health agencies and their branches or practice locations, except applications the Medicare contractor had received before May 13, 2026.⁠¹⁴ A new Connecticut agency that files now therefore cannot enroll in Medicare until the moratorium ends. I found no notice extending it as of 2026-10-12. CMS can extend in 6-month increments, so ask the agency’s Medicare contractor and check the Federal Register before mid-November 2026 before you count on Medicare revenue.⁠¹⁴ Once certified, the agency’s license can run up to three years, concurrent with its certification. DPH may also waive the renewal inspection for an agency certified within the previous 12 months.⁠¹

Medicaid. To be paid as a home health care agency by Connecticut Medicaid, an agency must hold the DPH license, meet the federal requirements in 42 CFR Parts 440, 441 and 484 (Part 484 is the Medicare home health rules), and enroll in Medicaid.⁠¹³ CMS left Medicaid moratoria to each state.⁠¹⁴ The regulation requires meeting those federal rules and being enrolled in Medicaid; it does not say whether a newly licensed agency that is not Medicare-certified can enroll. Ask the Department of Social Services, before you apply to DPH, whether it will enroll your agency while the Medicare freeze lasts.

Once you take Medicaid, Medicare or Connecticut Home Care Program for Elders money, you may not discriminate against applicants whose care those programs pay for, on the basis of source of payment. A violation can lead to suspension or revocation of the license.⁠¹ Whenever you refer a patient or arrange services from another provider, you must tell the patient in writing whether that provider is Medicare- and Medicaid-certified.⁠¹

Duties added by recent Connecticut laws

Several provisions of chapter 368v were added from 2022 onward. All of them apply from your first client:

• No-hire clauses are void. Since May 7, 2022, a client contract term that penalizes a client for hiring one of your employees directly is void as against public policy.⁠¹
• Safety information at intake (P.A. 24-19). During intake, collect any client history of violence toward health care workers, substance use, domestic abuse and psychiatric diagnoses, as far as law allows. Also collect location hazards such as weapons, syringes and the fire alarm status, and give this information to the staff you assign.⁠¹
• Safety curriculum and monthly meetings. Adopt a home care health and safety curriculum consistent with the one endorsed by NIOSH and OSHA, train staff on it every year, and hold safety assessments at your monthly staff meeting. Agencies paid by Connecticut Medicaid must show DSS evidence of the curriculum. DSS may pay a rate enhancement for reporting a workplace violence incident to DSS and DPH within 7 calendar days.⁠¹
• Annual abuse-of-staff report. Since January 1, 2025, agencies must report to DPH every year each instance of abuse by a client against a staff member, and what the agency did to protect the staff member.⁠¹
• Photo ID badges and the provider registry. Every employee must wear a badge with their name and photo at each appointment. You must also send employee information to DPH for the state’s home care provider registry.⁠¹

Before offering a job to anyone who will have direct access to patients, run a background search. It covers the nurse aide registry and state and national criminal history checks.⁠¹ A separate 2012 rule requires a “comprehensive background check” for home health applicants: an interview, Social Security number verification, a license check, a sex offender registry check, Connecticut criminal records, and records from other states if the applicant lived in Connecticut less than 3 years. That rule ends once DPH publishes notice that the 19a-491c program has been implemented for home health agencies.⁠¹ I could not find that notice in DPH’s published materials. Ask DPH whether the 19a-491c search, which the statute defines to cover home health care agencies, or the 2012 comprehensive check applies to your first hires, and run whichever it names.

Renewal, reports and ownership changes

The license is valid for two years and ends on the last day of a calendar quarter. It renews after an unscheduled DPH inspection and DPH approval of your renewal report.⁠¹ Renewals are filed through the Connecticut eLicense portal.⁠¹⁰ The license covers only the premises and people named in the application. It cannot be transferred, and it must be posted where people can see it.⁠¹

Ongoing paperwork includes these deadlines:

• an annual statistical report of services, due within 90 days after your fiscal year ends;⁠⁸
• an annual quality assurance report with record audits and outcome measures, and consumer participation in the annual program evaluation;⁠⁷⁠⁸
• annual reporting of governing authority members and owners of 10% or more;⁠³
• keeping administrative records for at least 7 years.⁠⁸

Any change in ownership or beneficial ownership, including a transfer to a relative, needs DPH’s prior approval. The new owner files the application at least 120 days before the proposed change. DPH reviews the compliance history of every health care facility each proposed owner has owned, operated or managed in the past five years.⁠¹ Changing only the legal form, such as converting a corporation to an LLC, does not count as a change in ownership if beneficial ownership stays the same.⁠¹

The other Connecticut care licenses are listed on the Connecticut page. Other states’ home health rules are compared under home health agency licenses.

Sources

1. 1
   Connecticut General Assembly, Conn. Gen. Stat. chapter 368v, Health Care Institutions (secs. 19a-490 to 19a-503) Checked 12 Oct 2026 · Back to text ↑
2. 2
   Connecticut eRegulations System, Regs. Conn. State Agencies 19-13-D67, Personnel Checked 12 Oct 2026 · Back to text ↑
3. 3
   Connecticut eRegulations System, Regs. Conn. State Agencies 19-13-D68, General requirements Checked 12 Oct 2026 · Back to text ↑
4. 4
   Connecticut eRegulations System, Regs. Conn. State Agencies 19-13-D69, Services Checked 12 Oct 2026 · Back to text ↑
5. 5
   Connecticut eRegulations System, Regs. Conn. State Agencies 19-13-D70, Contracted services Checked 12 Oct 2026 · Back to text ↑
6. 6
   Connecticut eRegulations System, Regs. Conn. State Agencies 19-13-D71, Personnel policies Checked 12 Oct 2026 · Back to text ↑
7. 7
   Connecticut eRegulations System, Regs. Conn. State Agencies 19-13-D76, Quality assurance program Checked 12 Oct 2026 · Back to text ↑
8. 8
   Connecticut eRegulations System, Regs. Conn. State Agencies 19-13-D77, Administrative organization and records Checked 12 Oct 2026 · Back to text ↑
9. 9
   Connecticut eRegulations System, Regs. Conn. State Agencies 19-13-D79, Facilities Checked 12 Oct 2026 · Back to text ↑
10. 10
    Connecticut Department of Public Health, Facility Licensing and Investigations Section (FLIS): Facility Licensing Checked 12 Oct 2026 · Back to text ↑
11. 11
    Connecticut Department of Public Health, Initial License Work Sheet for Home Health Care Agencies (revised 9/2016) Checked 12 Oct 2026 · Back to text ↑
12. 12
    Connecticut General Assembly, Conn. Gen. Stat. chapter 368z, sec. 19a-638, Certificate of need Checked 12 Oct 2026 · Back to text ↑
13. 13
    Connecticut eRegulations System, Regs. Conn. State Agencies 17b-262-725, Definitions (Medicaid home health services) Checked 12 Oct 2026 · Back to text ↑
14. 14
    Federal Register, Centers for Medicare & Medicaid Services, Announcement of Nationwide Temporary Moratoria on Enrollment of Home Health Agencies (2026-09717) Checked 12 Oct 2026 · Back to text ↑
15. 15
    Connecticut General Assembly, Conn. Gen. Stat. chapter 400o, Homemaker-Companion Agencies Checked 12 Oct 2026 · Back to text ↑

Was this information accurate? Report an errorPrint or save as PDF