Illinois home services agency license: opening a non-medical home care agency

Illinois licenses companion and personal care agencies

Illinois licenses non-medical home care. Section 3.3 of the Home Health, Home Services, and Home Nursing Agency Licensing Act says that on and after September 1, 2008, no person may “open, manage, conduct, or maintain a home services agency,” or advertise as one, without an IDPH license ⁠⁵. The advertising part matters before launch. A website or flyer offering home services counts, even before your first client.

The Act defines home services as “assistance with activities of daily living, housekeeping, personal laundry, and companionship” given to someone in their own residence so they can stay there safely ⁠⁵. It excludes anything that the Nurse Practice Act reserves for a licensed nurse ⁠⁵. A home services agency is one that provides those services directly or acts as a placement agency for workers who provide them ⁠⁵.

There is a practical reason to hold the license even if your clients don’t ask about it. Hospitals, nursing homes and other licensed providers that receive State funds may not refer patients or families to an unlicensed agency ⁠⁵.

Who is outside this license

Section 2.08 of the Act and Part 245 leave several businesses out ⁠⁵⁠⁶:

• Housecleaning only. An agency that “limits its business exclusively to providing housecleaning services” is not a home services agency ⁠⁵. If you add laundry for a client, companionship or help with bathing, the exclusion no longer applies.
• Programs funded only by the State or the VA. A program that serves clients exclusively through the Department on Aging’s Community Care Program, the DHS Office of Rehabilitation Services or the U.S. Department of Veterans Affairs is not a home services agency under the Act ⁠⁵. Once you take one private-pay client, you need the license.
• Other licensed settings. Agencies licensed under the Nurse Agency Licensing Act, the Hospital Licensing Act, the Nursing Home Care Act or the Assisted Living and Shared Housing Act are excluded ⁠⁵. Care inside an assisted living or shared housing establishment is covered by those licenses. See the shared housing establishment guide for the shared housing license.
• Prayer-healing agencies. Agencies run by and for members of a recognized church that relies on prayer or spiritual healing are not subject to licensure ⁠⁵⁠⁶.

The license is required for any agency providing care in Illinois, including out-of-state agencies and internet matching services. An out-of-state licensee must be authorized to do business in Illinois and must keep an office in the state ⁠⁶.

Choosing the right Illinois license

The Act creates five agency licenses, and IDPH’s FAQ tells applicants to start by deciding which ones fit the services they plan to offer ⁠². For a non-medical business, the choice is usually between the first two rows below.

Scroll the table sideways to see every column.

A placement agency is a different business, not a lighter version of the same one. Under Section 245.214, it may not employ or supervise the worker. It may not control assignments after placement or help the client pay the worker. It may charge only a one-time placement fee, and its contracts may last no more than 12 months ⁠⁶. Its advertising must say that the placed worker is the client’s employee ⁠⁶. If you want to run both models, you need two licenses and two fees, and each must operate as a separate entity ⁠²⁠⁶.

If any client will need nursing, wound care, injections or similar care, read the Illinois home health agency licensing rules in 77 Ill. Adm. Code 245. The home services application says plainly that the license “does not allow for any skilled services to be provided regardless of whether an individual is licensed or certified” ⁠³. An RN on your payroll cannot change that.

Exactly what your caregivers may do

Part 245 does not stop at the word “non-medical.” Section 245.40(c)(4) goes through 16 kinds of tasks and sets the conditions for each ⁠⁶. These are the ones that most often decide whether a client can be served:

• Medication reminding. Allowed only when the client, a family member, a nurse or a pharmacist has already sorted the medications into a container marked by day and time, other than the prescription bottle. The worker may ask whether the medication was taken, prompt the client, hand over the marked container and open it if the client cannot ⁠⁶. Workers may not set up medications ⁠⁶.
• Bathing, skin care, dressing, feeding and transfers. Allowed. For harder cases, such as prescription compression devices, thickened liquids, or lifts for clients who cannot reliably help, conditions apply. Compression devices also need a prescriber’s order. In each case the client or a representative must be able to give feedback, the worker must have task-specific training, and the agency must have conducted a competency evaluation ⁠⁶.
• Toileting. Workers may empty or change external urine collection bags. They may not insert or remove catheters, or care for external catheters ⁠⁶.
• Nail care and shaving. Workers may soak and file nails but may not trim them. Shaving is limited to electric or safety razors ⁠⁶.
• Oxygen. Respiratory care is skilled care. A trained worker may switch a client’s oxygen delivery from a stationary to a portable system, within limits ⁠⁶.

Workers may not act as a client’s power of attorney or handle the client’s money outside contracted services ⁠⁶. Before accepting a client, the agency must document the client’s functional limitations, medications, diet and mental status ⁠⁶. A home services agency “shall not provide medical services that would be performed by” a home health or home nursing agency ⁠⁶.

Setting up the business before you apply

Several requirements must be in place before the application goes in the mail, because the application asks you to prove them.

1. Form the legal entity

   The application asks for the legal name registered with the Secretary of State and an Illinois registered agent with an Illinois address ⁠³. Corporations list shareholders holding more than 5%. Sole proprietors sign a child-support declaration ⁠³. Franchisees can’t share the franchisor’s license; Part 245 requires each franchise business entity to hold its own ⁠⁶.

2. Buy the liability coverage

   The application must include a certificate of insurance showing at least $1 million per occurrence and $3 million in the aggregate ⁠⁶.

3. Open an office

   The agency manager must keep an office with a working telephone that is staffed during business hours. The office must protect client records and comply with local fire safety ordinances ⁠⁶. A drop-site cannot have its own staff or accept referrals ⁠⁶.

4. Name an agency manager and an alternate

   A home services agency must designate a person to supervise services, and the manager must designate a qualified alternate in writing ⁠⁶. Part 245 sets no minimum degree or license for this role. IDPH reviews the manager’s work history on Attachment E, the Agency Manager Qualification Review Form ⁠³⁠¹².

5. Set up a governing body

   Part 245.30 requires a governing body with bylaws or the equivalent, reviewed every year, and minutes of its meetings ⁠⁶. The application asks for the president, and corporations must also list a secretary ⁠³.

6. Get access to the Health Care Worker Registry

   The application must show that the agency is registered on the IDPH Web Portal and has access to the Health Care Worker Registry ⁠⁶. You’ll need this to run worker background checks.

What goes in the application packet

Home Services Application Form 445104 is a paper form. It is mailed to IDPH, Health Care Facilities and Programs Section, 525 W. Jefferson St., Fourth Floor, Springfield, IL 62761-0001, with a check or money order payable to IDPH. As of 2026-10-12, the form says “electronic submissions and payments are not accepted at this time” ⁠³. Signatures must be originals ⁠⁴.

The form and Section 245.90 require ⁠³⁠⁶:

• Agency name, address, business hours, and the counties you will serve. Your service area must be approved, and you need IDPH approval before you take clients in a new county ⁠²⁠⁶.
• Owners of at least 5% (Section 245.90) and corporate officers (the form asks corporations to list shareholders with more than 5%), and answers about felony convictions (or two or more misdemeanors involving moral turpitude) in the past five years for the applicant, officers and manager ⁠³.
• A staff list with job descriptions for every position. List employees by initials only, not Social Security numbers. If you use contracted workers, attach the contracts ⁠³.
• Sources of revenue and your fee schedule ⁠³.
• Your client contract under Section 245.220, a scope of services, and a sample service plan form ⁠³.
• Written policies on complaint resolution, employee health and safety, infection control, background checks, supervisory visits for clients and workers, client records, employee training, and client acceptance ⁠³⁠⁶.
• Proof of liability insurance and proof of Registry access ⁠³.
• Attachment E for the agency manager ⁠³.

The client contract has required contents. It must name the agency manager or another contact besides the worker, describe the agency’s license status, give the rate and the services it covers, and explain how to change or end the contract and how complaints are handled ⁠⁶. It must also include a notice that says who employs the worker. That party is responsible for wages, employment taxes, unemployment insurance, workers’ compensation, day-to-day supervision, and hiring and firing ⁠⁶. The Act makes this notice a condition of licensure ⁠⁵. IDPH’s instructions add that you need a separate client contract for each type of license you hold ⁠⁴.

Review, the provisional license and the first survey

1. Initial review

   IDPH says it reviews a new application within 30 days and sends any requests for changes by email ⁠².

2. Approval or denial within 90 days

   IDPH says the application must be completed and approved within 90 days of submission or it may be denied ⁠². Section 245.100 says IDPH will issue the provisional license within 90 days of receiving an application that meets Section 245.90 ⁠⁶.

3. Provisional license

   New agencies, and agencies not yet operating, receive a provisional license valid for 240 days. The $1,500 initial fee covers it ⁠⁵⁠⁶. IDPH’s FAQ says it will explain what must be operating for the licensure survey within the first six months ⁠².

4. On-site survey

   Within 30 days before the provisional license expires, IDPH inspects the agency. If you substantially meet the requirements, you receive a license ⁠⁵. If you don’t, but have made significant progress, IDPH may extend the provisional license once, for up to 90 days ⁠⁵⁠⁶. IDPH publishes a Surveillance Nurse Visit Checklist showing what surveyors look for ⁠¹⁠².

5. One-year license

   The license that follows expires one year from the end of the month in which the provisional license was first issued ⁠⁶.

IDPH may deny a license for lack of qualified personnel, for insufficient financial or other resources, or over the moral character of the applicant or supervisor. Convictions may be considered but are not an automatic bar ⁠⁵. A final finding that you violated the Unemployment Insurance Act or the Workers’ Compensation Act is also grounds for denial ⁠⁵. That matters if you plan to treat caregivers as independent contractors.

Hiring, screening and training caregivers

Background checks. The Health Care Worker Background Check Act includes home services in its definition of direct care. It names home services agencies as health care employers ⁠⁸. When you make a conditional job offer, you must start a fingerprint-based check through IDPH, unless the person already has one on the Registry. You must also check the Health Care Worker Registry before hiring ⁠⁷. You may employ an applicant conditionally for up to 3 months while the result is pending ⁠⁷. You must report hire and termination dates within 30 days and verify employment at least once a year ⁠⁷. Each worker file must also hold a copy of the Social Security card and proof of work authorization ⁠⁶.

Initial training. A home services agency must provide or arrange at least 10 hours of training per worker. Five hours come before the first assignment and five within the first 30 days of employment. The worker must pass a competency evaluation after each block ⁠⁶. Required topics include dementia care, abuse and neglect, first aid and emergencies, infection control, confidentiality, and each personal care task ⁠⁶. You may accept proof of training at another licensed home services agency within the previous 365 days, or hire a CNA listed on the Registry. You still have to give the competency evaluation ⁠⁶.

Annual training. Every worker needs at least 10 hours each year. The first 10 hours count for the first year ⁠⁶. Training records must show the date, time spent on each topic, the instructor’s qualifications, and the worker’s signature ⁠⁶.

Trainers and supervisors. Your trainer or supervisor needs two years of hands-on experience with home services tasks within the past five years. Alternatively, they can be a current home services supervisor or trainer who has had training on those tasks within the past year ⁠⁶. A supervisor must be available to workers at all times. On-site supervision happens at least every 90 days, and you may not bill the client for it ⁠⁶.

Dementia services. If you offer services to clients diagnosed with Alzheimer’s or another dementia, the Alzheimer’s Disease and Related Dementias Services Act applies ⁠⁶⁠⁹. You must designate an Alzheimer’s services supervisor, who needs 8 hours of dementia training a year. Staff with direct access to those clients need 6 hours of training within 60 days of hire, then 3 hours a year ⁠⁹. You also need a dementia care plan for each such client and must give written disclosure materials at enrollment ⁠⁹.

Day-to-day rules IDPH surveys against

• Service plan. Each client needs a written plan covering daily-activity assistance, medication reminder times, diet, functional limitations, mental status and visit frequency. A physician’s signature is not required. Review the plan at least once a year ⁠⁶.
• Records. Keep each client record for at least two years after the last service date. Workers must document the services provided at each visit ⁠⁶.
• Ending services. Give the client at least seven working days’ written notice with a reason. The exception is when the worker’s safety is at risk ⁠⁶.
• Quality improvement. Evaluate the whole program every year, and review a sample of active and closed client records every quarter ⁠⁶.
• Abuse reporting. Report suspected abuse of anyone aged 60 or older, or any eligible adult, to the elder abuse provider agency designated by the Department on Aging. For children, report to the DCFS hotline ⁠⁶. If an employee is accused, remove them from client contact right away. Complete a written investigation within 14 days, and send it to IDPH within 24 hours of finishing it ⁠⁶. Physical or sexual abuse by staff, a crime in the client’s home, or a death not caused by disease requires an immediate call to police ⁠⁶.
• Branches. A branch office must be no more than 100 miles from the parent office and must receive a documented supervisory visit at least monthly ⁠⁶.

Renewal, changes and penalties

File the renewal 60 to 90 days before the license expires ⁠⁶. IDPH sends a courtesy reminder at least 120 days ahead. A packet postmarked later than the 60th day before expiration incurs a $200 late fee, which must be paid before IDPH processes the renewal ⁠⁴. The renewal reports client admissions, discharges and clients aged 65 or older, excluding clients served only through the Community Care Program, DHS or the VA ⁠³⁠⁶. You must be operating and able to show client activity before your second renewal ⁠⁶.

Report changes to your name, manager, address, hours, phone or email within 10 days ⁠⁶. A new manager needs an Agency Manager Qualification Review Form. IDPH’s instructions say it “must be mailed and cannot be faxed or emailed” ⁠⁴. Licenses can’t be transferred. A buyer files a new application, with the fee, at least 30 days before the sale ⁠⁴⁠⁶. A transfer of more than 75% of the stock is a change of ownership ⁠⁶.

IDPH may fine an agency up to $100 per day, starting when the violation is identified and ending when it is corrected ⁠⁵⁠⁶. You have 10 days from a notice to request a hearing ⁠⁵. Operating without a license is declared a public nuisance, and the State can seek a court order to shut the agency down ⁠⁵.

Medicaid clients go through other agencies

IDPH’s FAQ says the home services license covers private pay and private insurance (HMO, PPO). Medicaid clients come through the Department on Aging’s Community Care Program or the DHS Division of Rehabilitation Services, and you must get approval from those agencies directly ⁠².

The Department on Aging certifies Community Care Program providers through an open process for “any willing and qualified agency” and encourages applicants to enroll in the HFS IMPACT Medicaid system ⁠¹⁰. The program’s rule sets a high bar for in-home service providers: at least three years of experience in business operations providing in-home service, one of them in Illinois ⁠¹¹. The Department may adjust the experience requirement, for example by counting the management team’s experience. It may also issue provisional certification of up to two years ⁠¹¹. A startup should plan on private-pay clients first.

Recent rule changes

Part 245 has been amended often. The worker qualification and training section (245.71) was last amended effective March 25, 2025. The fee section (245.95) was amended effective September 2, 2025, and the most recent amendment to the Part took effect January 30, 2026 ⁠⁶. As of 2026-10-12, IDPH’s posted application form carries a revision date of August 9, 2023 ⁠³. The official sources do not say whether IDPH plans a newer version, and some pages of the posted form carry a 6/8/2023 date. Before you mail the packet, ask IDPH (217-782-7412) whether the posted Form 445104 is the version it is accepting ⁠³.

Sources

1. 1
   Illinois Department of Public Health, Home Services Agencies Checked 12 Oct 2026 · Back to text ↑
2. 2
   Illinois Department of Public Health, Home Services Agencies Frequently Asked Questions Checked 12 Oct 2026 · Back to text ↑
3. 3
   Illinois Department of Public Health, Home Services Application (Form 445104) Checked 12 Oct 2026 · Back to text ↑
4. 4
   Illinois Department of Public Health, Initial License, Renewal License and Change of Ownership Application Instructions Checked 12 Oct 2026 · Back to text ↑
5. 5
   Illinois General Assembly, Home Health, Home Services, and Home Nursing Agency Licensing Act (210 ILCS 55) Checked 12 Oct 2026 · Back to text ↑
6. 6
   Illinois Joint Committee on Administrative Rules, 77 Ill. Adm. Code 245: Home Health, Home Services, and Home Nursing Agency Code Checked 12 Oct 2026 · Back to text ↑
7. 7
   Illinois General Assembly, Health Care Worker Background Check Act, 225 ILCS 46/33: fingerprint-based criminal history records check Checked 12 Oct 2026 · Back to text ↑
8. 8
   Illinois General Assembly, Health Care Worker Background Check Act, 225 ILCS 46/15: definitions Checked 12 Oct 2026 · Back to text ↑
9. 9
   Illinois Joint Committee on Administrative Rules, 77 Ill. Adm. Code 973: Alzheimer's Disease and Related Dementias Services Code Checked 12 Oct 2026 · Back to text ↑
10. 10
    Illinois Department on Aging, Apply to be a Provider Checked 12 Oct 2026 · Back to text ↑
11. 11
    Illinois Joint Committee on Administrative Rules, 89 Ill. Adm. Code 240: Community Care Program Checked 12 Oct 2026 · Back to text ↑
12. 12
    Illinois Department of Public Health, Agency Manager Qualification Review Form (Attachment E) Checked 12 Oct 2026 · Back to text ↑

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