Kansas non-medical home care: the supportive care services home health agency license
Kansas has no separate companion or homemaker registration. Any agency paid to help people at home with bathing, dressing, eating, toileting or similar tasks without nurse supervision needs a home health agency license limited to supportive care services. KDHE's Bureau of Facilities and Licensing issues it after a document review, and the initial fee is $250 if you expect fewer than 100 clients a year (as published on 2026-10-12).
Contents13 sections
Key takeaways
- Kansas licenses non-medical home care as a home health agency limited to "supportive care services" (K.S.A. 65-5101). There is no lighter companion or homemaker registration, and an agency that only advertises these services also needs the license.
- The license bars nursing of any kind: no RN supervision or delegation, no medication setup, no wound care. Medicaid HCBS waiver attendant care needs the Skilled Services license instead.
- The administrator and the alternate administrator must each be 21 or older, have one year of home health or related health care experience, and hold a bachelor's or associate degree or a KDHE-approved administrator course certificate. Both must live within 200 miles of the parent office.
- Fees as published on 2026-10-12: $250 initial and $100 renewal if you serve fewer than 100 unique clients a year; $500 and $350 if you serve 100 or more. They are paid online through PayIt and are not refundable.
- You may not serve anyone before the license is issued. To renew, you must stay "in operation": at least five clients in the past 12 months and at least one in the latest three months.
- KDHE drafted a rewrite of the home health rules in September 2025. It narrows what supportive care workers may do and changes the administrator qualifications. It had not been adopted as of 2026-10-12, as far as these sources show.
Quick facts
| Agency | Kansas Department of Health and Environment (KDHE), Bureau of Facilities and Licensing |
|---|---|
| License | Home Health Agency, Non-Medical Supportive Care Services |
| Who needs it | Any agency paid to provide non-nursing help with daily living in the client's residence |
| Initial fee | $250 (under 100 clients) or $500 (100 or more), as published on 2026-10-12 |
| Renewal fee | $100 or $350, filed at least 30 days before expiration |
| Service area | Within 200 miles of the parent office |
| Rules | K.S.A. 65-5101 to 65-5117; K.A.R. 28-51-100 to 28-51-117 |
Fees and forms as published on 2026-10-12. KDHE's forms were revised 03/2024. The regulations are those amended effective May 20, 2022.
One license family, two levels
Kansas does not license “home care” separately from “home health.” The Home Health Agency Licensure Act defines a home health agency as any agency that provides, for a fee, any of three kinds of service at the client’s residence: home health services (nursing, therapy, home health aide, medical social services), supportive care services, or attendant care under Medicaid home and community based services (HCBS) waivers 1. KDHE turns that into two license levels: Skilled Services, which can cover all three, and Non-Medical Supportive Care Services, which covers supportive care only 712.
The statute defines supportive care services as help with activities of daily living “that the consumer could perform if such consumer were physically capable,” without supervision by a healthcare professional such as a physician assistant or registered nurse 1. The listed examples are bathing, dressing, eating, medication reminders, transferring, walking, mobility, toileting and continence care 1. KDHE adds chore and companionship services to the scope. It says these services are “mainly accepted by private pay, private duty, and some private insurance” 7.
The license also reaches agencies that are not yet serving anyone. Under K.S.A. 65-5102, an agency “that holds itself out as providing” these services, or holds itself out as a home health agency, must be licensed 2. The regulations add that no one may provide supportive care services before the license is issued 6.
Kansas licensing has a gap in its history. KDHE stopped processing non-medical applications in 2017 after statute and rule changes, and restarted on March 1, 2024 with an online document upload 11. Older guidance that says Kansas is “not accepting” non-medical applications is out of date.
Supportive care or skilled: where the line falls
Choose the level before you write a single policy, because the attestation you sign makes the scope binding. Providing any service outside your license level is grounds for losing the license 9.
On a supportive care license 9:
- Nursing services of any kind are prohibited. That includes a nurse acting as supervisor, assigning or delegating tasks, setting up or giving medication, doing wound care or treatments, or doing assessments.
- Certified nurse aide and home health aide positions are excluded. A CNA can work for you as a supportive care worker but cannot perform the skilled tasks their certification allows.
- HCBS waiver services are outside the scope. KDHE’s attestation says HCBS is included only under the Skilled Services license, and some waivers also require CMS certification.
The statute supports this: a “home health aide” does not include employees of an agency that provides only supportive care services 1. K.A.R. 28-51-105(e) says a person applying for a supportive-care-only license “shall not provide nursing services” 6.
If your business plan depends on Medicaid HCBS attendant care, nurse oversight, or home health aides, read the Kansas skilled services home health agency guide. If clients will live in a house you run, you need a KDADS adult care home license instead. See the Home Plus guide and the assisted living guide. A daytime program in your own building falls under adult day care.
Who does not need the license
K.S.A. 65-5112 exempts 4:
- Individuals who personally provide care and are not under the direct control of, working for, or employed by any business entity. A caregiver hired directly by a family is outside the act; the same caregiver placed by your company is not.
- Workers employed under the self-directed care provisions of K.S.A. 39-7,100.
- Religious organizations serving their own adherents who rely on prayer or spiritual healing.
- Medicare-certified hospices serving only hospice patients, PACE programs serving only PACE participants, and Medicare-certified outpatient physical therapy agencies serving only their own patients.
The definition itself also excludes local health departments that are not federally certified, durable medical equipment companies, recognized independent living agencies, KDADS and KDHE 1.
Running an unlicensed agency is a class B misdemeanor 9. When KDHE finds one, the statute says it is offered a 60-day temporary license to keep operating while it applies. If it is not licensed within 30 calendar days, a fine is assessed, and no temporary license is granted where services pose imminent harm 2.
The administrator, the alternate, and the manager
Kansas requires three named roles, and the people filling them must exist on paper before KDHE will review your application.
Administrator and alternate administrator. For an agency providing only supportive care, each must 6:
- be at least 21;
- have at least one year of experience as an employee of a home health agency or “in a related health care service”; and
- hold a bachelor’s degree, an associate degree, or a certificate from a home health administrator course approved by KDHE.
The alternate must meet every requirement the administrator meets and covers all the administrator’s duties when the administrator is away 6. The administrator must live within the service area 6, and KDHE asks for evidence that both people live within a 200-mile radius of the parent office 10. KDHE’s page points to one KDHE-approved Kansas home health administrator course and asks you to get pre-approval for any other course before enrolling 7. You must notify KDHE in writing within five days of changing either person, including the new person’s name, address and qualifications 6.
The administrator’s regulatory duties include hiring to written job descriptions, keeping personnel and administrative records, running orientation and in-service training, filing required reports, and making sure every client gets the bill of rights in writing 6.
Manager. The rules define a manager as an employee who supervises supportive care workers, is available to them for consultation whenever services are being provided, and has at least one year of experience providing home health, HCBS or supportive care services 6. In practice the manager does the clinical-looking work that a nurse would do at a skilled agency: the client assessment, the plan of care (which the manager reviews at least every 60 days), written assignments (reviewed every three months), and on-site supervision of each worker at least every three months 6.
Governing body. You need bylaws or an operating agreement, renewed annually. You must also disclose each officer, director and owner, every corporate ownership interest of 5% or more, and any past home health agency ownership or management 6. If the agency is a corporation or LLC, it must be registered with the Kansas Secretary of State 9.
What your supportive care workers may and may not do
K.A.R. 28-51-117(g) is the most detailed task list in Kansas home care law, and your written policies must incorporate it 6. The table summarizes it under the rule in effect as of 2026-10-12.
| Task | Allowed | Not allowed |
|---|---|---|
| Medication | Asking whether meds were taken, verbal prompts, handing or opening a reminder container already filled by the client, family, a nurse or a pharmacist | Medication setup or administration; must report missed or extra doses to the manager at once |
| Skin care | Only on unbroken skin with no active chronic skin problems | Applying medication; wound care, including dressing changes |
| Ambulation | Clients who can balance and bear weight and whom a qualified health professional has judged independent with an assistive device | — |
| Dressing | Ordinary clothing, over-the-counter support stockings | Elastic wraps; prescription antiembolic or pressure stockings |
| Exercise | Normal movement as tolerated; encouragement to follow a prescribed program | Assisting with exercise prescribed by a therapist |
| Feeding | Clients who can chew and swallow and sit upright | Syringe, tube or IV feeding; clients at high risk of choking |
| Nail care | Soaking, pushing back cuticles without utensils, filing | Trimming (reserved to agencies licensed for home health services) |
| Shaving | Electric or safety razor | — |
| Toileting | Bedpans, commodes, incontinence pads, emptying catheter and ostomy bags | Inserting or removing catheters, suppositories, enemas |
| Transfers | Clients who can stand, pivot and assist; gait belt and lift device with training and demonstrated competency | Clients who cannot assist with the transfer |
| Oxygen | Removing a cannula or mask briefly to wash or shave; setting flow when changing tanks, if trained and competent | Respiratory care |
Bathing is allowed, but a client whose wounds need bandage changes around bathing must be served by an agency licensed for home health services 6. By statute, no unlicensed employee may prefill insulin syringes 14, and KDHE wants a written policy saying so 10.
Hiring: background checks, health screening and competency
Criminal record checks. Every applicant with direct access to clients goes through the KDADS criminal record check program under K.S.A. 65-5117 57. The statute:
- bars employment of anyone with a listed offense, such as abuse or mistreatment of a dependent adult or elder, or with adverse findings on a state or national registry;
- bars certain other felonies for six years after the sentence is completed, with a waiver possible after five;
- gives applicants 20 calendar days after authorization to submit fingerprints when fingerprinting is required;
- lets you hire someone provisionally, once, for 60 calendar days while KDADS decides, as long as they are supervised by a fully trained employee;
- has KDADS return a pass or fail within three working days of receiving the record information; and
- requires you, the employer, to pay the record check fee.
KDHE notes that a check run through the KBI’s own public service is not a substitute, because only KDADS can see juvenile records 10. A person found to need a guardian or conservator may not operate a home health agency 5.
Personnel files. Each employee’s file needs 6:
- a signed job description;
- reference checks completed before the hire date;
- a self-reported health history;
- a health assessment by a physician, nurse practitioner, clinical nurse specialist, physician assistant or registered nurse, done before the employee works with clients;
- a two-step tuberculosis skin test, also before client contact;
- repeat health assessments at least every two years;
- performance evaluations within six months of hire and annually after that; and
- the background check request and results.
Training. Each worker must show competency in 10 areas before working without the manager present, and be re-evaluated every year. The areas include communication with clients who have hearing loss or dementia, infection control, recognizing changes in body function, emergencies, the clients’ bill of rights, and any equipment used 6. Every manager and worker also needs ongoing training at least once a year, documented in their file 6. Abuse, neglect and exploitation training is required at hire and annually, and suspected abuse must be reported immediately under K.S.A. 39-1431 6.
The policy set KDHE reviews
The license is won or lost on paper. KDHE’s instruction guide sorts the required documents into folders on its file-transfer system 10:
- Governing body: bylaws or operating agreement, appointment letters for the administrator and alternate, ownership disclosures, residence evidence.
- Administrators: resumes, transcripts or course certificates, and job descriptions.
- Personnel policies: hiring, interviewing, reference checks, background checks, health records, TB testing, competency and provisional employment, plus an organization chart and staff roster.
- Contracts: if you use hourly or per-visit contractors, the seven contract terms set in K.A.R. 28-51-103(f).
- Abuse, neglect and exploitation: the K.S.A. 39-1430 definitions and the KDHE complaint hotline, 1-800-842-0078.
- Provision of services: admission criteria, plan of care, written assignments, on-call coverage, scope of practice, and medication and “no nursing” policies.
- Supervision, client records and client rights: records kept at least five years after discharge, with worker check-in and check-out times and confirmation that services were delivered 6.
Every policy must be written for Kansas, carry your agency’s name, and show governing body approval. KDHE rejects sections marked “See attached” or “Not applicable” 10. The guide also asks for copies of 10 employees’ personnel files, including the administrator, alternate and supervisors. If you have fewer than 10 employees, you note that on the roster 10. KDHE answers process questions but says it does not give individual consultation or business advice 8.
Applying, in order
Form the entity and pick the parent office
The application asks for the entity name exactly as filed with the Kansas Secretary of State, the registered agent, and the counties you will serve 8. You may serve clients and open branches only within 200 miles of the parent office 9. The service-area exception in K.A.R. 28-51-101(n) is written only for agencies providing home health services 6.
Line up the administrator, alternate and manager
Their qualifications go in with the documents 10.
Send the initial packet
Email the application to [email protected] with the signed attestation form, the agency and personal release-of-information forms, and the ownership attachments 8. Pay the nonrefundable fee through PayIt. KDHE has taken HHA fees only online since July 1, 2025 7.
Upload documents
After the application and fee arrive, KDHE emails a username and password for its file transfer system 8. You cannot reopen a file after uploading it, so gather everything first 10.
Trigger the review
Put a letter titled “Begin Review Process” on letterhead into the Miscellaneous folder. KDHE does not start reviewing until that letter is there 10.
Answer reviewer questions
KDHE emails about missing items and issues the license once every document meets the requirements 8. KDHE publishes no review timeline. The statute ties issuance to approval after a survey inspection, and on-site surveys follow at least once every 36 months 3.
Post the license
Display it in the main office. It covers only the agency named on it and cannot be transferred 3.
Fees as published on 2026-10-12
| Unique clients per licensure year | Initial | Annual renewal |
|---|---|---|
| Fewer than 100 | $250 | $100 |
| 100 or more | $500 | $350 |
A new agency estimates its unique clients for the first 12 months after applying. A client served on separate occasions counts once 68. For comparison, the skilled license starts at $500 6. The criminal record check fee is set by KDADS rule 5 and was not confirmed for this guide.
Renewal, changes and closing
The license runs one year 6. K.A.R. 28-51-101(b) requires the renewal application and fee at least 30 days before expiration 6. If the annual report and fee are not in within 30 calendar days after the renewal expiration date, the license is cancelled automatically 3. The renewal package is 7:
- the application marked “Annual Renewal”;
- a new attestation form;
- a Secretary of State certificate of good standing, if your entity is registered there; and
- license verification for the administrator, if applicable.
Two conditions catch small agencies. To be eligible for renewal you must be “in operation”: at least five clients in the past 12 months and at least one in the latest three months 6. When a surveyor asks, you have 30 minutes to produce client and administrative records, including complaints, meeting minutes, quality assurance and annual program review documents 6.
You must also report these changes 36:
- Name or address: written notice within five days, with the old license returned.
- Parent office location or phone number: notice before the change.
- Sale or change in control: a new license application before the sale takes effect. KDHE can issue a temporary operating permit of up to 90 days.
- Closing: written notice at least 30 days ahead, a transfer plan for each client, and the license mailed back.
What KDHE has proposed to change
On September 8, 2025, KDHE published draft amendments to the home health rules 12. The main changes:
- Three licenses instead of two: Skilled Home Health Services, HCBS, and Supportive Care Services, each with its own fee schedule 12.
- A “complete application packet”: no approval timeline starts until every required item is in, and applicants must be in good standing with the Secretary of State 12.
- Office rules: the parent-office requirements (local street address and phone, staffing during posted hours, no P.O. box) already sit in the 2022 definitions 6. The draft moves them into the licensing rule, extends them to branch offices, and adds a fixed location with a private space for confidential record review 12.
- New administrator qualifications for supportive care: age 21 plus one year of supervisory experience in personal care at a home health agency, and either a health-care undergraduate degree, any undergraduate degree plus two years delivering personal care, or home health aide certification plus one year of personal care and a KDHE-approved administrator course 12.
- A narrower task list: no nail care, no lift-device transfers, no ostomy bag changes, no setting oxygen flow and no passive range of motion. Tub or shower help would be limited to clients who can balance and bear weight 12.
At its October 9, 2025 listening session, KDHE said agencies already licensed for supportive care “will not be impacted by the licensing changes” and took comments through October 31, 2025 13. These are drafts: KDHE says they still need a formal public comment period after a hearing notice in the Kansas Register 12. The sources reviewed on 2026-10-12 show no published hearing notice and no adopted amendments, and a search of the Kansas Register found none. Before you write your policies, ask KDHE’s Bureau of Facilities and Licensing whether a hearing notice has been published and which version of K.A.R. 28-51-117 a new applicant will be reviewed under. Until the amendments are adopted, the May 20, 2022 rules described above apply 6.
Sources
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Kansas and neighboring states
Compare all 51| State | License | Who needs it | State fee |
|---|---|---|---|
| Kansas (this guide) | Home Health Agency license, Non-Medical Supportive Care Services | Any agency paid to give non-nursing help with daily living at home | $250 (under 100 clients) or $500 (100 or more), as published on 2026-10-12 |
| Oklahoma | Companion/Sitter Service Agency license; Home Care Agency license | Any agency offering companion or sitter services must be licensed | $1,000, nonrefundable |
| Colorado | Home Care Agency license, Class B | Agency providing personal care only; no skilled services | $2,720.30 (2026/2027 schedule) |
Shortened from each state's guide and our 51-state table, as of each guide's last review. Fees are the state's own; local permits and background checks cost extra.