Non-medical home care — companion care and personal care for seniors who want to age at home — is one of the few small businesses with structural demand growth for the next two decades. It's also a licensed, trust-based service where the founders who do the boring setup work correctly win. Here is the actual sequence.
Non-medical home care covers companionship, meal preparation, light housekeeping, errands and transportation, and hands-on personal care (bathing, dressing, grooming, transfers). It does not cover skilled nursing, wound care, injections, or administering medication — caregivers may remind and observe, never administer. Keeping your service scope crisply non-medical keeps you out of an entirely heavier licensing world.
Home care licensing is state-specific and ranges from a simple registration to a full application with policies-and-procedures review, surety bonds, and administrator requirements. In most states the authority sits under the Department of Health (sometimes Human Services or Aging). Ask them: What license class covers non-medical personal care? What must be submitted? What are the fees and timelines? Their answer is your real project plan.
An LLC is the common choice; get your EIN (free, irs.gov), open a business bank account, and gather insurance quotes early because licensing often requires proof: general liability, professional liability, workers' compensation (required nearly everywhere once you employ caregivers), and non-owned auto if caregivers drive clients.
This is the step founders underestimate. A functioning agency needs roughly 30 documents on day one: client contract and intake packet, needs assessment, care plans, consents, caregiver application, interview guide, employee handbook, orientation and competency checklists, visit logs, timesheets, medication reminder logs, incident reports, QA checklists, and a policies & procedures manual (many states require one for licensure). Drafting these from scratch takes 40–60 hours; adapting professional templates takes an afternoon plus an attorney review of the contract.
Your product is the caregiver who shows up. Run real interviews with scenario questions, check references, run the background checks your state requires, and put every hire through a documented orientation and competency checklist. Turnover is the industry's biggest cost — pay a dollar or two above the local floor and treat schedules with respect; it's cheaper than constant rehiring.
Take the caregiver wage, add payroll burden (12–20%), add overhead per billable hour, then apply a real margin (25–35%). Private-pay rates for companion/personal care run roughly $28–$45/hour across US markets in 2026. Use our free rate calculator to work it up in two minutes. Underpricing is the most common first-year mistake — you need margin to cover no-shows, overtime, and growth.
Hospital discharge planners, rehab and skilled-nursing social workers, senior-center staff, elder-law attorneys, and geriatric care managers place clients every week. Visit in person with a clean one-pager, be easy to reach, take the 4pm Friday discharge nobody else will staff, and report back reliably. Two or three referral relationships can fill your schedule faster than any marketing budget.
Documented visits, signed timesheets, incident reports filed the same day, QA home visits on a calendar. Clean documentation wins licensing inspections, defends you in disputes, and — not incidentally — is what lets you eventually sell the agency.
This guide is general information, not legal advice. Requirements vary by state and change — confirm with your state licensing authority and attorney.