How to start a home health agency in Nevada

Nevada requires a License to operate a home health agency (home office or branch office); statute term 'agency to provide nursing in the home' from Health Care Purchasing and Compliance Division, Nevada Health Authority (NRS 449.0032; formerly DPBH) to operate a home health agency. Fee: $5,168.

License required

Yes

License

License to operate a home health agency (home office or branch office); statute term 'agency to provide nursing in the home'

Issuing agency

Health Care Purchasing and Compliance Division, Nevada Health Authority (NRS 449.0032; formerly DPBH)

Fee

$5,168

Fee details

Nonrefundable application fee: home office $5,168; branch office $5,358 (NAC 449.013). An application lapses after 1 year if licensure requirements are not met.

Renewal

Every year · Annual renewal: home office $2,584; branch office $2,679 (NAC 449.013).

Insurance and bonds

Surety bond on initial licensure and each renewal (NRS 449.065): $5,000 if under 7 employees; $25,000 for 7-25; $50,000 for more than 25. A certificate of insurance is also required.

Medicare certification

Separately, CMS put a 6-month nationwide moratorium on new Medicare enrollment of home health agencies (including new branches and practice locations) into effect on May 13, 2026; it can be extended in 6-month increments, and CMS left any Medicaid/CHIP moratorium to each state.

Regulation

NRS 449.029-449.2428 (incl. NRS 449.065, 449.089); NAC 449 (incl. NAC 449.013 fees)

1. Submit a notarized original application (NRS 449.040) with the fee
2. Provide local zoning approval (business license, conditional or special use permit)
3. File the certificate of insurance and an original surety bond
4. Provide organizational documents, a 3-year business history (or resumes and references), and financial status information
5. Provide the administrator's resume, three references and license if applicable
6. Complete fingerprint-based background checks for the applicant and corporate officers and attend the mandatory background-check webinar
7. State Fire Marshal inspects after the application and fee are submitted
8. Division licensing survey

Program

Nevada Medicaid and Nevada Check Up (Nevada Health Authority)

Enrollment portal

Provider Flex (new enrollments, re-enrollments, ownership changes); Provider Web Portal (revalidations and updates)

Fiscal agent

Gainwell Technologies

Application fee

Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. Nevada's enrollment page and booklet do not list a separate state fee.

Fingerprinting

Provider types 19, 29, 33, 58 (specialty 205), 63, 64, 65 and 93 (specialty 708) must send a signed Nevada Department of Public Safety fingerprint background waiver for each owner holding 5% or more, because those owners may need a fingerprint-based criminal background check under 42 CFR 455.434. Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check.

Site visit

Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. Nevada's enrollment booklet does not describe a separate state site visit process.

Revalidation

At least every 5 years; DMEPOS providers (provider type 33) every 3 years. Notices go out 120, 90, 60 and 20 days before the due date. A provider can revalidate up to one year early through the Provider Web Portal ('Revalidate-Update Provider'). The application must be approved before the due date, or the contract ends and the provider cannot serve fee-for-service or MCO members. Nevada also runs an accelerated revalidation of high-risk providers (Web Announcement 3935).

Full Nevada Medicaid enrollment guide →

CON program

Yes

Program

Approval of Director for certain projects (NRS 439A.100), commonly called certificate of need

Agency

Nevada Department of Health and Human Services, Director (health planning); licensing withheld by the Health Care Purchasing and Compliance Division of the Nevada Health Authority

Services covered

• new construction by or for any health facility costing more than the greater of $2,000,000 or a regulatory amount, but only in counties under 100,000 population or in cities/towns under 25,000 inside larger counties
• closure of a hospital, or its conversion to another facility type, in counties of 100,000 or more (NRS 439A.102)

Nevada certificate of need details →

Model

hybrid

State vendor

Sandata (since 2023-12-15; AuthentiCare before)

Services in scope

• personal care
• home health
• attendant care
• homemaker
• chore
• respite
• companion

Alternate EVV allowed

Yes

Program

https://www.nevadamedicaid.nv.gov/EVV-PCA/

Nevada EVV requirements →

State minimum wage

$12.00 an hour

Effective

2024-07-01

Scheduled increases

No scheduled change found in the official sources reviewed.

Direct-care wage floor

SB 511 (2023): to get the $25/hour personal care services rate, providers must pay direct care workers at least $16.00/hour (from 2024-01-01) and sign a wage attestation.

Rate pass-through

Of the $25/hour PCS rate, not less than $16 must be paid as hourly wages to direct care workers (SB 511, s. 68).

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Home health agencies — active organization NPIs (NPPES)

954 (as of Sep 13, 2026)

Medicare-certified home health agencies (CMS Care Compare)

228 (as of May 27, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

711,617 (as of Jun 1, 2026)

All Nevada Home health Medicaid rates, ranked →