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Starting a Non-Medical Home Care Business In North Carolina

A Step-by-Step Guide to Starting Your Company

Starting a non-medical home care agency in North Carolina has several federal, state, and local department registrations.  There is a license required for all home care agencies, which can be obtained through the North Carolina Division of Facility Services. Read below for web links and contact information for these various business start-up procedures.

Home Care Licensing

There is a required license in North Carolina for home care businesses which must be submitted to the North Carolina Division of Facility Services.  There is a non-refundable license fee of $350 which must be renewed annually.  For detailed information, check with the NC Department of Health and Human Services at (919-715-8058) and speak with the Administrative Officer, Larry Barnes at extension #154 or click on the link above.

Registering Your Business Name

To register your business name in North Carolina, you or the partnership must file an Assumed Name Certificate with the Register of Deeds Office in the county or counties where you will do business. To view contact information for the county office nearest you, click on this Business ServiCenter link and click on County Register of Deeds Office at the top of the page. 

For additional questions or information on registering your business name, call The North Carolina Commerce Business Service Center toll free (1-800-228-8443).

Federal Employer Identification Number (FEIN)

A Federal Employment Identification Number is required of all home care companies who will have employees.  You may apply (Form SS-4) for an FEIN by calling the Business and Specialty Tax Line weekdays between 7 a.m. and 10 p.m. Eastern time at 1-800-829-4933.  You may also apply online using the Internet EIN Application.  For more information visit www.irs.gov/businesses.

State Income Tax Withholding

The State of North Carolina requires that every new employer complete and file with the North Carolina Department of Revenue a Registration and Application for income tax withholding.  After completing this form, you will need to mail it to the Department of Revenue at the address printed on the bottom of the form.  

Workers' Compensation

In order to determine if you are required by law to carry Workers’ Compensation Insurance, you must first determine your business entity.

If you are a sole proprietorship, partnership, LLC, estate, or trust, you are required by law to carry coverage once you have three (3) employees who are regularly employed, in addition to the sole proprietor, partners, formulators of the LLC, executor of the estate, and bearer of the trust.  It does not matter if these employees are full time, part time, regular seasonal or family members.
If you are incorporated, including all forms of corporations and those which have non-profit status, you are required by law to carry coverage once you have a total of three (3) people in the corporation.  Everyone is included in the headcount, including corporate officers.

To read further about this topic go to North Carolina Industrial Commission website, or call
The Department of Insurance at (919) 733-5631.

Unemployment Compensation

Generally, a sole proprietorship, partnership, or corporation is required to provide Unemployment Insurance coverage for its employees if the business: has one or more employees for twenty or more weeks in a calendar year, or pays $1,500 in wages during a calendar year.  The Employment Security Commission of North Carolina can answer more detailed questions online, or give them a call at (919)-733-4329. (If you are experiencing trouble linking to this site, type in this link in your web browser http://www.ncesc.com/business/UI/uiTax.asp#whoLiable.)

* In 2005 the Standard Beginning Tax Rate for a Taxable Wage Base of $16,700 was 1.200% (.01200).*

Who Pays for Home Care Services?

In some instances licensed home care agencies can receive Medicaid certification for specific services; e.g., Medicaid Community Alternatives Program (CAP), Personal Care Services (PCS), Home Infusion Therapy (HIT), etc. For further information concerning Medicaid services, contact the Division of Medical Assistance at 919-857-4017.

Many home care services are reimbursed by Medicare, Medicaid, worker's compensation, private or group health insurance, HMOs, Veteran and military benefits (VA/Champus), or through other special funds such as block grants. Also, private payment may be arranged with many agencies on an individual basis.

When services are reimbursed by either public sources of funding or through insurance, it's important to understand the eligibility criteria for reimbursement.

Eligibility Criteria for Reimbursement
While the Medicare and Medicaid home health programs reimburse home care services for homebound patients, other Medicaid programs also cover in-home services. These include: Medicaid Personal Care Services (PCS), Home Infusion Therapy (HIT), Community Alternatives Program (CAP), Durable Medical Equipment (DME), Private Duty Nursing (PDN) and Hospice.

State Management of Medicaid

For any additional questions about North Carolina state regulations on Medicaid for your business, please contact the:

North Carolina Department of Health and Human Services
Division of Medical Assistance
2501 Mail Service Center
Raleigh, NC 27699-2501
Local: 1-919-855-4100

Information on this page is believed accurate as of the most recent update, February 15, 2006.  Corrections or additions may be emailed to updates@privatedutytoday.com.  This guide is meant as a starting point for business creation research, and may not be complete or current.  Private Duty Today shall not be liable for errors or omissions.

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