Home Health Services in Massachusetts offer medical, therapeutic, and personal care to individuals with disabilities, chronic illnesses, or recovering from hospital stays. These services are regulated by the Massachusetts Department of Public Health (DPH) and reimbursed by MassHealth and Medicare, depending on eligibility and service type. 

1. GOVERNING AGENCIES

Agency: Massachusetts Department of Public Health (DPH)
Role: Licenses home health agencies under 105 CMR 140.000 regulations

Agency: MassHealth (Massachusetts Medicaid)
Role: Pays for home health services under Medicaid State Plan and community-based waivers

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Oversees Medicare-certified home health agencies and HCBS compliance

Agency: Executive Office of Health and Human Services (EOHHS)
Role: Provides policy guidance, provider bulletins, and LTSS systems

2. HOME HEALTH SERVICE OVERVIEW

Home Health Care includes:

• Skilled Nursing (e.g., wound care, injections, chronic disease monitoring)
• Home Health Aide Services (e.g., bathing, grooming, mobility assistance)
• Physical, Occupational, or Speech Therapy
• Medical Social Work
• Patient and caregiver education
• Medication management and care plan oversight

These services are delivered based on a physician’s order and documented in a plan of care (POC).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

To become a licensed home health agency (HHA) in Massachusetts, providers must:

• Register a business entity with the MA Secretary of State
• Obtain an EIN, NPI, and Medicaid ID
• Apply for a Home Health Agency license through the DPH Determination of Need (DoN) Program
• Submit a comprehensive application package and policy & procedure manual
• Pass a DPH survey inspection
• Employ qualified nursing and therapy professionals
• Maintain malpractice insurance and secure EMR systems

4. MASSACHUSETTS HOME HEALTH LICENSURE PROCESS

Step 1: Business Formation & Planning

• Establish legal entity and secure office location
• Develop staffing and service model (e.g., skilled, aide-only, full-service)

Step 2: Apply to DPH for Licensure

• Submit application under 105 CMR 140.000
• Include org chart, medical director, policies, emergency plan, etc.

Step 3: Site Visit and Licensing Survey

• DPH will inspect the office and review staff files, procedures, and compliance

Step 4: Enroll with MassHealth via ePREP

• Select appropriate home health categories: RN, LPN, PT, HHA, MSW, etc.

Step 5 (Optional): Apply for Medicare Certification

• For dual revenue streams and to serve Medicare-eligible patients

5. REQUIRED DOCUMENTATION

• Articles of Organization or LLC registration
• IRS EIN and Type 2 NPI
• DPH Home Health License
• MassHealth Provider ID and contract

Policy & procedure manual covering:

• Admission, discharge, and eligibility criteria
• Care planning, RN supervision, and therapy protocols
• Home Health Aide logs and time sheets
• HIPAA, infection control, and medication safety
• Quality assurance, grievances, and risk management
• Emergency and disaster preparedness
• Client rights, informed consent, and training documentation

6. STAFFING REQUIREMENTS

Role: Director of Nursing (RN)
Requirements: Active MA license, supervisory experience, responsible for clinical operations

Role: Licensed Practical Nurse (LPN)
Requirements: Works under RN delegation for skilled tasks

Role: Home Health Aide (HHA)
Requirements: Must complete state-approved training (75 hours), CPR certified

Role: Therapists (PT, OT, ST)
Requirements: State-licensed, responsible for evaluations and POC updates

Role: Medical Social Worker (if offering full-service model)

Training Requirements:

• HIPAA and infection control
• Delegation and nursing documentation
• Abuse/neglect reporting (MANDATED)
• ADL support, body mechanics, and safety
• Annual skills review and continuing education

7. MASSHEALTH SERVICE TYPES & BILLING

MassHealth reimburses licensed HHAs for:

• Skilled nursing visits
• Home health aide visits
• Physical therapy, occupational therapy, speech therapy
• Social work (MSW) assessments
• Telehealth services (in some cases, per bulletins)

Billing is done through:

• MassHealth LTSS Provider Portal
• Claims must follow POC requirements and be properly documented

8. TIMELINE TO LAUNCH

Phase: Business Registration and Planning
Timeline: 1–2 weeks

Phase: Policy Manual, Hiring, and DPH Application
Timeline: 4–6 weeks

Phase: DPH Survey and Licensure
Timeline: 6–10 weeks

Phase: Medicaid Enrollment and Service Start
Timeline: 4–6 weeks (can overlap)

9. CONTACT INFORMATION

Massachusetts Department of Public Health (DPH)
Website: https://www.mass.gov/guides/apply-for-a-health-care-facility-license

​Home Health Licensure Regulations (105 CMR 140)
https://www.mass.gov/doc/105-cmr-140-the-licensure-of-clinics/download

​MassHealth Provider Enrollment (ePREP)
Website: https://massfinance.ehs.state.ma.us

​LTSS Provider Portal
Website: https://ltss.mass.gov

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10. SCOPE OF WORK

• Business registration (LLC, EIN, NPI)
• DPH licensure application and inspection prep
• Policy & procedure manual tailored to MA Home Health standards
• Staff credentialing trackers and onboarding documents
• RN delegation forms, POC templates, and MAR logs
• MassHealth billing guidance and LTSS portal setup
• HIPAA-compliant communication tools and care coordination templates
• Referral development for discharge planners, SCOs, and ACOs