To obtain a state license in the following states, a potential provider requires a Certificate of Public Need (CON):
Alabama
Alaska,
Arkansas
Georgia
Hawaii
Kentucky
Maryland
Mississippi
Montana
New Jersey
New York
North Carolina
South Carolina
Tennessee
Vermont
Washington
West Virginia
District of Columbia
This process can be a little different from state-to-state. The long and short of it is that you have to demonstrate that the area that you want to open an agency is underserved by existing home health providers.
The CON process usually requires a feasability study of the area and completion of an application (state specific) The process can consume a lot of resources and take up to two years to get approved (or rejected).
An alternative for some potential providers is to purchase an existing home health provider number from an existing organization. If this is the direction you choose, a due diligence survey would be prudent. Unfortunately, it is not uncommon that an agency is purchased and is already under a record review by the fiscal intermediary. Meaning that some of the claims that have already been paid are subject to being returned to CMS. Other unfortunate buying decisions include buying an agency with an existing census only to discover that a large percentage of the census is not eligible for Medicare payment.
The only way to reduce your exposure to risk is to analyze not only the financial health of the organization, but the level of compliance as well.
Contact Anderson & Tuttle for assistance with either the CON process, including a feasibility study or for a due diligence assessment of an agency you are interested in acquiring.
Tags: certificate of need, feasability studies, home health CON, hospice CON
Washington State also requires CON. Here is the link for that process. http://www.doh.wa.gov/hsqa/FSL/CertNeed/default.htm