Stack of documents with a paperweight on a leather desk pad, How to Start a Home Health Care Business in Nevada

How to Start a Home Health Care Business in Nevada

Last verified: November 5, 2026

Nevada licenses home care in two separate tiers, and the one you pick sets your cost, your staff and your timeline. A personal care agency (nonmedical help with bathing, dressing, meals and similar daily tasks) is licensed under NRS Chapter 449B with a $1,374 application fee. A home health agency (skilled nursing in the home) is licensed under NRS Chapter 449 with a $5,168 application fee for the home office. Our recommendation: if you are not starting with a nursing team, start with the personal care license. This guide covers both, in the order you do the work.

Important: The 2025 Legislature created NRS Chapter 449B and removed the personal care agency definition from Chapter 449. The state forms and fee schedule we could read still cite the older Chapter 449 sections, so confirm the current form and fee with the Division before you pay.

Which License Do You Need?

The license follows the work your caregivers do, not the name on your sign. Check the table first, because the wrong tier means a rewritten application.

LicenseWhat it coversFee (initial / renewal)Source
Personal care agencyNonmedical help with daily living for older adults and people with disabilities, in the client's home$1,374 / $687NRS 449B.465; NAC 449.013
Home health agency, home officeSkilled nursing plus training in health and housekeeping skills, in the home$5,168 / $2,584NRS 449.0015; NAC 449.013
Home health agency, branch officeAn office other than the home office from which the agency provides services$5,358 / $2,679NAC 449.013
Employment agency for nonmedical servicesAn agency that contracts with individual caregivers instead of employing them$1,400 / $700NRS 449B.105; NAC 449.013

A personal care license does not let you provide skilled nursing. Skilled nursing in the home is the home health agency category, so ask the Division which category fits your service list before you write your policies. A state license also does not enroll you with Medicaid or Medicare (see the Medicaid section below).

What You Need Before You Start

  • A business name that is distinguishable from every entity in the Secretary of State database.
  • An LLC or corporation. The application asks for your Articles of Organization and operating agreement (LLC) or articles and bylaws (corporation).
  • An administrator. For a personal care agency the regulation requires the administrator to be at least 18, hold a high school diploma or equivalent, and read, write and speak English. A nursing license is not on that list.
  • An office address with local approval. The application needs evidence of zoning approval from the city or county, such as a business license, a conditional use verification form or a special use permit.
  • A surety bond and a certificate of insurance. Both are original documents in the application packet.
  • Fingerprints for the applicant and every corporate officer.

Step-by-Step: Form the Company and License the Agency

Step 1: Check the Business Name

Search the Nevada Secretary of State's online entity search for your name. An LLC name must include Limited Liability Company, Limited Company, Ltd., LLC, L.L.C., L.C., or LC, and a corporation name must carry a corporate designator such as Corporation, Corp. or Inc. Your name and signs also cannot contain terms that mislead the public about the services you offer (NRS 449B.475).

Cost: Free.

Step 2: Choose Your Business Structure

Most new home care owners choose an LLC for liability protection and simpler administration. A corporation costs more at the state level: the state business license is $500 for a corporation against $200 for an LLC. A sole proprietorship carries no liability protection, which is a poor fit for a business that works inside clients' homes. Our recommendation is an LLC unless your attorney or CPA advises otherwise. Our Nevada LLC guide covers the filing in detail.

Step 3: File the Articles of Organization

File through the Secretary of State's SilverFlume online filing portal. The articles name the LLC, its registered agent and the agent's physical Nevada address. The filing fee is $75 (NRS 86.561). The Secretary of State offers expedited handling; the statutory ceilings are $125 for 24 hours, $500 for 2 hours and $1,000 for 1 hour (NRS 225.140). Those are ceilings, not a posted price, so confirm the amount when you file. If you would rather hand off the filing and registered agent work, compare LLC formation services in Nevada.

Keep the file-stamped articles. The bank account, the insurance application and the Division's application packet all ask for them.

Step 4: Get a Federal EIN

Apply for an Employer Identification Number on the IRS website. It is free, and you need it for payroll and business banking. Paid sites that charge for the same form are not the IRS.

Step 5: File the Initial List and Get the State Business License

Every Nevada business needs a state business license. For an LLC the fee is $200 (NRS 76.100), and the initial list of managers or managing members costs $150 (NRS 86.263). Both are due by the last day of the month after you file your articles, per the Secretary of State state business license FAQ (read through a Wayback Machine snapshot dated October 14, 2026). The first-year state total for an LLC is $425 ($75 plus $150 plus $200). After that you owe $350 a year ($150 list plus $200 license), due by the last day of the anniversary month. The same FAQ lists a $100 late penalty on the license. More detail is on our Nevada business license page.

You will need this license number later: the Division will not renew a personal care license if the renewal application omits your state business license number (NRS 449B.175).

Step 6: Secure Zoning Approval, a Surety Bond and Insurance

Do these before you apply, because the Division returns an incomplete packet.

  • Zoning approval: Get a business license, conditional use verification or special use permit from the city or county where your office sits. See the local rules section below. If the office will be in your house, read our Nevada home-based business laws page first.
  • Surety bond: Required for the initial license and every renewal (NRS 449B.185). The bond amount is $5,000 if you employ fewer than 7 people, $25,000 for 7 to 25 and $50,000 for more than 25. It is payable to the state's Aging and Disability Services Division to cover property damage to an older client. The premium you pay is set by the surety, not the state.
  • Liability insurance: The agency must have proof that it is adequately covered against liabilities from its operations. We found no dollar minimum in the statute or regulation, so ask your broker what coverage the Division and your clients expect, and ask about workers' compensation for your caregivers.

Step 7: Apply for the Personal Care Agency License

Apply to the Health Care Quality and Compliance office of the state health agency. The statute names the Health Care Purchasing and Compliance Division of the Nevada Health Authority (NRS 449B.030); the forms we could read carry the Division of Public and Behavioral Health and HCQC names. The Division's personal care agency application checklist lists what goes in the packet:

  • A notarized original application form and the $1,374 fee.
  • Evidence of local zoning approval.
  • A certificate of insurance and the original surety bond.
  • Your articles of organization and operating agreement (LLC) or articles and bylaws (corporation).
  • A three-year business history, or resumes and three reference letters for the applicants if the history is shorter.
  • A financial status statement.
  • For the administrator: a resume, three reference letters, a diploma or equivalent and proof of being 18.
  • A form showing compliance with the background check rules for employees and independent contractors.
  • The elder abuse, neglect and exploitation training test, signed and dated.
  • Proof of the Division's mandatory applicant licensure training and background check webinar (you can complete the training before or after you apply).

Fingerprint-based background check reports and the State Fire Marshal's certificate of compliance can follow the packet: the Division sends the Fire Marshal an inspection request after it receives your application and fee. Under NRS 449B.300 each applicant submits fingerprints to the Central Repository for Nevada Records of Criminal History for an FBI report.

Processing time: We found no official processing time, so ask the Division for its current estimate and do not hire or sign a long lease on a guess. Penalty for skipping this step: operating without the license is a misdemeanor, the Division can issue a cease and desist order, and a court can impose a civil penalty of up to $10,000 for a first offense (NRS 449B.485). The license expires on December 31 after it is issued and is renewed each year (NRS 449B.210).

Step 8: If You Are Opening a Home Health Agency Instead

A home health agency license is separate, issued to a specific person for a specific location, and not transferable (NAC 449.752 and NAC 449.758). The application fee is $5,168 for a home office and $5,358 for a branch office. The surety bond uses the same $5,000, $25,000 and $50,000 tiers (NRS 449.065). Nevada adopts the federal Centers for Medicare and Medicaid Services surveyor guidance for home health agencies by reference (NAC 449.750), so build your clinical policies to the federal home health standards from the start. We did not read the home health application packet, so get its checklist from the Division and, because skilled nursing is clinical work, bring in a Nevada health care attorney before you commit money.

Step 9: Hire and Train Before the First Client

The Division's personal care services workbook (December 2024) is the checklist inspectors use. Its training section lists:

  • Elder abuse training: Before any client contact, then annually.
  • CPR and first aid: Within 6 months of hire, with an in-person skills demonstration.
  • Annual attendant training: At least 8 hours on meeting client needs.
  • Cultural competency: A 2-hour Division-approved course within 90 days of hire, then every two years.
  • Infection control: The staff member in charge completes 15 hours within 3 months of appointment and annually after that, and caregivers complete annual infection control training.

Within 10 days of hiring, you also collect each employee's written statement about any disqualifying crime and confirm it (NRS 449B.310). Nevada's minimum wage is $12.00 an hour, according to the Nevada Labor Commissioner, so price your client rates from your payroll cost, not from a competitor's rate.

Step 10: Open a Business Bank Account

Bring your articles, EIN letter and ID to the bank. Keeping personal and business money separate protects the liability shield the LLC gives you. Ask each bank about monthly fees and minimum balances, since those vary by bank.

Costs

ItemCostSource
Articles of Organization (LLC)$75NRS 86.561
Initial list of managers$150NRS 86.263
State business license (LLC)$200NRS 76.100
Personal care agency application$1,374NAC 449.013
Home health agency application (home office)$5,168NAC 449.013
Surety bond (bond amount, not the premium)$5,000, $25,000 or $50,000 by headcountNRS 449B.185
Yearly LLC list and license$350NRS 86.263, NRS 76.100
Yearly personal care license renewal$687, plus 6% of that renewal feeNAC 449.013

For a personal care agency the state fees before your first client come to $1,799 ($425 for the LLC plus $1,374 for the license). That excludes the bond premium, insurance, fingerprinting, training courses and any local license fee. For the wider picture see how much it costs to start a business in Nevada.

Local Zoning and Business License

The state license does not replace the city or county license. Your office address decides who issues it: Clark County lists six licensing jurisdictions (Clark County, Henderson, Las Vegas, North Las Vegas, Boulder City and Mesquite) in its business license guide, and an office outside those cities falls under the county. Elsewhere, see the City of Las Vegas business license page or the City of Reno business license guide. Fees and zoning rules differ by jurisdiction, so confirm the home care use is allowed at your address before you sign a lease.

Taxes and Payroll

  • Income tax: The Department of Taxation states that Nevada has no state income tax. Federal tax still applies.
  • Modified Business Tax: If you have employees, the Department's Modified Business Tax page lists 1.17% of quarterly wages above $50,000 for general businesses. Employers file every quarter, even when nothing is due.
  • Commerce Tax: Health care and social assistance (NAICS 62) pays 0.190% of Nevada gross revenue above $4,000,000 in a fiscal year (NRS 363C.510). A small agency under that threshold files nothing.
  • Sales tax: The Department's sales tax FAQ treats services not tied to tangible property as not taxable. If you also sell or rent supplies or equipment, ask the Department how those sales are taxed.

Medicaid and Medicare

Many home care agencies plan their revenue around Medicaid, but the state license and Medicaid enrollment are separate steps. Caregivers reimbursed by Medicaid for personal care services must meet the same state training rules as agency attendants (NRS 449B.220). We could not read the Nevada Medicaid provider enrollment requirements from the state site, so confirm the steps, forms and timeline with Nevada Medicaid before you build a budget that depends on Medicaid clients. Medicare billing for a home health agency is a federal process on top of the state license.

Common Mistakes

  • Treating the LLC as the license. The Secretary of State filing creates the company. It does not let you serve a client.
  • Applying for the wrong tier. Skilled nursing needs the home health agency license, not the personal care license.
  • Signing a lease before zoning approval. The Division asks for local zoning evidence for the address, and a lease you cannot use is money lost.
  • Skipping the surety bond. A personal care license is suspended by operation of law if the agency is no longer covered by its bond (NRS 449B.185).
  • Missing a renewal. The agency license expires on December 31, and the LLC list and state business license renew on your formation anniversary month.

Order of Work

  1. Form the LLC, get the EIN, and file the initial list and state business license.
  2. Choose an office address and get local zoning approval.
  3. Buy the surety bond and the insurance certificate.
  4. Submit the notarized application with the fee, then complete fingerprinting and the applicant training.
  5. Pass the State Fire Marshal inspection the Division requests.
  6. Hire and train staff, then accept your first client once the license is issued.

Important Disclaimer

This article is informational only and is not legal or tax advice. Home care licensing is specialized and changed in 2025. Before you spend money, ask a Nevada business attorney to review your entity and licensing plan, ask a CPA about payroll taxes, and confirm every fee, form and deadline with the Division, the Secretary of State and the Department of Taxation.

Sources

Keep exploring: related Nevada guides