90-day startup checklist

State-verify: formation, insurance, and “home care” definitions differ by state. This is a research sequence, not a filing calendar.

• Write down the service model you intend (for example non-medical personal care, companion, or skilled services only if that is actually your plan).
• List whether you expect private pay, Medicaid waiver / HCBS, other payers, or a mix — then treat each path as a separate research track.
• Form or confirm the legal entity with your attorney/CPA; do not assume a generic LLC is enough for your state’s license or payer rules.
• Open a dedicated business bank conversation and start an insurance broker conversation (professional liability, general liability, workers’ comp as applicable).
• Bookmark your state health / licensing agency home-care pages and your state Medicaid / HCBS provider pages. Save URLs and last-visited dates.
• Start a research log: program names, contacts, fees, and what is still unknown.

State-verify: staffing ratios, nurse supervision, background checks, and handbook rules are jurisdiction-specific. Drafts are not employment advice.

• Draft an educational business-plan outline with financial and risk placeholders for advisor review.
• Sketch roles and a text org chart for the staffing you think you will need — then check what your state actually requires.
• Outline daily / weekly / monthly ops rhythm, intake, incident/complaint handling, and emergency/on-call coverage as drafts.
• Prepare handbook, job-description, offer-letter, and onboarding outlines. Point I-9 / W-4 work to official government sources.
• Map clinical-care boundaries for your authorized scope only (client rights, service-plan worksheet, medication-assistance limits if applicable).
• Fill a “required vs have vs need” gap tracker from official manuals — not from this page.

State-verify: EVV, documentation, enrollment, and contracting are payer-specific. Templates are not applications and do not enroll you.

• Complete a payer-landscape worksheet: who pays, who contracts, what manuals apply.
• Prepare a private-pay agreement draft for attorney review — do not use it as-is.
• Build invoice / AR and generic EVV / visit-documentation checklists, then confirm them against your payer.
• Write question lists for the state agency, attorney, CPA, and insurance broker before you spend more on implementation.
• Do not hire, market unauthorized services, bill, or submit applications until official requirements are verified.
• Re-read the pack disclaimer. No approval, enrollment, or revenue outcome is promised.