How to Start a Non-Medical Home Care Agency in West Virginia: Licence or Registration

If you want to start a home care agency business in West Virginia, the first question is usually whether you need a license. For private-pay, non-medical in-home care, the short answer is that our research of W. Va. Code chapter 16B and the Office of the Inspector General rules in Title 71 found no state license for an agency that sends non-medical caregivers into clients' homes. That does not mean you can skip the state. You still have to register the business, file your entity paperwork, pay city taxes where they apply, and set up as a lawful employer. This guide walks through those steps in order and flags the points where you need a direct answer from a state agency before you commit money.

This article is informational content, not legal or tax advice. Rules, fees and agency practices can change. Confirm every point with the agency named before you rely on it, and talk with a West Virginia attorney and a CPA before you sign a lease, hire staff or take client money.

What You Need Before You Start

Gather these items before you file anything. Most are inexpensive or free to prepare, but a missing item can stall the process for weeks.

• A written list of the services you will deliver, such as companionship, housekeeping, meal preparation, transportation to appointments and personal care that stops short of nursing
• A description of who will pay for care: private-pay clients, long-term care insurance, or Medicaid
• Two proposed legal names, each checked against the Secretary of State business search at http://apps.sos.wv.gov/business/corporations/
• The $100 filing fee for Articles of Organization (Form LLD-1) if you form an LLC, or the $100 filing fee for Articles of Incorporation (Form CD-1) if you incorporate
• The $30 Business Registration Certificate fee from the West Virginia Tax Division
• A federal employer identification number from the IRS, which you need before you run payroll
• Optional: a $15 name reservation, which holds a name for 120 days
• Optional: the trade name fee if you will operate under a name other than your legal name
• The business address for each city where you will have an office or staff, and the city clerk or treasurer contact details for each
• Written questions for OHFLAC, the Bureau for Medical Services and the Health Care Authority, as described in the steps below
• A caregiver screening plan, including WV CARES background screening where it applies
• A bank account for the business and a cash reserve that covers the first months of caregiver payroll

Step-by-Step: Starting Your Agency

Step 1: Decide exactly what services you will deliver

The most important decision in this process is the line between non-medical and medical care, because it determines which agency, if any, regulates you. Companionship, housekeeping, meal preparation, errands, bathing and dressing assistance, and medication reminders (not administration) are the typical services for a private-pay agency. Hands-on nursing or medical tasks change the business. In West Virginia, a service that adds those tasks becomes a home health agency, which needs a Certificate of Need from the Health Care Authority under 16-2D-8. Dressing wounds, giving injections and caring for catheters are examples of tasks to avoid until you have a written answer on where the line falls.

Write the service list on one page. You will reuse it for your OHFLAC questions, your client service agreement and your insurance application, and each agency will ask what you actually do.

Step 2: Ask OHFLAC whether any registration applies

Vendor guides often mention an OHFLAC registration for home care businesses. In our research, that registration is a no-fee registration under 16B-6-3 for a service provider that runs a legally unlicensed health care home, meaning a residence where residents live and receive personal assistance. It is not a license for an agency that visits clients in their own homes, and a provider may run only one such home. If your model involves a residence where clients live, the registration may apply to you. If your model only sends caregivers into private homes, ask OHFLAC to confirm in writing that no registration or license is needed.

Also ask whether WV CARES background screening under 71 CSR 11 applies to your caregivers, what it requires of you as the employer, and whether it must be completed before the first shift.

Step 3: Check Medicaid before you accept a Medicaid client

Private-pay care and Medicaid-funded personal care follow different review tracks. A personal care agency approved by the Bureau for Medical Services is subject to Certificate of Need review for providing personal care services under 16-2D-2 and 16-2D-8(b)(22). Do not assume that a private-pay start keeps you out of that review if you enroll later. Call the Bureau for Medical Services and the Health Care Authority before you accept a Medicaid referral, and ask for their answer in writing.

Step 4: Form your entity and check the name

Most small agencies form an LLC. Articles of Organization (Form LLD-1) carry a $100 filing fee. Standard processing takes 5 to 10 business days. Expedited options are available: in-person same day $25, next business day $25, 2 hour $250 and 1 hour $500, each added to the filing fee. Online filings through the WV One Stop Business Portal at https://business4.wv.gov/ add a $1.00 processing fee.

The name must contain 'limited liability company', 'limited company', or the abbreviations 'L.L.C.', 'LLC', 'L.C.' or 'LC' under WV Code 31B-1-105. It must also be distinguishable from every other name already registered or reserved with the Secretary of State. Search the database before you commit, and if you need time to decide, reserve the name for 120 days for $15 at https://sos.wv.gov/reserveregister-business-name.

If you incorporate instead, Articles of Incorporation (Form CD-1) also carry a $100 filing fee. Corporations and LLCs both file a $25 annual report, covered in the cost table below. The entity choice affects taxes and liability, so confirm it with a CPA and an attorney.

A registered agent is optional. Form LLD-1 asks for an agent for service of process 'if any,' and the instructions say you may wish to maintain one. The Secretary of State is appointed as attorney-in-fact for every entity that files organizing documents, so it can accept legal papers for your company even if you name no agent. Many owners still list a street address they check every day. If you do name an agent or change the address, keep it current, because changes are filed on Form AAO for $15.00.

Step 5: File a trade name if you will operate under another name

If your agency will trade as something other than its legal name, file a trade name registration with the Secretary of State. Trade name registrations are not filed with county clerks. Individuals, sole proprietors and general partnerships file Form TN-1 with no filing fee. LLCs, corporations and other registered entities file Form NR-3 for $25.00, plus a $1.00 online processing fee if filed through the portal. The form and instructions are at https://sos.wv.gov/business/registration-and-waivers/register-trade-name-dba.

Step 6: Obtain the Business Registration Certificate before your first client

Every individual or business entity must obtain a Business Registration Certificate from the West Virginia Tax Division before engaging in business activity. The one-time fee is $30.00. You can file Form WV/BUS-APP or apply online at https://business4.wv.gov/. A separate certificate is required for each business location. The certificate is permanent until the business name, location or ownership changes.

Registering with the Secretary of State does not replace this certificate. Occupational, professional and municipal licenses may apply on top of it. Start from the Tax Division at https://tax.wv.gov/ and confirm the current process on the business registration page before you file.

Step 7: Check the city where your office sits

West Virginia has no general statewide business license, so the local layer matters more than most first-time owners expect. The state has 55 counties and 230 incorporated places, and the rules that reach a care agency often come from the city. Cities levy a gross receipts business and occupation (B&O) tax, may require a city business license, and may charge a weekly per-worker city service fee. The state B&O tax applies only to utilities, so the B&O tax that reaches a home care agency is a city tax.

Call the city clerk or treasurer where your office or staff will be based. Ask whether a business license is required, what the B&O rate is, whether the weekly per-worker service fee applies to caregivers, and whether the answer changes if you serve clients in other towns. Do not rely on another city's rates or a rate you saw in an online guide. Get the current answer from the city.

Step 8: Set up as a lawful employer

Caregivers are employees in most agencies, and the employer setup is where many new owners make expensive errors. Before your first shift, arrange workers' compensation coverage and confirm the requirements with the state workers' compensation agency. Set up payroll withholding, wage-and-hour compliance, time records and a written policy on overtime and travel time. Confirm your state and federal employer registrations with the Tax Division and the IRS as part of this step.

Classifying caregivers as independent contractors is a common and costly mistake. If the agency sets schedules, supplies training and controls how care is delivered, the classification is likely to be challenged. Confirm your approach with a CPA or an employment attorney before you hire.

Step 9: Use local business support

The West Virginia Small Business Development Center at https://wvsbdc.com/ can help you test your plan and check your startup steps, and the SBA's West Virginia district office page at https://www.sba.gov/district/west-virginia lists the resources available in the state. Bring your service list, your city questions and your OHFLAC and Medicaid answers. A plan review is most useful after you have those written answers, not before.

Filing Costs at a Glance

Item	Fee	Agency
LLC Articles of Organization (Form LLD-1)	$100	Secretary of State
Corporation Articles of Incorporation (Form CD-1)	$100	Secretary of State
Name reservation (120 days)	$15	Secretary of State
Annual report (filed January 1 to June 30)	$25	Secretary of State
Annual report filed after June 30	$75 ($25 fee plus $50 late fee for LLCs)	Secretary of State
Trade name for an LLC or corporation (Form NR-3)	$25.00, plus $1.00 if filed online	Secretary of State
Trade name for a sole proprietor (Form TN-1)	No filing fee	Secretary of State
Change of registered agent or address (Form AAO)	$15.00	Secretary of State
Business Registration Certificate (per location)	$30.00	WV Tax Division

City business license fees, city B&O tax, the weekly per-worker city service fee, workers' compensation premiums and any OHFLAC or Medicaid fees are not in this table. Confirm each of them with the agency that charges it.

Taxes You Will Encounter

An LLC pays no state franchise tax and, as a pass-through entity, no corporation net income tax. Its members report income on the personal income tax, which runs from 2.11% to 4.58% across five brackets for tax year 2026. A corporation pays the 6.5% corporation net income tax on federal taxable income, apportioned by a single sales factor. The state sales tax rate is 6%, and 101 municipalities add a 1% city sales tax today, rising to 107 municipalities from January 1, 2027. Ask the Tax Division which of your receipts are taxable, because a home care service is not automatically treated the same as a retail sale.

Common Mistakes to Avoid

• Treating the Secretary of State filing as the license. Forming an LLC is a filing, and the Business Registration Certificate is still required.
• Skipping the city. Many new owners register at the state level and only discover the city business license or B&O tax after their first invoice.
• Adding nursing tasks without a Certificate of Need decision. Once a service crosses into hands-on nursing, the business is a different regulated operation.
• Assuming Medicaid is out of reach. If you plan to enroll later, the personal care review may apply, so get the Bureau for Medical Services and Health Care Authority answers before you accept a referral.
• Relying on a no-fee OHFLAC registration for visits to clients' homes. The registration covers a residence where residents live and receive personal assistance, and one provider may run only one such home.
• Misclassifying caregivers as contractors to save on payroll costs.
• Missing the June 30 annual report. Filings after June 30 cost $75 because of the $50 late fee.
• Filing a trade name with a county clerk. Trade names are filed with the Secretary of State.
• Opening a second residence-based care home under the same OHFLAC registration, which the rules do not allow for one provider.

Expected Results

Following these steps may help you reach a clean starting position, though no outcome is guaranteed. Based on the standard processing times and fees above, you may have an active LLC within about two weeks if your name clears and you file with standard processing. You may have your Business Registration Certificate once the Tax Division processes your application, and you should confirm timing with the agency before you plan a launch date. You may also have written answers from OHFLAC, the Bureau for Medical Services, the Health Care Authority and your city, which are the milestones that matter most before you market or take a client.

Registration does not guarantee clients, referrals, reimbursement or profit. Referral relationships and caregiver recruiting often take longer to build than the paperwork does, and results vary by market, staffing and service mix. Treat the filings as the foundation, not the business plan.

Next Steps

Start with the list of services you will deliver, then send your written questions to OHFLAC. While you wait for those answers, file the LLC or check your name, register with the Tax Division, and call your city clerk. Hold off on Medicaid enrollment and on any nursing task until the Bureau for Medical Services and the Health Care Authority have answered in writing.

This article is informational content, not legal or tax advice. If your plan includes Medicaid clients, nursing tasks, a residence where clients live, or employees, consult a qualified West Virginia attorney and a certified public accountant before you begin operating.