New York Home Care Rules & Regulations: A Guide to Staying Compliant

Home care is a crucial part of New York’s healthcare continuum, offering much-needed support to people in their homes. Staying compliant with New York Licensed Home Care Service Agency (LHCSA), DOH, and DOL regulations in this ever-changing environment requires organization, adaptability, and a commitment to meeting state standards. But compliance isn’t just about checking items off a list in accordance with home care regulations — it’s about ensuring your agency delivers excellent care while building trust with your clients. 

In this guide, we’ll break down everything you need to know about home care regulations in New York state and share practical tips to help your agency stay compliant while delivering the exceptional care your clients rely on.

Licensing and Certification Requirements

New York home care services and agencies must be licensed or certified by the New York State Department of Health (NYSDOH). To establish a Licensed Home Care Services Agency (LHCSA), you’ll fill out this form and submit it to the Bureau of Project Management, Division of Health Facility Planning.

This application should demonstrate compliance with regulatory standards and criteria, including:

• Policies and procedures
• Organizational structure
• Financial viability
• Information about your quality assurance program

FI’s or Fiscal Intermediaries do not have as rigorous a process to begin working and much less oversight from the state. This program is currently undergoing significant change with the state implementing a state-selected Single FI that will require agencies to hand over their census.

Certified Home Health Agencies (CHHAs) are also subject to Certificate of Need (CON) requirements. This involves a comprehensive review process to determine the necessity and impact of the provision of the proposed services on the community.

Key Staffing and Training Requirements

Home health aides (HHAs) and personal care aides (PCAs) must complete state-approved training programs through the Personal Care Aide Training Program (PCATP) or a Home Health Aide Training Program (HHATP) before providing home care services. Once provider training has been successfully completed, they will be listed on the New York State Home Care Registry.

Agency tip: Use training management tools to track completed training and send reminders when renewals are due for every provider.

New York’s Latest Home Care Regulations

2025 has seen the arrival of several changes in home care legislation. Here are the main changes to home care services you need to know about.

Minimum Wage Legislation for Home Care Aides

Effective January 1, 2025, the minimum wage for home care aides in New York City, Long Island, and Westchester increased to $19.10 per hour and $18.10 per hour for home care aides for the rest of New York State. Rates will increase again on January 1, 2026.

Agency tip: Update your payroll platforms to reflect the new minimum wage rates and calculations for all employees and utilize tools like AlayaCare to enhance care coordination and delivery by streamlining workflows and balancing your team’s workloads.

New York State Paid Prenatal Leave Law

As of January 1, 2025, all privately-employed pregnant people in New York are eligible to receive 20 hours of additional paid leave for prenatal care. This is in addition to existing paid safe and sick leave regulations. 

Agency tip: Ensure you stay compliant with regulations for prenatal leave by utilizing a platform that tracks employees’ leave balances and automates payroll adjustments to ensure accurate compensation.

Navigating Common Labor Compliance Challenges

Home care regulations in New York require agencies to navigate pay laws that go beyond the minimum wage, including overtime, call-in pay, and additional pay for long shifts or uniform maintenance. In addition, laws require employers to provide paid leave in certain circumstances. Staying compliant with these rules is key to ensuring fair compensation and avoiding legal repercussions.

Laws for Extra Pay

Home care aides may be eligible for extra pay in addition to minimum wage in several situations, including overtime, call-in pay, spread of hours, and uniform maintenance assistance.

• Overtime: Home care employees must be paid 1.5 times their regular hourly pay for working beyond 40 hours in a week (or 44 for residential employees).
• Call-in pay: If home care aides are sent home early on a regularly scheduled work day, they may be entitled to extra hours of pay at minimum wage for that day.
• Spread of hours: If a workday lasts longer than ten hours, the home care aide may be entitled to extra hours of pay at the minimum wage rate.
• Uniform maintenance: A home care aide may be entitled to additional weekly pay if they clean their own uniform.

Agency tip: It’s not always easy to avoid overtime in-home care. To minimize confusion around overtime, use all-in-one tools to accurately calculate payroll by capturing key data points, adjust workloads to ensure shifts stay within daily and weekly limits, and ensure compliance with federal and state laws for overtime, breaks, and holidays.

NYC Paid and Sick Leave Law

NYC’s Paid Safe and Sick Leave Law requires employers to provide eligible employees with leave for personal or family health needs, domestic violence, or safety concerns.

Here are the main points you need to know:

• Employers with five or more employees or a net income of more than $1 million must provide up to 40 hours of paid leave annually.
• Employers with 100 or more employees must provide up to 56 hours of paid leave annually.
• Employers with four or fewer employees and a net income of less than $1 million must provide up to 40 hours of unpaid leave annually.
• Domestic workers are also entitled to paid leave.
• Employers must offer immediate access to accrued leave, provide a written safe and sick leave policy, and disclose leave balances on pay stubs or through an electronic system.

In 2021, NYC officials reached an $18.8 million settlement with two home care agencies for violating paid sick leave and overtime laws, affecting over 12,000 workers. The settlement ensures restitution and highlights the city’s commitment to protecting the rights of home care employees. 

Agency tip: To ensure compliance with paid safe and sick leave laws, use a system that automates time-off tracking, accurately processes payroll, and manages employee leave requests.

Embracing Technology to Ensure Compliance

New York’s home care regulations are constantly evolving, and home care agencies must meet strict regulations on licensing, certification, training, supervision, patient care, and labor laws like paid sick leave and overtime. AlayaCare’s cloud-based platform helps agencies stay compliant by:

• Automating compliance tracking.
• Ensuring secure and HIPAA-compliant documentation with advanced cybersecurity practices.
• Automating payroll, sick leave, and overtime calculations.

With AlayaCare as your partner, you can seamlessly manage regulatory changes, helping you minimize the risk of violations and penalties. AlayaCare’s platform is built for flexibility, allowing you to quickly adapt to regulatory changes with configurable workflows and automated updates so you can focus on what matters most — providing exceptional client care.

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