If you already operate a licensed home health agency in California, the 2026 home health moratorium still affects you.
Effective June 29, 2026, Senate Bill 164 changed California’s Home Health Agency licensing law. It also established a moratorium on new HHA licenses and new branch offices. CDPH then issued AFL 26-28 on August 27, 2026, explaining how they intend to implement the new law.
But, again, the changes are not limited to agencies trying to obtain a new license. Active California home health agencies now face new requirements and restrictions involving:
- what existing agencies must report
- new restrictions around ownership transactions
- the circumstances under which CDPH may deny, suspend, or revoke a license
- additional regulations that will affect how existing agencies operate.
*This article was written in consultation with Mariam Treystman.
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At The Home Health Consultant, we work with Medicare-certified home health agencies on licensing, Medicare enrollment, survey readiness, and ongoing compliance.
In this article, we’ll focus specifically on:
- what active California home health agencies need to know now,
- what changes require immediate attention,
- and which future requirements agencies should prepare for
…without acting on assumptions before CDPH issues additional guidance.
What Does the California Home Health Moratorium Mean for Existing Agencies?
The moratorium is a California state home health licensure moratorium. It’s important to note this is not a federal moratorium. Under this moratorium, CDPH generally may not issue a new license to operate a home health agency or add a branch office to an existing license.
The moratorium does not have a set expiration date. It will remain in place while CDPH develops new home health regulations and must end within 90 days after those regulations take effect.
That means there is currently no responsible way to give agencies a date when the moratorium will end. The trigger is the adoption of the revised regulations, not a predetermined number of years.
Like we mentioned in the introduction, CDPH's All Facilities Letter (AFL) makes clear that the restrictions reach beyond brand-new agencies.
But, ordinary license renewals and other report-of-change applications are not stopped by the moratorium. CDPH specifically identifies…
- a location change that does not change the service area, and
- A mailing-address change
…as examples of changes that may continue.
As we explained in our recent webinar, an active agency generally is not prohibited from moving simply because the moratorium exists. **The issue is whether the move takes the agency outside its currently approved GSA. **
Can a California Home Health Agency Still Be Sold During the 2026 Moratorium?
California law now explicitly states that an HHA license is not transferable.
It also states CDPH cannot approve a change of ownership during the first five years after the license was initially issued to that licensee. During that period, only the person or entity to whom the license was issued may use it.
There are exceptions, but they are narrow. CDPH may approve a change of ownership (CHOW):
- during that initial five-year period based on extenuating circumstances when the agency demonstrates either a need to ensure continuity of care for existing patients
OR
- if both financial hardship and that closing the agency would create an unmet need for home health services in its geographic service area.
There is another important unmet-need rule once an agency is beyond that period.
For a CHOW involving an agency that has been under the same licensee for at least five years, the buyer may not need to prove unmet need for the agency’s existing service area. This only applies IF the agency previously proved unmet need or can show that it is currently meeting a need in that area.
Important Note: Pending CHOW applications are not grandfathered in. CHOW applications pending on June 29, 2026 are subject to the five-year prohibition unless CDPH grants an exception.
What Actually Counts as a Change of Ownership for California Home Health Agencies Under the New Moratorium?
Ownership changes have always been something agencies should be careful about, but now it’s even more important.
For purposes of our webinar, we described a CHOW (change of ownership), as a change of 50% or more in the direct ownership of the licensed home health agency.
Direct ownership means ownership of the actual company that holds the home health agency license. It is different from indirect ownership, such as ownership of a parent company that owns the licensed agency.
A change of less than 50% in direct ownership is generally not treated the same way as a CHOW. The same is true for a governing body change that does not change ownership, or a change in an owner's title or role.
Important Note: However, the new California home health law does not clearly define every type of ownership transaction using the 50% threshold. Because of that, agencies should not assume a transaction is exempt from the new requirements just because it is structured as
- a stock transfer,
- parent-company change,
- or indirect ownership change.
If you are planning any ownership change, review the structure of the transaction before signing documents or submitting applications to CDPH.
What Does Every Existing California HHA Have to Submit by March 31, 2027?
Under the 2026 California home health moratorium, CDPH now requires a home health agency to report all of the following positions:
- Administrator Designee
- DPCS Designee
Important Note: Home Health Agencies did not previously have to report their DPCS designee. Now, you must report your DPCS designee to CDPH.
For each individual, the agency must submit a:
- HS 215A or successor form,
- a résumé,
- and a list of every licensed facility and HHA in which that individual currently serves in one of those management positions.
IMPORTANT NOTE: Existing agencies must make the one-time submission no later than March 31, 2027.
An HHA must also report a change in any of those four management positions within 10 business days, and submit the same required information.
The new law specifically states CDPH verification may include contacting the individual, your agency, or previous employers by telephone. So,
- Dates of employment,
- job titles,
- management positions,
- professional licenses,
- concurrent employment,
- and agency associations
…should be internally reviewed before submission.
These submissions should be taken very seriously, and reviewed meticulously before submitting. CDPH will be checking your work.
There is also a new ownership disclosure component. For a private HHA applicant owned by a corporation, partnership, or association, persons with a 5% or greater ownership interest are among those required to submit fingerprints for a criminal-record review.
Does the 2026 California Home Health Moratorium Limit How Many Agencies an Administrator or DPCS Can Work For?
No, there is no explicit number of agencies that a home health administrator or DPCS may work for…YET. But, it seems as though there may be in the near future.
The new law instructs CDPH to create a regulation establishing a limit on the number of HHAs with which home health management personnel may be involved at the same time. But the statute does not say that the limit is one, two, three, five, or any other number.
So an Administrator or DPCS who works with multiple HHAs should pay attention and prepare for change, but agencies should not begin terminating or resigning management personnel before CDPH releases more specific guidance.
A better step today is to identify exactly how many licensed agencies each management person is associated with, and make sure those relationships are accurately reflected in the required March 31st, 2027 submission. That gives your agency a clear picture before the eventual numerical limits are issued.
What Other New California Home Health Regulations are Coming?
The new law tells us three areas CDPH's revised HHA regulations must address.
First, CDPH must clarify the maximum time and distance HHA staff may travel to reach patients. For this, you must take typical traffic conditions and rural versus urban service areas into consideration.
Second, CDPH must establish a limit for how many agencies an administrator or DPCS may work for, as we discussed above.
Third, CDPH must create specific HHA office-space requirements.
What the statute does not currently provide are the final numbers or detailed standards.
- Travel time,
- concurrent management,
- and physical office standards
..are areas CDPH has been legally directed to regulate, but the details are still coming.
Has CDPH Gained New Authority to Revoke an Existing Home Health License?
To put it simply, yes. The new laws under the home health moratorium expand the statutory grounds upon which CDPH may deny an application or suspend or revoke an HHA license.
Those grounds now include:
- Prior Medicare or Medi-Cal termination for noncompliance
- A prior HHA license suspension or revocation involving an HHA owned, operated, or managed by the applicant or licensee
- A pattern and practice of state or federal violations during the prior three years
- Being listed on the HHS OIG List of Excluded Individuals/Entities
- Failure of HHA management personnel to cooperate with a CDPH inspection or complaint investigation
- *Failure to report a change in the owner, management personnel, service area, or location.
Failing to properly report a management change, ownership change, service-area change, or location change is now expressly included among the statutory grounds for license action.
We also want to remind agencies to stay current with annual license renewals. The underlying statute states that an HHA license expires every 12 months. The renewal application and fee are to be filed at least 30 days before expiration, and failure to timely renew results in expiration. While HHA license expirations would previously accrue fees until renewal, CDPH may now revoke the agency license instead. While there is no written time frame, CDPH has started revoking licenses at 18 months expirations. We expect this time frame to shrink even more.
What Should Active California Home Health Agencies Do About the Moratorium?
For an active agency, this moratorium should trigger a compliance review, not panic.
Confirm that the following information CDPH has on record for your agency is correct and up-to-date:
- Ownership
- Address
- GSA
- Administrator
- Administrator Designee
- DPCS
- DPCS Designee
Begin preparing the management documentation required by March 31, 2027, rather than waiting until the deadline is approaching.
Review résumés carefully because CDPH has authority to verify employment and agency associations.
Before relocating the office, expanding the service area, adding a branch, transferring ownership, or restructuring a parent company, determine how the new rules apply to that particular transaction.
And do not implement regulations that have not been written yet. CDPH has been directed to establish new management, travel, and office-space standards, but the final HHA requirements are still unknown.
We want to give intentionally cautious advice: prepare for tighter rules, but do not make drastic staffing changes based on guesses about what those rules will eventually say.
The overall direction, however, is clear. California is moving toward closer scrutiny of:
- who owns HHAs,
- where they operate,
- how far they serve,
- and whether agencies are timely and accurate in reporting changes.
For Medicare-certified home health agencies, protecting an existing license is becoming just as important as obtaining one, since state licensure is a prerequisite for maintaining your provider number.
Questions about how the California HHA moratorium affects your agency? Schedule a call with us for a personalized and free consultation to see how we can help your agency navigate ever-changing regulations.
Source note: This article is based on The Home Health Consultant's September 2026 moratorium webinar, California Health and Safety Code Chapter 8 as amended by SB 164, and CDPH AFL 26-28. Where the webinar discussed possible future requirements using the recent hospice regulations as examples.
*Disclaimer: The content provided in this article is not intended to be, nor should it be construed as, legal, financial, or professional advice. No consultant-client relationship is established by engaging with this content. You should seek the advice of a qualified attorney, financial advisor, or other professional regarding any legal or business matters. The consultant assumes no liability for any actions taken based on the information provided.
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