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Run the Payroll Fee Auditor →Blog · Payroll Management · Home Health
Home Health Agencies: New Hire Payroll Onboarding (2026)
New hire payroll onboarding at a home health agency is the W-4, the Form I-9 within three business days, new hire reporting inside the state deadline, the pay code for the role, and the home health agency checks this page cites before the first shift. BEG: $45 per employee per month inside the payroll software you already use, live in 3 to 5 days.
Checks specific to hiring in home health agencies
Medicare-certified home health agencies must document that each aide completed at least 75 hours of training with at least 16 classroom hours before 16 supervised practical hours, passed a competency evaluation performed by a registered nurse, and receives at least 12 hours of in-service training in every 12-month period. The agency must maintain documentation showing each standard was met.
The federal onboarding sequence
Form W-4 (and the state equivalent) before the first check; Form I-9 section 1 on day one and section 2 within three business days; the new hire report to the state directory within its deadline, federal default 20 days and shorter in several states; the pay code, exemption status and direct deposit authorization on the employee record; and for registered nurses and LPNs the pay basis documented so visit-based aide pay is taxed and counted for overtime correctly from the first run.
The rules behind this page, with sources
General information, not legal advice. Every rule below was read on the agency page linked next to it.
- Medicare-certified home health agencies must document that each aide completed at least 75 hours of training with at least 16 classroom hours before 16 supervised practical hours, passed a competency evaluation performed by a registered nurse, and receives at least 12 hours of in-service training in every 12-month period. The agency must maintain documentation showing each standard was met. [42 CFR 484.80]
Read the full guide to how to onboard a new employee in payroll, and the rest of the home health agency payroll library.
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Frequently Asked Questions
Hiring at a home health agency: 42 CFR 484.80
Medicare-certified home health agencies must document that each aide completed at least 75 hours of training with at least 16 classroom hours before 16 supervised practical hours, passed a competency evaluation performed by a registered nurse, and receives at least 12 hours of in-service training in every 12-month period. The agency must maintain documentation showing each standard was met.
How fast must a home health agency report a new hire?
Within the state's deadline, 20 days under the federal default and as short as 7 days in some states. The report goes to the state new hire directory, and a rehire after 60 days is reported again.
What does managed payroll cost for a home health agency?
$45 per employee per month, all-inclusive, inside the payroll software you already use, with no monthly minimum. Visit-based aide pay, travel time reimbursement and Medicaid billing vs payroll are configured at setup, not billed as add-ons.
Related Resources
Anthony leads payroll solutions at Business Executive Group, a national managed payroll firm serving businesses across industries including Home Health Agencies. BEG manages payroll at $45 PEPM, all-inclusive, with deep expertise in compliance, multi-state filing, and industry-specific payroll requirements. Get instant pricing at beghr.com.
Authoritative source: U.S. Department of Labor: Wage and Hour Division
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