How to Start a Home Care Agency in Alberta

The path in one paragraph

Starting a home care agency in Alberta is a registration-and-referral business, not a licensing battle. There is no Alberta home-care-agency licence to chase — the province's public-funding route runs through Client Directed Home Care Invoicing (CDHCI), a program administered by Alberta Blue Cross in which an AHS case manager authorizes a client's hours and maximum rate, the client chooses a registered provider, and the provider bills Alberta Blue Cross directly. Around that, you register the business through a registry agent, open a WCB-Alberta account within 15 days of your first hire, carry the program's insurance minimums, and hire trained, checked caregivers. Get the CDHCI registration right first; it is the revenue lane that separates an Alberta agency from a babysitting service with a nicer name.

First: the licence question everyone gets wrong

Beginners look for a health-care licence and find none, then assume no licence is needed. In Alberta the first half is right and the second half is the trap:

• There is no home-care-agency licence. Alberta does not license home care agencies. The Continuing Care Act and its regulations, in effect since April 1, 2024, govern the continuing care system — but they license and regulate care homes and facilities, not agencies that send caregivers into clients' homes. Do not market yourself as "licensed" on the strength of a registration you do not hold.
• The gate that matters is program registration, not a licence. To be paid from public funds you register as a CDHCI provider with Alberta Blue Cross. The provider guide lists the requirements plainly: comply with municipal business licensing, plus standard labour and tax regulations, plus the program's personnel and insurance rules. That is the whole gate — no health-ministry licence sits behind it.
• Three kinds of publicly funded home care exist. The Continuing Care Act defines three service models: care provided directly by Alberta Health Services, care provided by an AHS-contracted provider, and care where the client selects a provider of their choosing — that third model is CDHCI. A new agency's realistic entry point is the third one, because it has a published provider-registration path. AHS-contracted work is the second model and runs through AHS procurement, not through provider registration.
• Private pay needs no program registration at all. You can sell directly to families without touching CDHCI. But then you are competing on reputation alone, with no public funding behind your clients — which is why most Alberta agencies register for CDHCI even when private pay is their main lane.

Step 1: Pick your service model before you register anything

Home care splits into lanes with different staffing, pricing, and risk — and your model decides almost everything downstream:

• Companionship and homemaking (non-medical). Conversation, meal prep, light housekeeping, laundry, transportation, medication reminders (not administration). Lowest regulatory surface; staffed by caregivers and health care aides. Under CDHCI, homemaking is never a standalone service — it must accompany personal care or respite.
• Personal support (non-medical, hands-on). Bathing, dressing, mobility and transfers, continence care — the classic health care aide scope. This is where the market-standard hire is a trained aide, even though CDHCI does not mandate the regulated credential.
• Skilled / medical home care. Nursing visits, wound care, medication administration, post-surgical care. Requires regulated nurses; verify every registration yourself on the relevant Alberta college's public register.
• Publicly funded care (CDHCI). You deliver personal care, homemaking, or respite authorized in a client's AHS care plan and bill Alberta Blue Cross. Different sales motion — the client finds you on the registered vendor list — steadier volume, heavier compliance.

Most new agencies start in the first two lanes (private-pay families) and add CDHCI once registered. Decide now, because your insurance, hiring plan, and marketing all follow from it.

Step 2: Register the business

The paperwork is ordinary Alberta business registration, in this order:

1. Choose the structure. For a care business, incorporation deserves serious consideration. You are sending employees into clients' homes to care for vulnerable people; the liability exposure is real, and a corporation separates the business's liability from your personal assets in a way a sole proprietorship does not. See our Alberta incorporation guide for the full walkthrough, and talk to an Alberta accountant or lawyer before you choose — this guide is not legal advice.
2. Register the name. If you trade under any name other than your own personal name, file a Declaration of Trade Name at a registry agent — a private service provider authorized by Service Alberta. The government fee is $10, plus the agent's own service charge, which the province does not cap. Alberta names do not have to be unique, and registration grants no ownership of the name. Incorporation costs a $275 government fee instead, plus a NUANS report for a named company and the agent's charge.
3. Get a Business Number. Free from the CRA; you will need it for payroll, and for GST once your taxable revenue crosses the $30,000 small-supplier threshold. Alberta charges 5% GST only — there is no provincial sales tax. (Our sole-proprietorship and GST/HST guide walks through the BN and GST/HST mechanics.)
4. Check municipal licensing. Calgary, Edmonton, and most Alberta municipalities license businesses separately — your provincial declaration does not cover it. Confirm the requirement with the city where you will operate.
5. Open a WCB-Alberta account when you hire. If your industry requires workers' compensation coverage, you must open a WCB-Alberta account within 15 days of hiring your first worker. Do not discover this deadline after the fact.

Step 3: Register as a CDHCI provider

This is the step that makes public funding possible, and it is the one Ontario-style guides get wrong by assuming a licence exists. In Alberta the path is:

1. Meet the personnel requirements first. Every person delivering services to a client must have a clear criminal record check including a vulnerable sector search, dated no earlier than three years before the service date or the date they started continuous employment with you. Each provider representative must be your employee or retained by you, and must not be a family member of the client receiving the services.
2. Carry the insurance minimums. Alberta Blue Cross requires, at your cost, workers' compensation or employer's liability ($1,000,000 per accident; $1,000,000 per employee for disease), commercial general liability of $5,000,000 per occurrence, automobile liability of $2,000,000 per accident, professional liability of $5,000,000 per occurrence with a $10,000,000 aggregate, and a fidelity bond of $200,000 per loss. These amounts cannot be waived or reduced. Confirm with your broker that your coverage meets the program's standards — Alberta Blue Cross does not recommend brokers.
3. Register for online claims submission. Alberta Blue Cross offers online claims submission at no cost to health providers. Complete the request for secure website access and Alberta Blue Cross will create your access; a login ID and temporary password arrive in two separate emails.
4. Publish your listing details. Give Alberta Blue Cross your minimum consecutive hours per visit, your estimated hourly rate, and the languages you can support clients in. This information goes on your listing on the Alberta Blue Cross website, where clients choose their provider. Provide nothing and you may be approved to bill but will not appear on the website.

Keep the registration current and verifiable: families choose from the registered vendor list, and a provider who does not appear on it does not get chosen.

Step 4: Build the care team to a hireable standard

Your caregivers are the product. The hiring bar that wins private-pay clients:

• Health care aides: hire to the credential where you can. Health care aides are regulated in Alberta, held to common education and practice standards, with ongoing competence requirements and accountability through the College of Licensed Practical Nurses and Health Care Aides of Alberta. For CDHCI work the program does not require the regulated credential — personal support workers are eligible — but hiring trained aides is what families compare you on. See the College's site for what the credential means.
• Nurses: verify registration. If you offer skilled care, every nurse must hold current registration with their Alberta college. Check the public register yourself rather than taking a résumé at face value.
• Screen like a care business. Vulnerable-sector police checks (required for CDHCI in any case), reference checks with former care employers (not just character references), and current CPR and First Aid certification as a condition of client-facing work.
• Onboard to a plan of care. Even in the non-medical lanes, write a care plan for each client and supervise against it. Supervised, plan-driven care is both better service and your best evidence if your CDHCI compliance is ever reviewed.

Aide wages are the labour market you are buying into: Alberta job postings for personal support workers in home support list $20 to $25 an hour. Price your services against what good caregivers actually cost to retain, not against the cheapest competitor's flyer.

Step 5: How clients reach you — the AHS assessment

Understand the client's side, because it is your sales funnel for publicly funded work. To receive publicly funded home care, an Albertan must first be assessed by an AHS home care case manager — no referral from a physician is necessary, and anyone legally entitled to be in Canada who makes Alberta their permanent residence can be assessed. The first step is to call Health Link at 811 or email continuingcare@ahs.ca; a case manager completes a standardized assessment, develops a care plan with the client and family, and discusses the most appropriate service option. If the client is eligible for CDHCI, they can hire a registered CDHCI provider of their choice to deliver the personal care, caregiver respite, or home support services authorized in their care plan.

Two rules shape your business. First, CDHCI is not approved when the client lives in a home setting owned by the care provider agency or any congregate setting, such as a lodge, private assisted or supportive living, or a group home. Second, a separate AHS program — self-managed care — lets eligible clients act as the employer themselves, hiring, training, and managing their own caregivers under a one-year agreement with AHS. Do not confuse the two: in CDHCI the client hires your agency; in self-managed care the client becomes the employer and you are not in the picture.

Step 6: Bill it right, and know what is not covered

For CDHCI clients, bill Alberta Blue Cross directly for services provided within 60 days of service delivery. Alberta Blue Cross reimburses up to the maximum number of hours authorized per month and up to the maximum hourly rate approved by AHS. Monthly hours reset on the first of each month; unused hours do not carry over.

These are not covered by CDHCI, and must be charged directly to the client if you charge them at all:

• Hours that exceed the approved maximum monthly hours
• Charges above the AHS maximum hourly rate (clients who choose a provider above the rate pay the full difference themselves)
• Mileage, travel time, administration fees, statutory holiday, overtime, vacation pay, cancellation fees, supplies, or equipment charges
• Services purchased before approval starts or after it ends, services outside the client's zone of residence without AHS approval, and services purchased outside Alberta
• Periods when the client is admitted to acute care or a facility-based respite bed

Providers must not represent themselves as AHS employees or affiliates, or claim AHS endorsement, and must not be present during the scheduled AHS assessment appointment. All claims are subject to compliance verification reviews, and Alberta Blue Cross may recover overpayments. Keep your documentation clean: only services approved and listed on the client's letter of agreement from AHS can be claimed.

Price the service: the Alberta rate card

Families comparison-shop on hourly rate first and everything else second, so your rate card has to sit inside the market bands while leaving you a margin after labour, insurance, the CDHCI overhead, and travel between visits. What Alberta agencies actually publish in 2026:

Two pricing conventions matter almost as much as the rates. First, a minimum per visit is standard — some Alberta agencies set a two-hour minimum, and the CDHCI guide notes providers commonly charge a two-to-three-hour minimum call-out, which AHS does not grant extra hours to meet. Second, statutory holidays commonly carry a premium — one Edmonton agency charges $75 an hour for personal care and $60 for companionship on statutory holidays. Put both in writing up front rather than surprising families on the first invoice.

The margin math that has to work: Alberta personal support workers earn roughly $20 to $25 an hour in job postings, and agencies bill $26 to $50. That spread pays for your insurance, scheduling, caregiver backup, supervision, and travel time. Price below the band and you are subsidising every visit; price above it and you need a reason, like dementia specialisation or complex care, that families can see. Publish your starting rates ("from $35/hour" beats "call for a quote") and put the full fee schedule, minimums and premiums included, in writing before the first visit.

Step 7: Find clients — private pay first, CDHCI second

New agencies almost always start with private-pay families: the sales cycle is days, not assessment queues. What works in Alberta:

• Discharge planners and hospital social workers are the highest-trust referral source for post-hospital home care — introduce the agency in person, leave a one-page services sheet, follow up.
• A real local web presence. Families search "[city] home care" at 2 a.m. after a hospital discharge; a clear services page, transparent pricing ranges, and your CDHCI registered-provider status visible on the site beat a directory listing.
• Google Business Profile and reviews. Home care is a reviews business. Ask every satisfied family.
• Retirement homes and condos with aging residents — bulletin boards, info sessions, and relationships with building managers.

The second lane is CDHCI clients: once you are on the Alberta Blue Cross registered vendor list, assessed clients choose you themselves. It is slower to start — you need the registration, the insurance, and the listing details first — but CDHCI clients arrive pre-funded, and the billing goes to Alberta Blue Cross rather than to a family chasing an invoice.

Step 8: Run it like a compliance business

The agencies that survive treat compliance as operations, not paperwork:

• Keep the CDHCI registration and renewals on a calendar. An expired registration is an unregistered provider, and you disappear from the vendor list.
• Payroll discipline. WCB premiums, Employment Standards rules on hours, overtime, and public holidays, and payroll taxes all apply to your employees — never be the agency that fails to pay its caregivers.
• Document care. Care plans, visit notes, incident reports. Documentation is your quality system and your legal shield in one — and Alberta Blue Cross expects it for compliance verification reviews.
• Supervise actively. A nurse or experienced supervisor reviewing care documentation weekly is what separates managed care from caregiver-matching — in service quality and in how an inspector sees you.
• Report events. The CDHCI provider guide sets out reporting duties for events and incidents under the Continuing Care Act — know them before your first incident, not after.

Rules are current as of November 2026. Confirm program requirements with Alberta Blue Cross and AHS before you register — program rates and rules change, and the AHS maximum hourly rate is set case by case.

Related guides

• How to Start a Home Care Agency in Canada — the national licensing map this Alberta guide sits inside: who regulates agencies province by province, and the federal business number and payroll steps.
• How to Start a Home Care Business in Ontario — the Ontario companion: the $750 Temporary Help Agency licence and $25,000 security deposit Ontario requires, which Alberta does not.
• How to Register a Business in Alberta — the $10 trade name declaration through a registry agent, and the $275 incorporation route, behind Step 2.
• How to Incorporate in Alberta — the full Alberta incorporation walkthrough: the NUANS report, the filing package, and the annual return.
• How to Register a Sole Proprietorship and GST/HST in Canada — the BN, business-name registration, and the $30,000 GST/HST threshold behind Step 2.
• How to Open a Business Bank Account in Canada — keep client payments and payroll cleanly separated from day one.

Sources

• Client Directed Home Care Invoicing (CDHCI) Program Provider Guide (Alberta Blue Cross)
• Continuing Care FAQs (Alberta Health Services)
• Worker coverage (WCB-Alberta)
• Senior Home Care Costs in Canada 2026: Rates by City (Age Place Hub)
• Home Care Calgary (Pinnacle Age Well)
• Home care in Edmonton, Alberta (Halo Home Care)
• Register a business name (Alberta.ca)