Home health chief executive officer job description
A home health CEO leads an agency that sends nurses, therapists, aides and caregivers into patients' homes. The CEO picks where to grow, keeps hospital and doctor referral partners close, and answers to the owners for results and for the compliance program.
By the HireBus team · Updated · Pay data: BLS, May 2025
Median pay, home health care agencies · BLS, May 2025
We're looking for a CEO to lead our home health and home care agency. You'll set the plan for both service lines, decide where we grow, own our relationships with health systems and payers, and lead the people who run daily operations. You answer to the owners for results and for a strong compliance program.
2. Essential Duties and Responsibilities
Set the yearly plan and budget for skilled home health and personal care with the COO and CFO.
Decide where to grow: new counties, new payer contracts, new services, or buying another agency.
Build relationships with hospital systems, physician groups, and senior living operators that refer patients.
Negotiate or approve contracts with Medicare Advantage plans, Medicaid managed care plans, and other payers.
Oversee the compliance program, including billing integrity and the rules on dealing with referral sources, and report on it to the owners or board.
Hire, coach, and hold accountable the COO, CFO, and Community Liaison.
3. Key Tasks / Daily Activities
Review referrals, admissions, staffed hours, and cash by branch and service line.
Meet with leaders on problems they can't solve alone, such as a payer that stopped paying or no aides in one county.
Visit hospital leaders and large referral partners, often with the Community Liaison.
Read survey results, complaints, and quality reports, and follow up on anything that puts patients or the license at risk.
4. Key Performance Indicators (KPIs)
Revenue by service line: [your target].
Operating margin: [your target].
Admissions from new referral sources: [your target].
Clinician and caregiver turnover: [your target].
Care Compare quality star rating: [your target].
5. Required Qualifications and Skills
Bachelor's degree in business, health care administration, nursing, or a related field, or equivalent experience.
[10+] years of health care leadership, with [5+] years running a home health, home care, hospice, or similar business.
Working knowledge of Medicare home health rules, Medicaid personal care programs, and private-pay home care.
Has managed a budget and a leadership team, and reads financial statements with confidence.
Sound judgment on compliance questions, including referral relationships and billing.
6. Preferred Experience
Has grown an agency through new referral sources, payer contracts, or acquisitions.
Has led an agency through a state survey or an accreditation visit from The Joint Commission, CHAP, or ACHC.
Master's degree in health administration, business, or nursing.
Experience with home health and home care software such as [your EMR and scheduling system].
7. Physical Requirements
Office work with long periods at a computer and on the phone.
Driving to branch offices, hospitals, and referral partners.
With or without reasonable accommodation.
8. Work Environment and Schedule
Office-based, with regular travel to branches and referral partners in [your service area].
Regular hours: [Monday through Friday], with evening calls when a patient, survey, or staffing issue can't wait.
On call for serious incidents, such as a patient injury, an unannounced survey, or a data breach.
Occasional overnight travel for industry and payer meetings.
9. Compensation and Benefits
Pay: [range and hourly or salary basis].
Additional pay: [overtime, bonus or incentive terms, or none].
Benefits: [health, dental, vision, retirement, paid time off, and when they start].
10. Company Culture and Overview
[Two or three sentences on what your company does, the area you serve, and the support a new chief executive officer gets in the first 90 days.]
11. How to Apply
[Apply link or email]. Our process: [phone interview, in-person interview, and next steps]. Contact [hiring contact] if you need an accommodation during the application process.
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Medicare rules reach all the way up to this job. They decide who holds legal responsibility, what you may offer referral partners, and whether an agency you buy keeps its billing rights.
Two businesses under one name
Skilled home health runs on orders from a doctor or other allowed practitioner, and on Medicare's rules. Personal care runs on hourly rates from families, Medicaid waivers and long-term care insurance, under state rules. The two share caregivers, offices and a name. They don't share margins or risks. The CEO decides how much money, staff and time each one gets, and keeps a bad month in one from hiding in the other.
The owners hold legal responsibility too
Medicare requires a governing body, here the owners or board. It holds full legal responsibility for how the agency is run, its services, its money, its budget and its quality program. It also appoints the Administrator. The CEO brings it the budget, the plan and quality results in a form it can act on. That keeps its oversight real and on the record. Source: 42 CFR 484.105: Organization and administration of services (Cornell LII).
Referral partners come with legal limits
Patients come from hospitals, doctors' offices and senior living sites. The federal Anti-Kickback Statute is a criminal law. Under it, an agency can't knowingly and willfully offer anything of value to bring in or reward referrals of patients on Medicare, Medicaid or other federal health programs. Home health is also covered by the doctor self-referral (Stark) law. Gifts to referral sources, liaison bonuses, free staff for a facility and medical director deals all need a healthcare lawyer's review. Source: HHS Office of Inspector General: Fraud and abuse laws.
Buying an agency has a 36-month catch
Say an agency's majority ownership changes hands in a sale within 36 months of its first Medicare enrollment or its last change in majority owner. Its Medicare provider agreement and billing rights then don't pass to the buyer. The buyer must enroll as a new agency and get a new state survey or accreditation. There are exceptions, such as two years in a row of full cost reports. Check the seller's history before you sign. Source: 42 CFR 424.550: Prohibitions on the sale or transfer of billing privileges (Cornell LII).
Quality scores move Medicare money
Medicare's expanded Home Health Value-Based Purchasing Model raises or lowers each certified agency's fee-for-service payments. The change depends on how its quality scores compare with its peers. The first payment year was 2025. The scores come from data the agency already reports: OASIS assessments, Medicare claims and patient surveys. So the CEO plans quality results into the revenue forecast. Source: CMS: Expanded Home Health Value-Based Purchasing Model.
How much home health chief executive officers make
The closest BLS group for home health chief executive officers is chief executives. Chief executives who work for home health care agencies earned a median of $195,580 a year ($94.03 an hour) in May 2025, according to the Bureau of Labor Statistics. That’s below the $213,990 median for chief executives in all industries. About 810 of the 204,350 chief executives in that survey work for home health care agencies.
Expect a salary with an annual bonus. Let survey results and star ratings count in that bonus alongside margin, and get a healthcare lawyer's review before any part of it counts admissions or referrals.
Home health care agencies
$195,580$195,580 median Middle half $114,750–$361,060 10th–90th $91,330–$426,770
All industries
$213,990$213,990 median Middle half $129,540–$356,200 10th–90th $75,700–$507,730
10th–90th percentileMiddle halfMedianAnnual pay, May 2025. Source: BLS Occupational Employment and Wage Statistics.
Annual pay by percentile
Group
10th
25th
Median
75th
90th
Home health care agencies
$91,330
$114,750
$195,580
$361,060
$426,770
All industries
$75,700
$129,540
$213,990
$356,200
$507,730
Skills to hire for, and what you can teach
Hire for these
Can tell from the monthly numbers which branch and service line is losing money, and why
Earns trust from hospital executives, physician groups and payer contract managers
Asks counsel before a referral deal or a marketing plan goes out, not after
Has negotiated payer contracts or worked through a payer audit
Stays steady when a patient is hurt, a survey goes badly or a payer stops paying
Understands how rules and cash timing differ between Medicare, Medicaid waivers and families who pay privately
Teach these on the job
Which Medicaid waivers and managed care plans your state runs
The history and habits of your largest referral partners
Your branch leaders, their counties and their staffing gaps
Your accreditor's standards, if the agency is accredited
The agencies you compete with for nurses and caregivers
Most of what this CEO reads comes out of the home health EMR (such as Homecare Homebase, WellSky, Axxess or MatrixCare), the scheduling and EVV system on the personal care side, and the general ledger. Look for someone who reads those reports closely and asks why a number moved.
Home health chief executive officer interview questions
They have their own page: 6 questions that test this job, what strong and weak answers sound like, and a work exercise to run with your finalists.
No target in the template is filled in. Set each one from your last twelve months by service line, and have the owners approve them with the budget.
Revenue by service line
Monthly net revenue for skilled home health and for personal care, kept apart. Hold each against budget and against last year's matching month, and ask what moved referrals or authorized hours.
Operating margin
Operating income divided by net revenue, by service line and branch, from the monthly close. Read it next to staffing and quality results, since cutting visits or training can lift one quarter and hurt the next.
Admissions from new referral sources
Admissions this period from hospitals, practices and senior living sites that sent none in the prior year. Pull it from the referral source field in the EMR, and make sure intake fills that field in every time.
Clinician and caregiver turnover
Departures in the past year as a share of average headcount, split into nurses, therapists, home health aides and personal care caregivers. Compare branches, and read the exit reasons each quarter.
Care Compare quality star rating
The Quality of Patient Care star rating CMS posts for your agency, built from OASIS and Medicare claims data and updated every quarter. Track the separate patient survey star rating beside it.
The CEO chooses the counties, payers, services and deals, and which referral partners matter most, and answers to the owners. The COO turns those choices into staffed visits: staffing plans, scheduling, EVV, labor cost and new branches. Here the COO leads the Administrator and HR Manager. The CEO leads the COO, CFO and Community Liaison.
How much does a home health chief executive officer make?
Chief executives who work for home health care agencies earned a median of $195,580 a year ($94.03 an hour) in May 2025, according to the Bureau of Labor Statistics. The middle half earned between $114,750 and $361,060 a year. Pay also depends on your local market, experience and bonus terms.
Does a home health CEO need a clinical background?
Medicare's personnel rules set qualifications for the administrator and the clinical staff, not for the CEO, so federal rules leave the choice to you. What a CEO can't skip is a working grasp of the clinical rules: OASIS, plans of care, aide supervision and what surveyors check. Without it, a CEO can approve a growth plan the nursing team can't staff safely.
What compliance guidance applies to a home health agency?
The HHS Office of Inspector General publishes compliance guidance to help providers spot risk areas. Its general guide came out in November 2023. Its archive still holds a 1998 guide written for home health agencies. The CEO's part is to fund the program, give the compliance lead a direct line to the owners, and report on it to them.
Should we hire a CEO from a hospital or health system?
Hospital leaders bring referral contacts and payer know-how. But a hospital runs on beds and shifts under one roof. Home health runs on visits spread across counties, an hourly field staff and Medicare's 30-day payments. Ask hospital candidates what they would do in a week with no aides in one county. Ask what they know about home health surveys and the Anti-Kickback Statute.
