The short answer Alabama has no state license for home health agencies — oversight runs through SHPDA Certificate of Need review and Medicare certification, with ADPH as the survey agency; private-pay non-medical companion and personal care agencies are also unlicensed.
What Alabama requires
Alabama
Oversight agencies. The Alabama Department of Public Health (ADPH), Bureau of Health Provider Standards, serves as the CMS state survey agency for Medicare-certified home health agencies; the State Health Planning and Development Agency (SHPDA) administers Certificate of Need review.
Source ↗
CON instead of licensure. Alabama is one of the few states with no home health agency licensure requirement; agencies must instead obtain a Certificate of Need from SHPDA under Ala. Code § 22-21-260 et seq. (county-level need methodology at Ala. Admin. Code r. 410-2-4-.07) before serving an area, and Medicare agencies must be federally certified under 42 CFR Part 484.
Source ↗
Non-medical home care. Alabama does not license private-pay non-medical home care (companion/homemaker/personal care) agencies; with no home health licensure statute either, only CON approval and Medicare certification regulate market entry.
Source ↗
Surveys. ADPH, as the CMS state survey agency, conducts Medicare certification and complaint surveys against the 42 CFR Part 484 Conditions of Participation; deficiencies require an accepted plan of correction, and most new agencies certify via ACHC/CHAP/Joint Commission deemed status.
Source ↗
☆ Rules change. We watch them for you.
Get one short email when Alabama's home care requirements change. No spam, unsubscribe anytime.
Reviewed quarterly by Vitable Health.
The federal baseline (applies in every state)
Federal
No federal home care license. There is no federal license for home care or home health agencies. Licensure is a state function: each state (and DC) decides whether and how to license home health agencies and non-medical personal care/companion agencies, so requirements vary dramatically by jurisdiction.
Source ↗
Medicare certification (42 CFR Part 484). Agencies that bill Medicare for skilled home health must be certified as meeting the Medicare Conditions of Participation at 42 CFR Part 484 (patient rights, comprehensive assessment, QAPI, skilled professional services, home health aide standards, and more), on top of any state license.
Source ↗
Accreditation with deemed status. Most new Medicare home health agencies obtain certification through a CMS-approved accrediting organization with deeming authority — ACHC, CHAP, or The Joint Commission — whose surveys substitute for the state agency's Medicare certification survey.
Source ↗
State survey agencies enforce both. State survey agencies (usually the state health department) operate under agreements with CMS to survey Medicare-certified agencies, and most also run the state licensure survey program — initial surveys, renewal/recertification surveys, complaint investigations, and plan-of-correction enforcement per the CMS State Operations Manual.
Source ↗
Primary sources for this page
More Alabama guides