The short answer Arizona licenses home health agencies through the Department of Health Services but is one of the few states with no licensure or state oversight of non-medical home care agencies.
What Arizona requires
Arizona
Licensing agency. The Arizona Department of Health Services (ADHS), Bureau of Medical Facilities Licensing, licenses home health agencies under A.R.S. § 36-425.01 (with the definition at § 36-151) and A.A.C. Title 9, Chapter 10.
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No non-medical license. Arizona does not license or regulate non-medical home care (personal care, companion, homemaker) agencies at the state level — one of a small group of states with no oversight body for private-pay home care.
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Surveys and renewal. Home health agency licenses are renewed annually with ADHS licensing fees; ADHS conducts initial and periodic compliance surveys and complaint investigations, and also performs Medicare certification surveys as the CMS state agency.
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Industry self-regulation. Because non-medical home care is unlicensed, voluntary standards bodies (e.g., the Arizona In-Home Care Association) fill part of the gap; agencies should still expect Medicaid (AHCCCS/ALTCS) provider requirements if they bill those programs.
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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.
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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.
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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.
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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.
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