The short answer Arkansas licenses both skilled home health agencies and non-medical Private Care Agencies through the Department of Health; Act 853 of 2025 streamlined the private care framework.
What Arkansas requires
Arkansas
Licensing agency. The Arkansas Department of Health (ADH), Health Facility Services, licenses home health agencies (ADH Rules for Home Health Agencies) and non-medical Private Care Agencies (ADH Rules for Private Care Agencies, originally per Act 811 of 2019).
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Private Care Agency license. Agencies providing only personal care, companionship, and homemaker services must hold a Private Care Agency license from ADH rather than a home health license.
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2025 change (Act 853). Act 853 of 2025 (HB1439) consolidated oversight under ADH, eliminated the old DHS certification layer for private care agencies, and removed the requirement to maintain multiple regional offices — one primary Arkansas office now suffices.
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Surveys. ADH conducts an initial licensure inspection and periodic surveys with plan-of-correction requirements; home health agencies serving Medicare must also be certified, with ADH acting as the CMS state survey agency.
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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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Primary sources for this page
- https://healthy.arkansas.gov/programs-services/licensing-military-member-licensure-permits-plan-reviews/health-facility-services/
- https://healthy.arkansas.gov/wp-content/uploads/Private_Care_Agencies_Rule_2024.pdf
- https://www.arkleg.state.ar.us/
- https://healthy.arkansas.gov/programs-services/licensing-military-member-licensure-permits-plan-reviews/health-facility-services/
More Arkansas guides