The short answer Colorado licenses all home care agencies through CDPHE under a single framework with Class A (skilled) and Class B (non-medical) designations.
What Colorado requires
Colorado
Licensing agency. The Colorado Department of Public Health and Environment (CDPHE), Health Facilities and Emergency Medical Services Division, licenses home care agencies under C.R.S. § 25-27.5-101 et seq. and 6 CCR 1011-1, Chapter 26.
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Class A vs Class B. Class A licenses cover skilled home health services; Class B licenses cover non-medical personal care, homemaker, and companion services — both issued and surveyed by CDPHE.
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Deemed status option. CDPHE accepts accreditation from approved bodies (e.g., ACHC, CHAP, The Joint Commission) in lieu of routine state licensure surveys for qualifying agencies, though complaint investigations remain with the state.
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Renewal and surveys. Licenses renew annually with fees set by the department; initial licensure surveys, periodic re-surveys, and plan-of-correction requirements apply, and home care placement agencies (registries) must register separately.
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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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