Home Care Agency Licensure in Florida

Licensing agency. The Agency for Health Care Administration (AHCA), Bureau of Health Facility Regulation, licenses home care providers; the Health Care Licensing Procedures Act (Fla. Stat. ch. 408, Part II, and Rule 59A-35) governs applications for all types. Source ↗

Three provider types. Fla. Stat. ch. 400, Part III creates the home health agency license (skilled + aide services, Rule 59A-8), the nurse registry license (referral of independent-contractor caregivers), and homemaker and companion services provider registration (§ 400.509) for non-hands-on care. Source ↗

Level 2 screening tie-in. Owners, administrators, and all direct care personnel must clear Level 2 (fingerprint-based FDLE/FBI) background screening through the AHCA Background Screening Clearinghouse before licensure and before serving clients. Source ↗

Renewal cycle. Licenses run on a two-year cycle with renewal applications due 60 days before expiration; home health agency licensure fees run in the low thousands of dollars per biennium, while homemaker/companion registration is a modest flat fee. Source ↗

Surveys. AHCA conducts an unannounced initial licensure survey and unannounced surveys at least every 36 months thereafter, plus complaint surveys; Medicare-certified agencies typically use ACHC/CHAP/Joint Commission accreditation for certification, and 2025 amendments to Rule 59A-8 (implementing HB 1353, ch. 2025-127, Laws of Fla.) updated home health standards, including allowing contracted clinicians to perform case management. Source ↗

No CON, but quality gates. Florida has no CON for home health, but AHCA imposes financial-projection requirements, a controlling-interest review, and demonstrates a history of moratoria authority in fraud-heavy metro areas (e.g., past Miami-Dade restrictions on new HHA licensure for Medicare enrollment). Source ↗

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 ↗