The short answer Georgia licenses non-medical Private Home Care Providers and skilled home health agencies through the Department of Community Health, with CON required for home health.
What Georgia requires
Georgia
Licensing agency. The Georgia Department of Community Health (DCH), Healthcare Facility Regulation Division (HFRD), licenses Private Home Care Providers (O.C.G.A. § 31-7-300 et seq.; Ga. Comp. R. & Regs. 111-8-65) and home health agencies (O.C.G.A. § 31-7-150 et seq.).
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Private Home Care Provider license. Non-medical agencies license as Private Home Care Providers with service categories for companion/sitter, personal care, and nursing tasks; the license is location-based and renewed annually.
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CON for home health. New skilled home health agencies must obtain a Certificate of Need under O.C.G.A. § 31-6 before licensure — a meaningful barrier that pushes many operators to the private home care license instead.
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Surveys. HFRD conducts initial licensure inspections, periodic unannounced surveys, and complaint investigations with written plans of correction; fingerprint background checks for owners and direct access employees are required under Georgia's long-term care background check program (O.C.G.A. § 31-7-350 et seq.).
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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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