The short answer Maine licenses skilled home health services and, since a 2024 rule change, licenses (rather than registers) non-medical personal care agencies under 22 M.R.S. § 1717.
What Maine requires
Maine
Licensing agency. The Maine DHHS Division of Licensing and Certification licenses home health services providers under 22 M.R.S. ch. 419 and licenses Personal Care Agencies under 22 M.R.S. § 1717 and 10-144 CMR ch. 129 (Personal Care Agency Licensing Rule, adopted August 2024).
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Personal care agency license. Any agency placing or employing unlicensed assistive personnel for personal care in private homes must be licensed by DHHS (22 M.R.S. § 1717 converted the old registration scheme to licensure), maintain background checks, and comply with PSS (personal support specialist) training standards.
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Surveys. The Division conducts initial and renewal licensure surveys for home health agencies (also serving as the CMS survey agency) and enforces personal care agency licensing standards through complaint investigation.
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Worker standards. Maine ties oversight to its CNA/direct care worker registry — employers must verify listing and abuse-registry status before hire under 22 M.R.S. § 1717(3).
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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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