The short answer Michigan does not license home care: non-medical agencies operate without a state license, and skilled home health agencies need only Medicare certification, with LARA acting as the federal survey agency.
What Michigan requires
Michigan
No non-medical license. Michigan requires no state license for non-medical home care (personal care, companion, homemaker) agencies; the Attorney General publishes a consumer checklist in lieu of regulation.
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No state home health license. Michigan also has no state home health agency license — agencies providing skilled care bill Medicare via federal certification under 42 CFR Part 484, with LARA's Bureau of Survey and Certification conducting CMS surveys.
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Medicaid oversight. Agencies in MI Choice waiver or Home Help (Medicaid personal care) must meet MDHHS provider enrollment and program standards, which is the primary oversight channel for the non-medical Medicaid segment.
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Watch for change. Licensure bills surface regularly in the Michigan Legislature; as of mid-2026 none has been enacted, so verify status before assuming continued non-regulation.
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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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