The short answer Mississippi licenses home health agencies through MSDH — the 1983 CON moratorium that blocked new agencies for four decades was struck down by a federal court in early 2026, though CON review itself survives — and does not license private-pay non-medical home care.
What Mississippi requires
Mississippi
Licensing agency. The Mississippi State Department of Health (MSDH), Health Facilities Licensure and Certification, licenses home health agencies under Miss. Code Ann. § 41-71-1 et seq.
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CON moratorium struck down (2026). Mississippi's moratorium on Certificates of Need for new home health agencies, in place since 1983, was struck down in early 2026 by U.S. District Judge Carlton Reeves (in a suit brought by physical therapist Charles Slaughter) as violating due process and equal protection; the CON requirement itself was upheld, so new entrants must still obtain a CON — historically the practical route was buying an existing licensed agency, and appeal or legislative response remains possible.
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Non-medical home care. Private-pay non-medical (personal care/companion) agencies are not licensed in Mississippi; Medicaid personal care and waiver providers are overseen through the Division of Medicaid provider requirements instead.
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Surveys. MSDH conducts licensure renewals and surveys for home health agencies and serves as the CMS certification survey agency, with plan-of-correction enforcement.
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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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