The short answer Pennsylvania licenses non-medical operators as home care agencies or home care registries under 28 Pa. Code Chapter 611, and skilled operators as home health care agencies under Chapter 601 — both through the DOH Division of Home Health, with inspections tied to initial licensure and renewals.
What Pennsylvania requires
Pennsylvania
Chapter 611 vs Chapter 601. 28 Pa. Code ch. 611 governs home care agencies (employer model) and home care registries (referral model) providing non-medical personal care and companion services; ch. 601 governs licensed home health care agencies providing skilled nursing and therapy under the Health Care Facilities Act (35 P.S. § 448.101 et seq.).
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Licensing agency. The Pennsylvania Department of Health, Division of Home Health, administers both programs and has moved to an online application system for home care agency/registry licensure.
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Inspection before licensure and renewal. Under ch. 611, DOH conducts an inspection before issuing an initial license and before license renewal (28 Pa. Code § 611.2 requires a license to operate); deficiencies require an accepted plan of correction before the license issues.
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Fees. Fees are modest: the ch. 611 home care agency/registry application and annual renewal fee is $100, and the ch. 601 home health care agency fee is $50 — budget more for the survey-readiness work than the fee itself.
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Direct care worker requirements. Chapter 611 requires competency testing or approved training, PA criminal history (plus FBI check for recent out-of-state residents) under the Older Adults Protective Services Act, TB screening, and consumer disclosure notices before service starts.
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Medicare overlay. Skilled agencies billing Medicare need ch. 601 licensure plus Medicare certification; DOH is the CMS survey agency, and most new agencies certify via ACHC/CHAP/Joint Commission deemed status.
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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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Primary sources for this page
- https://www.pacodeandbulletin.gov/Display/pacode?file=%2Fsecure%2Fpacode%2Fdata%2F028%2Fchapter611%2Fchap611toc.html
- https://www.pa.gov/agencies/health/facilities/out-patient-healthcare-facilities/home-care
- https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/028/chapter611/s611.2.html
- https://www.pacodeandbulletin.gov/Display/pacode?file=%2Fsecure%2Fpacode%2Fdata%2F028%2Fchapter601%2Fchap601toc.html
- https://www.pa.gov/agencies/health/facilities/out-patient-healthcare-facilities/home-care
- https://www.pa.gov/agencies/health/facilities/out-patient-healthcare-facilities/home-care
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