The short answer Virginia licenses home care organizations (personal care, pharmaceutical, and nursing services) through the Department of Health, with accreditation able to substitute for routine inspections.
What Virginia requires
Virginia
Licensing agency. The Virginia Department of Health (VDH), Office of Licensure and Certification, licenses home care organizations under Va. Code § 32.1-162.7 et seq. (Article 7.1) and 12VAC5-381.
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Service categories. The home care organization license is issued for personal care, pharmaceutical services, and/or nursing services categories — non-medical agencies license under the personal care category; Medicare-certified home health agencies are separately licensed as home health organizations and face COPN (Virginia's CON) review.
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Accreditation option. Virginia law lets VDH accept accreditation by recognized bodies (ACHC, CHAP, The Joint Commission) in lieu of periodic licensure inspections for home care organizations, though initial licensure and complaint investigations remain with the state.
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Renewal and background checks. Licenses renew annually; Virginia requires criminal background checks under Va. Code § 32.1-162.9:1 for compensated employees with direct client contact.
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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://law.lis.virginia.gov/vacodefull/title32.1/chapter5/article7.1/
- https://www.vdh.virginia.gov/licensure-and-certification/division-of-acute-care-services/home-care-and-hospice/
- https://www.vdh.virginia.gov/licensure-and-certification/division-of-acute-care-services/home-care-and-hospice/
- https://www.vdh.virginia.gov/licensure-and-certification/division-of-acute-care-services/home-care-and-hospice/
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