The short answer West Virginia licenses skilled home health agencies (with CON) through OHFLAC; non-medical home care agencies are not licensed but must register with OHFLAC for central abuse registry access.
What West Virginia requires
West Virginia
Licensing agency. The West Virginia Office of Health Facility Licensure and Certification (OHFLAC), within the Office of the Inspector General, licenses home health agencies and monitors compliance under W. Va. Code ch. 16 and its legislative rules.
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CON for home health. New home health agencies must obtain a Certificate of Need approving service in each county before OHFLAC licensure — a significant entry barrier for skilled care.
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Non-medical registration. West Virginia does not license non-medical home care agencies, but home care providers not otherwise licensed or certified must register with OHFLAC to access the state central abuse registry for caregiver screening.
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Surveys. OHFLAC performs initial and renewal licensure surveys, complaint investigations, and Medicare certification surveys as the CMS state agency, with statement-of-deficiency and plan-of-correction processes.
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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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