How to start a home care agency in Arkansas

Arkansas requires a Private Care Agency license (Medicaid Personal Care) from Arkansas Department of Health, Health Facility Services to operate a home care agency.

License required

Yes

License

Private Care Agency license (Medicaid Personal Care)

Issuing agency

Arkansas Department of Health, Health Facility Services

Renewal

Every year · License runs on the calendar year and expires December 31; a new annual application is required. No private care agency fee is listed in the rule or the current application fee table.

Insurance and bonds

Liability insurance of at least $1,000,000 covering employees and independent contractors while providing personal and attendant care.

Survey and inspection

Review or inspection before initial licensure, then periodic inspections at least every three years; deficiencies must be corrected within 60 days.

Regulation

Ark. Code Ann. 20-10-2301 et seq.; Arkansas State Board of Health Rules for Private Care Agencies (effective June 17, 2024)

1. Obtain certification from DHS Division of Aging, Adult, and Behavioral Health Services as a home- and community-based services provider
2. Carry at least $1,000,000 liability insurance covering employees and contractors
3. Set up a fully operational primary office located in Arkansas
4. Submit the annual license application on the Department's forms
5. Pass the Department's review or inspection before the license is issued
6. Notify Health Facility Services of changes in name, location, contact information or ownership, and of closure

Staffing

• Administrator: an agency employee who is a physician, registered nurse, or has at least one year of supervisory/administrative experience in home health or related health programs
• Supervisor: a licensed nurse, or two years of full-time college study (a year of full-time supervisory work in a health care or community agency can substitute for a year of college)
• Aide training must be supervised by a registered nurse; aide competency must be observed by an RN

Training

• Personal care aides must complete a Department-approved training course of at least 40 hours (classroom plus clinical instruction for the home setting), including 4 hours on Alzheimer's disease and dementia
• At least 12 hours of in-service training every 12 months
• Aide service plan supervision at least annually

Program

Arkansas Medicaid

Enrollment portal

Arkansas Medicaid Health Care Provider Portal (MMIS provider enrollment)

Fiscal agent

Gainwell Technologies (Medicaid Provider Enrollment Unit for the Division of Medical Services)

Application fee

Arkansas collects the fee only from the provider types on its ACA-fee list; it is payable once every five years. Individual practitioners and groups of individual practitioners (physician, dental, therapy groups) do not pay, nor do providers that already paid Medicare or another state's Medicaid. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Arkansas requires fingerprint checks for all high-risk providers and their 5%+ owners (provider manual section 141.103) and notifies applicants by letter with instructions. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

Arkansas requires all providers to revalidate every five years; the portal mails notices ahead of the due date and the state asks for revalidations at least 60 days early. Licenses and certifications must also be resubmitted each year. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Arkansas Medicaid enrollment guide →

CON program

Yes

Program

Permit of Approval (POA)

Agency

Arkansas Health Services Permit Agency (under the Arkansas Department of Health), directed by the Health Services Permit Commission

Services covered

• nursing facilities
• assisted living facilities
• residential care facilities
• home health agencies
• hospice agencies and hospice facilities
• ICF/IID
• psychiatric residential treatment facilities

Moratoria

New permits are under moratorium for ICF/IID (since 1987; data table dates it to 03/1994), residential care facilities (since 2005, except replacement RCFs of 16 beds or fewer) and psychiatric residential treatment facilities (since 2008), per the agency's SFY 2024 annual report.

Arkansas certificate of need details →

Model

hybrid

State vendor

Fiserv AuthentiCare (personal care); Sandata (home health)

Services in scope

• personal care
• attendant care
• respite
• home health

Alternate EVV allowed

Yes

Program

https://humanservices.arkansas.gov/divisions-shared-services/medical-services/evv-info/

Arkansas EVV requirements →

State minimum wage

$11.00 an hour

Effective

2021-01-01

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Personal care / in-home supportive care organizations — active organization NPIs (NPPES)

390 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

773,838 (as of Jun 1, 2026)

All Arkansas Home care Medicaid rates, ranked →

• Choices in Homecare Waiver (1915(c))
• Autism Waiver (1915(c))
• Community and Employment Support Waiver (1915(c))
• Living Choices Assisted Living Waiver (1915(c))

Arkansas waivers and waiting lists →