How to start a home care agency in Georgia

Georgia requires a Private Home Care Provider license (service levels: companion sitting, personal care services, nursing services) from Georgia Department of Community Health, Healthcare Facility Regulation Division (HFRD), Private Home Care Program to operate a home care agency. Fee: $300 application processing fee at submission, plus an initial license fee equal to the annual fee: $250 per service level (companion sitting, personal care services, nursing services). For example, a companion-plus-personal-care provider would pay $300 + $500 under this schedule. Processing time: DCH says review usually takes about 60 days after it confirms receipt, but it does not commit to an exact timeframe.

License required

Yes

License

Private Home Care Provider license (service levels: companion sitting, personal care services, nursing services)

Issuing agency

Georgia Department of Community Health, Healthcare Facility Regulation Division (HFRD), Private Home Care Program

Fee

$300 application processing fee at submission, plus an initial license fee equal to the annual fee: $250 per service level (companion sitting, personal care services, nursing services). For example, a companion-plus-personal-care provider would pay $300 + $500 under this schedule.

Renewal

Every year · $250 per service level each year; late fee $150 at 60 days past due; follow-up inspection visit $250; permit replacement $50. 25% discount for agencies accredited by a department-approved body (ACHC, CARF, CHAP, CQL, The Joint Commission for PHCP).

Processing time

DCH says review usually takes about 60 days after it confirms receipt, but it does not commit to an exact timeframe.

Accreditation

Optional. Accreditation by ACHC, CARF, CHAP, CQL or The Joint Commission earns a 25% discount on the annual license fee.

Survey and inspection

Licensed providers are subject to unannounced periodic inspections.

Regulation

Ga. Comp. R. & Regs. 111-8-65 (Rules and Regulations for Private Home Care Providers)

1. Get a local city/county business license and Secretary of State incorporation papers (or IRS tax ID)
2. Complete GCHEXS fingerprint background checks for administrators, managers and owners (determination letter dated within 12 months)
3. Write the required policies and procedures
4. Hire an administrator and at least one other employee, with qualifications and personnel records
5. Submit the electronic application in the GAMMIS web portal, uploading the checklist documents, and pay application and license fees there
6. Respond to DCH review; once licensed, expect unannounced periodic inspections

Staffing

• Administrator with full authority for operations and no history of misconduct; at least one other employee required to open
• Personal care aides: pass the NLN online exam plus competency assessment, or complete a provided 40-hour training curriculum plus competency assessment; CNAs must hold current Georgia registration
• Companions/sitters: able to read, write and follow instructions; trained or competency-tested on client needs, basic meals, transportation, housekeeping, home safety, emergencies and infection control
• TB testing documented for employees

Training

• Personal care aide: NLN online exam and competency check, or 40-hour training and competency check
• Companion/sitter: training or competency assessment in the listed topics
• Administrator orientation training

Program

Georgia Medicaid and PeachCare for Kids (Department of Community Health)

Enrollment portal

Georgia Medicaid Management Information System (GAMMIS) — Enrollment Wizard

Fiscal agent

Gainwell Technologies (GAMMIS fiscal agent / third-party administrator; also handles CVO credentialing help)

Application fee

Georgia's Part I manual requires the fee from new, re-enrolling, revalidating and re-credentialing providers in the categories of service it lists, unless exempt, or a hardship waiver request instead. Applications without either are not processed, the fee is generally non-refundable, and an exempt provider pays once per service location even with several categories of service. 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

Georgia's high categorical risk categories are community mental health centers, newly enrolling home health agencies, and newly enrolling DME/orthotic and prosthetic supplier facilities. Georgia defines a criminal background check as a state and/or national fingerprint-based check. 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

DCH may do pre- and post-enrollment, unscheduled and unannounced site visits. Moderate-risk categories include ambulance providers, hospices, independent clinical labs, physical therapists, and revalidating home health agencies and DME suppliers. 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

DCH suspended providers that had not revalidated as of July 1, 2026; claims for dates of service from then on are not paid until the provider revalidates, and the new effective date is the revalidation submission date. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Georgia Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Georgia Department of Community Health (DCH), Office of Health Planning

Services covered

• hospitals (including destination cancer hospitals)
• special care units
• skilled nursing facilities
• intermediate care facilities
• personal care homes of 25 or more beds
• ambulatory surgical or obstetrical facilities
• freestanding emergency departments off a hospital's primary campus
• home health agencies
• health maintenance organizations
• certain diagnostic, treatment or rehabilitation centers
• bed capacity increases and new clinical services

Georgia certificate of need details →

Model

hybrid

State vendor

Tellus (with Conduent)

Services in scope

• personal care
• community living supports
• personal support services
• home health

Alternate EVV allowed

Yes

Program

https://www.mmis.georgia.gov/portal/Portals/0/StaticContent/Public/ALL/NOTICES/Presentation%20-%20Georgia%20Medicaid%20Fall%20Fair%202022%20-%20EVV%20-%20YouTube%2020221130181605.pdf

Georgia EVV requirements →

State minimum wage

$7.25 an hour

Effective

2009-07-24

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)

2,398 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,817,766 (as of Jun 1, 2026)

All Georgia Home care Medicaid rates, ranked →

• Comprehensive Supports Waiver Program (1915(c))
• Elderly and Disabled Waiver (1915(c))
• Independent Care Waiver Program (ICWP) (1915(c))
• New Options Waiver (NOW) (1915(c))

Georgia waivers and waiting lists →