How to start a home health agency in Arkansas

Arkansas requires a Home Health Agency license (Class A or Class B) from Arkansas Department of Health, Health Facility Services to operate a home health agency.

License required

Yes

License

Home Health Agency license (Class A or Class B)

Issuing agency

Arkansas Department of Health, Health Facility Services

Renewal

Every year

Survey and inspection

Branch offices are subject to survey by Health Facility Services.

Certificate of need

Required

Medicare certification

Class A license is issued to Medicare-certified agencies, which must meet the federal home health Conditions of Participation; non-certified agencies receive a Class B license. A Class A holder may get a derivative Class B license without a separate POA.

Regulation

Ark. Code Ann. § 20-10-801 et seq.; ADH Rules for Home Health Agencies in Arkansas (revised effective 2024-06-17)

1. Obtain a Permit of Approval (POA) for the service area before applying
2. Apply for a license on Department forms
3. License class is set by Medicare status: Class A if Medicare-certified, Class B if not
4. Renew annually; licenses run on a calendar year and expire December 31

Staffing

• Administrator must be an agency employee who is a physician, a registered nurse, or someone with at least one year of supervisory/administrative experience in home health or related programs
• Home health aide and personal care aide training must be supervised by a registered nurse

Training

• Home health aides: at least 75 hours of classroom plus supervised practical training, including at least 16 classroom hours before 16 hours of supervised practical training
• Personal care aides: at least 40 hours of classroom and clinical instruction
• All aide training programs must be approved by the Department
• Aides need at least 12 hours of in-service training every 12 months

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 →

For this business

Required (licensing source)

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.

Home health agencies — active organization NPIs (NPPES)

506 (as of Sep 13, 2026)

Medicare-certified home health agencies (CMS Care Compare)

92 (as of May 27, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

773,838 (as of Jun 1, 2026)

All Arkansas Home health Medicaid rates, ranked →