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Georgia · Private home care vs home health · 2026
Georgia has two licenses for care at home. A private home care provider license covers nursing, personal care and companion services, with no Certificate of Need. A home health agency needs a Certificate of Need first, and in 2026 neither the state nor Medicare is taking new ones.
Quick answer
In Georgia, a private home care provider is licensed by DCH for nursing services, personal care tasks or companion and sitter tasks, with no Certificate of Need. A home health agency is different: "A Certificate of Need for a home health agency will be required prior to the establishment of a new home health agency", and every home health agency must provide nursing, homemaker-home health aide and physical therapy services.
In 2026 that route is shut twice over. DCH’s 2028 need projection finds "No Projected Unmet Need" in all 12 planning areas, and CMS says: "Effective May 13, 2026, CMS will halt the enrollment of new Hospice and HHA providers or HHA branch or practice locations."
So a new agency in Georgia starts as a private home care provider. The license does not let you operate as a Medicare or Medicaid home health agency.
| Private home care provider | Home health agency | |
|---|---|---|
| What it covers | Nursing services, personal care tasks, and companion or sitter tasks: three categories you choose from. 111-8-65-.10(1) | Part-time or intermittent nursing under a physician’s written plan of care, plus therapy, medical-social or home health aide services. 111-2-2-.32(2)(a) |
| Services required | Only the categories you apply for. Companion-only agencies are licensed too. 111-8-65-.03(q) | Every home health agency must provide nursing, homemaker-home health aide and physical therapy services. Home Health |
| Certificate of Need | Not required. 111-8-65-.07(2) | Required before a new agency is established. 111-2-2-.32(1) |
| Medicare and Medicaid home health | The license does not let you operate as a home health agency under Medicare or Medicaid. O.C.G.A. §31-7-307(b) | Medicare enrollment is how home health agencies bill; new enrollment is paused nationally from May 13, 2026. QSO-26-11, Memorandum Summary |
| New ones in 2026 | Yes: apply in GAHLES. Application Checklist, p. 1 | No projected unmet need in any of the 12 planning areas for 2028. Need Projection Summary, planning areas 1-12 |
Georgia’s Certificate of Need rules define a home health agency as one primarily giving "part-time or intermittent nursing care provided by or under the supervision of a registered professional nurse", under a physician’s written plan of care, together with therapy, medical-social or home health aide services. A Certificate of Need is required before a new one is established, or before an existing one expands its service area. 111-2-2-.32(1)-(2)
Need is projected by planning area. DCH’s summary for horizon year 2028, dated March 27, 2026, lists all 12 planning areas with the result "No Projected Unmet Need". DCH, 2028 need projection
The rule carves out one case, for existing agencies: the Certificate of Need is required for an expansion "unless such expansion is a result of a non-reviewable acquisition of another existing home health agency". Whether a purchase is reviewable is for DCH’s Office of Health Planning and your lawyer to answer. 111-2-2-.32(1)
National · In force from May 13, 2026
CMS announced a six-month national moratorium on new hospice and home health agency enrollment in Medicare. "Effective May 13, 2026, CMS will halt the enrollment of new Hospice and HHA providers or HHA branch or practice locations." It can be extended in further six-month periods, and any change is announced in the Federal Register. "CMS regulations do not permit exceptions to a moratorium for individual providers or suppliers." CMS, QSO-26-11
It affects new enrollments only. Existing Medicare-certified agencies keep their ongoing obligations. It does not affect private home care, which is not Medicare home health.
A private home care provider license is open to new agencies now. You choose your categories: nursing services, personal care tasks such as help with bathing, toileting, grooming, dressing and eating, and companion or sitter tasks such as meals, housekeeping and transport. 111-8-65-.10(1)
CareRulebook
CareRulebook writes every policy Chapter 111-8-65 requires for the services you offer, personal care, companion or sitter, and nursing, with your agency’s details filled in and the rule quoted under every policy.
$199CareRulebook founding price for the first 50 Georgia agencies, then $249. Not a DCH fee.
No. Not as a new agency right now. Georgia requires a Certificate of Need, and DCH’s 2028 need projection finds no unmet need in any planning area. Separately, CMS halted new home health agency Medicare enrollment nationwide from May 13, 2026 for six months.
"Effective May 13, 2026, CMS will halt the enrollment of new Hospice and HHA providers or HHA branch or practice locations."
No. The statute says a private home care license does not let you operate as a home health agency under Medicare or Medicaid guidelines. That needs a separate home health license.
"A license issued under this article shall not entitle the licensee to operate as a home health agency, as defined in Code Section 31-7-150, under medicare or Medicaid guidelines."
No. As long as you do not also operate as a licensed home health agency or personal care home.
"A certificate of need issued pursuant to O.C.G.A. § 31-6-1et seq. is not required for licensure so long as the provider does not operate as a licensed home health agency or personal care home."
Yes. Unlike Texas, Georgia licenses companion and sitter tasks as one of three service categories. The only exemption that fits most founders is a caregiver working alone, with no employees, contractors or referral business.
"its own employees who provide nursing services, personal care tasks or companion or sitter tasks"
A private home care provider is licensed by DCH under Chapter 111-8-65 for nursing services, personal care tasks or companion and sitter tasks. A home health agency gives part-time or intermittent skilled nursing under a physician’s written plan of care, with therapy or aide services, must provide nursing, homemaker-home health aide and physical therapy services, and needs a Certificate of Need before it is established. The private home care license does not let you operate as a Medicare or Medicaid home health agency.
Not for a private home care provider. A Certificate of Need is required before establishing a new home health agency (Ga. Comp. R. & Regs. 111-2-2-.32).
Not as a new agency at the moment. DCH’s 2028 home health need projection, dated March 27, 2026, finds no projected unmet need in any of Georgia’s 12 planning areas, so the numerical need test for a new Certificate of Need is not met. Separately, CMS halted Medicare enrollment of new home health agencies nationwide from May 13, 2026, for six months, which it can extend.
Yes. Nursing services are one of the three private home care categories, given by a licensed RN or an LPN under supervision, with a Georgia RN supervising. That does not make you a home health agency for Medicare or Medicaid.
Six months from May 13, 2026, and CMS can extend it in further six-month periods. Any extension or lifting is announced in the Federal Register. CMS regulations do not permit exceptions for individual providers.
The Certificate of Need rule exempts a service-area expansion that results from a non-reviewable acquisition of another existing home health agency, and existing Medicare-certified agencies are not affected by the moratorium on new enrollments. Whether a particular purchase is reviewable is a question for DCH’s Office of Health Planning and a lawyer.
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