Georgia private home care provider license: one HFRD permit for sitter, personal care and nursing

One license, priced by the service line

Many states license companion agencies and personal care agencies separately, or skip companion-only businesses altogether. Georgia does neither. Chapter 111-8-65 of the Georgia rules defines “private home care services” as direct care in a patient’s residence. It covers three categories under one license:⁠¹

• Companion or sitter tasks: transport and escort, meal preparation and serving, and “household tasks essential to cleanliness and safety” for elderly, handicapped or convalescing people.⁠¹
• Personal care tasks: help with bathing, toileting, grooming, shaving, dental care, dressing and eating. They may also include home management, housekeeping, ambulation and transfer, and medically related activities such as medication reminders. Vital signs may be taken only alongside those tasks.⁠¹
• Nursing services: these “can only be provided by” a Georgia registered nurse or licensed practical nurse.⁠¹

You choose which of the three you will offer, and the fee follows that choice. As published on October 12, 2026, the annual license fee is $250 for each service offered, capped at $750, on top of a $300 application processing fee.⁠⁸⁠⁹ Adding a service line later is its own application in GAHLES, with notarized affidavits.⁠³

The rules also list what a PHCP license does not cover: physical, speech or occupational therapy, medical nutrition therapy, medical social services, home health aide services provided by a home health agency, and proxy caregiver services from a proxy caregiver hired by the patient.⁠¹ If your plan includes therapy, you are looking at a different license (see the comparison below).

Who has to be licensed, and who is exempt

The rules say no private home care provider may operate “without a license or provisional license issued by the department.”⁠¹ A provider is any person or entity, for-profit or nonprofit, that provides or arranges these services in one of three ways:⁠¹

1. Through its own employees

   who do nursing, personal care or companion or sitter tasks.

2. Through contracts

   with independent contractors who are health care professionals licensed under Title 43. HFRD’s 2022 packet put it more bluntly: “only RNs and LPNs can be employed as contractors in a PHCP.”⁠⁵

3. Through referrals

   , when the person making the referral has an ownership or financial interest in the services delivered. A referral business with a financial stake in the placements it makes falls inside the definition.

HFRD’s program page lists seven exemptions.⁠² The rule text has six of them:⁠¹

• an individual who provides the services personally, paid or unpaid, with no agents, employees, contractors or financially interested referral arrangements
• home infusion therapy, where intermittent skilled nursing is “an integral part” of delivering and infusing the drugs (nursing beyond that is not exempt)
• temporary placement of professionals and paraprofessionals to work somewhere other than a person’s residence
• services provided by licensed home health agencies
• services provided in a personal care home by that home’s own staff
• services within the scope of pharmacy practice

The program page adds a seventh: services provided by the federal government.⁠²

In practice, the solo exemption ends when you hire your first caregiver. A sole caregiver working for families is exempt. The same person with one part-time employee is a private home care provider.

A “residence” in these rules includes a client’s own home, a friend’s or relative’s home, or a personal care home. It does not include a hospital, nursing home or hospice.⁠¹ A licensed agency can therefore send aides into a personal care home to serve a resident privately. The home’s own staff need no PHCP license to care for its residents.⁠¹ Housing and care for two or more unrelated adults under one roof is a separate license: see the Georgia personal care home permit guide.

Private home care provider or home health agency

Both licenses come from HFRD, and a PHCP can send nurses into homes. The differences are in the gate, the payer and the service mix.

The certificate of need is the deciding factor. Rule 111-8-65-.07 says a CON “is not required for licensure so long as the provider does not operate as a licensed home health agency or personal care home.”⁠¹ A home health agency needs one, and the details are in the Georgia home health agency license guide. If your model is private-pay sitter, personal care or private-duty nursing, the PHCP license is the realistic route in Georgia.

The RN requirement, even for companion-only agencies

This is the Georgia requirement founders most often miss. HFRD’s checklist, updated August 6, 2026, says:⁠³⁠⁴

“The Administrator and a Registered Nurse (RN) are required to open a PHCP. An RN is permitted to hold the positions of Administrator, Owner, and Certified Nursing Assistant. Regardless of the service level provided, an RN is required for the initial application.”

The initial checklist asks for a copy of the RN’s current Georgia license.⁠³ An owner who is an RN can fill the nurse role. A non-nurse owner who plans to offer companion services only still needs an RN on the application.

The rules also set the administrator’s role. The governing body appoints an administrator with “full authority and responsibility for the operation” of the agency.⁠¹ The administrator needs a satisfactory fingerprint records check under chapter 111-8-12, must complete the orientation the rules require, and must not have made false statements about qualifications.⁠¹ The checklist asks for the administrator’s job description, signed and dated, with that full-authority language. It also asks for signed evidence that the administrator completed the four-part orientation in rule .09(6)(a).⁠³

Building the application file

All HFRD applications are filed online.⁠⁶ For a PHCP the portal is GAHLES (Georgia Healthcare Licensing, Enforcement, and Surveys), where you register, submit applications and plans of correction, and track their status.⁠³⁠⁷ The initial application checklist asks for:⁠³

1. Notarized Affidavit of Personal Identification

   under O.C.G.A. § 50-36-1(f)(1)(B), using the form in HFRD’s packet, plus a copy of the photo ID you showed the notary.

2. Notarized Affidavit of Compliance

   , with “Private Home Care Providers” selected. In it you swear that your entity “has developed policies and procedures mandated under the rules” and accept unannounced periodic inspections.⁠³ The affidavit is not a formality. You attest that the policies already exist.

3. A local business license

   from your city or county, current and showing the agency’s name and address. If your local government will not issue one, you need a written explanation from that government.

4. Georgia Secretary of State registration

   for your corporation or LLC, or other proof of legal authority if you are not a registered entity.

5. The electronic Owner Form

   in GAHLES, listing all individual owners and signed by the owner or the owner’s representative.

6. GCHEXS fingerprint determination letters

   dated within 12 months of submission, for every administrator and every individual owner with 10% or more ownership interest. If no individual holds 10% or more, a signed letter on company letterhead says so.

7. Administrator documents

   name, qualifications, job description and orientation evidence, as described above.

8. RN license copy

9. The licensure fee

The rules add that the application must describe the services you will offer and “the geographic area that will be served.”⁠¹ Plan your counties before you file. The checklist sends requests to add counties to an existing permit to the Private Home Care team by email.⁠³

HFRD asks you not to submit until every document is ready to upload. An incomplete filing can be delayed, rejected or lose its fee, and application fees are non-refundable.⁠³ If HFRD asks for more documents and you do not upload them, “the application will be denied.”⁠³

Policies HFRD expects to exist on day one

Because the affidavit says your policies are already written, draft them before you file. The rules require written policies and procedures on:⁠¹

• scope of services and types of clients served
• service agreements
• client record keeping, security, release and retention
• documenting services performed each day
• service planning
• client rights and responsibilities, and complaint handling

You also need a health screening program for employees and contractors, and a quality improvement program. The quality program must document client complaints, problems with care and corrective actions.⁠¹

Review time, the provisional license and the initial survey

HFRD reviews applications in the order received. As of the August 2026 checklist, the initial review timeframe is “30 business days from the application submission date.”⁠³ All status messages go to the contact email on your application.⁠³

Approval does not give you a permanent license. HFRD issues a provisional license, and the clock starts:⁠³

1. You have three months

   During that time you must “become operational and have admitted at least 3 clients.”⁠³

2. You ask for the survey

   Before the three months end, email the Private Home Care Unit at [email protected] to request your initial survey.⁠³

3. HFRD surveys you on site

   The survey checks your operational compliance. After you pass, HFRD issues the permanent permit.⁠³

If you miss the notice, the provisional license is “automatically voided.” You then need a new application and a full review. Extensions require prior written approval requested before the deadline.⁠³ Line up your first three clients, staff and paperwork before approval arrives, not after.

Staff qualifications and training

Every employee needs a satisfactory fingerprint records check before working as a direct access employee.⁠¹ Before starting work, each employee must also be screened for tuberculosis “in accordance with CDC guidance for baseline screening and testing for health care personnel.”⁠¹ The rules then set separate standards for each role.

A PCA qualifies through one of these routes:⁠¹

• a federal nurse aide training and competency evaluation program
• a nurse aide competency exam recognized by DCH
• a DCH-approved health care or personal care credentialing program
• a 40-hour training program run by a private home care provider

The 40-hour program must run under the direction of an RN or a health professional with comparable education and experience. It covers ambulation and transfer, bathing and other personal care, first aid and CPR, special conditions, home safety and sanitation, infection control, and medically related activities including vital signs. Twenty hours must be completed before the PCA serves clients. The other twenty must be finished within six months of the training’s start.⁠¹ HFRD’s 2022 packet described the PCA route as completing “the NLN exam on-line and assessment of competency,” or the 40-hour curriculum and a competency assessment.⁠⁵

Companions and sitters must show competency in these areas:⁠¹

• the needs of elderly, handicapped or convalescing people
• meal preparation and serving
• transportation and escort
• housekeeping and sanitation
• home safety
• medical emergencies in the home
• infection control

Every new employee gets an orientation before working with clients. It covers your policies, the employee’s duties, how to report client problems and emergencies, and the duty to report exposure to tuberculosis or hepatitis.⁠¹ After the first year, each employee needs at least eight clock hours of training a year and a written annual performance evaluation.⁠¹

Two less obvious rules:

• Bonding. Any employee with unlimited access to a client’s funds for home management, such as bill paying or shopping, must be bonded through the agency.⁠¹ A universal coverage bond is allowed.⁠¹
• Driving. If an employee drives clients in a vehicle the client does not own, you need either a signed waiver from the client or “reasonable efforts” to confirm motor vehicle insurance with medical coverage for the client.⁠¹

Supervision, service plans and visit intervals

Georgia ties supervision to the service line. Inspectors will check these intervals in your files.

Scroll the table sideways to see every column.

Two documents are due early for every new client:

• Service agreement. It must be completed by the second visit, if that visit is on a different day, or within seven calendar days of the first service, whichever comes first. It must list services, frequency, charges, your complaint line and DCH’s telephone number. It also covers authorization to use the client’s funds or vehicle when relevant.⁠¹
• Service plan. It must be completed within seven working days of the first service.⁠¹

For medically frail clients, an RN must write the initial service plan.⁠¹ When aides give personal care to medically frail clients, someone must be on call who can reach a nurse supervisor.⁠¹

Clients can cancel at any time and pay only for services already delivered. You may charge for travel and staff time if the cancellation arrives after your worker is on the way.⁠¹ Client records must be kept at least five years from the last service, and incident reports at least five years.⁠¹

Fees, renewal and surveys after you open

HFRD licenses carry an issue date but “no expiration date.” They stay valid until surrendered or revoked, as long as you pay the yearly fee.⁠¹⁰ The initial license fee covers the rest of the calendar year in which you pay it. Renewal fees for the next calendar year are collected from October 1 to December 31, and a $150 late fee is added automatically on January 1.⁠¹⁰ Annual fees are paid through the HFRD payment portal at forms.dch.georgia.gov.⁠¹⁰ DCH may revoke a license when annual fees are 60 days past due after a written invoice.⁠⁸

Accreditation can lower the cost. PHCPs are eligible for a 25% fee discount if they hold accreditation from a DCH-approved body and file the current decision at renewal.⁠⁸⁠⁹ DCH’s October 2024 schedule lists these approved accreditors for PHCPs: ACHC, CARF, CHAP, the Council on Quality and Leadership, and The Joint Commission.⁠⁹ Under the rules, DCH may also exempt an accredited provider from periodic on-site inspections.⁠¹

Without that exemption, HFRD says re-licensure surveys happen roughly every 18 to 24 months.⁠³ An agency with no clients can lose its license at survey time. If you have had no client in the three months before a scheduled survey, you get 30 days from the notice to admit one. If you do not, the permit is “considered void” and you must reapply.⁠³

When a survey finds violations, you have ten days from receiving the report to file an acceptable plan of correction.⁠¹ Fines under chapter 111-8-25 run in three categories, from $100 to $2,000 per violation per day. Total fines from one inspection are capped at $40,000.⁠⁸

Other changes need GAHLES filings:⁠¹⁠³

• Relocation: give DCH 15 days’ notice and file with an updated business license.
• Name change: file in GAHLES.
• Change of ownership: file in GAHLES. Licenses are not transferable, and each office location needs its own license. You can file the CHOW application while a sale is pending and upload the executed closing documents afterward.

Medicaid: the Elderly and Disabled Waiver

Private pay is the default, but Georgia Medicaid’s home and community-based waivers also buy in-home help. Personal support, described as “assistance with daily living activities, i.e. bathing, dressing, meals, and housekeeping,” is a core service across the waiver programs.⁠¹³

Georgia’s Elderly and Disabled Waiver Program covers CCSP and SOURCE. Its 2022 draft renewal application lists the provider license for Personal Support Services as an “Unrestricted license in private homecare issued by the DCH, Division of Healthcare Facilities Regulation.” It also says the Medicaid agency verifies agency licensure annually.⁠¹⁴ Two other waiver services in that application run through the same license:

• Skilled nursing services require a PHCP “with licensure to provide nursing services.”⁠¹⁴
• Respite care providers are listed under a Private Home Care Provider license.⁠¹⁴

GAMMIS lists separate EDWP policy manuals for Personal Support Services and for “Skilled Nursing Services by Private Home Care Providers,” both dated October 1, 2026.⁠¹⁵

The public sources do not say whether Medicaid enrolls an agency that still holds only a provisional PHCP license, or how long a permanent license must have been in place before you can apply to enroll. The renewal application only asks for an “unrestricted” license and annual verification, and I could not retrieve the October 1, 2026 General Services manual. Before you plan your first year around waiver revenue, ask DCH Provider Enrollment and the HFRD Private Home Care team in writing whether a provisional license qualifies, and what the waiver pre-qualification packet requires.⁠¹⁴⁠¹⁵

What changed in 2026

• Rules amended. Rules 111-8-65-.05 (licenses) and 111-8-65-.09 (administration and organization) were amended effective July 29, 2026. These were the first amendments to either rule since the chapter took effect on March 12, 2013.⁠¹¹⁠¹² The current text of rule .09 requires tuberculosis screening under CDC guidance and an employee health screening program.⁠¹
• New checklist and portal. HFRD posted an updated PHCP application checklist on August 6, 2026.⁠⁴ It moves filing to GAHLES, sets an initial review time of 30 business days, and spells out the RN requirement and the three-month provisional rule.⁠³
• Old packet still linked. As of October 12, 2026, the “Private Home Care Application” link on the program page still opens the packet posted in March 2022.⁠² That packet describes filing and paying through GAMMIS and a typical 60-day review.⁠⁵ Use the August 2026 checklist from HFRD’s Licensure Forms page instead.⁠⁴

For other Georgia care licenses, see the Georgia state overview and the non-medical home care license overview. Adult day programs are covered in the Georgia adult day center guide.

Sources

1. 1
   Georgia Secretary of State, Rules and Regulations of the State of Georgia, Ga. Comp. R. & Regs. ch. 111-8-65, Rules and Regulations for Private Home Care Providers Checked 12 Oct 2026 · Back to text ↑
2. 2
   Georgia Department of Community Health, Healthcare Facility Regulation Division, Private Home Care Program Checked 12 Oct 2026 · Back to text ↑
3. 3
   Georgia Department of Community Health, Healthcare Facility Regulation Division, Private Home Care Providers Application Checklist (updated 08/06/26) Checked 12 Oct 2026 · Back to text ↑
4. 4
   Georgia Department of Community Health, Healthcare Facility Regulation Division, Licensure Forms and Information Packets Checked 12 Oct 2026 · Back to text ↑
5. 5
   Georgia Department of Community Health, Healthcare Facility Regulation Division, Private Home Care Providers Application Packet (posted 03/22) Checked 12 Oct 2026 · Back to text ↑
6. 6
   Georgia Department of Community Health, Healthcare Facility Regulation Division, HFRD Forms and Applications Checked 12 Oct 2026 · Back to text ↑
7. 7
   Georgia Department of Community Health, GAHLES: Georgia Healthcare Licensing, Enforcement, and Surveys portal Checked 12 Oct 2026 · Back to text ↑
8. 8
   Georgia Secretary of State, Rules and Regulations of the State of Georgia, Ga. Comp. R. & Regs. ch. 111-8-25, General Licensing and Enforcement Requirements Checked 12 Oct 2026 · Back to text ↑
9. 9
   Georgia Department of Community Health, Healthcare Facility Regulation Division, Schedule of Licensure Activity Fees (October 2024) Checked 12 Oct 2026 · Back to text ↑
10. 10
    Georgia Department of Community Health, Healthcare Facility Regulation Division, Annual Licensing Fee Information (October 2024) Checked 12 Oct 2026 · Back to text ↑
11. 11
    Georgia Secretary of State, Rules and Regulations of the State of Georgia, Ga. Comp. R. & Regs. 111-8-65-.05, Licenses Checked 12 Oct 2026 · Back to text ↑
12. 12
    Georgia Secretary of State, Rules and Regulations of the State of Georgia, Ga. Comp. R. & Regs. 111-8-65-.09, Administration and Organization Checked 12 Oct 2026 · Back to text ↑
13. 13
    Georgia Department of Community Health, Georgia Medicaid, Waiver Programs Checked 12 Oct 2026 · Back to text ↑
14. 14
    Georgia Department of Community Health, Georgia Medicaid, Elderly and Disabled Waiver Program, 1915(c) renewal application (draft GA.008.08.00, 2022) Checked 12 Oct 2026 · Back to text ↑
15. 15
    Georgia Department of Community Health, Georgia Medicaid Management Information System, Provider Manuals (GAMMIS) Checked 12 Oct 2026 · Back to text ↑
16. 16
    Georgia Secretary of State, Rules and Regulations of the State of Georgia, Ga. Comp. R. & Regs. ch. 111-8-31, Home Health Agencies Checked 12 Oct 2026 · Back to text ↑

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