HomeCareAtlas Team · Updated September 2026
Researched from primary state regulatory sources.
How to Start a Home Care Agency in Arkansas
Starting a home care agency in Arkansas costs roughly $35,000 - $65,000 and takes 2-4 Months. Here's every step, fee, and deadline — sourced directly from Arkansas Department of Health (ADH Health Facility Services).
The Arkansas Department of Health (ADH) licenses Private Care Agencies. The ADH rule says this license is for agencies that give Medicaid personal care. If you will only serve private-pay clients, call ADH Health Facility Services first. Ask if you need this license, a Class B home health license, or neither. Why ask? The ADH home health rule says a license is needed for "Personal Care Aide Services." A Class B home health license covers agencies that are not in Medicare. Act 853 of 2025 (HB1439) was signed April 17, 2025. It says a private care agency is licensed by ADH and seeks Medicaid pay. It dropped the old DHS/DPSQA certification step. DHS now sets Medicaid provider rules on its own. It also dropped the need for regional offices. You only need a primary office in Arkansas. A private care agency must carry at least $1 million in liability insurance.
Arkansas does not require a state license to operate a non-medical home care agency. You can begin operations after completing standard business formation (LLC, EIN, business license) and obtaining insurance. Total startup costs range from $35,000 - $65,000, and you can be operational within 2-4 months. ADH licenses Private Care Agencies for Medicaid personal care. If you are private-pay only, call ADH first to ask which license, if any, you need.
- License Required
- No — Business license only
- Regulatory Body
- Arkansas Department of Health (ADH Health Facility Services)
- Application Fee
- $0 (no state license fee)
- Timeline
- 2-4 Months (our estimate (adh posts no processing time))
- Total Startup Cost
- $35,000 - $65,000
- Key Requirement
- ADH licenses Private Care Agencies for Medicaid personal care. If you are private-pay only, call ADH first to ask which license, if any, you need.
- Last Verified
- September 2026 against Arkansas Department of Health (ADH Health Facility Services) regulations
License Fee (none listed in ADH rule)
This is our best guess. Check with the Arkansas Department of Health (ADH Health Facility Services).
Our Estimate (ADH Posts No Processing Time)
This is our best guess. Check with the Arkansas Department of Health (ADH Health Facility Services).
Residents Age 70+
Competitive Market
How Arkansas compares to neighboring states
Arkansas Licensing Overview
The Arkansas Department of Health (ADH Health Facility Services) oversees all non-medical agencies.The Arkansas Department of Health (ADH) licenses Private Care Agencies. The ADH rule says this license is for agencies that give Medicaid personal care. If you will only serve private-pay clients, call ADH Health Facility Services first. Ask if you need this license, a Class B home health license, or neither. Why ask? The ADH home health rule says a license is needed for "Personal Care Aide Services." A Class B home health license covers agencies that are not in Medicare. Act 853 of 2025 (HB1439) was signed April 17, 2025. It says a private care agency is licensed by ADH and seeks Medicaid pay. It dropped the old DHS/DPSQA certification step. DHS now sets Medicaid provider rules on its own. It also dropped the need for regional offices. You only need a primary office in Arkansas. A private care agency must carry at least $1 million in liability insurance.
ADH Licensing (Updated by Act 853)
ADH licenses Private Care Agencies. Act 853 of 2025 removed the old DHS/DPSQA certification step. To bill Medicaid, you meet DHS's Medicaid provider rules and enroll separately.
Permit of Approval — Home Health Only
The ADH home health rule says an agency must get a Permit of Approval (POA) before it applies for a home health license (Class A or B). The Private Care Agency rule has no POA step. But state law (Ark. Code § 20-8-106) may exempt Class B applicants from the POA. We could not confirm this. If ADH says you need a Class B license, ask the Health Services Permit Agency (HSPA) if you need a POA and what it costs.
Single Office Requirement Simplified
Act 853 removed the requirement for multiple regional offices. Private care agencies now only need to maintain a primary office physically located in Arkansas. Note: the 2024 ADH rule (Section 5(B)) still mentions licensed regional offices. Act 853 struck them from the law, and the law wins.
Estimated Startup Costs (2026)
Budget for $35,000 - $65,000 to ensure 3-6 months of runway.
| Category | Low Est. | High Est. |
|---|---|---|
| ADH License Fee (none listed in the rule) | $0 | $0 |
| Permit of Approval Fee (home health only; may not apply to Class B — ask HSPA) | $0 | $3,000 |
| Medicaid Provider Enrollment (federal fee is $750 in 2026 for some provider types) | $0 | $750 |
| Gen/Prof Liability Insurance | $2,000 | $4,500 |
| Background Checks (ASP/FBI, per person) | $100 | $150 |
| Office Setup & Locked Storage | $2,000 | $5,000 |
| Initial Marketing | $1,500 | $4,000 |
| Working Capital (3-6 Mo) | $25,000 | $45,000 |
We map every cost and file your Arkansas license for you.
Arkansas Private Care Agency Licensing Roadmap
1-2 Weeks
Entity & EIN Formation
Register your LLC or corporation with the AR Secretary of State. Obtain an EIN from the IRS. Establish a physical office location in Arkansas (required by ADH). Act 853 simplified this — you only need one primary location, not multiple regional offices.
4-8 Weeks (home health only)
Confirm Which License You Need
Call ADH Health Facility Services. Ask if you need a Private Care Agency license, a Class B home health license, or neither. The ADH rule says a home health license needs a Permit of Approval (POA) from HSPA first, but state law may exempt Class B. The Private Care Agency license has no POA step. Ask HSPA before you budget for a POA.
1-2 Weeks
Administrator Appointment
Appoint a qualified administrator: must be a physician, registered nurse, or have at least one year of supervisory or administrative experience in home health care or related health provider programs.
3-4 Weeks
Policy & Training Setup
Develop the 40-hour aide training curriculum for ADH approval. The ADH rule requires at least 40 hours of classroom and clinical training, supervised by an RN, covering every topic in Table 1. Arkansas Medicaid splits it as 24 hours classroom and 16 hours supervised practical. Build policies covering client intake, care plans, incident reporting, infection control, TB prevention, and complaint resolution.
4-8 Weeks (estimated)
ADH Licensing Submission
Submit the Private Care Agency application packet to Health Facility Services for review. Include administrator credentials, training curriculum, policies, proof of $1 million liability insurance, and background check documentation. The license runs on a calendar year and expires every December 31.
Varies
Medicaid Enrollment (If Applicable)
If you want Medicaid clients (ARChoices, personal care), enroll as a Medicaid provider. This is a separate step. Act 853 removed the old DHS/DPSQA certification. DHS sets the Medicaid provider rules.
We can do all of them for you in Arkansas.
New 2026 Legal Mandates
The 40-Hour Rule
Current - Personal Care Aides must complete an ADH-approved training course of at least 40 hours before working independently. The ADH rule (Section 9) requires classroom plus clinical instruction under an RN. Arkansas Medicaid personal care rules split it as 24 hours classroom and 16 hours supervised practical.
Criminal and Registry Checks (A.C.A. § 20-38-101 et seq.)
The ADH rule requires a criminal history check for each worker. ADH's background check rule for home health, hospice, and private care agencies (2010) uses Arkansas State Police checks. For home health and hospice, workers who have not lived in Arkansas for the past 5 years also need an FBI check. Registry checks (such as the maltreatment registries) may also apply. Ask ADH which checks apply to your license.
12-Hour Annual In-Service
Every aide must get at least 12 hours of in-service training every 12 months (ADH rule, Section 11).
Act 853 of 2025 — Regulatory Changes
Signed April 17, 2025 - Act 853 (HB1439) changed the definition of a private care agency. It is now an agency licensed by ADH that seeks Medicaid pay. The old DHS/DPSQA certification is gone. It also dropped the need for regional offices. You only need a primary office in Arkansas. It kept the rule that agencies carry at least $1 million in liability insurance.
Physical Office Requirement
Agencies must maintain a licensed, fully operational primary office physically located within Arkansas that directs patient services and maintains records.
Our Arkansas licensing team tracks the law so you do not have to.
Caregiver Mandates
Important Warning
Arkansas requires RN involvement in aide training, client assessments, and supervisory visits. The ADH rule sets RN supervision at least once a year. Medicaid programs may require more. Confirm what applies to your payer source.
- Fingerprint Background Checks: Run a state criminal check through the Arkansas State Police for each worker (A.C.A. § 20-38-101 et seq.). ADH's rule for home health and hospice adds an FBI check if they have not lived in Arkansas for the past 5 years. Ask ADH if that applies to you.
- Registry Checks (Ask ADH): Arkansas may also require checks of the maltreatment registries and the CNA registry. We could not confirm which ones apply to your license. Ask ADH or DHS before you hire.
- RN Supervision: Arkansas requires RN involvement in aide training, initial client assessments, care plan development, and supervisory visits. The ADH rule says an RN sets the visit schedule and supervises at least once a year (Section 11). An RN must also watch each aide perform required skills.
- TB Prevention Plan: The ADH rule requires a written plan to prevent the spread of TB that follows current CDC guidelines. In practice that means TB screening for direct care staff at hire. Medicaid may add its own rule.
- 40-Hour Training (24 Classroom + 16 Practical): Personal care aides must complete at least 40 hours of ADH-approved training under RN supervision before working independently. Arkansas Medicaid splits it as 24 hours classroom and 16 hours supervised practical. Plus 12 hours of in-service training every 12 months.
Regional Billing Snapshots
*Regional rates vary by specialized care needs (Dementia, Parkinson's) and local competition.*
We launch Arkansas home care agencies start to finish.
Regional Market Opportunities
The Arkansas market is characterized by stable growth in urban hubs and severe caregiver shortages in rural counties. Note: billing rates and market data below are our estimates — not official numbers. Actual rates vary by metro area, client acuity, payer mix, and local competition.
Little Rock Metro
The state's largest referral market. High concentration of hospitals and senior centers.
Key: Focus on the Pulaski County corridor for the highest volume of private-pay clients.
Northwest Arkansas (Fayetteville/Bentonville)
The fastest-growing economic region. High-wealth seniors are moving here for retirement.
Key: Premium pricing is accepted here for specialized memory care services.
The Delta & Rural AR
Critically underserved. Significant opportunity for Medicaid-funded growth.
Key: Travel reimbursement management is the #1 operational challenge in this region.
Cost of care in Arkansas
What agencies charge clients vs. what caregivers earn in Arkansas. The difference is the agency's gross margin per billable hour — before overhead like insurance, admin, marketing, and compliance costs.
$27.5
Avg. hourly rate charged to clients
$17.92
Avg. caregiver hourly wage
$9.58
Gross margin per hour
35%
Gross margin %
What this means for agency owners
In Arkansas, agencies keep roughly $9.58 per billable hour after paying the caregiver. That's a 35% gross margin.
This is a typical margin for the industry. You will need to manage overhead carefully, but profitability is achievable with good operations.
Sources: Avg. hourly rate from CareYaya and CareScout 2025 surveys (averaged). Caregiver wage from Care.com. Gross margin is before overhead costs like insurance, admin, marketing, and compliance.
Arkansas Medicaid Programs
ARChoices in Homecare
The main Medicaid waiver for adults who need nursing-home-level care but want to stay home.
Agency Angle: Requires separate Medicaid provider enrollment (Act 853 removed the old DHS/DPSQA certification step). Billing goes through the Arkansas Medicaid (MMIS) portal.
Personal Care Program
State plan service providing assistance with ADLs (bathing, dressing, etc.).
Becoming a Provider
Essential 2026 Tech Stack for Owners
Tiles outlined in teal are areas HomeCareAtlas covers in our platform.
Arkansas Licensing FAQ
Does Arkansas require a Permit of Approval for non-medical agencies?
Not for the Private Care Agency license. That rule has no POA step. The ADH home health rule says home health agencies need a POA before they apply. But state law (Ark. Code § 20-8-106) may exempt Class B. We could not confirm this. If ADH tells you to get a Class B license, ask HSPA.
What changed with Act 853 of 2025?
Act 853 (HB1439) was signed April 17, 2025. A private care agency is now one licensed by ADH that seeks Medicaid pay. The old DHS/DPSQA certification step is gone. You no longer need regional offices, just a primary office in Arkansas. Agencies must still carry at least $1 million in liability insurance.
Can I use an online PCA training course?
Only if it is specifically approved by ADH and includes hands-on clinical training directed by an RN. Arkansas Medicaid requires at least 16 hours of supervised practical training. You cannot do the hands-on part online.
How long is the license valid?
One year. Licenses run on a calendar year and expire every December 31. You renew each year. The ADH rule does not list a license fee.
What qualifications does the administrator need?
The administrator must be a physician, registered nurse, or have at least one year of supervisory or administrative experience in home health care or related health provider programs. There is no standardized hour-based certification course.
Starting in a Nearby State?
Licensing requirements vary a lot between states. Compare your options:
Tennessee
$810 fee · 3-5 months
Texas
$2,625 fee · 4-6 Months
Missouri
No state license required · 4-8 Weeks
Oklahoma
$1,000 fee · 45-120 Days
Want us to handle your Arkansas licensing?
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Sizing up the competition? See the 700 home care agencies already operating in Arkansas →
Home care agencies in Arkansas
Want to see the competition up close? Look at who is already open, city by city.
- Home care agencies in Little Rock
- Home care agencies in Fort Smith
- Home care agencies in Springdale
- Home care agencies in Hot Springs
- Home care agencies in Needham
Looking for care for a family member? Find agencies near you
Considering other states?
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Where our numbers come from
We check each fact against Arkansas's own rules. Tap a source to read it yourself.
- License needed?YesBest guess — not confirmed yet
- Who oversees itArkansas Department of Health (ADH Health Facility Services)ADH Rules for Private Care Agencies §4(G)· Nov 2026
- License namePrivate Care Agency license (Medicaid personal care)Best guess — not confirmed yet
- The rulesArk. Code Ann. §20-10-2301 et seq.; ADH Rules for Private Care Agencies (2024)ADH Rules for Private Care Agencies §2· Nov 2026
- First license feeno feeBest guess — not confirmed yet
- License lasts1 yearADH Rules for Private Care Agencies §6(A)· Nov 2026
- BondNone (but $1 million liability insurance is required)ADH Rules for Private Care Agencies §4(N)(2); Ark. Code Ann. §20-10-2302· Nov 2026
- Owner/manager trainingNo state minimumADH Rules for Private Care Agencies §4(A)· Nov 2026
- Caregiver training40 hoursADH Rules for Private Care Agencies §§9(A)(3), 11(B)· Nov 2026
- Background checksCriminal history check required for each worker before hireADH Rules for Private Care Agencies §10· Nov 2026
- How long it takes2-4 MonthsBest guess — not confirmed yet
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This guide is for informational purposes only and does not constitute legal, regulatory, or business advice. Licensing requirements, fees, and regulations change frequently. Always verify current requirements with your state's licensing agency before making business decisions. HomeCareAtlas is not responsible for the accuracy or completeness of this information.
Researched and reviewed by
John Helmy, Founder of HomeCareAtlasBuilding tools and resources to help home care agency owners navigate licensing, compliance, and growth.