HomeCareAtlas Team · Updated April 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.
Arkansas requires non-medical personal care agencies to be licensed as Private Care Agencies through the Arkansas Department of Health. This is distinct from the Class B Home Health Agency license (which covers skilled/medical services). Important update: Act 853 of 2025 (HB1439) changed the regulatory framework — private care agencies are now licensed by ADH, and the old DHS/DPSQA certification requirement has been eliminated. Medicaid participation now requires separate provider enrollment, not DHS certification. Act 853 also removed the requirement for private care agencies to maintain multiple regional offices — agencies now only need to maintain a primary office location in Arkansas.
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. Act 853 eliminated DHS certification — now only ADH licenses Private Care Agencies, and a single office location is sufficient.
- 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 (estimated adh processing time)
- Total Startup Cost
- $35,000 - $65,000
- Key Requirement
- Act 853 eliminated DHS certification — now only ADH licenses Private Care Agencies, and a single office location is sufficient.
- Last Verified
- April 2026 against Arkansas Department of Health (ADH), Health Facility Services regulations
Private Care Agency License Fee
Estimated ADH Processing Time
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.Arkansas requires non-medical personal care agencies to be licensed as Private Care Agencies through the Arkansas Department of Health. This is distinct from the Class B Home Health Agency license (which covers skilled/medical services). Important update: Act 853 of 2025 (HB1439) changed the regulatory framework — private care agencies are now licensed by ADH, and the old DHS/DPSQA certification requirement has been eliminated. Medicaid participation now requires separate provider enrollment, not DHS certification. Act 853 also removed the requirement for private care agencies to maintain multiple regional offices — agencies now only need to maintain a primary office location in Arkansas.
ADH Licensing (Updated by Act 853)
ADH licenses Private Care Agencies. The old DHS/DPSQA certification requirement was eliminated by Act 853 of 2025. Medicaid participation now requires separate provider enrollment, not DHS certification.
Permit of Approval — May Apply
The Permit of Approval (POA) process is clearly required for Home Health (Class B) licenses. Private Care Agencies operating strictly under the PCA framework should confirm directly with ADH/HSPA whether a POA applies to their specific model. Do not assume every non-medical startup needs a POA.
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.
Administrator Certification
Every Private Care Agency License must designate a qualified administrator or agency manager.
- Training Cost:N/A
- Topics: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 mandated by the state.
Estimated Startup Costs (2026)
Budget for $35,000 - $65,000 to ensure 3-6 months of runway.
| Category | Low Est. | High Est. |
|---|---|---|
| Permit of Approval Fee (if applicable — confirm with HSPA) | $0 | $3,000 |
| Medicaid Provider Enrollment (if pursuing Medicaid) | $0 | $600 |
| 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 (if applicable)
Confirm POA Requirement
If your service model requires a Home Health (Class B) license, you must first obtain a Permit of Approval from the Health Services Permit Agency ($3,000 fee). Private Care Agencies operating strictly under the PCA framework should confirm directly with ADH/HSPA whether a POA applies to their specific model. Do not assume every non-medical startup needs 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 (24 hours classroom, 16 hours supervised practical under RN supervision) for ADH approval. Build policies covering client intake, care plans, incident reporting, infection control, 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, insurance certificates, and background check documentation.
Varies
Medicaid Enrollment (If Applicable)
If pursuing Medicaid clients (ARChoices, PCA program), apply for Medicaid provider enrollment separately. Note: Act 853 eliminated the old DHS/DPSQA certification — Medicaid enrollment is now a separate process. Personal care providers are classified as high-risk providers by Arkansas Medicaid, which may affect enrollment timelines and requirements.
We can do all of them for you in Arkansas.
New 2026 Legal Mandates
The 40-Hour Rule
Current - Personal Care Aides must complete 40 hours of state-approved training (24 hours classroom, 16 hours supervised practical under RN supervision) before working independently.
Child Maltreatment Registry Check
In addition to criminal background checks (ASP and FBI), all staff must be cleared through the Arkansas Child Maltreatment Central Registry. Employees who appear on the registry cannot provide direct care services. Registry hits can trigger enforcement action.
12-Hour Annual In-Service
Every PCA must complete 12 hours of ongoing training annually to maintain their eligibility.
Act 853 of 2025 — Regulatory Changes
Act 853 (HB1439) changed the definition of private care agencies to require licensing by ADH instead of certification by DHS/DPSQA. It also removed the requirement for multiple regional offices — agencies now only need a primary office in Arkansas. Personal care providers are now classified as high-risk providers by Arkansas Medicaid.
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 periodic supervisory visits. Agencies should confirm the exact supervisory frequency and model that applies to their license type and payer source.
- ASP/FBI Background Checks: Both state (ASP) and national (FBI) fingerprint-based checks are required for all staff.
- Child Maltreatment Registry: All staff must be cleared through the Arkansas Child Maltreatment Central Registry before providing direct care.
- RN Supervision: Arkansas requires RN involvement in aide training, initial client assessments, care plan development, and periodic supervisory visits. The exact frequency depends on license type and payer source.
- TB Screenings: Mandatory for all direct care staff upon hire.
- 40-Hour Training (24 Classroom + 16 Practical): Personal care aides must complete 24 hours of classroom training and 16 hours of supervised practical training under RN supervision before working independently. Plus 12 hours of annual in-service training.
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 industry estimates based on publicly available survey data — not regulatory benchmarks. 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(20,000+ recipients)
The primary waiver for seniors 65+ needing nursing-level care at home.
Agency Angle: Requires separate Medicaid provider enrollment (Act 853 eliminated the old DHS/DPSQA certification path). Personal care providers are now classified as high-risk by Arkansas Medicaid. Billing is handled through the 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?
The Permit of Approval (POA) process is clearly required for Home Health (Class B) licenses — those agencies must obtain a POA before applying for licensure. For Private Care Agencies (non-medical personal care), the POA requirement is less clear. Confirm directly with ADH/HSPA whether a POA applies to your specific model before budgeting the $3,000 fee.
What changed with Act 853 of 2025?
Act 853 (HB1439) made several key changes: private care agencies are now licensed by ADH instead of certified by DHS/DPSQA, the requirement for multiple regional offices was removed (only a primary Arkansas location is needed), and personal care providers are now classified as high-risk providers by Arkansas Medicaid.
Can I use an online PCA training course?
Only if it is specifically approved by ADH and includes the mandatory 16 hours of supervised hands-on practical experience directed by an RN.
How long is the license valid?
Applications for license renewal are on a calendar year basis and expire every December 31st.
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
$1,404 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
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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.