Verifying an Agency's License Before You Sign

Start by Knowing Which Kind of Agency You're Checking

Two separate licensing systems both answer to the phrase 'home care agency,' and confirming a specific one starts with knowing which system applies. A Medicare-certified home health agency operates under a federal certification, checkable through Medicare's own tools; a non-medical home care agency answers to whichever state it operates in, and that state sets its own rule for what a license is called and how to look one up.

That distinction is the same one behind the broader question of home care agency licensing generally — whether agencies are licensed at all depends on which kind is being asked about, and the verification step follows the same split.

An agency that mentions Medicare, or describes itself as a certified home health agency, is operating under the federal system. An agency offering companionship, homemaking, or non-medical personal care without mentioning Medicare is very likely the state-licensed kind instead. Asking directly which category an agency falls into is a faster first step than guessing from its marketing materials.

Checking a Medicare-Certified Agency on Care Compare

For a Medicare-certified home health agency, Care Compare is the federal tool built for exactly this question, and its two public star ratings are the fastest way to check standing without a phone call. The Quality of Patient Care rating draws on clinical assessments and Medicare claims data 1Ref 1Centers for Medicare & Medicaid Services (2025).Home Health Agency Quality of Patient Care Star Rating.How Care Compare's Quality of Patient Care star rating, based on OASIS assessments and claims, lets families check a Medicare-certified agency's standing., while a separate Patient Survey rating reflects what patients themselves reported about their experience with that specific agency 2Ref 2Centers for Medicare & Medicaid Services (2025).Patient Survey Rating for Home Health Agencies.How the HHCAHPS-based Patient Survey rating on Care Compare reflects patients' own experience with a Medicare-certified home health agency..

Reading both, rather than either alone, matters: one measures clinical process and outcomes, the other measures the patient's own experience, and an agency can score differently on each. Neither exists for a non-medical home care agency, since Care Compare is built specifically around Medicare certification.

Checking a Non-Medical Agency Through the State

For a non-medical home care agency, there is no single federal database — checking means going directly to that state's health department, department of aging, or licensing board, since each state runs its own registry and even calls the credential something different. An Area Agency on Aging can often point a family toward the right state office when the correct contact isn't obvious 3Ref 3Administration for Community Living (2025).Area Agencies on Aging.The role of an Area Agency on Aging as a coordinator of local aging services, useful as a starting point for finding a state's home care licensing contact..

This is also where the agency vs registry vs direct hire distinction starts to matter, and it sits inside the larger agency vs private caregiver question too: a licensed agency, a caregiver referral registry, and a directly hired caregiver each answer to a different (or no) licensing authority, so the verification question isn't the same across all three.

The name of the credential itself varies by state, too — some states issue a home care license, others a personal care registration or a homemaker-companion agency license, and the office that issues it might sit inside a health department in one state and a department of aging in another. Searching a state's public registry by the agency's name, rather than guessing which credential to look for, tends to work better given that inconsistency.

Turning a Claimed License Number Into a Confirmed One

A license number alone is not proof of anything until it is confirmed against the state's own current record, since a number an agency recites over the phone could be expired, suspended, or simply misremembered. Calling or searching the state's licensing lookup directly, and asking specifically whether any violation or disciplinary action is on file, is the step that turns a claimed license into a confirmed one.

For a Medicaid-funded case, that confirmation sometimes has a second layer: Medicaid pays for home care through several different authorities — 1915(c) waivers, state-plan options, and 1115 demonstrations among them — and a waiver program may require a provider to hold both the state license and a separate Medicaid enrollment, so confirming one doesn't automatically confirm the other 4Ref 4Centers for Medicare & Medicaid Services (2025).Home & Community Based Services Authorities.The different Medicaid authorities (waivers, state-plan options, demonstrations) used to fund home care, and how the funding authority can add a separate provider-enrollment layer on top of state licensing..

Once a check confirms current, active status, keeping a written note of what was confirmed — the date checked, who confirmed it, and the license number itself — creates a simple record to refer back to later, whether for a future renewal check or as documentation if a dispute ever comes up.

What a License Confirms — and What It Doesn't

A license confirms an agency cleared its state's minimum bar to operate — required paperwork, disclosures, whatever that state demands — not that the agency communicates well, staffs consistently, or handles a specific family's needs skillfully. Reading Care Compare's ratings alongside a licensing check, for a Medicare-certified agency, or pairing a state license check with direct questions, for a non-medical one, gives a fuller picture than either check alone.

A license also says nothing about agency background checks — the depth of agency screening a specific agency runs — or how many different caregivers show up on a given case; both are separate questions worth their own verification once the license itself checks out.

If the Check Turns Up a Problem

If a licensing search turns up nothing, or the answer doesn't match what an agency claimed, the same state office that maintains the license record is also usually the place that handles a formal complaint, and a long-term care ombudsman exists in every state specifically to help families raise concerns about a provider. Keeping a copy of whatever the state confirms — a license number, a certification date — makes any later question easier to document.

A pattern of complaints on file, even without a formal violation finding, is worth weighing on its own — a single old complaint means less than several recent ones covering the same issue, and a state's complaint record often shows both kinds side by side. Asking the agency directly how it would respond to what the record shows is a reasonable next step before ruling it out entirely.