The short answer New Hampshire licenses home care broadly under RSA 151 — home health care providers and agencies providing personal care/homemaker services in the home both fall under DHHS Health Facilities Administration licensure.
What New Hampshire requires
New Hampshire
Licensing agency. The NH DHHS Health Facilities Administration licenses home health care providers under RSA 151:2 and He-P 809, a framework that reaches agencies providing skilled care as well as homemaker, personal care, and companion services in the home.
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License scope. Because RSA 151's definition covers services 'in the home' broadly, most non-medical agencies license as home health care providers rather than operating unregulated — confirm classification with HFA when applying.
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Renewal and surveys. Licenses renew annually; HFA conducts initial licensure inspections, periodic surveys, and complaint investigations with plan-of-correction requirements, and serves as the CMS survey agency for Medicare-certified agencies.
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Background checks. NH requires criminal records and Bureau of Elderly and Adult Services registry checks for home care personnel under RSA 151:2-d and He-P rules.
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The federal baseline (applies in every state)
Federal
No federal home care license. There is no federal license for home care or home health agencies. Licensure is a state function: each state (and DC) decides whether and how to license home health agencies and non-medical personal care/companion agencies, so requirements vary dramatically by jurisdiction.
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Medicare certification (42 CFR Part 484). Agencies that bill Medicare for skilled home health must be certified as meeting the Medicare Conditions of Participation at 42 CFR Part 484 (patient rights, comprehensive assessment, QAPI, skilled professional services, home health aide standards, and more), on top of any state license.
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Accreditation with deemed status. Most new Medicare home health agencies obtain certification through a CMS-approved accrediting organization with deeming authority — ACHC, CHAP, or The Joint Commission — whose surveys substitute for the state agency's Medicare certification survey.
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State survey agencies enforce both. State survey agencies (usually the state health department) operate under agreements with CMS to survey Medicare-certified agencies, and most also run the state licensure survey program — initial surveys, renewal/recertification surveys, complaint investigations, and plan-of-correction enforcement per the CMS State Operations Manual.
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Primary sources for this page
- https://www.dhhs.nh.gov/doing-business-dhhs/licensing-certification/health-facilities-administration
- https://www.dhhs.nh.gov/doing-business-dhhs/licensing-certification/health-facilities-administration
- https://www.dhhs.nh.gov/doing-business-dhhs/licensing-certification/health-facilities-administration
- https://www.dhhs.nh.gov/sites/g/files/ehbemt476/files/inline-documents/sonh/he-p809.pdf
More New Hampshire guides