The short answer North Dakota licenses home health agencies through HHS but has no license for non-medical personal care agencies.
What North Dakota requires
North Dakota
Licensing agency. North Dakota Health and Human Services, Health Facilities Unit, licenses home health agencies (application, onsite inspection, and annual license printing handled through the HHS portal).
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No non-medical license. North Dakota does not require a state license for personal care, companion, or homemaker agencies; Medicaid QSP (qualified service provider) enrollment governs the Medicaid personal-care segment.
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Statutory basis. Home health licensure rests on N.D. Cent. Code ch. 23-17.3 and related administrative rules, with annual renewal.
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Surveys. The Health Facilities Unit reviews applications, conducts onsite inspections for initial and renewal licensure, and performs Medicare certification surveys as the CMS state agency.
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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.hhs.nd.gov/health/regulation-licensure-and-certification/health-facilities-unit/home-health-agencies
- https://www.hhs.nd.gov/health/regulation-licensure-and-certification/health-facilities-unit/home-health-agencies
- https://www.hhs.nd.gov/health/regulation-licensure-and-certification
- https://www.hhs.nd.gov/health/regulation-licensure-and-certification/health-facilities-unit/home-health-agencies
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