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New Jersey home health agency license: a closed certificate of need door, and the ways around it

New Jersey will not license a new home health agency unless the Department of Health (DOH) first awards it a certificate of need, and that can only happen during a DOH "call" for applications. The 2022 call was cancelled for lack of need. The July 1, 2025 call was postponed and, as of October 12, 2026, has not been reissued. For now, most founders get in by buying an agency that is already licensed, which needs DOH approval but no certificate of need.

Written by Editorial team Checked against 36 official sources Last reviewed How we review
Contents12 sections

Key takeaways

  • A new New Jersey home health agency needs a certificate of need (CON), and DOH accepts CON applications only during a published call. The 2022 call was cancelled for lack of need, and the July 1, 2025 call was postponed while DOH surveys existing agencies.⁠3⁠4⁠7
  • As of October 12, 2026, the DOH public notices page lists no new home health call and no cancellation. No new-agency route is open until one is published in the New Jersey Register.⁠3⁠5
  • Buying a licensed agency needs no CON. It does need a CN-7 transfer-of-ownership application at least 90 days before closing, a $1,000 fee, and DOH approval before the deal closes.⁠8⁠12⁠27
  • Every agency must provide nursing, certified homemaker-home health aide and physical therapy services, with nursing available 24 hours a day, seven days a week, and a full-time director of nursing.⁠11⁠19
  • DOH fees as published on 2026-10-12: $2,000 for the initial license and every annual renewal, plus a $500 inspection fee every other year.⁠8

Quick facts

AgencyNJ Department of Health, Office of Certificate of Need and Healthcare Facility Licensure
RuleN.J.A.C. 8:42; CON under N.J.A.C. 8:33
Certificate of needRequired, full review, only during a DOH call
Call statusJuly 1, 2025 call postponed; no new notice as of Oct. 12, 2026
CON fee$7,500; over $1M project cost: $7,500 + 0.25%
License fee$2,000 a year, plus $500 inspection fee every two years
Change of ownershipNo CON; CN-7 filed 90 days before closing, $1,000 fee
Required servicesNursing (24/7), CHHA aide services, physical therapy

Fees as published in N.J.A.C. 8:42-2.2 (amended effective Dec. 18, 2023) and N.J.A.C. 8:33-4.3, checked on 2026-10-12.

Whether New Jersey is taking new agencies

Under N.J.A.C. 8:42-2.1, a home health agency may not be “instituted, constructed, expanded, licensed to operate, or closed” unless the Commissioner of Health issues a certificate of need (CON). The CON must be issued “pursuant to a Certificate of Need Call.”⁠7 The order matters. You cannot file a CON application whenever you are ready. You can file only when DOH publishes a call for home health care services in the New Jersey Register.

The CON rule sets the calendar. N.J.A.C. 8:33-4.1 lists home health on the full-review schedule starting July 1, 2004, and every three years after that.⁠22 DOH publishes an expected two-year schedule each February and may add or delete calls. Where practical, it gives at least 90 days between the call notice and the filing date.⁠22 On the DOH certificate of need page, home health appears among the full-review categories, which go to the State Health Planning Board as well as to DOH.⁠2

Here is what happened to the last two scheduled calls:

  • July 1, 2022. DOH postponed the call on June 6, 2022, and then cancelled it in a notice published February 21, 2023. DOH said it had “determined that additional home health care services are not needed at this time.” The same notice set the next call for July 1, 2025, and kept the Commissioner’s right to call earlier if need was documented.⁠4
  • July 1, 2025. On July 21, 2025, DOH published a postponement. It said it was running a statewide survey of home health agencies to count “current patients, new patients, and readmitted patients by age group and county.” DOH said it would publish either a call notice or a cancellation once that work is done.⁠3

The DOH public notices page, last reviewed September 21, 2026, lists CON notices from 2026 for organ transplantation, burn centers, pediatric intensive care beds, neonatal bassinets and specialized long-term care beds. It lists nothing new for home health care services.⁠5 So on October 12, 2026, nobody can file a CON application to start a new home health agency in New Jersey. If you are planning one, watch the New Jersey Register for a home health call notice or a cancellation notice.

What this license covers, and what it does not

DOH defines a home health agency as an entity licensed to provide “preventive, rehabilitative, and therapeutic services to patients on a visiting basis in a patient’s home or place of residence.” Every agency must provide at least nursing, homemaker-home health aide and physical therapy services. The definition also notes that these agencies are eligible for Medicare certification.⁠6⁠1 You cannot get this license for a nursing-only or therapy-only business. All three services are required.

Neighboring categories founders mix up with it:

  • Non-medical home care and companion services. A business that places companion, personal care or health care workers in the homes of people with disabilities or people 60 and older registers with the Division of Consumer Affairs as a health care service firm (HCSF). The statute applies to any entity “that is not a home health care agency licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) or a hospice licensed pursuant to P.L.1997, c.78.”⁠28 A DOH-licensed home health agency is therefore outside the HCSF requirement. The DCA rule defines an HCSF as a firm that employs people and assigns them to provide “health care, personal care, or companion services.”⁠29 See /guides/new-jersey-health-care-service-firm-registration/.
  • Hospice. Hospice is a separate DOH facility type with its own licensing chapter, N.J.A.C. 8:42C.⁠1⁠33
  • Care inside a residence you operate. Assisted living is a different DOH license. See /guides/new-jersey-assisted-living-residence-license/. For daytime health services in a center, see /guides/new-jersey-adult-day-health-services-facility-license/.

Buying a licensed agency: the open route

With no call open, the practical way into New Jersey home health is buying an agency that already holds a license. Under N.J.A.C. 8:33-3.3, a CON is required only to transfer a general hospital or for a transfer that produces a new Medicare provider number for the hospitals involved. A CON is “not required for transfer of ownership of all other operating health care facilities.” The buyer files a licensing application instead.⁠27

What DOH requires of a buyer:

  1. File form CN-7 at least 90 days before closing

    The transfer application goes to the Director of the Office of Certificate of Need and Healthcare Facility Licensure. The seller “shall not finalize the transaction with the proposed transferee without prior approval of the Department.”⁠12

  2. Pay the $1,000 transfer fee

    It is nonrefundable (as published on 2026-10-12).⁠8

  3. Account for every owner

    The application must name each principal and account for 100% of ownership. DOH evaluates prospective owners on “character and competence and track record” in complying with licensing rules.⁠27 The licensing rule also bars ownership or operation by anyone convicted of crimes that bear on fitness to run an agency, such as assault, sexual offenses, crimes against incapacitated people and financial crimes. The exception is a person who shows rehabilitation under the Rehabilitated Convicted Offender Act, and a disqualified person may request a hearing.⁠12

  4. Expect a new license

    A license “is not assignable or transferable.” It becomes void if ownership changes, so the buyer operates under a license issued in its own name.⁠10

Two limits apply to this route. First, you cannot buy a CON project that has been approved but not yet licensed. N.J.A.C. 8:33-3.3(j) prohibits transfers of unimplemented certificates of need, and proceeding with one nullifies the CON and precludes licensure. Subsection (k) lets DOH allow a narrow exception at its discretion, so ask the Office before assuming a CON can be sold.⁠27 Second, if the agency bills Medicare, check its Medicare enrollment date before you sign. Under 42 CFR 424.550(b), when majority ownership of a home health agency changes within 36 months of its initial Medicare enrollment, or within 36 months of its last majority ownership change, the Medicare provider agreement and billing privileges do not transfer. The new owner must then enroll as a new agency and get a state survey or accreditation. One exception applies when the agency has filed two consecutive years of full cost reports since that date. Low- or no-utilization cost reports do not count.⁠31 If Medicare does issue a new provider number, 42 CFR 489.28 requires the agency to show “initial reserve operating funds” covering its first three months of operation, not counting expected Medicare receivables.⁠32

If a call opens: the CON application

If DOH publishes a home health call, the full-review application uses forms CN-1, CN-3 and CN-4. You file it electronically along with 35 paper copies.⁠23⁠7 The filing fee depends on total project cost and must be paid in full when you file, or the application will not be accepted. The fee is $7,500 for projects of $1,000,000 or less, and $7,500 plus 0.25% of total project cost above that (as published on 2026-10-12).⁠23

After DOH deems the application complete, the State Health Planning Board must send its written recommendation to the Commissioner within 90 days, unless the application is deferred or a hearing is held.⁠25 An approved CON is valid for five years unless the call sets a different period.⁠26 Any conditions in the approval letter become obligations you must carry out once licensed.⁠7

DOH reviews your track record closely. N.J.A.C. 8:33-4.10 groups home health care with other “ambulatory care and other” services such as primary care, hospice and ambulatory surgery. It lets DOH deny an application based on the applicant’s compliance history at facilities in that category, including facilities outside New Jersey. It also bars approval for any applicant with “existing non-waiverable violations of licensure standards.”⁠24

Licensure after the CON

  1. Preliminary conference (optional)

    Anyone considering an application may book a preliminary conference with the Office of Certificate of Need and Healthcare Facility Licensure.⁠8

  2. License application on form CN-7

    File it after you receive the CON, with the $2,000 nonrefundable licensing fee. The $500 biennial inspection fee is added to the initial license fee for a new agency (fees as published on 2026-10-12, under the rule as amended effective December 18, 2023).⁠8

  3. Survey

    Once DOH approves the written application and the office is ready for occupancy, the Division of Health Facility Survey and Field Operations surveys the agency. You correct any deficiencies, notify the licensing office, and DOH resurveys before it issues the license.⁠9

  4. No patients before approval

    An agency may not accept patients until it holds written approval or a license from the licensing office.⁠9

If a rule creates a hardship, you can request a waiver on Form CN-28. The request must state the rule, the hardship, an alternative that protects patients, and supporting documents.⁠34

Who must run the agency

Governing authority. The owner’s governing body takes legal responsibility for management, operations and financial viability. It must adopt bylaws and review them at least every three years, meet at least once a year with minutes, run a grievance system, and keep a written conflict of interest policy.⁠16

Administrator. The administrator must have one of the following:⁠6

  • a master’s degree in administration or a health-related field and two years of supervisory or administrative experience in home health care or another health care setting, or
  • a bachelor’s degree in one of those fields and four years of that experience.

An alternate must be designated in writing.⁠17 The administrator is also responsible for emergency preparedness policies under the federal home health standard, 42 CFR 484.102.⁠18

Director of nursing. The governing authority must appoint a full-time director of nursing who is available at all times, plus one or more registered nurse alternates.⁠19 The director must be a registered nurse with one of the following:⁠6

  • a master’s degree in nursing or a health-related field and two years of combined community health nursing and progressive management experience, or
  • a bachelor’s degree and three years of that experience.

An agency with only one office may have the director of nursing serve as administrator, but only if that person also meets the administrator qualifications.⁠17

Leadership changes. If the administrator or director of nursing leaves, you must notify DOH right away at (800) 792-9770 or [email protected]. Written confirmation must follow within 72 hours, giving the replacement’s name and qualifications.⁠15

Staffing and service rules

Core service obligations under N.J.A.C. 8:42
Requirement Rule
Nursing, aide and physical therapy services required 8:42-3.1(a)⁠11
Nursing available 24 hours a day, 7 days a week 8:42-3.1(a)2⁠11
Nursing routinely provided by your own staff; contract nurses allowed if oriented and supervised by agency staff 8:42-3.1(b)⁠11
PT, OT, speech, dietary counseling, aide and social work services may be direct or by written agreement 8:42-3.1(c)⁠11
A registered nurse calls back a patient with a clinical issue within one hour 8:42-7.3(d)⁠19
Only registered nurses perform patient assessments 8:42-7.3(c)5⁠19
A registered nurse is available at each branch office during its hours 8:42-7.3(b)⁠19
Telehealth is in addition to direct care, never instead of it 8:42-6.7⁠35

Aides must be CHHAs. Every homemaker-home health aide you use must be a certified homemaker-home health aide (CHHA), certified by the New Jersey Board of Nursing. Before a CHHA serves a patient, a registered nurse must orient the aide to that patient and give written instructions.⁠20⁠6 The Board’s CHHA training program runs at least 76 hours, with 60 hours of classroom instruction and 16 hours of clinical instruction. Programs may be run by a home care services agency or an approved educational institution.⁠30

Identification and consumer notice. You must give every CHHA and health professional a photo ID tag, and they must wear it during visits. Each patient also gets the Board of Nursing’s consumer guide to homemaker-home health aides, before service begins when possible.⁠11

Health screening at hire. All direct-care staff, including contract staff, need an IGRA or two-step Mantoux tuberculin test at hire, repeated every year. They also need measles and rubella testing, with vaccination offered where needed.⁠13

Written programs DOH expects to see

  • Policy and procedure manual. It covers program philosophy, an organizational chart, the quality assurance program, and abuse- and neglect-reporting protocols with a designated staff liaison. It must be reviewed at least every three years.⁠14
  • Annual abuse training. All direct-care staff, including subcontracted staff, need yearly training on identifying and reporting child abuse, sexual abuse, domestic violence and abuse of elderly or disabled adults.⁠14
  • Quality assurance plan. Review it at least once a year. It must include a quarterly audit of active and discharged patient records, and you must report the results to the governing authority at least once a year.⁠21

Fees as published on 2026-10-12

DOH fees for home health agencies
Item Fee Source
CON application, total project cost of $1,000,000 or less $7,500 N.J.A.C. 8:33-4.3⁠23
CON application, project cost above $1,000,000 $7,500 + 0.25% of total project cost N.J.A.C. 8:33-4.3⁠23
Initial license application $2,000 N.J.A.C. 8:42-2.2(b)⁠8
Annual renewal $2,000 N.J.A.C. 8:42-2.2(b)⁠8
Inspection fee (every other year; added to a new agency’s initial license) $500 N.J.A.C. 8:42-2.2(f)⁠8
Transfer of ownership $1,000 N.J.A.C. 8:42-2.2(c)⁠8
Relocation $250 N.J.A.C. 8:42-2.2(d)⁠8

Renewal and inspections

A license lasts one year or less. It renews each year on the original licensure date, or within 30 days after but dated as of that date. DOH sends the renewal fee request 30 days before expiration, and no renewal license issues until it receives the fee.⁠10 DOH may refuse renewal if local requirements are not met.⁠10 The $500 inspection fee is charged only every other year, even if DOH inspects more often. Failing to pay it means the license is not renewed.⁠8 DOH staff may survey the agency, or visit a patient’s home, at any time.⁠9

To close voluntarily, you must notify every patient, each patient’s physician and any payers at least 30 days in advance. DOH must receive the license within seven working days.⁠36

Sources

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New Jersey and neighboring states

Compare all 51
Home health agency licensing in New Jersey and neighboring states: license, size threshold and state fee
StateLicenseWho needs itState fee
New Jersey (this guide) Home Health Agency license Own nurses, aides and physical therapy in patients' homes; CON needed $7,500; over $1M project cost: $7,500 + 0.25%
New York Certified Home Health Agency (CHHA) certificate of approval Skilled nursing, therapy and aides; public need required $2,000, non-refundable
Pennsylvania Home Health Agency license Skilled nursing plus at least one other home service $250 per license
Delaware Skilled Home Health Agency license (aide-only agencies hold a separate Home Health Agency license) Any agency providing skilled home services; aide-only has its own license $500 application (nonrefundable), $300 annual renewal

Shortened from each state's guide and our 51-state table, as of each guide's last review. Fees are the state's own; local permits and background checks cost extra.