How to start an assisted living facility in New Jersey

New Jersey requires a Assisted living residence, comprehensive personal care home, or assisted living program license from New Jersey Department of Health, Division of Certificate of Need and Licensing to operate an assisted living facility.

License required

Yes

License

Assisted living residence, comprehensive personal care home, or assisted living program license

Issuing agency

New Jersey Department of Health, Division of Certificate of Need and Licensing

Medicaid waiver coverage

HHS's 2015 compendium reported that New Jersey's 1115 Managed Long-Term Services and Supports program covers assisted living services. Settings licensed after September 2001 must reserve 10% of units for Medicaid residents within 3 years of licensure.

Certificate of need

Required

Regulation

N.J.A.C. 8:36 (readopted effective Nov. 29, 2021; expires Nov. 29, 2028); N.J.S.A. 26:2H-1 et seq.; N.J.A.C. 8:33 (CON)

1. Get a Certificate of Need (form CN-19; N.J.A.C. 8:33)
2. After the CN, apply to the Commissioner for a license on Department forms
3. Send the admission agreement or scope-of-services document to the CN and Licensing Program for review with the application

Program

NJ FamilyCare / New Jersey Medicaid (Division of Medical Assistance and Health Services, NJ Department of Human Services)

Enrollment portal

NJMMIS.com Provider Enrollment Applications (downloadable packages by provider type)

Fiscal agent

Gainwell Technologies

Application fee

Some provider types must pay an application fee unless they paid one recently. Proof of a fee paid to Medicare or another state's Medicaid program in the past 5 years can be attached instead. Otherwise the payment goes to the NJ Division of Revenue lockbox with the application. Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts.

Fingerprinting

Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. The NJMMIS enrollment pages we reviewed do not describe a separate state fingerprinting process.

Site visit

Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. The NJMMIS enrollment pages we reviewed do not describe a separate state site visit process.

Revalidation

New Jersey revalidates providers every five years under the ACA. To revalidate, file the full enrollment package for your provider type with the Revalidation Cover Page on top; requests without the cover page are not processed. Signatures can be electronic. Send it by secure email, fax or mail to the Gainwell Provider Revalidation Unit. If you don't return the package, claims may be pended or denied. Revalidation Unit: 1-833-909-1522. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.

Full New Jersey Medicaid enrollment guide →

For this business

Required (licensing source)

CON program

Yes

Program

Certificate of Need (full review and Expedited Review, ERCN)

Agency

New Jersey Department of Health, Certificate of Need and Healthcare Facility Licensure; State Health Planning Board advises the Commissioner on full-review applications

Services covered

• long-term care (general, ventilator, pediatric)
• rehabilitation beds
• psychiatric beds
• new general hospitals and children's hospitals
• transfer of ownership of a general hospital
• maternal and child health, pediatric intensive care
• transplantation, burn centers, trauma units, mobile intensive care units
• home health
• new assisted living facilities
• hospital sub-acute unit capacity changes
• establishment, capacity, scope, location or cost changes and major moveable equipment for covered facilities (often expedited)

New Jersey certificate of need details →

State minimum wage

$15.92 an hour

Effective

2026-01-01

Scheduled increases

Rises to $16.48 on 2027-01-01 for most employers; $16.25 for seasonal and small employers; $15.00 for agricultural workers.

Direct-care wage floor

Long-term care facility direct care staff must be paid $3.00/hour above the standard state minimum wage ($18.92 in 2026); this rises to $19.48 on 2027-01-01.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Assisted living facilities — active organization NPIs (NPPES)

618 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,725,496 (as of Jun 1, 2026)

All New Jersey Home care Medicaid rates, ranked →

• New Jersey FamilyCare Comprehensive Demonstration (1115)

New Jersey waivers and waiting lists →