How to start a home care agency in New Jersey

New Jersey requires a Health Care Service Firm registration from New Jersey Division of Consumer Affairs (Office of the Attorney General) to operate a home care agency. Fee: $500.

License required

Yes

License

Health Care Service Firm registration

Issuing agency

New Jersey Division of Consumer Affairs (Office of the Attorney General)

Fee

$500

Fee details

$500 annual registration fee for each primary location (N.J.A.C. 13:45B-7.1).

Renewal

Every year · $500 per primary location each year; renewal requires a current $10,000 bond (unless perpetual or waived) and proof of accreditation.

Insurance and bonds

$10,000 surety bond required at registration and renewal; the Director may waive it for firms with net worth of $100,000 or more.

Accreditation

Required: accreditation by an entity recognized by the NJ Department of Human Services as an accrediting body for Medicaid homemaker agencies, due from the first renewal after 12 months of registration.

Regulation

N.J.S.A. 34:8-43 et seq.; N.J.A.C. 13:45B-7.1 and 13:45B-13.1 to 13.8

1. Form the business and identify officers, directors, principals, 10%+ owners and the managing agent
2. Obtain a $10,000 surety bond, or document net worth of $100,000+ to request a waiver
3. Each officer, director, principal and owner signs a criminal-conviction certification
4. File the registration application with the $500 fee per primary location
5. Obtain accreditation from a body recognized by the NJ Department of Human Services within 12 months of first registering (required at renewals)
6. Report ownership or management changes within 30 days
7. Renew annually

Staffing

• Before sending a worker who is not a certified homemaker-home health aide or otherwise licensed, the firm must give the client written notice (24 hours ahead unless waived) with the worker's name, address and training
• Firm must verify the worker is authorized to work in the U.S. and check employment history or obtain two character references

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 →

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 →

Model

hybrid

State vendor

HHAeXchange

Services in scope

• personal care
• MLTSS home-based supportive care
• DDD individual supports
• DDD in-home respite
• DDD community-based supports
• home health

Alternate EVV allowed

Yes

Program

https://www.nj.gov/humanservices/dmahs/providers-stakeholders/overview/evv.shtml

New Jersey EVV requirements →

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.

Personal care / in-home supportive care organizations — active organization NPIs (NPPES)

1,567 (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 →