How to start a hospice in New Hampshire

New Hampshire requires a Home hospice care provider (HHCP) license from New Hampshire Department of Health and Human Services, Health Facilities Administration to operate a hospice. Fee: $250.

License required

Yes

License

Home hospice care provider (HHCP) license

Issuing agency

New Hampshire Department of Health and Human Services, Health Facilities Administration

Fee

$250

Fee details

$250 application fee (RSA 151:5, X(b)); fees are not transferable between applications.

Renewal

Every year · Licenses expire about one year after issuance (last day of the month before the issue month); renewal application due at least 120 days before expiration.

Survey and inspection

Inspection for full compliance with RSA 151 and He-P 823 before an initial license, change of ownership, change of classification, or renewal.

Medicare certification

Medicare certification is separate from the state license (state survey or CMS-approved accreditor). CMS imposed a nationwide 6-month moratorium on new Medicare hospice enrollments (including new practice locations) effective 2026-05-13, extendable in 6-month increments; applications received by the Medicare contractor before that date are still processed, accreditation cannot be used for deemed-status entry during the moratorium, and a hospice undergoing a non-exempt ownership change within 36 months of enrollment must re-enroll as new and is therefore blocked. The federal notice leaves Medicaid/CHIP hospice moratoria to each state.

Regulation

RSA 151; N.H. Admin. R. He-P 823 (Home Hospice Care Providers)

1. Publish notice of intent to file in a newspaper of general circulation in 2 separate issues at least 10 business days before filing
2. If within 15 miles of a critical access hospital, notify its CEO by registered mail at least 10 business days before filing
3. Obtain written local approvals (health, building, zoning, fire) for the administrative building within 90 days before applying
4. Submit the Application for Residential or Health Care License signed by the applicant or 2 corporate officers, with Secretary of State authorization, the $250 fee, administrator and medical director resumes/licenses, and NH criminal records checks
5. Pass the pre-licensure inspection
6. Renew annually, applying at least 120 days before expiration

Staffing

• Administrator
• Medical director
• Applicant, licensee, administrator or medical director with listed convictions or findings are disqualified unless waived

Program

New Hampshire Medicaid (Fee for Service and Medicaid Care Management), NH DHHS

Enrollment portal

New Hampshire MMIS Health Enterprise Portal

Fiscal agent

Conduent (runs the NH MMIS portal and the Provider Relations call center)

Application fee

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. NH DHHS provider pages do not list a separate state fee.

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. NH DHHS provider pages do not list which provider types are high risk.

Site visit

NH DHHS says moderate- and high-risk providers must have a site visit and limited-risk providers do not. A Medicare site visit done within the past 5 years satisfies the requirement for NH Medicaid revalidation. 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.

Revalidation

Every enrolled provider (billing, rendering and ordering/referring/prescribing) revalidates about every 5 years, online in the MMIS portal only. The state mails and emails notices 60 days and 30 days before the due date and on the due date itself. No extensions are given. A provider who misses revalidation can have claims suspended, then loses fee-for-service enrollment and, after that, its health plan participation. Revalidating with Medicare, with another state or with a health plan does not count. Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years.

Full New Hampshire Medicaid enrollment guide →

CON program

No

Agency

New Hampshire Department of Health and Human Services (facility licensing)

Moratoria

RSA 151:2, VI bars new licenses and licensed-capacity increases for nursing homes, skilled nursing facilities, intermediate care facilities and rehabilitation facilities (including rehabilitation hospitals). Exceptions cover substance use / mental health rehabilitation facilities, continuing care facilities with an insurance-commissioner certificate of authority, and same-county transfers of beds that existed on July 1, 2016 without reducing county Medicaid beds. Pediatric ICFs existing before July 1, 2023 may house 2 extra residents through June 30, 2026.

New Hampshire certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

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.

Hospice agencies (community based) — active organization NPIs (NPPES)

52 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

23 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

167,648 (as of Jun 1, 2026)

All New Hampshire Hospice Medicaid rates, ranked →