Start a business · Skilled nursing facility
Skilled nursing facility license requirements by state
Nursing homes; usually subject to certificate of need. Whether each state requires a license, who issues it, what it costs, certificate of need and the Medicaid rate, with the official source for each.
- States compiled
- 51 of 51
- Require a state license
- 51
- No state license
- 0
- States with a CON program
- 37of states compiled
On this page
By state
Skilled nursing facility requirements in every state
States still being compiled are marked; we only publish a state once its details are confirmed against the official source.
| State | License | Issuing agency | Fee | Renewal | CON program | Medicaid rate |
|---|---|---|---|---|---|---|
| Alabama | Nursing facility license | Alabama Department of Public Health, Bureau of Health Provider Standards (State Board of Health) | Statutory fee set by Code of Ala. 1975 §22-21-24; the rul… | Every year · Licenses run for the calendar year and expire December 31; online renewal runs October 1 to December 31, with late fees through January 31. | Yes | $95.00per % |
| Alaska | Nursing facility license (provisional initial license, then biennial license) | Alaska Department of Health, Health Facilities Licensing & Certification | Fees are set in 7 AAC 12.615; the application does not pr… | Every 2 years · Renewal application due 90 days before the current license expires (AS 47.32.060); fees per 7 AAC 12.615. | Yes | $1,100.69per day |
| Arizona | Health care institution license — nursing care institution | Arizona Department of Health Services, Bureau of Medical Facilities Licensing | Application and license fees under A.A.C. R9-10-106; non-… | — | No | $232.06per day |
| Arkansas | Nursing home license (classified as Skilled Nursing Facility, Intermediate Care Facility, or ICF/IID) | Arkansas Department of Human Services, Division of Provider Services & Quality Assurance — Office of Long Term Care | Annual license fee of 10 cents per patient bed or $10, wh… | Every year | Yes | $70.00 |
| California | Skilled nursing facility license | California Department of Public Health, Center for Health Care Quality — Licensing & Certification (Centralized Applications Branch) | $1,061 per bed (FY 2026-27 schedule), per CDPH's licensin… | Every year · Annual license fee per bed per the CDPH fee table. | No | $324.03 |
| Colorado | Nursing care facility license | Colorado Department of Public Health and Environment (CDPHE), Health Facilities and Emergency Medical Services Division | Set by the CDPHE facility fee schedule (updated each July… | — | No | $419.22 |
| Connecticut | Chronic and convalescent nursing home (CCNH) license | Connecticut Department of Public Health, Facility Licensing & Investigations Section | — | — | Yes | $107.21 |
| Delaware | Skilled and intermediate care nursing facility license | Delaware Department of Health and Social Services, Division of Health Care Quality | — | Every year · Renew on the anniversary of initial licensure; file at least 30 days before expiration and pay the applicable fee. | Yes | — |
| District of Columbia | Nursing home (nursing facility) license | DC Health, Health Care Facilities Division (licensure); State Health Planning and Development Agency (CON) | License fee not stated in the sources used. CON applicati… | — | Yes | $9.07 |
| Florida | Nursing home license | Florida Agency for Health Care Administration (AHCA), Division of Health Quality Assurance | License fee $112.50 per bed for initial, renewal and chan… | Every 2 years | Yes | $301.36per day |
| Georgia | Nursing home permit (provisional permit up to six months for a new home, then permit) | Georgia Department of Community Health, Healthcare Facility Regulation Division | — | — | Yes | $277.64per day |
| Hawaii | Skilled nursing facility license | Hawaii State Department of Health, Office of Health Care Assurance (OHCA) | — | — | Yes | $504.80per day |
| Idaho | Skilled nursing facility license | Idaho Department of Health and Welfare, Division of Licensing and Certification — Bureau of Facility Standards | — | License expires on the date shown on it; renew on the Department form before expiration. | No | $226.90per day |
| Illinois | Long-term care facility license — skilled nursing facility (Nursing Home Care Act) | Illinois Department of Public Health, Office of Health Care Regulation — Bureau of Long-Term Care | $1,990 | Every year | Yes | $248.95 |
| Indiana | Comprehensive care facility license | Indiana Department of Health, Division of Long Term Care | Applicant pays the license fee set by rule; amount not re… | Every year · Renewal application due at least 45 days before the license expires. | Yes | $309.47per day |
| Iowa | Nursing facility license | Iowa Department of Inspections, Appeals, and Licensing (DIAL), Health Facilities Division | Statutory license fee under Iowa Code chapter 135C; amoun… | — | Yes | $278.25per day |
| Kansas | Adult care home license — nursing facility | Kansas Department for Aging and Disability Services (KDADS), Survey, Certification and Credentialing Commission | Base amount plus a per-bed amount, fixed by KDADS regulat… | Every year · License stays in effect on filing an approved annual report and paying the annual fee (K.S.A. 39-928). | No | $316.60per day |
| Kentucky | Nursing facility license (provisional, then annual) | Kentucky Cabinet for Health and Family Services, Office of Inspector General (Division of Health Care) | Annual fee: 50 beds or fewer, $750 plus $25 per bed; 51 o… | Every year | Yes | $365.78 |
| Louisiana | Nursing facility license | Louisiana Department of Health, Health Standards Section | — | — | Yes | — |
| Maine | Skilled nursing facility / nursing facility (or multi-level) license | Maine Department of Health and Human Services, Division of Licensing and Certification — Medical Facilities Unit | — | — | Yes | — |
| Maryland | Comprehensive care facility license | Maryland Department of Health, Office of Health Care Quality (OHCQ) | — | Every 2 years | Yes | $351.63 |
| Massachusetts | Long-term care facility license (convalescent or nursing home / skilled nursing facility) | Massachusetts Department of Public Health, Bureau of Health Care Safety and Quality | — | Every 2 years | Yes | $332.60per day |
| Michigan | Nursing home license | Michigan Department of Licensing and Regulatory Affairs (LARA), Bureau of Survey and Certification | — | — | Yes | $99.90 |
| Minnesota | Nursing home license | Minnesota Department of Health, Health Regulation Division | License fee in the amount set by statute (referenced in M… | — | No | $342.00per daily rate |
| Mississippi | Nursing home (skilled/intermediate nursing facility) license | Mississippi State Department of Health, Office of Health Protection — Health Facilities Licensure and Certification | — | — | Yes | $285.90 |
| Missouri | Skilled nursing facility (long-term care facility) license | Missouri Department of Health and Senior Services, Section for Long-Term Care Regulation — Licensure Unit | — | — | Yes | $210.39 |
| Montana | Long-term care facility license (skilled nursing care) | Montana Department of Public Health and Human Services, Office of Inspector General — Licensure Bureau | — | — | Yes | $220.15 |
| Nebraska | Skilled nursing facility, nursing facility, or intermediate care facility license | Nebraska Department of Health and Human Services, Division of Public Health — Licensure Unit | Initial and renewal licensure fee by size: 1–50 beds $1,5… | — | Yes | $321.16 |
| Nevada | Facility for skilled nursing license | Nevada Division of Public and Behavioral Health, Bureau of Health Care Quality and Compliance | Initial license: $2,252 per facility plus $108 per bed (n… | $1,126 per facility plus $54 per bed. | Yes | $160.65per day |
| New Hampshire | Nursing home license (He-P 803) | New Hampshire Department of Health and Human Services, Health Facilities Administration | $85 per licensed bed (DHHS initial/renewal application fe… | — | No | $271.22per day |
| New Jersey | Long-term care facility license | New Jersey Department of Health, Division of Certificate of Need and Licensing | — | — | Yes | $282.59 |
| New Mexico | Long-term care facility license — skilled nursing facility | New Mexico Health Care Authority, Division of Health Improvement — Health Facility Licensing and Certification Bureau | $12.00 per bed per annual license (initial and renewal); … | Every year · $12.00 per bed annually. | No | $826.00 |
| New York | Article 28 operating certificate — residential health care facility (nursing home) | New York State Department of Health; establishment approved by the Public Health and Health Planning Council | — | — | Yes | $610.37per day |
| North Carolina | Nursing home license | North Carolina DHHS, Division of Health Service Regulation — Nursing Home Licensure and Certification Section | Non-refundable initial license fee of $470 per facility p… | Renew online through the DHSR licensure site, reporting utilization data used for the State Medical Facilities Plan. | Yes | $326.33 |
| North Dakota | Nursing facility license | North Dakota Health and Human Services, Health Facilities Unit | — | — | No | $393.14per day |
| Ohio | Nursing home license | Ohio Department of Health, Bureau of Long Term Care Quality | Application fee and annual renewal licensing/inspection f… | Every year · $320 per 50 beds of licensed capacity annually. | Yes | $278.44per day |
| Oklahoma | Nursing facility (or specialized facility) license | Oklahoma State Department of Health, Protective Health Services — Health Facility Systems | $10 per licensed bed per year. Initial license is issued … | Every 3 years · Licenses renew every three years: beds × $10 × 3. | Yes | $246.26 |
| Oregon | Nursing facility license (or specialty nursing facility license) | Oregon Department of Human Services, Aging and People with Disabilities — Nursing Facility Licensing | — | Every year · Annual renewal tied to the recertification survey; renewal documents and fees due at least 45 days before license expiration (OAR 411-085-0010). | Yes | $568.23per day |
| Pennsylvania | Long-term care nursing facility license | Pennsylvania Department of Health, Division of Nursing Care Facilities | Application and renewal fees set by section 807(b) of the… | — | No | $255.27 |
| Rhode Island | Nursing facility license | Rhode Island Department of Health, Center for Health Facilities Regulation | — | — | Yes | $381.06 |
| South Carolina | Nursing home license | South Carolina Department of Public Health, Healthcare Quality | — | — | Yes | — |
| South Dakota | Nursing facility license | South Dakota Department of Health, Office of Licensure and Certification | — | — | No | $251.67 |
| Tennessee | Nursing home license | Tennessee Health Facilities Commission (licensure and Certificate of Need) | — | — | Yes | $95.00per percent of NF room and board rate |
| Texas | Nursing facility license | Texas Health and Human Services Commission, Long-Term Care Regulation | — | — | No | $225.64per day |
| Utah | Nursing care facility license | Utah Department of Health and Human Services, Division of Licensing and Background Checks (DLBC) | — | — | No | $248.23per Case Mix + Property + Flat Rate |
| Vermont | Nursing home license | Vermont Department of Disabilities, Aging and Independent Living — Division of Licensing and Protection | — | Every year · Licenses expire one year after issuance and must be renewed annually. | Yes | $409.20per day |
| Virginia | Nursing facility license | Virginia Department of Health, Office of Licensure and Certification (OLC) | — | — | Yes | $105.09 |
| Washington | Nursing home license | Washington Department of Social and Health Services, Aging and Long-Term Support Administration — Residential Care Services | — | — | Yes | $373.84 |
| West Virginia | Nursing home license | West Virginia Office of Health Facility Licensure and Certification (OHFLAC) | — | — | Yes | $436.57per day |
| Wisconsin | Nursing home license (states maximum bed capacity and level of care) | Wisconsin Department of Health Services, Division of Quality Assurance — Bureau of Nursing Home Resident Care | — | — | Yes | $226.35 |
| Wyoming | Nursing care facility license (provisional, then full) | Wyoming Department of Health, Aging Division — Healthcare Licensing and Surveys (HLS) | Licensure fee per WDH Chapter 1, Rules and Regulations fo… | — | No | $259.24per day |
Medicaid rate: the hospice room and board in a nursing home fee-for-service rate, linked to the state's fee schedule. Fees as printed by the licensing agency; where it gives a range or formula, the page for that state has the wording.