Starting a North Dakota Home Health or Personal Care Agency?

• North Dakota Home Health Agency — an HHS-licensed provider that supplies skilled nursing and at least one other therapeutic service and may separately pursue Medicare certification and Medicaid enrollment.
• North Dakota Personal Care Agency — a private-pay nonmedical provider that may separately seek Agency QSP enrollment for publicly funded services.

Yes. An entity meeting the statutory Home Health Agency definition must obtain a license from North Dakota Health and Human Services before accepting patients. An unlicensed entity may not operate or use the terms “home health agency” or “home health services.”

NDCC Chapter 23-17.3 establishes the licensing framework, and NDAC Chapter 33-03-10.1 contains the detailed operating standards. Medicare-certified agencies must also comply with 42 CFR Part 484 and other applicable federal requirements.

No. The agency must obtain its initial North Dakota HHS license before accepting patients for care or treatment.

HHS reviews the application, required attachments and statements, proposed services and geographic area, inspection findings, financial resources, ownership disclosures, recent licensing or certification actions, and specified criminal proceedings involving controlling persons.

The initial license is valid for no more than one year and expires December 31 of the year issued. Renewal licenses also expire December 31.

Yes. Initial approval includes an inspection or investigation. HHS may later conduct announced or unannounced onsite reviews, examine records, interview staff, conduct patient home visits with permission, or request written compliance documentation.

The agency must submit an acceptable plan of correction within 10 calendar days after receiving the deficiency statement. Corrections generally must be completed within 60 days of survey completion unless HHS specifies another schedule.

The governing body must employ a qualified administrator and designate an authorized alternate in writing. Skilled nursing services require a qualified nurse executive or director of nursing and a written RN alternate.

The nurse executive must be a North Dakota-licensed RN with at least three years of RN experience, including one year of full-time direct patient care experience in home health, and must be a full-time salaried agency employee.

Home Health Aides must meet the training and competency requirements in NDAC 33-03-10.1-18. The training program totals at least 75 hours, including at least 16 classroom hours before supervised practical training and at least 16 hours of supervised practical training. Aides also receive 12 hours of in-service education each 12 months.

Medicare certification is separate from the North Dakota license. An agency intending to bill Medicare must also complete CMS enrollment, satisfy the Medicare Conditions of Participation, meet OASIS requirements, and pass the applicable certification survey.

No. Medicaid provider enrollment is a separate electronic process. The agency must satisfy current enrollment, screening, ownership, NPI, service authorization, documentation, billing, EVV, and revalidation requirements.

A business providing only nonmedical personal care, homemaker, or companion services generally does not meet North Dakota's Home Health Agency definition, which requires skilled nursing and at least one other therapeutic service. Other business, local, employment, insurance, consumer, and program-specific requirements still apply.

A nonmedical scope commonly includes assistance with grooming, bathing, dressing, mobility, toileting, meals, homemaking, errands, transportation, and companionship. The written scope should exclude skilled nursing, therapy, and other services requiring licensed professionals unless the agency obtains the appropriate authority.

An Agency QSP is an agency enrolled by North Dakota HHS to provide approved home- and community-based services to eligible publicly funded clients after meeting program enrollment, screening, training, competency, documentation, and quality standards.

No. Agency QSP enrollment is separate. The agency must use the enrollment portal, select the services and counties it will serve, submit required documents, complete training, and receive approval before billing publicly funded services.

Yes. Direct-service employees and contractors must be entered into the enrollment portal and screened. The agency must receive approval before the worker provides services to publicly funded clients and must keep employee information current.

EVV applies to covered North Dakota Medicaid personal care and home health services requiring an in-home visit. North Dakota uses an open model with Therap as the state vendor and Sandata as the aggregator; an agency using another compliant system must submit required data to the aggregator.

As of September 4, 2026, North Dakota Medicaid's temporary moratorium covers new QSP Agency enrollment in Burleigh and Cass Counties. It began June 11, 2026 for six months and may be extended. Applicants should verify current status before relying on this information.

Licensed HHAs must maintain an ongoing agency-wide quality assessment and performance improvement program and document an annual performance improvement project. Agency QSPs should track service delivery, incidents, complaints, missed visits, employee performance, documentation, corrective actions, and participant satisfaction.

• Logo creation, customized WordPress website, one year of hosting, and domain registration.
• 500 business cards and 500 tri-fold brochures.
• North Dakota-specific policies, human-resources documents, admission or client-service documents, and operational forms.
• North Dakota HHS licensure and CMS preparation for the HHA package, or private-pay operational readiness and optional Agency QSP preparation for the Personal Care package.
• Members' area access, customization, ongoing guidance, and applicable updates.

No. Licensing and government fees, required public notices, accreditation, background checks, insurance, local approvals, office, personnel, EVV, survey expenses, software, mailing, and other third-party costs are separate unless expressly included in writing.

Home Health Forms provides customized documents, guidance, and preparation assistance. North Dakota HHS, CMS, survey organizations, accreditors, Medicaid, and other payers make their own decisions. Home Health Foms provides guidance and documents that meet regulatory requirements to ensure your success.

Customized policy manuals, forms, and related digital documents are generally emailed within five business days after all customization information is received. Website, printing, shipping, and other components may have separate timelines.

Eligibility depends on work completed, customized materials produced, digital products delivered, third-party expenses paid, printing ordered, and other services already performed.