New Jersey home care and home health consulting

How to start a home care agency in New Jersey and reach your first client faster

New Jersey does not license nonmedical home care through its health department. Firms that place caregivers or companions register as a Health Care Service Firm with the Division of Consumer Affairs, post a bond, hire an RN supervisor and must be accredited within 12 months. Hands on aides must be Board of Nursing certified CHHAs, and NJ FamilyCare expects accreditation before it enrolls you. Home health needs a Certificate of Need the state is not offering right now. We put all of it in the right order for you.

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  • Christine OchimasRN, LMFT, MBA
  • All three care typesNonmedical, home health, hospice
  • Written to New Jersey rulesN.J.A.C. 13:45B (Health Care Service Firms), N.J.A.C. 13:37-14 and your accrediting body's standards
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Updated November 2026 · Reviewed by Christine Ochimas, RN, LMFT, MBA

Quick answer: New Jersey regulates nonmedical home care businesses as Health Care Service Firms. Under N.J.S.A. 34:8-45.1 and N.J.A.C. 13:45B-13, a firm that places workers to give personal care or companion services in the homes of people with disabilities or adults 60 and older registers with the Division of Consumer Affairs and must be accredited within 12 months. Home health agencies need a Certificate of Need and a Department of Health license under N.J.A.C. 8:42. Hospices are licensed under N.J.A.C. 8:42C.
New Jersey path finder

Answer two questions. See exactly what New Jersey requires.

1. What care will you provide?
2. Who will pay for most clients?
Most growth

Personal care for NJ FamilyCare members

State license
Health Care Service Firm registration, plus accreditation before Medicaid enrollment (N.J.A.C. 10:60-1.3)
Who you deal with
Division of Medical Assistance and Health Services (NJ FamilyCare), Division of Consumer Affairs, each NJ FamilyCare health plan
Must haves
Firm registration and accreditation, NPI, NJ Medicaid provider enrollment, health plan contracts, CHHAs with 12 hours of yearly agency training, RN supervision, EVV through HHAeXchange
Realistic time to first client
Several months
See the NJ FamilyCare ready agency package

Orientation for New Jersey only. We confirm your exact path on the free call.

The real New Jersey problem

Three places new New Jersey agencies lose months

Each one keeps you paying rent, insurance and payroll while no clients arrive.

The accreditation clock

Registration lets a Health Care Service Firm open, but the law gives it only 12 months to become accredited by a body the Department of Human Services recognizes. NJ FamilyCare rules go further: firms must be accredited from the start to enroll as Medicaid providers. Owners who leave accreditation for later find their Medicaid plans and their next renewal both waiting on a survey.

What it costs: Months without Medicaid referrals, and a registration at risk if accreditation is not in place by the first renewal after 12 months.

Aides you cannot place yet

A firm may place only actively certified CHHAs that it employs, and each one works under tasks delegated by the firm's RN supervisor. Certification takes a 76 hour Board approved course, a competency exam and a criminal history check through the Board of Nursing. Firms that start recruiting after registration have clients waiting and nobody certified to send.

What it costs: Lost private pay clients in the first weeks, and caregivers who take another offer while they wait.

The home health Certificate of Need wall

A New Jersey home health agency cannot be licensed without a Certificate of Need issued in a Department of Health call. The Department cancelled the 2022 call after finding no need, postponed the July 2025 call while it surveyed agencies, and its current schedule shows the next home health window on July 1, 2028. Owners who plan a new home health agency on a normal licensing timeline stall here.

What it costs: Years of waiting, or the cost of buying an existing licensed agency instead.

What does a delay cost your agency?

Enter your own numbers. Nothing is stored or sent.

Spent before revenue catches up$18,000
Plan a faster launch
Know which business you are starting

Home care vs home health vs hospice in New Jersey

The three sound alike and are regulated differently. The one you choose decides your regulator, staffing, startup capital and timeline.

TopicNonmedical home careHome health (skilled)Hospice
What your staff doPersonal care by CHHAs (bathing, toileting, transferring, dressing, grooming), companion services, homemakingSkilled nursing, CHHA and physical therapy services at minimum, on a visiting basisPalliative and supportive care for people who are terminally ill, and their families
State licenseHealth Care Service Firm registration (Division of Consumer Affairs, N.J.A.C. 13:45B-13)NJDOH home health agency license (N.J.A.C. 8:42)NJDOH hospice license (N.J.S.A. 26:2H-80; N.J.A.C. 8:42C)
Certificate of NeedNoYes: only through a Department call, or by buying a licensed agencyNo: exempt by statute (N.J.S.A. 26:2H-80)
Main payersPrivate pay, NJ FamilyCare health plans (personal care assistant services and MLTSS), DDD waiver programs once approvedMedicare, NJ FamilyCare, commercial insuranceMedicare hospice benefit, NJ FamilyCare
MedicareNot coveredAccreditation or state survey, then Medicare enrollmentRequired: New Jersey licenses only Medicare certified hospices
Key staffRN health care practitioner supervisor; CHHA certified aides on payrollAdministrator, director of nursing, nursing supervisor, physical therapist, CHHAsAdministrator, physician medical director, RN, interdisciplinary team
Startup capitalLowest, plus the bond and accreditation feesHighest barrier: a Certificate of Need or an acquisitionHigh: interdisciplinary team and Medicare certification before revenue
Time to first clientWeeks (private pay) to months (NJ FamilyCare)Longest: depends on the Certificate of Need cycleLongest: licensure together with Medicare certification

Most New Jersey owners start as a Health Care Service Firm, earn accreditation, then add NJ FamilyCare. Because home health licensure depends on a Certificate of Need call, the realistic routes into home health are the next call or buying an existing licensed agency. A transfer of ownership does not need a Certificate of Need under N.J.A.C. 8:33-3.3, but it does need a new license application to the Department. We plan both from day one so your policies and hiring grow with you instead of being rewritten.

New Jersey requirements at a glance

Nonmedical home care credentialHealth Care Service Firm registration with the Division of Consumer Affairs, Regulated Business Section (N.J.S.A. 34:8-45.1; N.J.A.C. 13:45B-13). Required for companion only firms too.
AccreditationWithin 12 months of registration, from a body recognized by the Department of Human Services; required from the start for NJ FamilyCare enrollment
Bond and insurance$10,000 bond (waivable with a certified $100,000 net worth) and a general liability policy of at least $1,000,000
Aide credentialCertified Homemaker-Home Health Aide (CHHA) from the New Jersey Board of Nursing: 76 hour course, competency exam, criminal history check, renewal every two years
SupervisionRN health care practitioner supervisor: plan of care before placement, check in every 30 days, in home evaluation every 60 days
Home health and hospice licensingNew Jersey Department of Health: home health under N.J.A.C. 8:42 (Certificate of Need required), hospice under N.J.A.C. 8:42C (no Certificate of Need, Medicare certification required)
Medicaid agencyDivision of Medical Assistance and Health Services (NJ FamilyCare); providers enroll through the NJ Medicaid provider enrollment site
Medicaid home care routePersonal care assistant services and MLTSS through NJ FamilyCare health plans: Aetna, Fidelis Care, Horizon NJ Health, UnitedHealthcare Community Plan and Wellpoint
Electronic visit verificationRequired for personal care assistance, MLTSS Home Based Supportive Care, several DDD services and home health; the state vendor is HHAeXchange
Entity filingDivision of Revenue and Enterprise Services: certificate of formation, then Form NJ-REG for tax and employer registration

Summary of New Jersey requirements as of November 2026. Rules change; confirm with each agency before filing.

The process

Step by step: launching a home care agency in New Jersey

The order matters. Steps 4, 6 and 7 should start long before step 8, because NJ FamilyCare enrollment needs accreditation in hand and every aide needs Board of Nursing certification before you can place them.

  1. Form the business with the Division of Revenue

    Get an EIN, file your certificate of formation with the Division of Revenue and Enterprise Services ($100 for a for profit entity), then file Form NJ-REG for tax and employer registration.

    You do this; we give you the checklist
  2. Decide your services and payer mix

    Companion only, personal care with CHHAs, or both; private pay, NJ FamilyCare or both. The answer decides when you need accreditation and how many CHHAs you need on day one. Use the path finder above.

    Decided on your free consultation
  3. Set up insurance and employment basics

    Carry workers' compensation and a general liability policy of at least $1,000,000, as the Health Care Service Firm rules require. Put every caregiver on payroll: the firm definition assumes you pay wages and payroll taxes, and New Jersey's ABC test treats most workers as employees. Build earned sick leave into payroll: one hour for every 30 hours worked, up to 40 hours a year.

    You do this; we specify what is required
  4. Hire an RN supervisor and write your policies

    Firms that place aides need a health care practitioner supervisor: a physician, or an RN with community health nursing experience. Write policies for plans of care, delegation, supervision, hiring and licensure checks, records and client rights to N.J.A.C. 13:45B, N.J.A.C. 13:37-14 and your accrediting body's standards.

    We write this for you
  5. Register as a Health Care Service Firm

    Apply through the Division of Consumer Affairs Regulated Business online portal with ownership details for anyone holding 10% or more, a conviction certification for each owner and officer, licenses held in other states, the $10,000 bond or net worth waiver, and the $500 fee for each primary location. Renew every year.

    We prepare the application
  6. Build the CHHA pipeline

    Use an application form that collects one year of work history, confirm each prior employer, and confirm certification with the Board of Nursing before placement. Send new aides through a Board approved 76 hour program or sponsor your own, and track exams, background checks and two year renewals.

    We set up the system and tracker
  7. Get accredited within 12 months

    Choose a body on the Division's list of recognized accrediting organizations, such as ACHC, CHAP or The Joint Commission, prepare to its standards and schedule the survey early. Tell the Division within 10 days if accreditation ever lapses.

    We get you ready for the survey
  8. Enroll with NJ FamilyCare and contract with health plans

    Get an NPI and submit the Home Health Agency/Personal Care Assistant/Private Duty Nursing application on the NJ Medicaid provider enrollment site. Then apply to each NJ FamilyCare health plan serving your counties: Aetna, Fidelis Care, Horizon NJ Health, UnitedHealthcare Community Plan and Wellpoint.

    We prepare every plan's packet
  9. Set up electronic visit verification

    NJ FamilyCare requires EVV for personal care assistance and MLTSS Home Based Supportive Care. Connect to HHAeXchange, the state's EVV vendor, directly or through a connected EVV system before your first Medicaid visit, because claims need verified visit data.

    We walk you through setup

CHHA certification, RN supervision and background checks

The New Jersey Board of Nursing certifies homemaker home health aides under N.J.S.A. 45:11-24 and N.J.A.C. 13:37-14. A Health Care Service Firm may place only actively certified CHHAs that it employs, and each CHHA performs only tasks the firm's RN supervisor has delegated or directed (N.J.A.C. 13:45B-14.7).

  • Training: At least 76 hours: 60 hours of classroom and 16 hours of clinical instruction, with home care content, in a Board approved program run by a home care services agency or an approved school. A registered firm can apply to run its own program.
  • Competency exam: Given by the Board or a Board approved testing service at least four times a year. A graduate may work under RN supervision while waiting for the next exam. After two failed attempts, the person must retrain and cannot work as an aide until they pass.
  • Application timing: Aides apply to the Board within six months of finishing training, with proof that a home care services agency employs them or will employ them.
  • Criminal history check: Every applicant completes a Criminal History Certification of Authorization; the Board checks state and FBI records before certification and again at least every two years at recertification. Certain convictions disqualify unless the person proves rehabilitation.
  • Renewal: Every two years. A CHHA who has not renewed within 30 days of expiration is suspended without a hearing, and working while suspended counts as uncertified practice.
  • RN supervision: A licensed professional writes a plan of care before placement. The supervisor checks in at least every 30 days and makes an in home evaluation at least every 60 days, and documents every delegated task.
  • NJ FamilyCare personal care: Personal care assistants must be CHHAs, complete at least 12 hours of agency training (in service education) a year and be supervised by an RN employed by the agency.
  • Hiring records: Collect one year of work history, check it with each employer, confirm Board certification before placement and keep records for seven years.
  • Companions: Companion services are supervision and socialization without help with activities of daily living, so companions do not need CHHA certification. They are still placed through your registered firm; set a written screening policy and check what your accrediting body expects.
Start these first. Hire the RN supervisor, choose your accrediting body and recruit CHHAs, or aides in training, while your registration is being processed. Board certification runs on the aide's timeline, not yours.
Avoid these

Six mistakes that slow New Jersey agencies down

We look for every one of these in the first week of an engagement.

Applying to the Department of Health for a nonmedical business

What it costs
Weeks lost on the wrong agency while registration, the bond and accreditation sit untouched.
How we prevent it
Your first call ends with your exact New Jersey path: the Division of Consumer Affairs first, then accreditation.

Leaving accreditation for later

What it costs
No NJ FamilyCare enrollment until you are accredited, and a registration at risk after 12 months.
How we prevent it
We pick the accrediting body with you on day one and write your manual to its standards.

Paying caregivers as 1099 contractors

What it costs
New Jersey's ABC test puts the burden on you to prove all three parts, and a firm that schedules and supervises aides rarely can.
How we prevent it
Payroll, workers' compensation and earned sick leave set up before the first hire.

Letting companions give personal care

What it costs
Bathing, toileting or transfers by an uncertified worker breaks the CHHA rules and puts clients and your registration at risk.
How we prevent it
Clear service definitions and care plans that match each worker's credential.

Missing a CHHA renewal

What it costs
Thirty days after expiration the certification is suspended, and every shift after that is uncertified practice.
How we prevent it
A tracker that flags renewals, background rechecks and yearly training for every aide.

Planning a new home health agency on a normal timeline

What it costs
Without a Certificate of Need call, there is no path to a new license, so leases and clinical hires sit idle.
How we prevent it
We map the Certificate of Need schedule and the acquisition route before you spend on home health.
Catch these before they cost you

In a free 30 minute call we confirm your New Jersey path, flag the mistakes that apply to your plan, and give you a fixed price to handle the rest.

Get my free New Jersey plan
How we help

New Jersey launch packages

Three fixed price packages, matched to the path you choose. Your exact price is quoted in writing after your free call, before any work starts.

Fastest start

Private pay launch

For nonmedical agencies serving families who pay privately.

  • New Jersey path and a dated launch plan
  • Policy and procedure manual written to N.J.A.C. 13:45B (Health Care Service Firms), N.J.A.C. 13:37-14 and your accrediting body's standards
  • Service agreement, client rights and care plan forms
  • Caregiver hiring and screening workflow
  • Google Business Profile setup
Ask about this package
Clinical

Home health and Medicare

For skilled home health. Hospice is scoped separately.

  • Staffing and capital timeline
  • Policies written to NJDOH rules and the Medicare Conditions of Participation
  • License application and inspection readiness
  • Accreditation survey preparation
  • Medicare and Medicaid enrollment support
Ask about this package

Every package: one fixed price agreed in writing · you own 100% of your agency · no franchise fees or royalties.

On your own vs a franchise vs Lunaria

TopicOn your ownHome care franchiseWith Lunaria
Who owns the businessYouYou, under the franchisor's brand and rulesYou, 100%
Ongoing feesNoneRoyalties and brand fees, usually a share of revenueNone. One fixed project fee
Knowing what New Jersey requiresPieced together from manuals and forumsA national playbook, adaptedConfirmed on your first call, then in writing
Policy manualA template, often from another stateThe franchisor's standard manualWritten to N.J.A.C. 13:45B (Health Care Service Firms), N.J.A.C. 13:37-14 and your accrediting body's standards
Medicaid credentialingOne application at a timeVaries by franchisorPackets for each NJ FamilyCare health plan in your counties prepared together
Your brand and marketingUp to youThe franchisor's brand, with territory limitsYour brand, plus local search set up for you
Free download

The New Jersey home care startup checklist

Every New Jersey step in order: business setup, your payer path, policies, caregiver screening and training, Medicaid enrollment and getting found. The items to start first are starred.

  • Choose your services and payer mix (private pay, NJ FamilyCare, or both)
  • Get an EIN and file your certificate of formation with the Division of Revenue and Enterprise Services
  • File Form NJ-REG for tax and employer registration
  • Buy workers' compensation and general liability of at least $1,000,000
  • Set up payroll with earned sick leave (one hour per 30 hours worked, up to 40 a year)
  • and 15 more steps

We send no newsletters. Your details are never shared.

Or have us do it for you
Who you will work with

Christine Ochimas, RN, LMFT, MBA

Christine founded Lunaria Care Consulting to give nurses and caregivers a direct route from "I want my own agency" to a compliant business with clients. She reads state requirements the way a reviewer does and writes policies the way a nurse would actually use them.

  • We serve owners in all 50 states and DC, with a plan written for New Jersey
  • We help through enrollment and survey readiness, not just the application
  • We tell you what we cannot promise: no one can guarantee a state or health plan decision
Talk to Christine
Make your free call count

Have these ready for your consultation

  • The care you want to provide and the clients you want to serve
  • The New Jersey cities or counties you plan to cover
  • Where you are now: idea, business formed or already operating
  • Who you expect to pay: families, NJ FamilyCare, Medicare
  • Your target opening month and rough budget

No client or patient records. We never need them for a first call.

What it costs to start a home care agency in New Jersey

ItemNotes
Health Care Service Firm registration$500 a year for each primary location (N.J.A.C. 13:45B-7.1). Check current fees with the Division of Consumer Affairs.
Surety bondA $10,000 bond; the premium depends on your bond company. The Division may waive it for a firm with a CPA certified net worth of $100,000 or more.
AccreditationApplication, survey and renewal fees set by the accrediting body you choose
Entity formation$100 certificate of formation for a for profit entity with the Division of Revenue and Enterprise Services
InsuranceGeneral liability of at least $1,000,000, workers' compensation, auto coverage
CHHA training and certificationProgram tuition, exam and Board of Nursing fees per aide if you sponsor them
EVV and scheduling softwareHHAeXchange or a connected EVV system for NJ FamilyCare visits
Home health or hospice licenseNJDOH charges $2,000 for a home health license application and each renewal, plus a $500 biennial inspection fee; a hospice license is $2,000 to apply and $2,000 a year to renew
Operating reserveCovers payroll, rent and insurance while accreditation, Medicaid enrollment and health plan contracts are pending

Fees change. Confirm current amounts with each agency before budgeting.

How long it takes in New Jersey

Private pay

Weeks to a few months, once registration, the bond, insurance, an RN supervisor and certified aides are in place.

NJ FamilyCare

Several months: accreditation first, then NJ Medicaid enrollment, then contracting and credentialing with each health plan.

Home health or hospice

Longest: home health waits on a Certificate of Need call or an acquisition; hospice licensure runs together with Medicare certification.

New Jersey is dense and mostly suburban, so families compare several agencies within a few towns and often search for care for a parent who lives in a different town from their own. That makes a Google Business Profile with a clear service area and a page for each town you serve matter more than a single statewide page. Experienced CHHAs have many employers to choose from, so pay, scheduling and steady hours are part of how you win both caregivers and clients. In rural parts of South Jersey and the northwest, reliable coverage across longer drives is the selling point.

Frequently asked questions

Does New Jersey license nonmedical home care agencies?

Not through the Department of Health. A business that places workers to give personal care or companion services in the homes of people with disabilities or adults 60 and older registers as a Health Care Service Firm with the Division of Consumer Affairs under N.J.S.A. 34:8-45.1 and N.J.A.C. 13:45B-13.

Do New Jersey home care firms need accreditation?

Yes. A Health Care Service Firm must be accredited within 12 months of registration by a body the Department of Human Services recognizes, and must tell the Division within 10 days if it loses accreditation. NJ FamilyCare requires firms to be accredited before they enroll as Medicaid providers.

Do companion only businesses need to register?

Yes. The Health Care Service Firm law covers companion services, meaning supervision and socialization without help with activities of daily living. Companions do not need CHHA certification, but the firm still registers, posts the bond and becomes accredited.

What is a CHHA in New Jersey?

A Certified Homemaker-Home Health Aide, certified by the New Jersey Board of Nursing after a 76 hour approved program, a competency exam and a criminal history check. CHHAs renew every two years and work under tasks delegated by a registered nurse.

Does New Jersey require a Certificate of Need for home health or hospice?

Home health, yes: a new agency needs a Certificate of Need issued in a Department of Health call, and the current schedule shows the next home health window on July 1, 2028. Hospice, no: N.J.S.A. 26:2H-80 exempts licensed hospices, but New Jersey licenses only hospices that are Medicare certified.

Can a new home health agency or hospice enroll in Medicare right now?

Not while the federal pause lasts. On May 13, 2026, CMS began a six month nationwide moratorium on new Medicare enrollment of home health agencies and hospices, including new branches and practice locations. It is set to end around November 13, 2026, but CMS can extend it in six month increments, so it may have ended or been extended by the time you read this. Agencies already enrolled are not affected. It covers Medicare only, but New Jersey requires Medicare certification for hospice licensure and for NJ FamilyCare home health, so the pause holds up those routes too. Each state decides whether to pause its own Medicaid enrollment, so check with NJ FamilyCare.

Can New Jersey home care aides be independent contractors?

Rarely. New Jersey uses the ABC test, and the business must prove all three parts. A firm that schedules, supervises and bills for an aide's work will usually be treated as the employer, and the Health Care Service Firm rules assume aides are on your payroll.

How do New Jersey home care firms get Medicaid clients?

By enrolling with NJ FamilyCare through the NJ Medicaid provider enrollment site, then contracting with the NJ FamilyCare health plans that serve their counties: Aetna, Fidelis Care, Horizon NJ Health, UnitedHealthcare Community Plan and Wellpoint. The plans authorize personal care assistant and MLTSS services.

Is a franchise a better way to start a home care agency in New Jersey?

A franchise gives you a brand and playbook in exchange for fees and ongoing royalties. Starting independently with Lunaria costs one fixed price, and you own 100% of your agency with no franchise fees or royalties.

How much does New Jersey home care consulting cost?

Lunaria charges one fixed price per engagement, based on your path: private pay, NJ FamilyCare or home health and Medicare. You receive the price in writing after a free 30 minute consultation. There are no hourly charges. We work in all 50 states and DC.

Sources checked for this guide (43)

This guide is general information and reflects New Jersey requirements as we understood them in November 2026. Requirements change. Confirm current rules, fees and procedures with the New Jersey Division of Consumer Affairs, the New Jersey Board of Nursing, the New Jersey Department of Health, the Department of Human Services and CMS before filing. Lunaria Care Consulting provides professional consulting services and does not provide legal advice.

Reviewed by Christine Ochimas, RN, LMFT, MBAFounder, Lunaria Care Consulting · Updated November 2026

Other states: see all state guides. What we do: licensing, compliance, Medicaid enrollment and local search marketing.

Open your New Jersey agency with the steps in the right order

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