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North Carolina · Home care license · 10A NCAC 13J .0903
North Carolina home care licenses are applied for on paper and by mail, then decided on a review of your policies and staff files. Here is the form, the fee, where to send it, what DHSR does next, and how to renew and report changes once you are licensed.
Quick answer
To apply for a North Carolina home care agency license, download DHSR’s application form (DHSR-4204), complete one for each site, and mail it with the $510 fee and proof of DHSR-approved training to the Division of Health Service Regulation, 2712 Mail Service Center, Raleigh, NC 27699-2712. Training is required "the Division shall not issue a license until the applicant has received training approved by the Division" unless you can show you have owned or operated a home care agency before.
DHSR then emails you to request your policies, procedures and personnel documents. "An initial survey is conducted by reviewing the policies, procedures, and personnel documents for compliance with licensure requirements." If nothing more is needed, it emails your approval letter and you print the license. You have 12 months from when DHSR receives your application to finish.
The license lasts one year and expires at midnight on December 31. Renew it with another $510 each year.
The 12-month clock starts when DHSR receives your application, and DHSR recommends being ready for the initial survey before you apply. Have these in place first.
If you cannot show DHSR you have owned or operated a home care agency, it will not issue a license until you complete training it approves. DHSR does not run the training; it lists approved private trainers.
10A NCAC 13J .0903(a); DHSRDHSR’s list of approved trainers ↗
Hands-on in-home aide care is a home care service. Companion, sitter or respite care on its own is a home assistance service, which needs a license too. The form asks you to tick each service you will offer from the site.
G.S. 131E-136, -138(a)Home care, home health or home assistance? →
Each site needs its own license and its own application. In-home aide services are limited to your county, neighboring counties, or 90 minutes’ drive from the site.
An agency director who meets 13J .1001(b), and for in-home aide services an RN available while aides work. DHSR checks their files in the personnel documents you send.
DHSR emails for them after it receives your application, and reviews them before it licenses you. Its Initial Survey Checklist lists 32 policy and procedure items. Have them written before you mail the application.
The same form covers home care, nursing pools and hospice. Home care applicants fill in these parts. "A separate application is to be completed for each site from which home care (including home health), nursing pool, or hospice services are offered." Separate legal entities run from the same office apply separately.
The full legal name of the owner (corporation, partnership, individual or other entity) and every name you advertise under.
The street address of the site, its county, contact details, and the name of the administrator or director.
Tick Home Care Agency, then each service offered from this site: in-home aide services, nursing, therapies and others, and companion, sitter and respite care.
Proprietor, partnership, corporation or unit of government. A corporation gives its exact name on file with the NC Secretary of State and lists every officer and anyone with 5% or more.
Whether the agency is part of a multiple facility or agency system in North Carolina, owned by a hospital, or managed by another entity.
For each county, each service and whether in-house staff or a contractor provides it, with a list of contractors attached.
DHSR-4204, Licensure Application for Home Care, Nursing Pool, and Hospice (rev. 07/21)
From DHSR’s Requirements for Establishing a Home Care Agency, its FAQ (revised May 30, 2025) and 13J .0903. Tick steps off as you go; progress is saved in this browser only.
The Licensure Application for Home Care, Nursing Pool, and Hospice (DHSR-4204). Tick “Initial”. One application per site.
DHSR-4204Fill in every section that applies, attach the contractor list if you will use contractors, and sign to certify the application is accurate and true.
DHSR-4204, p. 7A check, money order or certified check payable to the N.C. Division of Health Service Regulation, plus your training certificate or proof that you have owned or operated a home care agency. The fee is not refundable.
G.S. 131E-138(c); DHSRDivision of Health Service Regulation, 2712 Mail Service Center, Raleigh, NC 27699-2712. Your 12 months to complete licensing start when DHSR receives the application and fee.
DHSRDHSR reviews the packet for accuracy and completeness and emails you to confirm it has your application and fee.
DHSRDHSR emails to request your policies, procedures and personnel documents. Personnel records should show the staff for each service you will provide. DHSR does not return anything you send.
DHSR; FAQ 16-17DHSR reviews what you sent for compliance with the licensing rules. It may ask for more. DHSR sets no time frame for this; it depends on how complete your documents are and on surveyor workload.
DHSR; FAQ 13If nothing more is needed, DHSR emails the approval letter and instructions to print the license from its Enterprise system. Post it where the public can see it, with a sign at the public door.
DHSR; 13J .0903(c)The $510 is a state fee paid to DHSR, not a CareRulebook price. Questions about the process go to DHSR’s Acute and Home Care Licensure and Certification Section on 919-855-4620.
CareRulebook
The form is the easy part. The initial survey is a review of your policies, procedures and personnel documents. CareRulebook writes the North Carolina policies DHSR’s checklist asks for, with your agency’s details filled in and the 13J rule quoted under every policy.
$199CareRulebook founding price for the first 50 North Carolina agencies, then $249. Not a DHSR fee.
DHSR says this is the main reason applicants are not approved: they do not understand or comply with the initial survey checklist and the licensing rules.
DHSREverything must be complete within 12 months of DHSR receiving your application and fee.
DHSR checklistWithout proof of past ownership or approved training, DHSR cannot issue the license.
13J .0903(a)Personnel records must show proof of staff to provide each service you applied for, with every item 13J .1003(f) requires.
DHSR FAQ 16Use the Initial Survey Checklist as your guide, as DHSR advises. See all 32 policy items →
Every license is for one year. "All home care licenses expire at midnight on December 31st." DHSR FAQ 24
"The completed renewal application and the license renewal fee must be received no later than December 31 to ensure your license is renewed with an effective date of January 1." Renewals received after January 1 take effect on the date received. DHSR FAQ 26
Miss it and DHSR says "If you do not renew your home care license prior to the expiration date, you will be operating without a license", which can lead to a referral to the Division of Health Benefits or other funders and can affect your Medicaid enrollment. DHSR FAQ 27
Once licensed, expect an unannounced inspection about every three years, and file a plan of correction within 10 working days of any cited deficiency. 13J .0904(f)
Write to DHSR’s Acute and Home Care Licensure and Certification Section at 2712 Mail Service Center, Raleigh, NC 27699. DHSR says "Email notifications are accepted at DHSR.homecare@dhhs.nc.gov". Medicaid is separate: "DHB (DMA), NC Tracks and DHSR are separate entities."
30 days before
Tell DHSR in writing at least 30 days before it takes effect. The license is not transferable, and DHSR only processes a change of ownership for an agency with a valid license.
13J .0903(d), (f); FAQ 3030 days before
Tell DHSR in writing before offering it to any client. DHSR asks for the staff and policies for that service and approves it once you meet its rules.
13J .0903(g); FAQ 2130 days before
Write to DHSR listing the counties to add. In-home aide services stay limited to neighboring counties or 90 minutes’ drive.
DHSR FAQ 225 working days
Tell DHSR in writing within five working days of the vacancy, with the replacement’s name and documents showing they qualify.
13J .1001(e); FAQ 38Before it happens
Tell DHSR in writing before the change of site or mailing address takes effect.
DHSR FAQ 39, 42In writing
Tell DHSR if you stop, or cannot provide for six months in a row, a service listed on your license.
13J .0903(h)New license
Each premises gets its own license, so a new site needs its own application.
13J .0902; FAQ 41DHSR publishes every licensed home care agency site as a spreadsheet: license number, licensee and trading name, owner, director, site address, county, services and expiry date. As of August 2026 it lists 3,336 sites, 3,107 of them licensed for in-home aide services (our count from DHSR’s list). DHSR, Home Care All list
It is a quick way to check that an agency you plan to buy holds a valid license, or to see who already serves your county.
No. A license covers the premises and persons named in the application. Tell DHSR in writing at least 30 days before the change, and DHSR only processes a change of ownership for an agency with a valid license.
"The license shall be issued for the premises and persons named in the application and shall not be transferable."
No. DHSR approves the training but does not run it. It lists the private trainers it has approved on its website.
"The Division of Health Service Regulation does not provide home care provider training."
No. Since 2023 the statute calls companion, sitter and respite services "home assistance services", and a home assistance services provider needs a license too.
"No person or governmental unit shall operate a home care agency or a home assistance services provider without a license obtained from the Department."
No. DHSR says the Medicaid personal care services plan is not a plan of care and cannot replace one.
"The Service Plan is not a Plan of Care and may not be substituted as a Plan of Care."
Download DHSR’s Licensure Application for Home Care, Nursing Pool, and Hospice (DHSR-4204), complete it, and mail it with the $510 fee and proof of DHSR-approved training (or of past agency ownership) to the Division of Health Service Regulation, 2712 Mail Service Center, Raleigh, NC 27699-2712. DHSR then emails you to request your policies, procedures and personnel documents and reviews them before licensing you.
DHSR’s published process is to download the application, complete it and mail it with the fee. DHSR then communicates by email, and once approved you print the license from its Enterprise system.
DHSR’s fee is $510 for an initial license, $510 for a change of ownership and $510 a year to renew. All fees are non-refundable. These are state fees, not CareRulebook prices.
DHSR does not set a time frame. It depends on whether your application is complete, whether it needs more information, and surveyor workload. You must complete every requirement within 12 months of DHSR receiving your application and fee.
Private trainers. DHSR does not provide the training itself but publishes a list of approved trainers on its Home Care Provider Training page. The training must cover the licensing requirements, the licensing process and the rules for running a home care agency.
Every home care license expires at midnight on December 31. DHSR must receive the renewal application and fee by December 31 for the renewal to take effect on January 1; renewals received later take effect on the date received.
No. A North Carolina license is issued for the premises and persons named in the application and is not transferable. Tell DHSR in writing at least 30 days before a change of ownership; DHSR only processes a change of ownership for an agency with a valid license.
DHSR publishes a list of every licensed home care agency site, with its license number, owner, county, services and expiry date, as a spreadsheet. As of August 2026 it lists 3,336 sites.
Yes. DHSR says the Division of Health Benefits (Medicaid), NCTracks and DHSR are separate, so you notify each of them about new counties and address changes.
The Medical Care Commission makes the home care rules and DHSR updates its forms, checklist and FAQ. Leave your email and we will tell you when either changes something in your policies.
No spam. Only emails about North Carolina home care rule changes. How we use your email.
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