Step 1.  DHHS - BHFA Application Package

The Application Package for a Change in Ownership of a Health Care Facility (8 pages) is required to be completed and submitted to the Bureau of Health Facilities Administration for licensing a new owner of a licensed residential care or health facility.

Send complete application package and fees to:

NH DHHS, Office of Program Support  

Bureau of Health Facilities Administration

129 Pleasant Street 

Concord, NH  03301-3857

Step 2.  Centers for Medicare & Medicaid Services (CMS) Forms

Certified health facilities also need to complete the:

CMS 855 A form.

Completed CMS 855A forms need to be sent to your fiscal intermediary for processing.