Health Facilities Administration

Health Facilities Administration (HFA) is responsible for the oversight and enforcement of basic standards designed to promote safe and appropriate care of persons receiving care and treatment in hospitals and other medical facilities, residential facilities, and through nonresidential health care providers.

HFA is comprised of several specific program areas, including:

  • The Health Facility Licensing Unit
    • Life Safety Code & Health Facility Construction
  • The Health Facility Certification Unit
  • The Community Residences Certification Unit
  • Clinical Laboratory Improvement Amendments (CLIA) Certificates

Health Facility Licensing Unit

The Health Facility Licensing Unit licenses and inspects a variety of health facilities, residential facilities and nonresidential health care providers including:

  • Psychiatric residential treatment programs
  • Adult day programs that provide services to three or more patients
  • Adult family care homes
  • Ambulatory surgical centers
  • Assisted living residence – residential care facilities
  • Assisted living residence – supported residential care facilities
  • Birthing centers
  • Collecting stations
  • Educational health centers
  • End stage renal dialysis centers
  • Freestanding emergency rooms
  • Freestanding megavoltage therapy
  • Home care service providers
  • Home health care providers
  • Home health hospice providers
  • Hospice houses
  • Hospitals and specialty hospitals
  • Individual Home Care Service Providers
  • Intermediate care facilities
  • Laboratories
  • Non-emergency walk-in care centers
  • Nursing facilities
  • Residential treatment and rehabilitation facilities
  • Substance Use disorder residential treatment facility

The Health Facility Licensing Unit investigates and attempts to resolve complaints filed against licensed health facilities, residential facilities and nonresidential health care providers. 

Health Facility Certification Unit

The Health Facility Certification Unit is the contract survey agency for the NH Medicaid Office and the US Centers for Medicare and Medicaid Services (CMS). The  Certification Unit certifies and inspects health facilities, nursing facilities and nonresidential health care providers that participate in the Medicare/Medicaid programs.  This unit also handles Clinical Laboratory Improvement Amendments (CLIA) certifications.

Life Safety Code & Health Facility Construction

Any Health Care Facility licensed by the State of NH must be in compliance with the NH State Fire Code including, but not limited to, the Life Safety Code NFPA 101 and the International Building Code. These codes and standards include requirements for sprinkler systems, fire alarms, building code issues, means of egress, and other important fire safety measures.

Community Residence Certification Unit

The Community Residence Certification Unit certifies and inspects community residences and day programs that serve individuals with developmental disabilities, mental illness and traumatic Brain Injury.

Notice

RSA 151:4 Paragraph III(a)(5) which required that an applicant for licensure has notified the public of the intent to file the application in a notice in a newspaper no less than 10 business days prior to the filing of the application has been repealed.

Further, RSA 151:4 Paragraph III (a)(7), requiring all applicants within 15 miles of a Critical Access Hospital (CAH) to notify the CAH was also repealed and has been replaced with RSA 151:4-a. Notification will only be required for Ambulatory Surgical Centers, Emergency Medical Care Centers, Hospitals, Birthing Center, Drop-in or walk-in care center, dialysis centers or special health care services in accordance with the requirements of RSA 151:4-a.

New Applications

If you are filling out an application for a new facility, please visit the Administrative Rules page and read the appropriate rule for the type of license you are applying for. Follow all directions in the rule and on the application. You can also read NH RSA 151.

Reports and Other Resources

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Applications and Forms

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FAQs

What is a Health Facility?

In New Hampshire, there are certain types of facilities that fall under the jurisdiction of the Health Facility Administration unit:

  • Psychiatric residential treatment programs
  • Adult day programs that provide services to three or more patients
  • Adult family care homes
  • Ambulatory surgical centers
  • Assisted living residence – residential care facilities
  • Assisted living residence – supported residential care facilities
  • Birthing centers
  • Collecting stations
  • Educational health centers
  • End stage renal dialysis centers
  • Freestanding emergency rooms-Licensed as Hospitals
  • Freestanding Megavoltage Therapy
  • Home care service providers
  • Home health care providers
  • Home health hospice providers
  • Hospice houses
  • Hospitals and specialty hospitals
  • Individual Home Care Service Providers
  • Intermediate care facilities
  • Laboratories
  • Non-emergency walk-in care centers
  • Nursing facilities
  • Residential treatment and rehabilitation facilities
  • Substance Use Disorder Residential Treatment Facility

What is a Certified Facility?

A certified facility is any facility, such as a hospital, an end stage renal dialysis center, most nursing homes, most ambulatory surgical centers, and home health agencies that participate in the Medicare/Medicaid programs. If you are unsure if a facility is certified, call (603) 271-9039.

What do I do if I want to file a complaint against a facility?

If you wish to file a complaint against a Licensed Health Facility, please contact:

NH Department of Health & Human Services
Health Facilities Licensing Unit
129 Pleasant Street
Concord, NH 03301
Telephone: (603) 271-9039
E-mail: DHHS.HFA-Licensing@dhhs.nh.gov

If you wish to file a complaint against a Certified Health Facility, please contact:

NH Department of Health & Human Services
Health Facility Certification Unit
129 Pleasant Street
Concord, NH 03301-3857
Telephone: (603) 271-9049
E-mail: DHHS.HFA-Certification@dhhs.nh.gov

When filing a complaint, please give us as much information as possible, such as:

  • The name or location of the facility
  • The name of person(s) involved
  • The specific allegations of the complaint
  • Whether you have already filed the complaint with another entity (local officials, Adult Protective Services, DHHS Long Term Care Ombudsman, or NH Attorney General)

Please note that HFA cannot take complaints against physician's offices.  Please contact the NH Board of Medicine at (603) 271-2151.

Can my complaint be anonymous?

Yes! You do not have to tell us your name when filing a complaint. However, depending on the nature of the complaint, HFA may give your complaint to other agencies/entities, such as the Office of Long-Term Care Ombudsman, Adult Protective Services, NH Attorney General, and local officials.

What are the licensing fees for each facility type?

Licensing fees vary by facility type, and are as follows:

  • Hospitals (General, CAH, Psychiatric, Rehabilitation) - $25.00 per licensed bed
  • Nursing Homes - $25.00 per licensed bed
  • Psychiatric Residential Treatment Programs -  $25.00 per licensed bed
  • Residential Treatment and Rehabilitation Facilities - $25.00 per licensed bed
  • Hospice Houses - $25.00 per licensed bed
  • Home Health Hospice Providers - $250.00
  • Home Health Care Providers (809) - $250.00
  • Individual Home Care Service Providers - $25.00
  • Personal Care Providers (822) - Less than 10 clients: $25.00; 10 or more clients: $100.00
  • Non-Emergency Walk-In Care Centers - $500.00
  • End Stage Renal Dialysis Centers - $500.00
  • Ambulatory Surgical Centers - $500.00
  • Educational Health Centers - $500.00
  • Freestanding Emergency Rooms - $500.00
  • Adult Day Care Centers - $200.00
  • Birthing Centers - $150.00
  • Case Management Agencies - $150.00
  • Laboratories - $150.00 per year for each category of testing licensed
  • Collecting Stations - $250.00
  • Adult Family Care Homes - $25.00 per licensed bed
  • Residential and Supported Residential Care Homes - $15.00 per licensed bed
  • Substance Use Disorder Residential Treatment - $25.00 per licensed bed
  • Freestanding Mega Voltage Therapy - $500.00

Why do we need Home Health and Hospice Notes for visits?

As part of the survey process, the surveyors are required to access and review patient records to ensure each facility is in compliance with the Administrative Rules set forth by the Department. Many of our facility types, included Assisted Living, are required by rule to have documentation that includes the name of the agency or individual providing the services, the date services were provided, a brief summary of the services provided, and any care of treatment plans created by the agency. For Home Health and Hospice providers caring for individuals in residential care and nursing facilities, the licensing surveyors are finding that the Home Health and Hospital staff are not leaving notes in patient records after each visit.

I am an Education Health Center, may I perform lab tests?

If you provide these services in the licensed facility, please leave appropriate documentation of the services provided in each record to assist the facility in maintaining compliance with their regulations.

Under NH Administrative Rule He-P 816.16 , Education Health Centers (EHC) may perform certain CLIA waived tests without requiring a New Hampshire Laboratory license. These tests include Rapid Strep Testing, Urine Dip Stick Testing, Finger Sticker Glucose Testing, and Rapid Flu Testing.

If you are performing any test other than those exempted by the rule, you must apply for a laboratory license. If you are performing CLIA waived testing for the sole purpose of risk assessment and the test results are not used for the diagnosis or treatment of disease, then a laboratory license is not required under He-P 808 . In addition, if you are collecting specimens to send out to a laboratory, you will require a collecting station license under He- P 817

What do I need to have available for Personnel Records?

As part of the survey process, the surveyors are required to access and review personnel records to ensure each facility is in compliance with the Administrative Rules set forth by the Department. Many facilities are keeping personnel records off-premises at a main office or holding location. This practice has made it difficult for surveyors to gain access to these records during the survey, or the process is significantly delayed. The rule states that “the licensee shall admit and allow any department representative at any time to inspect the following: (1) The licensed premises; (2) All programs and services provided by the [applicable facility]; and (3) Any records required by RSA 151 and [the applicable] He-P.” This includes personnel records.

The personnel records held off site must be accessible during survey. If a surveyor arrives to conduct a compliance inspection, the personnel records must be available within two hours of the surveyor’s arrival. The surveyor will continue with the inspection until the personnel records are provided. If the surveyor has completed all other aspects of the survey and the personnel records are not available, the facility will be cited. The personnel records are reviewed for many different aspects of compliance and if the surveyor is unable to verify whether or not each of the areas is in compliance, the facility can be cited for multiple deficiencies. We would like to avoid this and encourage you to ensure the personnel records are accessible

What is a reportable incident?

Each rule has a provision regarding reportable or unusual incidents. Although each licensing rule differs in language, the requirements are generally the same. Listed below is the definition and duty section that details the facility’s responsibility to report and what should be reported.

Definitions Duties and Responsibilities of Licensee
 

803.14(t)(1)-(4)

804.03(bx)

804.14(l)(1)-(5)

805.03(bz)

805.14(j)(1)-(3)

806.03(bk)

806.14(x)(1)-(4)

807.03(br)

807.14(x)(1)-(4)

809.03(ba)

809.14(o)(1)-(6)

810.03 (an)

810.14 (o)(1)-(2)

811.03(bu)

811.14(z)(1)-(4)

814.03(bg)

814.14(q)(1)(6)

816.03(ar)

816.14(s)(1)-(4)

817.03(z)

817.14(k)(1)-(2)

818.03(ay)

818.14(s)(1)-(6)

822.03(ay)

822.14(o)(1)-(6)

823.03(bi)

823.14(o)(1)-(7)

826.03(cb)

826.14(w)(1)-(4)

827.03(bx)

827.14(a)(1)

830.03(ch)(1)-(3)

830.14(v)(1)-(5)

Please review your applicable licensing category’s rules for the appropriate reporting requirements. Recently, the department has not received many reports as required by rule. For example, most rules state that an unexplained absence by a resident from a facility is reportable if the facility has searched the facility and its grounds and is unable to locate the resident. Even if the resident is found in 15 minutes down the street by a staff member and brought back safely, this would still be a reportable incident. We expect that each facility report to the department based on the time frame, such as 3 days or 24 hours, and type of incident, such as elopement, detailed in the rule.

Do I need a Communication System in my facility?

Most licensing categories contain a provision in the rule that dictates the licensee’s responsibility for a communication system that allows residents/clients/patients to contact staff when they are in need. Please make sure to evaluate the communication system within your facility to ensure the appropriate equipment or system is in place. The most important aspect of the communication system is whether or not it is effective. The surveyor’s will determine effectiveness by testing the equipment, interviewing residents, attempting to use the system, reviewing the written system that is in place, and more. Please make sure that you do have communication system in place and that it is effective.