Facility Licensure Information

A person can operate a nursing home after obtaining a license from the Division of Health Service Regulation (DHSR). A person may operate a nursing home or a combination home in the same building or in two or more buildings adjoining, or next to each other on the same site.

Once DHSR determines the nursing home complies with North Carolina laws and rules, DHSR will license the applicant. DHSR charges the applicant a nonrefundable initial license fee in the amount of $470.00 plus a nonrefundable initial per bed fee of $19.00.

Each nursing home must renew its license annually. Upon approval of the yearly renewal application, DHSR renews the license to operate. The nonrefundable annual license renewal fee is $420.00 base fee, plus a per-bed fee of $17.50. DHSR will not renew a license if outstanding fees and penalties imposed by the state against the home have not been paid.

Nursing Home Application

The information below provides step-by-step guidance on how to establish nursing home beds as a part of a continuing care retirement community and in a nursing home.

Change of Ownership (CHOW)

Bed Breakdown

These are the forms needed for making a change to the number of certified beds in a nursing facility. A floor plan is also required.

Administrator and Director of Nursing Change

Nursing homes are required to notify the Nursing Home Licensure and Certification Section within one working day following the occurrence of change in administrator or director of nursing. Please submit the completed Admin-DON Change form to DHSR.NH.ADMandDON.CHANGES@dhhs.nc.gov.

Please note we have added a request for the Nursing Home Administrator’s NCID user name so that we can associate the NHA with the facility in the Enterprise licensing system.

Changing the Name of a Nursing Home

To change the name of a nursing home with the Nursing Home Licensure and Certification Section, please send the following:

Send the documents to:

Qwonthafia Jones
2711 Mail Service Center
Raleigh, NC 27699-2711

In addition, applicants must complete a Medicare Enrollment Application - Institutional Providers, CMS-855A (PDF, 1.04 MB). This process is used to ensure that providers/suppliers meet the requirement of Sections 1814(a)(1) and 1833 (e) of Title XVIII of the Social Security Act, which authorizes collection of information to determine Medicare program payments.

You need to submit this completed form and direct any questions regarding the completion of this form to your Medicare Administrative Contractor.

Questions? Call 919-855-4536, or e-mail Qwony.Jones@dhhs.nc.gov.