Health Facilities Administration

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

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.

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: 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

If you wish to file a complaint against a Home Health Facility, please contact the Home Health Hotline for Complaints: 1-800-621-6232.

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.

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

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.

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

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.

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.

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.