Home Health Care in New Jersey: Regulations, Payment & Workforce Guide

Home Health Agency Requirements in New Jersey

New Jersey requires home health agencies to meet licensing standards established by the Department of Health (DOH) Health Facilities division, with additional oversight from the Division of Consumer Affairs.

Regulatory Framework

Home health agency licensing is governed by:

• N.J.A.C. Title 8, Chapter 42: Licensing Standards for Home Health Agencies
• N.J.S.A. 26:2H-1 et seq.: Statutory authority for health facility licensing
• Regulations current through Register Vol. 57, No. 12 (June 2025)

Regulatory Bodies

New Jersey splits regulatory oversight:

• Division of Consumer Affairs: Regulates agencies employing certified aides
• Board of Nursing: Regulates individual aide certification and scope of practice
• DOH Health Facilities: Establishes and enforces licensing standards

Licensing Requirements

Home health agencies must meet minimum health and safety standards established by state and federal rules and regulations. Key requirements include:

• Compliance with N.J.A.C. 8:42 standards
• Appropriate staffing and supervision structures
• Quality assurance and patient safety protocols
• Employee certification and training verification

Contact Information

For licensing questions and applications:

• NJ DOH Health Facilities: nj.gov/health/healthfacilities/
• Division of Consumer Affairs (CHHA agencies): njconsumeraffairs.gov/hhh

Certified Nursing Assistant (CNA) Certification

New Jersey's CNA certification process is managed by the Department of Health through the Nurse Aide in Long Term Care Facilities Training and Competency Evaluation Program (NATCEP).

Training Requirements

State-approved CNA training programs require:

• 90 hours total training
• 50 hours of classroom instruction
• 40 hours of clinical experience in a NJ-licensed long-term care facility

Certification Process

1. Complete a state-approved NATCEP training program
2. Pass the National Nurse Aide Assessment Program (NNAAP):
   • Written examination testing basic nursing principles
   • Clinical skills test demonstrating key competencies
3. Complete fingerprint-based criminal background check
4. Receive certification from NJ DOH

Renewal Requirements

CNA certification must be renewed every 24 months. Requirements include:

• At least 7 hours of paid employment performing nursing or nursing-related services in a licensed healthcare facility or agency within the 24 months before expiration
• No revocation or suspension of certificate
• Current criminal background check with fingerprinting

Continuing Education

Nurse aides must receive at minimum 12 hours of regular in-service education annually.

Contact Information

• NJDOH CNA Program: (866) 561-5914
• PSI Testing: (877) 774-4243
• Email: [email protected] (include "NATCEP" in subject line)

Certified Home Health Aide (CHHA) Certification

New Jersey maintains a separate Certified Home Health Aide credential for workers providing care in home settings, distinct from facility-based CNA certification.

Training Requirements

CHHA training programs require:

• 76 hours total training
• 60 hours of classroom instruction
• 16 hours of clinical training
• Training over approximately 2.5 weeks

Curriculum Focus

NJ Board of Nursing-approved CHHA programs prepare workers for:

• Home care agency employment
• Assisted living facility positions
• Basic personal care provision
• Nutrition support and rehabilitation services
• Care for patients recovering from illness at home

CNA to CHHA Conversion

Existing NJ CNAs can obtain CHHA certification through a streamlined pathway:

• 10-hour conversion class covering home care and hospice content
• Classroom lecture and final CHHA exam
• Skills training and competency test

Certification Timeline

Upon completing training:

1. Receive conditional approval to work
2. State completes criminal background check
3. Full CHHA certification issued (typically within 120 days)

Managed Long Term Services and Supports (MLTSS)

New Jersey no longer operates traditional HCBS waivers for the aged population. Instead, the state delivers long-term care through a managed care system under the NJ FamilyCare program.

Program Structure

MLTSS operates under the New Jersey FamilyCare Comprehensive Demonstration Waiver (an 1115 Demonstration Waiver). The program consolidated several previous waivers:

• Global Options for Long Term Care (GO)
• Community Resources for People with Disabilities (CRPD)
• Traumatic Brain Injury Waiver (TBI)
• AIDS Community Care Alternatives Program (ACCAP)

Key Advantage: No Waiting Lists

Unlike traditional HCBS waivers, MLTSS does not have enrollment caps. Individuals meeting eligibility criteria can receive services without joining a waiting list—a significant benefit for both consumers and providers.

2025-2026 Financial Eligibility

Category	2025	2026
Income limit (single)	$2,901/month	$2,982/month
Income limit (married, both applying)	$5,802/month	$5,964/month
Asset limit (single)	$2,000	$2,000
Community Spouse Resource Allowance	$157,920	$162,660

Functional Eligibility

Applicants must require Nursing Facility Level of Care (NFLOC), defined as needing hands-on assistance with at least three Activities of Daily Living (ADLs): transferring, mobility, eating, toileting, bathing, or dressing.

Available Services

MLTSS provides comprehensive services in multiple settings:

• Personal care assistance
• Light housekeeping
• Adult day care
• Home modifications
• Respite care
• Medical alert services

Residential Options

MLTSS participants may receive services in:

• Their own home
• Adult family care homes
• Comprehensive personal care homes
• Assisted living residences
• Nursing homes

Contact Information

• Aging & Disability Resource Connection: 1-877-222-3737
• NJ FamilyCare: 1-800-701-0710
• Online: NJ FamilyCare application portal

Personal Preference Program (PPP)

New Jersey's Personal Preference Program offers a self-directed option within MLTSS.

Program Features

• Monthly budget: Participants receive funds to manage their own long-term care needs
• Allowable expenses: Assistive technologies, home modifications, adult day care, personal care services
• Self-direction: Beneficiaries choose their own care providers
• Family hiring: Can hire family members, including spouses, as paid caregivers

Agency Implications

PPP creates both competition and opportunity for agencies. Some agencies serve as fiscal intermediaries for self-directing participants, while others compete with independently hired family caregivers.

PACE/LIFE Program

The Program of All-inclusive Care for the Elderly (PACE), known as LIFE in New Jersey, offers an alternative comprehensive care model.

Eligibility

• Age 55 or older
• Require nursing home level of care
• Eligible for Medicare or Medicaid

Available Counties (10)

PACE/LIFE services are available in: Mercer, Burlington, Camden, Hudson, Cumberland, Gloucester, Monmouth, Atlantic, Cape May, and Salem counties.

Electronic Visit Verification (EVV)

New Jersey implements EVV requirements in compliance with the 21st Century Cures Act.

Required Data Elements

New Jersey's EVV system captures:

• Type of service performed
• Individual receiving the service
• Date and location of service delivery
• Individual providing the service
• Time service begins and ends

Provider Responsibilities

Agencies must integrate EVV with scheduling and billing systems. Staff training on proper documentation is essential for compliance and avoiding claim issues.

Medicare Home Health in New Jersey

Medicare-certified home health agencies in New Jersey must maintain both federal certification and state licensure.

Certification Requirements

Agencies must:

• Meet all federal Conditions of Participation
• Comply with N.J.A.C. 8:42 licensing standards
• Complete successful initial and periodic surveys
• Maintain quality compliance standards

PDGM Operations

New Jersey agencies operate under the Patient-Driven Groupings Model (PDGM) with 30-day payment periods. Success requires accurate OASIS assessment, appropriate clinical coding, and efficient visit utilization.

New Jersey Labor Laws for Home Care

New Jersey provides strong worker protections including the Domestic Workers' Bill of Rights, high minimum wages, and comprehensive overtime coverage.

Minimum Wage Schedule

Category	2025	2026
Standard minimum wage	$15.13/hour	$15.92/hour
Seasonal/small business	$14.53/hour	$15.23/hour
Long-term care direct staff	$18.49/hour	$18.92/hour

Note: Long-term care facility direct staff receive a premium minimum wage significantly above standard rates.

Overtime Requirements

• 1.5x regular rate after 40 hours per workweek
• No companion exemption: New Jersey provides overtime coverage for all companions as defined in FLSA
• Home care workers employed by agencies are fully covered

Domestic Workers' Bill of Rights (Effective July 1, 2024)

Governor Murphy signed S-723/A-822 into law on January 12, 2024, establishing comprehensive protections for domestic workers including home care aides.

Written Contract Requirement

For work exceeding 5 hours per month, employers must provide written contracts specifying:

• Duties and responsibilities
• Base wage and overtime wage
• Weekly schedule
• Manner of payment
• Break, leave, and sick time policies
• Paid holidays
• Sleeping period (if applicable)
• Personal time allowances
• Value of housing provided (if applicable)
• Transportation requirements

Required Breaks

• Meal break: 30 minutes after 5 hours of work (paid unless worker is not working and can leave)
• Rest break: 10 minutes for every 4 hours worked
• Day off: Unpaid day off after 6 consecutive work days (live-in workers)

Termination Notice Requirements

• Standard: 2-week minimum notification before termination
• Live-in workers: 4-week minimum notification

Paid Sick Time

Household employers must provide up to 40 hours of paid sick time annually.

Independent Contractor Classification

New Jersey actively enforces misclassification rules. Classifying caregivers as independent contractors rather than employees can result in significant legal consequences. Agencies should ensure proper employment classification.

Workforce Challenges and Strategies

New Jersey agencies face workforce dynamics shaped by high wage requirements, strong worker protections, and competition from self-directed care options.

Key Challenges

• High labor costs: $15.92 minimum wage and long-term care premiums ($18.92) increase operational costs
• Domestic Workers' Bill compliance: Written contracts, breaks, and termination notice requirements add administrative burden
• PPP competition: Self-directed care allows consumers to hire family members directly
• Dual certification system: Managing both CNA and CHHA credentials requires robust HR systems
• No overtime exemption: Full overtime coverage for companions increases costs

Effective Strategies

• Embrace compliance as differentiation: Position robust worker protections as quality indicators
• Streamline CNA-to-CHHA conversion: Support credentialing with subsidized 10-hour conversion classes
• Contract templates: Develop compliant written employment contracts for efficient onboarding
• MLTSS partnerships: Build relationships with managed care organizations for referral streams
• Fiscal intermediary services: Consider offering support services for PPP self-directing consumers
• Training pipeline: Partner with community colleges offering CHHA programs

Retention Best Practices

• Wages competitive with long-term care facility rates ($18.92+)
• Comprehensive benefits differentiating from self-employment
• Clear career advancement from CHHA to CNA to nursing pathways
• Paid sick time compliance with transparent policies
• Recognition programs celebrating worker contributions

Resources and Links

• NJ DOH Health Facilities Rules
• Division of Consumer Affairs - CHHA
• NJ DOH Nurse Aides
• MLTSS Program
• Domestic Workers' Bill of Rights
• N.J.A.C. 8:42 Licensing Standards

The Bottom Line

New Jersey's home health care environment combines strong worker protections with a managed care delivery system that eliminates traditional waiver waiting lists. The Domestic Workers' Bill of Rights, dual CNA/CHHA certification structure, and premium long-term care wages create both compliance obligations and opportunities for agencies willing to invest in workforce excellence. Success in the Garden State requires embracing these protections as quality differentiators while building efficient systems to manage the administrative requirements.