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Home care staff requirements in New Hampshire

New Hampshire licenses home health care providers under He-P 809 and non-medical personal care and homemaker agencies as home care service provider agencies under He-P 822. Both require a New Hampshire Department of Safety criminal record check and a state elder abuse (BEAS) registry check before hire, a physical exam or health screening plus two-step TB testing before client contact, orientation before client contact, and annual in-service. Personal care workers who help with bathing, dressing, feeding or transfers need at least 8 hours of training first, and they must be supervised every six months.

Licenses

• Home health care providers are licensed under He-P 809 by the Department of Health and Human Services (He-P 809).
• Agencies that provide personal care or homemaker services through their employees are licensed as home care service provider agencies (HCSPAs) under He-P 822, unless they hold a He-P 809 license or another listed exemption (He-P 822.02).

Background checks

• Before hiring, the agency must get a New Hampshire Department of Safety criminal record check for every employee, volunteer and contractor who will give direct or personal care, except Board of Nursing licensees (He-P 822.17(b)(1); He-P 809.17(b)(1)).
• Agencies must verify the applicant is not on the state BEAS registry (Bureau of Elderly and Adult Services) and may not employ someone listed there unless BEAS grants a waiver (He-P 822.17(b)(4) and (g)(1); He-P 809.17(f)(1)).
• Agencies may not hire anyone convicted of a felony, sexual assault, violent crime, assault, fraud, theft, abuse, neglect or exploitation, or with an administrative finding of such conduct, unless the Department grants a waiver (He-P 822.17(c); He-P 809.17(c)).
• If disqualifying information is learned after hire, the agency must notify the Department right away and either stop using the person or request a waiver (He-P 822.17(e); He-P 809.17(d)).
• All staff must sign a statement at hire and every year that they have no disqualifying convictions or findings (He-P 822.17(t); He-P 809.17(r)).
• Board of Nursing licensees, such as LNAs, must be verified on the Board of Nursing licensing site or nursing assistant registry (He-P 822.17(g)(2); He-P 809.17(f)(2)).

Training and competency

• All staff must receive orientation before client contact covering client rights, job duties, agency policies, infection control, emergency plans, mandatory abuse reporting and body mechanics (He-P 822.17(i)(4); He-P 809.17(h)(4)).
• All staff must complete annual in-service education on client rights, infection control and emergency procedures (He-P 822.17(i)(5); He-P 809.17(h)(5)).
• Personal care workers must complete at least 8 hours of training before helping clients with transfers, feeding, bathing or dressing (He-P 822.17(n); He-P 809.17(l)).
• The 8-hour training must cover the role of the worker, communication, home safety and emergencies, personal care skills, transfers, nutrition, assistive devices, fall prevention, medication reminders and recordkeeping (He-P 822.17(o); He-P 809.17(m)).
• Under the home health rule, the clinical part of the 8-hour training must be taught by a licensed professional such as an LPN or RN (He-P 809.17(l)).
• LNAs are treated as already having the 8-hour training but still need agency orientation (He-P 822.17(p); He-P 809.17(n)).

Health screening

• Before client contact, staff must provide results of a physical exam or health screening by a licensed nurse or practitioner and a two-step TB test (Mantoux or other CDC-approved method), both done within 12 months before hire (He-P 822.17(i)(7); He-P 809.17(h)(7)).
• Staff may start work while waiting for the second step of the TB test if the first step is negative (He-P 822.17(i)(8); He-P 809.17(h)(8)).
• Staff with a past positive TB test get a symptom screen instead of a new TB test (He-P 822.17(u); He-P 809.17(s)).
• Staff with a newly positive TB skin test or suspected active TB must stay out of work until cleared by a licensed practitioner (He-P 822.19(e)).

Also in the personnel file

• Direct care staff must be at least 18 unless they are an LNA supervised by an RN or a supervised student (He-P 822.17(i)(6); He-P 809.17(h)(6)).
• Agencies must supervise each personal care worker every six months (He-P 822.17(r); He-P 809.17(p)).
• In home care service provider agencies, the director of client services must observe each personal care worker quarterly and do an annual evaluation (He-P 822.17(s)).
• Job descriptions must list duties, physical requirements and qualifications (He-P 822.17(a); He-P 809.17(a)).
• Employee files must include the application, signed client rights acknowledgment, signed job description, orientation and in-service records, licenses, health and TB records, the annual signed statement, the criminal record check and registry check results (He-P 822.17(w); He-P 809.17(v)).

Common questions

Some rules for New Hampshire weren't confirmed from an official source. Check with the state before relying on this page.

Sources

• N.H. Admin. Rules He-P 800 (includes He-P 809 Home Health Care Providers and He-P 822 Home Care Service Provider Agencies), NH General Court

This page summarizes state licensing rules in plain words, with links to the rules themselves. It is not legal advice, rules change, and your license type decides what applies: check the linked source and your licensing agency. Medicare-certified home health agencies also follow 42 CFR 484.80. Checked October 2026.

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