North Carolina · DHSR licensure · Updated October 20, 2026

NC Home Care Licensure Policy and Procedure Manual: How DHSR Reviews It

Your policies, procedures and personnel documents are North Carolina’s initial survey. Here is the licensure process step by step and what to have ready.

Short answer: In North Carolina, your policy and procedure manual is the initial survey. DHSR’s procedure says that after it reviews your application, staff email a request for your policies, procedures and personnel documents. The initial survey is then conducted by reviewing those documents for licensure compliance. If nothing more is needed, you get an approval letter by email.

How NC home care licensure works, step by step

Step	What happens (per DHSR)
1. Before applying	DHSR tells applicants to review the Initial Home Care Survey Checklist and the 10A NCAC 13J rules.
2. Application	Complete the licensure application, include the fee (check, money order or certified check payable to the N.C. Division of Health Service Regulation), and include proof that you previously owned and operated a home care agency or completed home care provider training. Mail it to DHSR.
3. Packet review	DHSR reviews the packet for accuracy and completeness and emails confirmation that it received the packet and fee.
4. Document request	DHSR emails a request for your policies, procedures and personnel documents.
5. Initial survey	DHSR reviews those documents for licensure compliance. If no further information is needed, you get an approval letter by email with instructions for getting your license.
6. Renewal	After initial licensure, the license is renewed every year.

DHSR says you have one year (12 months) from when it receives your initial application and fee to finish the licensure requirements. It also says the main reason applicants aren’t approved is that they don’t understand or comply with the initial survey checklist and the licensure rules.

What to have ready when DHSR asks for your documents

Policies and procedures

The eleven written policies 13J .1001(a) requires, from scope of services to community referrals
A geographic service area policy (13J .1001(g))
Infection control and TB policies (13J .1003)
Client rights notice and receipt (13J .1007; G.S. 131E-144.3, -144.4)
In-home aide duties, plan of care and 90-day supervision (13J .1107, .1110, .1202)
Service records and retention (13J .1401)

Personnel documents

13J .1003(f) lists what a personnel record holds: an application or résumé with verifiable education, training and work history; a signed job description; reference checks; TB records; hepatitis B immunization or declination and pathogen training for hands-on staff; annual evaluations; credential checks; and supervisor-verified competency in each assigned task. Add the Health Care Personnel Registry check (G.S. 131E-256) and the criminal history check (G.S. 131E-265).

Common reasons a manual slows licensure down

A national template that never mentions 13J, or uses another state’s supervision and retention numbers
Missing one of the eleven .1001(a) topics, often the time frame for returning service records or community referrals
No geographic area policy, or an area wider than the in-home aide distance limit in .1107
Personnel files that don’t match the manual’s own hiring procedure
Companion-only agencies using rules that the 2023 home assistance services law changed

For the rule-by-rule detail, read North Carolina home care agency policies and procedures.

Survey-ready documents

North Carolina Home Care Policy Manual

The policies DHSR reviews at the initial survey, mapped to 13J, plus the personnel forms. 108 pages, editable Word plus PDF, $79.

See the NC manual

FAQ

Does DHSR visit my office for the initial survey?

DHSR’s published procedure describes the initial survey as a review of your policies, procedures and personnel documents. Licensed agencies can still be inspected later.

How long does NC home care licensure take?

DHSR says applicants have one year (12 months) from receipt of the initial application and fee to complete the requirements.

Do I need home care training to apply?

DHSR asks for proof that you previously owned and operated a home care agency, or that you completed home care provider training.

How do I contact DHSR’s Acute and Home Care Licensure Section?

DHSR’s home care licensure page lists 919-855-4620.

Sources

This page summarizes North Carolina rules, statutes and DHSR guidance as reviewed on October 19–20, 2026 and is not legal advice. Confirm current requirements with the NC Division of Health Service Regulation.