50-State Regulatory Atlas District of Columbia
State licensing summary
District of Columbia: healthcare licensing and regulation
District of Columbia: state license; branch rule not confirmed; certificate of need required; not a compact state. Regulator: DC Health.
Educational summary, last reviewed October 17, 2026. Not legal advice — confirm with the state licensing agency or counsel.
13 findings: 8 verified, 5 provisional. How findings are sourced and labelled.
At a glance
- License
- State license requiredVerified
- Regulator
- DC Health
- Branch offices
- State license; branch rule not confirmedProvisional
- Certificate of need
- Certificate of need requiredVerified
- Service area
- Confirm with the state agencyProvisional
- In-state office
- See out-of-state rules below
- Medicare certification
- Separate federal step, only for agencies that bill MedicareVerified
Home health licensing
State license
VerifiedYes. DC Health licenses home care agencies (D.C. Code § 44-501; 22-B DCMR ch. 39). A certificate of need is a step in initial licensure.
In practice: Hold the authority the state requires before the first patient is admitted there, and keep its number, category and expiry with the office it covers.
Source: DC Health: Certificate of need
Certificate of need
VerifiedYes. A certificate of need is required to establish a new home health agency.
In practice: The certificate of need comes before the license and can limit where the agency may serve.
Source: DC Health: Certificate of need
Branch offices
ProvisionalConfirm with the state agency Not established in this review.
In practice: Track each office’s authority on its own where the state licenses offices separately, and with the parent where it lists them.
Source: DC Health: Certificate of need
Service area
ProvisionalConfirm with the state agency Not established in this review.
In practice: Check the patient’s address against the approved service area before accepting a referral.
Source: DC Health: Certificate of need
Out-of-state agencies
ProvisionalConfirm with the state agency Not established in this review.
In practice: A license in one state does not authorize care in another; the patient’s state decides.
Source: DC Health: Certificate of need
Home infusion nursing
Home infusion nursing
ProvisionalConfirm with the state agency Not established in this review.
In practice: Confirm the license category before staffing infusion visits in this state.
Source: DC Health: Certificate of need
Staffing and nurse licensure
Nurse licensure (compact)
VerifiedNot a member of the Nurse Licensure Compact. Nurses caring for patients here need this state’s own license.
In practice: Check each nurse’s license against the patient’s state, not the agency’s.
Detailed state rules for staffing agencies in this state are being added.
Medicare, hospice and VA programs in this state
District of Columbia is not one of the six states in CMS’s Review Choice Demonstration for home health (Illinois, Ohio, Texas, North Carolina, Florida, Oklahoma).
Source: CMS: Review Choice Demonstration for Home Health Services
District of Columbia is not one of the six states (Arizona, California, Nevada, Texas, Georgia, Ohio) where CMS applies its provisional period of enhanced oversight to newly enrolling hospices.
Source: CMS Medical Review: Hospice
VA Community Care Network region
VerifiedDistrict of Columbia is in Community Care Network Region 1, administered by Optum. Agencies join by contracting with the regional third-party administrator, not with VA. VA has re-procured the network as CCN Next Generation with two regions, East and West; which administrator serves which region from 2027 was not announced in the sources reviewed.
Time-sensitive. Region assignments change with CCN Next Generation; recheck VA’s announcements during 2027.
Source: VA: Community Care Network
Nurse entrepreneurship and independent practice
Three separate questions apply in District of Columbia: the nurse’s own license and scope of practice; who must order, prescribe or supervise the clinical service; and whether the business needs an agency, clinic, facility or pharmacy license. Private pay does not mean unregulated. A compact license authorizes the nurse, not the business: nurse licensure here is “Not a compact state” (finding).
District of Columbia is rated full practice on AANP’s State Practice Environment map (05/2026). AANP defines full practice as state law letting nurse practitioners evaluate patients, diagnose, order and interpret tests, and initiate and manage treatment, including prescribing, under the authority of the state board of nursing.
In practice: AANP’s rating is a national advocacy framework, separate from the Nurse Licensure Compact and from state law itself. Practice authority is set by the state’s nurse practice act and board.
Source: AANP State Practice Environment map (05/2026)AANP: State practice environment
No board of nursing or medical board guidance specific to IV hydration was found for the District of Columbia in the sources searched. General nurse practice, prescribing and pharmacy law still applies; this is not a finding that elective IV is permitted.
Not yet confirmed — check with the District of Columbia board of nursing.
Source: D.C. Code §44-501
Standing orders for elective IV
Not yet researchedNot yet researched for District of Columbia — confirm with the District of Columbia board of nursing. Nothing is inferred from the absence of a finding.
The District defines a home care agency as an organization “that directly provides skilled nursing services and at least one other therapeutic service” (D.C. Code §44-501), so a nursing-only business falls outside the definition; adding a second therapeutic service brings it in.
Source: D.C. Code §44-501
RN PICC insertion
Not yet researchedNot yet researched for District of Columbia — confirm with the District of Columbia board of nursing. Nothing is inferred from the absence of a finding.
LPN/LVN IV therapy limits
Not yet researchedNot yet researched for District of Columbia — confirm with the District of Columbia board of nursing. Nothing is inferred from the absence of a finding.
Boards and documents cited
Federal rules that apply in every state
Medicare certification
VerifiedMedicare certification under the home health Conditions of Participation (42 CFR Part 484) is a federal step for agencies that bill Medicare home health. It is separate from the state license. Where a state ties entry to certification, that state’s findings say so.
In practice: A branch serving a portion of the parent’s area is supervised and administered by the parent agency (42 CFR 484.2).
Source: 42 CFR 484.2
For a Medicare-certified agency, “its personnel must be qualified in all States in which they provide services” (State Operations Manual § 2184).
In practice: Nurse licensure follows the patient’s state.
Medicare’s home infusion therapy benefit is a separate Part B supplier benefit, not a home health benefit. It pays an accredited, qualified home infusion therapy supplier for professional services tied to specific parenteral drugs given through a pump that is durable medical equipment (42 CFR Part 486, Subpart I).
In practice: Most pharmacy-dispensed home infusion is not billable under this benefit; nursing for those patients is usually paid by other payers or under contract.
Compared with Texas
A certificate of need comes before the license. DC is not in the Nurse Licensure Compact.
Other service lines
State rules for these lines are being added to the guide: Medicare home health, Medicare home infusion therapy benefit, Infusion pharmacy, Hospice, Private duty nursing, Personal care and Medicaid HCBS, VA community care, Infusion suites.
Look up a licensed provider
- DC Health facilities directories VerifiedDC Health, Health Regulation & Licensing Administration
Directories of home care agencies, home health agencies and hospices, with nurse staffing agency licensing information.
- Health Care Facility Inspection Reports VerifiedDC Health, Health Regulation & Licensing Administration
Published inspection reports for licensed health care facilities.
National lookups
- Medicare Care Compare — Home health
Medicare-certified home health agencies with quality ratings and services offered.
- Medicare Care Compare — Hospice
Medicare-certified hospices with quality measures.
- CMS Provider Data Catalog — Home Health Care Agencies (6jpm-sxkc)
All Medicare-registered home health agencies with CCN, address, ownership, services, certification date and quality measures, as CSV and an unauthenticated API.
- CMS Provider Data Catalog — Hospice – General Information (yc9t-dgbk)
Medicare-certified hospices with CCN, address, county, ownership type and certification date, as CSV and an unauthenticated API.
- CMS QCOR — HHA 2567 Statements of Deficiencies
Federal survey statements of deficiencies for home health agencies, filterable by state, survey type, tag and CCN, with a full-dataset XLSX download.
- CMS QCOR — Hospice 2567s
Federal survey statements of deficiencies for hospices.
- NPPES NPI Registry
National Provider Identifier records with addresses, authorized official and taxonomies, with a public API.
- HHS-OIG List of Excluded Individuals/Entities (LEIE)
Individuals and entities excluded from federal health care programs, with a monthly downloadable database.
- SAM.gov Exclusions
Federal exclusion records across agencies.
- Nursys QuickConfirm
Nurse license status, discipline / board-issued alerts and expiry, free to employers and the public.
Associations
No DC association found — see the Maryland-National Capital Homecare Association (regional; its coverage of DC is not confirmed) and national associations.
- Maryland-National Capital Homecare Association (MNCHA)Regional; coverage of DC not confirmed
Official sources
About this guide. Published and maintained by Paloma Health Technologies; Findings are cited to official sources, dated and status-labelled; see the editorial policy. Educational summary, last reviewed October 17, 2026. Not legal advice — confirm with the state licensing agency or counsel.