Nursing Home License Application
About this free form template

Nursing Home License Application Template

Applying for a nursing home license requires detailed documentation of your facility's capacity, staffing, services, and compliance measures. Whether you're opening a new skilled nursing facility, expanding an existing operation, or renewing your license, this Nursing Home License Application template from Paperform helps you collect all the necessary information in one comprehensive, professional form.

Why Use This Nursing Home License Application Form?

Healthcare licensing involves extensive regulatory requirements, staff qualification documentation, and facility specifications. This template streamlines the application process by organizing all required information into clear sections—from bed capacity and nursing staff ratios to infection control protocols and CMS certification status.

Built for state health departments, healthcare licensing boards, and regulatory agencies, this form ensures applicants provide complete, accurate information while reducing back-and-forth requests for missing documentation.

What's Included in This Template

This comprehensive application covers all essential aspects of nursing home licensing:

  • Facility information including legal name, ownership structure, and contact details
  • Bed capacity and unit breakdown for different levels of care
  • Nursing staff ratios to ensure adequate patient-to-staff coverage
  • Dining facilities and nutritional services documentation
  • Activities and therapeutic programs for resident engagement
  • Infection control policies and procedures
  • CMS certification status and Medicare/Medicaid participation
  • Emergency preparedness plans and evacuation procedures
  • Building and safety compliance documentation
  • File upload capability for required supporting documents

Who Should Use This Form

This template is designed for:

  • State health departments processing nursing home license applications
  • Healthcare licensing agencies managing skilled nursing facility permits
  • Long-term care facilities applying for new licenses or renewals
  • Healthcare administrators preparing compliance documentation
  • Regulatory compliance officers tracking facility certifications

How Paperform Enhances Healthcare Licensing

Paperform makes regulatory applications faster and more accurate:

Professional presentation ensures your form meets government standards while remaining easy to complete. The document-style editor lets you include detailed instructions, regulatory references, and helpful guidance throughout the application.

Conditional logic shows or hides questions based on facility type, bed count, or certification status—ensuring applicants only see relevant sections and don't waste time on inapplicable requirements.

File uploads let applicants attach floor plans, staff credentials, insurance certificates, inspection reports, and other required documentation directly within the form, keeping everything organized in one place.

Calculation fields automatically verify staff-to-patient ratios meet state requirements, flagging potential issues before submission.

Streamline Your Workflow with Stepper

Once a nursing home license application is submitted, there's typically a multi-step review process involving different departments and inspections. With Stepper, Paperform's AI-native workflow automation platform, you can automatically:

  • Route applications to the appropriate reviewing officer based on facility type or location
  • Send automatic confirmations to applicants with application tracking numbers
  • Create inspection scheduling workflows that notify field staff of new applications
  • Update internal databases or case management systems with application data
  • Trigger email notifications at each review stage (initial review, inspection scheduled, deficiencies noted, license approved)
  • Generate approval letters or deficiency reports based on review outcomes

This eliminates manual data entry and ensures every application moves through your process consistently, with full visibility into status and bottlenecks.

Why Healthcare Agencies Trust Paperform

Healthcare licensing requires serious data security and compliance. Paperform provides:

  • SOC 2 Type II compliance ensuring your data handling meets rigorous security standards
  • Data residency controls to keep sensitive information within required jurisdictions
  • Role-based permissions so only authorized staff can access applications
  • Encrypted data transmission protecting applicant information
  • Audit trails documenting who accessed or modified applications

For agencies managing multiple facility types or jurisdictions, Agency+ plans let you create separate forms for nursing homes, assisted living facilities, and other healthcare licenses under one account, with centralized billing and team management.

Get Started in Minutes

This template is ready to customize for your state's specific licensing requirements. Add your agency branding, adjust bed capacity ranges, modify staffing ratio requirements, and include your jurisdiction's specific compliance questions. The document-style editor makes it easy to insert regulatory citations, update fee schedules, or add new sections as requirements change.

Paperform's generous usage limits and predictable pricing mean you won't face surprise charges during busy application periods. Whether you process 10 applications or 1,000, you'll have the capacity and features you need.

Transform Your Licensing Process

Manual nursing home license applications mean chasing missing documents, deciphering illegible handwriting, and manually entering data into tracking systems. This template, combined with Paperform's payment processing (for application fees), workflow automation, and integration capabilities, modernizes the entire process.

Start with this template today and give your agency—and applicants—a faster, clearer, more professional licensing experience. Trusted by over 500,000 teams worldwide, Paperform brings government-grade security with small-business simplicity to healthcare licensing.


Ready to digitize other healthcare permits and inspections? Explore Paperform's 30,000+ templates for health department applications, inspection checklists, and compliance reporting.

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logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
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