ADULT HEALTH SERVICES PROVIDER IN NEBRASKA

PROMOTING WELL-BEING AND INDEPENDENCE THROUGH PERSONALIZED HEALTHCARE SUPPORT

Adult Health Services in Nebraska offer comprehensive healthcare and support for adults with chronic conditions, disabilities, or age-related needs. These services focus on maintaining physical and mental well-being while enabling individuals to live independently. Adult Health Services are authorized under the Nebraska Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Nebraska Department of Health and Human Services (DHHS)

Role: Administers Medicaid waiver funding for Adult Health Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Nebraska Medicaid and Long-Term Care (MLTC) Division

Role: Ensures quality standards, service delivery, and compliance for Adult Health Services under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Medicaid-funded Adult Health Services meet HCBS quality, person-centered planning, and participant protection standards.

2. ADULT HEALTH SERVICES OVERVIEW

Adult Health Services provides personalized healthcare support to adults who need assistance due to age-related conditions, chronic illnesses, or disabilities.

Approved providers may deliver:

• Health Monitoring: Routine checks on vital signs, blood pressure, and chronic disease management.

• Medication Management: Medication administration, reminders, and compliance monitoring.

• Personal Care Assistance: Help with Activities of Daily Living (ADLs) such as bathing, grooming, dressing, and mobility.

• Therapeutic Services: Physical, occupational, and speech therapy to support functional independence.

• Mental Health Support: Counseling and behavioral support for individuals with mental health needs.

• Nutritional Support: Meal planning, dietary education, and assistance with feeding.

• Chronic Disease Management: Care planning and health education for conditions like diabetes, hypertension, and COPD.

All services are provided based on the Individualized Service Plan (ISP) to meet the participant’s specific health and wellness needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the Nebraska Secretary of State.

• Obtain EIN from the IRS and NPI (Type 2).

• Enroll as a Medicaid Waiver Adult Health Services provider via the Nebraska Medicaid Provider Enrollment Portal.

• Obtain licensure as a healthcare service provider from DHHS if applicable.

• Maintain general liability and professional liability insurance.

• Develop comprehensive policies for patient care, medication management, and safety.

• Ensure healthcare staff meet background checks, licensure, and training requirements.

4. NEBRASKA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the Nebraska Medicaid Provider Enrollment Portal for Adult Health Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, healthcare staff credentials, and policy manuals.

Program Readiness Review:

• DHHS evaluates provider readiness, including healthcare protocols, staff qualifications, and patient safety procedures.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Adult Health Services using designated billing codes.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Nebraska Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Healthcare Service License (if applicable)

• Proof of general and professional liability insurance

• Adult Health Services Policy & Procedure Manual, including:

  • Patient assessment, care planning, and health monitoring procedures

  • Medication management and chronic disease care protocols

  • Personal care assistance and daily living support guidelines

  • Staff credentialing, background checks, and ongoing training records

  • HIPAA compliance, patient rights, and grievance handling

  • Billing, documentation, and audit readiness procedures

  • Infection control, safety, and wellness monitoring practices

6. STAFFING REQUIREMENTS

Role: Adult Health Program Director

Requirements: Bachelor’s or Master’s degree in nursing or healthcare administration; licensed Registered Nurse (RN); supervisory experience preferred.

Role: Registered Nurses (RNs)

Requirements: Active RN license in Nebraska, CPR/First Aid certification, clinical experience in adult healthcare.

Role: Licensed Practical Nurses (LPNs)

Requirements: Active LPN license, supervised by an RN, and experience in providing in-home nursing care.

Role: Personal Care Aides (PCAs)

Requirements: High school diploma or GED; basic caregiving skills, supervised by an RN or therapist.

Role: Mental Health Support Staff

Requirements: Certification or licensure in mental health support; experience in behavioral interventions.

All staff must complete:

• Safety, infection control, and wellness training

• HIPAA compliance and patient rights education

• Ongoing professional development and competency evaluations

• Annual performance reviews and skills assessments

7. MEDICAID WAIVER PROGRAMS

Adult Health Services are available under the following Nebraska Medicaid Waivers:

• Aged and Disabled (AD) Waiver

• Traumatic Brain Injury (TBI) Waiver

• Developmental Disabilities (DD) Waiver

• Children with Disabilities Waiver

• Home and Community-Based Services (HCBS) Waiver

Services may include:

• Health monitoring and chronic disease management

• Personal care assistance and daily living support

• Physical, occupational, and speech therapy

• Mental health counseling and behavioral support

• Nutritional planning and meal preparation assistance

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: Nebraska Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Adult Health Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Nebraska Department of Health and Human Services (DHHS)

Website: https://dhhs.ne.gov/

Nebraska Medicaid and Long-Term Care (MLTC) Division

Website: https://dhhs.ne.gov/Pages/Medicaid.aspx

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEBRASKA ADULT HEALTH SERVICES PROVIDER

WCG supports healthcare agencies in launching Medicaid-compliant Adult Health Services in Nebraska, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing support

• Policy manual development tailored to adult healthcare and wellness

• Staff credentialing, training program templates, and patient care documentation guidance

• Medicaid billing setup and audit-prepared financial management

• Branding, outreach, and community engagement strategies

• Quality assurance systems for infection control, patient safety, and compliance

• Collaboration with healthcare providers and social support networks

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.