FACILITY-BASED DAY SUPPORT SERVICES PROVIDER IN TENNESSEE

Fatumata Kaba
3 days ago
3 min read

DELIVERING STRUCTURED, SKILL-BUILDING, AND COMMUNITY-READY PROGRAMS FOR ADULTS WITH DISABILITIES IN LICENSED FACILITY SETTINGS

Facility-Based Day Support Services in Tennessee offer structured activities in licensed, non-residential settings to help adults with intellectual and developmental disabilities (I/DD) develop skills for greater independence, social interaction, and community inclusion. These services are primarily offered through 1915(c) Waivers, Employment and Community First (ECF) CHOICES, and other TennCare-supported programs for individuals with significant support needs.

1. GOVERNING AGENCIES

Agency: TennCare (Tennessee Medicaid)

Role: Manages reimbursement and service authorizations under State Plan and waiver-based programs.

Agency: Tennessee Department of Intellectual and Developmental Disabilities (DIDD)

Role: Licenses and certifies Facility-Based Day Support providers, monitors safety and compliance, and approves staffing models and program content.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Establishes federal Home and Community-Based Services (HCBS) settings requirements and quality standards.

2. FACILITY-BASED DAY SUPPORT SERVICES OVERVIEW

Facility-Based Day Services are designed to support individuals who may not yet be ready for integrated employment or full community participation. These services must be person-centered and promote:

Skill Development: Daily living skills, communication, self-care, problem-solving
Social Engagement: Peer interactions, teamwork, games, role-playing
Pre-Vocational Readiness: Sorting, assembling, following schedules or simple routines
Health & Wellness Activities: Light exercise, nutrition education, hygiene reminders
Community Preparation: Simulated activities like bus navigation, budgeting, and safety skills

All services must align with the participant’s Individual Support Plan (ISP) and be delivered in compliance with HCBS Final Settings Rule expectations.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Tennessee Secretary of State
Obtain EIN and Type 2 NPI
Secure licensure through DIDD as a Facility-Based Day Services provider
Ensure facility meets health, fire, safety, and accessibility codes
Obtain zoning approval and occupancy permit
Develop a Facility-Based Day Services Policy & Procedure Manual

4. TENNESSEE PROVIDER ENROLLMENT PROCESS

Step 1: Form legal entity and obtain EIN/NPI

Step 2: Apply for certification through DIDD Provider Enrollment Unit

Step 3: Submit facility layout, safety plan, staff credentials, and curriculum outline

Step 4: Pass DIDD facility inspection and policy manual review

Step 5: Receive referrals through ISP teams and begin service delivery

5. REQUIRED DOCUMENTATION

Business registration documents, EIN, and NPI
Proof of commercial general liability and workers’ comp insurance
Facility licensure documents and inspection approvals
Staff rosters, background checks, and training records
Facility-Based Day Services Policy & Procedure Manual including:
- Daily activity and skill-building curriculum
- Participant supervision and emergency procedures
- Behavior support plan implementation
- Staff-to-participant ratio guidelines
- Documentation protocols for progress, attendance, and incident tracking
- Infection control and abuse prevention plans
- Transportation policies (if applicable)

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)

Requirements: Background clearance, training in ISP implementation, CPR/First Aid

Role: Program Coordinator or Day Services Manager

Requirements: Experience in adult education or I/DD services, administrative oversight

Role: Behavior Specialist (if needed)

Requirements: Experience implementing Positive Behavior Supports

All staff must complete:

HCBS person-centered training
Documentation and data tracking instruction
Behavior management and de-escalation techniques
Safety and emergency drills
Ongoing in-service trainings and competency checks

7. MEDICAID WAIVER PROGRAMS

Facility-Based Day Support Services are authorized under:

1915(c) Statewide and Self-Determination Waivers – For adults with I/DD in structured habilitation settings
ECF CHOICES (certain benefit groups) – As a temporary or transitional day service
State-Funded Services via DIDD – If waiver capacity is full or pending
Katie Beckett or EPSDT (under rare conditions) – If deemed necessary and non-duplicative

8. TIMELINE TO LAUNCH

Phase: Business Formation & Facility Readiness

Timeline: 1–2 months

Phase: DIDD Enrollment & Facility Licensing

Timeline: 2–3 months

Phase: Staff Hiring & Policy Manual Development

Timeline: 30–60 days

Phase: Service Delivery Start

Timeline: After ISP team authorization and safety approval

9. CONTACT INFORMATION

Tennessee Department of Intellectual and Developmental Disabilities (DIDD)

Website: https://www.tn.gov/didd

TennCare (Tennessee Medicaid Program)

Website: https://www.tn.gov/tenncare

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

FACILITY-BASED DAY SUPPORT SERVICES PROVIDER IN TENNESSEE

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — TN FACILITY-BASED DAY SUPPORT PROVIDER

WCG equips providers with the tools and strategies needed to build structured, engaging, and compliant day programs for individuals with I/DD in Tennessee.

Scope of Work: