HOME HEALTH CARE SERVICES PROVIDER IN INDIANA

DELIVERING SKILLED NURSING, THERAPY, AND PERSONAL CARE SERVICES TO SUPPORT HEALTH AND INDEPENDENCE AT HOME

Home Health Care Services in Indiana offer skilled nursing, therapy, and personal care support to individuals managing chronic illnesses, recovering from surgery, or living with disabilities, helping them maintain health and independence within their homes. These services are authorized under Indiana Medicaid, Medicare, and Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Indiana Family and Social Services Administration (FSSA) — Office of Medicaid Policy and Planning (OMPP)

Role: Administers Medicaid State Plan and HCBS Waiver funding for Home Health Care Services and oversees provider enrollment and reimbursement

Agency: Indiana State Department of Health (ISDH)

Role: Licenses Home Health Agencies (HHAs), conducts facility surveys, ensures compliance with health, safety, and quality standards

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Medicare- and Medicaid-certified Home Health Agencies meet federal Conditions of Participation (CoPs) and participant-centered care standards

2. HOME HEALTH CARE SERVICE OVERVIEW

Home Health Care Services provide intermittent skilled healthcare and personal care services delivered under a physician’s order and an individualized Plan of Care (POC).

Approved providers may deliver:

• Skilled nursing care (e.g., wound care, medication administration, chronic disease management)

• Physical therapy, occupational therapy, and speech-language pathology services

• Medical social services and health education

• Home health aide services for assistance with Activities of Daily Living (ADLs) like bathing, dressing, grooming, and mobility

• Post-acute recovery care following hospital discharge

• Health condition monitoring and caregiver support

All services must be based on assessed medical necessity and documented in the participant’s Plan of Care (POC).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business entity with the Indiana Secretary of State

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

• Apply for and obtain Home Health Agency License through the Indiana State Department of Health (ISDH)

• Obtain Medicare Certification through CMS (if serving Medicare beneficiaries)

• Enroll as a Medicaid provider through the Indiana Medicaid Provider Enrollment Portal

• Maintain general liability, professional liability, and malpractice insurance

• Develop comprehensive policies for skilled services delivery, participant protections, emergency response, infection control, and documentation

• Ensure clinical staff meet licensure, credentialing, background check, and ongoing training requirements

4. INDIANA PROVIDER ENROLLMENT PROCESS

Initial Application and Pre-Licensure Preparation:

• Submit Home Health Agency license application to ISDH with detailed policies, staffing plans, and facility readiness documents

Licensure and Certification Surveys:

• ISDH conducts pa re-licensure survey; CMS certification survey follows for agencies seeking Medicare/Medicaid certification

Medicaid and Medicare Enrollment:

• Following successful licensure and certification, complete enrollment via Indiana Medicaid Provider Portal and CMS PECOS (Medicare)

Billing Setup:

• Configure claims management systems for Medicaid and Medicare billing, including HCPCS and CPT codes for skilled services

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business Registration (Indiana Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• ISDH-issued Home Health Agency License

• Medicare Provider Number (if applicable)

• Proof of general liability, malpractice, and professional insurance

• Home Health Services Policy & Procedure Manual including:

  • Intake, referral, and care plan development protocols

  • Skilled nursing, therapy, and aide service documentation standards

  • HIPAA compliance, participant rights, and grievance procedures

  • Infection control, emergency preparedness, and critical incident reporting

  • Staff credentialing, licensure verification, competency evaluations

  • Medicaid/Medicare billing and audit-readiness procedures

6. STAFFING REQUIREMENTS

Role: Home Health Administrator

Requirements: Background in healthcare administration; experience with home health management preferred; background clearance

Role: Director of Nursing (DON)

Requirements: Active Indiana Registered Nurse (RN) license; supervisory experience; background clearance

Role: Registered Nurses (RNs) and Licensed Practical Nurses (LPNs)

Requirements: Active Indiana nursing licenses; CPR certification; clinical competency assessments

Role: Therapists (Physical Therapists, Occupational Therapists, Speech-Language Pathologists)

Requirements: Active Indiana licensure in discipline; background clearance

Role: Home Health Aides (HHAs)

Requirements: Completion of state-approved HHA training and competency evaluation; background screening clearance

All staff must complete:

• HIPAA compliance and participant confidentiality training

• Infection control, emergency preparedness, and abuse prevention training

• Skills competency evaluations and annual continuing education

7. MEDICAID WAIVER PROGRAMS AND STATE PLAN COVERAGE

Home Health Care Services are reimbursed through:

• Indiana Medicaid State Plan Home Health Benefit: Skilled nursing, therapy, and home health aide services for medically necessary care

• Aged and Disabled Waiver (A&D): Home health aide and nursing services to support community living

• Traumatic Brain Injury Waiver (TBI): Nursing and therapy services as part of comprehensive rehabilitation supports

Approved providers may deliver:

• Intermittent skilled nursing care

• Physical, occupational, and speech therapy

• Personal care services by home health aides

• Post-acute recovery support services

8. TIMELINE TO LAUNCH

Phase: Business Formation, Licensing, and Policy Development

Timeline: 2–4 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 3–6 months

Phase: ISDH Licensure Inspection and CMS Certification

Timeline: 3–6 months

Phase: Medicaid and Medicare Enrollment and Billing Setup

Timeline: 30–60 days

9. CONTACT INFORMATION

Indiana State Department of Health (ISDH) — Home Health Agency Licensing

Website: https://www.in.gov/health/

Indiana Family and Social Services Administration (FSSA)

Website: https://www.in.gov/fssa/

Centers for Medicare & Medicaid Services (CMS)

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

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — INDIANA HOME HEALTH CARE SERVICES PROVIDER

WCG assists home health agencies, therapy providers, and nursing care organizations in launching Medicaid- and Medicare-compliant Home Health Care Services across Indiana.

Scope of Work:

• Business registration, ISDH licensure application, and Medicare/Medicaid enrollment support

• Development of Home Health Care Services Policy & Procedure Manual

• Staff credentialing templates, care plan templates, and clinical documentation systems

• Medicaid and Medicare billing system setup and claims management support

• Website, domain, and professional branding development

• Clinical compliance programs for infection control, emergency preparedness, and incident reporting

• Quality assurance systems for service delivery monitoring and participant satisfaction

• Strategic partnership development with hospitals, discharge planners, and community organizations

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