HOME HEALTH CARE SERVICES PROVIDER IN OKLAHOMA

Fatumata Kaba
Sep 8
4 min read

DELIVERING CLINICALLY NECESSARY CARE TO INDIVIDUALS IN THE COMFORT OF THEIR HOMES

Home Health Care Services in Oklahoma provide skilled nursing, therapy, and personal assistance to individuals recovering from illness, managing chronic health conditions, or needing long-term medical oversight. These services are designed to help individuals maintain health, safety, and independence while avoiding unnecessary hospitalization or institutionalization. Home Health Services are covered under Oklahoma Medicaid (SoonerCare), Home and Community-Based Services (HCBS) waivers, and the State Plan.

1. GOVERNING AGENCIES

Agency: Oklahoma Health Care Authority (OHCA)

Role: Administers SoonerCare (Medicaid), approves provider enrollment, and oversees home health billing and service delivery.

Agency: Oklahoma State Department of Health (OSDH)

Role: Licenses and monitors home health agencies operating within the state.

Agency: Oklahoma Department of Human Services (OKDHS)**

Role: Coordinates waiver-based care management and referrals, especially under the ADvantage Waiver.

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

Role: Provides federal oversight, ensuring home health agencies meet quality and compliance standards.

2. HOME HEALTH CARE SERVICES OVERVIEW

Home health care services must be prescribed by a licensed physician and delivered based on an individualized care plan. They are primarily provided by licensed clinicians and trained aides.

Approved providers may deliver:

Skilled Nursing Services: Wound care, injections, medication management, catheter care, IV therapy, and disease monitoring.
Physical Therapy (PT): Recovery support for mobility, strength, and function.
Occupational Therapy (OT): Training for daily activities like dressing, eating, and bathing.
Speech-Language Pathology (SLP): Therapy for communication and swallowing disorders.
Home Health Aide Services: Personal care, bathing, grooming, and mobility assistance under RN supervision.
Medical Social Services: Support with care coordination and access to community resources.
Care Coordination: Communication with physicians, case managers, and family caregivers.
Documentation: Care notes, progress updates, care plan reviews, and SoonerCare billing logs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business with the Oklahoma Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Apply for a Home Care Agency License from the Oklahoma State Department of Health (OSDH).
Enroll with SoonerCare (OHCA) via the Oklahoma Medicaid Provider Portal.
Maintain general and professional liability insurance.
Develop clinical and operational policies, including HIPAA, emergency response, and infection control.
Comply with federal Medicare Conditions of Participation (CoPs) if also billing Medicare.

4. OKLAHOMA PROVIDER ENROLLMENT PROCESS

Licensing Application:

Apply to OSDH for a Home Care Agency license (Skilled or Personal Care category).

Medicaid Enrollment:

Once licensed, enroll as a SoonerCare provider with OHCA.

Readiness Review:

OSDH may perform an on-site inspection to ensure compliance with health and safety standards.

Approval & Billing Activation:

Upon approval, providers receive billing credentials and may begin offering home health services under SoonerCare.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License
IRS EIN confirmation
NPI registration
Home Care Agency License (OSDH)
Insurance documentation
Home Health Policy & Procedure Manual, including:
- Clinical care guidelines for skilled nursing and therapy
- Emergency response and infection control protocols
- Staff credentialing and supervision processes
- Documentation and SoonerCare billing policies
- HIPAA and participant rights procedures
- Incident reporting and grievance handling
- Quality assurance and plan-of-care review tools

6. STAFFING REQUIREMENTS

Role: Administrator / Clinical Supervisor

Requirements: Licensed RN with home health and supervisory experience.

Role: Registered Nurses (RNs)**

Requirements: Active Oklahoma license; responsible for skilled care delivery and care plan updates.

Role: Licensed Practical Nurses (LPNs)**

Requirements: Oklahoma licensure; work under RN supervision to perform delegated nursing tasks.

Role: Home Health Aides (HHAs)**

Requirements: STNA, CNA, or certified HHA training; trained in personal care and infection control.

Role: Therapists (PTs, OTs, SLPs)**

Requirements: Licensed and credentialed in Oklahoma; Medicaid enrolled.

Role: Medical Social Workers (MSWs)**

Requirements: Licensed clinical social workers with experience in discharge planning or in-home services.

All staff must complete:

Orientation on home health policies and safety procedures
HIPAA and participant rights training
Ongoing professional development and annual competency assessments
Background checks, TB tests, and CPR/First Aid certifications

7. MEDICAID WAIVER PROGRAMS

Home Health Care Services are available through:

State Plan SoonerCare (Medicaid)
ADvantage Waiver Program – for seniors and adults with physical disabilities
Medically Fragile Waiver – for individuals requiring skilled medical support at home
Living Choice Program – for individuals transitioning from institutional settings
DDS Waivers (limited skilled care when authorized)
MyLife MyChoice (self-direction with some home health coordination)