HOME HEALTH CARE SERVICES PROVIDER IN VERMONT

Fatumata Kaba
2 days ago
4 min read

DELIVERING SKILLED NURSING AND THERAPEUTIC CARE IN THE COMFORT OF HOME TO PROMOTE HEALING, SAFETY, AND INDEPENDENCE

Home Health Care Services in Vermont provide medically necessary skilled care to individuals recovering from illness or injury, living with chronic conditions, or needing rehabilitation. Services are delivered in the individual’s home to help them remain independent, avoid institutionalization, and recover safely with professional support.

Home Health Care is covered under Vermont Medicaid’s State Plan and may be integrated into Home and Community-Based Services (HCBS) Waivers when aligned with the participant’s care plan. Oversight is provided by the Vermont Department of Disabilities, Aging and Independent Living (DAIL), the Department of Vermont Health Access (DVHA), and the Division of Licensing and Protection (DLP).

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1. GOVERNING AGENCIES

Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL)

Role: Coordinates home- and community-based care programs and waiver integration.

Agency: Department of Vermont Health Access (DVHA)

Role: Administers Medicaid enrollment and reimbursement for Home Health services.

Agency: Division of Licensing and Protection (DLP)

Role: Licenses and certifies Home Health Agencies, conducts surveys, and enforces compliance with federal CMS conditions.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Oversees federal Medicare/Medicaid certification for home health providers.

2. HOME HEALTH CARE SERVICES OVERVIEW

Home Health services are prescribed by a physician and delivered under a formal Plan of Care. Services are provided by licensed professionals and must be intermittent (not 24-hour care).

Covered services include:

Skilled nursing (e.g., wound care, IV therapy, medication injections)
Home health aide assistance with ADLs
Physical Therapy (PT)
Occupational Therapy (OT)
Speech-Language Pathology (SLP)
Medical social services and counseling
Chronic disease monitoring and health education
Care coordination and discharge planning

Services must meet medical necessity criteria and follow documentation and quality standards set by CMS and DLP.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with Vermont Secretary of State
Obtain EIN and Type 2 NPI
Apply for a Home Health Agency license through DLP
Complete Medicare/Medicaid certification survey process (CMS 855A)
Enroll with Vermont Medicaid via the DVHA provider portal
Maintain clinical liability and workers’ comp insurance
Develop a CMS-compliant Home Health Policy & Procedure Manual

4. VERMONT PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN and NPI

Step 2: Apply for Home Health license with the Division of Licensing and Protection

Step 3: Submit CMS 855A application for Medicare/Medicaid certification

Step 4: Complete initial survey and Life Safety Code inspection

Step 5: Enroll with DVHA for Medicaid reimbursement

Step 6: Credential staff and prepare for audit-readiness

Step 7: Launch services upon Plan of Care approval and referral

5. REQUIRED DOCUMENTATION

Articles of Incorporation, EIN, and NPI
DLP Home Health license and CMS survey report
Medicare/Medicaid certification letter
DVHA Medicaid enrollment documentation
Home Health Services Policy & Procedure Manual, including:
- Nursing protocols and therapy service scopes
- Physician order and Plan of Care tracking
- Infection control and safety procedures
- Medication administration and chronic care workflows
- HIPAA and patient confidentiality standards
- Emergency response and incident reporting procedures
- Staff supervision, training, and credentialing logs
- Shift notes, billing templates, and outcome tracking tools

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)

Requirements: Vermont licensure; responsible for patient assessments and care plans

Role: Licensed Practical Nurse (LPN)Requirements: Works under RN supervision; provides direct skilled care

Role: Certified Home Health Aide (HHA)

Requirements: Supervised by RN; trained in ADLs and safety monitoring

Role: Physical, Occupational, and Speech Therapists (PT, OT, SLP)

Requirements: Vermont-licensed; services must be physician-ordered

Role: Medical Social Worker (optional)

Requirements: Vermont licensure; offers counseling and resource planning

All staff must complete:

HIPAA and CMS documentation training
Universal precautions and infection control
Annual skills validations and continuing education
CPR/First Aid certification (required for aides)

7. MEDICAID WAIVER PROGRAMS

Home Health services may also be integrated into:

Choices for Care (CFC) Waiver – Skilled nursing and therapies for older adults and adults with physical disabilities
Children with High-Tech Needs Program – Pediatric-focused care
Brain Injury Program – In-home skilled rehabilitation support
Developmental Disabilities Services Waiver – In specific medically complex cases

All services must be tied to a physician’s order and included in the participant’s Individual Support Plan or Plan of Care.

8. TIMELINE TO LAUNCH

Phase: Entity Formation & Policy Manual Development

Timeline: 2–4 weeks

Phase: State Licensing & CMS Certification

Timeline: 3–6 months

Phase: Medicaid Enrollment & Staff Credentialing

Timeline: 1–2 months

Phase: Service Launch

Timeline: Begins upon DLP licensure, Plan of Care approval, and referral authorization

9. CONTACT INFORMATION

Vermont Division of Licensing and Protection (DLP)

Website: https://dlp.vermont.gov

Department of Vermont Health Access (DVHA)

Website: https://dvha.vermont.gov

Vermont Department of Disabilities, Aging and Independent Living (DAIL)

Website: https://dail.vermont.gov

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

HOME HEALTH CARE SERVICES PROVIDER IN VERMONT

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

WCG helps agencies navigate licensing, CMS certification, and Medicaid enrollment to successfully launch compliant Home Health Care programs across Vermont.

Scope of Work: