HOME HEALTH CARE SERVICES PROVIDER IN WASHINGTON

Fatumata Kaba
6 hours ago
4 min read

DELIVERING SKILLED NURSING, THERAPY, AND HEALTH MONITORING TO INDIVIDUALS IN THE COMFORT OF THEIR HOMES

Home Health Care Services in Washington provide intermittent, medically necessary services to individuals who are recovering from illness, managing chronic health conditions, or requiring short-term support after a hospital stay. These services help clients remain independent, avoid unnecessary institutionalization, and safely heal at home under professional supervision.

Home Health Care is covered under Apple Health (Medicaid) and Medicare when authorized by a physician. Services may also be available to participants of Home and Community-Based Services (HCBS) Waivers, including the Community Options Program Entry System (COPES) and waivers administered by the Developmental Disabilities Administration (DDA).

https://video.wixstatic.com/video/dcc8e4_e15e57572b904fa8aa4a8d6caf590235/1080p/mp4/file.mp4

1. GOVERNING AGENCIES

Agency: Washington State Department of Health (DOH)

Role: Licenses and regulates Home Health Agencies (HHAs) and ensures compliance with federal and state healthcare standards.

Agency: Health Care Authority (HCA)

Role: Administers Apple Health (Medicaid) and oversees Medicaid reimbursement for home health services.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Governs federal participation, Conditions of Participation (CoPs), and Medicare certification for HHAs.

2. HOME HEALTH CARE SERVICES OVERVIEW

Home Health Services must be ordered by a physician and delivered under a Plan of Care.

Covered services may include:

Skilled Nursing Care – Medication administration, wound care, catheter care, IV therapy
Home Health Aide Services – Assistance with personal care under RN supervision
Physical Therapy (PT) – Strength, mobility, and recovery support
Occupational Therapy (OT) – Daily living skills training and adaptation
Speech-Language Pathology (SLP) – Communication and swallowing therapy
Medical Social Work – Crisis intervention, discharge planning, and counseling
Health Education – For patients and family caregivers
Coordination with Primary Care Providers

Home Health Services are intermittent, not 24/7 care, and require clinical documentation and medical necessity.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Washington Secretary of State
Obtain EIN and Type 2 NPI
Apply for a Home Health Agency license through the DOH Facility Licensing and Certification Division
If pursuing Medicare reimbursement: Apply for CMS Medicare Certification
Enroll as a Medicaid provider via the ProviderOne Portal
Maintain clinical liability, malpractice, and worker’s compensation insurance
Create a Home Health Policy & Procedure Manual in accordance with CMS Conditions of Participation and DOH rules

4. WASHINGTON PROVIDER ENROLLMENT PROCESS

Step 1: Register your business, obtain EIN and NPI

Step 2: Submit Home Health Agency license application to DOH

Step 3: Apply for Medicare Certification (if applicable)

Step 4: Enroll in ProviderOne as a Medicaid Home Health provider

Step 5: Complete staff credentialing and background checks

Step 6: Undergo pre-license and post-license inspections

Step 7: Begin services following physician orders and Plan of Care approval

5. REQUIRED DOCUMENTATION

EIN, NPI, and Articles of Incorporation
DOH Home Health Agency license
ProviderOne enrollment confirmation
CMS Certification (if billing Medicare)
Home Health Services Policy & Procedure Manual, including:
- Scope of skilled nursing, therapy, and aide services
- Plan of Care templates and physician communication logs
- Infection control, emergency, and universal precautions policies
- Medication administration and clinical charting protocols
- Staff orientation, credentialing, and continuing education policies
- Patient rights, HIPAA compliance, and grievance procedures
- Billing, time tracking, and shift documentation tools

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)

Requirements: WA licensure, CPR-certified, responsible for clinical assessments and POC implementation

Role: Licensed Practical Nurse (LPN)

Requirements: WA licensure, supervised by RN, may provide skilled nursing care

Role: Certified Home Health Aide (CHHA)

Requirements: Trained in ADLs, works under RN supervision, must meet DOH standards

Role: Therapists (PT, OT, SLP)

Requirements: Licensed by DOH, responsible for treatment plans and service delivery

Role: Medical Social Worker (MSW) (optional)

Requirements: Licensed in social work, supports emotional and planning needs

All staff must complete:

HIPAA and client rights training
Abuse prevention and emergency preparedness
Infection control and safety procedures
Annual competency assessments and continuing education

7. MEDICAID PROGRAMS THAT COVER HOME HEALTH

Home Health is available under:

Apple Health (State Plan Medicaid) – For short-term skilled home care with physician orders
Community Options Program Entry System (COPES) – Home health authorized within the waiver service package
DDA Waivers (Basic Plus, Core) – Skilled care authorized through PCSP
Medicare – If dual-eligible and medically qualified for post-acute care

8. TIMELINE TO LAUNCH

Phase: Business Setup & Licensing Application

Timeline: 1–2 months

Phase: CMS Certification (if applicable)

Timeline: 2–4 months

Phase: ProviderOne Enrollment & Staff Readiness

Timeline: 30–60 days

Phase: Launch of Services

Timeline: Begins upon license approval, staff onboarding, and physician Plan of Care authorization

9. CONTACT INFORMATION

Washington Department of Health (DOH) – Facility Licensing

Website: https://www.doh.wa.gov