HOME HEALTH SERVICES PROVIDER IN NEW YORK

Fatumata Kaba
Sep 3, 2025
4 min read

PROVIDING COMPREHENSIVE MEDICAL AND PERSONAL CARE TO INDIVIDUALS IN THE COMFORT OF THEIR HOMES

Home Health Services in New York support individuals with medical, therapeutic, and personal care needs, allowing them to receive healthcare at home rather than in a hospital or care facility. These services are designed to promote independence, manage chronic conditions, and provide rehabilitative care. Home Health Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New York State Department of Health (NYSDOH)

Role: Administers Medicaid waiver funding for Home Health Services and oversees provider enrollment, service authorization, and reimbursement.

Agency: Office for People With Developmental Disabilities (OPWDD)

Role: Provides oversight for home health services targeting individuals with developmental disabilities.

Agency: New York State Office of Mental Health (OMH)

Role: Ensures compliance for home health programs serving individuals with mental and behavioral health needs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid-funded Home Health Services meet quality, safety, and person-centered care standards.

2. HOME HEALTH SERVICES OVERVIEW

Home Health Services involve medical care, personal care, and therapeutic support provided in the individual’s home environment.

Approved providers may deliver:

Skilled Nursing Care: Administering medication, wound care, and chronic disease management.
Physical Therapy: Improving mobility and strength through rehabilitative exercises.
Occupational Therapy: Enhancing daily living skills and promoting independence.
Speech Therapy: Assisting with communication and swallowing disorders.
Medical Social Services: Providing counseling and connecting individuals to community resources.
Home Health Aide Support: Assisting with personal care, hygiene, and daily activities.
Medication Management: Ensuring proper administration and monitoring of medications.
Chronic Condition Monitoring: Tracking vital signs and managing health changes.
Post-Hospitalization Care: Supporting recovery at home after hospital discharge.
Documentation: Maintaining detailed records of care plans, treatments, and patient progress.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Home Health provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for medical care, personal care, and patient safety.
Ensure staff complete required background checks, health screenings, and professional licensure verifications.

4. NEW YORK PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application via the eMedNY Portal for Home Health Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, home health policies, and staff licensure documentation.

Program Readiness Review:

NYSDOH, OPWDD, and OMH evaluate provider readiness, including clinical protocols, safety measures, and staff qualifications.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for Home Health Services using designated billing codes.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Home Health Policy & Procedure Manual including:
- Clinical care protocols and medication management
- Infection control measures and hygiene standards
- Staff credentialing, background checks, and ongoing training records
- Documentation standards for care tracking and Medicaid billing
- HIPAA compliance, patient rights, and grievance handling
- Emergency response and patient safety protocols
- Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Home Health Program Director

Requirements: Registered Nurse (RN) license, Bachelor’s or Master’s in Nursing or Healthcare Administration; experience in clinical supervision and home health care.

Role: Registered Nurses (RNs)

Requirements: Active RN license; experience in home health care; CPR and BLS certifications.

Role: Licensed Practical Nurses (LPNs)

Requirements: State licensure; experience in patient care and medication administration.

Role: Home Health Aides (HHAs)

Requirements: Certified HHA training program completion; experience in personal care assistance.

Role: Physical/Occupational/Speech Therapists

Requirements: Appropriate licensure and certification in therapy specialties.

All staff must complete: