HOME HEALTH SERVICES PROVIDER IN SOUTH CAROLINA

Fatumata Kaba
Oct 13
3 min read

DELIVERING SKILLED MEDICAL CARE AND SUPPORTIVE HEALTH MONITORING TO MEDICAID PARTICIPANTS IN THE COMFORT OF THEIR HOMES

Home Health Services in South Carolina consist of skilled medical services provided to Medicaid recipients who are homebound or require intermittent care. These services are funded under the State Plan Medicaid benefit and various Home and Community-Based Services (HCBS) Waivers, such as CLTC, ID/RD, HASCI, and Community Supports Waiver. Providers may offer nursing, therapy, and aide-level care to help prevent institutionalization and promote independence.

1. GOVERNING AGENCIES

Agency: South Carolina Department of Health and Human Services (SCDHHS)

Role: Administers Medicaid and oversees provider enrollment, reimbursement, and compliance with home health regulations.

Agency: South Carolina Department of Health and Environmental Control (DHEC)

Role: Licenses and inspects home health agencies to ensure safety, quality, and clinical standards.

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

Role: Enforces federal regulations under Medicare Conditions of Participation and Medicaid HCBS waiver standards.

2. HOME HEALTH SERVICES OVERVIEW

These services are prescribed by a physician and delivered in the client’s residence. They address post-acute care, chronic condition management, rehabilitation, and supportive health monitoring.

Approved providers may offer:

Skilled Nursing Services: Medication administration, wound care, disease education, vitals monitoring
Certified Home Health Aide Services: ADL support under nursing supervision
Physical, Occupational, or Speech Therapy
Medical Social Work Support (if medically necessary)
Care Coordination and Documentation for plan of care
Medicaid & Medicare Billing for dual-eligible clients

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the South Carolina Secretary of State
Obtain EIN and Type 2 NPI
Apply for Home Health Agency License through DHEC
Enroll with SCDHHS as a Medicaid home health provider
Employ licensed RNs, therapists, and certified home health aides
Develop a comprehensive Home Health Services Policy & Procedure Manual

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain EIN and NPI

Step 2: Apply to DHEC for Home Health Agency licensure (includes inspection and operational readiness)

Step 3: Enroll with SCDHHS as a Medicaid provider for home health

Step 4: Submit required staff credentials, organizational chart, and care policies

Step 5: Complete provider certification, then begin accepting Medicaid referrals

5. REQUIRED DOCUMENTATION

Business registration, EIN, NPI
DHEC Home Health Agency license
SCDHHS Medicaid enrollment confirmation
Liability, malpractice, and workers’ compensation insurance
Home Health Services Policy & Procedure Manual including:
- Plan of care development and nursing documentation
- Medication management protocols
- Emergency and infection control procedures
- Home health aide supervision and service logs
- HIPAA and participant rights protections
- Billing templates and audit readiness documents

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)

Requirements: SC nursing license, develops care plans, provides skilled services, supervises aides

Role: Certified Home Health Aide (CHHA)

Requirements: DHEC-approved training program, CPR, background check

Role: Physical / Occupational / Speech Therapist (optional)

Requirements: SC licensure, provides therapy under physician orders

Role: Clinical Supervisor / Director of Nursing (required for licensure)

Requirements: RN with administrative experience in home health

All staff must complete:

Orientation on HIPAA and participant safety
Emergency preparedness and infection control
Documentation and billing training
Annual performance reviews and competency testing

7. MEDICAID WAIVER PROGRAMS

Home Health Services are billable under:

CLTC (Community Long Term Care) – For post-acute or chronic care at home
ID/RD Waiver – May authorize nurse visits or therapy for waiver participants
HASCI Waiver – Skilled nursing and therapy for traumatic brain/spinal injuries
Community Supports Waiver – Limited medical care based on need
State Plan Medicaid – Covers medically necessary in-home care with a physician’s order
EPSDT / TEFRA (Under 21) – Pediatric in-home nursing or therapy