HOME HEALTH SERVICES PROVIDER IN SOUTH DAKOTA

DELIVERING SKILLED CARE IN THE COMFORT OF HOME TO PROMOTE SAFETY, STABILITY, AND QUALITY OF LIFE

Home Health Services in South Dakota provide skilled nursing and therapeutic care to individuals in their homes under the State Plan Medicaid Home Health Benefit and select Home and Community-Based Services (HCBS) Waiver Programs, such as the Medically Fragile Waiver. These services support individuals recovering from illness, managing chronic conditions, or requiring clinical oversight to remain safely at home.

1. GOVERNING AGENCIES

Agency: South Dakota Department of Social Services (DSS) – Medical Services Division

Role: Manages Medicaid Home Health Services and reimbursement protocols.

Agency: South Dakota Department of Health (DOH) – Office of Health Protection

Role: Licenses and inspects home health agencies operating in the state.

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

Role: Regulates federal standards for Medicaid and Medicare-certified home health care.

2. HOME HEALTH SERVICES OVERVIEW

Home Health Services include medically necessary, intermittent skilled care delivered by licensed professionals in the individual’s home or community residence.

Covered services include:

• Skilled Nursing: Wound care, injections, medication management, IV therapy

• Home Health Aide Services: Personal care under nursing supervision

• Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (SLP)

• Medical Social Services (when applicable)

• Clinical Assessments and Ongoing Re-evaluations

• Care Plan Development and Coordination with Providers

• Medicaid Documentation and Billing Support

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business with the South Dakota Secretary of State

• Obtain EIN and Type 2 NPI

• Obtain South Dakota Home Health Agency License from DOH

• Enroll in Medicaid through DSS as a Home Health provider

• If Medicare-certified, maintain CMS accreditation

• Develop a Home Health Services Policy & Procedure Manual

4. SOUTH DAKOTA PROVIDER ENROLLMENT PROCESS

Step 1: Register the entity and obtain EIN/NPI

Step 2: Apply for a Home Health Agency License via DOH

Step 3: Complete Medicaid enrollment through DSS with required credentials

Step 4: Submit policy manual, staff rosters, and service area documentation

Step 5: Undergo state inspection and readiness verification (as applicable)

Step 6: Begin serving participants once approved and referrals are received

5. REQUIRED DOCUMENTATION

• Business registration, EIN, NPI

• DOH Home Health Agency License

• Proof of professional liability, workers’ comp, and general insurance

• Staff licensure and background checks

• Home Health Services Policy & Procedure Manual, including:

  • Care planning, reassessment, and physician communication

  • Medication management, wound care, and infection control

  • Personal care aide protocols

  • Emergency preparedness and after-hours response

  • HIPAA compliance and clinical documentation standards

  • Billing and claim submission templates

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN) / Clinical Supervisor

Requirements: South Dakota RN license, skilled care experience, supervisory training

Role: Home Health Aide (HHA)

Requirements: Certified through an approved training program; supervised by an RN

Role: Licensed Therapists (PT, OT, SLP)

Requirements: Active state license in discipline; documentation competency

Role: Medical Social Worker (optional)

Requirements: MSW and licensure (if needed for high-risk or transitional cases)

All staff must complete:

• HIPAA, infection control, and safety training

• Skills assessments and competency evaluations

• Emergency procedures and documentation training

• Annual continuing education and license renewals

7. MEDICAID WAIVER PROGRAMS & STATE PLAN COVERAGE

Home Health Services are covered through:

• State Plan Medicaid Home Health Benefit – Requires a physician order and a care plan

• Medically Fragile Waiver – For individuals needing ongoing skilled nursing at home

• EPSDT (for youth under 21) – May cover extended home health with physician documentation

• Other HCBS Waivers (limited use) – Home health may be authorized in exceptional cases

8. TIMELINE TO LAUNCH

Phase: Business Registration & Licensing Prep

Timeline: 1–2 months

Phase: DOH Licensing & Policy Manual Development

Timeline: 2–3 months

Phase: Medicaid Enrollment & Readiness Review

Timeline: 1–2 months

Phase: Begin Home Health Service Delivery

Timeline: Upon license issuance and provider number activation

9. CONTACT INFORMATION

South Dakota Department of Health – Office of Health Protection

Website: https://doh.sd.gov

South Dakota Department of Social Services – Medical Services Division

Website: https://dss.sd.gov

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

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

WCG helps RNs, therapy practices, and health entrepreneurs launch fully licensed and Medicaid-approved home health agencies to deliver skilled care in homes across South Dakota.

Scope of Work:

• DOH licensure application support

• Medicaid Home Health enrollment and documentation setup

• Home Health Policy & Procedure Manual creation

• Clinical forms for care planning, medication tracking, and daily notes

• Staff credentialing logs and scheduling tools

• HIPAA compliance training and survey readiness assistance

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.