HOME HEALTH SERVICES PROVIDER IN TENNESSEE

Fatumata Kaba
3 days ago
3 min read

DELIVERING SKILLED NURSING AND THERAPEUTIC CARE IN THE COMFORT OF HOME FOR TENNESSEANS WITH COMPLEX MEDICAL NEEDS

Home Health Services in Tennessee provide short-term, intermittent, or ongoing medical care at home for individuals recovering from illness, managing chronic health conditions, or requiring support for functional limitations. These services are authorized under TennCare’s Medicaid State Plan, 1915(c) HCBS Waivers, ECF CHOICES, and the Katie Beckett Program for children with medical complexity.

1. GOVERNING AGENCIES

Agency: TennCare (Tennessee Medicaid)

Role: Oversees Medicaid coverage, reimbursement, and prior authorization for home health services.

Agency: Tennessee Department of Health (TDH) – Board for Licensing Health Care Facilities

Role: Licenses home health agencies and monitors clinical compliance and safety standards.

Agency: Department of Intellectual and Developmental Disabilities (DIDD)

Role: Coordinates home-based health supports under waiver programs.

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

Role: Sets federal standards for home health under Medicaid and Medicare.

2. HOME HEALTH SERVICES OVERVIEW

Home Health Services provide clinical care in a home setting for individuals who require skilled medical support, typically under physician orders or as part of an ISP.

Services may include:

Skilled Nursing Care: Medication administration, wound care, injections, catheter care, chronic condition management
Therapy Services: Physical, occupational, or speech therapy (by licensed therapists)
Medical Social Work: Support with psychosocial needs and community resources
Home Health Aide Services: Assistance with ADLs under the supervision of a licensed nurse
Care Coordination & Documentation: Development of care plans, shift documentation, Medicaid billing

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business with the Tennessee Secretary of State
Obtain EIN and Type 2 NPI
Apply for licensure as a Home Health Agency through the Tennessee Department of Health
Enroll as a TennCare provider through applicable MCOs
Apply to DIDD or Katie Beckett (as needed) for home health authorization
Maintain liability, workers’ comp, and malpractice insurance
Develop a Home Health Services Policy & Procedure Manual

4. TENNESSEE PROVIDER ENROLLMENT PROCESS

Step 1: Form a business entity, obtain an EIN, and an NPI

Step 2: Apply for Home Health Agency licensure through TDH

Step 3: Complete agency site inspections and submit required documentation

Step 4: Enroll with TennCare MCOs and/or DIDD, depending on your target population

Step 5: Begin receiving referrals and service authorizations from case managers and physicians

5. REQUIRED DOCUMENTATION

Articles of Incorporation, business license, EIN, NPI
TDH Home Health license and inspection results
Staff credentials and clinical supervision plan
Liability and malpractice insurance
Home Health Services Policy & Procedure Manual, including:
- Admission protocols and physician order tracking
- Infection control and clinical documentation standards
- Medication management and nursing plan templates
- Emergency preparedness and patient safety protocols
- Discharge planning, quality assurance, and participant rights
- Medicaid billing forms and audit readiness tools

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)

Requirements: Active Tennessee license; develops care plans, supervises HHAs

Role: Licensed Practical Nurse (LPN)

Requirements: Licensed; provides direct skilled care under RN direction

Role: Certified Home Health Aide (HHA)

Requirements: Training certification, CPR/First Aid, supervised by RN

Role: Physical/Occupational/Speech Therapist (as applicable)

Requirements: TN licensure and physician-ordered service plan

Role: Clinical Director / Administrator

Requirements: Oversight of all clinical and operational services

All staff must complete:

HIPAA and infection control training
Documentation and Medicaid compliance procedures
Abuse prevention and emergency response training
Annual competencies and background checks

7. MEDICAID WAIVER PROGRAMS

Home Health Services are covered under:

TennCare Medicaid State Plan – For short-term skilled nursing and therapy at home
1915(c) Waivers – For individuals needing long-term, clinically supervised care
Katie Beckett Program (Part A) – For medically fragile children needing in-home skilled care
ECF CHOICES – When home health is necessary to support the ISP goals for individuals with I/DD

8. TIMELINE TO LAUNCH

Phase: Business Formation & Licensure Application

Timeline: 2–3 months

Phase: Facility Inspection & TennCare Enrollment

Timeline: 2–3 months

Phase: Staff Hiring, Policy Manual Completion

Timeline: 1–2 months

Phase: Referral Acceptance & Service Start

Timeline: Begins after licensure approval and MCO/DIDD authorizations

9. CONTACT INFORMATION

Tennessee Department of Health (TDH) – Health Care Facilities Licensure

Website: https://www.tn.gov/health

TennCare (Tennessee Medicaid Program)

Website: https://www.tn.gov/tenncare

DIDD (Department of Intellectual and Developmental Disabilities)

Website: https://www.tn.gov/didd

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

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

WCG supports solo nurses, nurse entrepreneurs, and licensed home health agencies in entering the TennCare ecosystem and meeting clinical compliance standards.

Scope of Work: