HOME MODIFICATION SERVICES PROVIDER IN WEST VIRGINIA

Fatumata Kaba
2 days ago
3 min read

CREATING SAFE, ACCESSIBLE, AND INDIVIDUALIZED LIVING SPACES TO SUPPORT INDEPENDENCE AND QUALITY OF LIFE AT HOME

Home Modification Services in West Virginia provide physical changes to a person’s home environment to promote safety, accessibility, and continued residence in a community-based setting. These modifications are often essential for individuals with mobility challenges, chronic health conditions, or developmental disabilities who receive long-term services under Medicaid waiver programs. These services are typically authorized through the Intellectual/Developmental Disabilities (I/DD) Waiver, Aged and Disabled Waiver (ADW), or Traumatic Brain Injury Waiver (TBIW). Oversight is provided by the West Virginia Department of Health and Human Resources (WVDHHR) and the Bureau for Medical Services (BMS), with service plan approval facilitated by Acentra Health (formerly Kepro).

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1. GOVERNING AGENCIES

Agency: West Virginia Department of Health and Human Resources (WVDHHR)

Role: Oversees waiver programs, monitors compliance, and determines eligibility.

Agency: Bureau for Medical Services (BMS)

Role: Administers Medicaid funding, claims, and provider enrollment.

Agency: Acentra Health (formerly Kepro)

Role: Reviews and authorizes home modifications through the participant’s Individualized Service Plan (ISP).

2. HOME MODIFICATION SERVICES OVERVIEW

Home Modification Services involve permanent or semi-permanent changes to a participant’s primary residence to increase safety, accessibility, and independence. Modifications must be directly related to the participant’s disability and approved through their service plan.

Examples of approved modifications:

Wheelchair ramps and stair lifts
Widened doorways and hallways
Roll-in showers or accessible bathtubs
Grab bars and handrails
Lowered countertops and sinks
Bathroom and kitchen adaptations
Voice-activated or remote-controlled environmental controls
Specialized lighting, alarms, or alerts for individuals with sensory impairments
Minor structural changes to accommodate durable medical equipment (DME)

All work must comply with local building codes, ADA guidelines, and Medicaid cost caps outlined in the waiver policy.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the WV Secretary of State
Obtain EIN and Type 2 NPI
Submit Medicaid provider application through Gainwell Technologies
Apply to become a waiver-approved Home Modification provider
Provide documentation of contractor licensing, insurance, and bonding
Submit a Home Modification Services Policy & Procedure Manual

4. WEST VIRGINIA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and secure EIN and NPI

Step 2: Apply to WVDHHR or BMS as a waiver Home Modification provider

Step 3: Enroll with Medicaid via Gainwell Technologies

Step 4: Submit contractor credentials, licensing, and bonding information

Step 5: Provide a comprehensive Policy & Procedure Manual

Step 6: Begin receiving referrals after service authorization by Acentra Health

5. REQUIRED DOCUMENTATION

Business registration and contractor license
General liability insurance and bonding documentation
Medicaid enrollment confirmation and provider number
Home Modification Services P&P Manual including:
- Project estimate and authorization workflows
- ADA compliance and accessibility standards
- Construction timelines and worksite safety protocols
- Final inspection and client sign-off forms
- Warranty and post-installation repair procedures
- Grievance and complaint handling policy
- Documentation templates for before/after photos, invoices, and service logs

6. STAFFING REQUIREMENTS

Role: Licensed Contractor / Construction Specialist

Requirements:

WV contractor license
Familiarity with ADA, accessibility, and waiver requirements
WV CARES background check (if entering participant homes)
Liability and worker’s comp insurance coverage

Role: Project Manager / Estimator

Responsibilities:

Coordinates site assessments, obtains materials, and ensures waiver compliance

Role: Administrative Support (optional)

Responsibilities:

Tracks authorizations, billing, and final approvals

All staff must complete:

HIPAA and confidentiality training
Training on Medicaid waiver expectations and communication with case managers
Worksite safety and incident reporting protocols

7. MEDICAID WAIVERS THAT COVER HOME MODIFICATIONS

I/DD Waiver – For individuals with developmental disabilities needing structural home changes
ADW (Aged and Disabled Waiver) – For seniors or adults with physical disabilities
TBIW (Traumatic Brain Injury Waiver) – For individuals needing home adaptation post-injury
CSEDW (Children with Serious Emotional Disorders Waiver) – On a case-by-case basis for safety modifications

Note: All modifications must be pre-approved, clearly documented in the ISP, and supported by an occupational therapist or physician recommendation when required.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Licensing

Timeline: 2–4 weeks

Phase: Medicaid and Waiver Enrollment Application

Timeline: 1–2 months

Phase: Manual Development & Documentation Submission

Timeline: 30–45 days

Phase: Service Launch

Timeline: Begins after authorization and referral from case manager or service coordinator

9. CONTACT INFORMATION

WV Bureau for Medical Services (BMS)

Website: https://dhhr.wv.gov/bms

Acentra Health (formerly Kepro)

Website: https://wv.acentra.com

WV Secretary of State – Business Registration

Website: https://sos.wv.gov

WV Division of Labor – Contractor Licensing

Website: https://labor.wv.gov

Gainwell Technologies – WV Medicaid Enrollment

Website: https://www.wvmmis.com

HOME MODIFICATION SERVICES PROVIDER IN WEST VIRGINIA

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — WEST VIRGINIA HOME MODIFICATION PROVIDER

WCG helps contractors and home adaptation providers launch compliant Medicaid waiver services with the right paperwork, standards, and reimbursement tools.

Scope of Work: