NURSING FACILITY SERVICES PROVIDER IN NEW HAMPSHIRE

PROVIDING COMPREHENSIVE LONG-TERM CARE IN A SAFE AND SUPPORTIVE ENVIRONMENT

Nursing Facility Services in New Hampshire provide 24-hour skilled nursing care and rehabilitative services for individuals with chronic illnesses, disabilities, or age-related health conditions. These facilities offer medical care, personal assistance, and therapeutic services in a residential setting. Nursing Facility Services are authorized under New Hampshire Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New Hampshire Department of Health and Human Services (DHHS)

Role: Administers Medicaid waiver funding for Nursing Facility Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Bureau of Elderly and Adult Services (BEAS)

Role: Ensures quality standards, service delivery, and compliance for Nursing Facility Services under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Medicaid-funded Nursing Facility Services meet HCBS quality, person-centered planning, and participant protection standards.

2. NURSING FACILITY SERVICES OVERVIEW

Nursing Facility Services offer continuous medical care and support for individuals with significant health and personal care needs.

Approved providers may deliver:

• 24/7 Skilled Nursing Care: Continuous monitoring and medical support for chronic conditions.

• Rehabilitative Therapies: Physical, occupational, and speech therapy as part of recovery and maintenance.

• Medication Administration: Accurate and timely dispensing of prescribed medications.

• Personal Care Assistance: Help with Activities of Daily Living (ADLs), including bathing, dressing, feeding, and mobility.

• Chronic Disease Management: Support for diabetes, hypertension, respiratory conditions, and more.

• Wound Care and Monitoring: Treatment of pressure ulcers, surgical sites, and chronic wounds.

• Dietary and Nutritional Support: Tailored meal planning and dietary management.

• Social and Recreational Activities: Engagement in group activities, therapy sessions, and community events.

• Family and Caregiver Support: Counseling, education, and involvement in care planning.

All services are delivered according to the Individualized Service Plan (ISP) to meet the participant’s medical and personal care needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the New Hampshire Secretary of State.

• Obtain EIN from the IRS and NPI (Type 2).

• Enroll as a Medicaid Waiver Nursing Facility provider via the New Hampshire Medicaid Provider Enrollment Portal.

• Obtain licensure from the New Hampshire Office of Professional Licensure and Certification (OPLC) as a nursing home or skilled nursing facility.

• Maintain general liability and professional liability insurance.

• Develop policies for skilled care, health monitoring, and residential safety.

• Ensure licensed nurses and direct care staff meet background checks, health screenings, and ongoing training requirements.

4. NEW HAMPSHIRE PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the New Hampshire Medicaid Provider Enrollment Portal for Nursing Facility Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, nursing facility licenses, insurance certificates, and policy manuals.

Program Readiness Review:

• DHHS and BEAS evaluate provider readiness, including healthcare protocols, safety measures, and staff qualifications.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Nursing Facility Services using designated billing codes.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (New Hampshire Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Nursing Facility License (if applicable)

• Proof of general and professional liability insurance

• Nursing Facility Services Policy & Procedure Manual including:

  • Skilled nursing care, medication management, and chronic disease protocols

  • Rehabilitation, therapeutic support, and personal care guidelines

  • Staff credentialing, background checks, and ongoing training records

  • Documentation standards for health monitoring and Medicaid billing

  • HIPAA compliance, patient rights, and grievance handling

  • Safety protocols, infection control, and emergency preparedness

  • Quality assurance and continuous care monitoring

6. STAFFING REQUIREMENTS

Role: Nursing Facility Program Director

Requirements: Bachelor’s or Master’s degree in nursing (BSN or MSN); licensed as a Registered Nurse (RN); experience in managing long-term care settings.

Role: Registered Nurses (RNs)

Requirements: Active RN license in New Hampshire; experience in skilled nursing care; background clearance.

Role: Licensed Practical Nurses (LPNs)

Requirements: Active LPN license in New Hampshire; supervised by an RN; experience in patient care and medication management.

Role: Certified Nursing Assistants (CNAs)

Requirements: State certification, experience in personal care and ADL assistance; supervised by an RN.

All staff must complete:

• Advanced training in skilled nursing practices and safety protocols

• HIPAA compliance and patient rights education

• Annual competency evaluations and professional development

• Ongoing training for infection control, wound care, and emergency management

7. MEDICAID WAIVER PROGRAMS

Nursing Facility Services are available under the following New Hampshire Medicaid Waivers:

• Choices for Independence (CFI) Waiver

• Developmental Disabilities (DD) Waiver

• Acquired Brain Disorder (ABD) Waiver

• In-Home Support (IHS) Waiver for Children

• Home and Community-Based Services (HCBS) Waiver

Services may include:

• 24/7 nursing care and health monitoring

• Chronic disease management and rehabilitative therapy

• Medication administration and dietary support

• Social and recreational activities for holistic well-being

• Family and caregiver training and support

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: New Hampshire Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Nursing Facility Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

New Hampshire Department of Health and Human Services (DHHS)

Website: https://www.dhhs.nh.gov/

New Hampshire Office of Professional Licensure and Certification (OPLC)

Website: https://www.oplc.nh.gov/

New Hampshire Medicaid Provider Enrollment Portal

Website: https://nhmmis.nh.gov/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW HAMPSHIRE NURSING FACILITY SERVICES PROVIDER

WCG supports agencies in launching Medicaid-compliant Nursing Facility Services in New Hampshire, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing assistance

• Policy manual development for skilled care and residential safety

• Staff credentialing, training program templates, and healthcare documentation guidance

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and community outreach strategies

• Quality assurance systems for clinical safety and continuous care

• Collaboration with healthcare providers for integrated care planning

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