PERSONAL CARE SERVICES PROVIDER IN NEW JERSEY

SUPPORTING INDEPENDENCE AND DAILY LIVING THROUGH PERSONALIZED CARE

Personal Care Services in New Jersey provide essential assistance with daily living activities for individuals with disabilities, chronic illnesses, or age-related conditions. These services help maintain independence and enhance quality of life by offering support tailored to each individual’s needs. Personal Care Services are authorized under New Jersey Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New Jersey Department of Human Services (DHS)

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

Agency: Division of Aging Services (DoAS)

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

Agency: Centers for Medicare & Medicaid Services (CMS)

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

2. PERSONAL CARE SERVICES OVERVIEW

Personal Care Services assist individuals with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) to maintain independence and well-being.

Approved providers may deliver:

• Personal Hygiene Assistance: Bathing, grooming, oral care, and dressing.

• Mobility Support: Transfers, ambulation, and positioning assistance.

• Toileting and Incontinence Care: Support with bathroom use and hygiene maintenance.

• Meal Preparation and Feeding: Preparing balanced meals, providing feeding assistance, and hydration support.

• Housekeeping and Laundry: Light cleaning, bed making, and laundry tasks.

• Medication Reminders: Non-skilled support with medication schedules.

• Companionship and Social Engagement: Providing social interaction and light emotional support.

• Safety Monitoring: Ensuring a safe environment and preventing accidents.

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

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the New Jersey Division of Revenue and Enterprise Services.

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

• Enroll as a Medicaid Waiver Personal Care provider via the New Jersey Medicaid Provider Enrollment Portal.

• Obtain licensure as a Personal Care Agency from DHS if applicable.

• Maintain general liability and professional liability insurance.

• Develop policies for personal care planning, safety protocols, and staff training.

• Ensure staff meet background checks, health screenings, and training requirements.

4. NEW JERSEY PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the New Jersey Medicaid Provider Enrollment Portal for Personal Care Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, staff qualifications, and policy manuals.

Program Readiness Review:

• DHS and DoAS evaluate provider readiness, including staff training, care protocols, and safety measures.

Approval & Medicaid Enrollment:

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

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (New Jersey Division of Revenue)

• IRS EIN confirmation

• NPI confirmation

• Personal Care Agency License (if applicable)

• Proof of general and professional liability insurance

• Personal Care Services Policy & Procedure Manual including:

  • Participant intake, assessment, and individualized care planning procedures

  • Personal care assistance, hygiene, and mobility support guidelines

  • Staff credentialing, background checks, and training requirements

  • Documentation standards for care tracking and Medicaid billing

  • HIPAA compliance, participant rights, and grievance handling

  • Safety protocols, emergency response, and infection control measures

  • Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Personal Care Program Director

Requirements: Bachelor’s degree in healthcare, social services, or a related field; supervisory experience preferred.

Role: Personal Care Aides (PCAs)

Requirements: High school diploma or GED; CPR/First Aid certification; training in personal care and ADL support; background clearance.

Role: Direct Support Professionals (DSPs)

Requirements: Experience in personal care and hygiene assistance; basic healthcare training; background clearance.

All staff must complete:

• Personal care skills training, including ADLs and IADLs

• Safety and infection control training

• HIPAA compliance and participant rights education

• Annual competency evaluations and professional development

• Ongoing training in client safety and wellness monitoring

7. MEDICAID WAIVER PROGRAMS

Personal Care Services are available under the following New Jersey Medicaid Waivers:

• Community Care Program for the Elderly and Disabled (CCPED)

• Supports Program Waiver

• Acquired Brain Injury (ABI) Waiver

• Personal Care Assistant (PCA) Waiver

• Home and Community-Based Services (HCBS) Waiver

Services may include:

• Personal hygiene and grooming assistance

• Mobility support and safety monitoring

• Meal preparation and feeding assistance

• Companionship and social support

• Light housekeeping and personal environment maintenance

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 Jersey Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Personal Care Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

New Jersey Department of Human Services (DHS)

Website: https://www.state.nj.us/humanservices/

Division of Aging Services (DoAS)

Website: https://www.state.nj.us/humanservices/doas/

New Jersey Medicaid Provider Enrollment Portal

Website: https://www.njmmis.com/

Centers for Medicare & Medicaid Services (CMS)

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

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW JERSEY PERSONAL CARE SERVICES PROVIDER

WCG supports agencies in launching Medicaid-compliant Personal Care Services in New Jersey, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing assistance

• Policy manual development for personal care planning and safety management

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

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and community outreach strategies

• Quality assurance systems for personal care safety and compliance

• Collaboration with healthcare providers and community organizations

Continue To Our Client Portal To Get Started

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