RESIDENTIAL SUPPORT SERVICES PROVIDER IN WEST VIRGINIA

Fatumata Kaba
Apr 14
3 min read

PROVIDING 24/7 SUPERVISION AND SUPPORT TO INDIVIDUALS IN COMMUNITY LIVING SETTINGS TO PROMOTE SAFETY, STABILITY, AND INDEPENDENCE

Residential Support Services in West Virginia deliver comprehensive care and supervision to individuals who require assistance with daily living in licensed or certified residential settings. These services ensure that participants can live safely in the community rather than in institutional facilities. Residential support is a Medicaid waiver service, primarily offered under the Intellectual/Developmental Disabilities (I/DD) Waiver and the Children with Serious Emotional Disorder Waiver (CSEDW). These programs are overseen by the West Virginia Department of Health and Human Resources (WVDHHR) and the Bureau for Medical Services (BMS).

1. GOVERNING AGENCIES

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

Role: Administers and regulates waiver services, including residential programs.

Agency: Bureau for Medical Services (BMS)

Role: Oversees Medicaid provider enrollment and compliance monitoring.

Agency: Office of Health Facility Licensure & Certification (OHFLAC)

Role: Licenses residential settings that provide health-related services or overnight supervision.

2. RESIDENTIAL SUPPORT SERVICES OVERVIEW

Residential Support Services provide supervised living arrangements where trained staff assist individuals with personal care, skill-building, medication oversight, and behavioral support.

Services may include:

24/7 supervision and personal care
Assistance with ADLs and IADLs
Medication administration or assistance
Support with meal prep, housekeeping, and hygiene
Behavioral redirection and skill reinforcement
Transportation coordination for appointments and activities
Social and recreational engagement
Documentation and progress reporting

These services are delivered in licensed homes, apartments, or group living environments, depending on the participant’s needs and the waiver program.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your agency with the WV Secretary of State
Obtain a Federal EIN and Type 2 NPI
Apply for Medicaid enrollment via Gainwell Technologies
Submit an application to become a Residential Services Provider under the I/DD Waiver
If providing medical oversight or overnight care, obtain a license from OHFLAC
Develop a Residential Support Services Policy & Procedure Manual
Establish staffing plans with required training and supervision

4. WEST VIRGINIA PROVIDER ENROLLMENT PROCESS

Step 1: Register business and obtain EIN and NPI

Step 2: Apply to WVDHHR as a waiver-approved residential provider

Step 3: Submit Medicaid provider application via Gainwell Technologies

Step 4: If required, apply for OHFLAC licensure

Step 5: Complete background checks and staff training

Step 6: Submit Policy & Procedure Manual for approval

Step 7: Begin operations once approved and authorized in ISP

5. REQUIRED DOCUMENTATION

WV business registration and NPI
Medicaid provider agreement and waiver program approval
OHFLAC facility license (if applicable)
Residential Support Services Policy & Procedure Manual including:
- Admission, discharge, and service coordination policies
- Emergency protocols, staffing schedules, and supervision plans
- Medication assistance and safety protocols
- Participant rights, grievance procedures, and HIPAA compliance
- Fire safety, infection control, and physical environment standards
- Incident reporting and documentation templates
- Behavioral support and crisis de-escalation procedures

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)

Requirements:

18+ years of age
WV CARES background check
Trained in CPR/First Aid, abuse prevention, documentation, and emergency procedures

Role: Residential Supervisor / Program Manager

Responsibilities: Oversees daily operations, staff performance, and ISP implementation

Role: Nurse (if providing medication administration)

Requirement: Licensed RN or LPN; may be required depending on participant needs and level of care

All staff must complete:

Annual training and skills assessments
HIPAA and participant rights training
Safety and crisis management training
Documentation and shift reporting

7. MEDICAID WAIVERS THAT COVER RESIDENTIAL SUPPORT

I/DD Waiver – Provides comprehensive residential services for individuals with developmental disabilities
CSEDW (Children with Serious Emotional Disorder Waiver) – May include residential placements for children
TBIW (Traumatic Brain Injury Waiver) – On a case-by-case basis for individuals needing community living support

Note: Each participant must have an approved ISP that justifies the level of residential care needed.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Enrollment Preparation

Timeline: 2–4 weeks

Phase: Medicaid & Waiver Application Submission

Timeline: 1–2 months

Phase: OHFLAC Licensure & Site Readiness (if applicable)

Timeline: 1–2 months

Phase: Staff Hiring & Training

Timeline: 3–5 weeks

Phase: Launch of Services

Timeline: Begins once provider approval and ISP authorizations are in place