SKILLED NURSING SERVICES PROVIDER IN ALABAMA

Fatumata Kaba
2 days ago
3 min read

LICENSED NURSING CARE FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES IN COMMUNITY SETTINGS

Skilled Nursing Services in Alabama provide medically necessary care to individuals with intellectual and developmental disabilities (IDD) who have complex health conditions. These services are delivered in-home or in a community setting and are regulated under the Alabama Department of Mental Health (ADMH) and funded through the state’s Home and Community-Based Services (HCBS) Medicaid Waiver programs.

1. GOVERNING AGENCIES

Agency: Alabama Department of Mental Health (ADMH)Role: Approves and monitors Skilled Nursing providers under HCBS Waivers

Agency: Alabama Medicaid Agency

Role: Administers Medicaid enrollment, billing, and compliance for waiver services

Agency: Alabama Board of Nursing

Role: Licenses Registered Nurses (RNs) and Licensed Practical Nurses (LPNs), and enforces nursing practice standards

Agency: Centers for Medicare & Medicaid Services (CMS)Role: Provides federal oversight for Medicaid-funded skilled services

2. SKILLED NURSING SERVICE OVERVIEW

Skilled Nursing Services are prescribed medical services provided by licensed nursing professionals. These services are designed to help individuals with IDD manage chronic medical conditions, recover from illness or surgery, or maintain health stability in the community.

Approved Skilled Nursing providers may deliver:

Medication administration and monitoring
Tube feedings and nutrition care
Wound care and dressing changes
Catheter care and other medical procedures
Health assessments and monitoring of chronic conditions
Education and training of caregivers on medical needs
Coordination with physicians and interdisciplinary teams

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your agency with the Alabama Secretary of State
Obtain an EIN from the IRS and a Type 2 NPI
Maintain a physical business location in Alabama
Employ RNs and/or LPNs with current licenses from the Alabama Board of Nursing
Develop policies aligned with nursing practice standards and ADMH regulations
Ensure staff training and documentation meet HCBS requirements

4. ADMH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Request Skilled Nursing Provider Application Packet from ADMH
Submit business plan, scope of nursing services, and staffing plan
Include policy and procedure manual and care coordination strategy

Background & Credentialing:

Conduct fingerprint-based criminal background checks for all staff
Verify nursing licenses and certifications
Screen for abuse/neglect registry and drug use

Program Review and Site Readiness (if applicable):

Review documentation systems and clinical protocols
Ensure medical records management and HIPAA compliance
Provide staff training plans, supervision structure, and QA procedures

Approval & Medicaid Enrollment:

Once ADMH-approved, enroll with Alabama Medicaid as a Skilled Nursing Waiver provider
Add appropriate HCBS service codes for Skilled Nursing

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC Certificate
IRS EIN Letter
NPI Confirmation
Lease or deed for physical office site
Alabama Board of Nursing licenses for all RNs/LPNs
Certificate of General and Professional Liability Insurance
ADMH-Compliant Policy & Procedure Manual, including:
- Medication administration and delegation
- Wound care protocols
- Infection control procedures
- Emergency medical procedures
- HIPAA compliance and confidentiality
- Supervision, documentation, and quality monitoring
- Coordination with physicians and IDT (Interdisciplinary Team)
Client intake, physician orders, and skilled nursing documentation forms
Staff orientation and clinical training records