SKILLED NURSING SERVICES PROVIDER IN ARKANSAS

DELIVERING PROFESSIONAL MEDICAL CARE TO SUPPORT HEALTH, INDEPENDENCE, AND COMMUNITY LIVING FOR INDIVIDUALS WITH COMPLEX NEEDS

Skilled Nursing Services in Arkansas are designed for individuals with medical needs that require the expertise of licensed nurses but can be safely provided in home or community-based settings. These services are authorized under Arkansas’s Home and Community-Based Services (HCBS) Medicaid Waiver programs and are intended to prevent unnecessary hospitalization or institutionalization by supporting individuals' health in the least restrictive environment.

1. GOVERNING AGENCIES

Agency: Arkansas Department of Human Services (DHS) – Division of Aging, Adult, and Behavioral Health Services (DAABHS)

Role: Approves Skilled Nursing providers, monitors clinical service delivery, and enforces HCBS waiver compliance

Agency: Arkansas Medicaid (under DHS)

Role: Oversees Medicaid provider enrollment, service authorizations, and reimbursement for Skilled Nursing Services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid compliance with HCBS person-centered care regulations

2. SKILLED NURSING SERVICE OVERVIEW

Skilled Nursing Services involve the provision of professional nursing care ordered by a physician and delivered according to an individualized service plan.

Approved providers may deliver:

• Medication administration and management

• Wound care and dressing changes

• Catheter care and maintenance

• Ostomy care

• Respiratory treatments (e.g., nebulizers, oxygen management)

• Tube feeding (enteral nutrition) and suctioning

• Health status monitoring and chronic disease management

• Coordination of care with physicians, therapists, and caregivers

• Health education for individuals and family members

All services must be provided by a Licensed Practical Nurse (LPN) or Registered Nurse (RN) and documented according to Medicaid and DHS standards.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Arkansas Secretary of State

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

• Maintain an active nursing services agency license if required (for agencies employing multiple nurses)

• Employ licensed nurses (RN or LPN) with active Arkansas licenses

• Secure malpractice insurance and worker’s compensation coverage

• Develop clinical policies and protocols for skilled nursing tasks and emergency response

4. DHS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Request Skilled Nursing Services application packet from DAABHS

• Attend waiver provider orientation (recommended)

Application and Documentation Submission:

• Submit agency organizational documents, staff licenses, and scope of skilled services

• Provide sample clinical documentation forms, medication logs, and emergency response protocols

• Include background check documentation and staff training plans

Program Readiness Review:

• DHS reviews clinical documentation processes, staff qualifications, and nursing protocols

• May request proof of malpractice insurance and professional supervision plans

• Evaluates participant intake procedures and coordination with healthcare providers

Approval & Medicaid Enrollment:

• After DHS approval, enroll with Arkansas Medicaid via the Medicaid Provider Enrollment Portal

• Select appropriate billing codes for Skilled Nursing Services under applicable HCBS programs

• Complete Medicaid agreements and billing system configuration

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License

• IRS EIN confirmation

• NPI confirmation

• Nursing licenses (RN/LPN) and agency liability insurance

• DHS-Compliant Policy & Procedure Manual including:

  • Participant intake, assessment, and care planning protocols

  • Medication administration procedures

  • Wound care, respiratory care, and catheter care policies

  • Incident reporting and emergency response procedures

  • Client rights, privacy policies, and HIPAA compliance measures

  • Staff background checks, training logs, and professional development records

  • Quality assurance tracking and clinical supervision plans

  • Medicaid billing, scheduling, and documentation systems

6. STAFFING REQUIREMENTS

Role: Skilled Nursing Supervisor (RN)

Requirements: Active RN license, supervisory experience in Medicaid home care or clinical services

Role: Skilled Nurse (LPN or RN)

Requirements: Current Arkansas nursing license, CPR certification, background check clearance

All staff must complete:

• HCBS waiver orientation and Medicaid documentation training

• Emergency response, infection control, and patient safety training

• Confidentiality, abuse prevention, and client rights training

• Annual continuing education and clinical skills updates

7. MEDICAID WAIVER SERVICES

The following Arkansas Medicaid Waivers authorize Skilled Nursing Services:

• ARChoices in Homecare Waiver

• Community and Employment Supports (CES) Waiver

• Living Choices Assisted Living Waiver

• Alternatives for Adults with Physical Disabilities (AAPD) Waiver

Approved providers may deliver:

• In-home skilled nursing visits

• Intermittent medical monitoring and treatments

• Care coordination with waiver case managers and healthcare teams

• Documentation of clinical services and progress per person-centered plans

8. TIMELINE TO LAUNCH

Phase: Business Formation and Licensing Compliance

Timeline: 2–3 weeks

Phase: DHS Application and Readiness Review

Timeline: 60–90 days

Phase: Staff Hiring, Training, and Clinical Systems Setup

Timeline: 30–45 days

Phase: Medicaid Enrollment and MMIS Billing Configuration

Timeline: 45–60 days

9. CONTACT INFORMATION

Arkansas Department of Human Services – Division of Aging, Adult, and Behavioral Health Services (DAABHS)Email: DAABHS.ProviderEnrollment@arkansas.govPhone: (501) 686-9164Website: https://humanservices.arkansas.gov/divisions-shared-services/aging-adult-and-behavioral-health-services/

Arkansas Medicaid Provider Enrollment Portal

Website: https://portal.mmis.arkansas.gov/ARMedicaid/Provider

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — ARKANSAS SKILLED NURSING SERVICES PROVIDER

WCG helps nurses and healthcare entrepreneurs establish Medicaid-compliant Skilled Nursing Services under Arkansas’s HCBS Waiver programs.

Scope of Work:

• Business registration and EIN/NPI setup

• DHS Skilled Nursing application and documentation support

• Development of Skilled Nursing Policy & Procedure Manual

• Staff credentialing templates and clinical documentation systems

• Medicaid enrollment and claims configuration assistance

• Website, domain, and email setup

• Client intake packet and nursing care planning templates

• Staff training materials and emergency preparedness guides

• Quality assurance tracking systems and incident reporting templates

• Referral networking and healthcare provider relationship strategies

Continue To Our Client Portal To Get Started

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