SKILLED NURSING SERVICES PROVIDER IN CONNECTICUT

Fatumata Kaba
Jul 8
4 min read

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

Skilled Nursing Services in Connecticut offer medically necessary interventions provided by licensed nurses to individuals with chronic health conditions, disabilities, or recovery needs. These services are authorized under Connecticut’s Medicaid Home and Community-Based Services (HCBS) waiver programs and are designed to promote health stabilization, and independence, and reduce unnecessary institutionalization.

1. GOVERNING AGENCIES

Agency: Connecticut Department of Social Services (DSS)

Role: Oversees Medicaid enrollment, authorizations, and compliance for Skilled Nursing Services

Agency: Connecticut Department of Public Health (DPH)

Role: Licenses and regulates nursing agencies and home health care providers

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring compliance with Medicaid HCBS rules and quality standards

2. SKILLED NURSING SERVICE OVERVIEW

Skilled Nursing Services include medical and nursing interventions ordered by a physician and tailored to meet the specific clinical needs of individuals in their home or community setting.

Approved providers may deliver:

Medication administration and complex medication management
Wound care, pressure ulcer treatment, and post-surgical care
Tracheostomy care and ventilator management
Catheter care and bowel program management
Diabetic care including insulin administration and blood glucose monitoring
Enteral feeding and G-tube management
Clinical assessments and monitoring of chronic conditions
Education and training for participants and caregivers
Care coordination with physicians, therapists, and interdisciplinary teams

All services must be provided by Registered Nurses (RNs) or Licensed Practical Nurses (LPNs) and follow the participant’s individualized service plan.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Connecticut Secretary of the State
Obtain EIN from the IRS and NPI (Type 2)
Obtain a Home Health Care Agency or Nursing Registry license from the Connecticut Department of Public Health (if providing skilled services in participant homes)
Employ Connecticut-licensed RNs and/or LPNs
Maintain professional liability and general business insurance
Develop clinical service policies aligned with Connecticut nursing standards and Medicaid HCBS rules

4. DSS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Request Skilled Nursing Services provider application materials from Connecticut DSS
(Recommended) Attend DSS provider orientation webinars or sessions

Application and Documentation Submission:

Submit agency licensure, organizational documents, staff rosters with licensure verification, and clinical service descriptions
Provide sample care plans, medication administration records, and emergency response protocols
Include background check documentation and staff training records

Program Readiness Review:

DSS reviews licensing, staffing, and documentation processes
May require on-site or virtual audit of compliance systems
Verifies emergency preparedness plans, HIPAA compliance, and participant rights protections

Approval & Medicaid Enrollment:

Upon DSS approval, enroll as a Medicaid provider through Connecticut’s Medicaid Management Information System (MMIS)
Finalize service codes selection and configure claims processing systems

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License
IRS EIN confirmation
NPI confirmation
Home Health Agency or Nursing Registry license (if applicable)
Professional liability and general insurance coverage
DSS-Compliant Policy & Procedure Manual including:
- Participant intake and nursing assessment procedures
- Clinical service delivery and care planning policies
- Medication management and administration procedures
- Emergency response and incident management protocols
- Client rights, privacy policies, and HIPAA compliance documentation
- Staff background checks, licensing verification, and annual training logs
- Quality assurance and service improvement plans
- Medicaid billing, authorization tracking, and documentation retention policies

6. STAFFING REQUIREMENTS

Role: Nursing Services Administrator

Requirements: Active Connecticut RN license; experience in home health management; background check clearance

Role: Registered Nurse (RN)

Requirements: Current Connecticut RN license; CPR certification; background check clearance

Role: Licensed Practical Nurse (LPN)

Requirements: Current Connecticut LPN license; CPR certification; background check clearance

All staff must complete:

DSS and Medicaid service documentation training
Emergency procedures, infection control, and abuse prevention training
Annual competency evaluations and clinical continuing education
HIPAA and confidentiality training

7. MEDICAID WAIVER SERVICES

The following Connecticut Medicaid Waivers authorize Skilled Nursing Services:

Connecticut Home Care Program for Elders (CHCPE)
Acquired Brain Injury (ABI) Waivers I and II
Connecticut Mental Health Waiver
Katie Beckett Waiver (for medically complex children)
Personal Care Assistance Waiver (with skilled nursing components if authorized)

Approved providers may deliver:

In-home skilled nursing services as part of person-centered service plans
Clinical assessments, medication administration, and chronic disease management
Coordination with case managers and healthcare providers
Training and support for family members and informal caregivers

8. TIMELINE TO LAUNCH

Phase: Business Formation and Licensing Setup

Timeline: 3–4 weeks

Phase: Connecticut DPH Licensing and Compliance Review (if required)

Timeline: 90–120 days

Phase: DSS Medicaid Application and Program Readiness Review

Timeline: 60–90 days

Phase: Staff Hiring, Training, and Clinical Systems Implementation

Timeline: 30–45 days

Phase: Medicaid Enrollment and Claims System Setup

Timeline: 45–60 days

9. CONTACT INFORMATION

Connecticut Department of Social Services (DSS)

Website: https://portal.ct.gov/DSS

Connecticut Department of Public Health (DPH) – Facility Licensing and Investigation Section

Website: https://portal.ct.gov/DPH

Connecticut Medicaid Provider Enrollment Portal (Gainwell Technologies MMIS)

Website: https://www.ctdssmap.com/CTPortal/

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

WCG helps home health agencies and healthcare entrepreneurs launch Medicaid-compliant Skilled Nursing Services under Connecticut’s HCBS Waiver programs.

Scope of Work: