SKILLED NURSING SERVICES PROVIDER IN DELAWARE

Fatumata Kaba
Jul 7
4 min read

DELIVERING LICENSED MEDICAL CARE IN THE HOME TO SUPPORT HEALTH, SAFETY, AND INDEPENDENT LIVING FOR INDIVIDUALS WITH COMPLEX NEEDS

Skilled Nursing Services in Delaware provide medically necessary, physician-directed care in the home for individuals with chronic or acute medical needs. These services are covered under Delaware Medicaid, including the Lifespan Waiver, and are overseen by the Division of Developmental Disabilities Services (DDDS) and the Division of Medicaid and Medical Assistance (DMMA).

1. GOVERNING AGENCIES

Agency: Delaware Division of Developmental Disabilities Services (DDDS)

Role: Authorizes waiver-funded skilled nursing services for individuals with developmental disabilities

Agency: Delaware Division of Medicaid and Medical Assistance (DMMA)

Role: Administers Medicaid State Plan and waiver reimbursements for skilled care

Agency: Delaware Division of Health Care Quality

Role: Licenses Home Health Agencies and oversees nursing practice standards

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures federal compliance for Medicaid-funded home health services

2. SKILLED NURSING SERVICE OVERVIEW

Skilled Nursing Services consist of clinical care provided by a Registered Nurse (RN) or Licensed Practical Nurse (LPN) based on a written physician’s order. These services help manage complex medical conditions in the home, preventing hospitalizations or nursing facility placement.

Approved providers may deliver:

Medication administration and injections
Wound care and catheter maintenance
Tracheostomy or ventilator monitoring
Tube feeding and nutritional support
Health assessments and documentation
Monitoring of chronic conditions (e.g., diabetes, seizure disorders)
Coordination with caregivers and primary care physicians

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Delaware Division of Corporations
Obtain EIN from the IRS and NPI (Type 2)
Obtain licensure as a Home Health Agency (HHA) through the Division of Health Care Quality
Enroll as a Medicaid provider through DMAP for skilled nursing reimbursement
Carry malpractice, liability, and workers’ compensation insurance
Hire and supervise licensed nurses (RN/LPN) with valid Delaware licensure
Maintain HIPAA-compliant documentation systems and quality assurance procedures

4. PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain NPI

Step 2: Apply for HHA licensure from the Division of Health Care Quality

Submit operations plan, staffing chart, nursing protocols, and emergency policies
Complete on-site survey and compliance checks

Step 3: Enroll in Delaware Medicaid (DMAP) for billing authorization

Step 4: Apply to DDDS for approval to serve individuals under the Lifespan Waiver

Step 5: Begin accepting referrals from physicians, DDDS teams, and case managers

5. REQUIRED DOCUMENTATION

Articles of Incorporation or business registration
IRS EIN Letter
NPI confirmation
HHA license from Delaware Division of Health Care Quality
Medicaid provider approval and waiver authorization
Policy & procedure manual including:
- Physician orders and care plan procedures
- Medication administration and nursing documentation logs
- Infection control and safety guidelines
- Incident reporting and emergency protocols
- Staff credentialing and supervision plan
- HIPAA compliance and patient rights policy
- Quality assurance and service audit tracking forms

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)

Requirements:

Delaware RN license
Experience in home health or skilled nursing
CPR certification, TB test, and background check

Role: Licensed Practical Nurse (LPN)

Requirements:

Delaware LPN license
Works under RN supervision
Clinical experience and Medicaid documentation familiarity

Role: Director of Nursing / Clinical Supervisor

Requirements:

Active RN license
Responsible for care oversight, staff supervision, and compliance

Training Requirements for All Staff:

HIPAA and documentation training
Emergency preparedness and infection control
Abuse prevention and mandated reporting
Annual skills verification and CEU tracking

7. MEDICAID WAIVER SERVICES

Skilled Nursing is reimbursed under:

Delaware Lifespan Waiver (administered by DDDS)
Delaware Medicaid State Plan

Approved providers may deliver:

Short-term or long-term skilled nursing services as medically necessary
Home-based care that aligns with the participant’s service plan
Documentation for service delivery and coordination with care teams
Clinical oversight and quality assurance under state and federal guidelines

8. TIMELINE TO LAUNCH

Phase: Business Formation

Timeline: 1–2 weeks

Phase: Home Health Agency Licensure

Timeline: 60–90 days

Phase: Medicaid Enrollment (DMAP)

Timeline: 30–60 days

Phase: DDDS Waiver Authorization

Timeline: 30–60 days

9. CONTACT INFORMATION

Delaware Division of Health Care Quality – HHA Licensing

Phone: (302) 421-7400

Website: https://www.dhss.delaware.gov/dhss/dhcq

Delaware Division of Developmental Disabilities Services (DDDS)

Phone: (302) 744-9600

Website: https://dhss.delaware.gov/dhss/ddds

Delaware Division of Medicaid and Medical Assistance (DMMA)

Phone: (302) 255-9500

Website: https://dhss.delaware.gov/dhss/dmma

Delaware Medicaid Provider Enrollment (DMAP)

Website: https://www.demap.dhss.delaware.gov

SKILLED NURSING SERVICES PROVIDER IN DELAWARE

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — DELAWARE SKILLED NURSING SERVICES PROVIDER

We help healthcare professionals and home health organizations become fully licensed and Medicaid-compliant Skilled Nursing providers under Delaware’s waiver and State Plan programs.

Scope of Work: