SKILLED NURSING SERVICES PROVIDER IN LOUISIANA

Fatumata Kaba
Aug 12
4 min read

DELIVERING PROFESSIONAL NURSING CARE TO SUPPORT COMPLEX MEDICAL NEEDS IN COMMUNITY SETTINGS

Skilled Nursing Services in Louisiana provide Medicaid waiver participants with medically necessary nursing care delivered by licensed professionals in home or community-based environments. These services are critical for individuals who require regular medical oversight, complex care management, or support with chronic conditions—enabling them to remain in their homes rather than institutional settings.

1. GOVERNING AGENCIES

Agency: Louisiana Department of Health (LDH) — Office of Aging and Adult Services (OAAS) & Office for Citizens with Developmental Disabilities (OCDD)

Role: Defines program requirements and monitors the delivery of skilled nursing services within HCBS waivers

Agency: Medicaid Management Information System (MMIS) / Molina Medicaid Solutions

Role: Handles Medicaid provider enrollment, claims processing, and reimbursement

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Provides federal oversight for skilled services under 1915(c) HCBS waiver programs

Agency: Managed Care Organizations (MCOs)** (under Bayou Health)

Role: Authorize skilled nursing services based on the participant’s Plan of Care (POC), coordinate care, and issue payments

2. SERVICE OVERVIEW

Skilled Nursing Services involve professional clinical care delivered by Registered Nurses (RNs) or Licensed Practical Nurses (LPNs) under the supervision of a physician or waiver case manager.

Covered services may include:

Medication administration and IV therapy
Wound care and catheter maintenance
Tube feedings and tracheostomy care
Vital sign monitoring and skilled assessments
Disease management for chronic conditions (e.g., diabetes, COPD, CHF)
Health teaching and caregiver education
Complex care coordination and reporting
Emergency response planning and delegated nursing tasks

All services must be medically necessary, documented in the participant’s Plan of Care, and pre-authorized by the participant’s MCO or waiver case manager.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Louisiana Secretary of State
Obtain IRS EIN and Type 2 NPI
Secure Home Health Agency Licensure (if operating as a full agency) or enroll as an individual licensed nurse
Enroll through the Louisiana Medicaid Provider Enrollment Portal
Maintain professional liability and workers’ compensation insurance
Hire and credential licensed RNs and LPNs in accordance with Louisiana State Board of Nursing (LSBN)
Develop a Skilled Nursing Services Policy & Procedure Manual
Implement HIPAA-compliant electronic health records and billing systems

4. LOUISIANA PROVIDER ENROLLMENT PROCESS

Step 1: Medicaid Provider Enrollment

Apply through https://www.lamedicaid.com under the appropriate waiver service category

Step 2: Home Health Licensure (if applicable)

Apply through the LDH Health Standards Section if operating as an agency

Step 3: Submit Supporting Documents

Provide business documents, nursing licenses, insurance, and sample care plans

Step 4: MCO Credentialing & Case Manager Coordination

Credential with MCOs for referrals and billing
Coordinate with case managers to initiate care per participant-specific Plan of Care

5. REQUIRED DOCUMENTATION

Louisiana Articles of Incorporation or Business License
IRS EIN and NPI confirmation
Home Health Agency License (if applicable)
Certificates of insurance (liability and workers’ comp)
Skilled Nursing Services Policy & Procedure Manual, including:
- Nursing assessment forms and care plan templates
- Medication administration records (MARs)
- Clinical documentation logs and shift notes
- HIPAA compliance policies and participant consent forms
- Emergency protocols and infection control procedures
- Nurse credentialing and license verification logs
- Billing logs, time sheets, and audit-ready service summaries