SKILLED NURSING SERVICES PROVIDER IN MICHIGAN

Fatumata Kaba
Jul 27
4 min read

DELIVERING PROFESSIONAL MEDICAL CARE IN THE HOME FOR INDIVIDUALS WITH COMPLEX HEALTH NEEDS

Skilled Nursing Services in Michigan provide essential medical care to individuals with chronic conditions, disabilities, or those recovering from illness or surgery. These services are delivered in the client’s home or community settings and are funded through Michigan Medicaid, Home and Community-Based Services (HCBS) waivers, and MI Choice Waiver Programs.

1. GOVERNING AGENCIES

Agency: Michigan Department of Health and Human Services (MDHHS)

Role: Oversees Medicaid-funded skilled nursing services and HCBS waiver compliance

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight and funding through 1915(c) waivers and Medicaid state plans

Agency: Michigan Board of Nursing

Role: Licenses Registered Nurses (RNs) and Licensed Practical Nurses (LPNs), ensuring adherence to professional standards

Agency: Michigan Department of Licensing and Regulatory Affairs (LARA)

Role: Issues licenses to home health agencies providing skilled nursing care

Agency: Local Area Agencies on Aging (AAA)

Role: Coordinate skilled nursing under the MI Choice Waiver for seniors and adults with disabilities

2. SKILLED NURSING SERVICE OVERVIEW

Skilled nursing services involve clinical care provided by licensed nurses (RNs and LPNs) to manage and treat medical conditions at home. These services are typically prescribed by a physician and documented in the client’s Plan of Care (POC).

Services may include:

Medication administration and intravenous therapy
Wound care and dressing changes
Catheter care, ostomy maintenance, and enteral feeding
Pain management and palliative care
Chronic disease monitoring (e.g., diabetes, hypertension)
Health assessments and vital sign monitoring
Care coordination with physicians and specialists
Client and caregiver education on medical management

Skilled nursing services are time-limited, based on medical necessity, and must be delivered according to a physician’s order.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Michigan Department of Licensing and Regulatory Affairs (LARA)
Obtain IRS EIN and Type 2 NPI
Secure general liability and professional malpractice insurance
Obtain a Home Health Agency License from LARA
Ensure all nurses are licensed by the Michigan Board of Nursing
Develop HIPAA-compliant policies and clinical protocols
Conduct background checks and verify nursing credentials

Clinical Licensing:

All RNs and LPNs must have active Michigan nursing licenses and be in good standing with the Board of Nursing.

4. PROVIDER ENROLLMENT PROCESS

Step 1: Apply for a Home Health Agency License

Submit your application via LARA's Licensing Portal

Step 2: Enroll with Michigan Medicaid

Apply through the CHAMPS system: CHAMPS Login

Step 3: Credentialing for MI Choice Waiver and HCBS Programs

Step 4: Prepare for State and Federal Inspections

Ensure compliance with safety, staffing, and clinical documentation standards

5. REQUIRED DOCUMENTATION

Articles of Incorporation or DBA registration
IRS EIN and NPI confirmations
Proof of LARA home health agency license
Proof of liability and malpractice insurance
Skilled Nursing Services Policy & Procedure Manual, including:
- Care planning and physician order templates
- Clinical progress notes and patient assessment forms
- Medication administration records (MARs)
- Infection control protocols and emergency plans
- HIPAA compliance and data security measures
- Training logs and staff credential verification
- Billing documentation and compliance records

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)

Requirements: Active Michigan RN license; CPR certification; clinical experience; CORI background check

Role: Licensed Practical Nurse (LPN)

Requirements: Valid LPN license in Michigan; supervised by RN; experience in home care preferred

Role: Director of Nursing (DON)

Requirements: RN license with supervisory experience; oversees clinical policies and quality assurance

Required Trainings:

Infection control and universal precautions
Medication administration and management
Wound care and chronic disease management
Pain management and palliative care
HIPAA and patient confidentiality
Abuse, neglect, and mandatory reporting

7. MEDICAID & HCBS WAIVER PROGRAMS COVERING SKILLED NURSING

Skilled nursing is covered under:

MI Choice Waiver Program (for the elderly and adults with disabilities)
Medicaid State Plan Home Health Services
Habilitation Supports Waiver (HSW) (for individuals with developmental disabilities)
Community Mental Health (CMH) Programs (for behavioral health support)
Medicare (if client qualifies)

Providers may bill for:

Hourly nursing care
Complex medical interventions (e.g., infusions, wound care)
RN supervision and care planning
Post-hospitalization transitional care
Chronic disease monitoring and management

8. TIMELINE TO LAUNCH

Phase: Business Registration and Insurance Setup

Timeline: 2–3 weeks

Phase: LARA Licensing and Medicaid Enrollment

Timeline: 2–4 months

Phase: Staff Hiring and Credential Verification

Timeline: 1–2 months

Phase: Clinical Policy Manual and Compliance Setup

Timeline: 1 month

Phase: Client Intake and Service Initiation

Timeline: Ongoing based on physician referrals and care plan authorizations

9. CONTACT INFORMATION

Michigan Medicaid Provider Enrollment (CHAMPS)

https://milogintp.michigan.gov/

Michigan Department of Health and Human Services (MDHHS)

https://www.michigan.gov/mdhhs

Michigan Department of Licensing and Regulatory Affairs (LARA)

https://www.michigan.gov/lara

Michigan Board of Nursing

https://www.michigan.gov/lara

Area Agency on Aging (AAA) Locator

https://www.michigan.gov/osa

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

WCG assists healthcare professionals, home health agencies, and community organizations in launching licensed, Medicaid-approved skilled nursing services across Michigan.

Scope of Work: