SKILLED NURSING SERVICES PROVIDER IN NEBRASKA

Fatumata Kaba
Sep 2
4 min read

DELIVERING MEDICAL CARE AND SUPPORT IN THE COMFORT OF HOME

Skilled Nursing Services in Nebraska provide medical care and monitoring for individuals with complex health needs, chronic conditions, or those recovering from surgery. These services ensure the delivery of professional healthcare in the home environment, promoting safety and quality of life. Skilled Nursing Services are authorized under the Nebraska Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Nebraska Department of Health and Human Services (DHHS)

Role: Administers Medicaid waiver funding for Skilled Nursing Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Nebraska Medicaid and Long-Term Care (MLTC) Division

Role: Ensures quality standards, service delivery, and compliance for Skilled Nursing Services under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Medicaid-funded Skilled Nursing Services meet HCBS quality, person-centered planning, and participant protection standards.

2. SKILLED NURSING SERVICES OVERVIEW

Skilled Nursing Services involve medical care provided by licensed nurses in the individual’s home, focusing on complex medical needs and health maintenance.

Approved providers may deliver:

Medication Management: Administration, monitoring, and education on prescribed medications.
Wound Care: Dressing changes, wound assessment, and infection control.
Chronic Disease Management: Monitoring and support for conditions like diabetes, COPD, and heart disease.
IV Therapy: Intravenous medication administration and fluid management.
Post-Surgical Care: Monitoring recovery, pain management, and mobility support.
Vital Sign Monitoring: Regular tracking of blood pressure, heart rate, respiration, and oxygen levels.
Patient Education: Teaching self-care practices for chronic condition management.
Palliative and End-of-Life Care: Providing comfort and support for terminally ill patients.

All services are provided based on the Individualized Service Plan (ISP) and must be ordered by a licensed physician.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the Nebraska Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Skilled Nursing provider via the Nebraska Medicaid Provider Enrollment Portal.
Obtain a Home Health Agency License from DHHS.
Maintain general liability and professional liability insurance.
Develop comprehensive policies for nursing care, infection control, and health monitoring.
Ensure nursing staff meet licensing, background checks, and health screenings.

4. NEBRASKA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application through the Nebraska Medicaid Provider Enrollment Portal for Skilled Nursing Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, nursing licenses, insurance certificates, and policy manuals.

Program Readiness Review:

DHHS evaluates provider readiness, including clinical protocols, safety procedures, and staff qualifications.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for Skilled Nursing Services using designated billing codes.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (Nebraska Secretary of State)
IRS EIN confirmation
NPI confirmation
Home Health Agency License
Proof of general and professional liability insurance
Skilled Nursing Services Policy & Procedure Manual including:
- Medication administration and management protocols
- Wound care and infection control procedures
- Chronic disease management and monitoring guidelines
- IV therapy and medical equipment handling protocols
- Patient education and self-care training methods
- Staff credentialing, background checks, and ongoing training requirements
- Documentation standards for patient care and Medicaid billing
- HIPAA compliance, patient rights, and grievance handling
- Emergency preparedness and health crisis management

6. STAFFING REQUIREMENTS

Role: Skilled Nursing Program Director

Requirements: Bachelor’s or Master’s degree in nursing (BSN/MSN); Licensed Registered Nurse (RN); supervisory experience preferred.

Role: Registered Nurses (RNs)

Requirements: Active Nebraska RN license; CPR/First Aid certification; experience in home healthcare.

Role: Licensed Practical Nurses (LPNs)

Requirements: Active LPN license; supervised by an RN; experience in skilled nursing care.

Role: Certified Nursing Assistants (CNAs)

Requirements: State certification, supervised by RN/LPN; experience in personal care support.

All staff must complete:

Safety, infection control, and clinical competency training
HIPAA compliance and patient rights education
Annual competency evaluations and professional development
Ongoing training in chronic disease management and emergency response

7. MEDICAID WAIVER PROGRAMS

Skilled Nursing Services are available under the following Nebraska Medicaid Waivers:

Aged and Disabled (AD) Waiver
Traumatic Brain Injury (TBI) Waiver
Developmental Disabilities (DD) Waiver
Children with Disabilities Waiver
Home and Community-Based Services (HCBS) Waiver

Services may include:

Skilled nursing care for chronic conditions
IV medication and infusion therapy
Wound care and post-surgical monitoring
Health assessments and vital sign monitoring
Palliative care and comfort management

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: Nebraska Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Skilled Nursing Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Nebraska Department of Health and Human Services (DHHS)

Website: https://dhhs.ne.gov/

Nebraska Medicaid and Long-Term Care (MLTC) Division

Website: https://dhhs.ne.gov/Pages/Medicaid.aspx

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

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

WCG supports healthcare agencies in launching Medicaid-compliant Skilled Nursing Services in Nebraska, offering:

Scope of Work:

Business registration, Medicaid enrollment, and licensing support
Policy manual development tailored to skilled nursing and chronic care
Staff credentialing, training program templates, and clinical protocols
Medicaid billing setup and audit-prepared financial management
Branding, website development, and community outreach strategies
Quality assurance systems for infection control and safety monitoring
Collaboration with healthcare providers and hospital networks for client referrals