SKILLED NURSING SERVICES PROVIDER IN NEW HAMPSHIRE

PROVIDING MEDICAL CARE AND SUPPORT IN THE COMFORT OF HOME

Skilled Nursing Services in New Hampshire offer essential medical care, health monitoring, and rehabilitative support to individuals with chronic illnesses, disabilities, or recovery needs. These services are delivered by licensed nurses to ensure health maintenance, symptom management, and recovery support. Skilled Nursing Services are authorized under New Hampshire Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New Hampshire 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: Bureau of Elderly and Adult Services (BEAS)

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 professional medical care provided by licensed nurses to manage health conditions, support recovery, and maintain well-being.

Approved providers may deliver:

• Health Monitoring: Regular checks of vital signs, blood glucose, and other health indicators.

• Medication Administration: Administering injections, IV therapy, and prescribed medications.

• Wound Care: Cleaning, dressing, and monitoring of wounds or surgical sites.

• Chronic Disease Management: Monitoring and supporting conditions like diabetes, COPD, or heart disease.

• Post-Surgical Care: Managing recovery, including pain management and mobility assistance.

• Rehabilitative Support: Assisting with exercises, physical therapy coordination, and therapeutic interventions.

• Patient Education: Teaching patients and families self-care techniques and medication management.

• Care Coordination: Communicating with healthcare providers and managing care plans.

All services are delivered according to the Individualized Service Plan (ISP) to meet the participant’s medical and personal care needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the New Hampshire Secretary of State.

• Obtain EIN from the IRS and NPI (Type 2).

• Enroll as a Medicaid Waiver Skilled Nursing provider via the New Hampshire Medicaid Provider Enrollment Portal.

• Obtain licensure as a Home Health Agency from DHHS if applicable.

• Maintain general liability and professional liability insurance.

• Develop policies for patient care, medication management, and health monitoring.

• Ensure licensed nurses meet background checks, health screenings, and continuing education requirements.

4. NEW HAMPSHIRE PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the New Hampshire 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 and BEAS evaluate provider readiness, including nursing protocols, safety measures, 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 (New Hampshire Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Home Health Agency License (if applicable)

• Proof of general and professional liability insurance

• Skilled Nursing Services Policy & Procedure Manual including:

  • Patient assessment, care planning, and medical documentation protocols

  • Medication administration and chronic disease management guidelines

  • Staff credentialing, background checks, and training documentation

  • HIPAA compliance, patient rights, and grievance handling

  • Documentation standards for care tracking and Medicaid billing

  • Infection control, safety protocols, and emergency preparedness

  • Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Skilled Nursing Program Director

Requirements: Bachelor’s or Master’s degree in nursing (BSN or MSN); licensed as a Registered Nurse (RN); experience in healthcare management.

Role: Registered Nurses (RNs)

Requirements: Active RN license in New Hampshire; experience in skilled nursing care; background clearance.

Role: Licensed Practical Nurses (LPNs)

Requirements: Active LPN license in New Hampshire; supervised by an RN; experience in patient care and medication management.

Role: Certified Nursing Assistants (CNAs)

Requirements: State certification, experience in personal care and ADL assistance; supervised by an RN.

All staff must complete:

• Advanced training in skilled nursing practices and safety protocols

• HIPAA compliance and patient rights education

• Crisis management and infection control training

• Annual competency evaluations and professional development

• Ongoing training for nursing licensure maintenance

7. MEDICAID WAIVER PROGRAMS

Skilled Nursing Services are available under the following New Hampshire Medicaid Waivers:

• Choices for Independence (CFI) Waiver

• Developmental Disabilities (DD) Waiver

• Acquired Brain Disorder (ABD) Waiver

• In-Home Support (IHS) Waiver for Children

• Home and Community-Based Services (HCBS) Waiver

Services may include:

• Health monitoring and medication administration

• Wound care and post-surgical support

• Chronic disease management and rehabilitative care

• Patient education and family support

• Coordination with healthcare providers for integrated care

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: New Hampshire 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

New Hampshire Department of Health and Human Services (DHHS)

Website: https://www.dhhs.nh.gov/

Bureau of Elderly and Adult Services (BEAS)

Website: https://www.dhhs.nh.gov/programs-services/aging-and-adult-support

New Hampshire Medicaid Provider Enrollment Portal

Website: https://nhmmis.nh.gov/

Centers for Medicare & Medicaid Services (CMS)

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

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

WCG supports agencies in launching Medicaid-compliant Skilled Nursing Services in New Hampshire, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing assistance

• Policy manual development for skilled nursing care and patient safety

• Staff credentialing, training program templates, and care documentation guidance

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and client engagement strategies

• Quality assurance systems for clinical safety and compliance

• Collaboration with healthcare providers for integrated care planning

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.