SKILLED NURSING SERVICES PROVIDER IN NORTH DAKOTA

Fatumata Kaba
Sep 18
4 min read

DELIVERING HIGH-QUALITY MEDICAL CARE AT HOME FOR INDIVIDUALS WITH COMPLEX HEALTH NEEDS

Skilled Nursing Services in North Dakota provide specialized medical care delivered by licensed nurses within an individual's home or residential setting. These services are designed to support individuals with chronic conditions, disabilities, or age-related health challenges by offering clinical care, health monitoring, and therapeutic interventions. Skilled Nursing Services are authorized under North Dakota Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: North Dakota Department of Human Services (NDDHS)

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

Agency: North Dakota Medical Services Division (MSD)

Role: Manages Medicaid waiver services and oversees Medicaid provider participation.

Agency: North Dakota Division of Aging Services

Role: Provides oversight for skilled nursing services targeting elderly individuals and adults with disabilities.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid-funded Skilled Nursing Services meet quality, safety, and person-centered care standards.

2. SKILLED NURSING SERVICES OVERVIEW

Skilled Nursing Services offer medically necessary care delivered by Registered Nurses (RNs) or Licensed Practical Nurses (LPNs) in home settings, helping individuals manage complex medical needs.

Approved providers may deliver:

Chronic Disease Management: Monitoring diabetes, hypertension, and cardiac conditions.
Wound Care: Dressing changes, wound monitoring, and infection prevention.
Medication Administration: Administering intravenous (IV) therapy, injections, and oral medications.
Post-Surgical Care: Monitoring surgical sites, managing pain, and providing rehabilitative care.
Health Monitoring: Recording vital signs, glucose levels, and other clinical metrics.
Catheter and Ostomy Care: Maintenance, cleaning, and monitoring for complications.
Respiratory Care: Managing ventilators, oxygen therapy, and breathing exercises.
Therapeutic Interventions: Administering physical, occupational, or speech therapies as prescribed.
Patient and Family Education: Teaching self-care techniques and managing chronic conditions.
Documentation: Keeping accurate records of care plans, clinical notes, and patient outcomes.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the North Dakota Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Skilled Nursing provider via the North Dakota Medicaid Management Information System (MMIS).
Obtain licensure as a Home Health Agency from the North Dakota Department of Health.
Maintain general liability and professional liability insurance.
Develop policies for skilled nursing care, medication administration, and patient safety.
Ensure staff complete required background checks, health screenings, and licensure verifications.

4. NORTH DAKOTA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application via the North Dakota MMIS for Skilled Nursing Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, clinical policies, and staff licensure documentation.

Program Readiness Review:

NDDHS and MSD evaluate provider readiness, including clinical 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 (North Dakota Secretary of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Skilled Nursing Policy & Procedure Manual including:
- Clinical care protocols and patient monitoring guidelines
- Medication administration and chronic disease management procedures
- Staff credentialing, background checks, and ongoing training records
- Documentation standards for care tracking and Medicaid billing
- HIPAA compliance, patient rights, and grievance handling
- Infection control, safety, and hygiene practices
- Emergency response and crisis management protocols
- Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Skilled Nursing Program Director

Requirements: Registered Nurse (RN) license, Bachelor’s or Master’s in Nursing or Healthcare Administration; experience in clinical supervision and home healthcare management.

Role: Registered Nurses (RNs)

Requirements: Active RN license; experience in clinical care and chronic disease management; CPR and BLS certifications.

Role: Licensed Practical Nurses (LPNs)

Requirements: State licensure; experience in patient care and medication administration.

Role: Nurse Aides

Requirements: Certification as a Nurse Aide (CNA); experience in personal care and direct support.

All staff must complete:

Training in skilled nursing procedures, chronic disease management, and patient safety
HIPAA compliance and patient rights education
Annual competency evaluations and ongoing professional development
Safety, infection control, and emergency response training
Documentation and record-keeping best practices