DELIVERING LICENSED SKILLED NURSING AND THERAPEUTIC CARE IN THE COMFORT OF THE CLIENT’S HOME TO PROMOTE RECOVERY, STABILITY, AND INDEPENDENCE

1. GOVERNING AGENCIES

Agency: Alabama Department of Public Health (ADPH) – Bureau of Health Provider Standards
Role: Licenses and monitors Home Health Agencies operating in the state

Agency: Alabama Medicaid Agency
Role: Administers Medicaid reimbursement and waiver funding for eligible Home Health Services

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal HCBS and Medicare Conditions of Participation are met for in-home care

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2. HOME HEALTH SERVICE OVERVIEW

Home Health Services deliver skilled, intermittent care to eligible individuals in their residences. Services must be ordered by a physician and performed by licensed medical professionals. The goal is to manage illness, prevent institutionalization, and promote recovery in a familiar environment.

Approved providers may deliver:

• Skilled nursing care (RNs and LPNs)
• Physical, occupational, and speech therapy
• Medical social work and chronic care education
• Home health aide services (under nurse supervision)
• Wound care, catheter care, injections, and IV therapy
• Health assessments, vitals monitoring, and documentation
• Care coordination with physicians and waiver case managers

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3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the Alabama Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Apply for a Home Health Agency license through ADPH
• Enroll with Alabama Medicaid and complete waiver credentialing (if serving waiver participants)
• Employ or contract with licensed RNs, LPNs, and therapists
• Carry malpractice, general liability, and workers’ compensation insurance
• Maintain HIPAA-compliant documentation and quality assurance systems

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4. PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and obtain an NPI
Step 2: Apply for Home Health Agency Licensure with ADPH

Submit administrative forms, staffing chart, policy manual, and undergo survey inspection

Step 3: Enroll with Alabama Medicaid as a Home Health Services provider
Step 4: If serving waiver participants, request enrollment for applicable waivers (e.g., Community Waiver, ID Waiver)
Step 5: Coordinate with case managers and physicians for referrals and service authorization

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or LLC Certificate
• IRS EIN Letter
• NPI confirmation
• Home Health Agency license from ADPH
• Alabama Medicaid provider enrollment confirmation

Policy & procedure manual including:

• Intake and physician order protocols
• Skilled nursing documentation templates
• Care plan tracking and supervisory visits
• Incident reporting and emergency procedures
• HIPAA compliance and participant confidentiality
• Staff credentialing, orientation, and continuing education
• Service logs for Medicaid billing and audits

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6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements:

• Active Alabama nursing license
• CPR certification and TB screening
• Experience with in-home and community-based clinical care

Role: Licensed Practical Nurse (LPN)
Requirements:

• Licensed in Alabama and supervised by RN
• Skilled in medication administration and daily care protocols

Role: Therapist (PT, OT, SLP)
Requirements:

• Licensed in respective discipline in Alabama
• Trained in in-home rehabilitation techniques and documentation

Training Requirements for All Staff:

• HIPAA and patient privacy
• Emergency preparedness and infection control
• Documentation for Medicaid and waiver audits
• Cultural competence and person-centered care
• Ongoing annual CEUs and clinical supervision

7. MEDICAID WAIVER SERVICES

Home Health Services may be reimbursed through:

• Alabama Medicaid State Plan
• State of Alabama Community Waiver Program
• ID Waiver (Intellectual Disabilities Waiver)
• LAH Waiver (Living at Home Waiver)

Approved providers may deliver:

• Skilled care per physician order
• Short-term or ongoing in-home clinical support
• Documentation tied to waiver participant goals
• Coordination with waiver teams and primary care providers

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8. TIMELINE TO LAUNCH

Phase: Business Formation
Timeline: 0–1 week

Phase: ADPH Home Health Agency Licensing
Timeline: 60–90 days

Phase: Alabama Medicaid Enrollment
Timeline: 60–90 days

Phase: Staff Hiring and Program Readiness
Timeline: 2–4 weeks

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9. CONTACT INFORMATION

Alabama Department of Public Health – Bureau of Health Provider Standards
Phone: (334) 206-5175
Website: https://www.alabamapublichealth.gov/providerstandards

Alabama Medicaid Agency – Home Health Services
Phone: (334) 242-5000
Website: https://medicaid.alabama.gov

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10. SCOPE OF WORK

• Business registration (LLC, EIN, NPI)
• ADPH Home Health Agency licensing support
• Alabama Medicaid enrollment and waiver credentialing
• Policy & procedure manual for nursing care, therapy, and documentation
• Templates for care plans, physician orders, nursing notes, and incident logs
• Website, domain, and email setup
• Staff credentialing trackers and CEU monitoring systems
• Client intake packet, consent forms, and HIPAA documentation
• Incident reporting systems and audit preparation tools
• Referral networking with hospitals, physicians, and case managers