DELIVERING CLINICALLY COMPLEX CARE FOR INDIVIDUALS WITH MEDICAL NEEDS IN HOME AND COMMUNITY SETTINGS

Skilled Nursing Services in Alaska are designed for individuals with ongoing medical needs that require professional nursing care as part of their Medicaid Waiver plan. These services ensure the health and safety of clients through timely, qualified interventions by licensed nursing professionals. Authorized under Alaska’s Home and Community-Based Services (HCBS) Medicaid Waivers, skilled nursing supports individuals in maintaining independence while receiving medical oversight outside of institutional settings.

1. GOVERNING AGENCIES

Agency: Alaska Department of Health – Division of Senior and Disabilities Services (SDS)
Role: Approves skilled nursing providers, reviews care plans, ensures adherence to waiver program regulations

Agency: Alaska Medicaid (via Department of Health)
Role: Handles Medicaid enrollment and billing for skilled nursing services

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Oversees HCBS waiver implementation and ensures compliance with federal quality and person-centered standards

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2. SKILLED NURSING SERVICE OVERVIEW

Skilled Nursing Services offer professional nursing interventions provided by Licensed Practical Nurses (LPNs) or Registered Nurses (RNs) in the client’s home or other non-institutional settings.

Services may include:

• Medication administration and monitoring
• Wound care and dressing changes
• Tube feedings and suctioning
• Catheter care
• Vitals monitoring and clinical assessments
• Care coordination with physicians and therapists
• Health education for individuals and caregivers

All services must be documented and linked to the individual’s person-centered support plan and cannot duplicate other nursing or clinical services.

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3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Registered business with Alaska’s Division of Corporations, Business and Professional Licensing
• Valid NPI (Type 2) and EIN
• Licensed nursing professionals (LPN or RN) with active Alaska licensure
• Office or clinical base within Alaska
• Proof of malpractice insurance and worker’s compensation coverage
• Staff credentialing and nurse supervision protocols

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4. SDS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Request Skilled Nursing Services application packet from SDS
• (Optional) Attend orientation for HCBS waiver providers

Application Submission:

• Submit credentials, staffing plans, and scope of nursing services
• Include documentation templates, staff training schedules, and quality control measures

Program Readiness Review:

• SDS evaluates licenses, staff training, and readiness to deliver services
• May conduct site inspection if facility-based services are included

Reviews participant care plans and documentation systems

• Approval & Medicaid Enrollment:
• Upon SDS approval, register with Alaska Medicaid via MMIS
• Select appropriate service codes and nursing modifiers under HCBS
• Finalize electronic claims submission and Medicaid agreements

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5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License
• EIN Confirmation and NPI Registration
• RN/LPN licenses and proof of insurance
• SDS-Compliant Skilled Nursing Policies including:
• Medication and clinical protocols
• Client care documentation forms
• Staff oversight and incident management plans
• Infection control and emergency procedures
• HIPAA privacy and informed consent documentation

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6. STAFFING REQUIREMENTS

Role: Skilled Nursing Supervisor (RN)
Requirements: Active RN license, supervisory experience, Medicaid documentation experience

Role: Skilled Nurse (LPN or RN)
Requirements: Current Alaska nursing license, CPR certification, background check

All staff must complete:

• SDS waiver-specific training
• Documentation and confidentiality procedures
• Safety and emergency training
• Ongoing clinical education and annual reviews

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7. MEDICAID WAIVER SERVICES

Skilled Nursing Services are authorized under the following Alaska Medicaid Waivers:

• Alaskans Living Independently (ALI) Waiver
• Adults with Physical and Developmental Disabilities (APDD) Waiver
• Individuals with Intellectual and Developmental Disabilities (IDD) Waiver
• Children with Complex Medical Conditions (CCMC) Waiver

Providers may offer:

• Intermittent or scheduled nursing interventions
• In-home medical care per waiver-authorized plan
• Coordination with other providers or family caregivers
• Documentation of nursing activities and clinical progress

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8. TIMELINE TO LAUNCH

Phase: Business Formation and Licensing Setup
Timeline: 1–2 weeks

Phase: SDS Application and Compliance Review
Timeline: 60–90 days

Phase: Nurse Hiring and Training Completion
Timeline: 30–45 days

Phase: Medicaid Enrollment and MMIS Billing Configuration
Timeline: 45–60 days

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9. CONTACT INFORMATION

Alaska Department of Health – Division of Senior and Disabilities Services (SDS)
dsdsprovider@alaska.gov
(907) 269-3666
https://dhss.alaska.gov/dsds

Alaska Medicaid Provider Enrollment – Conduent MMIS
https://medicaidalaska.com

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10. SCOPE OF WORK

• Business registration and EIN/NPI setup
• SDS application support and readiness coaching
• Custom Policy & Procedure Manual for nursing care
• Staff credentialing logs and clinical documentation templates
• Medicaid enrollment and billing system configuration
• Website, domain, and email setup
• Client intake and health coordination packet
• Skilled nursing training materials and audit prep tools
• Incident tracking and quality assurance dashboards
• Community networking and physician referral strategies