1. Program Definition and Services 

Skilled Nursing Services in Massachusetts refer to care provided by licensed nurses to individuals with complex medical needs. These services include: 

• Continuous Skilled Nursing (CSN) for complex care members requiring more than two continuous hours of nursing per day 

• Medication management 

• Wound care 

• Blood glucose monitoring 

• Assistance with oxygen 

2. Regulations 

Skilled Nursing Services are governed by: 

• 130 CMR 414.000: Independent Nurse 

• 130 CMR 630.000: Home and Community-Based Services Waiver Services 

• 105 CMR 150.000: Standards for Long-Term Care Facilities 

3. Licensing or Certification 

Providers must be licensed as Registered Nurses (RNs) or Licensed Practical Nurses (LPNs) in accordance with the Massachusetts Nurse Practice Act (M.G.L. c. 112) and regulations at 244 CMR 3.00. 

4. Responsible State Agency 

The Massachusetts Executive Office of Health and Human Services (EOHHS) and MassHealth oversee Skilled Nursing Services. 

5. Application Process 

Providers apply through MassHealth's Provider Online Service Center. Individual practitioners and organizations can apply to become eligible providers. 

6. Required Documentation 

Providers must submit: 

• Proof of nursing licensure 

• Certification of required training (e.g., home health aide, nurse's aide, or personal care training) 

• Documentation of experience in providing skilled nursing services 

7. Timeline for Approval 

The specific timeline for approval is not provided in the available information. Providers should contact MassHealth for details on the approval process timeline. 

8. Pre-Application Process 

There is no formal pre-application process mentioned. However, providers should ensure they meet all eligibility requirements before applying. 

9. Pre-Application Training 

While no specific pre-application training is mentioned, nurses must maintain their professional licenses and complete any required continuing education. 

10. Additional Notes 

• Skilled nursing services are limited to one visit per week per participant, with exceptions possible for specific circumstances 

• Services must be medically necessary and prescribed by a physician or ordering non-physician practitioner 

• As of March 6, 2025, assisted living nurses in Massachusetts can provide limited skilled care to residents under a recently extended law 

• Skilled Nursing Care Facilities (Level II) provide continuous skilled nursing care and rehabilitation services