1. GOVERNING AGENCIES

Agency: Nebraska Department of Health and Human Services (DHHS)
Role: Administers Medicaid waiver funding for Adult Day Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Nebraska Medicaid and Long-Term Care (MLTC) Division
Role: Ensures quality standards, service delivery, and compliance for Adult Day Services under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Medicaid-funded Adult Day Services meet HCBS quality, person-centered planning, and participant protection standards.

2. ADULT DAY SERVICES OVERVIEW

Adult Day Services offer supervised, community-based care and social interaction in a structured environment, providing respite to family caregivers while promoting participant well-being.

Approved providers may deliver:

• Social and Recreational Activities: Group exercises, games, arts and crafts, and community outings
• Health Monitoring: Vital sign checks, medication administration, and chronic disease management
• Personal Care Assistance: Help with grooming, toileting, and mobility
• Nutrition and Meal Services: Providing balanced meals and snacks
• Therapeutic Activities: Physical, occupational, and cognitive therapy as needed
• Socialization and Support: Facilitating peer interactions and community involvement
• Respite Care: Temporary relief for family caregivers

All services are provided based on the Individualized Service Plan (ISP) to meet the participant’s specific needs and preferences.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the Nebraska Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Enroll as a Medicaid Waiver Adult Day Services provider via the Nebraska Medicaid Provider Enrollment Portal
• Obtain an Adult Day Center License from DHHS if applicable
• Maintain general liability and professional liability insurance
• Develop policies for participant safety, activity planning, health monitoring, and emergency preparedness
• Ensure staff meet background checks, health screenings, and relevant training requirements

4. NEBRASKA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the Nebraska Medicaid Provider Enrollment Portal for Adult Day Services under HCBS waivers

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, staff qualifications, and policy manuals

Program Readiness Review:

• DHHS evaluates provider readiness, including safety protocols, care plans, and staff qualifications

Approval & Medicaid Enrollment:

• Upon successful review, providers receive authorization to bill Medicaid for Adult Day Services using designated billing codes

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Nebraska Secretary of State)
• IRS EIN confirmation
• NPI confirmation
• Adult Day Center License (if applicable)
• Proof of general and professional liability insurance

Adult Day Services Policy & Procedure Manual including:

• Participant intake, assessment, and care planning procedures
• Activity planning, safety protocols, and meal service guidelines
• Staff credentialing, background checks, and training requirements
• HIPAA compliance, participant rights, and grievance handling
• Billing, service documentation, and audit readiness procedures
• Emergency response and health crisis management policies
• Infection control and hygiene standards

6. STAFFING REQUIREMENTS

Role: Adult Day Program Director
Requirements: Bachelor’s degree in social services, healthcare, or related field; experience managing community-based care settings preferred.

Role: Direct Care Staff
Requirements: High school diploma or GED, CPR/First Aid certification, experience in personal care and activity facilitation, background clearance

Role: Activity Coordinators
Requirements: Training in recreational therapy or group activity planning, experience in community engagement

Role: Healthcare Staff (if applicable)
Requirements: Licensed nurse or therapist, experience in monitoring health and providing basic medical care

All staff must complete:

• Safety and infection control training
• HIPAA and participant rights education
• Activity planning and person-centered care training
• Annual competency evaluations and ongoing professional development

7. MEDICAID WAIVER PROGRAMS

Adult Day Services are available under the following Nebraska Medicaid Waivers:

• Aged and Disabled (AD) Waiver
• Traumatic Brain Injury (TBI) Waiver
• Developmental Disabilities (DD) Waiver
• Children with Disabilities Waiver
• Home and Community-Based Services (HCBS) Waiver

Services may include:

• Group activities and socialization
• Health monitoring and medication management
• Assistance with personal care and ADLs
• Therapeutic recreation and wellness programs
• Respite care for family caregivers
• Meal and nutritional support during program hours

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: Nebraska Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days

Phase: Medicaid Billing Setup and Adult Day Service Launch
Timeline: 30–45 days

9. CONTACT INFORMATION

Nebraska Department of Health and Human Services (DHHS)
Website: https://dhhs.ne.gov/

Nebraska Medicaid and Long-Term Care (MLTC) Division
Website: https://dhhs.ne.gov/Pages/Medicaid.aspx

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/

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10. SCOPE OF WORK

• Business registration, Medicaid enrollment, and licensing assistance
• Policy manual development for adult day care and activity planning
• Staff credentialing, training program templates, and health monitoring guidance
• Medicaid billing setup and audit-prepared financial management
• Branding, website development, and outreach strategies
• Quality assurance systems for safety monitoring and compliance
• Community networking for client referrals and partnership opp