1. Program Definition and Services Provided 

Skilled Nursing Services in Minnesota involve intermittent nursing care provided in a patient's home by a registered nurse (RN) or licensed practical nurse (LPN) under the supervision of an RN. These services are ordered by a physician and include tasks such as wound care, medication management, and intravenous therapy. Skilled nursing visits are designed to meet specific medical needs that cannot be safely provided by non-skilled personnel. 

2. Regulations 

The primary regulations governing Skilled Nursing Services are found in Minnesota Statutes Chapter 256B.0625, which covers covered services for skilled and intermediate nursing care, and Minnesota Statutes Chapter 256B.0653, which addresses home health agency services. Additionally, federal regulations from the Centers for Medicare and Medicaid Services (CMS) apply to Medicare-certified home health agencies. 

3. Licensing or Certification 

To operate as a Skilled Nursing Service provider in Minnesota, you must be a Medicare-certified home health agency with a comprehensive home care license. This certification is required for providing skilled nursing services. 

4. Responsible State Agency 

The Minnesota Department of Health (MDH) is responsible for licensing home health agencies, while the Minnesota Department of Human Services (DHS) oversees the provision of skilled nursing services under Medical Assistance programs. 

5. Application Process 

The application process for becoming a Medicare-certified home health agency involves submitting an application to CMS and meeting specific standards outlined in the CMS Home Health Agency Manual. In Minnesota, you must also obtain a comprehensive home care license from MDH. 

6. Required Documentation 

The following documents are typically required for the application: 

• Completed application form 

• Proof of business registration (e.g., articles of incorporation, EIN) 

• Proof of liability insurance 

• Workers' compensation insurance (if applicable) 

• Background study data collection forms for all staff 

• Training documentation for staff 

• Accreditation from a CMS-approved accrediting organization (if applicable). 

7. Timeline for Approval 

The certification process typically takes several months after the application is deemed complete by CMS and MDH. This timeframe may vary based on the completeness of the application and any additional information requested. 

8. Pre-Application Process 

There is no formal pre-application process, but applicants are encouraged to review the CMS Home Health Agency Manual and ensure they meet all requirements before submitting their application. 

9. Pre-Application Training 

While there is no mandatory pre-application training, providers may benefit from familiarizing themselves with CMS guidelines and standards for home health care. 

10. Additional Notes 

• Skilled nursing visits must be ordered by a physician and provided according to a written service plan. 

• Providers must comply with federal and state regulations regarding patient rights and confidentiality. 

• Services must be medically necessary and provided by qualified nursing staff.