1. Program Definition and Services

Skilled Nursing Services in New Hampshire deliver professional medical care and clinical support to waiver participants in their homes to maintain community living and prevent institutionalization. Services include:

• In-Home Personal Care: Direct home clinical care (Health Monitoring, Medication Infusion/IV Therapy, Feeding Tube Management, and Sterile Wound Care)
• Residential Personal Care: Clinical coordination in community-based residential settings (Post-Surgical Monitoring, Chronic Disease Management, Doctor Coordination, and Tracheostomy Care)

2. Regulations

The program is governed by the following regulations:

• New Hampshire Code of Administrative Rules, Part He-P 809 (Home Health Care Licensing)
• New Hampshire Code of Administrative Rules, Part He-M 517 (HCBS Waiver Services)
• New Hampshire Nurse Practice Act (RSA 326-B)
• New Hampshire Revised Statutes Annotated (RSA) Chapter 151 (Facility Licensing)
• Federal Home and Community-Based Services Settings Final Rule (42 CFR § 441.301)

3. Licensing or Certification

Providers must be licensed as a Home Health Care Provider (HHCP) by the Health Facilities Administration (HFA) under NH DHHS. Following licensure, agencies must obtain approved provider status through the electronic New Hampshire Medicaid Provider Enrollment Portal.

4. Responsible State Agency

The New Hampshire Department of Health and Human Services (DHHS), via the Health Facilities Administration Licensing Unit, the Bureau of Developmental Services (BDS), and the Bureau of Elderly and Adult Services (BEAS), is responsible for applications, safety audits, and certification.

5. Application Process

The application process uses a dual-track framework. Providers first file a licensing packet with the DHHS Health Facilities Licensing Unit. After securing the HHCP license, providers enroll online through the electronic New Hampshire Medicaid Provider Portal (NHMMIS.nh.gov).

6. Required Documentation

While requirements vary based on the target waiver, providers typically must submit:

• Business registration in good standing with the New Hampshire Secretary of State
• Agency policy manuals (clinical care protocols, emergency plans, and infection controls)
• Staff qualifications, training logs, and verified active nursing licenses (RN, LPN, LNA)
• Proof of commercial general liability and medical malpractice/professional liability insurance

7. Timeline for Approval

The exact timeline fluctuates based on agency capacity. State licensure and subsequent electronic NHMMIS portal screening typically takes between 90 and 120 days from the submission of a complete packet.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their state business entity, secure an IRS Employer Identification Number (EIN), and obtain a Type 2 Organizational National Provider Identifier (NPI) mapped to home health or clinical care taxonomies.

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access details for billing structures, verification systems, and waiver rules are sent to qualified applicants once preliminary profile elements are accepted by state licensing inspectors.

10. Additional Notes

• Administrative offices and service sites must satisfy all state clinical, environmental, and privacy safety guidelines
• Services must be delivered by agency employees overseen by an RN Director of Patient Services with at least 2 years of home health experience
• All staff must clear background screenings and fingerprinting through the NH Department of Safety and the BEAS state abuse registry
• Providers must maintain clinical tracking logs utilizing Electronic Visit Verification (EVV) workflows for Medicaid documentation and billing

Why Choose Waiver Consulting Group?

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

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