1. Program Definition and Services

Residential Habilitation Services in Tennessee provide 24/7 supervised care, life skills training, and health maintenance support for adults with intellectual and developmental disabilities (I/DD). The program aims to maximize functional independence and community integration while preventing institutional placement. Services include:

• Daily Living Support: Hands-on assistance with personal hygiene, bathing, dressing, grooming, meal preparation, and medication administration
• Community Integration Habilitation: Providing individual transport, building social/peer networks, organizing leisure tasks, budgeting training, and implementing person-centered therapy outcomes

2. Regulations

The program is governed by the following regulations:

• Rules of the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), Chapter 0465-02-11 (Minimum Program Requirements for Residential Habilitation Facilities)
• Rules of the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), Chapter 0465-02-03 (Application of Rules for Distinct Service Categories)
• TennCare Rules and Regulations, Chapter 1200-13-01 (Medicaid Long-Term Services and Supports)
• Federal HCBS Final Settings Rule (42 CFR 441.301)

3. Licensing or Certification

Providers must be licensed by the Tennessee Department of Intellectual and Developmental Disabilities (DIDD) Office of Licensure for each specific residential site location and maintain active credentialing as an approved HCBS waiver network provider.

4. Responsible State Agency

The Tennessee Department of Intellectual and Developmental Disabilities (DIDD), working in close clinical partnership with the Bureau of TennCare (Tennessee Medicaid), is responsible for reviewing applications, conducting home inspections, and licensing residential habilitation providers.

5. Application Process

The application process is conducted through the electronic TennCare Provider Registration Portal and the DIDD Provider Enrollment Unit. Providers must submit formal application packets online and schedule physical facility checks to initiate the process.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Proof of compliance with state safety, fire safety, and ADA environmental accessibility guidelines
• Agency Quality Assurance and Residential Operations Policy and Procedure Manuals
• Staff backgrounds, professional credentials, and executive clinical leadership rosters
• Proof of general liability, professional liability, and workers' compensation insurance

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. Providers should contact the DIDD Office of Licensure for detailed information on current processing timeframes, which typically span 3 to 4 months.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity with the Tennessee Secretary of State, secure an Employer Identification Number (EIN), and obtain a Type 2 National Provider Identifier (NPI).

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access details for the DIDD Provider Orientation and Core Training Modules are sent to qualified applicants once preliminary business paperwork is reviewed.

10. Additional Notes

• Providers must ensure that residential settings meet all state occupancy rules, limiting homes to no more than 4 residents total
• Medication administration must be performed directly by a licensed nurse or state-certified medication aides following the TN Nurse Practice Act
• All direct support staff must clear mandatory background checks, registry checks (Abuse Registry, Sexual Offender Registry), and fingerprint screenings
• Providers must maintain detailed records of daily face-to-face service notes for Medicaid documentation and billing

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