1. Program Definition and Services
Skilled Nursing Services in New York provide short-term support to children and adults with intellectual/developmental disabilities. The program aims to help maintain individuals with disabilities in the community, averting the need for long-term services and supports. Services include:
- In-Home Nursing Care: Individual support in the individual/family home or community
- Residential Clinical Support: Supervision and care in a licensed residential, community-based setting
2. Regulations
The program is governed by the following regulations:
- New York Codes, Rules and Regulations, Title 10, Part 766 (Rule 766)
- New York Codes, Rules and Regulations, Title 14, Part 635 (Rule 635)
- Education Law, Article 139 (New York State Nurse Practice Act)
- Social Services Law (Protection of People with Special Needs)
- Child Protective Services Act (State Central Register Reporting)
3. Licensing or Certification
Providers must be certified by the New York State Department of Health and follow all Home and Community-Based Services (HCBS) requirements
4. Responsible State Agency
The Office for People With Developmental Disabilities (OPWDD) is responsible for reviewing applications and certifying skilled nursing services providers
5. Application Process
The application process is conducted through the electronic New York Medicaid Portal. Providers must submit forms online to initiate the application 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 and operational rules, Agency policies, and procedures
Staff qualifications and training records
Proof of general and professional liability insurance
7. Timeline for Approval
The exact timeline for approval fluctuates based on agency capacity. Providers should contact their regional office for detailed information on current processing timeframes
8. Pre-Application Process
Prospective providers must complete specific foundation tasks before applying. They must establish their business entity and secure necessary federal identification numbers
9. Pre-Application Training
The state hosts mandatory administrative and compliance training sessions online. Access details are sent to qualified applicants once preliminary paperwork is reviewed
10. Additional Notes
Providers must ensure that intensive medical settings meet all state accessibility and environmental safety guidelines In-Home Nursing Care must be provided directly by the certified agency's employed personnel
All direct care staff must conduct mandatory background clearances and fingerprinting screenings
Providers must maintain detailed records of face-to-face services for Medicaid documentation and billing
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