Home Health Agencies

Initial Licensure Requirements – read Title 175 NAC 14-003.01

• Stage 1: Submit to the Department a complete application
• Stage 2: Pass an onsite inspection 
  

Please see the Inspections section of this page for initial inspection information.  

Renewal Licensure Requirements – read Title 175 NAC 14-003.02

• Stage 1: Department mails to licensee a notice of expiration and a renewal application.
• Stage 2: Licensee returns to the Department the renewal application with correct owner signatures, owner titles, dates, renewal fee, and additional items as required at 175 NAC 14-003.02A.
• Stage 3: Department mails to licensee an updated license card after a complete renewal application is received. 

Fees: The licensee must pay fees for licensure and services as set forth at 175 NAC 14-004.10.

Forms: The initial application form may be completed online but must be printed, signed, and mailed to our office. We require an original signature on all applications.

• Initial License Application
• Renewal License Application: please call (402) 471-4967
  

Brochure: Medicare Home Health Agency Hotline Brochure (double-side print this trifold form) must be provided by HHA staff to all Medicare patients at time of admission to the HHA. 

Notifications: An applicant or licensee must notify the Department in writing, by mail, email, or fax.

Additional General Requirements:

• Change of ownership: The sale, whether of stock, title, or assets, lease, or discontinuance of operations terminates the license. The licensee must notify the Department in writing 10 days before a home health agency is sold, leased, or discontinued. A license is issued only for the premises and persons named in the application and is not transferable or assignable.
• Change in premises: Does not terminate the license of a home health agency. The licensee must notify the Department in writing before a home health agency changes location. If the location change includes a county change, the new county must be contiguous with the home health agency's geographic service area previously approved by the Department.

Forms: The following form may be completed online but must be printed, signed, and mailed to our office.
Change or Correction Request Form

The Department inspects the home health agency prior to and following licensure to determine compliance with 175 NAC 14-006 – Standards of Operations, Care and Treatment. The home health agency may not operate without an active license issued by the Department. Inspection requirements are at 175 NAC 14-005.

Initial Licensure Inspections:

An onsite inspection is scheduled with the applicant after the Department has received a complete initial licensure application as required at 175 NAC 14-003.01A and 14-003.01B, and a written notification from the applicant with the date the applicant will be ready for the inspection. Unless the applicant requests a later date, the Department has 30 working days to conduct this initial onsite inspection after a complete application is received by the Department.

Prior to submitting an initial license application or requesting the initial onsite licensing inspection, the applicant should be ready to operate, but not operating. The agency's owner, Administrator and back-up Administrator must be prepared to demonstrate during the Department's onsite inspection how the agency will comply with the requirements at 175 NAC 14-006. Compliance is demonstrated through the use of agency-specific organizational charts, job descriptions, policies, procedures, forms, and similar items prior to the applicant being issued a license by the Department.

Compliance Inspections:

Following initial licensure, the Department may conduct unannounced onsite inspections at any time the Department deems necessary to determine compliance with 175 NAC 14-006.

Inspection Results: See 175 NAC 14-005. 

Certification means: The service is in compliance with the federal requirements 42 CFR Part 484.1-484.55 and is eligible to receive payment under the Medicare program. The service must have a Home Health Agency (HHA) state license issued by the Department prior to being certified in the Medicare/Medicaid program.

• Centers for Medicare and Medicaid Services (CMS) HHA Center - News and resources for Home Health Agencies
  
• CMS Survey & Certification  

• CMS Medicare Provider/Supplier Enrollment  

Any HHA seeking Medicare certification is required to meet the Medicare Conditions of Participation (CoP) prior to certification. This includes compliance with the OASIS (Outcome and Assessment Information Set) collection and transmission requirements. New HHAs must demonstrate that they can transmit OASIS data prior to the initial certification survey. Transmission must also occur upon receipt of the CMS Certification Number. CMS advises HHAs to save copies of their validation reports. The following are links to OASIS and OASIS-related web sites.

• OASIS Information
• OASIS Coding & Billing Questions
• OASIS Test Transmissions: (402) 471-9678

Contacts

Medicare Initial Provider Enrollment Application Packet: (402) 471-4967 

MDS/OASIS Automation Coordinator

Dawn Sybrant, DHHS Program Specialist
DHHS Medicaid and Long Term Care
Phone (402) 471-9678, Fax (402) 471-9092
E-mail: dawn.sybrant@nebraska.gov

MDS/OASIS Education Coordinator

Division of Public Health, Licensure Unit
Phone (402) 471-4967 Fax (402) 742-2308
E-mail:  dhhs.OutpatientAndInHomeCareServices@nebraska.gov​