Adult Residential Care Provider (ARCP)

Initial Licensure

The Department of Health (LDH) shall not process any application until all completed forms, required applicable accompanying information, and the application fee (where required) are received.

The application process will be terminated for applicants who have not completed the submission of all the required forms and supplemental information within 90 days of notification of the request for the missing information. Applicants who are still interested in applying must begin the initial process with the submission of a new application packet with a new initial licensing fee.

All applicable fees must be submitted by way of company check, cashier's check, or money order payable to LDH. Application fees are non-refundable.

When all of the required forms, fees, and information have been received, the applicant will be notified of approval of the packet. Once approval has been received, the ARCP applicant shall notify LDH of the readiness for an initial survey within 90 days. Failure to notify LDH of readiness for an initial licensing survey within 90 days will result in the application being closed. Once the application is closed, the ARCP provider must restart the application process.

Note: All ARCPs are required to file an electronic report with the ESF-8 Portal (EMSTAT) during a declared emergency, disaster, or public health emergency. Please visit the ESF-8 website to register your ARCP.

Step 1

Information to be included in the completed initial licensing packet:

1. Obtain Healthcare Licensing Plan Review approval from the Office of State Fire Marshal Health Care Licensing Plan Review Internet Site 

Office of State Fire Marshal Plan Review Contact Information: Phone: 225-925-4920 or Fax: 225-925-4414.

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Step 2

Please submit the following requested information with your application:

1. ARCP Licensing Application form
2. Application fee of $600 and Facility Unit fee - $5 for every unit. A unit is an apartment or resident room
3. Payment Transmittal Form
4. Letter of Intent (include the level you plan to license; facility name; facility address, and if new construction, the construction completion date)
5. Form HSS-1513L (Disclosure of Ownership)
6. Copy of Healthcare Licensing Plan Review Approval Letter
7. Copy of approved floor plan diagram with green stamp approval from the Office of State Fire Marshal
8. A copy of criminal background checks from the Louisiana State Police for all owners of the facility
9. Approved criminal background check agencies. Proof of financial viability to include: a. A letter of credit issued from a federally insured, licensed lending institution in the amount of at least $100,000 or the cost of three months operation, whichever is less; or b. a notarized affidavit of verification of sufficient assets equal to $100,000 or the cost of three months operation, whichever is less;
10. Proof of general liability insurance of at least $300,000 per occurrence
11. Proof of workers' compensation insurance as required by state law
12. Proof of professional liability insurance of at least $100,000 per occurrence/$300,00 per annual aggregate, or proof of self-insurance of at least $100,000, along with proof of enrollment as a qualified healthcare provider with the Louisiana Patient's Compensation Fund (PCF):
    1. If the ARCP is self-insured and is not enrolled in the PCF, professional liability limits shall be $1,000,000 per occurrence/$3,000,000 per annual aggregate
    2. NOTE:  LDH/HSS shall specifically be identified as the certificate holder on any policies and any certificates of insurance issued as proof of insurance by the insurer or producer (agent)
13. CLIA (Lab Memo and Application Packet) (Level 4 ARCP)
14. On-site Inspection Approvals (Office of Public Health and State Fire Marshal)
    1. Office of Public Health
    2. Office of State Fire Marshal: Phone: 225-925-4920
    3. OPH Plan Review Questionnaire
15. Copy of Louisiana Secretary of State Articles of Incorporation
16. Other Licenses: Approval from any pertinent local agencies as required in your area (zoning, occupation license, local fire ordinance, etc.)

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Step 3

The Health Standards Section will conduct an initial licensing survey to verify compliance with the minimum licensing regulations before issuing the ARCP license.

License Renewal

Please be sure to complete all sections of the renewal application. If a particular section does not apply to the facility, please insert N/A. If all sections of the application are not completed, the application will be returned to the administrator. 

Note- All ARCPs are required to file an electronic report with the ESF-8 Portal (EMSTAT) during a declared emergency, disaster, or public health emergency. Please visit the ESF-8 website to register your ARCP.

Effective June 20, 2017, providers wanting to send express mail must do so by using either U.S. Postal Service Priority Mail or Priority Mail Express, not FedEx or UPS.

1. Adult Residential Care Provider Renewal Application form
2. Payment Transmittal Form
3. Non-refundable License Renewal Fee
4. Proof of Financial Viability to Include: a. A letter of credit issued from a federally insured, licensed lending institution in the amount of at least $100,000 or the cost of three months' operation, whichever is less; or b. affidavit of verification of sufficient assets equal to $100,000 or the cost of three months' operation, whichever is less (for verification of sufficient assets letter must be notarized);
5. Current State Fire Marshal report;
6. Current Office of Public Health inspection report
7. Proof of general liability insurance of at least $300,000 per occurrence
8. Proof of workers' compensation insurance as required by state law
9. Proof of professional liability insurance of at least $100,000 per occurrence/$300,00 per annual aggregate, or proof of self-insurance of at least $100,000, along with proof of enrollment as a qualified healthcare provider with the Louisiana Patient's Compensation Fund (PCF):
   1. If the ARCP is self-insured and is not enrolled in the PCF, professional liability limits shall be $1,000,000 per occurrence/$3,000,000 per annual aggregate
   2. NOTE: LDH/HSS shall specifically be identified as the certificate holder on any policies and any certificates of insurance issued as proof of insurance by the insurer or producer (agent)

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Change of Ownership Information

Providers must complete this document when they have a change in their ownership structure. This document would be used for both a change of ownership (CHOW) as defined by state and/or federal regulations, or a change of ownership information (CHOI) that does not meet the state and/or federal regulations CHOW definition.

For Health Standards to make a CHOW/CHOI determination, all providers must submit the following documents:

1. *Letter of Intent (including d/b/a and entity name of the previous and the new owner, the effective date of transfer of ownership, address, and phone number)
2. *A diagram showing the ownership structure before and after the change
3. *Copy of the executed bill of sale
4. *CHOW/CHOI License Application
5. *855A/B approval letter for the following providers: Home health, hospice, hospitals, RHCs, ASCs, ESRDs, portable x-ray, community mental health, and OPT

Note: If this action is a CHOI, the documents above are the only documents you need to submit; however, the Department may, at its discretion, request additional documentation in support of the CHOI. If so, you will be contacted for any of the said additional documents. There is no fee for a CHOI. 

If this action is a CHOW, the following documents are also needed:

1. Does your facility have a CLIA certificate? If yes, contact the CLIA program here.
2. *Licensing Fee: Health Standards Fee Schedule

The fee for a CHOW is usually the same as a license renewal unless the facility is making additional changes. For the providers completing an acquisition/merger, please contact the program desk for assistance.

Additional Documents Required:

1. CHOW application
2. Payment Transmittal Form and Payment
3. Letter of Intent
4. Bill of sale/legal CHOW documents
5. Criminal background checks for all owners
6. Proof of Financial Viability: a. A letter of credit issued from a federally insured, licensed lending institution in the amount of at least $100,000 or the cost of three months of operation, whichever is less; or b. affidavit of verification of sufficient assets equal to $100,000 or the cost of three months' operation, whichever is less
7. Secretary of State Articles of Incorporation
8. Proof of general liability insurance of at least $300,000 per occurrence
9. Proof of workers' compensation insurance as required by state law
10. Proof of professional liability insurance of at least $100,000 per occurrence/$300,00 per annual aggregate, or proof of self-insurance of at least $100,00, along with proof of enrollment as a qualified healthcare provider with the Louisiana Patient's Compensation Fund (PCF):
    1. If the ARCP is self-insured and is not enrolled in the PCF, professional liability limits shall be $1,000,000 per occurrence/$3,000,000 per annual aggregate
    2. NOTE: LDH/HSS shall specifically be identified as the certificate holder on any policies and any certificates of insurance issued as proof of insurance by the insurer or producer (agent)
11. Office of Public Health Plan Review Approval – See “Residental Plan Review Packet” – Website:  OPH Plan Review Questionnaire

For all other Change of Ownership Information, please contact the HSS Ownership Group

Note: All ARCPs are required to file an electronic report with the ESF-8 Portal (EMSTAT) during a declared emergency, disaster, or public health emergency. Please visit the ESF-8 website to register your ARCP. Website (click here)

Once all application requirements are completed and approved by LDH, a new license shall be issued to the new owner.

Emergency Preparedness

Re-Entry Process for Reoccupying and Reopening Following Emergency Events

• LDH-HSS Memo-Reoccupy Requirements updated 08/02/2024
  • HSS EP Form
  • OSFM Memo-Healthcare Facilities Evacuated during a Hurricane or State Declared Emergency
  • OPH-Health Care Facility Reoccupation Tool

The Louisiana Department of Health (LDH) created the ESF-8 Portal as a gateway to a suite of applications which are used to gather Emergency Status information on facilities licensed by the Department.

THE "ESF-8 Portal" AND ITS APPLICATIONS ARE NOT TO BE USED TO REQUEST IMMEDIATE EMERGENCY SUPPORT OR ASSISTANCE! REQUEST FOR EMERGENCY RESOURCES SHOULD BE ROUTED THROUGH YOUR PLANNED CHANNELS STARTING WITH LOCAL EMERGENCY RESOURCES! ESF-8 Portal and its Applications are not continuously monitored.

All Levels 1-4 of Adult Residential Care Providers are to enter, maintain and update the following ESF -8 Applications and provide information as required or as requested:

Security Management - To be kept current and updated as needed or as requested;

• The contact information entered in this application will be used to send communications related to emergency situations or ESF-8 functions and applications. The facility is required to keep the facility contacts current;

Mstat - To be kept current and updated as requested or as required;

• Statuses for Operation, Evacuation, Power, Fuel, and Utility - to be kept current;
• Census - The facilities census information shall be updated as requested;
• Generator(s) information - To be kept current and updated as needed or as requested;
• Transportation information - To be kept current and updated as needed or as requested;
• Evacuation Destination(s) information - To be kept current and updated as needed or as requested;
• Utility Providers information - To be kept current and updated as needed or as requested; and,
• Patient/Resident List information - To be entered as requested or submitted as requested.

The following information will be needed to complete your ESF-8 applications updates:

• Emergency Contacts (persons in security management) - Names, Types/Positions, Phone and Email information
• Utility Providers- Name and account # for Electricity, Water, Natural Gas providers
• Evacuation Host Sites - Names, Addresses, Contact information, Agreement dates
• Emergency Transportation Providers- Names, Addresses, Contact information, Agreement dates
• Census Information - the current facility census, total number of residents including those on leave or at hospital, triaged by "Red, Yellow, Green" transportation needs
• Facility Generator(s) -  Make/Model, Output in Kilowatts, Phase (single or three), Voltage, Burn Rate, Services supplied, Fuel type, Fuel Tank information

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Payments & Payment Transmittal form must be submitted to Chase Bank P.O. Box Below:

LDH Licensing Payments
P.O. Box 734350
Dallas, TX 75373-4350

Documentation, such as the application form, Disclosure of Ownership, OPH reports must be sent to the Health Standards Section at:

Health Standards Section
P.O. Box 3767
Baton Rouge, LA 70821-3767

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