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) is received.

The application process will be terminated for applicants who have not completed the submission of all the required forms and supplemental information within ninety (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 new initial licensing fee.

All applicable fees must be submitted by way of Company Check, Cashier's Check or Money Order payable to DHH. 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. Website (click here)

Step 1

Information to be included in the completed Initial Licensing Packet:

1. Obtain Health Care 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 or website

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Step 2

Please submit the following requested information with your application:

1. ARCP Licensing Application form
2. Application fee of $600.00 & Facility Unit fee - $5 for every unit. A unit is an apartment or resident room
3. Payment Transmittal Form (click link to open Payment Transmittal Form on Payment Procedure website)
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) (click link to open form)
6. Copy of Health Care 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 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 worker's 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 $100,00, along with proof of enrollment as a qualified health care 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:  The 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 & Application Packet) (Level 4 ARCP)
14. On-site Inspection Approvals (Office of Public Health & State Fire Marshal)
    1. Office of Public Health- click here
    2. Office of State Fire Marshal-  Phone- 225-925-4920
    3. OPH Plan Review Questionaire - click here
15. Copy of Louisiana Secretary of State Articles of Incorporation
16. Other Licenses - approval from any pertinent local agencies as required in your areas. (Zoning, occupation license, local fire ordinance, etc.)

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Step 3

Health Standards Section will conduct an initial licensing survey to verify compliance with the minimum licensing regulations, prior 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 US Postal Services 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 Marshall 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 worker's 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 $100,00, along with proof of enrollment as a qualified health care 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:  The 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 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 by clicking here.
2. *Licensing Fee: Click here for the link for the 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 worker's 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 health care 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:  The 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:  https://ldh.la.gov/page/building-premise-plans-review-documents

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

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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