Adult Residential Care Provider 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)

FNR Review - All Level 4 ARCP applicants are required to obtain Facility Need Review Approval prior to submitting a license application packet. Any Level 4 ARCP packets submitted without FNR approval will be denied. 

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 (click on link to open web page)

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

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-  click here 8x11 floor sketch or drawing of the premises
  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.)

Step 3

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

 

IMPORTANT:

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

DHH Licensing Payments

P.O. Box 734350

Dallas, TX 75373-4350

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

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