Adult Residential License Renewal Procedure

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. Website (click here)

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. Non-refundable License Renewal Fee;
  3. 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);
  4. Current State Fire Marshall Report;
  5. Current Office of Public Health inspection report;
  6. Proof of general liability insurance of at least $300,000 per occurrence
  7. Proof of worker's compensation insurance as required by state law
  8. 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)

 

HSS Payment Procedure website: http://new.dhh.louisiana.gov/index.cfm/page/1737

 

IMPORTANT:

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

LDH Licensing Fee
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