Adult Day Health Care License Renewal

The following is required to complete the Adult Day Health Care renewal process:

  1. Adult Day Health Care Provider Renewal Application;
  2. HSS PaymentTransmittal Form- Listed on the HSS Payment Procedure website
  3. Application license fee;
  4. $600.00 license renewal fee;
  5. Proof of continuous financial viability without interruption including the maintenance of a line of credit issued from a federally insured, licensed lending institution in the amount of at least $50,000;
  6. Current State Fire Marshall Report.  Facilities located in New Orleans must also submit the city Fire Marshall Report;
  7. Current Office of Public Health inspection report;
  8. For PACE ADHC Providers (only):
    1. proof of PACE program agreement, if accredited;
    2. Licensing Application Addendum for PACE. Effective April 1, 2018, all license renewal applications shall include a completed emergency preparedness attestation form; 
  9. 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:

 

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