HSS Change of Ownership Information: HCBS
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:
- Letter of Intent (including d/b/a (doing business as) and entity name of the previous and the new owner, the effective date of change of ownership, address and phone number).
- A diagram showing the ownership structure “before” and “after” the change
- Copy of the executed legal transaction documents (Bill of Sale, lease, etc.)
- CHOW/CHOI License Application
- Change of Ownership Application
- 855A/B approval letter for the following Medicare Certified providers: Home Health, hospice, hospitals, RHCs, ASCs, ESRDs, portable x-ray, community mental health, CORF, Nursing Facilities, 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 are also needed:
- Does your facility have a CLIA Certificate? If yes, you may also be required to complete a CHOW for CLIA.
Note: The fee for a CHOW is usually the same as a license renewal unless the facility is making additional changes. For providers completing an acquisition/merger, please contact the program desk for assistance.
The Louisiana licensing regulations for Home and Community Based Service Providers (HCBS) states that a change of ownership (CHOW) of an HCBS provider shall be reported in writing to the department within five working days of the change. The license of an HCBS provider is not transferable or assignable and cannot be sold. If the CHOW is accepted and processed by the LDH Health Standards Section (HSS), the new owner will be issued a new license. The new owner is not eligible to bill Medicaid for services until their license is issued and they have submitted the necessary provider enrollment forms to the Molina Healthcare Provider Enrollment section. If the CHOW results in a change of geographic address, an on-site survey may be required prior to issuance of the new license.
It is important to note that if an HCBS Provider is providing PCA, SIL or Respite services and wishes to undergo a CHOW, the prospective NEW owner shall be required to do the following two procedures simultaneously (at the same time):
The prospective NEW owner of an HCBS agency shall submit a new Facility Need Review (FNR) application to the department’s FNR program manager. The FNR application shall be accompanied by a letter of intent to purchase an HCBS agency. The specific HCBS agency shall be identified on both the FNR application and in the letter of intent. There is an FNR application fee of $200. FNR approval for the new owner shall be granted upon submission of the new application and proof of the change of ownership, which must show the seller’s or transferor’s intent to relinquish the FNR approval to the prospective new owner. A copy of the FNR application, instructions and a copy of the FNR rule can be found at the following link: Facility Needs Review
Additional Documents Required:
Once all application requirements are completed and approved by the department, a new license shall be issued to the new owner.
A CHOW will not be processed if the current owner (seller) meets any of the following:
- Is under license revocation;
- Is under investigation by the State Attorney General's office;
- Is excluded from participation in the Medicaid program or under vendor hold;
- Is under penalties imposed by the IRS or other federal or state agency or
- Has ceased to operate and does not meet operational requirements to hold a license as defined by Section 5031, Business Location, of HCBS licensing standards.
For all other Change of Ownership Information, please contact the HSS Ownership Group