La. Admin. Code tit. 48 § I-12523

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-12523 - Home and Community-Based Service Providers (PCA, RC, SIL, and MIHC Modules Only)

A. Except as otherwise provided in this Chapter, no HCBS provider shall be licensed to operate unless the FNR committee has granted an FNR approval for the issuance of an HCBS provider license. Once the FNR approval is granted, an HCBS provider is eligible to be licensed by the department, subject to meeting all of the requirements for licensure.

B. The geographic service area for proposed or existing HCBS providers is the LDH administrative region that the provider is or will be licensed.

C. Determination of Need/Approval

1. The FNR committee will review the application to determine if there is a need for an additional HCBS provider in the geographic service area for which the application is submitted.

2. The FNR committee shall approve the FNR application only if the data contained in the application, and other evidence effectively establishes the probability of serious, adverse consequences to recipients' ability to access healthcare if the provider is not allowed to be licensed.

3. In reviewing the application, the FNR committee may consider, but is not limited to, evidence showing:

a. the number of other HCBS providers in the same geographic service area servicing the same population; and

b. allegations involving issues of access to healthcare and services.

4. The burden is on the applicant to provide data and evidence to effectively establish the probability of serious, adverse consequences to recipients' ability to access healthcare if the provider is not allowed to be licensed. The FNR committee shall not approve an FNR application if it fails to provide such data and evidence.

D. Applications for approvals of licensed providers submitted under these provisions are bound to the description in the application with regard to the type of services proposed as well as to the physical location and/or geographic service area as defined in the application. Facility need review approval of licensed providers shall expire if these aspects of the application are altered or changed.

E. Except as provided in the Subparagraphs below, FNR approvals for licensed providers are non-transferrable and are limited to the physical location and the name of the original licensee.

1. An HCBS provider undergoing a change of physical location in the same licensed geographic service area shall submit a written attestation of the change of physical location, including the license number, state ID, current address and new address, and the department shall re-issue the FNR approval with the name and new physical location. An HCBS provider undergoing a change of physical location outside of the licensed geographic service area shall submit a new FNR application and fee and undergo the FNR approval process.

2. An HCBS provider undergoing a change of ownership shall submit a new application to the department's FNR program, requesting a transfer of the FNR approval to the new owner. Facility need review approval for the new owner shall be granted upon submission of the new application and proof of the change of ownership, provided that the legal change of ownership documents require the seller's or transferor's written relinquishment of the FNR approval.

3. Facility need review approval of a licensed provider shall automatically expire if the provider is moved or transferred to another party, entity, or geographic service area/physical location without application to and approval by the FNR program.

F. FNR-approved HCBS applicants shall become licensed no later than six months from the date of the FNR approval.

1. A one-time 90-day extension may be granted, at the discretion of the department, when delays are caused by circumstances beyond the control of the applicant. Inappropriate zoning is not a basis for extension.

2. Failure to meet any of the timeframes in this Section shall result in an automatic expiration of the FNR approval of the HCBS agency.

La. Admin. Code tit. 48, § I-12523

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 35:2438 (November 2009), Amended LR 412637 (12/1/2015), Promulgated by the Department of Health, Health Standards Section, LR 50231 (2/1/2024).

AUTHORITY NOTE: Promulgated in accordance with R.S. 40:2116 et seq.