La. Admin. Code tit. 48 § I-12510

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

Section I-12510 - Initial Application and Review Process for Nursing Facilities

A. The department will conduct an FNR to determine if there is a need for additional nursing facilities or beds to be licensed by LDH and/or enrolled to participate in the Title XIX program.

B. Facility need review applications shall be submitted on 8.5 inch by 11 inch paper that shall not include Health Insurance Portability and Accountability Act (HIPAA) protected information, to the HSS, FNR program manager by one of the following means:

1. via postal service to the designated FNR program mailing address; or

2. electronically via the HSS designated system or software.

C. Application forms may be requested in writing or by telephone from the FNR program, or accessed via the department's designated website.

D. The applicant shall also submit with its application, any written documentation or evidence the applicant believes supports its FNR application, including but not limited to the following examples.

1. Any data/documents regarding waiting lists for the proposed services in the applicant's service area.

2. Any letters from healthcare facilities, medical professionals or others, who have clients/patients/recipients awaiting the proposed services in the applicant's service area.

3. Any data/documentation of complaints about clients/patients/recipients not being able to access the proposed services in the applicant's service area.

4. Any data/documentation about population groups that do not have access to the proposed services in the applicant's service area, to whom the applicant will provide such services.

5. Other data/documentation about the need in the applicant's service area for the proposed services.

6. Other data/documentation about the probability of serious adverse consequences to recipient's ability to access healthcare if the applicant was not allowed to be licensed.

E. The applicant representative specified on the application will be the only person to whom the FNR program will send written notification in matters relative to the status of the application during the review process. If the applicant's application information or representative changes at any time during the review process, the applicant is required to notify the FNR program in writing.

F. The required nonrefundable FNR application fee of $200 shall be submitted either by mail to the designated payment address or electronically via the HSS designated system or software.

G. The review period of the initial application will be no more than 90 days from receipt of the FNR application; thereafter, a decision will be rendered by the department. The review period begins on the first day after the date of receipt of the completed application.

H. Grandfather Provision. An FNR approval shall be deemed to have been granted under this program without review for NFs that meet one of the following descriptions:

1. all valid Section 1122 approved healthcare facilities/beds;

2. all valid approvals for healthcare facilities/beds issued under the Medicaid Capital Expenditure Review Program prior to the effective date of this program;

3. all valid approvals for healthcare facilities issued under the FNR program; or

4. all NF beds that were enrolled in Medicaid as of January 20, 1991.

I. Exemptions from the FNR process shall be made for:

1. a NF that needs to be replaced as a result of destruction by fire or a natural disaster, such as a hurricane; or

2. a NF and/or facility building owned by a government entity that is replaced due to a potential health hazard.

La. Admin. Code tit. 48, § I-12510

Promulgated by the Department of Health, Health Standards Section, LR 50986 (7/1/2024).

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