Louisiana Administrative Code
Title 48 - PUBLIC HEALTH-GENERAL
Part I - General Administration
Subpart 5 - Health Planning
Chapter 125 - Facility Need Review
Subchapter A - General Provisions
Section I-12501 - Definitions

A. Definitions. When used in this Chapter the following terms and phrases shall have the following meanings unless the context requires otherwise.

Abeyance of Nursing Facility Beds-a situation in which a nursing facility, if it meets certain requirements, may have all (but not only a portion) of its approved beds disenrolled from the Medicaid Program without causing the approval for the beds to be revoked after 120 days.

Adult Residential Care Provider (ARCP)-a facility, agency, institution, society, corporation, partnership, company, entity, residence, person or persons, or any other group, that provides adult residential care services for compensation to two or more adults who are unrelated to the licensee or operator. Adult residential care includes, but is not limited to the following services: lodging, meals, medication administration, intermittent nursing services, and assistance with personal hygiene, assistance with transfers and ambulation, assistance with dressing, housekeeping and laundry. For the purposes of this Facility Need Review (FNR) Rule, ARCP refers to an entity that is or will be licensed as an ARCP level 4-adult residential care provider. All ARCPs that have received FNR approval prior to August 1, 2022 shall retain FNR approval unless such FNR approval has expired. Facility need review approval is not required for any ARCP that is initially licensed August 1, 2022 or thereafter.

Agonist-a drug that activates certain receptors in the brain.

Antagonist-a drug that blocks opioids by attaching to the opioid receptors without activating them. Antagonists cause no opioid effect and block full agonist opioids. Examples of antagonists include, but are not limited to naltrexone and naloxone.

Applicant-the person who is developing the proposal for purposes of receipt of FNR approval for the healthcare facility or provider beds to proceed to apply for licensure, and/or certification by the Louisiana Department of Health (LDH).

Applicant Representative(s)-the person(s) specified by the applicant on the FNR application form to whom written notifications are provided relative to the status of the application during the review process.

Application-the required and completed FNR form(s), documentation, fee, and any other required information.

Approval-a determination by the FNR committee that an application meets the requirements of the FNR program for purposes of proceeding with licensure and/or certification by the department.

Behavioral Health Services (BHS-mental health services, addictive disorders and substance use disorders treatment services, or combination of such services, for adults, adolescents, and children.

Behavioral Health Services Provider (BHSP)-a facility, agency, institution, person, society, corporation, partnership unincorporated association, group, or other legal entity that provides behavioral health services or, presents itself to the public as a provider of behavioral health services. For the purposes of this Rule, FNR shall be applied to providers or applicants who elect to provide psychosocial rehabilitation services, community psychiatric support and treatment services, and/or opioid treatment program services licensed under a BHSP license.

CMS-Centers for Medicare and Medicaid Services.

Community Home-a type of community residential facility that has a capacity in accordance with R S. 28:451.2, or current law

Community Psychiatric Support and Treatment (CPST) Services-behavioral health services as defined in Title 48, Chapter 56.

Department-the Louisiana Department of Health (LDH).

Denial-a determination by the department's FNR committee that a proposal does not meet the requirements of the Facility Need Review (FNR) program and that the proposed healthcare facility or provider beds may not be licensed and/or certified.

Facility Need Review (FNR)-a review conducted for specific provider types to determine whether there is a need for additional licensed and/or certified healthcare providers and/or beds.

FNR Committee-LDH secretary appointed committee to review and render a decision to approve or deny an FNR application in accordance with R.S. 40:2116, or current law.

FNR Program-the program within LDH, Health Standards Section that oversees the day-to-day operations of FNR application intake and submission to the FNR committee, and communicates with applicants regarding the status of the application, and tracks the status of the decisions of the FNR committee.

Full Agonist-a drug that activates the opioid receptors in the brain fully, resulting in the full opioid effect. Examples of full agonists include, but are not limited to, heroin, oxycodone, methadone, hydrocodone, morphine, and opium.

Geographic Service Area-the geographic area under which a healthcare provider operates and/or provides services pursuant to licensing requirements, and for the purposes of FNR application review, the geographic area in which additional need will be assessed.

Group Home-a type of community residential facility that has a capacity in accordance with R.S. 28:451.2, or current law.

Health Standards Section (HSS)-the section of LDH that is responsible for licensing healthcare facilities, certifying those facilities that are applying for participation in the Medicaid (Title XIX) and Medicare (Title XVIII) Programs, and conducting surveys and inspections.

Home and Community Based Service (HCBS) Providers-those agencies, institutions, societies, corporations, facilities, person or persons, or any other group intending to provide or providing respite care (RC) services, personal care attendant (PCA) services, supervised independent living (SIL) services, monitored in-home caregiving (MIHC) services, or any combination of services thereof, including RC providers, SIL providers, MIHC providers, and PCA providers.

Hospice-an autonomous, centrally administered, medically directed program providing a continuum of home, outpatient, and homelike inpatient care for the terminally ill patient and his family. It employs an interdisciplinary team to assist in providing palliative and supportive care to meet the special needs arising out the physical, emotional, spiritual, social, and economic stresses that are experienced during the final stages of illness and during dying and bereavement.

Hospice Inpatient Facility-facility where specific hospice levels of care ranging from residential to acute, including respite, are provided in order to meet the needs of the patient/family.

Hospice Outpatient Provider-hospice services are provided to patients in their place of residence (e.g. their home, adult residential care provider, nursing home).

Hospice Providers-hospice inpatient facility or hospice outpatient provider that is licensed by LDH in accordance with the requirements of R.S. 40:2183, or current law.

Hospital Service District-a political subdivision of the state of Louisiana created or authorized pursuant to R.S. 46:1051 et seq., or current law.

Intermediate Care-Level I (IC-I)-a level of care within a nursing facility that provides basic nursing services under the direction of a physician to persons who require a lesser degree of care than skilled services, but who need care and services beyond the level of room and board. Services are provided under the supervision of a registered nurse (RN) seven days a week during the day tour of duty with licensed nurses twenty-four hours a day.

Intermediate Care-Level II (IC-II)-a level of care within a nursing facility that provides supervised personal care and health related services, under the direction of a physician, to persons who need nursing supervision in addition to help with personal care needs. Services are provided under the supervision of a RN 7 days a week during the day tour of duty with licensed nurses 24 hours a day.

Intermediate Care Facility for the Developmentally Disabled (ICF-DD)-a facility that provides developmentally disabled residents with professionally developed individual plans of care, supervision, and therapy in order to attain or maintain optimal functioning.

LDH Administrative Regions-the administrative regions and the parishes that comprise these regions are as follows:

Major Alteration-any repair or replacement of building materials and equipment that does not meet the definition of minor alteration.

Medicaid Program-the Louisiana medical assistance program administered in accordance with Title XIX of the Social Security Act.

Medicaid Program-the Louisiana medical assistance program administered in accordance with Title XIX of the Social Security Act.

Medication for Opioid Use Disorder-Food and Drug Administration (FDA) approved medication for opioid use disorder utilized to reduce opioid use and harmful opioid related behaviors when used as part of a comprehensive treatment program.

Minor Alteration-repair or replacement of building materials and equipment with materials and equipment of a similar type that does not diminish the level of construction below that which existed prior to the alteration. This does not include any alteration to the function or original design of the construction.

Monitored In-home Caregiving (MIHC) Services- home and community-based services module as defined in LAC 48:I, Chapter 50, pursuant to a HCBS provider license.

Notice of Abeyance-a written notice issued by the department to a nursing facility stating that the criteria for placing all of the facility's approved beds in abeyance have been met.

Nursing Facility (NF)-an institution that is primarily engaged in providing the following services to residents:

Opioid Agonist Treatment Medication-Food and Drug Administration approved medication to treat Opioid Use Disorder

Opioid Treatment Program (OTP)-a program that engages in medication-assisted opioid treatment of clients with an opioid agonist treatment medication.

Office of Behavioral Health (OBH)-LDH office and single state agency that is statutorily responsible for the treatment and prevention of addictive disorders and substance use disorders.

Opioid Treatment Program Needs Assessment- the determination of a need for new a new opioid treatment program in a geographic service area(s) by the department's Office of Behavioral Health in accordance with the criteria identified in Section 12527.

Partial Agonist-a drug that activates the opioid receptors in the brain, but to a much lesser degree than a full agonist. Buprenorphine is an example of a partial agonist.

Pediatric Day Health Care (PDHC)Providers- a facility that serves medically fragile individuals under the age of 21, including technology dependent children who require close supervision, in accordance with the requirements of LAC 48:I, Chapter 52.

Person-a human being or juridical person.

Personal Care Attendant (PAC)-home and community-based services module as defined in LAC 48:1, Chapter 50, pursuant to a HCBS provider license.

Physical Location-the specific address, building, or other permanent structure wherein the provider operates its business.

Pre-Approved Beds-beds and/or facilities that are automatically granted FNR approval in accordance with the grandfather provisions of this program.

Program-the Facility Need Review Program.

Psychosocial Rehabilitation (PSR) Services-behavioral health services as defined in Title 48, Chapter 56.

Respite Care (RC) Services-an intermittent service designed to provide temporary relief to unpaid, informal caregivers of the elderly, and/or persons with disabilities, pursuant to a HCBS provider license.

Secretary-the secretary of Louisiana Department of Health (LDh).

Supervised Independent Living (SIL) Services-home and community-based services module as defined in LAC 48:I, Chapter 50, pursuant to an HCBS provider license.

Skilled Nursing Care-a level of care within a nursing facility that provides intensive, frequent, and comprehensive nursing care, and/or rehabilitation services ordered by and under the direction of a physician. Services are provided under the supervision of an RN 7 day s a week during the day tour of duty with licensed nurses 24 hours a day. Skilled beds are located in nursing facilities and in distinct parts of acute care hospitals.

Skilled Nursing Facility-a nursing facility with the staff and equipment to give skilled nursing care and/or skilled rehabilitation services, and other related health services.

State Opioid Treatment Authority-the OBH authority within LDH who is designated to exercise the responsibility and authority within the state for governing the treatment of opioid use disorders within OTPs.