Current through Register Vol. 50, No. 9, September 20, 2024
A. No
healthcare provider designated in
R.S.
40:2116 or R.S. 40.2116.1 shall be licensed
by LDH and/or certified to participate in the Title XIX program without first
obtaining FNR approval and complying with any and all licensing regulations
promulgated by LDH. Any person establishing, managing, or operating a facility,
provider, service, or bed without the approval required by this Chapter shall
immediately cease providing services and shall be prohibited from obtaining a
license from LDH and/or participating in the Title XIX program, until FNR
approval has been granted by the department.
B. The FNR committee shall consist of the
following members:
1. the secretary of LDH,
or his designee;
2. the assistant
secretary of the Office of Behavioral Health (OBH) of LDH, or his
designee;
3. the assistant
secretary of the Office for Citizens with Developmental Disabilities (OCDD) of
LDH, or his designee;
4. the
assistant secretary of the Office of Aging and Adult Services (OAAS) of LDH, or
his designee;
5. the assistant
secretary of the Office of Public Health (OPH) of LDH, or his
designee;
6. the Medicaid director
of LDH, or his designee;
7. the
Medicaid medical director of LDH, or his designee; and
8. any additional FNR committee members
appointed by LDH secretary when necessary in reviewing applications of OTPs,
including but not limited to the following individuals:
a. the LDH OBH medical director or physician
who has expertise in substance use disorder treatment and, in particular,
opioid treatment;
b. an addiction
counselor licensed in the state of Louisiana by Addictive Disorder Regulatory
Authority; and
c. the Louisiana
State Opioid Treatment Authority.
C. The FNR committee will conduct an FNR to
determine if there is a need for additional providers, facilities, or beds to
be licensed by LDH and/or enrolled to participate in the Title XIX program for
the following healthcare facility types, as defined under this Chapter:
1. intermediate care facilities for persons
with developmental disabilities (ICF-DD);
2. home and community-based service (HCBS)
providers of respite care (RC) services, personal care attendant (PCA)
services, supervised independent living (SIL) services, and monitored in-home
caregiving (MIHC) services;
3.
hospice providers;
4. pediatric day
health care (PDHC) facilities;
5.
behavioral health services providers (BHSP)of psychosocial rehabilitation (PSR)
services, and community psychiatric support and treatment (CPST) services;
and
6. behavioral health services
providers of opioid treatment program (OTP) services;
7. - 8. Repealed.
D. The responsibilities and duties of the FNR
committee include, but are not limited to:
1.
conducting initial and supplemental reviews of each FNR application, as
applicable;
2. determining whether
each application meets the established criteria for FNR approval; and
3. sending FNR application approval and/or
denial notices.
E. No FNR
committee member shall have a proprietary or financial interest in any
healthcare facility subject to FNR.
F. The department will determine if there is
a need for additional providers, facilities, or beds to be licensed by LDH
and/or enrolled to participate in the Title XIX program for nursing
facilities.
G. Except as otherwise
provided in the grandfather provisions of these regulations, each healthcare
provider designated in
R.S.
40:2116 or
R.S.
40:2116.1 shall first receive FNR approval
before applying to be licensed by LDH and before being certified to participate
in the Title XIX program.
1. - .4.
Repealed.
H. Grandfather
Provision. An approval shall be deemed to have been granted under this program
without review for NFs, ICFs/DD, and/or beds 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 Expenditures 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.
5. - 8.
Repealed.
I. Additional
Grandfather Provision. An approval shall be deemed to have been granted under
FNR without review for HCBS providers of RC, PCA, SIL, or MIHC services,
ICFs/DD, hospice providers, PDHC providers, or BHSPs that meet one of the
following conditions:
1. Home and Community
Based Service providers that were licensed by January 31, 2009 or had a
completed initial licensing application submitted to the department by June 30,
2008;
2. existing licensed ICFs-DD
that are converting to the Residential Options Waiver;
3. licensed Adult Day Health Care (ADHC)
providers who are enrolled or will enroll in the Louisiana Medicaid Program as
a Program for All-inclusive Care for the Elderly (PACE) provider and apply for
an HCBS license to provide PCA services as required by the program;
4. hospice providers that were licensed or
had a completed initial licensing application submitted to the department by
March 20, 2012;
5. pediatric day
health care providers that were licensed by the department before March 1,
2014, or an entity that meets all of the following requirements:
a. has a building site or plan review
approval for a PDHC facility from the Office of State Fire Marshal by March 1,
2014;
b. has begun construction on
the PDHC facility by April 30, 2014, as verified by a notarized affidavit from
a licensed architect submitted to the department, or the entity had a fully
executed and recorded lease for a facility for the specific use as a PDHC
facility by April 30, 2014, as verified by a copy of a lease agreement
submitted to the department;
c.
submits a letter of intent to the department's HSS by April 30, 2014, informing
the department of its intent to operate a PDHC facility; and
d. became licensed as a PDHC by the
department no later than December 31, 2014.
6. behavioral health services providers that
are licensed to provide PSR and/or CPST, or that have submitted a completed
application for licensure as a BHSP that includes PSR and/or CPST, prior to
February 20, 2018;
7. behavioral
health services providers that are licensed to provide OTP services, or that
have submitted a complete application for licensure as a BHSP that includes OTP
services prior to January 1, 2024; or
8. behavioral health services providers that
fall within the provisions of Act 33 of the 2017 Regular Session of the
Louisiana Legislature, commonly referred to as accredited mental health
rehabilitation providers, that submit a completed BHSP licensing application by
December 1, 2017 and become licensed by April 1, 2018.
J. 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.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254 and
R.S.
40:2116 et
seq.
