How to start an adult day care center in Louisiana

Louisiana requires a Adult day health care center license (medical model; 2 or more unrelated functionally impaired adults; open at least 5 continuous hours a day) from Louisiana Department of Health, Health Standards Section to operate an adult day care center. Fee: A non-refundable application fee is required where applicable (company check, cashier's check or money order); the amount is not on the page.

License required

Yes

License

Adult day health care center license (medical model; 2 or more unrelated functionally impaired adults; open at least 5 continuous hours a day)

Issuing agency

Louisiana Department of Health, Health Standards Section

Fee

A non-refundable application fee is required where applicable (company check, cashier's check or money order); the amount is not on the page.

Renewal

Renewal requires the ADHC renewal application and proof of continued financial viability, including the $50,000 line of credit.

Insurance and bonds

Proof of financial viability: a line of credit of at least $50,000 from a federally insured, licensed lender.

Medicaid waiver coverage

HHS (2014) reported that licensed ADHC providers serve the Community Choices and Adult Day Health Care 1915(c) waivers.

Certificate of need

Required

Regulation

LAC 48:I, Chapter 42 (Adult Day Health Care licensing standards)

1. Get Facility Need Review approval (HHS 2014: no ADHC license is issued without it)
2. Submit the ADHC licensing application with the fee and listed attachments, including a $50,000 line of credit and local zoning, occupational and fire approvals
3. Respond within 90 days if LDH reports the packet incomplete
4. Pass the Health Standards Section initial licensing survey

Program

Louisiana Medicaid (Louisiana Department of Health) — Healthy Louisiana

Enrollment portal

Louisiana Medicaid Provider Enrollment Portal (via www.lamedicaid.com)

Fiscal agent

Gainwell Technologies (Louisiana Medicaid fiscal intermediary; runs provider enrollment and screening)

Application fee

Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Louisiana applies fingerprint-based criminal background checks by risk level at enrollment and at every revalidation. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

Louisiana applies site visits by risk level at enrollment and at every revalidation. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

Louisiana revalidates all providers, including ordering/referring providers, at least every five years, and DMEPOS providers every three years. Notices go out by email and letter; there are no exemptions or extensions, and missing the due date means denied claims and deactivation, requiring a full new application. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Louisiana Medicaid enrollment guide →

For this business

Required (licensing source)

CON program

Yes

Program

Facility Need Review (FNR)

Agency

Louisiana Department of Health, Health Standards Section (FNR program)

Services covered

• nursing facilities and nursing facility beds (licensed and Medicaid-certified)
• HCBS providers: personal care attendant, supervised independent living, monitored in-home caregiving and respite
• hospice providers and inpatient hospice facilities
• pediatric day health care facilities
• behavioral health providers offering psychosocial rehabilitation (PSR) and/or community psychiatric support and treatment (CPST)
• residential substance abuse treatment
• opioid treatment program clinics
• ICF/IID

Moratoria

A statutory moratorium (R.S. 40:2116.1(B)) bars new FNR approvals for nursing facilities or additional nursing facility beds until it expires; the rules separately allow relocation, conversion and abeyance of existing beds.

Louisiana certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

Direct-care wage floor

OCDD waivers (New Opportunities, Children's Choice, Supports, Residential Options): since 2021-10-01 direct support workers must be paid at least $9.00/hour, alongside a $2.50/hour rate increase.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Adult day care clinics/centers — active organization NPIs (NPPES)

119 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,264,327 (as of Jun 1, 2026)

All Louisiana Home care Medicaid rates, ranked →

• Adult Day Health Care (ADHC) Waiver (1915(c))
• Children's Choice (CC) Waiver (1915(c))
• Community Choices (CC) Waiver (1915(c))
• Coordinated System of Care (CSoC) Severely Emotionally Disturbed (SED) Children's Waiver (1915(c))
• New Opportunities Waiver (NOW) (1915(c))
• Residential Options Waiver (ROW) (1915(c))
• Supports Waiver (1915(c))

Louisiana waivers and waiting lists →