How to start a private duty nursing agency in Louisiana

Louisiana requires a Home health agency license and Medicare certification (LDH Health Standards Section) from Louisiana Department of Health — Health Standards Section (license/certification); Louisiana Medicaid (enrollment) to operate a private duty nursing agency.

License required

Yes

License

Home health agency license and Medicare certification (LDH Health Standards Section)

Issuing agency

Louisiana Department of Health — Health Standards Section (license/certification); Louisiana Medicaid (enrollment)

Regulation

Louisiana Medicaid Services Manual, Chapter 23 (Home Health), Section 23.4

1. Obtain a home health agency license and Medicare/Medicaid certification through LDH Health Standards Section
2. Enroll with Louisiana Medicaid as a home health agency
3. Obtain prior authorization for extended skilled nursing (3+ continuous hours/day) for beneficiaries under 21

Staffing

• Louisiana-licensed RNs or LPNs

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 →

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 →

Model

hybrid

State vendor

Statistical Resources, Inc. (LaSRS)

Services in scope

• personal care
• home health
• HCBS waiver services

Alternate EVV allowed

Yes

Program

https://ldh.la.gov/medicaid/electronic-visit-verification

Louisiana EVV requirements →

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.

Nursing care agencies (private duty nursing) — active organization NPIs (NPPES)

180 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

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

All Louisiana Private duty nursing 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 →