1. GOVERNING AGENCIES

Agency: Louisiana Department of Health (LDH) — Office of Aging and Adult Services (OAAS)
Role: Administers Medicaid waiver programs that fund adult day health services and monitors provider compliance

Agency: Health Standards Section (HSS) of LDH
Role: Licenses and inspects Adult Day Health Care facilities to ensure compliance with state health and safety standards

Agency: Medicaid Management Information System (MMIS) / Molina Medicaid Solutions
Role: Processes enrollment, claims, and reimbursement for approved ADHS providers

Agency: Managed Care Organizations (MCOs)
Role: Authorizes services under a participant’s Plan of Care (POC), coordinates service delivery, and manages claims processing

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2. SERVICE OVERVIEW

Adult Day Health Services are center-based, medically supervised day programs that provide:

• Nursing services (e.g., medication administration, health monitoring)
• Assistance with Activities of Daily Living (ADLs) such as toileting and grooming
• Structured recreational and therapeutic activities
• Nutritional support, including meals and snacks
• Social services and caregiver support
• Physical, occupational, or speech therapies (as authorized)
• Transportation to and from the day center (if required and approved)

ADHS must be delivered according to a Plan of Care developed by the participant, case manager, and care team, and overseen by licensed health professionals.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the Louisiana Secretary of State
• Obtain an IRS EIN and Type 2 NPI
• Secure Adult Day Health Care (ADHC) Facility Licensure from the LDH Health Standards Section
• Enroll as a Medicaid provider through the Louisiana Medicaid Provider Enrollment Portal
• Maintain liability and malpractice insurance
• Hire licensed nurses, direct care staff, and activity coordinators
• Develop an Adult Day Health Services Policy & Procedure Manual
• Implement HIPAA-compliant EHR, scheduling, and billing systems

4. LOUISIANA PROVIDER ENROLLMENT PROCESS

Step 1: ADHC Facility Licensure

• Apply to the LDH Health Standards Section
• Undergo inspection of facility design, safety systems, staffing, and service plans

Step 2: Medicaid Provider Enrollment

• Apply through the Louisiana Medicaid Provider Enrollment Portal
• Submit facility licensure, business documents, and staffing plans

Step 3: MCO Credentialing

• Enroll with Louisiana’s Medicaid MCOs to receive referrals and billing access

Step 4: Participant Referrals and Plan of Care Coordination

• Coordinate with waiver case managers and health teams
• Begin service delivery after authorization and intake assessments

5. REQUIRED DOCUMENTATION

• Louisiana ADHC Facility License
• Articles of Incorporation and IRS EIN confirmation
• NPI registration and Medicaid enrollment confirmation
• Insurance certificates (liability, workers’ comp, and malpractice)

Adult Day Health Services Policy & Procedure Manual, including:

• Intake assessments, care plans, and daily progress notes
• Medication administration records (MARs)
• Staff schedules, training logs, and supervision notes
• Activity and meal planning logs
• Incident reporting, safety protocols, and emergency procedures
• Transportation consent and route logs (if applicable)
• HIPAA compliance and participant rights documentation
• Billing templates, attendance logs, and audit-ready documentation

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN) or Licensed Practical Nurse (LPN)
Requirements: Licensed in Louisiana, responsible for health assessments, medication administration, and clinical oversight

Role: Direct Support Worker (DSW) or CNA
Requirements: Certified and trained in ADLs, safety, and behavioral support

Role: Program/Activity Coordinator
Requirements: Experience in group facilitation, recreational therapy, or adult education

Role: Administrator / Program Director
Requirements: Supervisory and regulatory compliance experience, background check, familiarity with HCBS waivers and LDH licensure rules

All staff must complete:

• HIPAA training and confidentiality agreements
• Abuse, neglect, and exploitation prevention
• Infection control and emergency response procedures
• Annual continuing education and licensure tracking

7. MEDICAID PROGRAMS & HCBS WAIVERS

Adult Day Health Services are covered under:

• Community Choices Waiver (CCW)
• Program of All-Inclusive Care for the Elderly (PACE) (in some regions)
• Long-Term Personal Care Services (LT-PCS) (supportive overlaps, not primary coverage)
• MCO-authorized supplemental day programs (under Plan of Care)

Service delivery setting: Licensed Adult Day Health Care (ADHC) facility only — must meet state regulatory requirements.

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8. TIMELINE TO LAUNCH

Phase: Business Registration and Facility Setup
Timeline: 2–4 months

Phase: ADHC Licensure and Medicaid Enrollment
Timeline: 3–6 months (depending on inspection readiness)

Phase: MCO Credentialing and Staff Onboarding
Timeline: 1–2 months

Phase: Participant Intake and Service Launch
Timeline: Rolling, based on referrals and POC authorizations

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9. CONTACT INFORMATION

Louisiana Medicaid Provider Enrollment Portal
Website: https://www.lamedicaid.com

LDH Health Standards Section (ADHC Licensure)
Website: https://ldh.la.gov/page/282

​Louisiana Department of Health (LDH)
Website: https://ldh.la.gov

​Office of Aging and Adult Services (OAAS)
Website: https://ldh.la.gov/page/119

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10. SCOPE OF WORK

• ADHC licensure preparation, facility readiness, and inspection support
• Medicaid enrollment and MCO credentialing
• ADHS Policy & Procedure Manual development
• Intake forms, staffing templates, and daily note systems
• HIPAA-compliant scheduling, attendance, and billing tools
• Program design support for person-centered day activities and health monitoring
• Outreach and referral development with case managers and elder care networks