How to start a home care agency in Louisiana

Louisiana requires a Home and Community-Based Services (HCBS) Provider license — Personal Care Attendant (PCA) module from Louisiana Department of Health (LDH), Health Standards Section to operate a home care agency. Fee: $600.

License required

Yes

License

Home and Community-Based Services (HCBS) Provider license — Personal Care Attendant (PCA) module

Issuing agency

Louisiana Department of Health (LDH), Health Standards Section

Fee

$600

Fee details

$600 non-refundable initial HCBS license fee, sent to the LDH payment processor (Dallas lockbox) with the payment transmittal form. Facility Need Review (FNR) approval is a separate process; LDH notes a $200 FNR fee in connection with changes of ownership.

Renewal

Every year · $600 renewal, plus $200 for each branch or satellite; $100 delinquent renewal fee. Other fees: change of ownership $600, name change $25, address change $600, add a branch $200, delete a module $25.

Insurance and bonds

Financial viability per R.S. 40:2120.2: a line of credit of at least $50,000 from a federally insured lender; general and professional liability insurance of at least $300,000; workers' compensation insurance. LDH Health Standards must be named as certificate holder.

Accreditation

LDH accepts deemed-status requests for HCBS providers; accreditation is not required.

Survey and inspection

Initial on-site licensing survey after a complete application.

Certificate of need

Required

Regulation

La. R.S. 40:2120.2–2120.7; LAC 48:I Chapters 50 and 51 (HCBS minimum licensing standards); LAC 48:I Chapter 125 (Facility Need Review)

1. Obtain Facility Need Review (FNR) approval for the PCA module before applying (required for PCA, in-home respite, supervised independent living and monitored in-home care)
2. Owners and administrator watch LDH's three required online provider training videos and print the certificates
3. Run statewide criminal and national sex offender background checks on all owners and the administrator through Louisiana State Police or an LSP-authorized agency
4. Get a $50,000 line of credit from an FDIC-insured lender and the required insurance, naming LDH Health Standards as certificate holder
5. Email or mail the HCBS license application with the PCA module selected and the checklist documents; pay the fee
6. Pass the initial licensing survey, which LDH schedules only after a complete application and training are confirmed

Staffing

• Administrator who lives in Louisiana and has either a bachelor's degree plus 4 years of experience serving the elderly or people with developmental disabilities; or 6 years in a health or social service business plus 4 more years serving those groups; or a Louisiana RN license plus 2 years caring for elderly or disabled adults

Training

• Owners and administrator must complete LDH's three mandatory online provider training classes before licensure

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 →

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.

Personal care / in-home supportive care organizations — active organization NPIs (NPPES)

1,494 (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 →