Adult Day Care Regulations in Louisiana

Who regulates adult day care in Louisiana

The Louisiana Department of Health (LDH) Health Standards Section licenses adult day health care (ADHC) centers. The minimum licensing standards are in LAC 48:I Chapter 42, with several sections amended in March 2024.

The LDH Office of Aging and Adult Services (OAAS) runs the Medicaid waiver that pays for ADHC services.

Types of adult day programs in Louisiana

Louisiana's licensed category is the adult day health care center, which the rules describe as a medical model program. A center serves two or more functionally impaired adults, age 17 or older, who are not related to the owner or operator, and must be open at least five hours each day of operation and five days a week.

The sources reviewed for this guide did not identify a separate state license for social, non-medical adult day programs, so confirm with the Health Standards Section how your program model will be treated.

How to get licensed in Louisiana

All ADHC centers must be licensed by LDH, and operating without a current license is unlawful. The Health Standards Section lists these steps:

1. Get Healthcare Licensing Plan Review approval from the Office of State Fire Marshal.
2. Submit a complete application packet: the ADHC licensing application, the Disclosure of Ownership form, the fee, criminal background checks for all owners, a letter of intent, articles of incorporation, a floor sketch, proof of financial viability (a line of credit from a federally insured, licensed lender) and liability insurance. Packets left incomplete for 90 days are closed.
3. Have the premises approved by the Office of Public Health and the Office of State Fire Marshal, and get any local approvals such as zoning.
4. HSS conducts an initial licensing survey to verify compliance before issuing the license.

A license is valid for one year. Submit the renewal packet, with proof of continuous financial viability and current fire marshal and public health inspection reports, at least 30 days before it expires. ADHC is not among the provider types listed for Facility Need Review in LAC 48:I.12503, other than a PACE-related provision.

Key requirements

• Staffing ratio: at least one full-time direct service worker for every nine participants (LAC 48:I.4267).
• Nursing: an RN or LPN must be on the premises for at least eight hours, the hours the center is open, or the time participants are present, whichever is less. An LPN works under RN supervision, and an RN reviews each participant's medications at least monthly.
• Director: a bachelor's degree in a human services-related field, or eight years of supervisory experience in that field instead of the degree.
• CPR: a CPR-certified staff member must be on the premises whenever participants are present.
• Hours: at least five hours each day of operation and at least five days a week.

Medicaid funding for adult day in Louisiana

Louisiana Medicaid pays for ADHC through the Adult Day Health Care Waiver, a 1915(c) waiver run by OAAS. The waiver renewal proposed for July 1, 2022 states that all services must be prior authorized. The waiver serves people 65 and older and people 22 to 64 with a physical disability who meet nursing facility level of care and long-term care Medicaid eligibility.

Waiver services include ADHC, support coordination, home-delivered meals on non-center days, and personal emergency response. Under LAC 50:XXI.2103, participants must attend at least 36 days per calendar quarter unless the support coordinator approves an exception. LDH's 2020 Community Choices Waiver code schedule also lists ADHC.

Billing basics

LDH's ADHC procedure code schedule (OAAS-PC-06-001, effective July 1, 2020) lists ADHC services under code S5100, billed per 15 minutes, with a maximum of 40 units a day or 200 units a week. Confirm the current schedule with LDH.

The ADHC Waiver provider manual issued in December 2010 directs providers to bill the Medicaid fiscal intermediary in 837I format or on the UB-04, after the service month, and says services without current prior authorization are not reimbursable. Confirm current billing instructions with LDH.

Electronic visit verification (EVV) applies to adult day health care in Louisiana. LDH's EVV Policy and Procedures, revised March 2026, lists center-based ADHC among services that must use EVV, with clock in and clock out through the state system, LaSRS, or a compliant third-party system.

Other ways centers are paid

Enrolled veterans who meet VA eligibility and clinical criteria can get Adult Day Health Care through the VA, which may be provided at VA medical centers, State Veterans Homes or community organizations.

Official resources

• LDH Health Standards Section: Adult Day Health Care
• LAC 48:I Chapter 42: ADHC Licensing Standards
• OAAS Adult Day Health Care Waiver
• OAAS Home and Community Based Services
• LAC 50:XXI.2103: ADHC Waiver Program Description
• LDH EVV Policy and Procedures

Frequently asked questions

Do I need a license to open an adult day center in Louisiana?

Yes, for adult day health care. All ADHC centers must be licensed by the LDH Health Standards Section, which surveys each new center before issuing the license.

Does Louisiana Medicaid pay for adult day care?

Yes. The Adult Day Health Care Waiver, a 1915(c) waiver run by OAAS, pays licensed centers for prior-authorized ADHC services for eligible adults who meet nursing facility level of care.

Who inspects adult day centers in Louisiana?

The Health Standards Section conducts licensing surveys. The Office of Public Health and the Office of State Fire Marshal must also approve the premises, and their current inspection reports are required at renewal.

Is adult day care in Louisiana subject to EVV?

Yes. LDH requires center-based adult day health care providers to use electronic visit verification, through LaSRS or a compliant third-party system.