Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 125 - Facility Need Review › Subchapter A - General Provisions › Section I-12501 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
A. Definitions.
					 When used in this Chapter the following terms and phrases shall have the
					 following meanings unless the context requires otherwise.
Abeyance of Nursing Facility Beds-
a
						situation in which a nursing facility, if it meets certain requirements, may
						have all (but not only a portion) of its approved beds disenrolled from the
						Medicaid Program without causing the approval for the beds to be revoked after
						120 days.
Adult Residential Care Provider (ARCP)
-a
						facility, agency, institution, society, corporation, partnership, company,
						entity, residence, person or persons, or any other group, that provides adult
						residential care services for compensation to two or more adults who are
						unrelated to the licensee or operator. Adult residential care includes, but is
						not limited to the following services: lodging, meals, medication
						administration, intermittent nursing services, and assistance with personal
						hygiene, assistance with transfers and ambulation, assistance with dressing,
						housekeeping and laundry. For the purposes of this Facility Need Review (FNR)
						Rule, ARCP refers to an entity that is or will be licensed as an ARCP level
						4-adult residential care provider. All ARCPs that have received FNR approval
						prior to August 1, 2022 shall retain FNR approval unless such FNR approval has
						expired. Facility need review approval is not required for any ARCP that is
						initially licensed August 1, 2022 or thereafter.
Agonist-
a drug that activates certain
						receptors in the brain.
Antagonist-
a drug that blocks opioids by
						attaching to the opioid receptors without activating them. Antagonists cause no
						opioid effect and block full agonist opioids. Examples of antagonists include,
						but are not limited to naltrexone and naloxone.
Applicant-
the person who is developing
						the proposal for purposes of receipt of FNR approval for the healthcare
						facility or provider beds to proceed to apply for licensure, and/or
						certification by the Louisiana Department of Health (LDH).
Applicant Representative(s)-
the
						person(s) specified by the applicant on the FNR application form to whom
						written notifications are provided relative to the status of the application
						during the review process.
Application
-
the
required and completed FNR form(s), documentation, fee, and any other required
						information.
Approval-
a determination by the FNR
						committee that an application meets the requirements of the FNR program for
						purposes of proceeding with licensure and/or certification by the
						department.
Behavioral Health Services
(
BHS
-mental health services, addictive disorders and substance
						use disorders treatment services, or combination of such services, for adults,
						adolescents, and children.
Behavioral Health Services Provider
						(BHSP)-
a facility, agency, institution, person, society, corporation,
						partnership unincorporated association, group, or other legal entity that
						provides behavioral health services or, presents itself to the public as a
						provider of behavioral health services. For the purposes of this Rule, FNR
						shall be applied to providers or applicants who elect to provide psychosocial
						rehabilitation services, community psychiatric support and treatment services,
						and/or opioid treatment program services licensed under a BHSP license.
CMS-
Centers for Medicare and Medicaid
						Services.
Community Home-
a type of community
						residential facility that has a capacity in accordance with
						R S.
						28:451.2, or current law
Community Psychiatric Support and Treatment
						(CPST) Services
-behavioral health services as defined in Title 48,
						Chapter 56.
Department
-the Louisiana Department of
						Health (LDH).
Denial-
a determination by the
						department's FNR committee that a proposal does not meet the requirements of
						the Facility Need Review (FNR) program and that the proposed healthcare
						facility or provider beds may not be licensed and/or certified.
Facility Need Review (FNR)-
a review
						conducted for specific provider types to determine whether there is a need for
						additional licensed and/or certified healthcare providers and/or beds.
FNR Committee-
LDH secretary appointed
						committee to review and render a decision to approve or deny an FNR application
						in accordance with
						R.S.
						40:2116, or current law.
FNR Program-
the program within LDH,
						Health Standards Section that oversees the day-to-day operations of FNR
						application intake and submission to the FNR committee, and communicates with
						applicants regarding the status of the application, and tracks the status of
						the decisions of the FNR committee.
Full Agonist-
a drug that activates the
						opioid receptors in the brain fully, resulting in the full opioid effect.
						Examples of full agonists include, but are not limited to, heroin, oxycodone,
						methadone, hydrocodone, morphine, and opium.
Geographic Service Area
-the geographic
						area under which a healthcare provider operates and/or provides services
						pursuant to licensing requirements, and for the purposes of FNR application
						review, the geographic area in which additional need will be assessed.
Group Home-
a type of community
						residential facility that has a capacity in accordance with
						R.S.
						28:451.2, or current law.
Health Standards Section (HSS)-
the
						section of LDH that is responsible for licensing healthcare facilities,
						certifying those facilities that are applying for participation in the Medicaid
						(Title XIX) and Medicare (Title XVIII) Programs, and conducting surveys and
						inspections.
Home and Community Based Service (HCBS)
						Providers-
those agencies, institutions, societies, corporations,
						facilities, person or persons, or any other group intending to provide or
						providing respite care (RC) services, personal care attendant (PCA) services,
						supervised independent living (SIL) services, monitored in-home caregiving
						(MIHC) services, or any combination of services thereof, including RC
						providers, SIL providers, MIHC providers, and PCA providers.
Hospice-
an autonomous, centrally
						administered, medically directed program providing a continuum of home,
						outpatient, and homelike inpatient care for the terminally ill patient and his
						family. It employs an interdisciplinary team to assist in providing palliative
						and supportive care to meet the special needs arising out the physical,
						emotional, spiritual, social, and economic stresses that are experienced during
						the final stages of illness and during dying and bereavement.
Hospice Inpatient Facility-
facility
						where specific hospice levels of care ranging from residential to acute,
						including respite, are provided in order to meet the needs of the
						patient/family.
Hospice Outpatient Provider
-hospice
						services are provided to patients in their place of residence (e.g. their home,
						adult residential care provider, nursing home).
Hospice Providers
-hospice inpatient
						facility or hospice outpatient provider that is licensed by LDH in accordance
						with the requirements of
						R.S.
						40:2183, or current law.
Hospital Service District-
a political
						subdivision of the state of Louisiana created or authorized pursuant to
						R.S.
						46:1051 et seq., or current law.
Intermediate Care-Level I
(
IC-I
)
-
a level of care within a nursing
						facility that provides basic nursing services under the direction of a
						physician to persons who require a lesser degree of care than skilled services,
						but who need care and services beyond the level of room and board. Services are
						provided under the supervision of a registered nurse (RN) seven days a week
						during the day tour of duty with licensed nurses twenty-four hours a
						day.
Intermediate Care-Level II
(
IC-II
)
-
a level of care within a nursing
						facility that provides supervised personal care and health related services,
						under the direction of a physician, to persons who need nursing supervision in
						addition to help with personal care needs. Services are provided under the
						supervision of a RN 7 days a week during the day tour of duty with licensed
						nurses 24 hours a day.
Intermediate Care Facility for the
						Developmentally Disabled
(
ICF-DD
)
-
a
						facility that provides developmentally disabled residents with professionally
						developed individual plans of care, supervision, and therapy in order to attain
						or maintain optimal functioning.
LDH Administrative Regions
-the
						administrative regions and the parishes that comprise these regions are as
						follows:
a. Region I: Orleans,
					 Plaquemines, Jefferson, and St. Bernard;
b. Region II: Ascension, East Baton Rouge,
					 East Feliciana, Iberville, Pointe Coupee, West Baton Rouge, and West
					 Feliciana;
c. Region III:
					 Assumption, Lafourche, St. Charles, St. James, St. John, St. Mary, and
					 Terrebonne;
d. Region IV: Acadia,
					 Evangeline, Iberia, Lafayette, St. Landry, St. Martin, and Vermilion;
e. Region V: Allen, Beauregard, Calcasieu,
					 Cameron, and Jefferson Davis;
f.
					 Region VI: Avoyelles, Catahoula, Concordia, Grant, LaSalle, Rapides, Vernon,
					 and Winn;
g. Region VII: Bienville,
					 Bossier, Caddo, Claiborne, DeSoto, Natchitoches, Red River, Sabine, and Webst
					 er;
h. Region VIII: Caldwell, East
					 Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Richland,
					 Tensas, Union, and West Carroll; and
i. Region IX: Livingston, St. Helena, St.
					 Tammany, Tangipahoa, and Washington.
Major Alteration-
any repair or
						replacement of building materials and equipment that does not meet the
						definition of minor alteration.
Medicaid Program
-the Louisiana medical
						assistance program administered in accordance with Title XIX of the Social
						Security Act.
Medicaid Program-
the Louisiana medical
						assistance program administered in accordance with Title XIX of the Social
						Security Act.
Medication for Opioid Use Disorder
-Food
						and Drug Administration (FDA) approved medication for opioid use disorder
						utilized to reduce opioid use and harmful opioid related behaviors when used as
						part of a comprehensive treatment program.
Minor Alteration
-repair or replacement
						of building materials and equipment with materials and equipment of a similar
						type that does not diminish the level of construction below that which existed
						prior to the alteration. This does not include any alteration to the function
						or original design of the construction.
Monitored In-home Caregiving (MIHC)
						Services
- home and community-based services module as defined in LAC
						48:I, Chapter 50, pursuant to a HCBS provider license.
Notice of Abeyance-
a written notice
						issued by the department to a nursing facility stating that the criteria for
						placing all of the facility's approved beds in abeyance have been met.
Nursing Facility (NF)-
an institution
						that is primarily engaged in providing the following services to
						residents:
a. skilled nursing care and
					 related services for residents who require medical or nursing care;
b. rehabilitation services for the
					 rehabilitation of injured, disabled, or sick persons; or
c. on a regular basis, health-related care
					 and services to individuals who, because of their mental or physical condition,
					 require care and services (above the level of room and board) that can be made
					 available to them only through institutional facilities. Such institutional
					 facilities are those facilities that are not primarily for the care of mental
					 diseases.
Opioid Agonist Treatment
						Medication
-
Food
and Drug Administration approved
						medication to treat Opioid Use Disorder
Opioid Treatment Program (OTP)-
a program
						that engages in medication-assisted opioid treatment of clients with an opioid
						agonist treatment medication.
Office of Behavioral Health
(OBH)-LDH
						office and single state agency that is statutorily responsible for the
						treatment and prevention of addictive disorders and substance use
						disorders.
Opioid Treatment Program Needs
						Assessment-
the determination of a need for new a new opioid treatment
						program in a geographic service area(s) by the department's Office of
						Behavioral Health in accordance with the criteria identified in Section
						12527
.
Partial Agonist-
a drug that activates
						the opioid receptors in the brain, but to a much lesser degree than a full
						agonist. Buprenorphine is an example of a partial agonist.
Pediatric Day Health Care
						(PDHC)Providers-
a facility that serves medically fragile individuals
						under the age of 21, including technology dependent children who require close
						supervision, in accordance with the requirements of LAC 48:I, Chapter
						52.
Person
-a human being or juridical
						person.
Personal Care Attendant (PAC)-home and community-based
						services module as defined in LAC 48:1, Chapter 50, pursuant to a HCBS provider
						license.
Physical Location
-the specific address,
						building, or other permanent structure wherein the provider operates its
						business.
Pre-Approved Beds
-beds and/or facilities
						that are automatically granted FNR approval in accordance with the grandfather
						provisions of this program.
Program
-the Facility Need Review
						Program.
Psychosocial Rehabilitation (PSR)
						Services
-behavioral health services as defined in Title 48, Chapter
						56.
Respite Care (RC) Services-
an
						intermittent service designed to provide temporary relief to unpaid, informal
						caregivers of the elderly, and/or persons with disabilities, pursuant to a HCBS
						provider license.
Secretary-
the secretary of Louisiana
						Department of Health (LDh).
Supervised Independent Living (SIL)
						Services
-home and community-based services module as defined in LAC
						48:I, Chapter 50, pursuant to an HCBS provider license.
Skilled Nursing Care-
a level of care
						within a nursing facility that provides intensive, frequent, and comprehensive
						nursing care, and/or rehabilitation services ordered by and under the direction
						of a physician. Services are provided under the supervision of an RN 7 day s a
						week during the day tour of duty with licensed nurses 24 hours a day. Skilled
						beds are located in nursing facilities and in distinct parts of acute care
						hospitals.
Skilled Nursing Facility
-a nursing
						facility with the staff and equipment to give skilled nursing care and/or
						skilled rehabilitation services, and other related health services.
State Opioid Treatment Authority-the
OBH
						authority within LDH who is designated to exercise the responsibility and
						authority within the state for governing the treatment of opioid use disorders
						within OTPs.