Louisiana Certificate of Need Requirements: Facility Guide
Certificate of Need (CON) laws were designed to regulate the amount of healthcare infrastructure in a given area, controlling costs by avoiding duplicative, inflated services. The Louisiana certificate of need was adopted with the same intentions in mind, though it’s called a Facility Need Review (FNR). Despite the difference in names, Louisiana is still considered one of the 35 certificate of need states and the terms are largely used interchangeably.
Process standards vary across the different CON-requiring states as their laws all contain unique provisions. We’ll review some key aspects of Louisiana’s FNR program and identify additional resources that can assist you to secure approval for your latest non-acute care facility project.
The Certificate of Need: Louisiana Laws and Regulations at a Glance
Certificate of need requirements can be quite complex, and the Louisiana Facility Need Review is no exception. The table below provides a digestible overview of the program’s key provisions (specific to Louisiana) alongside pertinent regulatory information.
| Legal Authorities | Louisiana Revised Statute, Title 40:
Louisiana Administrative Code, Title 48, Chapter 125: |
| Requirements | The Louisiana FNR applies to a narrower scope of service providers than many other CONs, focusing primarily on non-acute care provision. The following must apply for FNR approval prior to implementing new or additional facilities, providers, programs, services, or beds.
Nursing facilities are also covered by the FNR process, though there’s a moratorium (in effect through July 1, 2027) on any new nursing facility beds. The moratorium does not apply when:
Other activities that may require FNR approval include:
Exemptions from FNR review include:
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| State Agency | The Louisiana Department of Health (LDH)
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| Fees | A $200, non-refundable application fee must accompany all other requested or required information when applying for FNR review.Payments must be sent with the required Louisiana Health Standard Section (HSS) Payment Procedure Form to:
LDH Licensing Payments P.O. Box 734350 Dallas, TX 75373-4350 |
| Application Forms | Applicants may apply online or by mail. Unlike other states that have one readily available certificate of need form, Louisiana’s FNR application packet must be requested from the Facility Need Review program in writing or by phone. The online process guides applicants through its requirements step-by-step.
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| Penalties | Although there are no explicit fees or criminal proceedings associated with FNR noncompliance, failure to abide by FNR rules could result in revoked or denied participation in Medicaid programs, among other penalties. |
The Louisiana Certificate of Need: Additional Considerations
The FNR program will correspond with the initial point of contact (POC) listed within the application only. If the POC for a certain project changes, the program must be notified of the switch in writing. Until then, the original POC will be the exclusive recipient of any notifications or correspondence during the review period.
The FNR review period is restricted to 60 days. Extensions may only be initiated by the FNR Program itself, with a maximum allowance of 30 additional days. Application approvals or rejections are sent to the POC. Rejection notices will include specifications on the reasons behind the decision, helping guide the appeal process should the applicant choose to do so.
What Are Certificate of Need Laws’ Pros and Cons?
These regulations aren’t without their controversy and Louisiana is no exception, leading many to ask on the public stage, What is a certificate of need in healthcare’s real benefit? In Louisiana, this question has led some providers to take legal action, suing the state over its FNR policy.
As with many healthcare-related issues, understanding the full impact of the FNR is a complex undertaking. We can start by addressing some of the possible advantages and disadvantages posed by the program.
| The FNR may prevent oversupply of healthcare services, keeping service duplication and inflation from driving up associated costs.
Healthcare planning may better align with community planning, distributing resources more evenly across Louisiana. By keeping competition from undercutting prices by denying certain services, existing facilities and services can remain financially viable while still providing essential (and often costly) patient care. |
The process restricts patient autonomy by controlling the number of available providers and preventing patients from having their choice of service provider.
Limiting the number of providers and services can reduce care access points for patients, delaying or limiting necessary treatments. FNR policies may work counter to the original regulatory intentions, facilitating higher healthcare costs due to lack of competition. |
Want to Make the Most of Available Regulatory Benefits?
Whether you’re looking to use the Louisiana certificate of need advantages to protect your patient population or optimize federal reimbursements, IntelyCare is here to support you. Stay on top of regulatory updates with our expert-backed facility guides and healthcare management tips.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.