1. Program Definition and Services 

Skilled Nursing services in Louisiana are medically necessary services ordered by a physician and provided by licensed registered nurses or licensed practical nurses under the supervision of a registered nurse. These services include: 

• Assessments and health-related training/education for participants and caregivers 

• Healthcare needs related to prevention and primary care activities 

• Nursing procedures and interventions based on the individual's needs 

2. Regulations 

The program is governed by Louisiana Administrative Code, Title 50, Part II, Subpart 3, Chapter 101, Subchapter G, and Title 50, § XXI-16317. Providers must comply with regulations set forth by the Louisiana Department of Health (LDH) for skilled nursing facilities. 

3. Licensing or Certification 

A license is required to operate as a Skilled Nursing Facility (SNF) in Louisiana. Nurses providing services must have either a current, valid license as a registered nurse from the State Board of Nursing or a current, valid license as a practical nurse from the Board of Practical Nurse Examiners. 

4. Responsible State Agency 

The Louisiana Department of Health (LDH) is responsible for issuing the required license for Skilled Nursing Facilities. 

5. Application Process 

The application process requires submission by mail. Providers must submit a completed application form and required documentation to the Louisiana Department of Health. 

6. Required Documentation 

The application packet must include: 

• Completed licensing application form 

• Proof of financial viability 

• General and professional liability insurance certificates 

• Worker's compensation insurance 

• Staff licenses and background check clearances 

• Service delivery plans, policies, and procedures 

• Facility architectural plans and inspection reports (for facility-based services) 

• Physician's order, letter of medical necessity, Form 90-L, Form 485, individual nursing service plan, summary of medical history, and skilled nursing checklist for each beneficiary 

7. Timeline for Approval 

The exact timeline for approval is not specified in the provided information. However, providers should expect the process to take several weeks to months, depending on the completeness of the application and the current workload of the licensing department. 

8. Pre-Application Process 

There is no specific pre-application process mentioned. However, providers must ensure they meet all eligibility criteria before applying. 

9. Pre-Application Training 

While specific pre-application training is not mentioned, nurses must have one-year experience serving persons with developmental disabilities. 

10. Additional Notes 

• Skilled nursing facilities must provide 24-hour nursing services. 

• A registered nurse is required for at least eight consecutive hours a day, seven days a week, except where waived. 

• The facility must maintain a minimum nurse staffing ratio of 2.6 hours per skilled resident over a 24-hour period. 

• Nurses must submit updates every 60 days, including any changes to the beneficiary's needs and/or physician's orders. 

• Services are based on 15-minute units of service. 

• Providers must conduct a documented review of the service plan at least quarterly and make changes as needed.