New York Issues New LHCSA Application and Guidance

August 31, 2022


On August 17, 2022, the New York State Department of Health (“DOH”) issued its new long-awaited licensure application for Licensed Home Care Services Agencies (“LHCSAs”).  The application is for entities seeking approval to establish a new LHCSA or to change ownership or control of an existing LHCSA. It is also for use by LHCSAs affiliated with an Assisted Living Program (“ALP”), Program of All-Inclusive Care for the Elderly (“PACE”), Nurse-Family Partnership (“NFP”) or Continuing Care Retirement Community (“CCRC”) seeking to expand the scope of their licenses by serving patients outside of those programs.

This marks the end of DOH’s years-long suspension of the acceptance and processing of LHCSA applications. The 2018-2019 State Budget established a two-year moratorium on the processing and approval of LHCSA licensure applications.  The moratorium became effective on April 1, 2018 and continued until March 31, 2020.  At the end of the moratorium, DOH issued regulations, effective April 1, 2020, which added new public need and financial feasibility requirements for LHCSA applications to the previously existing character and competence review process.  At that time, while the moratorium had ended, DOH suspended the acceptance and processing of LHCSA applications pending its issuance of a revised licensure application that comports with its new regulatory requirements.  The industry has been waiting for DOH to issue the new application.

With the new LHCSA application, DOH also issued guidance, including a Dear Administrator Letter and a Frequently Asked Questions document that has information on the following topics: application submission/review, application fee, public need methodology, financial feasibility and financial review, change of ownership, and other regulatory requirements.

 The new public need methodology includes a rebuttable presumption that there is no need for additional LHCSAs in counties with five (5) or more LHCSAs actively serving patients. With its guidance documents, DOH issued a report listing  counties identified as having no need and counties designated with presumed need.

 Applications for licensure based on change of ownership for LHCSAs actively serving at least twenty-five (25) patients will not be subject to public need review and will be evaluated only on financial feasibility and the character and competence of the proposed operator, unless the proposed operator seeks to serve patients outside of the LHCSA’s approved counties. In addition, LHCSA applicants affiliated with an ALP, PACE, NFP, or CCRC are exempt from the public need methodology if the proposed agency seeks to serve exclusively patients within one of those programs.

Click here for the new LHCSA application as well as the related guidance and other documents issued by DOH.

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