Louisiana is only one of several states which require a separate state licensure of rural health clinics in addition to CMS certification. In late 2024, significant revisions were made to LAC Title 48, Chapter 75, the state statute for rural health clinic licensure. We will discuss how these changes impact the LDH licensing process. We will also look at what these changes in the LDH survey process mean operationally for RHCs as well as share observations about current licensure trends.