​​​Residential Care Facilities for the Elderly and Adult Residential Care Facilities Provider Enrollment

Assisted Living Waiver Program 

Residential Care Facilities for the Elderly (RCFE) and Adult Residential Care Facilities (ARF) are responsible for providing Assisted Living Waiver (ALW) services to participants, allowing them to maintain independence and continue to receive nursing level of care as needed. The RCFE/ARF work in conjunction with the Care Coordinator Agencies (CCA) to ensure participants receive individualized care in a homelike and community setting.

 Basic Requirements

  • All facilities enrolling in the ALW program must meet licensure and certification requirements set forth by the Department  of Social Services, Community Care Licensing (CCL). Participating facilities must be in substantial compliance and good  standing with licensing regulations (Ref: Title 22, § 87101(s)(9)). Facilities on probation with and/or have pending accusation against the licensee are not in substantial compliance for the purpose of the ALW (Ref. H&S § 1569.33).

  • Participating ALW facilities are not regarded as healthcare facilities, but social-based facilities. Although the RCFE/ARF is a licensed facility, ALW residents are considered as living in their own home, not in a healthcare setting.

  • ALW facilities are required to have licensed nursing staff, either on call or employed, in order to provide skilled nursing services as needed to waiver participants. 

  • Facilities shall employ staff as necessary to ensure provision of care and supervision to meet client health and safety needs. 

  • Facilities are required to provide private or semi-private bathrooms, a dining room, or common activities room that may also serve as a dining room.

  • Facilities must be able to offer private or shared bedrooms. 

  • Facilities housing more than six participants are required to have an Individual Response System (IRS) enabling individuals to summon for assistance at any time.

RCFE/ARF provide the following services:

  • Provision and oversight of personal and supportive services
  • Assist with self-administration of medication
  • Provide three meals per day plus snacks
  • Housekeeping and laundry
  • Transportation or arrangement of transportation
  • Activities
  • Skilled nursing services as needed

Refer to the HCBS Waiver for the complete ALW requirements.

RCFE/ARF Provider Enrollment Steps

1.  In order to participate in the ALW program, the following application packet is required:

For a Change of Ownership or Change of Location contact: ProFacWAIVER@dhcs.ca.gov

2.  Enrolling providers are required to have a National Provider Identifier (NPI). For more information and to apply for your NPI number, visit the NPI Overview webpage . The unique 10-digit number allows universal recognition of individual health care providers. Once enrolled as a Medi-Cal provider in the ALW program, the NPI number is used in administrative and financial (billing) transactions.

3.  Upon review and approval of the ALW application, an onsite visit will be completed to verify the applicant's qualifications. Facilities will
receive notification of their enrollment status.

Application Submission

Send application packet to:

Provider and Facility Site Review Unit
Integrated Systems of Care Division
Department of Health Care Services
1501 Capitol Avenue, MS 4502
P.O. Box 997437
Sacramento, CA 95899-7437

Important note: Do not send applications to the Provider Enrollment Division

Resources

 
Last modified date: 11/13/2019 11:59 AM