Starting a Community Based Residential Facility (CBRF)

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The following is the text of response sent to all inquiries about opening a CBRF in Wisconsin (also see CBRF Plan Review Requirements):

Thank you for your interest in licensure as a Community Based Residential Facility (CBRF).

The Division of Quality Assurance (DQA) in the Department of Health Services (DHS) serves the frail elderly, persons with developmental disabilities, mental illness, physical disabilities, sensory disabilities, and persons with substance abuse problems. 

Regulation of facilities primarily serving adults is the responsibility of the Division of Quality Assurance (DQA). DQA is responsible for administering Wisconsin Administrative Code DHS 83 as required by Chapter 50 of the Wisconsin Statutes, which governs licensure of a CBRF.

The Division of Quality Assurance (DQA) does not refer residents for placement in assisted living facilities nor does the DQA provide funding to facilities to care for residents.  Residents may be eligible to receive waiver funding through county Departments of Health or Human Services or Family Care Managed Care Organization.  For more information regarding funding for residents in assisted living, please visit the following websites:

Family Care

Community Options Program (COP and COP-W)

Community Integration Program (CIP II)

A CBRF means a place where five or more unrelated adults reside in which care, treatment or services above the level of room and board, but not including nursing care, are provided to persons residing in the facility as a primary function of the facility.

To apply for a license, please review Chapter DHS 83 Wisconsin Administrative Code http://www.legis.state.wi.us/rsb/code/dhs/dhs083.pdf (exit DHS; PDF, 262 KB) and Chapter 50 of the Wisconsin Statutes http://www.legis.state.wi.us/statutes/Stat0050.pdf (exit DHS; PDF, 323 KB). Also, please contact your regional office to arrange for attendance at an informational meeting.

An initial licensing process is used for first time licensee applicants. A complete application is necessary to begin the process. DHS 83.05(2) identifies the required content of a complete application.

When the Department determines that the application is complete, an on-site licensing visit will be scheduled. The Department has 70 days to approve or deny a license.

This 70 days for processing begins after a complete license application packet is received and the department completes the on-site survey.

1. CBRF Initial License Application (F-60287) (PDF, 215 KB) - signed and notarized
2. License Fee
3. Program Statement
4. Facility Floor Plan
5. Fire Inspection form (F-60795) (PDF, 195 KB) or other documentation used by the local fire authority
6. Evidence of 60 day operating funds
7. Assisted Living Facility Model Balance Sheet (F-62674A) (PDF, 45 KB)

1. Admissions Agreement
2. Grievance Procedure
3. Evidence of a good faith effort to establish a Community Advisory Committee (Community Advisory Committee Documentation, form F-60367) (PDF, 15 KB)
4. DSL Memo Series 99-11 (Community Advisory Committee) (PDF, 17 KB)
5. Evidence of site approval, if the land is zoned for commercial, industrial or manufacturing use
6. Approval by the Department of Natural Resources, where a public water supply is not available
7. Emergency Plan
8. Resident Rights and House Rules.  Procedure to review resident rights violations and complaints and reporting mechanism (Community-based Residential Facility (CBRF) Residents' Rights Complaint Report, form F-62430) (PDF, 60 KB)

Applications not acted upon by the applicant will be closed after one (1) year.

Caregiver Background Checks:

Caregiver background checks must be completed at least every four years. Caregiver Background Check requirements can be found on the Department of Health and Family Services website at http://dhs.wisconsin.gov/caregiver/CBCprocess.htm.

Select Background Checks, Rules and Regulations. The website includes information on Wisconsin Administrative Codes Chapter DHS 12 – Caregiver Background Checks; Chapter DHS 13 – Reporting and Investigation of Caregiver Misconduct; copies of forms and answers to frequently asked questions.

• The owner of the entity, whether or not the person has regular, direct contact with clients.
  
  If the owner is a corporation or other type of business that does not have a single owner, then the organization may designate one principal officer to legally represent the organization for the purposes of fulfilling the background check requirement.
  
  For new applicants, the individual who signs the application fulfills this requirement.

• Principal officers, corporation or board members of the business organization, who have regular, direct contact with clients.
• Non-client residents (over age 10) of the entity who have regular, direct contact with clients.

• An individual, e.g. the entity administrator designated by the government agency or tribe who operates the entity, whether or not the person has regular, direct contact with clients.
• Non-client residents (over age 10) of the entity who have regular, direct contact with clients.

New applicants for licensure must submit a Background Information Disclosure (BID) form, HFS-64 and a BID Appendix form, HFS-69, for each individual as described above, following the process at http://dhs.wisconsin.gov/caregiver/CBCprocess.htm.

• The forms may be accessed via the DHS Forms Numeric List - HFS.

• Employed by or under contract with an entity;
• Has regular, direct contact with the entity's clients or the personal property of the clients; and is under the entity's control.
  
  "Direct contact" is defined as face-to-face physical proximity to a client that affords the opportunity to commit abuse or neglect or misappropriation of a client’s property.

A completed caregiver background check consists of:

• A completed Background Information Disclosure (BID) form (F-82064) (PDF, 30 KB);
• Response from the entity's inquiry to the Department of Justice; and
• The letter from DHS containing information regarding any government findings of misconduct or credential limitations.

Copies of background checks for anyone covered under this rule must be available for review upon Department request.

Licensing Fee:

1. A licensing fee of $306.00 + $39.60 per resident based on capacity of facility is charged every two years. The fee for the twelve-month probationary license is 1/2 this amount. The fee is submitted with the application and made payable to "DHS."

"Initial application fees and/or license/certification continuation fees are NON - REFUNDABLE."

Exception: Community based residential facilities where the total monthly charges for each resident do not exceed the monthly state supplemental payment rate under s. 49.77(3s) are exempt from the licensing fee.

Plan Review:

All construction plans for new CBRFs of any size, additions (including the installation of smoke and heat detection systems and sprinkler systems) to existing buildings and remodeling must be reviewed and approved by the Department before construction (see CBRF Plan Review Requirements).

The fees for plan review services are listed at DHS 83.56(3), and are submitted with the appropriate forms listed below:

For Free-Standing CBRFs

Submit the Free Standing CBRF Plan Approval Application (F-62496) (PDF, 52 KB) with the fees and the plans to:

Department of Health Services
Division of Quality Assurance
Bureau of Health Services
P. O. Box 2969
Madison, WI 53701-2969

All free-standing CBRFs for nine or more residents and not attached to a health care facility (i.e. nursing home) must meet the relevant requirements of the Wisconsin Enrolled Commercial Building Code, enforced by the Department of Commerce. Contact:

Department of Commerce
Division of Safety and Buildings
Plan Review Section
201 W. Washington Avenue – P.O. Box 7162
Madison, WI 53707-7162
Phone: (608) 266-3151

If the CBRF is attached or integrated into another operation, submit the following forms with the plans instead of the Free-Standing CBRF plan approval form:

• F-62333: Plan Approval Application (PDF, 128 KB) - Construction plans submitted for review by the Wisconsin Department of Health and Family Services, Health Services Section.  Fee calculator (Excel spreadsheet) to assist you in determining the application fees.

• F-62494: Health Care Facility Construction Documentation Checklist (PDF, 46 KB) - A tool for assistance in the preparation of the Project Occupancy Inspection.

• F-62495: Compliance Statement (PDF, 18 KB) - Required prior to initial occupancy of a new building or addition and prior to final occupancy of an alteration of an existing building.

CBRFs for 5-8 residents must meet the requirements of the Uniform Dwelling Code (UDC), Chapters 20-25, enforced by the Department of Commerce.

You should also contact the local municipality to obtain needed building permits and zoning approval.

Note: If an existing CBRF is being investigated for purchase, it is important to note that there is no transfer of licensure. A new applicant will not be licensed until a completed application is received, an onsite visit is conducted and all code requirements are met.

Address any questions and return the application, other materials and checks to the Division of Quality Assurance, Bureau of Assisted Living   regional office assigned to the county in which the facility is located. DQA regional office locations are found at: http://dhs.wisconsin.gov/bqaconsumer/AssistedLiving/ALSreglmap.htm.

Additional information for CBRF operators, management and staff is located at: http://dhs.wisconsin.gov/rl_DSL/CBRF/CBRFintro.htm.

Department of Commerce: Starting a Business in Wisconsin (exit DHS)

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Last Updated: April 07, 2009