Starting a Community Based Residential Facility (CBRF)
The following is the text of response sent to all inquiries about
opening a CBRF in Wisconsin:
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:
Options Program (COP and COP-W)
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:
- Print the Opening and Operating a Community Based Residential
Facility Speaker Slides prior to viewing the webcast:
- Part 1 speaker slides (PDF,
- Part 2 speaker slides (PDF,
- After viewing both Parts 1 and 2 of the webcast, print and sign the Verification
of Completion - CBRF Webcast that is displayed on a slide at the end
of Part 2. This Verification of Completion must be submitted with your
application materials for licensure.
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.
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
The following information must be submitted:
- CBRF Initial License Application
(Word, 252 KB) - signed
- License Fee
- Program Statement
- Facility Floor Plan
Inspection form (F-60795) (PDF, 195 KB)
or other documentation used by the local fire authority
- Evidence of 60 day operating funds
Living Facility Model Balance Sheet (F-62674A) (PDF,
- Verification of Completion - CBRF Webcast
Additional documentation may also be requested for review by Department
staff, including but not limited to:
- Admissions Agreement
- Grievance Procedure
- Evidence of a good faith effort to establish a Community Advisory
Advisory Committee Documentation, form F-60367) (PDF,
- DSL Memo Series 99-11 (Community
Advisory Committee) (PDF, 17 KB)
- Evidence of site approval, if the land is zoned for commercial,
industrial or manufacturing use
- Approval by the Department of Natural Resources, where a public
water supply is not available
- Emergency Plan
- 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)
Information provided on the following checklist may assist you in
completing the application process: CBRF
Initial Licensure Checklist (F-62416)
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://www.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 Department will complete caregiver background checks on the
following persons prior to initial licensure and every 4 years thereafter:
For non-government entities
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.
applicants, the individual who signs the application fulfills this
- 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.
For government and tribal entities
- 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://www.dhs.wisconsin.gov/caregiver/CBCprocess.htm.
The entity must complete a caregiver background check on all
caregivers. A caregiver is a person who is all of the following:
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.
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:
Copies of background checks for anyone covered under this rule must be
available for review upon Department request.
- A licensing fee of $389.00 + $50.25 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" (Department of Health
"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
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.
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:
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.
Care Facility Construction Documentation Checklist (PDF,
46 KB) - A tool for assistance in the preparation of the Project
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
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://www.dhs.wisconsin.gov/bqaconsumer/AssistedLiving/ALSreglmap.htm.
Additional information for CBRF operators, management and staff is
located at: http://www.dhs.wisconsin.gov/rl_DSL/CBRF/CBRFintro.htm.
Wisconsin Economic Development Corporation (WEDC):
a Business in Wisconsin (exit DHS)
PDF: The free Acrobat Reader®
software is needed to view and print portable document format (PDF) files.
May 28, 2013