Arkansas Department of Human Services (DHS) – Division of Aging, Adult, and Behavioral Health Services (DAABHS)

Role: Approves and monitors Residential Care Facilities (RCFs) and ensures compliance with HCBS standards

Arkansas Department of Human Services (DHS) – Office of Long Term Care (OLTC)

Role: Licenses Residential Care Facilities and monitors health and safety standards

Arkansas Medicaid (under DHS)

Role: Oversees Medicaid enrollment, reimbursement, and service delivery for Residential Care Services

Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid-funded services meet HCBS rules and person-centered requirements

2. RESIDENTIAL CARE SERVICE OVERVIEW 

Residential Care Services support individuals who need assistance with daily living activities but do not require the intensive medical care provided in nursing facilities. Services are delivered in licensed community settings that promote a home-like environment.

Approved providers may deliver: 

• Assistance with Activities of Daily Living (ADLs), including bathing, dressing, toileting, and mobility
• Support with Instrumental Activities of Daily Living (IADLs) such as meal preparation, housekeeping, and laundry
• Medication assistance and health monitoring (as permitted by regulations)
• 24-hour supervision and safety monitoring
• Structured recreational and social activities
• Nutritional support with daily meals and snacks
• Transportation assistance to appointments and community activities

All services must be individualized through person-centered service plans and support the individual's goals for autonomy and inclusion.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites: 

• Register business with the Arkansas Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Obtain a Residential Care Facility license from the Arkansas Office of Long Term Care (OLTC)
• Secure liability insurance and meet fire safety, sanitation, and building code requirements
• Maintain policies and procedures compliant with Arkansas residential care regulations
• Ensure appropriate staff-to-resident ratios and staff training on personal care and resident rights

4. DHS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application: 

• Request Residential Care Services provider application packet from DHS or OLTC
• Attend recommended provider orientation sessions

Application and Documentation Submission:

• Submit Residential Care Facility license, staffing plans, emergency procedures, and sample service agreements
• Provide documentation of staff qualifications, background checks, and training programs
• Include resident intake forms, person-centered planning templates, and safety protocols

Program Readiness Review: 

• DHS/OLTC review the facility's compliance with safety and service standards
• May conduct on-site inspections prior to Medicaid approval
• Evaluation of staffing models, client documentation, and emergency preparedness plans

Approval & Medicaid Enrollment: 

• After state approval, enroll with Arkansas Medicaid as a Residential Care Services provider
• Complete billing and claims configuration through the Medicaid portal
• Set up service authorization tracking and documentation systems

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License
• IRS EIN confirmation
• NPI confirmation
• Residential Care Facility license
• Proof of compliance with building codes, fire safety inspections, and health regulations

Policy & Procedure Manual including: Resident intake and person-centered service planning

• ADL/IADL support protocols
• Medication assistance and health monitoring procedures
• Resident rights, privacy protections, and grievance policies
• Emergency evacuation and disaster preparedness plans
• Staff background checks, credentialing records, and training logs
• Incident reporting, infection control, and quality assurance tracking
• Medicaid billing and service logging procedures

6. STAFFING REQUIREMENTS

Role: Facility Administrator Requirements: Experience managing residential care or health service facilities, background check clearance, and required administrator training

Role: Direct Care Staff / Personal Care Aides Requirements: High school diploma or GED recommended; CPR/First Aid certification; background check clearance

Role: Medication Assistant (optional if providing medication administration) Requirements: Completion of a Medication Assistant Program and state certification

All staff must complete: 

• Orientation on resident rights, elder abuse prevention, and person-centered practices
• Emergency response and safety training
• Confidentiality and HIPAA compliance training
• Ongoing annual in-service training and competency reviews

7. MEDICAID WAIVER SERVICES

The following Arkansas Medicaid Waivers authorize Residential Care Services:

• ARChoices in Homecare Waiver
• Living Choices Assisted Living Waiver (for individuals requiring more structured residential services)

Approved providers may deliver: 

• Supportive residential living services focused on ADLs and IADLs
• 24/7 supervision and safety monitoring
• Structured socialization and recreational activities
• Health monitoring and medication support

8. TIMELINE TO LAUNCH

Phase 1: Business Formation and Facility Licensing Preparation Timeline: 2–4 weeks

Phase 2: OLTC Licensing Inspections and Approvals Timeline: 60–90 days

Phase 3: Staff Hiring, Training, and Documentation Readiness Timeline: 30–45 days

Phase 4: Medicaid Enrollment and Claims Setup Timeline: 45–60 days

9. CONTACT INFORMATION

Arkansas Department of Human Services – Division of Aging, Adult, and Behavioral Health Services (DAABHS) Website: https://humanservices.arkansas.gov/divisions-shared-services/aging-adult-and-behavioral-health-services/

Arkansas Office of Long Term Care (OLTC) Website: https://humanservices.arkansas.gov/divisions-shared-services/office-of-long-term-care/

Arkansas Medicaid Provider Enrollment Portal Website: https://portal.mmis.arkansas.gov/ARMedicaid/Provider

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — ARKANSAS RESIDENTIAL CARE SERVICES PROVIDER

We help providers and entrepreneurs launch Medicaid-compliant Residential Care Services under Arkansas's HCBS Waiver programs.

SCOPE OF WORK ( What Waiver Consulting Group (WCG) Does)

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.Getting Started