Residential Care Services in Massachusetts offer structured, long-term housing and support for individuals who cannot live independently due to medical, behavioral, or functional needs. These services are funded through MassHealth Home and Community-Based Services (HCBS) waivers, and administered primarily by the Department of Developmental Services (DDS), Massachusetts Rehabilitation Commission (MRC), and Department of Mental Health (DMH).

​

1. GOVERNING AGENCIES

Agency: Department of Developmental Services (DDS)
Role: Oversees group homes, shared living, and residential habilitation services for individuals with intellectual or developmental disabilities

Agency: MassHealth (Medicaid)
Role: Authorizes residential services and reimburses under waiver programs

Agency: Executive Office of Health and Human Services (EOHHS)
Role: Oversees waiver compliance, funding, and provider eligibility

Agency: Department of Mental Health (DMH)
Role: Authorizes residential treatment for individuals with serious mental illness

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight and funding through 1915(c) waivers

2. RESIDENTIAL CARE SERVICE OVERVIEW

Residential care supports individuals who need help with daily living tasks, supervision, or behavioral management in a structured home setting.

Service models include:

• 24-hour staffed group homes
• Shared Living arrangements (host families)
• Adult foster care
• Supervised independent living
• Behavioral residential treatment homes

Core supports provided:

• ADL/IADL support (e.g., hygiene, meal prep, medication reminders)
• Behavioral and mental health support (if applicable)
• Life skills training and community integration
• Transportation coordination
• 24/7 supervision and safety monitoring
• Health services coordination with clinicians

Services must be outlined in an Individual Service Plan (ISP) or Plan of Care (POC) and follow person-centered planning practices.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Massachusetts Secretary of the Commonwealth
• Obtain IRS EIN and Type 2 NPI
• Secure general liability, property, and workers’ comp insurance
• Apply for DDS or DMH residential program licensure
• Comply with residential program standards (health, safety, and staffing)
• Conduct CORI checks and fingerprinting for all staff
• Develop emergency preparedness plans and staffing schedules
•  

4. PROVIDER ENROLLMENT PROCESS

Step 1: Apply for DDS or DMH Residential Program Licensure
Submit policies, facility information, and operational plans for review

Step 2: Enroll with MassHealth as a Waiver Provider
Apply via Provider Online Service Center (POSC)

Step 3: Facility Readiness Inspection
Pass fire, health, and ADA compliance inspections before resident occupancy

Step 4: Finalize Contracts and Begin Service Delivery
Coordinate with DDS or DMH area offices for referrals and ongoing monitoring

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or DBA filings
• IRS EIN and NPI confirmations
• Proof of residential property insurance
• DDS/DMH facility license and inspection reports

Residential Care Services Policy & Procedure Manual, including:

• House rules and resident rights
• Staff schedules and supervision logs
• Emergency evacuation and response plans
• Daily living skills support templates
• Incident reports and medication administration records (MARs)
• Behavioral support plans (if applicable)
• Facility maintenance and safety checklists
• Documentation for audits and ISP compliance

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)
Requirements: High school diploma or GED, CPR/First Aid, experience with disabilities preferred, background checks required

Role: Program Manager / House Supervisor
Requirements: Experience in residential or habilitation services, staff supervision and scheduling, ISP implementation

Role: Nurse Consultant / Clinical Supervisor (optional but recommended)
Requirements: MA RN/LPN license for homes supporting complex medical needs

Required Training Topics:

• Abuse, neglect, and mandatory reporting
• Person-centered care and ISP goal tracking
• Infection control and health protocols
• Emergency procedures and fire safety
• Human rights and behavioral management techniques
• Medication administration (MAP certification)

7. MASSHEALTH & WAIVER PROGRAMS THAT COVER RESIDENTIAL SERVICES

Residential care is reimbursed under:

• DDS HCBS Waivers (Community Living, Intensive Supports)
• ABI Waivers (Acquired Brain Injury)
• MFP Waivers (Money Follows the Person – Residential Supports)
• DMH Adult Community Clinical Services (ACCS)
• Adult Foster Care Program (administered by MassHealth)
• Group Adult Foster Care (GAFC)

Providers must coordinate with:

• Support coordinators and clinicians
• ISP/POC teams
• State licensing monitors and quality reviewers

8. TIMELINE TO LAUNCH

Phase: Business Registration and Insurance Setup
Timeline: 2–4 weeks

Phase: Facility Preparation and Licensure Application
Timeline: 60–90 days

Phase: Staff Hiring and Policy Manual Completion
Timeline: 1 month

Phase: MassHealth Enrollment and Service Approval
Timeline: 1–2 months

Phase: Program Launch and Resident Intake
Timeline: Ongoing based on referrals and bed availability

9. CONTACT INFORMATION

MassHealth Provider Enrollment Portal
https://www.mass.gov/orgs/masshealth

​Department of Developmental Services (DDS)
https://www.mass.gov/orgs/department-of-developmental-services

​Department of Mental Health (DMH)
https://www.mass.gov/orgs/massachusetts-department-of-mental-health

​Executive Office of Health and Human Services (EOHHS)
https://www.mass.gov/orgs/executive-office-of-health-and-human-services

​

10. SCOPE OF WORK

• Business setup and DDS/DMH licensure assistance
• Facility readiness and health/safety inspection prep
• Residential Care Policy & Procedure Manual creation
• Staff training templates and supervision schedules
• ISP tracking forms and incident documentation logs
• MassHealth waiver credentialing and billing workflows

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — MASSACHUSETTS RESIDENTIAL CARE PROVIDER

We support healthcare entrepreneurs, nonprofits, and behavioral health providers in launching licensed, Medicaid-approved residential programs across Massachusetts.

​

To get started, click the link to request portal access