How Wisconsin licenses assisted living
Wisconsin does not issue a single "assisted living license" the way some states do. The Wisconsin Department of Health Services (DHS), Division of Quality Assurance (DQA), Bureau of Assisted Living regulates four distinct license/certification types, each with a different scope of practice -- this is the single most important fact to understand before comparing communities here:
- Community-Based Residential Facility (CBRF) — a residential setting where five or more unrelated adults live together and receive room and board, supervision, and support services, plus up to three hours of nursing care per week per resident. Licensed under Wisconsin Admin. Code ch. DHS 83.
- Residential Care Apartment Complex (RCAC) — independent apartment units (not shared rooms) where residents receive room and board, personal care, nursing services, and up to 28 hours per week of supportive care per resident, a materially higher care-hour ceiling than a CBRF.
- Adult Family Home (AFH) — a private home where three or four unrelated adults reside and receive care, including up to seven hours per week of nursing care. Smaller one-to-two-bed adult family homes are regulated separately under DHS's Division of Medicaid Services rather than DQA licensing.
- Skilled Nursing Facility (Nursing Home) — licensed under a separate rule chapter, Wisconsin Admin. Code ch. DHS 132, providing 24-hour licensed nursing care. Nursing homes are the one senior-care category with federal CMS Care Compare star ratings in addition to Wisconsin's own survey and inspection record.
Each license type has its own admission/retention limits — for example, a CBRF's roughly three-hours-a-week nursing ceiling — and exceeding them can require a move to a higher level of licensed care. DHS's Bureau of Assisted Living can be reached at 608-266-8482 or [email protected].
What each license does and does not allow
- A CBRF caps nursing care at roughly three hours per week per resident. Exceeding that ceiling is one of the more common triggers for a required move to a higher level of care.
- An RCAC can deliver up to 28 hours per week of supportive care, in private apartments rather than shared rooms — a materially different setting and care ceiling than a CBRF.
- An adult family home serves just three or four unrelated adults, with up to seven hours per week of nursing care; one- and two-bed homes are regulated separately by DHS's Division of Medicaid Services.
- A nursing home is licensed under a wholly separate rule chapter (DHS 132) and is the only category with federal CMS Care Compare star ratings alongside Wisconsin's own survey record.
