According to Wisconsin state statutes, assisted living facilities provide care or services to individuals that is beyond the level of room and board but does not constitute 24-hour medical supervision or skilled nursing care. In this state, the two primary types of assisted living facilities are Adult Family Homes and Community Based Residential Facilities. To open an assisted living facility in Milwaukee, Wisconsin, you must comply with all state and local requirements regarding opening a business as well as obtain the appropriate licenses related to assisted living facilities from the Wisconsin Department of Health Services, Division of Quality Assurance.
Decide whether you will open an Adult Family Home (AFH) or Community Based Residential Facility (CBRF). While the licensing process is mostly the same, each type of facility has special requirements designed to meet the needs of residents. Adult family homes are restricted to no more than four residents at a time, but may provide up to seven hours of nursing care per resident per week. CBRFs are allowed to have as many residents as the building can accomodate according to space-per-resident regulations but are restricted to three hours of nursing care per week. Additionally, CBRF assisted living homes must have a state approved administrator whereas AFHs can be run by the business owner.
Research and review the building codes, reporting regulations, and other laws related to your type of assisted living facility. This information can be found in Chapter DHS 83 (CBRF) or Chapter DHS 88 of the Wisconsin Administrative Code, which is available online through the Department of Health Services (DHS) website.
Additionally, if you are opening an AFH, this is a good time to watch the "Starting an Adult Family Home" webcast found on the DHS website. Viewing this webcast is required prior to becoming licensed and offers useful information about the licensing process and regulations related to AFHs.
Find a suitable building to house your assisted living facility, keeping in mind the building requirements laid out in the Wisconsin assisted living regulations. In addition to space and safety specifications, these regulations also specify that assisted living facilities provide a homelike atmosphere, which means you can open either type of assisted living in a regular single-family home if it meets the building requirements. And adult family homes can be opened in the house you live in, if desired. However, if you choose to construct a new house or remodel an existing home, you must submit a Plan Review to the DHS for approval prior to beginning construction. Also important to note: Wisconsin laws state that you cannot open an assisted living in a building located on land zoned for commercial, industrial or manufacturing use, so check with the Milwaukee Department of City Development prior to purchasing or leasing existing buildings.
Develop a Program Statement that specifies how many residents your facility is equipped to provide care for, the types of residents you intend to serve, the specific services your assisted living will offer and how you will provide those services, limitations in the care you can provide and a description of the home.
If you are opening a community based residential facility, this is a good time to begin contacting individuals who reside in the neighborhood, potential residents or family members of potential residents, and Milwaukee city officials to form a community advisory board. You must demonstrate to the DHS that you have made a good-faith effort to put together a community advisory board prior to applying for a CBRF license.
Create a financial plan for your assisted living facility, including fee structures, payment methods accepted, and estimated operating expenses and anticipated income. Wisconsin statues dictate that you must prove your financial ability to operate your assisted living for at least 60 days without income during the licensing process. This is also a good time to ensure you have adequate insurance for your home and your vehicle if it will be used to transport assisted living residents.
File a Registration of Firm Name with the Milwaukee County Register of Deeds if your assisted living will operate as a sole proprietorship or general partnership. All other types of businesses must file articles of organization and a trade name with the Wisconsin secretary of state.
Contact the Milwaukee Development Center to obtain an occupancy certificate for your assisted living facility. Additionally, contact your local fire house to schedule a fire safety inspection and be sure to obtain a copy of this report.
Apply for a Federal Employer Identification Number (FEIN) from the IRS either online or by filling out and mailing Form SS-4. Use this number to register your business with the Wisconsin Department of Revenue. You can register online through their website or by submitting Form BTR-101 at the local Milwaukee office location.
Complete and submit an application for an assisted living facility license to the Milwaukee/Southeastern Region Division of Public Health office. Include with your application the licensing fee, your Program Statement, evidence of your financial solvency, your fire inspection report and a floor plan of your facility. Adult family home applications must also include verification that you have viewed the required webcast and that you hold adequate insurance for your home.
Prepare your assisted living home for inspection by DHS officials, and comply with any additional requests such as completing additional caregiver training or obtaining a criminal background check. Within 70 days of receiving all the required materials and completing the inspection, the DHS will notify you of its decision. If approved, you will be issued a license that must be displayed in your assisted living facility. If denied, you will given the reasons and provided with information about correcting deficiencies or filing an appeal.
- Wisconsin Dept. of Health Services: Chapter DHS 88, Licensed Adult Family Homes
- Wisconsin Dept. of Health Services: Chapter DHS 83, Community Based Residential Facilities
- Wisconsin Dept. of Health Services: Starting Up an Adult Family Home
- Wisconsin Dept. of Health Services: Residential Options - Definitions
- Wisconsin Dept. of Revenue: Business Tax Registration FAQs
- Genworth. "Cost of Care Trends and Insights." Accessed Oct. 25, 2020.
- U.S. Centers for Medicare & Medicaid Services. "What Part A covers." Accessed Oct. 25, 2020.
- Social Security Administration. "Supplemental Security Income (SSI) in California," Page 2. Accessed Oct. 25, 2020.
- U.S. Department of Veteran Affairs. "Enhanced or Special Monthly Pension Aid and Attendance or Housebound," Pages 1-2. Accessed Oct. 25, 2020.
- U.S. Department of Veteran Affairs. "VA pension rates for Veterans." Accessed Oct. 25, 2020.