RESIDENTIAL CARE SERVICES PROVIDER IN MASSACHUSETTS

Fatumata Kaba
Aug 8
4 min read

DELIVERING 24-HOUR SUPPORTIVE HOUSING IN SAFE, STABLE ENVIRONMENTS FOR INDIVIDUALS WITH DEVELOPMENTAL, PHYSICAL, OR BEHAVIORAL HEALTH NEEDS

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), the Massachusetts Rehabilitation Commission (MRC), and the 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

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

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

Scope of Work: