Told You Can't Open a Group Home Directly? Welcome to Gated Entry

Trying to open a residential group home and getting told you can't apply directly? You're not doing anything wrong — in some states, the rules have changed.

A growing number of programs now use a gated entry model. You can't start with residential licensing. Instead, you enter through a community-based service first, enroll with Medicaid, bill under that service, and then advance toward residential. Knowing this new sequence is what keeps you from losing months.

What a gated entry model means

Certain services, often residential licensing, now sit behind a gate. You can't apply for them as your first service. The state asks you to begin with a community-based service, deliver it, and bill Medicaid for it before you advance toward the gated service.

Which services are the entry point

The entry service varies by state but is typically community participation support or supported living. These are different from each other and from residential care, and each has its own endorsement, enrollment, and training requirements. Choosing the right one shapes the rest of your path.

How you reach residential

Form your business, complete the required modules, get the right credentials and Medicaid enrollment for your entry service, and start billing. As you build a track record, you position yourself to advance toward residential licensing when it opens.

Key takeaway: In a gated entry state, you can't start with residential licensing. Enter through a community-based service, enroll and bill under it, then advance. Knowing the sequence saves you months.

Start Any Program. In Any State.®

Ready to talk it through? 20+ years clearing the path in all 50 states — we've done this before, and we'll do it for you. Book a video consultation at waivergroup.com/videoappointment, call 302.888.9172, or email inquiries@waivergroup.com.