Rosenthal Community Care Services
Full-Service Assisted Living Waiver (ALW) Provider Enrollment | RCFE
Full-Service Assisted Living Waiver (ALW) Provider Enrollment | RCFE
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California Assisted Living Waiver (ALW) Provider Enrollment Package
Full-service application preparation and enrollment coordination for qualifying California Residential Care Facilities for the Elderly (RCFEs) and Adult Residential Facilities (ARFs) seeking to become ALW providers.
RCCS fee: $5,000 through December 2026 | $6,000 beginning January 2027
Includes application-related consultations, corrections, submission coordination, follow-up, and a conditional RCCS Application Protection Guarantee. Government fees are separate.
Two Provider Applications. Separate State Reviews. One Coordinated Consulting Engagement.
An RCFE or ARF does not become an Assisted Living Waiver provider simply by holding a CDSS license or accepting a resident who has Medi-Cal. DHCS has a separate ALW facility provider-enrollment process that requires two application components and a subsequent qualification-verification review.
RCCS coordinates preparation of the ALW Program Initial Provider Application and the Medi-Cal Provider Enrollment Packet, tracks outstanding documents, supports agency-requested application corrections, and prepares the facility for the review format required by DHCS.
The State reviews the ALW program and Medi-Cal enrollment components separately. DHCS lists the ALW Program Application first and the Medi-Cal Provider Enrollment Packet second in its published RCFE/ARF provider-enrollment instructions. Both components must complete their respective reviews before the State's qualification-verification stage and final enrollment determination.
Important: Facility Provider Enrollment Is Not Resident Medi-Cal Eligibility
There are two different meanings of “Medi-Cal application” in the assisted-living context. Facility provider enrollment uses the Medi-Cal provider forms (including DHCS 6204, 6207, and 6208) as one part of the facility's ALW enrollment. Individual resident eligibility is a separate matter: a person seeking ALW services must meet the participant eligibility rules, including full-scope Medi-Cal without a share of cost.
This product is for facility provider enrollment, not preparation of an individual resident's Medi-Cal benefits application, ALW assessment, or waiver-slot request.
What You Are Purchasing
One full-service initial ALW provider-enrollment consulting engagement for one qualifying CDSS-licensed RCFE or ARF at one physical location. RCCS assists with both application components and the associated supporting materials. DHCS alone determines whether an application is accepted, approved, or denied.
The Correct California ALW Facility Provider-Enrollment Process
The sequence below distinguishes readiness work from the three published DHCS enrollment steps. The program and Medi-Cal components are separately reviewed; the State does not promise a fixed completion date.
Confirm License, Qualifications & Documents
Review the current CDSS facility license, good-standing requirements, location within an ALW county, NPI, business records, staffing and nursing availability, relevant HCBS policies, and supporting evidence. RCCS identifies missing documents; the applicant obtains authentic official records and makes any operational corrections.
ALW Program Application
Prepare the signed RCFE/ARF Program Initial Provider Application, ALW Program Provider Agreement, Home and Community-Based Setting Characteristics Provider Attestation (DHCS 5304), and checklist attachments. The program packet is emailed to DHCS's Provider and Facility Site Review Unit (PFSRU).
Program email: ProFacWAIVER@dhcs.ca.gov
Medi-Cal Provider Enrollment
Prepare DHCS 6204, DHCS 6207, and DHCS 6208; secure the applicant's required original signatures and notarizations; collect the supporting business documents; and coordinate the applicable State application fee. This packet is mailed to the DHCS Integrated Systems of Care Division, Provider Enrollment Unit (PEU)—not the general Provider Enrollment Division.
Packet questions: WaiveProEnroll@dhcs.ca.gov
Qualification Verification & Final Notice
Following review and approval of the required application components, DHCS completes an on-site or off-site visit to verify qualifications. The State then issues notice of the facility's enrollment status. RCCS provides mock Q&A, documentation readiness guidance, and other agreed preparation—not the official State review.
Why the Order Matters
DHCS explicitly identifies the program application as the first application and the Medi-Cal provider application as the second for RCFE/ARF ALW provider enrollment. This does not mean the program application is necessarily fully approved before the second packet can be prepared. The two reviews are separate, and both must be completed for full facility enrollment. This page follows the State's published step order without claiming an unsupported fixed interval between submissions.
Mailing Rules for the Medi-Cal Paper Packet
DHCS directs applicants to mail original-signature forms to its Integrated Systems of Care Division, Provider Enrollment Unit, 1501 Capitol Avenue, MS 4502, P.O. Box 997437, Sacramento, CA 95899-7437. DHCS says to disregard any conflicting mailing address printed on the forms and not send this ALW enrollment packet to its Provider Enrollment Division.
For paper preparation, DHCS prohibits staples, binders, sticky tabs/notes, oversized paper, correction fluid, and highlighter. It permits paper clips, binder clips, and rubber bands and requires Medi-Cal form pages to be in the proper order. RCCS conducts a final packet review against these instructions before coordinated mailing.
Official workflow: DHCS RCFE/ARF Provider Enrollment Steps.
What Is Included in the RCCS ALW Enrollment Package?
RCCS prepares, assembles, cross-checks, coordinates, and monitors the contracted initial enrollment application. Required external records must still come from their legal issuer, and the facility operator must truthfully certify and sign its own documents.
01. Initial Eligibility Review
Verify ALW county participation, CDSS license status and available licensing history, facility identifiers, baseline staffing and nursing arrangements, and documentation gaps before assembling the application.
02. ALW Program Application
Prepare and assemble the signed RCFE/ARF Program Initial Provider Application and ALW Program Provider Agreement, with associated information and State checklist materials.
03. HCBS Attestation Support
Assist with the DHCS 5304 Home and Community-Based Setting Characteristics Provider Attestation; organize the facility's policy references and documentary evidence supporting applicable federal settings requirements.
04. Medi-Cal Provider Forms
Prepare applicable DHCS 6204, DHCS 6207, and DHCS 6208 forms and cross-check ownership disclosures, tax records, NPI, licensing, insurance, and other required supporting documentation.
05. Signatures & Notarization
Identify the State's original-signature and notarization requirements, organize execution instructions, and review completed forms for apparent missing fields or signatures before mailing. Applicants procure their notarizations.
06. Submission Coordination
Check completeness, assemble the correct packet for each DHCS unit, prepare mailing/submission instructions, and assist with submission when expressly authorized and permitted under applicable rules.
07. Unlimited Application Corrections
Provide unlimited application-related revisions and supplemental responses requested by DHCS for the same initial enrollment project, within the signed agreement and without representing an unrelated new application.
08. Tracking & Follow-Up
Maintain an internal status and outstanding-items log, coordinate appropriate agency follow-ups, monitor deadlines communicated to RCCS, and notify the client of material requests and milestones.
09. Unlimited Application Consultations
Provide phone or remote consultations directly related to the contracted application, including form explanations, DHCS correspondence, document questions, and enrollment next steps.
10. Mock Review Preparation
Offer mock agency questions, records-review exercises, and a facility walk-through or remote equivalent as agreed, tailored to potential on-site or off-site qualification verification.
11. Determination & Corrections Support
Review the State's reported enrollment outcome and help address application-related requests for clarification, correction, or permitted resubmission within the agreed initial scope.
12. RCCS Application Protection
Provide conditional refund protection if a qualifying material RCCS error or omission solely causes a covered application failure or more than 90 calendar days of directly attributable delay, subject to the signed agreement.
Unlimited Does Not Mean Unlimited Separate Projects
The unlimited-corrections and consultations commitments apply to the one contracted facility's initial ALW enrollment application while that engagement remains active. Separate facilities, changes of ownership or location, new legal entities, unrelated regulatory consulting, ongoing operations, and future revalidations are not included unless expressly added to the service agreement.
Official ALW Program and Medi-Cal Provider Application Documents
DHCS publishes two different document checklists. RCCS uses the State's current instructions and distinguishes supporting documents that RCCS can draft or organize from documents the client or issuing authority must provide.
Part A: ALW Program & HCBS Submission
- Signed RCFE/ARF ALW Program Initial Provider Application
- Signed ALW Program Provider Agreement
- Signed DHCS 5304 HCBS Setting Characteristics Provider Attestation
- NPPES confirmation showing the facility's National Provider Identifier (NPI)
- Facility floor plan with designated rooms and intended occupancy
- Facility resident admission agreement
- Last two CDSS facility licensing reports requested by DHCS
- Current CDSS-issued facility license
- Sample full month of planned meals, including snacks
- Sample activity schedule and list of staff training topics
- Facility evacuation plan (LIC 610E)
- Public-facing brochure, handout, or acceptable facility-information URL
- Lease or similar agreement, or appropriate signed ownership exemption letter
- Policies/procedures or on-site manual cross-referenced to HCBS requirements
- Other supporting documents needed for responses to federal settings requirements
Part B: Medi-Cal Provider Enrollment Packet
- DHCS 6204 Medi-Cal Provider Application — signed and notarized
- DHCS 6207 Medi-Cal Disclosure Statement — signed and notarized
- DHCS 6208 Medi-Cal Provider Agreement — signed and notarized
- Applicable State application fee paid in the State-approved form
- Business email associated with the RCFE/ARF
- NPPES/NPI confirmation and proof of Federal Taxpayer Identification Number
- City business license or appropriately substantiated exemption letter
- CDSS facility license
- Copies of required State-issued identification for individuals listed on forms
- DBA/fictitious business name statement, if applicable
- General liability insurance for the facility address
- Workers' compensation insurance or qualifying documentation where an exemption applies
- Surety bond or qualifying exemption documentation
- Secretary of State confirmation and formation documents, as applicable
- Original paper application mailing instructions and packet checklist
Document Exceptions Are Not Automatic
The DHCS checklist describes specific alternatives, such as a signed facility-ownership statement in place of a lease, a city business-license exemption letter where no license is required, a factually supported workers' compensation exemption for qualifying operations, and a surety-bond exemption where its stated conditions are met. RCCS does not invent eligibility for an exemption. The facility must provide accurate facts and supporting records, and DHCS decides whether submitted documentation is acceptable.
Newly licensed facilities may not have two prior CDSS licensing reports. Because the published checklist requests the last two reports, a missing report is flagged for direct agency clarification rather than silently omitted or replaced with an assumed substitute.
What RCCS Cannot Issue
RCCS cannot issue or authenticate a CDSS license, official inspection report, NPI, IRS notice, insurance policy, surety bond, business license, notarization, government fee receipt, or DHCS enrollment approval. Our scope is professional document preparation, organization, review, and application coordination—not acting as the issuing government agency or third-party insurer.
Source: DHCS Program and Medi-Cal Application Checklists (PDF).
ALW Application Package Pricing and 2026 State Enrollment Fee
RCCS Initial Enrollment Service
Professional consulting fee for one qualifying initial ALW facility provider-enrollment engagement purchased under an accepted 2026 agreement.
Includes both application components, application-related corrections and consultations, tracking, follow-up, and agreed mock readiness support.
Discuss Your Facility's ApplicationScheduled RCCS Professional Price
The scheduled RCCS price for the same general initial enrollment consulting package, subject to the executed service agreement and applicable State requirements.
A consultation request or inquiry by itself does not reserve 2026 pricing; the accepted service agreement and payment terms control.
The 2026 DHCS Medi-Cal Enrollment Application Fee Is $750, Not $730
DHCS's updated Calendar Year 2026 Application Fees page states that the applicable provider-enrollment fee is $750 for applications submitted January 1–December 31, 2026. Certain older ALW-specific documents still show $730, which DHCS identifies as the 2025 amount. RCCS follows the updated calendar-year fee schedule rather than repeating the outdated checklist amount.
For paper Medi-Cal applications subject to the fee, DHCS's general payment instructions specify a cashier's check payable to the State of California, Department of Health Care Services. The applicant pays the State fee separately; RCCS does not include it in the $5,000 professional price. Verify the fee and payment instructions immediately before mailing, especially if submitting in 2027 or later.
Official sources: DHCS current application-fee schedule and RCFE/ARF Medi-Cal packet requirements.
Other Expenses Are Separate
Notarization, government and third-party charges, insurance, surety bonds, required business records, property or staffing modifications, and any separately authorized travel expense are not included in the RCCS consulting fee unless the signed agreement explicitly says otherwise. The State may revise fees, forms, and instructions independently of RCCS pricing.
Mock Qualification Review, Interview Practice & Facility Readiness
DHCS describes a required on-site or off-site qualification-verification visit after review and approval of the two application components. Its public RCFE/ARF enrollment instructions do not promise that every applicant will have the same interview, inspection, or review format.
Mock Agency Questions
Practice explaining the facility's operations, program responsibilities, resident rights, staffing and nursing arrangements, supporting documents, and HCBS person-centered setting requirements as applicable.
Mock Site or Records Review
Review the facility's application records and observable readiness factors such as resident privacy, safety, emergency procedures, supporting policies, and staff availability in an on-site or remote format agreed with RCCS.
Readiness Findings
Receive a list of identified concerns and recommended corrective actions for the operator to evaluate and implement before the State's qualification-verification stage.
Who Controls the Official Outcome?
Only DHCS conducts or directs the official enrollment verification. RCCS cannot guarantee a pass, substitute its mock review for the State's review, or control the facility's day-of staffing and practices. The owner or licensee remains responsible for continuous CDSS and applicable ALW compliance. A covered error made by RCCS in its express application work is evaluated separately under the refund guarantee.
On-site readiness services are available for covered Southern California engagements as specified in the contract. Remote preparation or separately agreed travel may apply elsewhere.
Accountability for Our Application Work—Without Promising a Government Decision
When a Documented Material RCCS Error Solely Causes the Covered Failure
If the contracted initial enrollment application is denied, rejected, closed, or cannot proceed solely and directly because of a material RCCS error, omission, action, or inaction within work expressly promised by RCCS, RCCS will be given a reasonable opportunity to correct, supplement, and—where permitted—resubmit or otherwise cure the issue.
If that qualifying RCCS-caused problem cannot reasonably be cured, or a material covered RCCS error solely results in more than 90 calendar days of actual, directly attributable delay, the client may qualify for a refund of 100% of the RCCS professional fees actually paid for this specific package, subject to the executed agreement's notice, documentation, cure, and eligibility terms.
Refund Limit
The maximum refund under this product guarantee is limited to RCCS professional service fees actually paid for this one ALW enrollment package. State fees, notary charges, third-party services, staffing, insurance, travel, consequential damages, lost profit, and fees for other services are not included.
Material Error & Causation
There must be a documented error within RCCS's promised scope, and that error must be the sole direct cause of the qualifying failure or delay. A routine agency request for an update does not by itself trigger a refund.
Reasonable Opportunity to Cure
RCCS must receive the required notice and a fair opportunity to correct a covered error, subject to State procedures and the contract. Correction or resubmission is not represented as automatic acceptance by DHCS.
The 90-Day Standard
The 90-day provision concerns delay caused solely by a covered RCCS error, not total calendar time since engagement, an ordinary State review queue, or a promised DHCS processing deadline.
Examples Outside the Guarantee
- A failed State verification caused by the facility's actual safety, staffing, medication, records, or operational practices rather than an RCCS application error.
- Missing, late, invalid, or inaccurate information; original signatures; notarizations; State fees; NPI, licensing, insurance, or other documents that the applicant must provide.
- Applicant misrepresentation, undisclosed ownership or facility changes, regulatory violations, CDSS licensing actions, or loss of required qualifications.
- DHCS processing queues, discretionary determinations, State scheduling delays, changed requirements, and independent acts of government or other third parties.
- The client's refusal or failure to perform responsibilities assigned to the client in the service agreement or to implement necessary operational corrections.
- A separate project, materially changed application, or issue outside the express scope of the contracted initial enrollment services.
A Clear Contract Governs Every Engagement
The service agreement is provided for review before the engagement and governs exact services, deliverables, client duties, notice, remedies, refund evaluation, and other conditions. This product page is not a guarantee that DHCS will approve an application in 90 days—or at all. Where a conflict exists, the signed contract controls to the extent permitted by law.
Who Can Apply as an ALW RCFE or ARF Provider?
Licensed RCFEs
Residential Care Facilities for the Elderly licensed by CDSS in an ALW-participating county may seek provider enrollment if they satisfy DHCS qualifications, substantial-compliance requirements, and applicable HCBS standards.
Licensed ARFs
Eligible Adult Residential Facilities can also apply for ALW provider participation under DHCS's RCFE/ARF enrollment process, subject to the facility's license, population served, staffing, and program requirements.
Existing Care-Home Operators
Owners and administrators who already have a CDSS license and want application preparation, documentation review, coordination of the two provider packets, and support with final verification readiness.
Selected DHCS Baseline Facility Requirements
- A valid CDSS license and substantial compliance/good standing; DHCS identifies facilities on probation or with pending accusations against the licensee as not meeting its stated substantial-compliance standard.
- Licensed nursing staff available on call or employed so skilled nursing services can be provided as needed; sufficient care and supervision staff for participant health and safety.
- Private or semi-private bathrooms, a dining room or common activities space that can serve as a dining room, and the ability to offer private or shared bedrooms.
- For facilities housing more than six participants, an Individual Response System permitting participants to summon assistance at any time.
- Ability to deliver applicable ALW services, respect resident rights and HCBS setting standards, and operate within CDSS licensing authority.
Participating Counties (DHCS List Reviewed October 2026)
Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma.
RCCS supports qualifying provider-enrollment clients remotely across California's participating ALW counties. Southern California service areas include the High Desert (Hesperia, Victorville, Apple Valley, Oak Hills, Adelanto, and Barstow), the Inland Empire (San Bernardino, Fontana, Rialto, Highland, Redlands, Loma Linda, Rancho Cucamonga, Ontario, Upland, Chino, and surrounding communities), plus Riverside, Orange, Los Angeles, and San Diego counties. On-site preparation depends on the agreed service area.
RCCS can assess apparent readiness but does not confer eligibility, licensing, or State approval. See DHCS ALW Provider Enrollment.
What the Facility Must Provide—and What This Package Excludes
Your Responsibilities
- Provide accurate current ownership, entity, facility, CDSS, and business information.
- Provide official records, NPI confirmation, required identification, license, reports, insurance, and other support documentation.
- Execute original signatures and notarizations and pay required government or third-party fees.
- Respond promptly to outstanding items or State requests and disclose material changes.
- Maintain required staffing, nursing availability, safe conditions, licensing compliance, resident protections, and HCBS policies.
- Take corrective action on facility-level or operational deficiencies identified before or during verification.
Not Included
- Initial CDSS RCFE/ARF licensing or license renewal.
- Separate Care Coordination Agency or Home Health Agency enrollment.
- Individual resident Medi-Cal eligibility applications, ALW slot requests, assessments, or participant enrollment.
- Guaranteed referrals, resident occupancy, State approval, waiver slots, or reimbursement.
- Ongoing ALW claims billing, collections, appeals, or revenue-cycle management.
- Facility staffing, nursing service provision, routine staff instruction, or day-to-day management.
- State fees, notarizations, insurance, surety bonds, external professional fees, or facility upgrades.
- Separate changes of ownership or location, new facilities, future revalidations, or unrelated enrollment projects.
For initial CDSS facility licensing, RCCS offers a separately contracted RCFE/ARF Full-Service Licensing Package. ALW billing and other claims services require separate terms.
California ALW Provider Enrollment — Frequently Asked Questions
Which application comes first: the ALW Program Application or Medi-Cal?
For a facility enrolling as an ALW provider, DHCS publishes the ALW Program Application as Step 1 and the Medi-Cal Provider Enrollment Packet as Step 2. The two components are reviewed separately and both are needed before final enrollment. This is distinct from individual participant eligibility, which requires a person to have full-scope Medi-Cal with no share of cost, along with other ALW qualifications.
Is the Medi-Cal provider packet the same as applying for a resident's Medi-Cal benefits?
No. The facility's Medi-Cal enrollment packet establishes the provider's participation status as part of ALW enrollment. A resident's Medi-Cal coverage, functional eligibility, assessment, and ALW waiver-slot process are separate and are not included in this facility application service.
Do I need a CDSS facility license before becoming an ALW provider?
Yes. DHCS requires enrolling RCFE/ARF facilities to meet CDSS licensing requirements and its applicable substantial-compliance and ALW program standards. RCCS's separate CDSS licensing service is not part of this product.
Are both DHCS application components included in RCCS's price?
Yes. This professional consulting package covers document preparation and application coordination for both the ALW program and Medi-Cal provider components for the same facility, subject to the agreed scope. Government application fees and other third-party expenses are separate.
Does the ALW packet need to be mailed?
DHCS directs facilities to email the ALW Program Application to the Provider and Facility Site Review Unit. The Medi-Cal Provider Enrollment Packet must be mailed to the Integrated Systems of Care Division Provider Enrollment Unit because original wet signatures are required. Do not mail the packet to the general Provider Enrollment Division.
Which Medi-Cal forms must be notarized?
DHCS's RCFE/ARF instructions identify DHCS 6204 (Provider Application), DHCS 6207 (Disclosure Statement), and DHCS 6208 (Provider Agreement) as requiring signatures and notarization. Applicants must execute the original documents as required.
What is the State's 2026 enrollment application fee?
DHCS's updated calendar-year 2026 fee schedule specifies $750 for applicable Medi-Cal provider enrollment applications submitted in 2026. Older ALW-specific materials still show the 2025 amount of $730. The State fee is separate from RCCS's consulting fee and should be rechecked before payment or mailing.
Will DHCS inspect or interview the facility?
DHCS states that an on-site or off-site qualification-verification visit occurs following review and approval of the program and Medi-Cal application components. Its public instructions do not impose the same stand-alone interview format on every applicant. RCCS provides mock questions and agreed readiness reviews tailored to the anticipated process.
Does the 90-day guarantee mean State approval within 90 days?
No. DHCS does not publish a guaranteed 90-day provider approval period in the cited RCFE/ARF enrollment instructions. RCCS's provision concerns more than 90 days of delay solely and directly caused by a covered material RCCS error, under the signed contract—not normal State queue or processing time.
Does every denial trigger a refund?
No. A refund requires a documented material RCCS error within the promised service scope that is the sole direct cause of the qualifying adverse outcome, together with the contract's required notice, cure, and other conditions. A denial caused by facility noncompliance or State discretion is not automatically a qualifying RCCS failure.
How many application corrections and consultations are included?
Unlimited application-related corrections, updates, and remote/phone consultations for this one contracted initial application, within the signed agreement. A different facility, significant entity/location change, new enrollment, future revalidation, or ongoing billing is separate.
Can RCCS promise ALW referrals, resident slots, or payments after approval?
No. Provider enrollment does not itself establish any individual participant's ALW eligibility or guarantee placements, waiver slots, occupancy, or claims payment. DHCS reports that ALW participant slots are limited and that there is a waitlist, and qualified participants are served through separate care-coordination and enrollment procedures.
Does Medi-Cal pay the participant's room and board under ALW?
No. DHCS explains that ALW participants pay the facility directly for room and board, while the waiver addresses authorized services. This is separate from the application package and should be considered when planning facility operations and resident admissions.
Which California counties participate in ALW?
As listed by DHCS in October 2026: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, and Sonoma. Verify participating counties and program policy before submitting a new project.
Verify Requirements Directly With DHCS
RCCS prepares applications against the published California Department of Health Care Services instructions available at the time of the engagement. The following official sources support the provider enrollment sequence, checklist, fee, qualifying counties, and program requirements described above:
- DHCS — RCFE/ARF Provider Enrollment Steps (program packet first; Medi-Cal packet second; verification)
- DHCS — ALW Program and Medi-Cal Checklists (PDF) (supporting evidence and forms; older fee reference)
- DHCS — RCFE/ARF Medi-Cal Application Requirements (notarized forms and business records)
- DHCS — Calendar-Year Application Fees (current 2026 amount, accepted paper payment method)
- DHCS — Assisted Living Waiver Program (participant eligibility, room and board, counties, and waitlist)
Independent Consulting Disclosure
Rosenthal Community Care Services is an independent private consulting company. RCCS is not DHCS, CDSS, an authorized government enrollment office, or an issuer of State licensure or approval. Program rules, submission processes, application fees, and eligibility standards may change. The signed RCCS agreement defines the services purchased; only DHCS can decide provider enrollment.