Wisconsin Assisted Living Licensing: CBRF, RCAC, and AFH Explained

Wisconsin Doesn't Have "Assisted Living" — It Has Three Separate Licenses

Search for "assisted living" in Wisconsin statutes and you won't find a single licensing category with that name. Instead, the state regulates three distinct residential care settings under separate administrative codes, each with its own staffing rules, clinical limits, and physical-plant requirements. A facility marketing itself as "assisted living" could be a five-bed CBRF in a converted house or a 200-unit RCAC with private apartments — and the care they can legally provide differs dramatically.

Understanding which license a facility holds tells you exactly what care it can deliver, when your parent would need to transfer out, and whether Medicaid can help pay for it.

Community-Based Residential Facility (CBRF) — DHS 83

CBRFs are the most common assisted living setting in Wisconsin. Licensed under Wis. Admin. Code Chapter DHS 83, they serve five or more residents and provide 24-hour on-site staffing.

What they can do:

• Medication management — storage, administration, and complex regimen oversight
• Behavioral support and structured daily programming
• Secured (locked) memory care units for residents with dementia, with Division of Quality Assurance approval
• Personal care assistance (bathing, dressing, toileting, mobility)

What they can't do:

• Nursing care is capped at three hours per resident per week. If your parent's needs exceed that limit or require continuous medical monitoring, a CBRF cannot provide the full level of care.

Staffing requirements: Staff working with dementia residents must complete dementia-specific training within 90 days of hire. All direct-care staff need training in residents' rights, fire safety, medication procedures, and standard precautions.

Memory care specifics: Wisconsin does not issue a separate "memory care" license. Memory care is a service program within a CBRF. To operate one, the facility must declare a dementia client group during licensure, submit a written program plan, and get DQA approval for any physical security measures like delayed-egress locks.

Residential Care Apartment Complex (RCAC) — DHS 89

RCACs offer private, self-contained apartments — each with a lockable door, kitchen or kitchenette, and private bathroom. Licensed under DHS 89 for five or more units, RCACs serve residents who are largely independent but need supportive services and emergency backup.

What they can do:

• Up to 28 hours of supportive, personal, and nursing services per resident per week (including personal care, housekeeping, and meal preparation)
• 24-hour emergency response system
• Medication reminders and cueing

What they can't do:

• Locked memory care is legally prohibited in an RCAC
• No continuous staffing — emergency response, not active supervision
• Nursing and other services are limited to the 28-hour weekly cap; an RCAC is not a nursing home

Two tiers: Wisconsin has both certified RCACs (which can accept Family Care Medicaid waiver members) and registered-only RCACs (private-pay exclusively). The distinction matters — if your parent might eventually need Medicaid to cover care, a registered-only RCAC won't accept that funding.

Adult Family Home (AFH) — DHS 88

AFHs are small residential settings — one to four residents in a private home. Licensed under DHS 88, they offer a family-style environment with more personal attention than larger facilities.

What they can do:

• Personal care and daily living assistance
• Up to seven hours of nursing care per resident per week — more than double the CBRF limit
• Individualized attention in a small setting

What they can't do:

• Serve more than four residents (three if the operator also lives in the home and no additional staff is present)
• Provide continuous medical monitoring or hospital-level intervention

AFHs work well for residents who need consistent personal care in a home environment but don't require the programming or clinical infrastructure of a larger facility.

Which License Covers Which Needs

How to Verify a Facility's License

The Division of Quality Assurance maintains the Wisconsin Provider Finder — a searchable database of every licensed care facility in the state. Search by facility name, county, or provider type to confirm the license class, survey history, and any deficiency citations.

Survey history records show every state audit and validated complaint from the preceding three years, including the severity of violations and the facility's plan of correction. If a recent survey report is missing (federal-to-state IT transitions sometimes cause delays), contact the Bureau of Assisted Living regional office or email [email protected] for physical copies.

The Wisconsin Care Decision Guide includes a facility tour evaluation form that maps questions directly to each license type's clinical limits, so you know exactly what to verify during a visit.

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