How to apply for an Assisted Living Medicaid Contract

Once the Application for an Assisted Living Facility Medicaid Contract is approved by Residential Care Services, a Contract request memo, identifying the Contract type, will be forwarded to the Contracts unit.

After the request is received, the Assisted Living Facility (ALF) Contract manager will send a request to the Contractor to complete and return the following forms:

Note: Please do not return these forms until they are requested by the ALF Contract Manager.

The information provided on these forms will be used to prepare the Medicaid Contract and a validation will be completed for all staff with management, ownership or controlling interest listed to ensure that they meet federal and state requirements as a condition for participation in Medicaid reimbursement.  After the validation is completed, a facility Contract will be prepared and forwarded to the Contractor for signature. Once signed by both parties, the fully executed Contract is returned to the Contractor and they are authorized to admit Medicaid clients into the facility.

Page Topic: 
Medicaid Contracts