Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. General Description


  • Community Based Residential Facilities (CBRFs) are group living arrangements that serve five or more residents and provide room, board, supervision and other supportive services. Residents have private or shared rooms and most have shared bathrooms.

  • CBRFs were first licensed in the late seventies. CBRF is an umbrella category that includes single family homes used for group living, group homes, dormitories, and apartment buildings with separate apartments. CBRFs vary in size from 5 to over 100 beds. Whatever their size or setting, they are all licensed under the same provisions and subject to the same regulations. Facilities with over 20 beds are subject to additional requirements for fire protection, sanitation, construction and maintenance, and other aspects of the physical environment.

  • The licensing term CBRF is an umbrella category that covers facilities that may provide care to people of all ages with all types of physical and mental impairments. CBRFs are intended for people who are neither acutely ill nor need extensive amounts of nursing care, yet cannot live independently. Some CBRFs serve a specific population, e.g., the frail elderly, working age adults with disabilities, elderly with dementia, while others serve a heterogeneous population, e.g., people of all ages with a range of physical or mental impairments.

    The CBRF regulations state that it is desirable to provide services to a specialized target group, but the state does not require it, in part because the state has many rural areas and there may not be a large enough population in each target group to guarantee full occupancy. Whatever the population served, the CBRF regulations require that the facility be able to meet the residents' needs. Most residents of CBRFs are elderly persons who pay privately, so generally, public policy does not drive the industry.

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