For assisted-living facilities
Running an ALW resident's care: roles, records, and who to call when things change.
The working reference for ALW facilities: who does what with the Beta care coordinator, 2026 rates, the care plan, change-of-condition escalation and incidents.
This is the working reference for facilities with residents enrolled in California's Assisted Living Waiver (ALW). It covers who does what between your team and the Beta care coordinator, what the care plan needs to say, how to escalate a change in condition, and how to keep ALW service billing separate from room and board.
Contact Beta's Facility Coordination Team
Important: Beta is a Care Coordination Agency (CCA), the state-listed organization that does the ALW assessment and care planning with the participant. Your license, your reporting duties to the California Department of Social Services (CDSS) and your admission decisions stay yours. ALW pays for services in the care plan, never room and board, and the California Department of Health Care Services (DHCS) alone controls enrollment and slot release. In an emergency, call 911 first.
Operational responsibility matrix
| Area | Facility responsibility | CCA responsibility |
|---|---|---|
| Admission | Evaluate and accept/decline within law and capability | Share authorized assessment information |
| Care plan (the Individualized Service Plan, or ISP) | Implement the services assigned to you | Develop, monitor and revise |
| Staffing, daily services and medication | Deliver and document within license | Monitor delivery |
| Monthly visit | Facilitate access and information | Conduct required visit |
| Change in condition | Respond and report | Reassess/coordinate |
| Incident | Follow licensing/program reporting | Review and complete CCA actions |
| Residential charge | Explain agreement/charges | Explain ALW distinction; no housing billing |
Service rates and residential charges
Current 2026 assisted-living-service tiers range from $95.69 to $270.80 per day; these are provider-service reimbursement figures. The residential arrangement is separate: current CDSS guidance distinguishes room-and-board and care-and-supervision components within the Non-Medical Out-of-Home Care (NMOHC) basic-services amount.
Never bill the participant for a service already paid through ALW, call the entire provider tier "room and board", hide additional charges, or use old annual amounts. Review current rates.
The care plan (ISP) and monthly visits
Every shift lead should be able to say which ISP services the facility is responsible for, the level of assistance, risks, transfer method, supervision needs, the backup plan, and who to contact when the plan no longer matches need. The ISP is meant to guide actual care, not sit in a file.
For the monthly CCA visit, make available the participant, staff observations, incidents, medication changes, hospital use, unmet needs and any concerns. The participant must be able to raise concerns without pressure.
Changes in condition and incidents
This is the single trigger list Beta's facility and healthcare pages point to.
Urgent/emergency
Call emergency services and follow licensing procedures; notify the CCA and representative as required.
Material but not emergent
Notify the care coordinator promptly.
Triggers: a hospitalization or ER visit; a fall; a new transfer, equipment or wound need; a new behavior or supervision need; a medication or treatment change; hospice or home-health starting or stopping; missed services; a resident or family concern; or any change that may affect safety, care tier, staffing, the ISP or the person's ability to stay in the setting.
Routine
Document and discuss at planned coordination, still meeting all reporting requirements.
Reassessment and tier changes
A facility may request review, but a tier change is not a price negotiation. Document what changed, when, how often, the exact assistance, nighttime need, risk and what the plan is missing, not "needs more care" without examples.
Incidents
Licensing reports and the ALW/CCA incident process may both apply. Keep a current crosswalk of the two, incident type, protection, notifications, timeframe, form, follow-up, closure, built from current DHCS/CDSS resources.
Healthcare, home health and hospice
When another provider enters, confirm orders or coverage, identify each party's scope, avoid duplicate billing, update the CCA, set medication and durable medical equipment (DME) responsibility, and keep participant choice central. Open the ALW + Hospice Coordination Guide.
Public profile and operational audit
Assign a profile owner for quarterly verification, corrections and expiring stale availability. Profile copy must describe what you actually do; overstating capability puts the resident and your license at risk. The full profile list is on the working-with-Beta page.
Audit yearly: enrollment and license, contacts and staffing, ISP implementation and visit process, change-in-condition and incident crosswalk, secure communication and participant rights, and rate/residential charge separation.
Your next step
Operational question about a current resident? Contact the facility coordination team.
Official sourcesChecked against the official sources
Use the official sources below to confirm time-sensitive program details.
This page provides general California ALW information. It is not an eligibility decision or a promise of enrollment, and it is not a guarantee of facility placement. You may choose any Care Coordination Agency listed by DHCS and any participating facility.