Plain-language ALW guide
Moving from a nursing home to assisted living with ALW: what has to happen, and who does it
How a nursing-facility resident moves to assisted living with ALW: the 60-day priority rule, the steps in order, and who does what.
If your family member has been in a nursing facility for 60 days or more, they may get earlier priority on the Assisted Living Waiver (ALW) waitlist. The move takes a chain of steps that have to line up. Here they are, in order.
Families: tell Beta's ALW team about your family member. Apply for ALW.
Nursing-home teams: Refer a patient or client.
Important: The 60-day stay affects waitlist priority; it does not guarantee enrollment or a placement. A released slot is not a bed, so don't plan a discharge date around an unconfirmed slot or bed. The person stays where they are until every piece is in place.
Why the admission date matters
Under current state waitlist policy, a person who has been in an institution for at least 60 days when the waitlist request is submitted gets first priority. If they meet that condition at submission and later go home, current policy indicates the priority can stay with them.
Get the admission date in writing from the nursing home, and tell us about any gaps or planned discharge.
The steps, in order
Brackets show who owns each step.
- Find out if ALW may fit. 21 or older, full-scope Medi-Cal with no monthly share of cost, needing the level of care a nursing home gives: eligibility page. (You, with us)
- Choose a Care Coordination Agency. The Care Coordination Agency (CCA) is the state-listed organization that does the ALW paperwork and care planning with you. Beta can be yours. (You)
- Ask to be added to the state's waitlist. We send the request. (Beta)
- Wait, and stay ready. Keep Medi-Cal active and the person safely where they are. (You)
- An opening is released to you. The state releases it; we call you. Then: after a slot opens. (The state, Beta)
- The nurse assessment and your care plan. A Beta nurse assesses the person; we write the care plan (the ISP) with you. (Beta)
- Choose a home that takes ALW. It must have an opening and be able to carry out the care plan. (You; the home decides admission)
- Enrollment paperwork. We complete the state's nursing-facility transition checklist and submit the package. (Beta)
- Move-in and first month. Medications, equipment, transport and the residential agreement are assigned in writing before the move. (Shared)
- Ongoing check-ins. Your Beta care coordinator visits monthly. (Beta)
What the receiving home needs to know
Diagnoses, medications, wounds, equipment, transfers, fall risk, continence, memory and behavior, night-time supervision. Leaving out a need to make placement look easier usually means the home can't keep the person later. See choosing a home.
The paperwork the state requires
The state's nursing-facility transition checklist currently includes a Medi-Cal eligibility printout, the nursing home's face sheet, the signed ALW assessment, the care plan, any healthcare power of attorney, and the amenity, freedom-of-choice and participant-rights forms. Its timing rules run from the assessment signature date; always use the live form. Open the document guide.
Move-day checklist
Go through this with both homes before the move.
For the nursing-home team
Use the secure referral form, name one transition contact, and send the admission date, face sheet and latest functional information. The safe discharge plan stays with your team. The referral checklist lists what helps most.
Your next step
Families: tell us about your family member. Nursing-home teams: send a secure referral.
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.