ALW guide
Moving from a nursing home to assisted living with ALW
How a nursing-home resident moves to assisted living with ALW: the waitlist priority for stays of at least 60 days, the steps in order and who does each.
The Assisted Living Waiver (ALW) waitlist gives first priority to people in a nursing facility or other institutional setting. The stay must be at least 60 days when the waitlist request is submitted. Priority is not enrollment or a bed. The move takes a chain of steps that have to line up.
Important: The 60-day stay affects waitlist priority. It does not guarantee enrollment or a placement. A released opening (the state calls it a waiver 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
The priority rule is in DHCS Policy Letter 24-002. If the person goes home after the request is submitted, the priority stays with them. Proof of the stay is still required. The nursing home's face sheet (its summary record for the resident) is one example.
Get the admission date in writing from the nursing home, and tell us about any gaps or planned discharge.
The steps, in order
These are the ten steps of the application process, seen from a nursing home. The name in parentheses says who does each step.
- Find out whether ALW may fit. The person must be 21 or older. They need full-scope Medi-Cal with no monthly share of cost, and the level of care a nursing home gives. The eligibility page has the full rules. (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. To ask, use Apply for ALW. Applying asks Beta to be your agency. The state decides eligibility and releases openings. (Beta)
- Wait, and stay ready. Keep Medi-Cal active and the person safely where they are. (You)
- The state releases an opening to you. We call you. Then read what happens after a slot opens. (The state, then Beta)
- The nurse assessment and your care plan. A Beta nurse assesses the person. We write the care plan, called the Individualized Service Plan (ISP), with you. (Beta)
- Choose a home that takes ALW. It must have a room open 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. Before the move, Beta, the home and you put in writing who handles medications, equipment, transport and the residential agreement. (Beta, the home and you)
- Ongoing check-ins. Your Beta care coordinator visits monthly. (Beta)
If Medi-Cal is not active yet, or has a share of cost, see the guide to Medi-Cal with no share of cost.
What the receiving home needs to know
Tell the home about diagnoses, medications, wounds and equipment. Tell it about transfers, fall risk, continence, memory and behavior, and night-time supervision. If you leave out a need to make placement look easier, the home may not be able to keep the person later. See choosing a home.
The paperwork the state requires
The state's transition checklist for nursing-home residents (DHCS form 1327) lists what the enrollment package holds. It needs a Medi-Cal eligibility printout and the nursing home's face sheet. It needs the ALW assessment, signed by a registered nurse, and the care plan (ISP). It needs a durable power of attorney if there is one. It also needs the amenity, freedom-of-choice and patient's rights forms. The signed assessment must reach the state within 60 days of the nurse's signature. 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
Call Beta's ALW team at (747) 293-5777. Give your organization, your role, a callback number, the person's setting and county, and the general need. Name one transition contact. Do not send the face sheet or other patient details by email or through a form. Beta names the route for records on the call. The safe discharge plan stays with your team. The referral checklist lists what helps most. Refer a patient or client takes your own details, and a coordinator calls you back.
Families: request a callback. Nursing-home teams: call Beta, or send your own details through the referral form, and a coordinator calls you back.
About this informationReviewed August 27, 2026. Program details may change. View official sources and page limitations.
Written by Beta's ALW team and reviewed by Sergio B., Program Coordinator, against the official sources this page lists; facts checked through August 27, 2026. Where this page and an official source differ, the source controls.
This page gives general California ALW information. DHCS decides eligibility after the nurse assessment and releases openings. Each home decides its own admissions. Nothing here is an eligibility decision or a promise of enrollment, and it does not guarantee a place in a home. You may choose any Care Coordination Agency listed by DHCS and any participating home.
Something out of date? Tell Beta's ALW team.