The 3 ALW Income Streams
Most RCFE Owners Are Missing
A quick-reference guide for California residential care providers who have ALW residents and want to make sure they are capturing every dollar they are entitled to.
Most facilities with ALW residents are leaving money on the table by only collecting the base daily rate. There are two additional revenue streams available for the same residents, but most billers do not set them up properly. Here is how all three work.
The standard daily rate DHCS pays for each ALW-enrolled resident. This covers core residential care services under your RCFE or ARF license.
$2,800 to $8,100 per resident depending on the tier rate.
Late submissions, missing documentation, and wrong billing codes leave money sitting uncollected for months.
Clean submissions on a consistent weekly cycle. Zero aged claims over 60 days. Every resident billed every month.
Additional daily rates available for residents who need a higher level of support. These are separate billing codes layered on top of the base rate.
$2,500 to $10,000 additional per qualifying resident per month. Stacks on top of stream one.
Most billers do not screen for qualifying residents. If nobody asks the right questions during intake, this rate never gets claimed.
Your residents may already qualify. We can further discuss in detail regarding their level of care to see if they would be a good candidate.
The monthly portion of a resident's income (typically from SSI) that is paid directly to the facility for room and board. This is separate from Medi-Cal/ALW reimbursements and must be properly calculated and collected.
$1,400 to $1,600 per resident per month.
Many facilities either do not collect the full share of cost, calculate the amount incorrectly, or do not structure it properly. In some cases, residents are not receiving their full eligible benefits, which directly impacts what the facility should be collecting. This leads to consistent under-collection.
Any RCFE with ALW residents.
Want Kamil to run these numbers for your facility?
Free 15-minute call. He will look at your bed count, ALW mix, and current billing and tell you exactly what you may be leaving on the table.