Arkansas residential care facility license: the 2005 bed moratorium and the buy-in route

The moratorium comes first

Before you look at rooms or staffing, deal with this: the Arkansas Health Services Permit Agency, which issues Permits of Approval for residential care facilities,⁠⁹ stopped accepting applications for new residential care facilities on July 1, 2005. The ban also covers replacement facilities, additional beds and any expansion of existing bed capacity.⁠³ There is one exception. An RCF of 16 beds or fewer can be replaced, as long as the replacement has no more beds than the facility was licensed for before the application.⁠³

DHS’s Office of Community Services page repeats the moratorium notice and cites 1,978 licensed RCF beds statewide from the October 2024 Forecasted Bed Need Report.⁠⁷ The permit agency’s newer October 2026 Bed Need Book, updated September 30, 2026, puts the statewide total at 1,773 licensed RCF beds.⁠¹⁰ The book shows the supply getting smaller. Many former RCFs appear in its assisted living list with notes such as “converted 40 RCF to ALF”, and others are marked closed or “did not renew.”⁠¹⁰ Licensed RCFs on the list range from large campuses down to homes of 9 and 10 beds, such as Oakdale Country Estate in Newport (9 beds) and Helen’s Residential Care in West Memphis (10 beds).⁠¹⁰

That leaves a founder three practical routes:

• Buy a licensed RCF. Acquiring an existing health facility by purchase, lease, donation or transfer of ownership does not need a Permit of Approval.⁠⁵ The license itself is not transferable, so you go through the change-of-ownership process described below.⁠¹
• Replace a small RCF you already own. This is the 16-bed exception, limited to the beds you already have.⁠³
• License an assisted living facility instead. A new ALF needs its own Permit of Approval and county bed need. The October 2026 Bed Need Book limits one applicant to 75 beds per service area per cycle under the population-based method.⁠¹⁰ See the Arkansas assisted living facility license guide.

Permit agency rules also let RCFs that were licensed or held a Permit of Approval when the Arkansas Assisted Living Act (Acts 2001, No. 1230) took effect, and anyone who later buys them, be licensed as assisted living facilities without a Permit of Approval.⁠⁴ That rule explains the many conversions in the Bed Need Book. It also means a licensed RCF you buy can be moved into assisted living licensure later.

Does your home count as an RCF?

The permit agency’s rules use the statutory definition: a building used, for pay and around the clock, to give a place to live and board to three or more people whose abilities may be impaired, who do not need hospital or nursing home care every day, but who may need help with activities of daily living.⁠² The definition then adds that it covers any facility meeting that description “regardless of licensure category or the existence of a licensure category.”⁠² The Office of Long Term Care’s list of the facility types it licenses has no adult family home or small care home category.⁠⁸ A house taking in three paying adults who need help with daily living therefore appears to fall inside the RCF definition, and inside the moratorium; confirm with the Office before you take residents.

The licensure rule says no residential long-term care facility may be established, run or maintained in Arkansas without a long-term care facility license under Ark. Code § 20-10-201 et seq.⁠¹ The Office of Long Term Care can go to court for an injunction against an unlicensed facility and against admitting new residents into it.⁠¹

The RCF rule does not apply to facilities run by the Veterans Administration. It also excludes facilities regulated or licensed by DHS’s Division of Developmental Disabilities Services or Division of Aging, Adult, and Behavioral Health Services, and facilities regulated by the Bureau of Alcohol and Drug Abuse Prevention.⁠¹

Several other license types are easy to confuse with an RCF:

• Boarding home. The rule describes a residence that may offer meals and housekeeping but no oversight, supervision or care.⁠¹ Once you supervise or care for residents, you are no longer a boarding home.
• Assisted living facility (Level I or II). This covers assisted living services for more than three unrelated adults, and it is the only route open to new building projects. See the ALF guide.
• Adult day care. Daytime care only, with no overnight residence.
• Private care agency. Personal care delivered in clients’ own homes.

What an RCF may and may not do

The rule limits RCF services to independently mobile adults who do not need daily hospital or nursing home care but may need help with daily living.⁠¹ An RCF may not provide nursing or medical services. It may not offer or provide services to anyone who needs hospitalization, substance abuse treatment or nursing services. Its staff may not give or try to give medications.⁠¹ The core service is “supportive services”: occasional or intermittent guidance, direction or monitoring while residents carry out daily living and social activities. Supportive services do not include continuous monitoring or hands-on physical help.⁠¹

Independently mobile has a specific meaning. The resident must be physically and mentally able to leave the building in an emergency, including using any stairs on the exit path. Residents who use canes, wheelchairs or walkers qualify only if they need no more than verbal or minimal help and can get out in three minutes or within the time the local fire code sets.⁠¹

Your written admission criteria must require that each resident:⁠¹

• is 18 or older, independently mobile and able to self-administer medications;
• can understand and respond to reminders and guidance from staff;
• is not totally incontinent of bowel and bladder and has no feeding or IV tube;
• has no communicable disease that is a direct threat to others, and needs no nursing beyond what a certified home health agency can give on a temporary or infrequent basis;
• has no mental illness, dementia or addiction that requires a higher level of care or active treatment;
• does not need restraints, lock-up or confinement, is not violent at the time of admission, and is not being admitted against their will by court order or released from a correctional facility.

You must interview each prospective resident or sponsor before admission and document it.⁠¹ If you admit residents with a mental illness who need active treatment, you must arrange an active treatment plan with a mental health provider, whatever the size of the facility.⁠¹ A certified home health agency may treat residents in the building, and you keep copies of its care plans and notes. Residents who need frequent skilled nursing on a continuing basis are assessed by the Office of Long Term Care for nursing home placement.⁠¹

Discharge is allowed only for unmet medical needs, danger to the resident or others, nonpayment, or closure of the facility. The resident gets 30 days’ written notice (a transfer for the welfare of the resident or others may be immediate if the need is documented), can appeal to the Director of the Office of Long Term Care within seven calendar days, and gets a hearing scheduled within 14 days of filing the objection.⁠¹ If the Office decides a resident is no longer appropriate for the facility, you have 10 days to arrange the transfer.⁠¹

Buying an existing RCF: the change-of-ownership sequence

A license is tied to the owner and to the site. It cannot move to a new owner or a new location.⁠¹ Buying the facility’s title, leasing the entire facility, a partnership dissolving or adding a partner, a non-surviving merger, a consolidation, and a switch between nonprofit and for-profit status all count as a change of ownership. Board turnover and mergers in which the licensed corporation survives do not.⁠¹ If buyer and seller follow the notice rules, the buyer’s license is issued on the same terms as the seller’s, as though it were a renewal.⁠¹

1. Confirm the facility is licensed and in good standing

   Use the Bed Need Book list and the facility’s latest statement of deficiencies, which must be posted in the building.⁠¹⁰⁠¹ A facility that closes, surrenders its license or misses renewal must meet the rules for new construction and licensure to be licensed again, so do not let a seller’s license lapse before closing.⁠¹

2. Skip the Permit of Approval, but check any move

   An acquisition is exempt from Permit of Approval review.⁠⁵ Moving long-term care beds from one site to another within the service area needs Health Services Permit Commission approval.⁠⁵

3. Seller gives written notice at least 30 days before the change

   ⁠¹

4. File at least 30 days before closing

   Submit a new application with the license fee, be inspected, and meet the standards.⁠¹ The application must identify every person with a direct or indirect ownership interest of 5% or more, the corporate officers and directors or the partners, and the facility’s name and address. It must include a statement that the facility is responsible for any resident funds it handles and will replace funds that are lost or stolen, and copies of any required outside service agreements.⁠¹ DHS may deny the license on the grounds in Ark. Code § 20-10-224(f)(1).⁠¹

5. Get the provisional license

   Once the Office of Long Term Care has your application and fees, the 30-day notice and signed evidence of the transfer of operational control, it issues a provisional license. That license carries all the rights of licensure except Medicaid or Medicare provider status.⁠¹ You may advertise under a new name, but until the permanent license issues you must use the old name in incident reports, notices and plans of correction.⁠¹

6. Receive the license

   DHS decides within 30 days of a complete application.⁠¹ As buyer, you take on any plan of correction the seller agreed to, while the seller stays liable for penalties for violations before the sale.⁠¹

Rule 401-708(c) says that if an existing facility not built to Chapter 21 of the 1985 Life Safety Code is relicensed after a change of ownership, the new licensee must comply fully with the appropriate Life Safety Code and make the building accessible to wheelchair users.⁠¹ This sits uneasily with the “same terms as the seller” provision in § 401-201(b)(2), and the rule does not say which controls. Ask the Office of Long Term Care in writing which applies to the building you are buying before you sign.

Call the Office of Long Term Care’s licensing line for assisted living, residential care and adult day care at 501-396-6153.⁠⁸ DPSQA also takes provider applications at [email protected] and says completed applications go to a specialist within two business days.⁠⁷ Neither page says which office receives an RCF change-of-ownership application, so ask the licensing line before you file.

Replacing a small RCF under the exception

If you already own an RCF of 16 beds or fewer, you can apply to replace it with the same or fewer beds.⁠³ Replacement goes through the permit agency, and an approved permit comes with deadlines. You have nine months to sign a construction contract. The contract must call for the foundation within six months and completion within 18 months, and the license must be obtained within 15 months of the foundation due date. Missing these deadlines terminates the permit.⁠⁶ The Office of Long Term Care must approve the floor plan before construction. The new building must meet Chapter 21 of the 1985 Life Safety Code and be accessible to wheelchair users. When it is finished you submit proof that electrical, plumbing and gas work passed state and local code inspection, with the inspector’s license number.⁠¹

The administrator

Every RCF needs a full-time administrator, on the premises at least 40 hours a week during normal business hours. The administrator runs daily operations and is the Office of Long Term Care’s point of contact.⁠¹ An absence of more than seven consecutive days must be reported in writing with the name of the person in charge.⁠¹ The administrator must:⁠¹

• hold an RCF administrator certification from a program the Office approves (or have completed an Office-prescribed course, an approved training program, or a one-year administrator-in-training program);
• be at least 21, of good moral character and sound physical and mental health, which the Office may check through criminal records and doctor statements;
• be a high school graduate or hold a GED;
• have no conviction relating to the operation of a long-term care facility and no conviction for abusing, neglecting or mistreating people, checked against the adult maltreatment registry.

A copy of the valid certification goes to the Office with each license application, each renewal, and each change of administrator.⁠¹ The rule defines a “certified administrator” by reference to the course run by the Arkansas Association of Residential Care Facilities.⁠¹

Staffing by census, not capacity

Arkansas sets minimum direct care staffing per shift based on how many residents you actually have, not how many beds are licensed.⁠¹

Scroll the table sideways to see every column.

Small facilities (16 or fewer beds) get two allowances. Any staff member on duty counts as direct care even while cooking, cleaning or doing paperwork, and the night staff member may sleep in the facility.⁠¹ Facilities over 16 beds count only direct care staff toward the table and may not schedule the administrator as direct care during business hours. Once a facility has 17 or more residents, dietary staff may not do other work on the same shift. Multi-building facilities need one awake staff member at all hours plus relief coverage.⁠¹ The Office may waive staffing standards if you show you can meet residents’ needs with fewer staff.⁠¹

Staff who care for residents must be 18 or older. They need a tuberculosis skin test within their first two weeks and every year after, and no one convicted of abusing, neglecting or mistreating people may be employed.⁠¹ Orientation covers job duties, resident rights, abuse and neglect reporting, and fire and tornado drills. Every employee with direct resident contact then gets four hours of in-service training every quarter, covering resident rights, evacuation, fire extinguishers, incident reporting and medication supervision.⁠¹ Residents may work for the facility, but never in place of direct care staff, and may never be left in charge.⁠¹

DPSQA’s rules table shows that 20 CAR Part 404, the Office of Long Term Care’s rule on criminal records checks for long-term care facility employees, was repealed effective July 1, 2026.⁠¹² Part 401 itself sets no check procedure for employees: it bars employing anyone convicted of abusing, neglecting or mistreating people and has the Office investigate the administrator’s character.⁠¹ Ask the Office of Long Term Care which criminal records check procedure it now requires for RCF staff before you hire.

The building

These standards apply in full to facilities licensed after the rule’s effective date. Older facilities keep some grandfathered features until they are altered, and any change must meet the standards in force when it goes into service.⁠¹

Dining and living rooms may not be used as bedrooms, and residents may not reach their bedroom through a bathroom.⁠¹ Men and women may not share a room unless they are married or are consenting adults who agree in writing.⁠¹ You need a public water connection where one is available, and a public sewer connection if one is within 300 feet.⁠¹ Facilities licensed after this rule took effect must be able to hold resident areas at 72°F in winter and at 80°F in summer when it is above 95°F outside.⁠¹ You must also give the Office documentation that the location complies with local zoning, on a site that does not flood and has room for an exercise area.⁠¹

Fire and life safety

Buildings built after the rule took effect must meet Chapter 21 of the 1985 Life Safety Code. Earlier facilities of 15 beds or fewer follow Chapter 20 of the 1981 edition, and all facilities must meet local life safety codes.⁠¹ Other requirements:⁠¹

• UL-listed smoke detectors in every bedroom, living room, dining room and corridor, tested monthly with a written log.
• 5-pound ABC fire extinguishers on every floor or wing, checked every year.
• Fire drills with residents and staff every quarter, and a tornado drill every year, all documented.
• Battery emergency lights in halls and stairwells and lighted exit signs, except in facilities licensed for five beds or fewer.
• No residents on the third floor or higher of a combustible building. Exit doors open outward in facilities of 16 or more beds, with panic hardware or turn knobs and no keyed locks.
• No space heaters without the Office’s written emergency authorization, no extension cords or multi-plug adapters, and no chain locks or padlocks in resident areas.
• An exit diagram posted in each sleeping area, and emergency numbers posted in large print.

Policies, agreements and money

Before opening under your ownership you need written policies covering resident rules, admission, discharge and transfer, incident reporting, personal allowance accounts, residents’ rights, fire safety, smoking, visitors and mail, medical emergencies, and relocating residents in disasters or utility outages.⁠¹ Every resident signs a printed admission agreement listing what the basic charge covers and what costs extra, along with the rules for rate changes and a refund policy. Residents may cancel within 14 days of moving in for a full refund, less a prorated charge for services already received.⁠¹

The basic charge must cover three meals, with no more than five hours between breakfast and lunch or between lunch and dinner and no more than 14 hours overnight. It also covers snacks, cleaning of common areas, laundry of facility linens, and an activities program.⁠¹ For residents on Supplemental Security Income, you hold their personal allowance in a trust account, free of charge and never mixed with facility funds.⁠¹

Alleged abuse, neglect, exploitation or misappropriation must be faxed to the Office of Long Term Care on Form DMS-7734 by 11:00 a.m. the next business day. A DMS-762 investigation report follows within five working days.⁠¹

Medications

RCF owners and staff may not administer, repackage or relabel any resident’s medication.⁠¹ Staff may remind residents, read the label aloud, and open the container, but the resident takes the medication out.⁠¹ Medications the facility stores go in a locked area in individual labeled bins. Expiration dates are checked monthly, and stock supplies of medication are prohibited.⁠¹ Staff who supervise medications get annual training on the facility’s medication policies.⁠¹

Fees, renewal, inspections and penalties

An initial license takes effect on the date the Office finds you in compliance and expires the following June 30.⁠¹ DPSQA’s Information for Providers page instead says renewals are due by the anniversary of the license issue date.⁠⁸ The rule is the stronger source, but the two differ, so ask the Office of Long Term Care which date it will put on your renewal notice.

The Office can inspect every area and record. Deficiencies need a written plan of correction within 10 days.⁠¹ Civil penalties are set by class:⁠¹

• Class A: up to $2,500 for a first violation and $5,000 for a second within six months. A third starts proceedings to end the Medicaid agreement and may lead to license revocation.
• Class B: up to $1,000, and $2,000 for a second within six months.
• Class C: up to $500 each, doubling for repeats within six months to $1,000.
• Class D: up to $250 each, doubling for repeats within six months to $500.
• Monthly cap: total penalties in any month may not exceed $5,000.

The Office can also suspend admissions or relocate residents, and DHS can deny, suspend or revoke a license.⁠¹

Medicaid personal care in an RCF

An RCF can enroll as an Arkansas Medicaid Personal Care provider. It must have its DPSQA RCF license on file with Medicaid Provider Enrollment and be certified by DPSQA.⁠¹¹⁠¹³ An enrolled RCF may provide Medicaid personal care only on its own licensed premises and only to Medicaid beneficiaries who live there.⁠¹¹ Residents in the personal care program must be told in writing that they may choose their personal care provider, and you keep that record.⁠¹ Because a provisional license after a purchase does not carry Medicaid or Medicare provider status, plan for a gap in Medicaid billing until the permanent license issues.⁠¹

Recent changes and open points

• October 2026: the permit agency’s Bed Need Book shows 1,773 licensed RCF beds, against the 1,978 still quoted on DHS’s Office of Community Services page from the October 2024 report.⁠¹⁰⁠⁷
• July 1, 2026: 20 CAR Part 404, the criminal records check rule for long-term care facility employees, was repealed.⁠¹²
• January 1, 2025: the RCF licensure rules were codified as 20 CAR Part 401 in the Code of Arkansas Rules. That version is the one in force as of 2026-10-12.⁠¹²⁠¹

Sources

1. 1
   Arkansas Department of Human Services, Division of Provider Services and Quality Assurance, 20 CAR Part 401, Rules for the Licensure of Residential Long-Term Care Facilities (version effective 01/01/2025) Checked 12 Oct 2026 · Back to text ↑
2. 2
   Code of Arkansas Rules, Health Services Permit Agency, 20 CAR § 255-701, Residential care (definition) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Code of Arkansas Rules, Health Services Permit Agency, 20 CAR § 255-705, Moratorium Checked 12 Oct 2026 · Back to text ↑
4. 4
   Code of Arkansas Rules, Health Services Permit Agency, 20 CAR § 255-704, Acts 2001, No. 1230 (RCF conversion to assisted living) Checked 12 Oct 2026 · Back to text ↑
5. 5
   Code of Arkansas Rules, Health Services Permit Agency, 20 CAR § 255-103, Scope of review (Permit of Approval) Checked 12 Oct 2026 · Back to text ↑
6. 6
   Code of Arkansas Rules, Health Services Permit Agency, 20 CAR § 255-106, Continuing effect of a permit of approval Checked 12 Oct 2026 · Back to text ↑
7. 7
   Arkansas Department of Human Services, DPSQA, Office of Community Services Checked 12 Oct 2026 · Back to text ↑
8. 8
   Arkansas Department of Human Services, DPSQA, Information for Providers (Licensing a Facility) Checked 12 Oct 2026 · Back to text ↑
9. 9
   Arkansas Department of Health, Arkansas Health Services Permit Agency Checked 12 Oct 2026 · Back to text ↑
10. 10
    Arkansas Health Services Permit Agency, Bed Need Book, October 2026 (updated 09/30/2026) Checked 12 Oct 2026 · Back to text ↑
11. 11
    Code of Arkansas Rules, Arkansas Department of Human Services, Arkansas Medicaid Personal Care Provider Manual, Section II Checked 12 Oct 2026 · Back to text ↑
12. 12
    Arkansas Department of Human Services, DHS Rules (DPSQA rules table) Checked 12 Oct 2026 · Back to text ↑
13. 13
    Arkansas Department of Human Services, DPSQA, How to Become a Provider: Licensing, Requirements, and Processes Checked 12 Oct 2026 · Back to text ↑

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