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Residential Vacancy Form

The Residential Vacancy Notification Form is used to list a vacancy or to remove a listed vacancy. 

This form should only be completed by providers who are contracted with Community Care, Inc. If you have questions about whether or not you are contracted please call 866-937-2783 and select option 2 prior to submitting this form.

ATTENTION:  Providers should complete the vacancy form when the vacancy is filled to notify Community Care the vacancy is no longer available.  All vacancies submitted will be removed from Community Care records 60 days after the vacancy is received.  Providers will be responsible to resubmit the vacancy should it exist after 60 days.

Reason for Submitting Form:

Type of Facility:

Vacancy is for Gender:

Available Room Is:

Room Location is on the:


PLEASE NOTE: Upon pressing the submit button, you should see a message stating that we have received your information. If you do not, please scroll up, complete any of the required fields noted in red, then submit the form again.
Community Care only lists vacancies for contracted providers who have submitted Residential Summaries. The vacancy list is always available for Community Care’s care managers to review. We ask that you use the online form above to report your vacancies and not call the care managers/sites directly to discuss or announce your vacancies. We cannot guarantee referrals since we are unable to determine how many members will be seeking placements at any given time.

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