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California

A brief overview of Assisted Living in California

 

What is it called?

  • Residential Care Facilities for the Elderly

 

What services are provided?

  • Assistance with activities of daily living
  • Observation and reassessment
  • Postural support that can be released by the resident
  • Room and Board
  • Social and recreational services
  • Help with arrangements for incidental medical or dental care
  • Limited assistance with administration of medication
  • Dementia and hospice care, provided regulatory requirements are met

 

Who can be admitted?

  • Residents over the age of 60, or residents requiring compatible care to current residents
  • Residents requiring assistance with daily activities
  • Residents with manageable incontinence
  • Residents with indwelling catheters, if they can be cared for by the resident 
  • Residents with diabetes as long as the resident can perform glucose testing and medication administration is arraged for
  • Residents requiring the following treatments, as long as they are provided by the resident or other outside health professional:
  •        -Oxygen administration
  •        -Intermittent positive pressure breathing therapy
  •        -Colostomy or ileostomy
  •        -Manual fecal impaction removal, enema, suppositories
  •        -Intramuscular, subcutaneous, or intradermal injections

Who is inappropriate?

  • Must be refused admission
    • Adults with certain medical conditions including:
      • active, communicable tuberculosis, stage 3 or 4 pressure sores, gastrostomy, nasogastric tubes, staph or other serious infections, and tracheostomy
    • Adults who need 24 hour skilled nursing or intermediate care
    • Adults who require a greater amount of care and supervision than the other residents
    • Adults whose health makes them inappropriate for care in the facility
    • Adults who are bedridden
    • Adults who have a mental disorder resulting in ongoing behavior that would upset the general resident group
  • Can be evicted
    • Residents who are ineligible according to admission guidelines (see above)
    • Residents who fail to pay or violate other facility policies
    • Residents who fail to comply with state or local law
    • Residents who pose a threat to themselves or others
  • Exceptions to eviction
    • Admission and Retention rules can be waived if the resident receives care from a hospice agency as long as the facility and agency execute an agreement and the resident’s roommate does not object
    • If the facility has appropriate fire clearance or bedridden patients are expected to be ambulatory in fewer than 14 days the residents may remain in the facility

 

Is nurse staffing required?

  •  Not specified

 

What training is required for direct care staff?

  • Initial Training
    • 10 hours within first 4 weeks of employment
  • Continuing Education
    • 4 hours per year
  • Direct care staff serving patients with dementia receive at least 6 extra hours of training initially and 8 hours of continuing education each year
  • Direct care staff who assist residents with the self-administration of medication must meet specified medication training:
  •        -For facilities with 15 or fewer residents: 6 hours of initial training, including 2 hours of hands-on shadow training
  •        -For facilities with 16 or more residents: 16 hours of initial training, including 8 hours of hands-on shadowing training 

 

Is public payment available?

  • According to the 2010 Assisted Living State Regulatory Review, the Department of Health Care Services administers a federal home and community based waiver to provide a Medi-Cal benefit to persons participating in the Assisted Living Waiver (ALW).  Participants must be both Medi-Cal eligible and nursing-home eligible.  They may reside in either a licensed Residential Care Facility for the Elderly (RCFE) or publicly subsidized housing.  The ALW currently serves 5 counties: Sacramento, San Joaquin, Los Angeles, Sonoma and Fresno.  On March 1, 2010 it is expected to expand into two more counties: San Bernardino and Riverside. 
  • For More Information See:

California Long Term Care Ombudsman

State CRISISline: 1-800-231-4024

http://www.aging.ca.gov/programs/ombudsman.asp

 Department of Health Services

 (916) 445-4171

 http://www.dhcs.ca.gov/services/pages/seniors.aspx

 


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