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: