Articles Posted in Residential Care Facilities

Residential care facilities for the elderly are a largely unregulated in California. Despite the fact that they house more than 100,000 Californians, many with limited mobility, there is currently no requirement that they maintain disaster readiness plan other than a one-page disaster plan. That soon may change.

Last week the California State Senate voted to support a bill promoted by Assemblywoman Lois Wolk that would require care facilities for the elderly to prepare for emergencies such as natural disasters or power outages. Wolk’s bill requires a comprehensive plan for emergencies that enables a facility to be totally self-reliant for at least 72 hours. It would also require that the disaster plan be available for viewing by residents and local fire and police.

The bill, labeled AB 749, will be heard by the appropriations committee before debate on the assembly floor.

Residential care facilities for the elderly (RCFE), or assisted living facilities, are typically board and care homes for individuals age 60 or older who can no longer live by themselves, but do not need 24-hour nursing care. Typically, a RCFE will provide a bed, all meals, and assistance with certain daily activities such as bathing, dressing, meals, and with medication distribution. The residents, however, must be able to take their own medications.

RCFEs and assisted living facilities are licensed by the State of California, and are limited under the code of regulations to the type of care they can provide. In addition, each facility must undergo periodic inspections by the Department of Social Services.

It is important to point out that RCFEs are not permitted to provide medical care. As a result, individuals with certain medical conditions may not be admitted or retained by a residential care facility. A few of those conditions include, but are not limited to, bed sores of a Stage III or larger, or people who require tube feedings. Other conditions are restricted and may not be permitted, such as individuals who require catheters or colostomies. RCFEs may admit people who suffer from dementia, but only after meeting certain regulatory requirements. Always check for the facility’s written plan for caring for individuals with memory impairment.

People frequently ask for a recommendation to a “good” nursing or residential care facility. It’s a question that is difficult to answer, other than to state that the style of the building or the cost of the care is rarely a good indicator of quality of care. I have sued nursing and residential facilities that look like the Ritz Carleton, and I know that smaller, “mom and pop” facilities are capable of providing excellent care.

The first step is to find a facility that suits your needs. In may be its location in relation to family or friends, or one that offers a specific service such as dementia care. Once you have narrowed it down to a few, visit the facilities and speak with the administrator or the admissions director, and ask for a tour. While on the tour introduce yourself to other residents and ask them about the facility, the things they like and don’t like, and ask if you can speak with the privately. Frequently your first impression is the most accurate, so trust your instincts.

After the tour, return unannounced to the facilities you like best a few days after your tour, and visit at various times of the day so you can see the program it runs throughout the day. It’s important that these visits are unannounced so you can see the “real” facility and not the one portrayed on the official tour (hopefully they are the same).