TYPES OF ELDER CARE FACILITIES
If you are just getting started with your elder care facility research, be sure to read our helpful tips for evaluating nursing homes listed below.
The Lawrence M. Knapp skilled nursing home attorneys at our firm have extensive experience in dealing with SNFs. A Skilled Nursing Facility or nursing home is a health care facility or a distinct part of a hospital which provides continuous custodial and supportive care to patients whose primary need is skilled nursing care on an extended basis. These facilities provide 24-hour inpatient care and, at a minimum, include a physician, skilled nursing staff, dietary and pharmaceutical services, and an activity program.
All nursing homes in California are licensed by the California Department of Public Health (DPH), and must meet California nursing home standards. In addition to being licensed, nursing homes which choose to participate in the Medicare and Medi-Cal programs must be certified by the federal government in order to qualify for payments from these programs. Federally certified facilities must meet federal standards as well as the California requirements. Most California nursing homes are certified to participate in both Medicare and Medi-Cal.
If you or someone you love has been a victim of elder neglect or elder abuse in a nursing home, our nursing home lawyers can offer legal advice on how to resolve your situation. Should you need to take your case to court, we have the experience and skill necessary to successfully litigate your claim and maximize the compensation that you deserve. Contact a skilled nursing home lawyer at our Lawrence M. Knapp firm today to discuss your case by completing the Free Case Evaluation Form or by calling our office at (888) 607-4807.
A guide to RCFEs by our Lawrence M. Knapp residential care facility lawyers.
A Residential Care Facility for the Elderly (RCFE) is a non-medical housing facility that caters to elder residents who need assistance with activities of daily living such as eating, grooming, hygiene, taking medications, assistance with walking, toileting and other daily tasks. Such arrangements are usually entered into by the resident, the resident’s guardian, conservator or other responsible person, but before admission such placement must be qualified by a physician as an appropriate placement. This type of housing arrangement is only appropriate when the resident has minimal health care issues. If you are unsure of whether or not such a facility is the right choice for yourself or a family member, contact our Lawrence M. Knapp residential care facility lawyers and we can help you decide.
Typically, 75 percent of the residents who reside in an RCFE are sixty years of age or older and varying levels of care and supervision to each resident, as agreed to at time of the admission or as determined necessary at subsequent times of reappraisal. Residents under the age of sixty are permitted, and are usually individuals who cannot care for themselves due to developmental or physical disabilities.
The key distinction between nursing homes and RCFEs is that, while residents of RCFEs may be unable to live by themselves, they do not require skilled nursing care. RCFEs are considered to be non-medical facilities, and are not required to have nurses, certified nursing assistants or doctors on staff. Other terms often used to refer to this level of care are: assisted living facilities, board and care homes, rest homes and that component of Continuing Care Retirement Communities (CCRCs) that provides attentive personal care and supervision. Those who require actual skilled nursing care are generally not permitted for residency at an RCFE.
RCFEs are licensed and supervised by the California Department of Social Service, Community Care Licensing Division. RCFEs are listed on the California Department of Social Services’ CCL website, www.dss.ca.gov, which is updated weekly.
How our Lawrence M. Knapp residential care facility lawyers can help if you have been a victim of elder abuse or neglect
If you or someone you love has been seriously hurt or injured as a result of elder abuse or elder neglect in a residential care facility, you may be entitled to seek compensation by filing a lawsuit under the California Elder Abuse Act. Contact a San Diego Elder Abuse Act attorney at our firm today for a free consultation to see if you have a case worth pursuing.
In California, the term “assisted living facility” is synonymous with an RCFE or “residential care facility for the elderly”. These are non-healthcare facilities that are regulated by California’s Department of Social Services and not California’s Department of Health Services, which regulates healthcare facilities such as Skilled Nursing Facilities.
Assisted living facilities provide residents with: supervision and assistance with activities of daily living; coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being. Assistance may include the administration or supervision of medication, or personal care services provided by a trained personnel. Assisted living is an elder-care alternative that provides care for residents who cannot live independently in a private residence, but who do not need the 24-hour medical care provided by a nursing home. Assisted living tries to provide care and services while also promoting a resident’s independence and dignity.
Independent elder facilities are commonly referred to as retirement communities. They are designed for people who no longer work, and are generally restricted to those over a certain age (such as 55+ communities). Such facilities/communities are geared towards independent elders and oftentimes provide extensive amenities for an active lifestyle such as clubhouses, swimming pools, arts and crafts, boating, trails, and golf courses.
Independent elder facilities/communities are typically organized as condominium associations and therefore California condominium law governs such facilities.
An adult day care (ADC) program is generally operated as a day care facility for elderly adults who need certain supervision and assistance with activities of daily living such as eating, hygiene, assistance with taking medication and recreational activities. Of importance, any facility, place, or building that is maintained and operated to provide care to persons 18 years of age or older in need of personal services, supervision, or assistance essential for sustaining the activities of daily living or the protection of these individuals on less than a 24-hour basis is considered an adult day care program.
While many adult day care programs offer rehabilitative services, including physical and occupational therapies, meals and nutritional counseling, social services (case management), and/or recreational and social activities, they are not licensed to provide medical care. Adult day care programs in the State of California are licensed by the Department of Social Services’ Community Care Licensing Division, which is responsible for the oversight of facilities that provide less than 24 hour care to ensure safe, effective and quality care for all Californians.
A newly developed concept in California, adult day care programs are listed on the California Department of Social Services’ CCL website, www.dss.ca.gov. This list is updated weekly.
State Sponsored Alzheimer’s Day Care Resource Centers
An Alzheimer’s day care resource center is a center developed to provide a program of specialized day care for participants with dementia or Alzheimer’s disease.
The California Department of Aging provides grant funding to thirty six (36) Alzheimer’s Day Care Resource Centers to provide specialized day programs for individuals with Alzheimer’s disease or related dementias. Alzheimer’s Day Care Resource Centers try to meet the physical and psychosocial needs of people with Alzheimer’s disease to help prevent acute care costs and nursing home placement.
Under the state sponsored program, Alzheimer’s Day Care Resource Centers are required to provide support groups and respite for caregivers, give expert assessment and care planning, offer professional and lay training, provide a safe, supervised, structured environment, collect data for research, and increase public awareness. The goals of the program are to save public dollars by preventing or delaying placement into a nursing home or care in more expensive settings, maintain optimal functioning of each individual’s physical and mental health over the inevitable course of the disease, enable older persons with dementia to remain living at home for as long as possible, and provide regular respite from 24-hour care responsibility for caregivers.
In California, there are two distinct types of care facilities that serve the needs of Developmentally Disabled Adults. These different facilities depend on the type of care required by the disabled adult, and are classified as follows:
1. Nursing Care Facilities for the Developmentally Disabled
Intermediate care facility/developmentally disabled–nursing is a facility with a capacity of 4 to 15 beds that provides 24-hour personal care, developmental services, and nursing supervision for developmentally disabled persons who have intermittent recurring needs for skilled nursing care but have been certified by a physician and surgeon as not requiring continuous skilled nursing care.
These types of facilities serve medically fragile persons (dependent adults) who have developmental disabilities or demonstrate significant developmental delay that may lead to a developmental disability if not treated. Typically, these types of facilities are housed in a nursing home or other type of skilled nursing facility with elder patients.
Intermediate nursing care facilities for the developmentally disabled are licensed and overseen by the Department of Public Health’s Center for Health Care Quality (CHCQ), which is responsible for the regulatory oversight of health care facilities to secure safe, effective and quality healthcare for all. CHCQ evaluates health care facilities for compliance with state laws and regulations, and also investigates complaints or inappropriate or illegal conduct, as well as certifies health care facilities’ compliance with federal laws and regulations.
Complaints about an intermediate nursing care facility can be made to the California Department of Public Health, Licensing and Certification Division, through their website at www.cdph.ca.gov.
All licensed health care facilities are listed on the Office of Statewide Health Planning and Development’s website, www.oshpd.ca.gov. This list is updated as of June 30 and December 31 of each year.
2. Habilitative Care Facility for the Developmentally Disabled
An intermediate, habilitative care facility for the developmentally disabled is a facility with a capacity of 4 to 15 beds which provides 24-hour personal care, habilitation, developmental, and supportive health services to 15 or fewer developmentally disabled persons who have intermittent recurring needs for nursing services, but have been certified by a physician and surgeon as not requiring continuous access to skilled nursing care.
These facilities, which can also be called long-term care facilities, convalescent facilities, or nursing homes, typically provide basic needs, such as food, shelter and companionship to dependent adults who are mentally incapacitated and cannot live independently. These facilities provide a safe, comfortable living environment for their residents, and usually offer programs and activities to encourage social engagement.
Intermediate habilitative care facilities are licensed by the Department of Social Services’ Community Care Licensing Division, which is responsible for the oversight of these facilities to secure safe, effective and quality care.
Intermediate, habilitative care facilities are listed on the California Department of Social Services’ Community Care Licensing website, www.dss.ca.gov. This list is updated weekly.
An acute care facility is a health facility having a duly constituted governing body with overall administrative and professional responsibility, and an organized medical staff that provides 24-hour inpatient care, including the following basic services: Medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, and dietary services.
All acute care facilities in the State of California are governed by the Department of Public Health’s Center for Health Care Quality (CHCQ), which is responsible for the regulatory oversight of health facilities to secure safe, effective and quality healthcare for all Californians. CHCQ evaluates health care facilities for compliance with state laws and regulations, and also investigates complaints and ensures health facilities’ compliance with federal laws and regulations.
Complaints about an acute care facility can be made to the California Department of Public Health, Licensing and Certification Division, through their website at www.cdph.ca.gov.
All licensed acute care facilities are listed on the Office of Statewide Health Planning and Development’s website, www.oshpd.ca.gov. This list is updated as of June 30 and December 31 of each year.
An intermediate/step-down facility is defined as a facility which is organized, operated, and maintained to provide for the monitoring and care of patients with moderate or potentially severe physiologic instability requiring technical support but not necessarily artificial life support.
A step down facility can be used after a hospitalization for a patient who is not strong enough to return home. These facilities are also called subacute or transitional units, and are usually located in a hospital or nursing home. They also typically have a greater patient-to-nurse ratio.
Hospice care is a specialized form of interdisciplinary health care that is designed to provide palliative care to alleviate the physical, emotional, social, and spiritual discomforts of an individual who is experiencing the last phases of life due to the existence of a terminal disease, provide supportive care to the primary caregiver and the family of the hospice patient, and that meets all of the following criteria:
- Considers the patient and the patient’s family, in addition to the patient, as the unit of care.
- Utilizes an interdisciplinary team to assess the physical, medical, psychological, social, and spiritual needs of the patient and the patient’s family.
- Requires the interdisciplinary team to develop an overall plan of care and to provide coordinated care that emphasizes supportive services, including, but not limited to, home care, pain control, and limited inpatient services. Limited inpatient services are intended to ensure both continuity of care and appropriateness of services for those patients who cannot be managed at home because of acute complications or the temporary absence of a capable primary caregiver.
- Provides for the palliative medical treatment of pain and other symptoms associated with a terminal disease, but does not provide for efforts to cure the disease.
- Provides for bereavement services following death to assist the family in coping with social and emotional needs associated with the death of the patient.
- Actively utilizes volunteers in the delivery of hospice services.
- To the extent appropriate, based on the medical needs of the patient, provides services in the patient’s home or primary place of residence.
Facilities, agencies and health care professionals that provide hospice services are regulated and licensed by the California Department of Public Health, Center for Health Care Quality (CHCQ), which is responsible for the regulatory oversight of health facilities to secure safe, effective and quality healthcare for all Californians. CHCQ evaluates facilities, agencies and health care professionals for compliance with state laws and regulations, and also investigates complaints and certifies their compliance with federal laws and regulations.
Complaints about hospice care can be made to the California Department of Public Health, Licensing and Certification Division, through their website at www.cdph.ca.gov.
All licensed hospice care facilities and agencies are listed on the Office of Statewide Health Planning and Development’s website, www.oshpd.ca.gov. This list is updated as of June 30 and December 31 of each year.
Research a Nursing Home’s History & Records
As law firm that specializes in nursing home and elder care cases, we understand the importance of taking proactive measures and researching a nursing home or care facility when looking for the right fit for you or your loved one. Fortunately a nursing home’s history and records are made available to the public by the California Department of Public Health. They provide comprehensive listings of all Nursing Home Class AA Citations, which are citations for violations which the department has determined to have been the “direct proximate cause of death of a resident or patient of a long-term care facility.” Also, you can type in the name of a specific facility and find out information regarding any citations, which the department has issued against that nursing home.
We also recommend studying the comprehensive list of nursing homes provided by California Advocates for Nursing Home Reform. By viewing the list for your county at www.canhr.org/NH_Data/CountyMenuHTML.html you can find information regarding the number of citations issued against a facility, as well as the severity or “class” of the citation and the last time the facility was inspected. You may even notice whether a particular facility is improving its quality of care by looking for an increase or decrease in citations issued over time.
Elder Abuse
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