RCFE is an acronym which stands for “Residential Care Facilities for the Elderly” and is a designation only used in California. These facilities are also commonly referred to as “Board and Care Homes”; “Assisted Living Facilities”; “Rest Homes”; and “Continuing Care Retirement Communities.”
RCFE’s provide individuals age 60 and older with room, board, housekeeping, supervision, and personal care assistance with basic activities like personal hygiene, housekeeping, dressing, eating, and walking. In addition, RCFE’s will store and distribute medication so that residents don’t need to worry about forgetting to take their medication. Upon distribution the medication can then be administered by the resident himself/herself or with the assistance of RCFE staff.
The purpose of RCFE’s is to provide residents who need the above-mentioned assistance with a living environment that feels like a home rather than a healthcare facility. The type of resident who typically stays at a RCFE is someone who doesn’t need 24-hour nursing care but who still needs 24-hour care and supervision because he/she is unable to live by himself/herself. At the same time, however, RCFE’s are tasked with promoting maximum possible independence. Together with the facility’s home-like atmosphere, this kind of independence preserves the dignity of residents. And in order to make residents feel at home some RCFE’s even allow residents to have pets.
RCFE’s are considered non-medical facilities, and as such are not required to have healthcare providers such as nurses, certified nursing assistants, or doctors on staff. Thus, individuals with serious medical conditions are not permitted to stay at RCFE’s and the state of California considers RCFE’s as “social-based facilities” rather than healthcare facilities. Nevertheless, many individuals with non-serious health conditions are permitted to stay at RCFE’s, and even individuals with certain health conditions that require medical attention may stay at RCFE’s if the facility meets California state licensing standards for “restricted” health conditions.
RCFE’s must be licensed by California’s Department of Social Services and satisfy the care and safety regulations set forth by the state of California. Although RCFE’s aren’t required to have healthcare providers such as doctors or nurses on staff, one regulation governing RCFE’s is a requirement that every RCFE have either licensed nursing on staff or on-call.
Some other regulations governing RCFE’s in California include the following:
1. Communities with six or more residents must have an Individual Response System which enables residents to electronically summon assistance any time they need it
2. Residents must have access to private or semi-private bedrooms and bathrooms
3. RCFE’s must provide three meals per day and have snacks available to residents
Since RCFE’s are not medical facilities the cost of staying at these facilities isn’t directly covered by Medicare or Medi-Cal. However, there is a special program in 15 California counties (Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma) called the “Assisted Living Waiver Program” in which certain eligible individuals who have been determined to need nursing home level care may receive Medi-Cal funds to stay either at an RCFE or in public housing.
To find a RCFE for your loved one you can contact the local District Office of Community Care Licensing, which has a list of RCFE facilities. You can also find information and resources about RCFE’s on the CCL website. In addition, certain Ombudsman Programs have lists of facilities and provide pre-placement services and licensing reports. Finally, California Advocates for Nursing Home Reform has put together a RCFE factsheet on this website.
If you are interested in determining the quality of a RCFE then by law you’re entitled to request a copy of the facility’s annual inspection report as well as any substantial complaints that have been made about the particular RCFE over the past year. In addition, inspection reports and any complaints made in the past 60 months can be accessed online at the California State Department of Social Service’s Community Care Licensing Division (CCL).