Q: What are Residential Care Facilities for the Elderly?
Residential Care Facilities for the Elderly (RCFEs) — sometimes called “Assisted Living” (e.g., 16+ beds) or “Board and Care” (e.g., 4 to 6 beds) — are non–medical facilities that provide room, meals, housekeeping, supervision, storage and distribution of medication, and personal care assistance with basic activities like hygiene, dressing, eating, bathing and transferring.
Q: What is an RCFE…NOT?
RCFE’s are not nursing homes. The typical resident may need assistance with certain Activities of Daily Living (ADL’s) such as medication administration assistance, meals, housekeeping and other activities, but does not require 24 hr nursing/medical care.
Q: Who licenses Residential Care Facilities?
The Department of Social Services oversees regulation, licensing and oversight. Despite generally small in capacity, smaller residential care homes are required to go through the same licensing procedure as large assisted living facilities. For more information in regard to regulations please visit http://www.ccld.ca.gov/. You can also find detailed information at the following links.
- Title 22, Div 6, Chap 8, Art 1-2 – Residential Care Facilities for the Elderly
- Title 22, Div 6, Chap 8, Art 3-5 – Residential Care Facilities for the Elderly
- Title 22, Div 6, Chap 8, Art 6 – Residential Care Facilities for the Elderly
- Title 22, Div 6, Chap 8, Art 7-9 – Residential Care Facilities for the Elderly
Q: What training is required for residential care home staff?
The RCFE administrator must complete state required training and pass a test in order to be certified. Caregivers are required to go through general training related to elderly care, medication training, dementia training and ongoing training if residents have special needs.
Q: Is there a doctor or nurse on duty?
RCFE’s are not required to employ a full-time doctor or nurse but Daybreak Retirement Villa is owned and operated by a licensed medical professional with extensive experience in elder care which is intimately involved in the care of residents. Residents continue to see their own physicians. Caregivers are available to assist residents with coordination of transportation to their doctor’s office as needed. Frequently, a physician will travel to the home to see his or her patient in the community.
Q: Is my loved one safe living in a small residential care home?
Yes. Licensing requires all staff including the owner and administrator to be fingerprinted and have their background checked before working in an RCFE. All care homes follow Title 22 and Health & Safety Code regulations. It spells out everything from admission, personnel, operation, safety, activities, medical needs etc. Licensing also conducts unannounced inspections to ensure the quality of service. The local ombudsman office is also involved to ensure the quality of care.
Q: What are the benefits of living in a smaller residential care home?
There are several differences between a large facility and a smaller RCFE. In a large facility, one caregiver usually takes care of 20 or more residents. At a smaller home, caregiver to resident ratio is normally 1 to 3. The resident gets much more individual attention from the caregivers. In a large facility, there may be 2 or 3 shifts with different staff each shift. In a smaller home, there is typically 24 caregiver to provide continuous and consistent care. This helps limit miscommunication between shifts and is especially beneficial for residents with special needs like dementia. In a large facility, due to the number of residents, it is difficult to cater to personal preference in terms of activities and food service. In a small care home, it’s a focal point of our services.
Q: Who can live in a residential care home?
Anyone who is over 60 years old and does NOT need 24 hours nursing care can live in a care home. Typically residents are ambulatory or non-ambulatory, need help in ADLs (Activities of Daily Living), such as cooking, laundry, bathing, housekeeping etc. Many of them have multiple medical conditions. Caregivers are allowed to assist with medication management but NOT allowed to perform tasks required by licensed professionals such as nurses and doctors. A smaller RCFE usually works with a home health care agency, family physician or mobile doctor to coordinate medical needs.
Q: Is it more expensive to live in a smaller residential care home?
No. On the contrary, despite more personalized service, it generally costs less to live in a smaller home. The starting rate is generally lower for the same level of care.
Q: What is included in the cost?
The monthly cost includes rent, three meals and snacks and all care needs. Medication and medical services are NOT included.
Q: My loved one has dementia. Can he receive care in an RCFE?
Yes. Some RCFEs specialize in dementia care. Such facilities need to meet certain requirements including training for staff and administrators.
Q: What is Hospice?
Hospice care is a type of care and philosophy of care that focuses on the palliation of a chronically ill, terminally ill or seriously ill patient’s pain, anxiety and other symptoms. They also attend to their emotional and spiritual needs. Hospice care is provided by specially trained members of a multidisciplinary team of professionals who work with family members and patients. They provide additional psychological and physical support to reduce symptoms. Hospice care may take place in a skilled nursing facility, Residential Care Facility, in the hospital, or while at home. They will work to provide seamless support during transfers to different care locations for those patients that need different levels of care.
For more information on Hospice care visit: National Hospice and Palliative Care Organization
Q: How can hospice help me or my family?
For many people at the end of their life, we as family members want to help but most of the time don’t know how. We want to ensure there is comfort, dignity, and respect for our loved one’s wishes. This is where hospice care can help. For patients who are eligible, Medicare or Medi-Cal may cover all the costs of hospice care that may include doctors, nurses, social workers and other staff.
Q: What else should I consider when looking at different hospice agencies
There are several hospice providers and you should consider asking about the services they provide. Care coordination, nursing, home health aide and social worker support, medical equipment, pharmacy, consultation hours, emergency visits and spiritual/Chaplain support are some common topics to discuss. Hospice agencies in San Diego County
Q: Does Medicare or Medi-Cal pay for the Residential Care Facility costs?
No. Because these are not “medical” facilities, neither Medicare nor MediCal pays directly for the residential care/assisted living “Board and Care”. Residents usually pay “out of pocket” or from long-term care insurance.
Q: What are the unique features of Daybreak Retirement Villas?
•Highly upgraded, in quiet and upscale neighborhoods
•Nurse supervised care to ensure the quality of care
•Spacious, comfortable private and semi-private rooms
•Computer access and Wi-Fi available for residents to connect with out of town family through Skype
•Home cooked meals, planned activities and much more
•Extensive experience in hospice and dementia care