RCFEs in California

What is an RCFE?

RCFE refers to “Residential Care Facility for the Elderly” and encompasses Assisted Living, Memory Care, and Continuing Care Retirement Communities (CCRCs). RCFEs provide a special combination of housing, personalized supportive services, and 24-hour staff designed to respond to the individual needs of those who require help with activities of daily living (ADLs).

These services are provided in a variety of communities, including family-owned-and-operated communities, providers who serve seniors in several communities within California, and providers who offer services in communities in multiple states. These senior housing options are non-institutional, home-like settings that promote maximum independence and dignity for each resident and encourage family and community involvement.

How are RCFEs Regulated?

In California, RCFEs are licensed by the Department of Social Services and are governed by a robust set of laws and regulations. The regulatory framework is designed to promote resident independence and self-direction to the greatest extent possible in a residential, non-medical setting.

What do RCFEs Provide?

Services may include:

  • Assistance with ADLs: eating, bathing, dressing, toileting, mobility, etc.
  • Medication management
  • Social and recreational activities
  • Housekeeping services
  • Meals
  • Transportation
  • Dementia care
  • Health-related services

What Do Communities Cost?

Costs vary by community type, location, apartment size, and the services needed by each resident. A base fee may cover all services, or there may be additional charges for special services. All fees are identified in the admission agreement.

One difference between CCRCs and other senior housing models is the structure provided by the CCRC contract. While residents of other housing types usually pay monthly fees, CCRC residents typically pay both an entrance fee and a monthly fee, which is tied to current services and anticipated future care.

Assisted Living, Memory Care, and CCRCs in California are almost entirely private pay. Unlike health facilities or other home and community-based programs, MediCal does not cover Assisted Living except through a small waiver program in 15 counties.

Why Are Communities so Different?

These models of care help promote quality of life for hundreds of thousands of seniors and their families because services can be personalized to align with residents’ needs and preferences. And since those preferences and needs vary widely, there is no single blueprint. Variations in size, amenities, services, and pricing enable consumers to choose an environment that they consider attractive, a community that meets their needs, and pricing that works for them.

Trained for Success

Communities share the common goal of providing excellent service, care, and support to their residents. In keeping with this goal, the extensive training requirements established for staff and administrators—including initial and ongoing education and testing—ensure that they are well-trained to meet the needs of residents. According to a study commissioned by CALA, California’s well-trained staff members are essential to the mental, physical, and emotional well-being of residents.

Informed Consumers

Current law requires admission agreements to disclose pricing structures and reasons rates may go up. Communities must also provide written disclosure of their prior rate increase history for the past three years. Disclosure of the reasons for a rate increase, along with the amount of the increase, are required at least 60 days in advance. These laws help ensure that consumers understand the cost of care and have adequate notice of changes.

The Long-Term Care Ombudsman Program can inform consumers with questions or concerns about care services. Consumers may also take advantage of information provided by local Community Care Licensing offices. A phone call will provide a verbal review of licensing history at a specific community that a consumer may be considering.