Update on RCFE Orientations

There have been some rumors floating around about California Community Care Licensing Division reinstating the RCFE orientation classes in January 2011.  While it is true that some licensing offices throughout the state have made this admission, there is no definite word from C.C.L.D. regarding this action.  I have heard from only one individual that they have been contacted and asked to appear for their orientation class in early January.  We have made contact with several licensing offices and have had mixed messages regarding a schedule.  It sounds like we may nearly be back to business as usual.  You should check with your local licensing office for more information.

How do I evict a resident?

Q - I am having trouble with one of my residents and would like to evict him.  How do I do this and stay in compliance with licensing?

A - There are two ways to evict a resident within licensing regulations.

The first is to give the resident a 30 day notice.  You do have to have a reason for the 30 day notice.  The regulations say one of the following five problems are reason for eviction; Title 22 Section 87224(a) (Page 71)

1.    Nonpayment of the rate for basic services within ten days of the due date.

2.    Failure of the resident to comply with state or local law after receiving written notice of the alleged violation.

3.    Failure of the resident to comply with general policies of the facility. Said general policies must be in writing, must be for the purpose of making it possible for residents to live together and must be made part of the admission agreement.

4.    If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87463, and the licensee and the person who performs the reappraisal believe that the facility is not appropriate for the resident.

5.    Change of use of the facility.

You do not need permission from licensing but you need to send them a notice of the eviction within 5 days.

The second way is to give the Resident a 3 day notice.  You do need permission from licensing before you give a 3 day notice.  The licensee may, upon obtaining prior written approval from the licensing agency, evict the resident upon three (3) days written notice to quit. The licensing agency may grant approval for the eviction upon a finding of good cause. Good cause exists if the resident is engaging in behavior which is a threat to the mental and/or physical health or safety of himself or to the mental and/or physical health or safety of others in the facility.  Title 22 Section 87224(b)-(Page 71)

You need to send a copy of the notice to licensing within 5 days.  Title 22 Section 87224(f)-(Page 71)

The licensee shall, in addition to either serving thirty (30) days notice or seeking approval from the Department and service three (3) days notice on the resident, notify or mail a copy of the notice to quit to the resident's responsible person. Title 22 Section 87224(c)-(Page 71) 

My first recommendation is trying to fix the problem with the resident.  If that is impossible, and to avoid the formal paperwork, you may want to suggest to the resident that it may be best for them to relocate.  If the resident chooses to leave based on your suggestion it makes things much easier.

Remember even if you get permission for a 3 day notice or the 30 days is up you cannot simply roll the resident to the curb and leave him/her there.  It then might help to get the Ombudsman, the Public Guardian and/or APS involved to help you.   If none of this will work you will have to go to court and do an eviction similar to the resident being a tenant.

Good Luck!

Be Ready for Your Inspection!

The new Fall Licensing Update is out.  Please follow this link for a copy.

Fall 2010 Update

One of the items to follow in this update is the new proposal for inspections.  Currently, CCLD's inspection protocol is to conduct compliance inspections of all facilities at least once every five years, with an additional annual 30 percent random sampling of all facilities receiving inspections.  All of these inspections include a comprehensive review of compliance with all licensing laws and regulations. Due to budget constraints, the CCLD is unable to meet these inspection mandates and has made the proposal to align its resources with its mandates while also strengthening health and safety protections.

The "Strengthening Health and Safety Protections" proposal will require annual unannounced inspections of all facilities with the exception of family child care homes, which will receive a biannual inspection.  Certain facilities will not be eligible for a key indicator inspection and will, therefore, receive an unannounced comprehensive health and safety compliance inspection.  This would include facilities that are under a noncompliance plan, are on probation, or are pending administrative action.  Facilities that do not fall within the parameters described above would receive an inspection using the Health and Safety Compliance Review Tool to review the key indicators of compliance and risk.  The CCLD's annual compliance inspections would expand to a comprehensive review when warranted.  The CCLD anticipates that inspections conducted using the Health and Safety Compliance Review Tool will take approximately half the time it currently takes to complete a health and safety compliance inspection.

We should always be ready for a visit from licensing.  You can use the self inspection tools from licensing to prepare your facility for any inspection.

The first tool is the Facility Review Worksheet. 

http://www.ccld.ca.gov/res/pdf/rcfe1.pdf

The second tool is the Administrative Assessment Tool which covers the whole facility operations.

 http://www.ccld.ca.gov/res/pdf/RCFEAdministrativeAssessment.pdf

If you have a question that you would like to have answered on Tuesdays with Tom send him an email.  Use the subject line Questions for Tom in your email.

Email Tom at communitycareoptions@usa.net

Hospice or Comfort Measures?

Q:  The family of one of my resident’s wants the resident to be placed on comfort measures instead of Hospice even though Hospice would be appropriate right now.  The family and the doctor are willing to sign a release to do this.  Do you think it is OK?  What about licensing?

A:  First of all we always recommend Hospice when it is appropriate.  Remember Hospice is not just for the resident.  It is also for the family and for the caregivers.  There is also the benefit of counseling for those grieving during the first year after the Hospice patient dies.

You cannot force the resident to go on Hospice.  However, without the resident entering into a Hospice program they may quickly move to a level beyond the scope of residential care.  The resident could ultimately end up in a skilled nursing facility to live out their days.  It is important to have a straight forward discussion with family members about Hospice and educate them on the it's benefits.

The Hospice regulations can be found in Title 22 on page 172

section 87633 (HOSPICE CARE FOR TERMINALLY ILL RESIDENTS)

Remember that when the resident becomes total care you still need to send in for a Total Care exception.  This should change with licensing in the near future when it will be part of the Hospice Waiver. 

If you have a question that you would like to have answered on Tuesdays with Tom send him an email.  Use the subject line Questions for Tom in your email.

Email Tom at communitycareoptions@usa.net

Baby Boomers and The Age of Alzheimer's Disease

An interesting OP-ED article from The New York Times was sent to me recently.  It is concerning Baby Boomers and Alzheimer's Disease.

We've all been saying "the Baby Boomers are coming" when talking about the future of residential care.  It's true!  Starting January 1, 2011 there will be 10,000 Boomers turning 65 each day.  Startling!  So, we need to plan for it.  One area we need to focus is in the field of Alzheimer's research.  Have a look at the N.Y. Times article.  It's an eye-opener.

"The Age of Alzheimer's" - NYTimes

 

If you have a question that you would like to have answered on Tuesdays with Tom send him an email.  Use the subject line Questions for Tom in your email.

Email Tom at communitycareoptions@usa.net