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2025 dementia regulations: the steps to remember

The short step lists from each lesson of The 2025 RCFE dementia regulations: what changed for administrators, on one page. Print it for the station or the break room. Each list points back to its lesson, where the sources are linked.

Open the coursePrint a poster with a QR code

Decision guide

A resident's behavior has changed: what does the record need?

Has the resident's behavior caused harm, or could it cause harm, to her or to others?

  • Yes

    Will her services need to change because of it, such as more help or more supervision?

    • Yes

      Treat it as a significant change. Tell her licensed medical professional immediately or as soon as reasonably possible and record the call. Tell her and her representative, describe the behavior in her reappraisal, change her care, and hold the reappraisal meeting.

    • No

      Could her access to items such as cleaning solutions, tools or sharp objects put her or others at risk?

      • Yes

        Record the risk in her reappraisal, along with the behavior and the events before it, and put reasonable interventions in place. The home may require central storage of those items.

      • No

        Can the staff on duty give the supervision her appraisal now calls for and still cover the other residents?

        • Yes

          Write it into her reappraisal: the behavior, the events just before it if known, and the least restrictive interventions staff will use.

        • No

          Evaluate staffing against every current appraisal and add staff. Delayed egress devices and locked doors do not replace trained staff in sufficient numbers.

  • No

    Keep observing and recording changes. Update her appraisal in writing as often as necessary, and at least once every 12 months.

This guide follows Title 22 as read on 2026-10-22. It does not diagnose or decide a case. Whether a change needs new services is the licensee's call, made with the resident's licensed medical professional; questions about how a rule applies go to your Adult and Senior Care Regional Office.

Step through it one question at a time: alwbeta.com/training/courses/dementia-regulations-2025#decision-guide

Lesson 1

What changed on January 1, 2025, and where the rules live now

A surveyor, a family or a new hire may quote a dementia rule from an old binder. Before you answer, you need to know which rules changed on January 1, 2025, and where each one sits now. This lesson gives you that map, so you can check any policy against the current text.

  1. In effect since January 1, 2025: check every dementia policy dated earlier
  2. Find each standard in its new home: 87208, 87219, 87307, 87309, 87455, 87457, 87458, 87463, 87705, 87706
  3. Section 87707 is repealed: training sits in 87208, 87705 and 87706
  4. Behavior is addressed regardless of diagnosis
  5. Section 87705 covers residents diagnosed with dementia, not MCI
  6. Use the 87101 terms: behavioral expression, elopement, unsafe wandering

Lesson: alwbeta.com/training/courses/dementia-regulations-2025#lesson-dem25-what-changed

Lesson 2

The plan of operation and the dementia care program

Your plan of operation is not just a document on file. Since 2025 the licensee must run the home by it and may be cited for not doing so. This lesson helps you decide what every plan must now say, and what a home that advertises dementia care must add.

  1. Run the home by the plan; the licensee may be cited for not doing so
  2. Plan item (a)(6): training per 1569.625, 1569.626, 1569.69, 87411 and 87705
  3. Plan item (a)(11): how the home addresses behavioral expression
  4. Promote dementia care? Add the 87706 narrative
  5. Keep dementia ads three years; written program description before admission
  6. Stopping the program: written notice at least 30 calendar days ahead

Lesson: alwbeta.com/training/courses/dementia-regulations-2025#lesson-dem25-plan-of-operation

Lesson 3

Training and staffing duties under the 2025 rules

You approve the training calendar and the schedule. Both answer to the 2025 text: section 87705 sets the dementia training topics, the statute sets the hours, and staffing follows each resident's current appraisal. This lesson prepares you to decide whether a new hire may work alone and whether a shift is staffed.

  1. Training plan covers the 87705 topics, including nutrition
  2. Twelve dementia hours: six before working alone, six within four weeks
  3. Eight hours of dementia in-service every year
  4. Staff sufficient and competent; check against each current appraisal (87463(j))
  5. Fewer than 16 residents: awake night staff when a resident with dementia needs it
  6. Delayed egress devices and locks never replace trained staff

Lesson: alwbeta.com/training/courses/dementia-regulations-2025#lesson-dem25-training-staffing

Lesson 4

The medical assessment (LIC 602A) and the appraisals

Admission and retention rest on three records: the medical assessment, the pre-admission appraisal and each reappraisal. The 2025 rules changed who may sign the assessment, what it covers and what the appraisals record. This lesson prepares you to accept or return an assessment, and to know what a reappraisal must say.

  1. Medical assessment before acceptance: licensed medical professional, within the last year
  2. LIC 602A (4/25) is a courtesy form; section 87458 is the rule
  3. Assessment covers cognitive conditions and any known behavioral expression
  4. Appraisals record whether access to specified items puts anyone at risk
  5. Reappraise as needed, at least every 12 months; least restrictive intervention
  6. Significant change: tell the medical professional and the resident promptly, and document it

Lesson: alwbeta.com/training/courses/dementia-regulations-2025#lesson-dem25-assessment-appraisal

Lesson 5

The PINs, the FAQ and putting the changes in place

CDSS explained the package in notices, a guide and an FAQ. They tell you what to post, which form to use and how inspectors will check. This lesson prepares you to plan the home's rollout: what residents and families get, what staff learn, and what you check before a licensing visit.

  1. PIN 24-09-ASC (December 16, 2024): the package; PIN 25-05-ASC (May 27, 2025): the LIC 602A
  2. Post both where everyone can reach them; distribute to residents or representatives
  3. Five principles: retention, the spectrum of conditions, behaviors, person-centered care, balance
  4. Addendum to older forms until CDSS updates them
  5. Inspections use the updated CARE Tools
  6. Unclear? The FAQ 2.0, then the Adult and Senior Care Regional Office

Lesson: alwbeta.com/training/courses/dementia-regulations-2025#lesson-dem25-pins-rollout

Beta’s ALW team, course version 2026.10.3, text checked against its sources on October 22, 2026. Educational only. Not continuing-education, licensure or regulatory credit. Follow your employer’s current procedure and the person’s current plan. Call 911 for a medical emergency.

Call the ALW teamFit check