5 lessonsAbout 35 minutesNo CE or licensure credit

RCFE basics for visiting clinicians: what the home can and cannot do

Five lessons for hospice, home-health and other visiting professionals on what a California RCFE can and cannot do: non-medical care and supervision, what facility staff may do with medications, which restricted-condition tasks stay with you, what you leave in writing, and the handoff and records that follow each visit.

Written for

  • Hospice and home-health partners
  • Healthcare and referral professionals
Course version
2026.10.3
Text checked against its sources

Before you begin

What you will be able to do

  • Sort a task you plan for an RCFE resident as one facility staff may do, one they may do only after your written instruction, or one that stays with the resident or a licensed professional, naming the section that decides.
  • Check a PRN order and the physician's written statement against section 87465 before staff help with it, and say what is missing and who completes it.
  • Leave the written items the RCFE rules ask of a visiting professional: your contacts in the record of care, written instruction naming the staff you instructed, and the signed agency agreement.
  • Hand off a change in condition, a refusal or a hospice stop to the home, and through it to the physician and representative, and for an ALW participant to the care coordinator, on the timelines the sources set.

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Sources

Sources behind this course

Each lesson lists the sources it uses. Open the original for the exact rule, form or instruction that applies to your work. The source library describes each one in more detail.

California CDSS (regulation text on Cornell LII)

Title 22, section 87101: Definitions

The definitions of an allowable health condition, an appropriately skilled professional and a licensed professional.

Where to look: Subdivisions (a)(6), (a)(10) and (l)(3).

Open section 87101 on Cornell LII
California CDSS (regulation text on Cornell LII)

Title 22, section 87458: Medical assessment

The medical assessment a licensee obtains before accepting a resident, and what it contains.

Where to look: Subdivisions (a) to (c).

Open section 87458 on Cornell LII
California CDSS (regulation text on Cornell LII)

Title 22, section 87465: Incidental medical and dental care

Assistance with self-administered medications, PRN orders and labels, the three PRN cases, centrally stored medications and the destruction record.

Where to look: Subdivisions (a)(5), (b) to (e), (h) and (i).

Open section 87465 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87609 (Allowable health conditions and the use of home health agencies)

Accepting or keeping residents who need incidental medical services; the written agreement with a home health agency; scope of care.

Where to look: Subdivisions (a) to (c).

Open section 87609 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87611 (General requirements for allowable health conditions)

Department approval for licensees with recent enforcement history; the record of care; monitoring.

Where to look: Subdivisions (a) to (f).

Open section 87611 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87612 (Restricted health conditions)

The eleven restricted health conditions and health services, each with its own section.

Where to look: Subdivision (a)(1) to (11).

Open section 87612 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87613 (General requirements for restricted health conditions)

Communication and hands-on training before admission; changes in condition; refusals.

Where to look: Subdivisions (a) to (d).

Open section 87613 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87615 (Prohibited health conditions)

The conditions with which a person shall not be admitted or retained.

Where to look: Subdivision (a)(1) to (6).

Open section 87615 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87616 (Exceptions for health conditions)

The written exception request, what it contains, and the hospice exception.

Where to look: Subdivisions (a) to (c).

Open section 87616 on Cornell LII
California CDSS (regulation text on Cornell LII)

Title 22, section 87618: Oxygen administration, gas and liquid

When a home may accept or retain a resident who uses oxygen, and the home's duties.

Where to look: Subdivisions (a) to (c).

Open section 87618 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87621 (Colostomy/ileostomy)

When a home may accept or retain a resident with an ostomy, what instructed staff may do, and the professional's review.

Where to look: Subdivisions (a) and (b).

Open section 87621 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87623 (Indwelling urinary catheter)

Who inserts, removes and irrigates a catheter, who changes the bag and tubing, and what instructed staff may do.

Where to look: Subdivisions (a) and (b).

Open section 87623 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87626 (Contractures)

When a home may accept or retain a resident with contractures, and who performs prescribed exercises.

Where to look: Subdivisions (a) and (b).

Open section 87626 on Cornell LII
California CDSS (regulation text on Cornell LII)

Title 22, section 87628: Diabetes

When a home may accept or retain a resident with diabetes, and the home's duties on medication help, supplies and diets.

Where to look: Subdivisions (a) and (b).

Open section 87628 on Cornell LII
California CDSS (regulation text on Cornell LII)

Title 22, section 87629: Injections

Who gives injections, and the home's duties on supplies and infection control.

Where to look: Subdivisions (a) and (b).

Open section 87629 on Cornell LII
California CDSS (regulation text on Cornell LII)

California Code of Regulations, title 22, section 87631 (Healing wounds)

Who cares for a healing wound or a stage 1 or 2 pressure injury, documentation, and skin tears.

Where to look: Subdivisions (a) and (b).

Open section 87631 on Cornell LII
California CDSS (regulation text on Cornell LII)

Title 22, section 87633: Hospice care waiver

The conditions for hospice care in the home, the care plan, reports and the exception for restricted and prohibited conditions.

Where to look: Subdivisions (a), (b), (g) and (j).

Open section 87633 on Cornell LII
California CDSS

LIC 602A, Medical Assessment for Residential Care Facilities for the Elderly (4/26)

The state's medical assessment form for RCFEs: diagnoses, self-management, physical and mental health, medication management, ambulatory status and hospice care.

Where to look: The note to the medical professional (page 1), the diagnosis blocks (pages 2 and 3), medication management and ambulatory status (page 8), and hospice care (page 9).

Open LIC 602A (PDF)
California DHCS

Application for a 1915(c) HCBS Waiver, CA.0431.R04.00 (the Assisted Living Waiver, from March 1, 2024)

The care coordinator's role and reassessment, the jointly developed ISP, and the incident reports RCFEs send to the CCA and DHCS.

Where to look: The Care Coordination service definition in Appendix C-1/C-3 (page 45), Appendix G-1 (pages 100 and 101) and the quality section in Appendix H (page 121).

Open the ALW waiver application (PDF)
Call the ALW teamFit check