Assisted Living & CCRCs

LeadingAge California engages in a constant and determined fight to preserve and maintain services to California’s seniors and their providers through policy and advocacy

Assisted Living
The majority of assisted living members are a part of a continuing care retirement community while some are free standing. Assisted living is state regulated. State regulations vary on who can be admitted and reside in assisted living. Assisted living is primarily private pay.

Continuing Care Retirement Communities
CCRCs offer an innovative and independent lifestyle that is different from other housing and care options for older people. Through long-term contracts that provide for housing, services and nursing care, usually in one location, the CCRC meets a resident’s needs for their entire life.

To learn more click on a topic heading below.

Assisted Living

Assisted Living Waiver
The Assisted Living Waiver provides a Medi-Cal benefit for assisted living residents in certain counties.  Visit 
www.caassistedliving.org for more information.

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Continuing Care Contracts

CCRC Statutes
Continuing Care Retirement Communities (CCRCs) are governed by the Health & Safety Code, commencing with Section 1770. Download the CCRC Statutes

State CCRC Website
The Continuing Care Contracts Branch of the Department of Social Services is responsible for oversight of continuing care contracts. To visit their website, click here.

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Legal Issues

Legal Update: RCFE Food Service Not Subject to County Oversight
Joel Goldman, of Hanson, Bridgett, Marcus, Vlahos & Rudy, LLP, provides clarification that RCFEs are not subject to the provisions of the California Uniform Retail Food Facilities Law (CURFFL). Download the Legal Update here.

Return-to-Home Law
In 1998, LeadingAge California sponsored AB 742 (Washington, Chapter 124, Statutes of 1998). This state legislation would guarantee that a resident enrolled in Medicare risk HMO would be allowed to "return home" when that home is equipped to care for them. This legislation was pre-empted by the federal bill, H.R. 5661. Specifically, the Medicare "give backs" portion of the "Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act (BIPA)" which (42 U.S.C. 1395w-22) gives seniors who are enrolled in the Medicare+Choice plan the option to return to their home care facility following hospitalization if the following conditions are met:

• The enrollee elects to return to that facility;
• The home facility must agree to the enrollee's return;
• The home facility must agree to accept the same terms and condition of payment that would apply to an in-network provider under the enrollee's managed care plan.

Should you encounter problems in exercising the resident's rights under these provisions, members are encouraged to contact the plans program manager. Contacts for Kaiser and PacifiCare are listed below:

Sue Herman
Plan Manager
PacifiCare
(415) 744-4908

Anita Kveviel
Plan Manager
Kaiser Permanente
(415) 744-3652

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Operation and Regulation
 
Click here for:
• updated provider statutes with the modifications made by SB 244,
• a compliance checklist, and
• a sample residents' rights poster.
 
DSS Issues Memo Clarifying Use of "Point Systems"
A memo issued on July 29, 2005 from DSS’ Policy Development Bureau seeks to clarify statutory requirements for admission agreements and the use of “point systems.” Specifically, the memo is meant to provide Licensing Program Analysts (LPAs) with consistent criteria for evaluating these two areas. 
 
LeadingAge California will be meeting with the Department on this issue and will advise members of any changes if they occur. It should be noted that CCRCs are exempt from Article 9 of Chapter 3.2 of the RCFE statutes. Therefore, much of the content of the memo does not apply. Download the memo here.
 
Navigating the Fingerprinting & Background Check Process 
According to the Department of Justice and the Community Care Licensing Division, 96% of fingerprint clearances should be available within 3-5 days when using Live Scan. Staff with client contact and volunteers must be cleared prior to their presence in the facility. Common issues that cause delays include missing court information, applicant born prior to 1945 requiring a manual file search, and missing or incorrect data submitted with the fingerprints. Visit http://www.ccld.ca.gov/PG404.htm to learn more. 
 
The information below is provided to assist you in checking on status of your applicants:

Checking on Status of Fingerprint Submission
You should allow a minimum of seven days before making a status inquiry. Applicants should check first with the DSS-Care Giver Background Check Bureau since the Department of Justice sends results directly to the applicant agency.

24-hour Automated Telephone Service Available: 916-227-4557.  If DSS does not have results yet and digital Live Scan fingerprints were submitted, you can use the automated telephone system to check on your submission. You will need the following information: (1) your date of birth; and (2) the 10-digit Automated Transaction Identifier (ATI) number that appears at the bottom of the Department of Justice form requesting Live Scan fingerprint background checks. The ATI number always appears in the following sequence: 1 LETTER; 3 NUMBERS; 3 LETTERS and 3 NUMBERS.

There is no automated system for checking on paper fingerprint card submissions. To check on card submissions or if you have specific applicant submission problems, contact the state Department of Justice's Applicant Processing Program at (916) 227-3823. Because of the volume of calls received and time needed to research each request, there may be delays in responding to your inquiry.
 
Additional Information:
• The Background Check Requirement Overview, click here.
• Livescan Locations, click here.
• CCLD Frequently Asked Questions (FAQs), click here.
• Checking the Status of Fingerprint Submission guidelines (DOJ), click here.
• Applicant Fingerprint Transaction Follow-up Request, click here.
 
 

Resources and Links

Technical Support Documents
DSS' Technical Support Program has several self-assessment guides available. To download, click on the name of the document below:

Administrative Assessment
Compatible Needs
Hospice Guide
Incidental Medical Services
Preadmission Questionnaire
Resident Records
Staff Records

HIPAA: An Introduction
Allan Jergesen, Esq. of Hanson, Bridgett, Marcus, Vlahos & Rudy, LLP provides members a general introduction to HIPAA including background of the HIPAA legislation, and several components that make up HIPAA.  Click  here to access the complete text in PDF.  

Links
• Map and listing of all LeadingAge California member CCRCs and MLRCs in California
• Department of Social Services:

Adult & Senior Care Updates
Community Care Licensing Division
Administrator Certification Program
Online Evaluator Manual
Continuing Care Contracts Branch
Office of Regulation Development

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LeadingAge California
1315 I Street, Suite 100, Sacramento, CA 95814
916-392-5111