Forms Required for Moving Into RCFEs

Residential Care Facilities for the Elderly (RCFEs) include assisted living or board and care homes. These senior communities provide help with activities of daily living such as dressing and bathing, but do not provide skilled medical care (as a skilled nursing facility would, for example).

In California, RCFEs are licensed and monitored by the California Department of Social Services. This means that senior housing staff are required to maintain specific documentation related to all residents. You will be asked to complete some of these RCFE forms before you move into one of these senior communities.

Here is an overview of these required RCFE forms. Some senior communities may have other documentation they will want you to complete as well.

Identification and Emergency Information

This includes basic information about you as well as contact information for family and others who help you with finances or should be contacted in an emergency.

Physician’s Report

This form is completed by your doctor and provides basic medical information. Because RCFEs do not provide skilled nursing care, this form is required to determine whether the facility is appropriate for you. You, or your legal representative, will need to sign to give your doctor permission to provide the information requested.

Resident Appraisal

You, or someone you authorize, will need to complete this form. Like the Physician’s Report, this form provides information about your health, but from your perspective, rather than your doctor’s. It also asks you to share information about your interests and activities, what you like and don’t like, the type of help you think you need, and any other information that will help the staff determine if the community is appropriate for you.

Release of Resident Medical Information

You, or someone you authorize, will need to complete and sign this form for each relevant medical professional who may have information to share with the senior community.

Personal rights

This RCFE form outlines your rights as a resident in the senior community. Staff at the community are required to review these rights with you, answer any questions you may have, and let you know who you should contact if you have any complaints or feel your rights have been violated. You, or someone you authorize, will need to sign this form to indicate that you have been told about and received a written copy of your personal rights.

Resident Personal Property and Valuables

Senior housing facilities are responsible for keeping any personal property or valuables you bring with you safe. This form is a list of these items. You, or someone you authorize, will be asked to sign next to each item listed and you will be given a copy. The list will be updated as needed when you get rid of or add items.

Appraisal of Needs and Services Plan

Senior communities are required to work with you and anyone else you wish to identify your needs and develop a plan to meet those needs. This is a detailed plan that covers social, emotional, mental, health, and functional skills. For each need, it includes the time frame for addressing the need, who will be responsible for helping you with that need, and how they will evaluate progress. You, or someone you authorize, will need to sign the form once the assessment and plan are completed.

Consent for Emergency Medical Treatment

You, or someone you authorize, will be asked to complete this RCFE form to give permission to the senior community to provide emergency medical treatment if needed.

Telecommunications Device Notification

Senior communities are required to provide you with equipment or services you may need to use the telephone if you are deaf or have a hearing impairment. You, or someone you authorize, will be asked to sign this form to acknowledge that you have been informed of this right and the steps you need to take to get the equipment if needed.

This may seem overwhelming, but you don’t have to tackle this process alone. In addition to the staff at the senior community, Seniorly is here to help. Our on-staff gerontologist is always available to speak with families about their concerns prior to moving into a community and can provide expert advice regarding the transition process.