Dementia Care in Residential Care Facilities for the Elderly (RCFEs) and Miscellaneous Regulation Changes Information and Resources

This webpage serves as a hub for communications, resources, and documents related to this regulation package. The regulation package updates are effective January 1, 2025.

This webpage will be regularly updated with new information as it becomes available. Please check back for updates.

Background and Summary of Updates

The updates made by this package are intended to support person-centered care for residents and their ability to remain in RCFEs, allowing them to age in place in the least restrictive environment they have come to know as home.

Key updates include:

  • Integrated Standards: Regulations are modernized so that the standards for dementia care, previously housed in one regulatory section, are integrated into several sections to support care for all residents.
  • Focus on Resident Behaviors: Regulations now address resident behaviors, regardless of diagnosis, with a focus on individual needs and behavioral expressions.
  • Modernized Language: Definitions that support the regulations are modernized to align with terms used by experts in dementia care and use neutral, objective language to describe a condition rather than language that implies potential inability or negative effects of the condition.
  • Access to Items Based on Individual Need: A key part of these changes is that all residents, regardless of diagnosis, may or may not be allowed access to specified items (e.g., cleaning solutions or sharp objects) based on their individual needs and appraisal.

The updated regulations also include miscellaneous changes, such as:

  • Medical Assessments: Now required to be signed by a licensed medical professional and include details on behavioral expressions.
  • Waste Containers: These containers must be emptied in a timely manner, rather than being emptied at least once per week or more often if necessary and removing the requirement to have tight-fitting covers.
  • Slip-Resistant Mats, Strips or Flooring: The term "nonskid" is replaced with "slip-resistant," and such mats, strips or flooring must be used in all bathtub and shower floors. The mats, strips or flooring must be maintained in good condition and retain its slip-resistant properties.
  • Firearms: If licensees permit residents to retain firearms at the facility, firearms must be stored in compliance with Health and Safety Code section 1569.282. Also, admission agreements must specify all policies concerning the retention or prohibition of firearms by residents of the facility.
  • Bedridden: Requirements related to residents are updated to correct a reference, use person first, condition second (e.g., person who is bedridden) language, and make other non-substantive clarifying changes.

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