Facility-Based Care
 

Assisted Living/Residential-Care Facilities for the Elderly (RCFEs) - Assisted living facilities provide personal care and safe housing for people who may need supervision for medication and assistance with daily living but who do not require 24-hour nursing care.

 

• Regulation – Licensed by Dept. of Social Services (DSS), Community Care Licensing Division 

• Payment – Funded primarily though private payments. Nearly 30 percent of RCFE residents rely on SSI/SSP non-medical out-of-home grants.

 

Continuing Care Retirement Communities (CCRCs) - Includes three levels of care: independent, assisted living and skilled nursing care. CCRCs require an entrance fee paid by the applicant upon admission and includes services for more than one year and up to the lifetime of the resident. 

 

• Regulation – Licensed by Dept. of Social Services, Continuing Care Contracts Branch. Skilled nursing level licensed by the California Department of Public Health (CDPH)

• Payment – Private Payment

 

Skilled Nursing Facilities (SNFs) - Also called nursing homes, convalescent hospitals, and skilled nursing and rehab centers, these facilities provide comprehensive nursing care for chronically ill or short-term residents of all ages, along with rehabilitation and specialized medical programs. 

 

• Regulation – Licensed and Medi-Cal and/or Medicare certified by the California Department of Public Health  (CDPH).

• Payment – Funded primarily by Medi-Cal. Some funding provided through Medicare, managed care and private payment.

 

Subacute-care Facilities - Specialized units often in a distinct part of a nursing facility, subacute-care facilities focus on intensive rehabilitation, complex wound care and post-surgical recovery for residents of all ages who no longer need the level of care found in a hospital. 

 

• Regulation – Licensed and Medi-Cal and/or Medicare certified by CDPH.

• Payment – Funded primarily by Medi-Cal. Some funding through Medicare, managed care and private payment.
   

Hospice - Hospice provides care and support for terminally ill people and their families. Can be provided in a facility setting or at home. 
 

• Regulation – Hospice license required for in-home care. Dual license required in a facility setting. Medicare certification required for Medicare or Medi-Cal payments.

• Payment – Funded through Medicare, Medi-Cal, private insurance and private payments.

​

Institutes for Mental Health (SNF/STPs) - Designated in California as "special treatment programs," these facilities provide extended treatment periods for people of all ages with chronic mental-health problems; many of the clients are younger than 65. Specialized staff serve clients in a secured environment. 

 

• Regulation – Licensed and Medi-Cal certified by CDPH. Local mental health departments are responsible for placement and program content.

• Payment – A combination of state and county funding.

 

Intermediate Care Facilities (ICFs) - These facilities provide room and board along with regular medical, nursing, social and rehabilitative services for people not capable of full independent living. 

 

• Regulation – Licensed and Medi-Cal and/or Medicare certified by CDPH.

• Payment – Funded primarily by Medi-Cal. Some funding through Medicare and private payment.

 

Intermediate-Care Facilities for the Developmentally Disabled (ICF/DDs) - Known at the federal level as ICF/IIDs (intermediate care facilities serving people with intellectual and developmental disabilities), these facilities provide services for people of all ages with mental retardation and/or developmental disabilities. ICF/DDs have 16 or more beds; ICF/DD-Hs (habilitative) and ICF/DD-Ns (nursing) have 15 or fewer beds and average six beds in a home setting.  ICF/DD-CN (Continuous Nursing) is a 10 facility waiver pilot program providing licensed vocational or registered nursing on a 24-hour basis for 4-15 clients in a home-like community based setting.  

 

• Regulation – Licensed and Medi-Cal certified by CDPH. The Department of Developmental Services and Regional Centers are responsible for placement and quality assurance.

• Payment – Nearly 100% Medi-Cal.

 

 

Home and Community-Based Care

Adult Day Health Care - Adult day health care that provides some medical care, plus physical, occupational and speech therapy. 

 

• Regulation – Licensed and Medi-Cal certified by CDPH. These programs also receive oversight from the Department of Aging.

• Payment – Primarily Medi-Cal.

 

Community Care Facilities - Community care facilities also includes Residential Care Facilities for the elderly (RCFE) and Adult Residential facilities (ARFs)  ARFs may serve persons with developmental disabilities who are clients of regional centers via the Home and Community Based Services Waiver.  

 

• Regulation - Licensed by Dept of Social Services, Community Care Licensing Division.

• Payment - Funding through home and community-based Medi-Cal waiver program. Regional Center funding for the developmentally disabled, or private pay.

​

Congregate Housing - Housing with a common living area and non-medical support services to meet basic needs of older people. 

 

• Regulation – Dept of Social Services, Community Care Licensing Division.

• Payment – Grants provided through the Federal Government (Housing & Urban Development). Some funding through SSI/SSP for those eligible.

​

Home Health Care - Home health care provides medically-oriented care for acute or chronic illness in the patient's home, usually as a follow-up to acute or other facility discharge. 

 

• Regulation – Licensed and Medicare and Medi-Cal certified by CDPH.

• Payment – Funded primarily through Medicare, with limited coverage through Medi-Cal, private insurance and private payments.

 

Personal Care Services - Personal care services are provided for people who need assistance with daily living but do not require nursing. 

 

• Regulation – No separate license required.

• Payment – Primarily funded through In-Home Supportive Services for those eligible. Some Medi-Cal, for those eligible, and private payments.

 

Respite Care - Respite care provides short term inpatient or home care delivered to an elderly person as a substitute for their regular caregiver. 

 

• Regulation – No separate license required of existing licensed providers.

• Payment – Funding through home and community based waivers and the Department of Aging.