Do you provide assistance and medical care to patients in a Residential Board and Care Facility for the Elderly (RCFE)? Do you call instructions and patient care orders to the RCFE staff? Do you have a copy of the RCFE’s policies & procedures manual denoting the services the staff may or may not perform?

Effective July 1, 2015, all RCFE facilities are to maintain their own liability insurance. California AB 1523 requires all residential care facilities for the elderly to maintain their own liability insurance in an amount of at least $1,000,000 per occurrence and $3,000,000 in the annual aggregate to cover injury to residents or guests caused by the negligent acts or omissions to act of, or neglect by, the licensee or its employees. Although you may still be the treating physician, if the RCFE staff fails to monitor and provide adequate care to residents/patients, some of this negligence may now fall upon the facility and its staff.

These new requirements mark a shift from current law. At present, under California Health & Safety Code, Sec 1569.1, any medical negligence or liability issues that occurs while a patient is under your care and is a resident in a care facility fall under the treating physician’s medical professional liability (malpractice).

Residential Care Facilities operate under the supervision of Community Care Licensing, a sub- agency of the California Department of Social Services.

Residential Care Facilities are nonmedical facilities that provide assistance with all daily living activities, such as bathing, dressing, toileting, and urinary or bowel incontinency care. They also perform the supervision and the storage/distribution of patient medications. RCFEs are not required to have nursing, certified nursing assistants, medical assistants, or doctors on staff. This level of care and supervision is for people who are unable to live by themselves and need 24-hour assistance and care.

Physicians currently treating patients who reside at RCFEs should note the following suggestions:

  • Maintain a list of all your patients and their medical records in your office for patients at RCFEs.
  • Ask to see or request a copy of the facility professional liability coverage.
  • Maintain open communications with facility staff and supervisors.
  • Request a copy of all current and new/updated facility policies and procedures for patient care.
  • Use caution when calling instructions and care plans to facility staff.
  • Closely monitor all patients under your care.

A copy of California AB-1523 can be accessed here.