The Physician's Report for Residential Care Facilities for the Elderly (RCFE), form LIC 602A, is a document issued by California's Department of Social Services. It serves several critical purposes in admitting residents into Residential Care Facilities for the Elderly.
What Is This Form For?
The LIC 602A form is designed to provide a comprehensive assessment of an individual's health status by a physician. It ensures that the residential care facility can meet the prospective resident's needs. This form is crucial for the facility's staff to understand the individual's medical conditions, physical limitations, and any specific care requirements.
Why Is It Required?
It is needed to safeguard the health and safety of individuals entering residential care by ensuring that the facility is informed about and capable of meeting their medical and care needs. It helps in planning individualized care and support services for residents.
Who Should Use It (Who Is The Intended Audience)?
The intended audience for this form includes physicians or medical practitioners who assess the individual seeking admission to an RCFE, the individuals themselves (or their representatives), and the administrative staff of the residential care facilities.
How Should The Form Be Filled Out?
The form should be filled out by a licensed physician, who conducts a thorough medical examination of the individual and records their findings. It typically includes personal information, medical history, physical condition, mental status, and any specific healthcare needs or recommendations for care within the facility.
What Are The Critical Pieces Of Information That The Form Requires?
- Personal identification and contact information of the individual.
- Comprehensive medical history, including diagnoses, treatments, and medications.
- Physical health assessment, including mobility and any physical limitations.
- Mental health status, including cognitive functions and any behavioral issues.
- Specific care needs, dietary restrictions, and activity recommendations.
- Physician's recommendations regarding the level of care required and any special considerations.
When Should It Be Submitted (Are There Any Deadlines Or Other Date/Time Considerations)?
The form should be submitted to an RCFE during the admission process. While specific deadlines may vary by facility, they are generally expected to be completed and submitted before or during admission to ensure the facility can provide the necessary care.
Where And How Should The Form Be Submitted (Online, By Mail, By Phone, etc.)?
Submission methods can vary depending on the facility's practices. The form may be submitted in hard copy directly to the facility's administrative office. Some facilities or state departments may also offer online submission options. It's best to check with the specific facility or the Department of Social Services for their preferred submission method.
How Much Does It Cost To Submit Or File The Form?
Typically, there is no filing fee for the LIC 602A form itself. However, there may be costs associated with the medical examination required to complete the form, depending on the healthcare provider's policies and whether the examination is covered by insurance.