Form LIC 602A. Physician's Report For Residential Care Facilities For The Elderly (RCFE)

The LIC 602A form, also known as the Physician's Report for Residential Care Facilities for the Elderly (RCFE), is a vital document required by the California Department of Social Services' Community Care Licensing. This form serves the purpose of gathering comprehensive medical information about elderly individuals who are seeking admission to residential care facilities.

The LIC 602A form consists of multiple sections that are crucial for assessing an individual's health condition. These sections include fields such as patient identification, medical conditions, medications, cognitive status, physical limitations, and behavioral issues. Each field plays a significant role in providing a detailed overview of the person's health status and specific care requirements.

The parties involved in completing the LIC 602A form are the physician or healthcare provider responsible for evaluating the individual's health condition and the residential care facility where the person intends to reside. Collaborating closely during the form filling process is essential to ensure accuracy and provide up-to-date information.

When filling out the LIC 602A form, various data points are required. This includes personal information of the individual, medical history, current medications, diagnoses, treatment plans, and any relevant laboratory or diagnostic test results. Additionally, attaching supporting documents such as medical records, test reports, or assessments completed by other healthcare professionals may be necessary.

Application examples and use cases for the LIC 602A form include:

1. Admission to Residential Care Facility: The form is used when an elderly individual wishes to move into a residential care facility. It helps the facility staff assess the person's health condition and determine whether they can provide appropriate care.

2. Care Planning: The LIC 602A form assists in developing personalized care plans for residents based on their medical needs and limitations. It allows facility staff to understand the level of care required and tailor services accordingly.

Related forms or alternative options to the LIC 602A form may include:

1. Physician's Report - Skilled Nursing Facilities (SNF): This alternative form is used for individuals requiring a higher level of medical care and seeking admission to a skilled nursing facility.

2. Physician's Report - Community Care Facilities (CCF): This alternative form is used for individuals who require care in community-based facilities, such as adult residential facilities or group homes.

Once completed, the LIC 602A form is typically submitted directly to the residential care facility where the individual intends to reside. It is essential to fill out all relevant sections accurately and legibly. The facility securely stores the completed form as part of the resident's medical records, ensuring ongoing care planning and documentation.

Overall, the LIC 602A form is a crucial document for evaluating the health condition of elderly individuals seeking admission to residential care facilities. By providing detailed medical information, this form enables facility staff to understand residents' needs and create appropriate care plans. Accurate completion and submission of the form facilitate effective communication between healthcare providers and residential care facilities, ensuring high-quality care for the elderly.