senior depression rcfe

7 Ways to Help Seniors Cope With Depression

According to the Kaiser Family Foundation, almost 25% of adults 65 years and older have experienced some level of depression or anxiety during the COVID-19 pandemic. 

When running an RCFE, there is no standard solution to depression that will work with all your residents. Caregivers need to recognize that every senior is one-of-a-kind. 

Each case of elderly depression is also different. An approach that is effective with one individual may not work with the next.

This post will explore several effective ways to deal with senior depression in an RCFE setting.

Implement Strategies to Assist Seniors Dealing With Depression

Although the COVID pandemic certainly contributed to depression in elderly citizens, the easing of restrictions may not instantly make those anxious and depressed feelings go away. 

Every RCFE administrator may want to put some of these suggestions into play to help their residents recover from these difficult times.

1. Adjusting Communication Skills and Activity Planning 

One of the most important things you can do when someone in your care is experiencing depression is to listen. Often what an elderly individual needs most is someone to just hear them and pay attention to the feelings they are experiencing.

By listening carefully you will often hear clues to some of the causes of their anxiety and depression.

As moods start to normalize, let your residents express preferences and help plan new ventures. It’s vital for residents to feel they still have some control over their lives.

Start simple and focus on positive activities that can have a direct reflection on their mental health like exercise, nutrition or even starting a new hobby.

As Covid restrictions ease more and more, perhaps consult with a local senior center to see what group activities and social engagements are being planned.

A safe reemergence back into a social stream can quickly resume normalcy that may spark positive emotional results.

2. Foster a Positive Mental Outlook 

If you are a caregiver to an empathetic resident, it can sometimes be tempting to unload your problems and/or stresses on this captive audience. 

While there are times you may need or want to share personal feelings, talking about issues with your job or personal life can cause worry or increase low spirits for an already emotionally compromised senior.

As much as possible, keep conversations upbeat. 

It can be something simple, such as a home repair you successfully accomplished or a new recipe that turned out well. 

Don’t forget to ask your residents to also name something they recently enjoyed. This helps to direct their focus towards something positive.

3. Help Develop Purpose 

None of us enjoy feeling useless or unwanted. 

Seniors are no exception. They need a sense of purpose.

Brainstorm ways to target goals and objectives for your residents. Hobbies are a great start. Tying them into ways to help others also adds a big dose of purpose to the activity. 

Interests and abilities may differ, but everyone likes to feel like they are making a difference. 

Small examples could include installing a hummingbird feeder. 

Even planting a few vegetable or flower seeds can create a sense of daily purpose and fruition as your resident watches his or her garden grow. 

Encourage your residents to focus on simple projects for family members or even local charities. A senior in full control of their faculties might want to consider writing a family history or personal memoir for their children or grandchildren. 

Senior care residents will often respond positively to contributing through creative efforts, utilizing their existing skills or even just volunteering their time.

4. Address Sleep Issues

Starting the day right is difficult if you’ve had a lousy night’s sleep. Working to improve your residents’ sleeping patterns and helping to overcome insomnia issues will go a long way towards helping to stabilize their moods.

You may also consider some environmental factors like eliminating caffeine after midday, omitting afternoon naps and avoiding heavy evening meals to help ensure a good night’s sleep.

5. Get Your Senior Involved With Exercise or Movement

Exercise is a great way to get endorphins flowing. 

For some seniors, this can be a “slam-dunk”, but others may express that they are not interested or that they have earned the right to just “sit back and relax”. 

Unfortunately, inactivity often goes hand-in-hand with sleep issues and depression. Try to encourage some activity and exercise while also taking care to address valid reasons for inactivity, such as pain or disabilities.

Solicit suggestions for appropriate exercise activities from a medical provider or physical therapist. 

Many RCFE continuing education classes also provide some limited information and training in this area. For example, when dealing with seniors with limited ability, try chair exercises or a pedal device for leg movement while sitting.

6. Begin or Increase Social Activities

This looks different for every senior, depending on capabilities and personal preference, but you’ll notice that most residents will enjoy informal visits with family members or other persons who share similar interests. 

For the more shy or introverted residents, start small. 

Having morning coffee with a friend or neighbor, participating in a group activity or even just a FaceTime session with a family member can make a real emotional impact.

7. Keep Up With Technology

Speaking of FaceTime, seniors who learned to make use of web conferencing through services like Zoom or who used video chat apps such as FaceTime during the pandemic should continue to utilize them regularly. 

Getting to stay connected, even virtually, with family and friends can be a huge morale booster to most residents.

Try to introduce tech-weary seniors to things like YouTube where they can watch how-to videos, live church services and other events they might otherwise be missing. 

Technology remains a good way to interact with others and help residents stay connected to the outside world. Learning new technology also helps keep a senior’s mind stimulated.

Not only does the resident feel as if they are growing mentally, but that they’re also evolving with the ever-changing times and not just feeling like they’re a relic to the past.

Devise a Plan To Help Seniors Adjust to Post-Pandemic Life

Although many factors can contribute to depression in older adults, the fear of Covid-19, the stress of the stringent lockdowns, and just the overall impact it has had on this demographic certainly intensified the problem. 

As the number of vaccinated citizens continues to increase, and the country starts to open up again, it is important for RCFE administrators and their staff to plan a smooth transition and return to normal protocols with the differing needs of elderly individuals in mind.

Even though the CDC, as well as state and local health departments, dictates many details of the gradual reopening, an RCFE administrator should still be ready to acknowledge that residents may need to adjust on their own timelines.

Part of any transition plan should include appropriate training of all caregiving staff on the signs and symptoms of depression and the appropriate ways to report and intercede. Online training is available for facilities to use to expand caregiver knowledge and meet required CDSS requirements. 

Does Your RCFE Need Help With Senior Depression?

If your assisted living facility is struggling with Post-Pandemic depression issues, or even just a general loss in community morale, please don’t hesitate to reach out for support. Assisted Living Education is here to help and support you while we all journey together on the path to recovery.

How to Turn Your Home Into an Assisted Living Facility

In California, there are currently 7,500 licensed Residential Care Facilities for the Elderly (RCFE) with occupancy levels at approximately 174,000 beds.
Other names associated with RCFE have assisted living facility, board and care home or retirement home. These are all RCFE’s and they all have the same regulations. According to a recent report by the California Advocates for Nursing Home Reform, there is a growing demand for increased assisted living facilities and capacity.

In this demanding environment, many RCFE administrators are looking to convert their homes into an assisted living facility. Indeed, operating an RCFE out of your home can be a fruitful and rewarding endeavor, but it’s important to understand what you are getting into.

For the purpose of this article, we will explore some of the considerations of opening an RCFE in your home and provide some information that can help you decide if opening a small RCFE is right for you.

Preliminary Considerations of Opening a Home RCFE

Operating an assisted living facility is a meaningful privilege, but also a heavy responsibility and a state-regulated endeavor. Before you begin this journey here are some suggestions to consider as you begin the initial process of licensing your home as an RCFE.

  1. Make sure you are committed to the project and the thought of losing the privacy of your home life.
  2. Create a mission statement which is a set of goals you hope to achieve by opening your home as a senior facility.
  3. Research state laws and local zoning regulations about assisted living facilities and determine if your home is compatible.
  4. Take all the state-mandated RCFE classes to assure you have the proper training and information to begin the licensing process.

Like any other business, you will want to create a solid business plan. This plan will help guide you so that you will always know “what’s next.”

Evaluate the Local Need for a New Assisted Living Facility

Like most other businesses, you will want to begin by determining the need in your area for the services you are offering. Your future residents are the cornerstone of a successful RCFE, so give them top priority as you put a plan in place. 

Even with a building that meets requirements, proper licensing, administrator certification and compassionate staff, you cannot run a successful facility without an adequate number of residents. You also need to consider the number of bedrooms, bathrooms and available living space in your home.  

Keeping your rooms occupied and your residents happy is vital to the success of your RCFE.

So how can you determine the need for assisted living in your area? 

Consider these resources:

Visit the CDSS website and select the “Find licensed facilities” box. You can search by city or zip code to locate facilities in your area.

  • Contact local government agencies and organizations that serve senior citizens.
  • Research and visit assisted living facilities in the area.
  • Talk with patient advocates at local clinics and hospitals.
  • Reach out to regional assisted living training institutions, including community or technical colleges.

Begin the Process for an RCFE License

Once you have done your homework, verifying that there is an adequate need in your community, then turn your attention to obtaining proper credentials. 

In California, CDSS requires that you have an RCFE license for your home before you admit any residents for care. You also personally need RCFE certification to prove you completed training and have the knowledge to safeguard the residents. As the owner of a home turned into an assisted living facility, you will need both.

It is important to keep in mind that RCFE licensing and RCFE administrator certification training takes time, patience and resources to complete. 

The process begins by taking the required orientation course on the California Department of Social Services website

Additionally, you will also have to fill out an application and sign up for an accredited RCFE administrator training course. You will also have to meet state educational and experience requirements when applicable. 

The required qualifications are generally reasonable and you should be able to obtain any that you might be missing, but this can add some time to the certification and licensing processes. 

One important requirement to plan for is the CDSS requirement that you show proof of three months of operating expenses in designated savings accounts before approving your license.

Once you have completed your certification and submitted your RCFE licensing application, CDSS will begin processing the application in Sacramento. 

Once your paperwork has been reviewed and any missing paperwork submitted, your application packet will be sent to the local CDSS office that will oversee your facility. 

A Licensing Program Analyst (LPA) will be assigned to your facility. The LPA will contact you and set up the Component II interview. Once this interview has been conducted, the LPA will order a fire inspection and verify operating funds in your account.

Finally, after you have received approval from the local fire marshal, LPA will send a checklist and schedule an on-site visit to inspect and approve your home.

Use the Wait Time Wisely

Sometimes it can seem like there is a lot of downtime in this process, but there are actually a lot of ways you can utilize that to your advantage. 

While you are waiting for the DSS to review your license application, we suggest you also work on marketing your facility to prospective residents as well as finding caring, competent and reliable employees to help run your facility. 

Although you may adjust your opening date along the way, you will want to have employees trained and your home ready for admissions when you do open your doors.

Seek Professional Assistance

As our population continues to age there will certainly be an increase in the need for high-quality RCFE’s. 

If you feel like this could be a good fit for you, then the first step is to do your homework and create a plan. 

If this process seems overwhelming, you would be correct. 

CDSS has guidelines they follow during the application process and if you do not reply or submit missing documents in time, you could be at risk for CDSS to deny your application. This would mean you are not allowed to resubmit an application for one year. 


To prevent this scenario from happening, you would be wise to seek the assistance of someone who has experience in licensing and working with CDSS. To ensure that you do everything correctly the first time and save precious time during the licensing process,  Assisted Living Education can help. Our experience and positive relationship with CDSS can save you time and money while you complete the process to get your building licensed. We have assisted 100’s of individuals successfully obtain a license for their buildings and helped them on the path to having a viable and safe assisted living facility.  

If this is something you are interested in, don’t hesitate to reach out to us. We are here to help.

RCFE Administrator License

How Do I Get an RCFE License in California?

Opening and operating an RCFE requires licensure and Administrator certification and is a great business model that benefits those receiving care as well as the investor. 

This article describes in more detail on how to obtain your RCFE license. 


A Closer Look at RCFEs

RCFEs are known by many names, especially in states outside California. Some examples include assisted living facilities, retirement homes and board and care facilities. 

They house elderly residents and provide assistance with things like general care, grooming, social activities, and medication assistance. Licensed facilities can be as small as one resident or as large a facility that has several hundred. 


RCFE Licensing — RCFE Administrator Certification Training

California requires that anyone operating the facility as an RCFE administrator be certified and the facility must be licensed.  In order to become an administrator, you must complete the 80-hour Certification course, pass the state exam with a score of 70% or better and submit a certificate application with the required documents and fee.

To open a facility, an applicant must complete the three-hour online orientation that is required by the Department of Social Services (CDSS). An application for licensure is submitted once you have legal control of the building that you plan to operate from. 

The RCFE Certification Course gives you the basic knowledge to operate an RCFE successfully and competently and to prepare for the role of an RCFE administrator. 


Because you will have the responsibility for a number of people’s health and well-being under your care, and you need to know what you’re doing. 


What RCFE Training Includes

A well-structured certificate program includes both online and classroom learning. Once training is completed, you must take the exam and submit your application. Once CDSS processes the application, a certificate will be issued to you and is valid for two years.

In regard to the actual training, Assisted Living Education provides a thorough curriculum that covers all the aspects of opening an RCFE that includes laws and regulations, staffing requirements, application process and allowable and prohibited health conditions that affect client care.

These are just some of the topics you should be prepared to learn during RCFE training in preparation for your Administrator Certificate:

  • Personnel requirements, including initial and ongoing training
  • Background checks
  • Resident Records, Documentation and Privacy
  • Types of Services that can be provided in an RCFE
  • Health-related Services (and staffing requirements)
  • Compliance Requirements and Oversight

Preparing the RCFE license application to open an RCFE can be quite challenging.  The RCFE license is a necessary step to opening a facility. After you establish a facility, you’re going to need properly trained staff and possibly hiring an administrator if you are not going to manage your own facility.

The elderly population may need a variety of services and different levels of care. Assistance with activities of daily living (ADL’s) such as grooming, toileting and medication assistance are some of the common tasks that most caregivers can provide. 

As the level of assistance increases, however, so must the skillset of the caregiver.

RCFEs are not medical facilities and should not provide medical care that falls under the scope of a registered nurse or doctor unless those people are either employees of the facility, on call to the facility to provide as needed assistance or assistance is through the use of a home health or hospice agency. 

These agencies assist the facility with specific care needs that a facility is limited by or restricted from performing assistance. If caring for residents with dementia, staff are required to have a specific amount of hours of training to provide proper support and assistance. 


Proper Staff-to-Client Ratio  

Unlike skilled nursing facilities, RCFE’s do not have regulated staff to client ratios. 

For example, there must be at least one qualified employee (meets the required training to provide care as a caregiver) on call on the premises for 1-15 residents.

In facilities with 16-100 residents, there must be at least one employee on duty on the premises and awake. Another employee must be on call and capable of responding within 10 minutes.

In facilities with 101-200 residents, there must be one employee on call on the premises. Another employee must be on the premises awake and another employee must be on call and capable of responding within 10 minutes.

The need for elderly care will only grow in demand. If you are interested in opening and operating an RCFE in California, now is a great time to enter the industry. 

An increasing aging population will require qualified, ongoing care delivered by caring professionals. Contact Assisted Living Education or check out our upcoming RCFE classes for more information on how to get started on licensing a property as an RCFE or for online classes to maintain your current Administrator Certificate.  


RCFE class on online marketing

4 Key Steps to Improve Your RCFE’s Online Marketing

Today, seniors and their families are initially looking for assisted living facilities online. Therefore, it is more important than ever that your assisted living facility ranks well in Google and other places that people search for assisted living facilities.

The higher you rank and the better your online reviews, the more likely that you will attract greater interest, more visitors and qualified new residents.

We knew little about online marketing when we started but wanted to summarize the basics for you here. Even if you are new to the world of SEO (Search Engine Optimization) or already have some knowledge, the information in this blog will provide you with key insights that can be easily accomplished.

1 – How to Get More People to Your Website

If you are still in the early stages of setting up an assisted living facility, you first need to look into RCFE certification. While getting your RCFE certification and license, you can start the process of building your website. Look at how other facilities are listed online.  Do they have a website and are they in online directories such as Yelp or Google My Business?  What do you like and not like so you can inform the people building your website?

Once the site is created and is live, you can start trying to rank for keywords. In other words, you hope to find keywords that people would logically be searching for assisted living and try to get as high on the Google search results as possible, so viewers will find you.

A good search engine strategy centers on finding the keywords that people looking to find a facility in a specific town are most often searching. Essentially, you need to comprehend what terms people are likely to type into their search engine bar so your website can appear.

Most likely, the keywords would revolve around phrases like “assisted living” or “assisted living facility” or “senior assisted living” along with the city your community resides in.

For example, if your facility was in Encino, California, you’d most likely want to show up in search results when people typed in “assisted living Encino”.

The simple strategy is then to place that keyword in the text of your home page – maybe even a couple of times. That way, Google will see that keyword on your site and make the connection to the search. Thus, you’ll have a better chance of ranking higher when that phrase is searched for.

Even if you already run an established community, you can gain a lot of potential search engine ground by adding those keywords to your existing website on several of the pages that you think would best describe your facility.


2 – Claim Your Google My Business & Other Directory Listings

Many of the major search engines allow you to make a specific business listing where you can include all of your facility’s key information. Google being the largest search engine in the world is the place you want to begin.

The Google My Business listing is the most popular, most visited and simplest for you to claim. It’s easy to sign your business up and costs nothing. You simply go to Google, search “Google my business” and click on the “manage now” button.

The rest of the process will take minutes by just following the directions on each screen. Enter your business’ information along with contact details, and you will immediately have a new presence with Google My Business (GMB).

Often, these listings also automatically display a map of your location. Further enhancing your GMB presence, you can easily upload photos of your facility or your staff to personalize the listing further.

Now, when someone types in the name of your facility, this listing will be near or at the top of the results. Over time, other keywords that you have been adding to your website pages may also display this GMB page increasing your prospective clients even further.

Here is an example of Google’s local search results for “assisted living Encino”

Note how the facility with the most reviews showed up at the top of list.  More about reviews below.

While Google may be the biggest directory in the world, we’d also suggest setting up similar profiles on other directories such as:

Yelp for Business

Better Business Bureau

Assisted Living Directory

Taking the time to get your assisted living business noticed is almost as important as the RCFE licensing process if you want to be successful.

RCFE online reviews

Reading online RCFE reviews help people find the best assisted living facilities near you.

3 – Solicit Reviews From Satisfied Clients

The importance of online reviews cannot be understated.

A recent survey showed that people were 270%  more likely to purchase a good or service that had at least one five-star review as compared to a company that had no reviews at all.  Almost three times more likely to choose your facility just because of reviews.

Once you have set-up your directories, engage with your satisfied clients – both past and present – and ask them to please post a positive, five-star review on these places. (To make it simple for them to do, you may want to email them the request with a series of direct links to your Google My Business, Yelp and other business directory pages.)

You also want to manage the reviews – both favorable or unfavorable – in a timely fashion. This direct interaction with your audience shows you care about your quality of service and care what your customers think.

If you have any negative reviews, it is a good idea to address these directly. Offer an apology or explain the circumstances behind this complaint. Online reputation management is key to growing the word-of-mouth and credibility of your facility.

In addition, placing any positive reviews on your website in a testimonial section also helps enhance the selling of your service.

4 – Engage Visitors on Your Website

So you’ve started getting potential new clients to come to your website after seeing you rank high in search results and reading all your positive reviews. Now the goal is converting them from visitors into customers.

You want to make your site easy to comprehend with a very clear “call to action”. In other words, you should quickly and clearly make the case why your facility is the best one for mom or dad. Then get the web user to call your business or fill out a contact form.

The phone number and contact form should be present at all times on the page. Your web developer should recognize that the forms and phone should be at the top of the page in a stationary spot that doesn’t move out of the reader’s eye even if he or she scrolls down the page.

The other key to closing new leads is a lightning quick response. If a call is made after hours and a message is left, that lead should be the top priority for a recall first thing in the morning.

Similarly, when the contact form is filled out, there should be a follow-up action (preferably a phone call to the person) within minutes, even seconds. With so many search results out there for assisted living facilities, chances are the same family that reached out to you also did so to several other facilities.

In this case, it’s often a race as the first facility to contact that potential client will more often than not win the client’s business.

It is optimal to have a member of your RCFE administrator staff who can be tasked with managing and following up with interested parties right away.


These are just some of the basics that can seriously help improve your online marketing. It may seem intimidating at first but it gets easier once you start.  If you would like to know more than I recommend you reach out to great people and the company we use for digital online marketing.

Please let us know if you found this blog helpful.


About Assisted Living Education

Assisted Living Education is the premier provider of RCFE certification, RCFE classes, licensing, products and services for assisted living. Our teachers are industry professionals with many years of experience that are engaging, entertaining and highly informative. They offer RCFE consulting services and share real RCFE experience that will help you be successful in this fast growing career industry.

Good luck!


RCFE certification required for Assisted Living

The 5 Key Strategies for Operating a Top Rated RCFE 

In 2020, the average life expectancy in the United States was nearly 79 years, as compared to the life expectancy in 2000 of 77 years. 

The good news is Americans are living longer, the bad news is our nation is not fully prepared for the challenge of meeting the increased needs of an aging population that will be almost 25% of the U.S. population by 2030. 

This is why more Residential Care Facility for the Elderly (RCFE) will be needed. 

About RCFEs 

The core services that an RCFE provides to people who are 60 years or older includes: safe and healthful living accommodations; personal assistance and care; observation and supervision; planned activities; food service; and arrangements for obtaining incidental medical and dental care. 

Most facilities also assist with storing and distributing medications that a resident can self-administer. 

This type of facility is for a person who is no longer able to live alone but does not require 24 hour skilled nursing care. RCFEs are considered a social model and skilled nursing facilities (SNF) are medical models. A RCFE is not required to have a licensed nurse on staff. 

Another difference between the two different levels of care is which licensing entity they report to. RCFE’s report to the Department of Social Services (CDSS) and SNF’s report to the Department of Health Care Services (DHCS).

So what does it take to become a RCFE owner? Find a building to own or rent and submit an RCFE License Application to CDSS. You should also take the 80 hour RCFE Administrator certification course to become the administrator who will oversee the day to day operations. If you do not want to do hands on oversight, you can hire an administrator. 

So what are the 5 strategies to operate a successful RCFE?

1 – Location, Location, Location. 

Do you know the area you are thinking about opening a building in? How saturated is the area with RCFE’s? Does the city have a significant senior population to support your facility? 

The CDSS website,, has all facilities listed by address, city or zipcode. The Census Bureau can help to identify the makeup of a given age population in a particular area. You should “secret shop” the competition. What are they doing right? How does the facility look and smell? What are the residents and staff doing while you are touring? 

Families are looking for a clean, safe and engaging place to move their loved one. Is the facility close to a hospital and physician offices? How far from a freeway is the building? Have you selected a neighborhood that also has well maintained homes? Is the building clean and well lit? First impressions are everything.

2 – So What Is Your Plan? 

Finding a building in the right neighborhood is really the easy part (you may not think so as you go through the process). Your lender will want to see your business plan. How much experience do you and your employees have in the area of senior care? Are you hiring an administrator with experience? What is your budget? 

You will need a corporate entity, such as a Limited Liability Corporation (LLC) at the time you submit the license application to CDSS and a budget is included. Do you have three months of operating costs plus funds for repairs while you get started. This is a business that can not operate on a “shoestring budget”. Creating a business plan will help you to execute a successful business model.

3 – Hire the Right Staff 

Hiring great employees is going to be the most problematic and stress inducing process you will experience. You will find employees, but are they Great employees? 

Finding residents will not be your main problem. You may purchase a facility in which staff are already in place. Interview them, do not assume they are staying or that you want to retain them. Staff will make or break your business! 

Are you going to hire an assisted living administrator? Is an administrator in place if you buy an existing RCFE? Does the staff respect the administrator? This person sets the tone of the building. 

Once you own the building, speak to families and see what their concerns are. They often do not want to see the staff leave, as the staff “knows” what the residents’ needs are. Communication is the key to happy relations with the families. Family members are often your second biggest challenge.

4 – Know Your Licensing Entity 

Once you submit the license application, you will get a notification that the Licensing Program Analyst (LPA) assigned to your area is going to interview you and tour the facility before the license is approved. You do not want to get on the bad side of the LPA. How do you stay in her/his good graces? You follow the regulations. It is that simple. 

Provide safe and healthful care. 

Train the staff properly. 

Communicate when something goes wrong (you learn what those forms are in the Administrator course). All the LPA wants is that the residents are safe, eating well, have meaningful activities and they are not being abused. 

Those should be the same reasons you decided to enter the Elder Care field. 

5 – Market Your Services 

How are you going to get a resident to move in now that you own the RCFE? The facility may have been operating for a long time and may already have a reputation in the community. Referral agents, discharge planners and social workers need to know there is a change in ownership, which might be a good thing. 

Reach out to your competitors and let them know that you are the new owner and you can help each other fill those empty beds. Do not underestimate the power of networking. 

Join a local assisted living association, attend conferences, and network with hospitals and doctors who provide referrals to your services. 

The need for elderly care is expected to increase in the years to come. This need will require RCFEs operating under capable leadership and providing quality care at an affordable cost. If you have been considering opening an RCFE, now is a good time to execute your vision. You can begin by understanding the qualifications and receiving the appropriate training to become a certified administrator. 

When you’re ready to provide the necessary care for the need that exists, learn how Assisted Living Education can prepare you for operating a successful RCFE. The satisfaction of caring for seniors in need makes the life of an RCFE owner one that will prove both rewarding and life affirming.

6 Steps for a Successful RCFE (Updated for 2021)

Starting your first Resident Care Facility or RCFE can be exciting, fulfilling and daunting all at the same time. Between securing a location and getting your RCFE administrator certifications it can be easy to overlook some of the important basic ideas that will help ensure your first RCFE is a success.

Over the years, we have worked with hundreds of newly minted RCFE administrators to make sure their facilities, policies and business strategies are setting them, and their residents up for the best possible experience. In that time, we’ve learned a thing or two (or six) on some of the foundational elements of what makes a successful RCFE. Here is what we would say our 6 most important tips for building a successful RCFE facility are…

1. Spend Time Creating Your Team

More than just a team, you are creating a professional business culture. And where that culture starts is you and your employees. Those first several hires are vital to any new venture, regardless of the industry, and especially in a care-oriented industry like this one. The people you choose and personalities they bring set the tone and precedent for all that is to come.

With everything in flux, you might be tempted to “fire drill” the hiring process in a rush to hit the ground running. This is never a good idea. We’ve all heard the phrase beggars can’t be choosers. In hiring, no matter the circumstances, that should never apply. Give yourself permission to spend time creating your team. Yes, your team. You have a vision, and it is okay to be selective on who will join you on your path to seeing it through.

2. Choose Your Residents Wisely

Just as you are creating a culture with your first employees, so are you building a RCFE community. Your first resident is your benchmark and will set the tone for your facility in ways you might not expect. For example, if your first resident has Alzheimer’s and has repetition tendencies, then it might be difficult to admit residents who are cognitively with it.

Remember, just as you have a choice, so do your residents — and there’s a lot of factors that go into their decision to go with your RCFE facility. As facilities grow in size, culture and community are becoming increasingly important. If a resident-to-be doesn’t see a community they can engage with (even if one exists), they might very well pass. Whether it’s bound in fact or not, perception is reality.

3. Know All of Your State’s Regulations, Codes, and Policies — And Comply with Them

These laws exist for a reason, both for the protection of your residents and for yours. The quickest way to have your facility shuttered is to be out of compliance with your state’s RCFE regulations. That also means current administrators need to stay on top of continuing RCFE education classes. You went into caregiving to do just that:  give care. How can you adequately do that if you’re out of compliance, or don’t even know what codes and policies your facility is supposed to be complying with?

Moreover, having a firm grasp of your state’s regulations could very well be crucial down the line. Don’t be afraid to wield them like a shield — the first line of defense towards any future liability claims.

Need to brush up on your policy? You can always turn to experts like Assisted Living Education to help make sure you are up to date.

4. Communicate Regularly

Not only is communication vital so that everyone on your team can always be on the same page, but it’s also a regulatory requirement. The law mandates that any change of condition in the resident — say, they have a urinary tract infection or they’re more confused than usual — must be communicated to their physician and responsible party (i.e. a family member), if any.

This makes sense, of course. A change in an individual’s condition can have life or death consequences, and a lapse in communication could prevent a resident from receiving critical treatment. Shift changes present a particular challenge in this regard. There’s a potential for information to get lost in the mix in the transition between your facility’s day and night teams. Certain symptoms, such as insomnia — a potential indicator and risk factor of depression — might only present themselves at late in the evening, so it’s imperative everyone is kept in the loop, and that changes are noted in writing.

And let’s not forget your duty as a licensed RCFE Administrator to maintain communication with your State Regulators. Any time a resident experiences an unusual incident — such as a fall, an injury, or a medical emergency requiring a 911 out to the hospital — a report must be made to your Licensing Program Analyst at the Department of Social Services with within 1 business day via telephone, and within 7 days via a written report. This takes us into our next tip.

5. Document, Document, Document

Any time there is a resident incident, such as a fall, it must be documented — either internally, if it isn’t that serious, or on a State-provided form to be submitted to the DSS if it triggers a 911 call or something similar. Like the above, incidents need to be reported to the resident’s physician and responsible party, and it’s best to do this in writing so you have a paper trail.

Liability, though you might not want to think about it, should always be a concern. Thus, it’s wise to perform internal audits and random record reviews on a routine basis. You always want to be able to certify compliance if the need arises. This is where the term “defensive documentation” comes into play. When you document incidents, or anything really, specificity, precision, and descriptive detail are all musts.

Resident records (appointments included), personnel records, administrative records, dementia records — these are all things you are required to keep, keeping in mind that certain records must be secured in a HIPAA compliant fashion. As a guideline, take a look at the list of documents and records that must be kept at residential care facilities in California. Remember that every state is different, so unless your facility is located in California, what you are required to retain might be different.

6. Don’t Be Afraid to Say No

The words “this is my island” spring to mind. This facility is yours, and as an RCFE Administrator, you cannot be afraid to say no. We covered this in part in Tips #1 and #2, what to do in the beginning, but there’s a corollary on the other end of the spectrum:  what to do when an end is inevitable.

If an employee misbehaves, routinely underperforms, or puts your residents or facility in any modicum of risk (health, liability, or otherwise), then it is your duty to fire them promptly. With the safety and wellbeing of those in your care on the line, they must be your first primary concern.

But what if an individual’s medical needs exceed your facilities abilities?

It’s sad to say, but this is a quandary you will likely face dealing with residents suffering from advanced Alzheimer’s and dementia. Much as you might want to keep them in your care, your licenses might not permit it. The care they require might go beyond the scope of what you can supply. In these situations, or in cases of residents who exhibit violent behaviors or a flagrant disregard for community rules, letting go of a resident might be a necessary course of action as well.

The Essential Component of Success

Looking back on the six tips we just shared, you might notice that at their core they are all about the same thing:  Care. Caring enough to do things right. Providing the best care. Taking time to assure your level of care by maintaining compliance, and by communicating. Although there is a lot more to running a successful RCFE facility than just these 6 things, mastery of these will give you a great foundation to build your business on. And in the event that you need additional support or training, the experts here at Assisted Living Education is always here to lend a hand.

Assisted Living Education is the premier provider of RCFE certification, RCFE classes, licensing, products and services for assisted living. Our teachers are industry professionals with many years of experience that are engaging, entertaining and highly informative. They offer RCFE consulting services and share real RCFE experience that will help you be successful in this fast growing career industry.

RCFE administrator conference, RCFE associations

The Benefits of Joining an Assisted Living Association

If you are considering opening a Residential Care Facility for the Elderly (RCFE), you may benefit from joining an assisted living association. Your first step to effectively own and operate an RCFE is to become an RCFE administrator, which requires an administration certification.

You also must obtain an RCFE license. You can take advantage of all the resources assisted living associations provide to RCFE administrators while also getting support as you navigate the RCFE certification process. Here are five benefits of joining an assisted living association.

 1. Resources

If you’re new to the industry, there are many resources available to you as an assisted living administrator. Even if you are a seasoned professional, assisted living associations provide fantastic resources for all things industry-related.

For instance, they are often the go-to source for keeping up with regulations and laws. They also keep up with industry trends and share relevant information on everything from resident care to health care. Resources are always important, but they are especially so now in the midst of the global Covid-19 pandemic and RCFE’s efforts to keep residents healthy and safe.

2. Advocacy

There is strength in numbers. When you join an assisted living association, you gain a representative and an advocate. RCFE administrators and residents benefit from advocacy because it allows their voice to be heard by people making decisions that impact the industry and RCFE operations.

Assisted living association leaders must stay current on pending legislation and policy efforts. They represent you, your RCFE, and your residents to ensure any changes are as smooth and unencumbered as possible. They also communicate relevant information you need to know and act as an intermediary between RCFEs, state legislatures, and social services.

3. Professional Development

Assisted living associations are in the perfect position to coordinate and facilitate professional and workforce development. As an assisted living administrator, you require trained, skilled staff to provide the right care and services for your residents.

Assisted living associations can support you in your recruiting efforts, onboarding, and ongoing skills development. No matter whether you’re in the first year of your RCFE career or your 20th, ongoing professional development is necessary. Your membership in an association allows you to engage in numerous training and ongoing education opportunities.

4. Events

Assisted living associations commonly host annual conferences and other sessions that allow you to immerse yourself in educational events, industry news, and trends. When you attend events, you can hear from industry leaders, guest speakers, and others in the field.

Leave the event and return to your RCFE refreshed and full of new ideas and insights. Conferences and other events allow you to take the information you receive and practically apply them immediately. Events can also include trade shows, opportunities for recognition and awards, and the option to gain continuing education credits.

5. Networking 

When you join an assisted living association, you get to network with others in the industry. Networking is vital; it allows you to be seen, connect with people in your field, share and learn best practices, trouble-shoot, recruit and seek new job opportunities. In a world where things change rapidly, it is nice to have access to industry peers where you can bounce ideas, learn, mentor, and connect over common ground. 

If you’re an RCFE administrator, you will benefit from joining an assisted living association. Associations offer many benefits, including resources, advocacy, professional development opportunities, events, education, and networking.

As an association member, you join a community of like-minded individuals and industry leaders dedicated to supporting one another, sharing ideas, answering questions, and performing at a high-level. Stay informed on industry trends, ahead of the curve on regulations and pending legislation, and operating at optimal performance.

As an assisted living administrator, you are responsible for ensuring your RCFE maximizes its operations and services. The best way to achieve this goal is to become a member of an assisted living association. The leading California association is the California Assisted Living Association (CALA). 

Assisted Living Education is the leading provider of RCFE certification classes, licensing, products and services for assisted living. Our teachers are industry professionals with many years of experience that are engaging, entertaining and highly informative.

We always welcome your feedback, and if you have other important terms you would like added to the list, please let us know. Assisted Living Education is a recognized leader in the industry, and our instructors have years of professional RCFE experience that will help ensure your success in this burgeoning industry.

RCFE Staffing Requirements Overview

In California, one option for seniors 60 years or older requiring long term care is a “social model” that provides room, meals, personal care assistance, supervision, observation, housekeeping and planned activities. A Residential Care Facility for the Elderly (RCFE) can care for one or more persons and must be licensed by the State of California to provide care services.

RCFEs operate as a bridge for those who require some level of assistance that prevents them from living on their own but who do not require 24-hour medical care, service, or supervision.

RCFE’s vary in size but there are basically two models: 16+ residents or 1-15 residents. The 16+ are owned or operated by Sunrise, Brookdale and Atria to name a few. The 1-15 model is typically a home in a residential area and often called a “board and care”. Unlike nursing homes, RCFEs may have licensed professionals as personnel, but it is not required to do so.

RCFE Administrator Certification and Licensing

The administrator is responsible for the care and supervision of residents, staff management, and adhering to regulations, policies and procedures. Regulations require the administrator to complete an 80-hour certification course and pass a 100 question state examination with a score of 70% or better to receive a certificate. 

The administrator must complete 40 hours of continuing education units (CEUs) every two years. Fortunately, Assisted Living Education (ALE) is one of 15 vendors that provide RCFE administrator certification classes. Additionally, the RCFE itself must be licensed. The process involves completing an RCFE license application, which ALE offers assistance with your RCFE application and licensing. A facility license is renewed annually and must be inspected by DSS yearly.

RCFE Staff Requirements

California laws require RCFE’s to ensure that the community has “sufficient staff at all times and competent to provide the services necessary to meet resident needs.” There is no detailed requirement of how a community is to interpret this regulation. 

The resident care needs indicate how many staff are required to render care. The communities with 1-15 residents usually have two to three caregivers during the day and one caregiver at night. There are no resident ratios. The administrator or a qualified designated substitute must be on-site 24 hours a day.

California regulations require the following:

  • Employees who provide direct care to the residents and employees who supervise employees must be 18 years or older. 
  • The administrator must be 21 years or older.
  • The administrator must have a high school diploma or GED for 1-15 residents; 15 college units and one year of experience for 16-49 residents; 2 years of college and three years experience for a community with 50 or more residents. 
  • At least one staff member must be CPR certified and on the premises 24 hours per day. 
  • Any personnel who provide care to the residents must have first-aid certification.  
  • All personnel and some volunteers must have a Criminal Record Clearance before employment approval. 
  • All personnel must have a health screen and negative TB test.
  • Additional staff shall be employed as necessary to perform office work, cooking, house cleaning, laundering, and maintenance of buildings, equipment and grounds. 

RCFE Staff Training Requirements

All personnel assisting residents with ADL’s must complete 20 hours of initial training prior to assisting a resident and an additional 20 hours of training within the first four weeks of employment. 

The topics include: the aging process; personal care; physical limitation; ADL’s; resident rights; medication policies and procedures; psychosocial needs of the elderly; recognizing signs and symptoms of dementia; 12 hours of dementia training; postural supports; hospice care; restricted health conditions; LGBT; elder and dependent adult abuse reporting; theft and loss; disaster training; food service and safety; and care of a bedridden resident.

Staff are also taught required subjects by the Occupational Health and Safety Administration (OSHA) that includes universal precautions, Hepatitis B, bloodborne pathogens, Personal Protective Equipment (PPE), and Safety Data Sheets (MDS).

All staff assisting residents with self-administration of medications must receive 10 hours of training for 1-15 residents and 24 hours for 16 or more residents and all communities must provide an additional 8 hours training each year.

ALE provides online training for employees that allows the employee to progress at his/her pace. The following link will provide information about ALE’s training products for staff training

RCFE Policies and Procedures

Once the facility is licensed, RCFEs are required to have a Plan of Operation that includes: policies and procedures for admissions; staffing plan, qualifications and duties; plan for training staff; organizational chart; sketches of the floorplan and the yard; policy for family visits and communication. ALE has created an assisted living policies and procedures manual

The topics covered here provide you a high-level overview of RCFE staffing requirements in California along with links to helpful resources. Thank you for the essential care RCFE’s deliver to the aging community, and we hope the information here will help you continue to achieve that goal. 


The Benefits of Senior Living During the Covid-19 Crisis

Senior living will always play an important role in the healthcare process of aging adults and despite some unflattering media attention, most Residential Care Facilities for the Elderly (RCFE) are actually doing well with the Covid-19 crisis. Many have been able to keep their facilities COVID-19 free, providing their residents with a safe and secure home, while the country works hard towards long term solutions to this pandemic.

Even with a COVID-19 free environment, this does not change the fact that the conversation in regard to bringing on new residents has started to evolve. To help ensure that your facility is ready for this change and some of the questions that will follow, we at Assisted Living Education (ALE) have put together some information that can help guide your teams as society begins to move forward.

National Voice For A Change of Narrative

While it is true that some Assisted Living Facilities across the country have been impacted, most facilities have quickly adapted to the safety guidelines and have continued to provide excellent care with very low risk to their residents. Communities with a negative COVID-19 population are often overlooked because this fact is not as newsworthy. To illustrate this, Seniors Better Together, a Seattle-based cooperative, has launched a national marketing campaign. Their intention is to communicate the safety and benefits of elderly care and assisted living facilities during this time. Here at ALE we are supportive of these industry voices and feel that a proper communication strategy is important to the success of any well managed RCFE.

Utilizing a Positive Messaging Strategy

Like many RCFE administrators, you are probably in the process of updating your marketing materials to address the current reality of things. Through this process of communicating the safety, efficacy, and benefits of senior living during the pandemic is more crucial than ever, so we’ve put together some high level takeaways for you here.

1. Senior Living Communities Are Safe

Safety is the most important message to communicate effectively and compellingly right now. Let the public know that you follow the Centers for Disease Control’s guidance and incorporate best practices into your procedures related to COVID-19. Another safety aspect to include is visitor limitation, sanitization, virus specific training and specific protocols you have in place to ensure the safety of your residents. Finally, assure prospective clients that you have ample long-term supplies of PPE and other supplies that may be reduced in quantity to the regular public.

2. Elderly Care Facilities Promote Safe Socialization

Seniors sometimes battle loneliness and feelings of isolation, especially during periods of quarantine that come along with a pandemic. In residential living, there are opportunities for safe socializing and community living. Teams take all the necessary precautions to sanitize and effectively mitigate the risk that comes with community living, while also allowing opportunities to be active and engaged. Since isolation is linked to adverse mental health outcomes, especially for the elderly, sharing your strategies on interpersonal communication and engagement help both new and existing residents feel more comfortable.

3. Trained Medical Professionals Oversee Medical Safety

There is always some level of risk for COVID-19, but with the proper precautions and oversight, that risk can be mitigated. When using on-site medical professionals, residents can be seen, diagnosed, and treated more quickly and with less exposure than when traveling to see a primary care physician. This results in more active monitoring and faster treatment. Medical teams and residential staff are also better equipped to sanitize and execute CDC policies that protect the most vulnerable population. The end result is improved quality of care with less risk to exposure.

4. Care Facilities Allow for Exercise and Physical Activities

Physical activity among the elderly is directly related to mental and emotional health. In assisted living communities, clients can choose to participate in a variety of exercise programs such as stretch daily, walks, virtual and non-virtual activities. A senior living at home may not feel a need to exercise or does not have someone to motivate them to get up and move.  It is important to explain to prospective residents the importance of staying active even while faced with the obstacles of social distancing and how important that is to their wellbeing.

5. Families Can Focus on Relationships as Opposed to Care

When an aging family member moves into an assisted living community, the adult children are often relieved that there is now a partner to assist their loved one. Many families experience a loss or reversal of their roles within the family unit. Relationships might be strained, as many adults do not want their children telling them what to do.  Many families find that by letting go of the care aspect of providing for their loved one, they can shift and realign themselves with their loved one’s  Providing care, supervision and observation gives many families peace of mind, making residential facilities one of the best options for their relationship that need full time care. As an added benefit these communities provide an environment for parents and children to interact in a more meaningful way that may reduce family tensions.

Senior Living Is Still a Safe and Viable Option

Information about COVID-19 changes  rapidly, and all senior living communities should be dedicated to staying informed. Understanding and taking ownership of the information being used in your marketing and communications is key in this process. The process ensures that prospective residents and their families have the most relevant information available to them so they can make the best decisions possible. When managed correctly with proper safety precautions, RCFEs are still among the best solutions for providing a high level of care, comfort, and most importantly safety to those that need it the most.

If you or your RCFE is looking for guidance during this difficult time please don’t hesitate to reach out to Assisted Living Education. We are here to help and support our clients and their businesses.

15 Terms All RCFE Administrators Should Know

Just a cursory scroll through the RCFE Manual of Policies and Procedures from the California Department of Social Services illustrates just how many different terms you should be familiar with as an RCFE Administrator. In fact, they number in the hundreds. Wouldn’t that be a long blog post! In the interest of brevity, we wanted to share with you some of the most important. Here are the top 15 terms that you need to know if you are an RCFE Administrator or are pursuing RCFE certification. 

  1. Dementia Plan of Operation:  An amendment to a Plan of Operation that details a facility’s dementia care intentions, policies, and procedures. The California Department of Social Services requires that you have in place a Dementia Plan of Operation before you can serve this fast and growing demand market.
  2. Hospice Waiver RequestThe written request a licensee must submit to the DSS and be approved for in order to be permitted to retain terminally ill patients.
  3. RCFE Admissions Agreement:  The contract that includes all applicable documents that a resident or their responsible guardian must sign as a condition of their admission to an RCFE.
  4. RCFE Admission Package:  The full packet of documents, rules, policies, releases, and agreements, etc., that a prospective resident or their conservator must read through, sign (where applicable), and return. This package includes the aforementioned Admission Agreement.
  5. RCFE Emergency Disaster Plan:  A plan, including emergency contacts and procedures, that is required by the DSS to prepare your facility staff and residents in the event of a disaster or emergency.
  6. OSHA Manual for RCFE:  A manual for Residential Care Facilities to help guide compliance with OSHA safety regulations.
  7. RCFE Employee Handbook:  The company policy and information manual provided to an employee by an RCFE.
  8. Plan of Operation for RCFE:  The definitive operational plan and its related materials that a facility must maintain on facility and submit to a licensing agency with the license application.
  9. RCFE Operations Manual:  The document of approved standard procedures that a Residential Care Facility for the Elderly must provide to its employees to ensure job functions are performed accurately, efficiently, and uniformly.
  10. RCFE Staff Training Classes:  The vital training classes that all prospective and current employees must take as a condition of employment, continued or otherwise. 
  11. RCFE Test Preparation:  An educational tool designed to help your study for your California Initial RCFE Administrator Certification exam.
  12. RCFE Administrator:  The person designated by the licensee to oversee and manage a Residential Care Facility for the Elderly. (May also be the licensee themselves.
  13. RCFE License:  The basic permit to operate a residential care facility for the elderly issued to you by the California Department of Social ServicesRCFE Live CEUs:  The in-person, in-room continuing education classes (or units) that may be used to renew your RCFE and/or ARF certificate. The DSS requires that at least 20 of the 40 hours necessary for recertification be live.
  14. RCFE Online CEUs:  Online continuing education classes that may be used in conjunction with the 20 required Live CEUs to fulfill the 40 hour training requirement for certificate renewal
  15. Department of Social Services (DSS): the governing body in California that provides program oversite for the most vulnerable of California’s population. Part of the DSS is the Community Care Licensing Division which is in charge of licensing and regulations for RCFE’s. Due to COVID-19, there have been changes to guidelines for every RCFE administrator and staff member to follow.

Earning your RCFE Certification is so much more than understanding a few words in a blog post. It’s a life-changing undertaking, and we’re here to guide you along the way. Enroll with Assisted Living Education today.

If you are interested in learning more about important terms, concepts, and informational resources related to running an RCFE, please check out our RCFE comprehensive glossary page.  This comprehensive list will point you in the right direction for getting up to speed with the latest industry terms and knowledge needed for RCFE certification and licensure.

We always welcome your feedback, and if you have other important terms you would like added to the list, please let us know.  Assisted Living Education is a recognized leader in the industry, and our instructors have years of professional RCFE experience that will help ensure your success in this burgeoning industry.