What health needs can a California care home take?
Daily care, medicines and many health conditions, but not 24-hour skilled nursing. Some conditions, such as a feeding tube, rule a care home out unless the resident is on hospice in a home with a hospice care waiver.
Checked against Title 22 and the Health and Safety CodeHow we check
- May care for
- Oxygen, diabetes, injections, catheters, wound care and the other conditions on the state’s list, each under its rules.
- May not admit or keep
- Someone who needs 24-hour skilled nursing, has active tuberculosis, or has a condition such as a feeding tube, a tracheostomy or a stage 3 or 4 pressure injury.
- The exception
- A resident on hospice, in a home with the state’s hospice care waiver, under a hospice care plan.
This guide covers licensed care homes for older adults: assisted living and board and care (the state calls them RCFEs). A nursing home is the place for daily skilled nursing. The home’s written appraisal decides for one person.
Checked against Title 22 and the Health and Safety CodeHow we check
Check what a care home can provide
Pick the needs of the person moving in to see how California’s rules for licensed care homes treat each one.
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The rules this check uses
The law’s own words, with the day we last checked each one.
“Residential care facility for the elderly” means a housing arrangement chosen voluntarily by persons 60 years of age or over, or their authorized representative, where varying levels and intensities of care and supervision, protective supervision, or personal care are provided, based upon their varying needs, as determined in order to be admitted and to remain in the facility. Persons under 60 years of age with compatible needs may be allowed to be admitted or retained in a residential care facility for the elderly as specified in Section 1569.316.
The following persons may be accepted or retained by the licensee:
(1) Persons capable of administering their own medications.
(2) Persons receiving medical care and treatment outside the facility or who are receiving needed medical care from a visiting nurse.
(3) Persons who may need assistance with self-administration of medication as specified in Section 87465, Incidental Medical and Dental Care Services.
(4) Persons who display behavioral expression as defined in Section 87101, Definitions.
(5) Persons who may need assistance with managing money.
(6) Persons with mild temporary emotional disturbance resulting from personal loss or change in living arrangement.
(7) Persons who are bedridden provided the requirements of Section 87606 are met.
(8) Persons who are under 60 years of age whose needs are compatible with other residents in care, if they require the same amount of care and supervision as do the other residents in the facility.
(9) Persons who have been diagnosed as terminally ill and who have obtained the services of hospice, certified in accordance with federal medicare conditions of participation and licensure, provided the licensee has obtained a facility hospice care waiver in accordance with the provisions of Section 87632, Hospice Care Waiver, and hospice care is being provided in accordance with the provisions of Section 87633, Hospice Care for Terminally Ill Residents.
This section applies to the care of residents diagnosed with dementia. Mild cognitive impairment, as defined in Section 87101, Definitions, is not considered to be dementia.
Ensuring staff receive the following training as part of the training requirements specified in Section 87208 Plan of Operation:
(A) Dementia care, including, but not limited to, knowledge about hydration, nutrition, skin care, communication, therapeutic activities, behavioral challenges, the environment, and assisting with activities of daily living;
(B) Recognizing symptoms that may create or aggravate behavioral expression, as defined in Section 87101, Definitions, including, but not limited to, dehydration, urinary tract infections, and problems with swallowing; and
(C) Recognizing the effects of medications commonly used to reduce behavioral expression.
The licensee shall ensure that the facility has an auditory device or other staff alert feature to monitor exits on exterior doors and perimeter fence gates accessible to those residents who may be at risk for elopement, as defined in Section 87101, Definitions.
In order to accept or retain terminally ill residents and permit them to receive care from a hospice agency, the licensee shall have obtained a facility hospice care waiver from the Department.
Important! The licensee must have an approved hospice waiver or an exception from the department when accepting or retaining residents who receive hospice services.
“Nonambulatory Person” means a person who is unable to leave a building unassisted under emergency conditions. It includes, but is not limited to, those persons who depend upon mechanical aids such as crutches, walkers, and wheelchairs. It also includes persons who are unable, or likely to be unable, to respond physically or mentally to a sensory signal approved by the State Fire Marshal, or an oral instruction relating to fire or other dangers and, if unassisted, to take appropriate action relating to such danger.
All facilities shall maintain a fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal. Prior to accepting or retaining any of the following types of persons, the applicant or licensee shall notify the licensing agency and obtain an appropriate fire clearance approved by the city, county, or city and county fire department or district providing fire protection services, or the State Fire Marshal:
(1) Nonambulatory persons.
(2) Bedridden persons
Notwithstanding paragraph (2) of subdivision (a), bedridden persons may be admitted to, and remain in, residential care facilities for the elderly that secure and maintain an appropriate fire clearance. A fire clearance shall be issued to a facility in which one or more bedridden persons reside if either of the following conditions are met:
(1) The fire safety requirements are met. Residents who are unable to independently transfer to and from bed, but who do not need assistance to turn or reposition in bed, shall be considered nonambulatory for purposes of this paragraph.
(2) Alternative methods of protection are approved.
The licensee may provide care for residents who have any of the following restricted health conditions, or who require any of the following health services:
(1) Administration of oxygen as specified in Section 87618.
(2) Catheter care as specified in Section 87623.
(3) Colostomy/ileostomy care as specified in Section 87621.
(4) Contractures as specified in Section 87626.
(5) Diabetes as specified in Section 87628.
(6) Enemas, suppositories, and/or fecal impaction removal as specified in Section 87622.
(7) Incontinence of bowel and/or bladder as specified in Section 87625.
(8) Injections as specified in Section 87629.
(9) Intermittent Positive Pressure Breathing Machine use as specified in Section 87619.
(10) Stage 1 and 2 pressure injuries as specified in Section 87631(a)(3).
(11) Wound care as specified in Section 87631.
Ensure that facility staff who will participate in meeting the resident's specialized care needs complete training provided by a licensed professional sufficient to meet those needs.
(A) Training shall include hands-on instruction in both general procedures and resident-specific procedures.
(B) Training shall be completed prior to the staff providing services to the resident.
Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly:
(1) Stage 3 and 4 pressure injuries.
(2) Gastrostomy tubes.
(3) Naso-gastric tubes.
(4) Staphylococcus aureus (“staph”) infection or other serious infection.
(5) Residents who depend on others to perform all activities of daily living for them as set forth in Section 87459, Functional Capabilities.
(6) Tracheostomies.
Facilities that have satisfied the requirements of Section 87632, Hospice Care Waiver, are not required to submit written exception requests under this section for residents or prospective residents with restricted health conditions under Section 87612 and/or prohibited health conditions under Section 87615 provided those residents have been diagnosed as terminally ill and are receiving hospice services in accordance with a hospice care plan as required under Section 87633, Hospice Care for Terminally Ill Residents, and the treatment of such restricted and/or prohibited health conditions is specifically addressed in the hospice care plan.
As specified in Section 87209, Program Flexibility, the licensee may submit a written exception request if he/she agrees that the resident has a prohibited and/or restrictive health condition but believes that the intent of the law can be met through alternative means.
No resident shall be accepted or retained if any of the following apply:
(1) The resident has active communicable tuberculosis.
(2) The resident requires 24-hour, skilled nursing or intermediate care as specified in Health and Safety Code Sections 1569.72(a) and (a)(1).
Except as otherwise provided in subdivision (d), no resident shall be admitted or retained in a residential care facility for the elderly if any of the following apply:
(1) The resident requires 24-hour, skilled nursing or intermediate care.
(2) The resident is bedridden, other than for a temporary illness or for recovery from surgery.
Which health needs can a care home care for?
A care home gives daily care: help with bathing, dressing, meals and medicines, and supervision. It may also care for residents with these health conditions, as the state lists them: Title 22 §87612(a)
- oxygen;
- catheter care;
- colostomy or ileostomy care;
- contractures;
- diabetes;
- enemas, suppositories or fecal impaction removal;
- incontinence of bowel or bladder;
- injections;
- an Intermittent Positive Pressure Breathing machine;
- stage 1 and 2 pressure injuries;
- wound care.
Each has its own rules in Title 22. Staff who give the care must first be trained for it by a licensed professional. Title 22 §87613(a)(2)
“Can you care for these needs, who on your staff would do it, and what training have they had?”
Which conditions rule a care home out?
A care home may not accept or keep a resident with active communicable tuberculosis, or one who needs 24-hour skilled nursing or intermediate care. Title 22 §87455(c)
Nor may it admit or keep a resident with these conditions, in the state’s words:
“Persons who require health services for or have a health condition including, but not limited to, those specified below shall not be admitted or retained in a residential care facility for the elderly:(1) Stage 3 and 4 pressure injuries.(2) Gastrostomy tubes.(3) Naso-gastric tubes.(4) Staphylococcus aureus (“staph”) infection or other serious infection.(5) Residents who depend on others to perform all activities of daily living for them as set forth in Section 87459, Functional Capabilities.(6) Tracheostomies.”
The list begins “including, but not limited to”: a condition not on it can still be beyond what a home may care for.
What about someone who is bedridden?
A care home may not admit or keep a bedridden resident, except during a temporary illness or recovery from surgery. Health and Safety Code §1569.72(a) A temporary illness is one that lasts 14 days or less. Health and Safety Code §1569.72(d)(1)
A home with a fire clearance for bedridden residents may admit and keep them. Health and Safety Code §1569.72(c) That clearance is a fire safety approval, not a waiver. A home’s page shows it when the state record has it, and “not on file” when it does not.
Can hospice change the answer?
Yes. A home that holds the state’s hospice care waiver needs no further exception for a resident who is terminally ill and on hospice, when the hospice care plan covers the condition. Title 22 §87616(c)
Hospice in a care home explains the approval and what must be in place first.
Can a home ask the state for an exception?
Yes. A home that agrees a resident has a prohibited or restricted condition, but believes the intent of the law can still be met another way, may ask the state in writing for an exception. Title 22 §87616(a) The state decides; until it says yes, the general rule holds.
What if needs change after moving in?
A home may give written notice to leave if a reappraisal finds a need the home is not right for. Title 22 §87224(a)
Separately, the state must order a move when a resident’s health condition is beyond the license, needs hospital care, or is on the prohibited lists. Title 22 §87637(a) The resident or their responsible person may ask for a review of that order, in writing, within 3 working days of receiving it. Title 22 §87638(b)
What about dementia?
Any licensed care home may care for a resident with dementia, under Title 22’s dementia rules. Title 22 §87705(a) Memory care in California explains them.
Licensed care homes near you
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Questions families ask · 5
What disqualifies someone from assisted living?
Needing 24-hour skilled nursing, active tuberculosis, or a condition on the state’s prohibited list, such as a feeding tube or a tracheostomy. A resident on hospice in a home with a hospice care waiver is the exception.
Can someone on oxygen live in assisted living?
Yes. Oxygen is on the state’s list of conditions a home may care for, under its rules.
Can a care home take someone with a feeding tube?
Not as a rule: gastrostomy and naso-gastric tubes are on the prohibited list. The hospice exception, or a written exception the state approves, are the two ways around it.
Can a care home take someone in a wheelchair?
Yes, a home whose fire clearance covers residents who cannot leave the building on their own in an emergency. A home’s page shows that clearance when the state record has it.
Can a home make a resident leave when their health changes?
It may, if a reappraisal finds the home is no longer right for the resident, with written notice. The state can also order a move for some health conditions.
Bring the resident’s doctor’s report to each home. The home’s own appraisal decides for one person.
Next, step 2 of 6: Ways to pay for care
- Paying for a care home in California
Most residents pay privately: about 17% had any care paid by Medicaid in 2022 (CDC). The California median for assisted living was $7,000 a month in 2025 (CareScout).
- Medi-Cal’s Assisted Living Waiver
Medi-Cal can pay a participating home for care, not rent, in 15 counties. 15,910 people were waiting in March 2026 (DHCS).
- SSI in a care home
SSI/SSP pays $1,626.07 a month in a licensed care home in 2026. A home that accepts it may charge $1,444.07 for basic services.
- When the money runs out
A home may give 30 days’ notice once the basic rate is 10 days late. Ask before moving in whether it will take SSI or Medi-Cal later.