The concept of assisted living predated the enactment of Medicare, but there were no laws or regulations addressing how to operate care homes. In The Gerontologist, Keren Brown Wilson, PhD said residential care and assisted living started evolving into a more formalized setting in 1979.
In 1973, California enacted the community care facilities act with the purpose of providing quality care in a homelike setting to mentally ill, and developmentally and physically disabled adults and children. Disabled elderly were being housed with those adults but the setting was not optimal. In 1985, the legislature enacted the RCFE Act to give the elderly a better option.
In 2020, the number of RCFEs may be rebounding after the horrific closure of over 1,000 between 2007-2009. Although the number of RCFEs only increased by one from July 2018 to June 2019, the apparent increase from July 2019 to June 2020 is estimated at 127. However, it also appears the number of “placed elderly” did not significantly increase in proportion to the increase in facilities.
What is your vision of California RCFEs after Covid-19? I think the industry will receive more oversight from the Department of Public Health Services (nursing home regulators) with stricter guidelines for compliance and more laws and regulations. If that happens, there will be more operators exiting the industry, more facilities going “underground,” more elders abused in horrible care homes, more caregivers financially abused (something we see now) and an attempt to return to days without government intervention.
The number of licensed RCFEs will go down, but more will open—illegally.