Why have “care plans” become such an issue? Should it be an issue? Care plans do exist in residential care but are not written by administrators or staff. Instead, and as required by laws and regulations, home health and hospice staff write care plans for one simple and understandable reason—care plans are a medical approach to a resident’s medical condition. There is only one definition of “care plan” in Title 22 and it is clearly for hospice, and the definition references “plan of care.” The definition is plain: “‘Hospice Care Plan’ means the hospice agency’s written plan of care for a terminally ill resident. The hospice shall retain overall responsibility for the development and maintenance of the plan….”

Why do analysts insist that social, non-medical facilities write “care plans” when no requirements exists? Residential care represents “the least restrictive environment” states Health and Safety Code 1569.71, and 1569.1 states that RCFEs are “not primarily medically oriented” and “represent a humane approach to meeting the housing, social and service needs of older persons, and can provide a homelike environment.”

What place do care plans have in a “least restrictive” and “homelike environments?” The truth is simple: care plans are not required unless written by a medical professional for a medical condition and as ordered by a medical provider as a “method of intervention” under Title 22 87611(b). Title 22s resident records section does not require anything remotely tied to a care plan, and “needs and services plans” has never been in the RCFE Title 22. The approach is “Where in Title 22, clearly and plainly stated in the regulations of the state, are care plans required?” No analyst can show you.