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California’s Form 602 for Residential Care Facilities

Dana Larsen
By Dana LarsenJuly 7, 2016

Families in California have an additional step when moving their loved ones into residential care facilities for the elderly (RCFE). They have to submit a physician’s report, called Form 602.

Read below to learn more about the form and get answers to commonly asked questions.

California’s Form 602 for Residential Care

A physician’s report, Form 602, must be completed for all residents, or prospective residents, of residential care facilities for the elderly licensed by the California Department of Social Services. The physician’s report requires the following:

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  1. A patient history.
  2. A patient physical examination.
  3. A Tuberculosis skin test (normally takes 2-3 days to get a result) or a chest x-ray to rule out active pulmonary tuberculosis.

Since moves to these communities can happen quickly, it’s important to learn about the form, what’s needed and what your family might want to consider in preparation of admittance to the community of your choice.

Read commonly asked questions below to learn more about Form 602’s requirements and what your family can do to avoid potential hold-ups or problems that could arise that could delay the RCFE move-in process.

1. What is Form 602 and Why Do Families Need It in California?

Form 602 is a physician’s report, state-required form, that assists in the communities knowing what the potential resident needs pertaining to care, medication, assistance and more. This is a standard State of California/Dept. of Social Services form that will help determine the care needs, diagnosis and medical history of the senior. A recent TB test will be required (that is good for 6 months), or a chest X-ray (that is good for one year), to show negative results for TB. Please note that this form is required at any RCFE community in California.

2. Do Doctors Need to Complete the Form?

Yes, a senior’s primary physician needs to complete this form; or the attending physician, if potential resident is in a skilled nursing community or hospital. Physicians, especially geriatricians, are very familiar with these forms.

Please note that it is preferable to have the form completed by the potential resident’s primary care physician because they have a more in-depth knowledge of the potential resident. Also, that it can take a little time to get these forms returned, so the earlier in the process the form is submitted to the physician, the better.

3. How Do Families Get an Appointment with Their Elder’s Doctor to Discuss the Form 602?

Families would make an appointment like they would go about getting any other appointment. However, it’s important to mention when making the appointment that the purpose of the appointment is to the complete a physician’s report, form 602 (as this can take extra time and the office needs to be prepared). It’s important to note that, depending on the type of insurance or medical group, some require you to go through their member services, initially.

4. Where Can Families Access Form 602?

Families can find the form on the California Department of Social Services website.

A Place for Mom advisors also have the forms handy to send them to families in California who are in need.

5. Is There Anything Else We Need to Know About Form 602 for Residential Care Facilities for the Elderly?

There are multiple items that need specific attention on the form. For example, clarification of mild cognitive impairment (MCI) compared to dementia, or specifics about whether the senior can leave the community with or without assistance (meaning, this is physically, not with an assistive device like a wheelchair, cane or walker). The form is designed to properly inform the residential care community about the resident’s current medical and care condition so that they can receive the best possible care and supervision. 

It’s important to note that all boxes and items on the form need to be filled out to ensure there are no questions about care. If a mistake is made on the form, it should not just be crossed out and corrected on the form. There needs to be a new page explaining the change, with a signature of the physician next to the correction.

Families should be the biggest advocates when it comes to getting the forms filled out accurately and in a timely manner. They should contact the physician’s office to check the form’s progress and make sure they clearly communicate the importance of getting the form back in an expeditious manner as it assists in the assessment of not only cost of care, but also in helping the family make a well-informed choice when it comes to picking a new home with and for their loved one.

Does your family have experience with California’s Form 602? What questions do you have about California’s Form 602 for residential care facilities? Share them with us in the comments below.

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