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HOSPICE & RESIDENTIAL CARE

Hospice in an RCFE: How Residential Care and Hospice Work Together

Clarify the distinct responsibilities of the RCFE, hospice team, resident and family when hospice services are provided in residential care.

A hospice nurse supporting an older resident and her daughter in a home-like room

A resident may receive hospice services in an RCFE when regulatory requirements are met and the facility can safely support the person. Hospice brings an interdisciplinary clinical team focused on comfort and quality of life. The RCFE continues to provide housing, non-medical care and supervision. Families need a coordinated plan rather than assuming hospice supplies around-the-clock bedside staff.

Two teams, two roles

The hospice agency may provide nursing, social work, spiritual care, aides, medications and equipment related to the hospice plan. Visit frequency is based on the plan of care and condition.

RCFE staff continue daily support and observe changes. They must know how to reach hospice and what to do between visits. Ask which tasks belong to each team.

Build the plan before a crisis

Discuss goals of care, expected symptoms, comfort medications, equipment, after-hours contacts and family preferences. Ensure relevant orders and advance-care documents are available to the appropriate teams.

Ask what would trigger a hospice visit, emergency call or transfer. Families may have strong preferences, but staff need clear legal and clinical instructions.

Ask about staffing and additional support

Hospice is not automatically continuous one-to-one caregiving. If the resident needs prolonged bedside assistance, turning, feeding or supervision beyond the RCFE’s plan, ask how that support will be provided and paid for.

The facility should be candid about what its staff can do across all shifts. Needs may rise quickly near the end of life.

  • Which hospice agency is involved?
  • Who is the 24/7 hospice contact?
  • What equipment and medication will arrive?
  • What will RCFE staff do between visits?
  • What extra caregiving may be needed?
  • How will family be notified of changes?

Protect comfort and dignity

Ask how privacy, visitors, cultural practices and spiritual needs will be honored. Discuss food and fluid preferences with the clinical team rather than creating conflict around intake.

The resident retains rights and should be involved in decisions to the extent possible. Family goals should not erase the resident’s expressed choices.

Review financial terms

Hospice coverage does not automatically pay the RCFE room-and-board charge. Review the admission agreement, hospice benefit and any increased care fees separately.

For contract questions, return to the RCFE admission agreement guide.

Supporting daily well-being in a nature-rich setting

Huntington Manor’s Poway grounds create more than a pleasant backdrop. Garden views, birds, outdoor paths and the sound of water can offer opportunities for quiet, conversation, light activity and familiar routines. These environmental features support daily life; they do not replace medical evaluation, therapy or individualized care planning.

Sources and further reading

  1. California Department of Aging: Assisted Living Facilities (opens in a new tab)
  2. CDSS: Residential Care Regulations (opens in a new tab)
  3. CDSS: LIC 613C-2 Personal Rights of RCFE Residents (opens in a new tab)

This article is educational and does not replace individualized medical, legal, financial or benefits advice. Program rules, provider networks and eligibility can change; confirm current details with the responsible agency or health plan.

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