Handling Resident Transfers Between Facilities: Updating the LIC 602A
| Regulatory Foundation for LIC 602A Compliance | Explains the legal basis of the LIC 602A form and CDSS oversight. |
| Key Purpose of LIC 602A During Resident Transfers | Covers how the form ensures eligibility, supports care planning, and reduces risk. |
| Breaking Down the LIC 602A: Essential Elements | Lists required fields, who can complete the form, and critical data points. |
| Timelines and Triggers for Reassessment | Details validity periods, annual reviews, and when updates are required. |
| Managing Resident Transfers | Describes transfer procedures, temporary returns, and documentation standards. |
| Intersection with Fire Clearance Requirements | Explains mobility categories and the 14-day limit for bedridden residents. |
| Operational Best Practices for Administrators | Outlines SOP creation, digital compliance tools, and confidentiality rules. |
| Risk Matrix for Common Compliance Failures | Summarizes frequent errors and corrective actions for each risk condition. |
| Practical Recommendations and Takeaways | Provides final guidance for maintaining compliance and resident safety. |
When a resident moves between care facilities, every detail matters. The key phrase — Handling Resident Transfers Between Facilities: Updating the LIC 602A Correctly — describes one of the most regulated processes in California’s senior care system. The LIC 602A form, known as the Physician’s Report for Residential Care Facilities for the Elderly (RCFE), determines whether a person is medically eligible to live in an assisted living setting.
This guide explains how to update the form correctly, avoid mistakes, and make each transition safe and lawful.
Why the LIC 602A Form Matters
Oversight and Legal Basis
All RCFEs operate under the supervision of the California Department of Social Services (CDSS) and its licensing branch, Community Care Licensing Division (CCLD).
According to Title 22, Division 6, Section 87458, each resident must have a medical assessment signed by a licensed physician within the past year.
These facilities are licensed to provide only non-medical care and supervision — not skilled nursing. That’s why the LIC 602A form is essential. It confirms whether a resident’s condition fits the RCFE’s license limits. If the physician lists medical needs requiring skilled care, the form signals that the resident may no longer qualify to stay.
The Form as Legal Protection
The LIC 602A protects both the resident and the facility. It ensures that the level of care matches the resident’s actual condition and helps administrators prove compliance. If the updated form shows new medical issues or mobility limits, the RCFE must immediately review whether it can safely provide care. Ignoring such changes can result in fines or license violations.
The Role of LIC 602A in Transfers
Confirming Admission or Return
Whenever a resident moves into a facility — or returns from a hospital or nursing home — the LIC 602A verifies that assisted living remains appropriate for their health status.
Supporting Individualized Care
The details inside the form guide care planning. They show what kind of help a person needs with daily tasks such as walking, bathing, dressing, or managing medications.
Reducing Risk
Accurate documentation helps prevent misunderstandings and legal disputes. By tracking conditions like falls, side effects, or chronic illnesses, the form provides evidence that the facility took proper precautions.
What the LIC 602A Includes
Who Fills Out the Form
Only licensed professionals — MD, DO, NP, or PA — can complete and sign the LIC 602A. While hospital physicians may fill it out at discharge, it’s better if the resident’s primary care doctor (PCP) does it, since they know the full medical history.
Key Information Required
The form covers:
Diagnoses and medical history — main and secondary conditions, length of medical supervision, and treatment notes.
Physical condition — height, weight, blood pressure, and findings from the latest exam.
Tuberculosis (TB) test — date and result of a PPD, IGRA, or chest X-ray. Missing TB data is a common licensing violation.
Daily living abilities (ADLs) — how independently the resident can move, eat, bathe, or dress, and whether help is needed for transfers or mobility.
Medication management — list of current prescriptions and level of supervision required.
Incomplete or outdated forms often lead to citations during inspections.
Timelines and Triggers
Validity Period
For new admissions, the LIC 602A must be dated within 90 days of move-in.
For ongoing residents, a new medical assessment is required every 12 months under CCR §87587.
Significant Changes
Any major change in health or function — such as hospitalization, a fall, or a new diagnosis — requires an updated LIC 602A right away. Facilities cannot wait until the next annual review.
Reporting Serious Incidents
If a resident experiences injury, death, or an unexplained absence, CCR §87561 requires written notification to CDSS within seven days. These reports must align with the medical information in the updated form.
Managing Resident Transfers
Transfers Between RCFE Facilities
Before accepting a transfer, the new facility must have a current LIC 602A, no older than 90 days. The information must match the new admission agreement and care plan. If it doesn’t, admission should be postponed until corrected.
Temporary Transfers and Returns
When a resident returns from a hospital or skilled nursing facility, this is treated as a significant change. A new LIC 602A must show any new diagnoses, medication adjustments, or mobility limits. This ensures the RCFE still meets licensing requirements.
Involuntary Transfers
Involuntary discharge is only allowed for legal reasons, such as when the facility can no longer meet the resident’s needs. The updated LIC 602A serves as official proof that the medical condition has changed enough to require relocation.
Mobility and Fire Clearance
How Mobility Is Defined
The LIC 602A classifies residents into three groups tied to fire clearance:
Ambulatory: Can leave the building without help.
Nonambulatory: Needs help or uses a wheelchair or walker.
Bedridden: Needs assistance turning or changing position in bed.
Changes in mobility status require immediate review of fire safety permissions.
The 14-Day Rule
According to Health & Safety Code §1569.72(c), a bedridden resident may stay in an RCFE for no more than 14 days unless special clearance is granted. If recovery takes longer, the facility must obtain permission or arrange a transfer.
Ignoring this rule is one of the most serious violations in assisted living operations.
Practical Management Steps
Standard Procedures
Each RCFE should follow a clear internal policy (SOP):
Always get an updated LIC 602A after a hospital or SNF stay.
Send the physician request before the resident returns.
Check that the form includes TB test, diagnoses, and mobility data.
These steps ensure the facility has all required documentation before re-admission.
Using Digital Tools
Electronic systems like EHR or eMAR help administrators track due dates, store medical data securely, and set reminders for annual reviews. Automation prevents missed deadlines and improves communication between staff and healthcare providers.
Confidentiality Rules
Each resident, or their legal representative, must authorize the release of medical data by signing the privacy section of the LIC 602A. This step keeps the process compliant with federal privacy standards.
Common Compliance Risks
| Condition in Updated LIC 602A | Compliance Risk | Required Action |
|---|---|---|
| Needs skilled nursing care | Violation of RCFE license | Initiate transfer immediately |
| Bedridden beyond 14 days | Fire clearance violation | Get clearance or discharge resident |
| Nonambulatory without clearance | Safety restriction breach | Update fire clearance immediately |
| Major cognitive decline | Mismatch between needs and care plan | Reassess and adjust services |
| Missing or outdated TB test | Administrative citation | Complete and record test results |
Summary Recommendations
Treat every hospital return as a significant change and update the form.
Get information from the primary care physician whenever possible.
Review mobility and cognitive data regularly.
Use digital alerts for all review deadlines.
Check fire clearance after every medical update.
Following these rules helps RCFEs avoid compliance issues and maintain quality care.
Conclusion
Accurate updates of the LIC 602A during resident transfers keep both facilities and residents safe.
When administrators act quickly and document clearly, they protect their license — and, more importantly, ensure that each person continues to receive the right level of support.
For guidance on completing or reviewing the LIC 602A, facility administrators can consult a licensed geriatric physician familiar with RCFE requirements. A short conversation with a specialist often prevents long-term problems.
Sources Used
California Department of Social Services (CDSS) — Title 22, Division 6, Chapter 8: Residential Care Facilities for the Elderly (RCFE)
California Code of Regulations (CCR) — Section 87458: Medical Assessment
California Code of Regulations (CCR) — Section 87587: Reappraisal of Residents
California Code of Regulations (CCR) — Section 87561: Reporting Requirements
California Health and Safety Code §1569.72(c) — Fire Clearance Requirements for Bedridden Residents
Community Care Licensing Division (CCLD) — Evaluator Manual for RCFEs — Guidelines for Medical Assessments and Significant Change Documentation
California Department of Public Health (CDPH) — Tuberculosis Testing and Reporting Guidelines for Long-Term Care Settings
