Why Families Should Never Ask to Leave Info Off the LIC 602A
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Moving a loved one into an assisted living facility or board-and-care home is one of the most stressful experiences a family can go through. There is often emotional guilt and a desperate desire to find a "nice, homelike" place rather than a clinical one.
In this high-pressure environment, families sometimes view the LIC 602A (Physician’s Report for Residential Care Facilities for the Elderly) as a bureaucratic hurdle to be cleared. This leads to a dangerous temptation: asking the doctor to "soften" the report—omitting a history of aggression, downplaying incontinence, or leaving off a dementia diagnosis to ensure the loved one is accepted into a specific facility.
While the motivation is often love (or desperation), hiding medical facts is not a strategy—it is a safety hazard. It endangers the resident, the facility staff, and the physician.
Here is why total transparency on the LIC 602A is non-negotiable, supported by data from major health organizations.
The LIC 602A Is Not Just Paperwork; It Is a Safety Manual
To a family member, the form looks like red tape. To a care facility (RCFE), it is the foundation of the Plan of Care.
Facilities in California are licensed for specific levels of care. Some are licensed for "non-ambulatory" residents (those who cannot get out of bed or a chair without help); others are not. Some have a "dementia waiver" allowing them to have locked doors; others do not.
If you ask a doctor to check "Ambulatory" when your parent actually needs physical help walking, you are placing them in a building that may legally lack the staff to evacuate them during a fire. You aren't "getting them in"; you are setting them up for a potential tragedy.
CDC (Centers for Disease Control and Prevention): CDC guidelines on long-term care safety emphasize that accurate assessment of mobility is critical for fall prevention. If a facility is unaware of a patient's instability, they cannot implement necessary safety protocols. Misclassifying mobility is a leading cause of preventable injuries in care settings.
Hiding Problems Leads to Immediate Eviction
The most common reason families omit information is the fear of rejection. “If they know Dad yells at night, they won't take him.”
This may be true for that specific facility. However, omission does not cure the behavior. If a resident moves in and immediately displays behaviors that were hidden—such as wandering, combativeness, or complex medical needs—the facility will quickly realize they cannot handle the resident.
This triggers an eviction notice. Instead of settling in, the family faces an emergency demand to find a new place within 30 days (or even 3 days if there is a safety threat).
NIH (National Institutes of Health): Research confirms that forced, rapid relocation of elderly patients causes "Transfer Trauma" (Relocation Stress Syndrome). According to NIH data, frequent and unprepared moves are linked to a sharp decline in cognitive function, increased depression, and physical deterioration. By hiding the truth and causing an inevitable eviction, families unknowingly expose their loved ones to this trauma.
Doctors Cannot Treat "Blindfolded"
When a family asks a doctor to leave information off the report, they are creating a gap in the medical history.
The caregivers and new doctors at the facility rely on the LIC 602A to know how to treat the resident. If a history of adverse drug reactions or behavioral triggers is deleted, the new staff is flying blind. This is a direct path to medical errors.
Kaiser Permanente (Division of Research): Studies by Kaiser Permanente researchers highlight that accurate medical documentation and continuity of care are the strongest defenses against medical error. Gaps in patient history during the transition from home to a care facility significantly increase the risk of adverse events and hospital readmissions.
Aesthetics vs. Safety: The "Chandelier Trap"
Families often hide medical realities because they want their loved one in a facility with "chandeliers and granite countertops" rather than a more clinical setting that is actually equipped to handle higher needs.
This prioritizes optics over safety.
True Advocacy: Ensuring your loved one is in a place that can handle their worst days, not just their best days.
False Advocacy: Getting them into a "pretty" facility that is ill-equipped to keep them safe.
Mayo Clinic: Experts at the Mayo Clinic note that the living environment must match the stage of the disease, particularly for dementia. Patients who wander or show aggression require specialized strategies and secured environments. Placing such a patient in a standard, open assisted living facility denies them the specialized support they need and increases their anxiety.
Summary: Honesty is the Only Policy
The LIC 602A is the voice of the resident when they cannot speak for themselves. It tells the caregivers: "Here is what I need to be safe. Here is what I need to live well."
Deleting lines from that story doesn't change the reality of the patient's condition; it only removes the safety net. When filling out admission paperwork, families must adopt a policy of radical transparency. It may make finding a facility harder, but it ensures that when you find the right one, your loved one can stay there safely and permanently.
List of References
California Department of Social Services (CDSS). (2025). Form LIC 602A: Medical Assessment for Residential Care Facilities for the Elderly. [PDF Document].
Centers for Disease Control and Prevention (CDC). (2015). Falls in Nursing Homes. CDC 24/7: Saving Lives, Protecting People.
Walker, C., Curry, L. C., & Hogstel, M. O. (2007). Relocation stress syndrome in older adults transitioning from home to a long-term care facility: Myth or reality? Journal of Psychosocial Nursing and Mental Health Services, 45(1), 38-45. (Индексировано в PubMed/NIH).
Kaiser Permanente Division of Research. (2021). Predictive model paired with case management reduced rate of readmitted hospital patients. Research Spotlight.
Mayo Clinic Staff. (2023). Dementia care: Housing options. Mayo Clinic Patient Care & Health Information.
