Stuck on the LIC 602A? How to Secure a Physician's Signature for RCFE Placement
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For families in California, the LIC 602A (Physician’s Report) is the most important document when transitioning a loved one into an Assisted Living or Residential Care Facility for the Elderly (RCFE). It serves as the legal "green light," proving the facility can meet the resident's specific needs.
When a primary care physician (PCP) refuses to sign this form, it can stall the move and cause immense stress. This guide explains why doctors hesitate and provides a clear path to getting the paperwork completed.
Understand the Medical Reasons for Refusal
A doctor’s refusal is usually not personal; it is often based on clinical standards and safety protocols:
Tuberculosis (TB) Clearance: The form requires proof that the patient is free of TB. According to federal guidelines, an up-to-date screening (skin test or blood test) is mandatory for anyone entering communal living. Without this, a doctor cannot legally sign.
Cognitive Assessment Needs: If a patient shows signs of confusion, the doctor must perform a formal evaluation. Scientific research suggests that tools like the MMSE (Mini-Mental State Examination) are vital to determine if a senior can safely make decisions.
Lack of Recent Data: Doctors cannot certify a patient’s "functional status" (their ability to walk, eat, or bathe) if they haven't seen them in person recently. Data accuracy is critical for the safety of seniors during transitions.
Key Nuances You Must Know
The Expiration Date
The LIC 602A has a "shelf life." In most cases, it is only valid for 6 months. If your move-in process is delayed, you may need a new form signed based on a fresh evaluation.
Restricted Health Conditions
Pages 2 and 3 of the form cover specific medical conditions like catheter care, open wounds, or oxygen use.
The Risk: If a doctor checks a box for a condition that the facility is not licensed to handle, the move-in will be denied. Discuss these points with the doctor to ensure the facility’s care level matches the report.
Memory Care Requirements
If your loved one is moving into a "secured" Memory Care unit, the doctor must complete the section regarding cognitive impairment. Without a specific statement that the patient requires a "secure perimeter," the facility cannot legally admit them to a locked unit.
A Step-by-Step Plan for Families
Step 1: Schedule a "Paperwork-Specific" Appointment
Don't try to handle this over the phone. Tell the scheduler: "I need an appointment specifically for a physical assessment to complete the LIC 602A form for assisted living." * Pro Tip: Bring an updated list of all medications and any Advance Directives to help the doctor align the form with the patient’s long-term care goals.
Step 2: Pre-Fill the Basics
Help the doctor focus on the clinical parts. Fill out the name, date of birth, and medical history sections yourself. Use "Sign Here" sticky notes on the lines requiring the doctor’s signature and medical license number.
Step 3: Address Liability Concerns
Some doctors fear that signing the form makes them legally responsible if a patient falls at the facility.
The Talking Point: Remind the doctor that the LIC 602A is an assessment tool, not a guarantee of safety. It tells the facility where the patient needs help so they can prevent accidents.
Alternatives if Your Doctor Still Refuses
If your PCP is unavailable or unwilling to sign, you have other options. You do not need your specific PCP; you need any licensed physician.
Specialists: Geriatricians or Neurologists are often more comfortable signing these forms because they specialize in aging and dementia.
Mobile Physicians (House Call Doctors): This is often the easiest path. There are doctors who specialize in visiting seniors at home to perform assessments specifically for RCFE placement. They are experts in the LIC 602A and can often complete it much faster.
Facility Advocacy: Ask the facility's nurse to call your doctor’s office. A "peer-to-peer" conversation can often resolve misunderstandings about the form’s requirements.
References
Centers for Disease Control and Prevention (CDC) – Diagnosing Tuberculosis (Official Screening Guidelines)
National Institutes of Health (NIH) / PMC – Assessing Older Adults' Decision-Making Capacity for Independent Living
National Institutes of Health (NIH) / PMC – Comprehensive Geriatric Assessment in Primary Care Settings
Mayo Clinic – Living Wills and Advance Directives for Medical Decisions
Centers for Medicare & Medicaid Services (CMS) – Medical Review and Compliance Guidelines
Kaiser Permanente Division of Research – Aging and Care Coordination for Seniors
