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Violation

California Code § 87633(a)(4)Hospice Care Plans

How CCLD inspectors cite this regulation, what providers do to stay clear of it, and where it appears in the public record.

Type B, generalAffects rcfe27 facilities cited in the last 90 days
ℹ️ Educational reference based on public CCLD inspection records. Not legal or compliance advice. Verify requirements with official sources. Full disclaimer →

Regulation text

What California Code § 87633(a)(4) actually says

California Code § 87633(a)(4)

A written hospice care plan which specifies the care, services, and necessary medical intervention related to the terminal illness as necessary to supplement the care and supervision provided by the facility is developed for each terminally ill resident or prospective resident by that resident's hospice agency, and agreed to by the licensee and the resident, or prospective resident, or the resident's or prospective resident's Health Care Surrogate Decision Maker, if any, prior to the initiation of hospice services in the facility for that resident, and all hospice care plans are fully implemented by the licensee and by the hospice(s).

From the field

What providers tell us about this citation

Based on community experience, not official guidance.

28 California RCFEs were cited for missing or incomplete hospice care plans, with Kern County alone accounting for 7 citations. An LPA will request hospice documentation for every terminal resident during inspection. Keep a signed copy of each hospice care plan in the resident file and a second copy accessible to caregiving staff, because an unsigned or missing plan triggers a citation even if hospice services have already started.

By the numbers

27*CCLD
facilities cited in the last 90 days

That is 1 in 500 facilities CCLD inspected.

SOURCE

*CCLD: California Community Care Licensing Divisionviolation_citationsUpdated weekly

12*CCLD
counties where this citation appeared

SOURCE

*CCLD: California Community Care Licensing Divisionviolation_citationsUpdated weekly

--*CCLD
rank among most-common citations

SOURCE

*CCLD: California Community Care Licensing Divisionviolation_citationsUpdated weekly

Trajectory
Steady

Last 90 days vs. previous 90 days.

27 facilities were cited for this in the last 90 days. See if yours is one of them.

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What other providers do

Common practices to stay clear of Hospice Care Plans

Common practices shared by providers. Confirm requirements with your licensing analyst.

Common practices

What to avoid

  • Allowing hospice services to begin before the written care plan is completed and signed by all parties
  • Failing to implement specific hospice care plan interventions because staff assumed the hospice agency would handle them alone
  • Not updating the hospice care plan when a resident's terminal illness requires new medical interventions

Regional record

Where this citation appeared in the past 90 days

Citation counts and rates by California county, drawn from CCLD inspection records.

Regional citations for Hospice Care Plans, last 90 days
CountyCitations
Kern7
Los Angeles5
Fresno3
Orange2
Sacramento2
Contra Costa2
Sonoma1
Ventura1
Imperial1
Riverside1

SOURCE

*CCLD: California Community Care Licensing Divisionviolation_citationsUpdated weekly

Public record

Check any facility for § 87633(a)(4)

Free public record. No account needed.

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FAQ

Frequently asked questions

Answers based on public CCLD data and regulation text. May not reflect recent changes.

What is a hospice care plan violation in an RCFE?
A violation of Title 22, Section 87633(a)(4) occurs when an RCFE does not have a written hospice care plan for a terminally ill resident receiving hospice services. The plan must specify the care, services, and medical interventions the hospice agency will provide to supplement your facility's regular care. Without this plan, staff may not know which hospice responsibilities belong to the facility versus the agency.
How common are hospice care plan violations in California assisted living?
According to CCLD inspection records, 28 California RCFEs were cited for this deficiency across 13 counties, with all citations classified as Type B. Kern County had the highest count at 7 citations, followed by Los Angeles at 5. This violation affected 0.21% of California RCFEs and is more frequent in counties with larger hospice-served populations.
What happens if an RCFE is cited for a missing hospice care plan?
This violation is classified as Type B, meaning it poses a potential risk to residents if not corrected. The facility must submit a plan of correction to CCLD and implement the missing hospice care plan. Type B citations carry lower penalties than Type A, but multiple Type B deficiencies in end-of-life care can lead to increased inspection frequency and closer scrutiny of your resident care practices.
How do I fix or prevent a hospice care plan citation?
Require the hospice agency to provide the written care plan before any hospice staff begin services in your facility. Collect signatures from the licensee, the resident or their surrogate decision maker, and the hospice agency representative. Keep the signed plan in the resident's file and train caregiving staff on which hospice interventions they must support. Review each terminal resident's hospice plan monthly with the hospice coordinator.
Does a hospice care plan violation affect my RCFE license?
Yes. CCLD records all citations, including Type B hospice care plan deficiencies, against your facility's license. A pattern of end-of-life care violations signals to Licensing Program Analysts that your community needs closer oversight. Correcting the deficiency quickly and maintaining complete hospice documentation for every terminal resident protects your license from escalated enforcement actions.

Related violations

Other citations in this regulation family

This information is educational and does not constitute legal advice. Consult a licensed residential care compliance consultant for guidance specific to your facility. Citation data is sourced from California Community Care Licensing Division public records and is refreshed regularly.