California rules, plainly
They said no. Here is what they are actually allowed to say no to.
California regulation splits health conditions into two groups: a short list that normally bars a care home from taking somebody, and a longer list it may accept subject to conditions. Almost every page you will find gets the first one wrong in the same way — by presenting it as final. It is not.
Two things nearly every other page leaves out
The prohibited list is not complete. Regulation 22 CCR 87615 introduces it with the words “including, but not limited to”. A condition that is not named can still bar admission.
And it is not an absolute bar. Under 22 CCR 87616 a community may ask the state for a written exception where it believes it can meet the resident's needs another way. A community holding a hospice care waiver may not have to ask at all.
This matters more than it sounds. A family told flatly that a care home “cannot” take their mother because of a feeding tube often goes and buys skilled nursing instead — which is a different licence, a different building and a great deal more money than they may need to spend.
Group one
Prohibited conditions
22 CCR 87615
These normally bar a community from admitting or keeping a resident:
- Stage 3 and stage 4 pressure injuries
- Gastrostomy tubes
- Naso-gastric tubes
- Staph infection, or another serious infection
- Depending on others to perform all activities of daily living
- A tracheotomy
“Depending on others for all activities of daily living” points to 22 CCR 87459, which covers bathing, dressing and grooming, using the toilet, transferring in and out of a bed or chair, continence and eating — and that list is also open rather than closed. The word is all: needing help with several is not the same thing.
Group two
Restricted conditions
22 CCR 87612
A community may care for these, subject to the conditions in the section named beside each:
- Oxygen22 CCR 87618
- Catheter care22 CCR 87623
- Colostomy or ileostomy care22 CCR 87621
- Contractures22 CCR 87626
- Diabetes22 CCR 87628
- Enemas, suppositories, impaction removal22 CCR 87622
- Incontinence of bowel or bladder22 CCR 87625
- Injections22 CCR 87629
- Intermittent positive pressure breathing machine22 CCR 87619
- Stage 1 and stage 2 pressure injuries22 CCR 87631(a)(3)
- Wound care22 CCR 87631
This is the list families most often mistake for the prohibited one. Incontinence, diabetes, a catheter, wound care and oxygen are all here — restricted, not barred.
The specific questions
The conditions families actually ask about
Can they take a feeding tube?
Not by default — gastrostomy and naso-gastric tubes are both on the prohibited list. But a community can apply for a written exception under 22 CCR 87616, and one holding a hospice care waiver may not need to. Ask which it has, in writing.
Can they take someone on oxygen?
Yes, in defined circumstances. Under 22 CCR 87618 a community may accept a resident using oxygen gas where that resident is mentally and physically capable of operating the equipment, can determine their own need for oxygen and can self-administer it, or where intermittent administration is carried out by an appropriately skilled professional. Liquid oxygen is handled separately within the same section, and the section also sets duties on the community for storage, smoking restrictions and equipment.
Will they take someone on hospice?
Only if the community holds a hospice care waiver from the Department of Social Services under 22 CCR 87632. It must also notify the Department in writing within five working days of hospice services starting, or of admitting somebody already receiving hospice. The limit on how many terminally ill residents it may serve at once comes from that community's own approved waiver rather than from a number fixed in the regulation — so ask what its waiver actually permits.
What about a wheelchair?
A wheelchair user is “non-ambulatory” in California law — the definition covers anyone unable to leave a building unassisted in an emergency, and expressly includes people who depend on crutches, a walker or a wheelchair. Under 22 CCR 87202 the community must notify the licensing agency and obtain an appropriate fire clearance before accepting or keeping such a resident. It is a reasonable thing to ask to see.
Insulin and injections?
Restricted, not prohibited: diabetes sits at 22 CCR 87628 and injections at 87629. A community can accept a resident who needs them. The question worth asking is who actually administers the injection, because that is not simply whoever is on shift.
Is there a weight limit?
No. California sets none, and weight is not a listed prohibited condition. A community declining on those grounds has to rest its decision on the assessments the regulations require and on the specific limits those regulations set. It is also true that no community is obliged to accept any particular person: 22 CCR 87464(d) says in terms that “a facility need not accept a particular resident for care”.
The other direction
When it genuinely is not a care home
Some limits are real and are not matters for negotiation. A residential care facility may not accept or keep somebody who requires 24-hour skilled nursing care, nor somebody with active communicable tuberculosis. Those are different in kind from the conditions above, and a community that waved them away would be telling you something about itself.
If that is the situation, skilled nursing is a different licence from a different department, and we will say so rather than place somebody where they cannot lawfully be cared for.
Common questions
Conditions and admission, answered
- What conditions will assisted living not accept in California?
- Regulation 22 CCR 87615 names six: stage 3 and 4 pressure injuries, gastrostomy tubes, naso-gastric tubes, staph or another serious infection, depending on others for all activities of daily living, and a tracheotomy. But the regulation says these are 'including, but not limited to', so the list is not complete — and it is not an absolute bar, because a community can ask the state for a written exception under 22 CCR 87616.
- Can assisted living take someone with a feeding tube in California?
- Gastrostomy and naso-gastric tubes are on the prohibited list, so the default answer is no. It is not the end of the matter: a community can apply to the state for a written exception under 22 CCR 87616, and since July 2015 a community holding a facility-wide hospice care waiver does not have to request one each time for a hospice resident whose care plan covers the condition. Ask the community directly whether it holds either.
- Can a care home take a resident on oxygen?
- Yes — oxygen is a restricted condition, not a prohibited one. Under 22 CCR 87618 a community may accept a resident using oxygen gas where the resident is mentally and physically capable of operating the equipment, can determine their own need for it and can self-administer, or where intermittent administration is done by an appropriately skilled professional. Liquid oxygen is dealt with separately in the same section.
- Will a care home take my mother if she uses a wheelchair?
- Often yes, but the community needs the right fire clearance first. Under 22 CCR 87202 it must notify the licensing agency and obtain an appropriate fire clearance before accepting or keeping a non-ambulatory resident, and California's definition of non-ambulatory expressly includes people who depend on crutches, a walker or a wheelchair. Ask to see the current clearance.
- Can care home staff give insulin injections?
- Diabetes and injections are restricted conditions rather than prohibited ones, so a community can accept a resident who needs them. Who may actually give the injection is the part families should ask about directly, because it is not simply any member of care staff.
- Is there a weight limit for assisted living in California?
- No. California sets no weight limit and weight is not a listed prohibited condition. A community's decision has to rest on the assessments the regulations require — the suitability evaluation, the pre-admission appraisal and the medical assessment — and on the specific limits in the regulations, such as the bar on retaining someone who depends on others for all activities of daily living.
Section numbers above were read against the California Code of Regulations and the Department of Social Services' published regulation manual. Regulations change; this is general information for families, not legal advice, and a community's own licensing analyst is the authority on its particular case.
Last reviewed . Regulation citations are re-read at source whenever this page is revised.
Tell us the condition and we will tell you who can take it
We know which Anaheim homes hold a hospice waiver, which have a non-ambulatory fire clearance, and which have taken a resident like yours before. That is a shorter conversation than ringing ninety-seven of them.
Tell us who you are looking after
Four short questions. Nothing you answer is shared with a facility until you say so.
Prefer to talk now? (714) 975-9652, open every day until 6pm.