There is always the possibility of a little wiggle room when dealing with prohibited or restricted conditions by the CCLD. If the facility feels they are able to provide the care that the person needs, then they shall submit the plan they have derived that will ensure the condition will be cared for effectively. For more information take a look at the regulation below, provided by CCLD:
87616 EXCEPTIONS FOR HEALTH CONDITIONS 87616
(a) As specified in Section 87209, Program Flexibility, the licensee may submit a written exception request if he/she agrees that the resident has a prohibited and/or restrictive health condition but believes that the intent of the law can be met through alternative means.
(b) Written requests shall include, but are not limited to, the following:
(1) Documentation of the resident’s current health condition including updated medical reports, other documentation of the current health, prognosis, and expected duration of condition.
(2) The licensee’s plan for ensuring that the resident’s health related needs can be met by the facility.
(3) Plan for minimizing the impact on other residents.
(c) Facilities that have satisfied the requirements of Section 87632, Hospice Care Waiver, are not required to submit written exception requests under this section for residents or prospective residents with restricted health conditions under Section 87612 and/or prohibited health conditions under Section 87615 provided those residents have been diagnosed as terminally ill and are receiving hospice services in accordance with a hospice care plan as required under Section 87633, Hospice Care for Terminally Ill Residents, and the treatment of such restricted and/or prohibited health conditions is specifically addressed in the hospice care plan.
Health and Safety Code section 1569.73(a) provides in relevant part:
“(a)(2) The terminally ill resident, or the terminally ill person to be accepted as a resident, has obtained the services of a hospice certified in accordance with federal medicare conditions of participation and licensed pursuant to Chapter 8 (commencing with Section 1725) or Chapter 8.5 (commencing with Section 1745).
(3) The facility, in the judgment of the department, has the ability to provide care and supervision appropriate to meet the needs of the terminally ill resident or the terminally ill person to be accepted as a resident, and is in substantial compliance with regulations governing the operation of residential care facilities for the elderly.
(4) The hospice has agreed to design and provide for care, services, and necessary medical intervention related to the terminal illness as necessary to supplement the care and supervision provided by the facility.
(5) An agreement has been executed between the facility and the hospice regarding the care plan for the terminally ill resident or terminally ill person to be accepted as a resident. The care plan shall designate the primary caregiver, identify other caregivers, and outline the tasks the facility is responsible for performing and the approximate frequency with which they shall be performed. The care plan shall specifically limit the facility’s role for care and supervision to those tasks allowed under this chapter.”
87617 DEPARTMENTAL REVIEW OF HEALTH CONDITIONS 87617
(a) Certain health conditions as specified in Sections 87618, Oxygen Administration-Gas and Liquid, through 87631, Healing Wounds, may require review by Department staff to determine if the resident will be allowed to remain in the facility. The Department shall inform the licensee that the health condition of the resident requires review and shall specify documentation which the licensee shall submit to the Department.
(1) Documentation shall include, but not be limited to the following:
(A) Physician’s assessment(s).
(B) Pre-admission appraisal.
(C) Copies of prescriptions for incidental medical services and/or medical equipment.
(2) The documentation shall be submitted to the Department within 10 days.
(b) If the Department determines that the resident has an allowable health condition, the licensee shall provide care and supervision to the resident in accordance with the conditions specified in Sections 87618, Oxygen Administration-Gas and Liquid, through 87631, Healing Wounds.