Recuperative Care, also referred to as medical respite care, is short-term residential care for homeless individuals who no longer require hospitalization but still need to heal from an injury or illness (including behavioral health conditions) and whose condition would be exacerbated by an unstable living environment.
Recuperative care allows individuals to continue their recovery and receive post-discharge treatment while obtaining access to primary care, behavioral health services, case management, and other supportive social services.
Recuperative Care is primarily used for individuals who are experiencing homelessness or those with unstable living situations who are too ill or frail to recover from an illness (physical or behavioral health) or injury in their usual living environment, yet are not otherwise ill enough to be in a hospital or qualify for another safe option.
- Recuperative Care allows recovery and oversight after acute medical in-patient hospitalization or skilled nursing facility care in order to improve health outcomes of our Members.
- It provides our Members the opportunity to access medical and supportive services needed to assist their recuperation.
- It improves the lives of our most vulnerable population.
In order to qualify, Members must:
- Be an active L.A. Care Medi-Cal (MCLA) Member, AND
- Be homeless or have unstable housing and/or a lack of support in their housing, AND
- Require care that is not outside of limited or short-term assistance with activities of daily living (ADL), AND
- Require care necessary to achieve or maintain medical stability and prevent hospital admission or re-admission.
Members must be able to meet the Recuperative Care facility's level of care criteria. Please note each Recuperative Care facility may have their own eligibility criteria. Referring parties must check the eligibility and exclusion criteria for the respective Recuperative Care facility.
Who can refer a Member for Recuperative Care?
- Anyone can refer a Member to the program; there is no wrong door.
- Initial referral and transfer request can be submitted using the referral form.
- Referring entities can work directly with an L.A. Care contracted Recuperative Care facility to find an accepting facility. When working directly with a Recuperative Care facility, you do not need to submit a duplicative referral directly to L.A. Care.
- When the Recuperative Care center has made a decision, the Recuperative Care facility will submit the Authorization Request form to L.A. Care.
- If, for any reason, the Recuperative Care facility is not able to accommodate your referral, the referring party is responsible for initiating a new referral to a different L.A. Care contracted Recuperative Care provider.
- You do not need to send L.A. Care any additional clinical documentation unless the Recuperative Care facility is unable to accept the referral and you choose to have L.A. Care assist with your request.
How can I submit a referral?
- Referrers can submit the Recuperative Care Referral Form via secure fax to 1.213.536.0634.
- Please refer to our Quick Reference Guide for more information, including timeline and responsibilities.
When is a Member discharged from recuperative care?
- The Member does not meet extension criteria. In order to qualify for an extension in Recuperative Care, the Member must continue needing medical oversight and continued care. Additionally, the Member may not exceed the 90-day duration.
- The Member has completed their 90-day stay.
Discharge Process
- Discharge planning should begin day one (1).
- Extensions must be requested 10 days prior to an authorization expiring.
- L.A. Care holds the authority to approve or deny these extensions.
How is a Member discharge reported to L.A. Care?
- A Recuperative Care provider must notify L.A. Care of the discharge and provide a discharge summary within 48 hours of the Member exiting the Recuperative Care program.