Can RCFEs Administer Injections?
One of the most confusing questions for administrators is: “Can RCFE caregivers give injections?” The answer is no, unlicensed RCFE staff cannot give injections. However, residents may self-administer their injections, and licensed professionals such as RNs, LVNs, or other appropriately skilled professionals can legally administer them under Title 22.
According to Title 22, section 87629(a), an RCFE may “accept or retain a resident who requires intramuscular, subcutaneous, or intradermal injections if the injections are administered by the resident or by an appropriately skilled professional.” The term “appropriately skilled professional” is defined in section 87101(a)(10) as someone “trained and licensed to perform medical procedures prescribed by a physician.” This includes Registered Nurses (RNs), Licensed Vocational Nurses (LVNs), Physical Therapists, Occupational Therapists, and Respiratory Therapists. A family member may also give injections only if they hold one of these valid professional licenses.
Unlicensed family members are not permitted to give or assist with injections in an RCFE. While some outdated Evaluator Manual references suggest exceptions for hospice residents, those are not legally enforceable, they are opinions, not regulations. The same applies to “friends” or “uncompensated spouses” giving injections; no such authority exists in state law or the Health and Safety Code.
Recent updates to Title 22 §87470(a)(3) clarify that staff may assist residents with the self-administration of injectable medications under specific infection-control guidelines, such as ensuring sterile preparation areas and single-use needles. However, staff assistance stops short of administering the injection itself.
In summary:
Only licensed professionals (RN, LVN, PT, OT, RT) or self-administering residents may give injections.
Family members can do so only if they are licensed healthcare professionals.
RCFE caregivers may assist with setup and observation, but not with the injection itself.
