Assisted Living in Florida

Agency: Agency for Health Care Administration
Phone: (850) 412-4304
Website: http://www.ahca.myflorida.com/assistedliving

Assisted living facilities provide housing, meals, and one or more 'personal services' (e.g., assistance with activities of daily living [ADLs] and self-administered medication).

Facility Scope of Care:
Facilities may provide assistance with personal services including medications. Facilities may hold one of three special licenses: an extended congregate care license allows facilities to provide more extensive ADL assistance and nursing services to frail residents; a limited nursing services license allows certain nursing services defined in the regulations; and a limited mental health license allows facilities to serve low-income, chronically mentally ill residents.

Move-In/Move-Out Requirements:
To be admitted, a resident must be capable of performing ADLs with supervision or assistance; not require 24-hour nursing supervision; be free of stage II, III, or IV pressure sores; be able to participate in social and leisure activities; be ambulatory; and not display violent behavior. A resident must be discharged if he or she is no longer able to meet the admission criteria or is bedridden for more than seven days. A resident must receive a face-to-face medical exam every three years to determine appropriate continued residency.

Resident Assessment:
Within 60 days prior to residents' admission, but no later than 30 days after admission, residents shall be examined by a physician or advanced registered nurse practitioner who shall provide the administrator with a medical examination report. Medical examinations conducted up to 30 days after a resident's admission to the facility must be recorded on the Resident Health Assessment form (AHCA Form 1823). For those residents examined 60 days prior to admission, any information required that is not contained in the medical examination report conducted must be obtained by the administrator within 30 days after admission using the AHCA Form 1823

Medication Management:
Unlicensed staff may provide hands-on assistance with selfadministered medications. However, a licensed health care provider's order is required when a licensed nurse provides assistance with self-administration or administration of medications, including over-the-counter products. Assisted living facilities may not require a resident to have a physician's order for over-the-counter medication. In addition to core educational requirements, staff must have a minimum of four additional hours of training provided by an RN, licensed pharmacist, or Department of Elder Affairs staff.

Physical Plant Requirements:
Private resident units must provide a minimum of 80 square feet of usable floor space and multiple-occupancy resident rooms must provide a minimum of 60 square feet per resident. An additional minimum of 35 square feet of living and dining space per resident is required.

Residents Allowed Per Room:
Prior to October 17, 1999, a maximum of four persons were permitted for multiple occupancy. Resident bedrooms designated for multiple occupancy in facilities newly licensed or renovated six months after October 17, 1999, shall have a maximum occupancy of two persons.

Life Safety:
The state fire marshal applies the provisions of the National Fire Protection Association Life Safety Code, NFPA 101, 1994 edition, Chapter 22, for new facilities and Chapter 23 for existing facilities. Any new assisted living facility, regardless of size, that applies for a license must be equipped with an automatic fire sprinkler system. If a licensed facility undergoes major reconstruction or addition to an existing building, the entire building must be equipped with an automatic fire sprinkler system. (Major reconstruction of a building means repair or restoration that costs in excess of 50 percent of the value of the building as reported on the tax rolls, excluding land, before reconstruction.) Beginning July 2011, all assisted living facilities with 17 or more beds are required to have an automated defibrillator.

Alzheimer's Unit Requirements:
Facilities that advertise special care for persons with Alzheimer's disease or related disorders (special care units) must have a physical environment that provides for the safety and welfare of residents; offer activities specifically designed for these residents; have 24-hour staffing availability; and employ staff who have completed an eight-hour approved training course and four hours of continuing education per year

Staff Training for Alzheimer's Care:
Staff in special care units must complete an eight-hour, approved training course and four hours of continuing education per year.

Staffing Requirements:
Staffing requirements vary depending upon the number of residents (e.g., a total of 375 staff hours would be required each week at a facility with 46-55 residents.) At least one employee certified in first aid must be present at all times. Staffing must be sufficient to meet residents' needs. All staff are required to undergo a background screening that includes a national FBI fingerprint check, captured digitally.

Staff Education Training:
Direct-care staff who have not taken the core training program shall receive a minimum of one hour of in-service training within 30 days of employment. Direct care staff, other than nurses, certified nursing assistants, and home health aides, must receive three hours of in-service training within 30 days of employment.

Medicaid Policy and Reimbursements:
A Medicaid home and community-based services waiver and the Medicaid Assistive Care Services program under the Medicaid state plan cover services for low-income residents.