Assisted Living: Defined

The state regulatory agency, the Agency for Health Care Administration (AHCA), defines assisted living in Florida as:

“An assisted living facility (ALF) is designed to provide personal care services in the least restrictive and most home-like environment. These facilities can range in size from one resident to several hundred and may offer a wide variety of personal and nursing services designed specifically to meet an individual's personal needs.”

Assisted Living in Florida

Every facility has a standard license

Facilities can add a “specialty” license

Small or large, all licensed assisted living facilities have the same rules and laws

Seniors looking at computer

Facilities are licensed to provide routine personal care services under a "Standard" license, or more specific services under the authority of "Specialty" licenses. ALFs meeting the requirements for a Standard license may also qualify for specialty licenses. The purpose of "Specialty Licenses" is to allow individuals to "age in place" in familiar surroundings that can adequately and safely meet their continuing healthcare needs.

All facilities in Florida are regulated by the same rules and laws, regardless of size. A small, residential home can serve as an assisted living facility and is beholden to the same rules and laws as the largest, resort-style facility.  Each facility is licensed as a Standard facility and can add a specialty license to offer additional services.

Florida has Three Specialty Licenses

The State of Florida allows for three specialty license types, each of these licenses permitting certain and specific services to their residents.

Specialty Licenses in Florida 

Limited Nursing Services

Extended Congregate Care

Limited Mental Health

A Standard License is the most basic license type that allows for assistance with personal services which can include activities of daily living, supervision of self-administration of medication, and other similar services as defined by the rule.  All facilities are licensed as a Standard facility and can choose to add the specialty licenses.

A Limited Nursing Service License Allows More Nursing Services

A Limited Nursing Services license allows acts that may be performed by a licensed nurse. Limited nursing services shall be for persons who meet the admission criteria established for assisted living facilities and shall not be complex enough to require 24-hour nursing supervision and may include such services as the application and care of routine dressings, and care of casts, braces, and splints.

Extended Congregate Care is the Highest License in Assisted Living

An Extended Congregate Care license allows acts beyond personal services that may be performed by persons licensed while carrying out their professional duties and other supportive services which may be specified by rule. The purpose of such services is to enable residents to age in place in a residential environment despite mental or physical limitations that might otherwise disqualify them from residency in a facility.

A Limited Mental Health License Helps Some Seniors

A Limited Mental Health license allows for the care and concern of those determined by the State to be mental health residents. Care includes assistance with personal services as well as additional services specific to those requiring mental health programs.

Hospice Services in Assisted Living

Each license allows the assisted living provider to provide services within the scope of its license offering some exceptions to those residents who consent to and are admitted to the services of a licensed hospice. These services include providing total care to bedbound residents who previously were required to leave their assisted living homes as their hospice status exceeded the scope of the facility license.

Each assisted living facility is required to have policies and procedures to address the care services provided in their facility. Starting with the Residency Agreement, an assisted living facility puts forth in writing the services it intends to provide – which are not necessarily all of those permitted by its license. Assisted Living providers have the option of providing services allowed within the scope of their license and it is important that seniors and their families know what will be provided as the senior continues to age in place.

This piece was originally written when I was a guest blogger for Amy B. Van Fossen, PA!

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