Daytona Beach Senior AdvisorWhat must a person meet to move into a Florida ALF?
Under rule 59A-36.006 a resident of a standard, LNS or LMH facility must be at least 18, free of a communicable disease likely to spread, able to carry out daily activities with help if needed, able to transfer with assistance, able to take medications by self-administration or with help, not a danger to self or others, not bedridden and not in need of 24-hour nursing supervision.
The administrator must also decide, using an assessment, the medical examination required by s. 429.26 and fire-safety standards, that the building can meet the person's needs. Needing two people to help with a transfer does not by itself disqualify anyone.
Which medical needs rule out a standard facility?
Residents of standard, LNS and LMH facilities may not need artificial airway management (CPAP and BiPAP are allowed), tube-feeding assistance, blood gas monitoring, wound vacuums or post-surgical drains, blood products, or care of an unstabilized surgical wound, and standard and LMH facilities cannot give IV therapy or dialysis on site.
A stage 3 or 4 pressure sore bars admission; a stage 2 sore is acceptable if a home health agency or nurse (or the facility's own nurses under an LNS license) treats it and it heals within 30 days. Portable oxygen and routine colostomy care are allowed in a standard facility that employs or contracts with a nurse.
Can someone on hospice stay in an ALF?
Yes: s. 429.26(1)(c) lets an ALF admit or keep a resident receiving licensed hospice care, even one who becomes bedridden, when the facility and resident agree, the hospice provides the extra care and the physician agrees the needs can be met there.
A written care plan must show how the facility and hospice will cover scheduled and unscheduled needs. This is how many families here avoid a move in the final weeks from a Port Orange or Ormond Beach ALF to a nursing home.
When must a resident move out, and with how much notice?
A resident who no longer meets the facility's admission and continued-residency criteria must be relocated, and except in emergencies the facility must give at least 45 days' written notice with its reasons and the Long-Term Care Ombudsman Program's number, 1-888-831-0404.
Shorter notice is permitted only for a physician-certified emergency transfer to a higher level of care or when the resident's behavior harms others (s. 429.28(1)(k)). ECC facilities apply their own retention criteria within AHCA's guidelines, the main reason to favor one when a parent's needs are likely to grow.
How do we find out whether a specific ALF can take our parent?
Get the admission policy in writing, bring the physician's examination (AHCA Form 1823 is the standard form), and have the administrator say which needs the license covers, which would need an outside agency and which would eventually force a move.
The 105 licensed ALFs here range from 5 to 190 beds; 18 are in Palm Coast, 13 are in Port Orange, 12 are in Daytona Beach, and 8 hold LMH, 11 LNS and 3 ECC licenses.
At a glance
| A standard Florida ALF may | A standard Florida ALF may not | |
|---|---|---|
| Transfers | Accept residents who need one or two helpers to transfer | Keep a bedridden resident who is not on hospice |
| Medications | Have a licensed nurse administer them | Provide IV therapy or dialysis on site |
| Discharge | End residency with 45 days' written notice and reasons | Remove a resident without written notice |
Sources: Chapters 408, 429 and 651, Florida Statutes; Florida Administrative Code chapters 59A-36 and 65A-2; publications of AHCA, DCF, OIR and the Department of Elder Affairs; and the CareScout and VA tables named on the page. See our editorial standards for how figures are checked.
