Staffing rules for Florida assisted living

How much staff time must a Florida ALF schedule each week?

Rule 59A-36.010 sets a minimum of weekly direct-care staff hours based on the combined count of residents, day care participants and respite residents, starting at 168 hours for five or fewer and climbing to 539 hours for 86 to 95, plus 42 hours for every additional 20.

Source: Fla. Admin. Code r. 59A-36.010(3)(a).

Only hours actually worked by staff on duty count. Vacant positions, people on leave, and employees who only cook, clean, maintain the building or do office work are left out; an administrator's hours count when he or she is scheduled and giving hands-on care.

Does someone have to be awake all night?

Yes in any ALF with 17 or more residents, and every ALF must have at least one staff member with current first aid and CPR certification in the building at all times.

Homes below 17 residents may have staff who sleep on site overnight, which is the usual arrangement in the small residential ALFs in Deltona, Palm Coast and Port Orange neighborhoods. If your parent wanders, falls or gets up several times a night, ask exactly who is awake and where.

What does the hourly minimum look like in practice?

Spread across the 168 hours of a week, the 539-hour floor for a building of about 90 residents averages a little more than three people on duty at a time, which is why the rule also requires additional staff whenever residents' scheduled and unscheduled needs are not being met.

AHCA can order staffing above the minimum when supervision falls short (59A-36.010(3)(d)), and a facility must show residents or their representatives the direct-care schedule on request. Ask for a recent week of it during a tour.

What must an ALF administrator have?

An administrator must be at least 21, hold a high school diploma or equivalent if hired after October 30, 1995, pass Level 2 background screening and complete AHCA's core training and competency test within 90 days of starting, followed by continuing education.

One administrator may run up to three ALFs, or several on one campus, with a manager named for each; a separate allowance covers three facilities of 16 beds or fewer within 15 miles of one another. AHCA must be told within 10 days of an administrator change.

What training do caregivers receive?

Direct-care staff complete the training required by rule 59A-36.011; facilities that advertise Alzheimer's care, and future memory care licensees, add dementia training under s. 430.5025, and ECC and LMH facilities add training specific to those licenses.

New staff must also submit a health statement within 30 days of hire. Rather than asking whether a dementia course exists, ask how many caregivers on this month's schedule have completed it.