Florida Assisted Living
Florida is a premier destination for older adults looking for somewhere sunny and warm to spend their golden years. For those who need a little extra help with daily tasks, the state's assisted living communities provide residential supervision and personal care. In this guide, you'll find the information you need to determine if assisted living is the right senior living option for you or your family member. You can also learn important details about costs, financial help and other factors about assisted living facilities in Florida.
The typical resident population in Florida's assisted living communities is 70% female. Overall, 77% of residents are ages 75 and older, with 32% of residents ages 75 to 84 and 45% ages 85 and older.
In Florida, the Bureau of Health Facility Regulation licenses several types of assisted living facilities (ALFs). The capacity of ALFs varies from as few as one resident to facilities that can house hundreds of residents. Under a standard license, an assisted living facility is licensed to provide personal care services. The facility may also qualify for specialty licenses that allow them to provide additional services.
The specialty services include limited nursing services, extended congregate care services, and limited mental health services. These services allow residents to stay in a familiar place that will provide for their safety and health care needs as they age. The ALF must meet certain additional requirements to qualify for these licenses.
An assisted living facility is a building, buildings, or a part of a building that provides housing, meals, and one or more services associated with activities of daily living (ADLs). ALFs also assist in the self-administration of medication for its residents. An ALF can employ or contract with a third party to administer medications and perform various nursing tasks, manage residents' medication organizers, and observe the residents.
Adult Foster Care is a licensed, full-time, family-style home, typically a private home where residents are provided room, board, and personal care 24 hours a day. These homes can house up to five adults that are frail or disabled.
An ALF with a limited nursing services (LNS) license may provide the following services:
An LNS facility may also qualify as an Extended Congregate Care (ECC) facility. This license permits the facility to allow residents to age in place when they have mental or physical limitations that would not qualify them to be a resident at a ‘standard’ ALF. This facility can provide a higher level of care to its residents.
A Limited Mental Health license permits the facility to provide services for three or more residents who receive insurance or income due to a mental disorder. The income sources this license covers include Social Security Disability Insurance, Supplemental Security Income or the state SSI supplement known as OSS. To qualify for this license, the facility must develop a living support plan for the resident and their case manager outlining the residents’ needs.
An ALF is required to determine whether the facility can meet a prospective resident's needs before admission. For someone to be admitted and retained in the facility, they must not require 24-hour nursing supervision and be able to perform ADLs, including transfers, with supervision or assistance. In addition, the prospective resident must be free of stage 2, 3 and 4 pressure sores, be able to participate in both social and leisure activities, and not exhibit behaviors that would be a danger to themselves or other residents.
A standard ALF and a facility licensed as an LNS facility cannot retain residents requiring 24-hour nursing supervision or are bedridden for more than seven days. A resident who develops pressure sores up to stage 2 may remain in the facility if the facility is licensed as an LNS or if the resident contracts with a home health agency or RN to provide for the resident's needs.
The services an ALF can provide depend on the facility's licenses. A standard ALF is permitted to provide personal care services and is permitted to assist residents with the self-administration of medications.
Facilities that qualify for and have an LNS license can provide additional nursing services for their residents. The nursing services they can provide include:
All residents must be examined by a physician or advanced RN practitioner at most 60 days prior to admission or within 30 days of admission. This health professional must provide the facility administrator with a medical examination report, which is used to create a service plan for each resident. All residents must have a nursing assessment performed by a licensed nurse employed or contracted by the facility. The assessment must be documented, highlighting any significant changes in the status of the resident. This assessment determines if the resident must be relocated to a nursing home, hospital, or specialized health care facility.
If a resident complies with all criteria related to the delivery of services in the facility by third parties, the resident or the representative may contract with third parties to get services. The administrator must assist in facilitating those services and coordinate with the provider to meet specific goals.
Any facility that provides dementia care services must offer activities specially designed for residents with cognitive impairment in an environment that provides for their safety and welfare and the safety and welfare of other residents.
A standard ALF is permitted to assist its residents with self-administrating medications. These are regularly scheduled medications intended for residents with stable medical conditions. Licensed nursing staff may administer medications. Assistance with medications includes taking previously dispensed, properly labelled containers from storage and bringing them to the resident, opening the container, removing the medication and closing the container, placing a dose in the resident's hand or another container and helping the resident lift their hand to their mouth, applying topical medications, and keeping a record of when the resident receives assistance.
Unlicensed persons may assist with self-administration if they have met training requirements, which equal four hours upon hire and two hours annually, and upon written, informed consent of the resident or the person designated responsible for the resident.
The ALF must provide a variety of regular meals that meet the residents’ nutritional needs. Therapeutic diets, ordered by the residents' care provider, must also be provided to residents that require special diets. Meals must also be adapted to the food habits and preferences of the residents.
All menus, both standard and therapeutic, must be reviewed by a registered dietitian, a licensed nutritionist, or a registered dietetic technician at least annually. This review is used to determine if the meals offered by the facility meet nutritional requirements.
Food may be divided between three or more meals per day and should include snacks as necessary to accommodate residents’ needs and preferences.
An administrator is responsible for the operation and maintenance of every facility. The administrator is responsible for managing staff and providing care to all residents. The facility must employ direct care staff. There must be at least one staff member who has completed first aid and CPR courses in the facility.
LNS facilities employ or contract with a nurse who is available to provide various nursing services to residents on an as-needed basis.
All ALFs must retain sufficient staff to ensure the safety and care of individual residents. There must also be staff to assist and act on the facility's evacuation and emergency management plans. Minimum staffing hours:
All administrators, financial officers, and employees of ALFs must pass a criminal history record check via fingerprint search through the FBI and the Florida Department of Law Enforcement. This check determines if an employee or prospective employee has any disqualifying offences.
All employees must have at least 26 hours of training and a competency test. Facility administrators must complete this training in the first 90 days of becoming employed in that position and 12 hours of continuing education every two years.
All non-nursing or home health aide staff who provide direct care for residents must receive a minimum of one hour of in-service training in infection control before providing personal care to residents. They must receive three hours of in-service training within 30 days of employment covering resident behavior and needs and assisting with ADLs.
Staff providing direct care for residents who have not yet completed the core training indicated above must receive a minimum of one hour of in-service training covering residents' rights, neglect and exploitation, recognizing and reporting resident abuse, reporting major and adverse incidents, and facility emergency procedures.
All administrators of facilities licensed as an ECC facility must complete six hours of training in working with individuals with mental health diagnoses within six months of the facility obtaining an LMH license or within six months of employment in a licensed LMH facility. In addition, administrators must receive three hours of continuing education on mental health topics, including diagnosis, treatment, services, behaviors, and appropriate interventions for residents with mental health issues.
There are additional staffing requirements for any facility that advertises that it provides care for persons with dementia. The facility must have 24-hour staffing. If the facility has more than 16 residents, a minimum of one staff member must be on duty and awake 24 hours a day. If the facility has fewer than 17 residents, there must be either an awake staff member or the facility must provide a monitoring system that ensures the safety of all residents.
The facilities advertising dementia care must provide their staff with specialized training. All staff in these facilities must fulfill the core training requirements and receive an additional four hours of individual training covering the characteristics of Alzheimer’s disease, how to communicate with residents with dementia, family issues, ethical issues, and the residents’ environment. Any staff member providing direct care to residents with dementia must have an additional four hours of training (within the first nine months of employment) covering behavior management, activities for residents, assistance with ADLs, caregiver stress management, and medical information related to dementia.
The direct care staff must also receive four hours of continuing education on dementia-specific topics each year. Staff members with “incidental contact” with residents must be given general information on interacting with individuals with dementia within three months of employment.
Standard and LNS facilities do not need to provide residents with apartment-style units or private rooms. Facilities licensed after October 1999 may provide rooms shared by up to two people and must have bathrooms shared by no more than four residents. Facilities licensed before October 1999 may provide units for up to four residents with one toilet and sink for every six residents and bathing facilities for every eight residents.
ECC facilities must provide a private room, apartment, or semi-private room shared with one roommate of the resident’s choice. A maximum of four residents may share bathrooms with a toilet, sink, and bathtub or shower.
Facilities participating in the Managed Long-Term Care Waiver Program must offer a private room or apartment. Units can only be shared with the resident’s approval. Assistive care services provided through the state Medicaid plan do not require apartment-style units.
Before admission, each resident must have a medical evaluation by a physician. This examination will be used to develop a care plan to be reviewed with the resident and any representative, if necessary.
In Florida, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 65% of communities providing skilled nursing. Many have health care specialists and on-site services, with 50% of communities offering dental care. In addition, 58% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Florida, 80% of communities conduct depression screenings, and 49% offer mental health counselling. Social work programs are also found in 51% of ALFs. Social workers can provide counselling, conduct assessments, and help ensure residents have access to all the necessary resources.
Some assisted living residents live with various medical conditions. In Florida, 47% have Alzheimer's disease or another form of dementia. In addition, 45% have high blood pressure, 30% have heart disease, 28% have depression, and 16% have diabetes.
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Many assisted living residents in the state receive help with their ADLs. In Florida, 17% of residents need help eating. Other commonly used services include bed transfer (38%), toileting (47%), and walking (49%). Caregivers in ALFs help 52% of residents dress, and 63% need help bathing.
The average cost of assisted living care in Florida is $4,000. This cost is $500 lower than the monthly national average of $4,500 per month. The cost of living in Florida is slightly more than the national average by 0.3%, with health care costs less than the national average by 2.3% and housing costs less than the national average by 1.0%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $2,350 in the Gainesville area to a high of $5,300 per month in the Naples area of Florida.
Living close to one of Florida’s borders may make assisted living in a neighboring state affordable. Both of Florida’s neighbors have a lower average cost of assisted living. Georgia has an average monthly cost of $3,535, and Alabama has an average cost of $3,503 per month.
How to Pay for Assisted Living
The Florida Department of Elder Affairs oversees operations in ALFs throughout the state. The state's Long-Term Care Ombudsman program ensures residents' rights are respected and mediates complaints regarding violations, neglect, and elder abuse.
In some cases, older adults might require legal advice or support. Resources exist throughout Florida to help people who've faced elder abuse or neglect and those who require help appealing benefit decisions.
The state provides a Senior Legal Helpline for those ages 60 and over with low incomes. The Florida Elder Law Risk Detector app also provides a tool to help determine if violations have been committed. The Alliance for Aging can also help older adults across many income levels access legal services and lawyer referrals.
Assisted the state regulates living communities in Florida. A community must have a valid standard license to provide personal care services, while those providing continuing care, such as nursing or memory care services, must have a specialty license.
The state is dedicated to providing safe, reliable assisted living care for older adults. The Bureau of Health Facility Regulation accepts and investigates complaints about assisted living communities.
The typical resident population in Florida's assisted living communities is 70% female. Overall, 77% of residents are ages 75 and older, with 32% of residents ages 75 to 84 and 45% ages 85 and older.
Assisted Living Facility (ALF) Requirements
In Florida, the Bureau of Health Facility Regulation licenses several types of assisted living facilities (ALFs). The capacity of ALFs varies from as few as one resident to facilities that can house hundreds of residents. Under a standard license, an assisted living facility is licensed to provide personal care services. The facility may also qualify for specialty licenses that allow them to provide additional services.
The specialty services include limited nursing services, extended congregate care services, and limited mental health services. These services allow residents to stay in a familiar place that will provide for their safety and health care needs as they age. The ALF must meet certain additional requirements to qualify for these licenses.
An assisted living facility is a building, buildings, or a part of a building that provides housing, meals, and one or more services associated with activities of daily living (ADLs). ALFs also assist in the self-administration of medication for its residents. An ALF can employ or contract with a third party to administer medications and perform various nursing tasks, manage residents' medication organizers, and observe the residents.
Adult Foster Care is a licensed, full-time, family-style home, typically a private home where residents are provided room, board, and personal care 24 hours a day. These homes can house up to five adults that are frail or disabled.
Assisted Living Specialty Services
An ALF with a limited nursing services (LNS) license may provide the following services:
- Passive range of motion exercises
- Application of heat or ice
- Cutting the toenails of diabetic residents with circulatory problems
- Conduct urine dipstick tests
- Replace self-maintained catheters or perform intermittent urinary catheterizations
- Change dressings that do not require irrigation or packing
- Conduct nursing assessments (must be done by a registered nurse)
- Provide 24-hour supervision of hospice patients
An LNS facility may also qualify as an Extended Congregate Care (ECC) facility. This license permits the facility to allow residents to age in place when they have mental or physical limitations that would not qualify them to be a resident at a ‘standard’ ALF. This facility can provide a higher level of care to its residents.
A Limited Mental Health license permits the facility to provide services for three or more residents who receive insurance or income due to a mental disorder. The income sources this license covers include Social Security Disability Insurance, Supplemental Security Income or the state SSI supplement known as OSS. To qualify for this license, the facility must develop a living support plan for the resident and their case manager outlining the residents’ needs.
Assisted Living Admission Requirements
An ALF is required to determine whether the facility can meet a prospective resident's needs before admission. For someone to be admitted and retained in the facility, they must not require 24-hour nursing supervision and be able to perform ADLs, including transfers, with supervision or assistance. In addition, the prospective resident must be free of stage 2, 3 and 4 pressure sores, be able to participate in both social and leisure activities, and not exhibit behaviors that would be a danger to themselves or other residents.
A standard ALF and a facility licensed as an LNS facility cannot retain residents requiring 24-hour nursing supervision or are bedridden for more than seven days. A resident who develops pressure sores up to stage 2 may remain in the facility if the facility is licensed as an LNS or if the resident contracts with a home health agency or RN to provide for the resident's needs.
Assisted Living Service Requirements
The services an ALF can provide depend on the facility's licenses. A standard ALF is permitted to provide personal care services and is permitted to assist residents with the self-administration of medications.
Facilities that qualify for and have an LNS license can provide additional nursing services for their residents. The nursing services they can provide include:
- Application of dressings for abrasions, skin tears, and closed surgical wounds that do not require packing or irrigation.
- Care for stage 2 pressure sores
- Catheter, colostomy, and ileostomy care and maintenance
- Care for casts, braces, and splits
- Nursing assessments either by an RN or under the direct supervision of an RN
- Total help with ADLs for residents that have been admitted to hospice
All residents must be examined by a physician or advanced RN practitioner at most 60 days prior to admission or within 30 days of admission. This health professional must provide the facility administrator with a medical examination report, which is used to create a service plan for each resident. All residents must have a nursing assessment performed by a licensed nurse employed or contracted by the facility. The assessment must be documented, highlighting any significant changes in the status of the resident. This assessment determines if the resident must be relocated to a nursing home, hospital, or specialized health care facility.
If a resident complies with all criteria related to the delivery of services in the facility by third parties, the resident or the representative may contract with third parties to get services. The administrator must assist in facilitating those services and coordinate with the provider to meet specific goals.
Any facility that provides dementia care services must offer activities specially designed for residents with cognitive impairment in an environment that provides for their safety and welfare and the safety and welfare of other residents.
Assisted Living Medication Provisions
A standard ALF is permitted to assist its residents with self-administrating medications. These are regularly scheduled medications intended for residents with stable medical conditions. Licensed nursing staff may administer medications. Assistance with medications includes taking previously dispensed, properly labelled containers from storage and bringing them to the resident, opening the container, removing the medication and closing the container, placing a dose in the resident's hand or another container and helping the resident lift their hand to their mouth, applying topical medications, and keeping a record of when the resident receives assistance.
Unlicensed persons may assist with self-administration if they have met training requirements, which equal four hours upon hire and two hours annually, and upon written, informed consent of the resident or the person designated responsible for the resident.
Assisted Living Food Requirements
The ALF must provide a variety of regular meals that meet the residents’ nutritional needs. Therapeutic diets, ordered by the residents' care provider, must also be provided to residents that require special diets. Meals must also be adapted to the food habits and preferences of the residents.
All menus, both standard and therapeutic, must be reviewed by a registered dietitian, a licensed nutritionist, or a registered dietetic technician at least annually. This review is used to determine if the meals offered by the facility meet nutritional requirements.
Food may be divided between three or more meals per day and should include snacks as necessary to accommodate residents’ needs and preferences.
Assisted Living Staffing Requirements
An administrator is responsible for the operation and maintenance of every facility. The administrator is responsible for managing staff and providing care to all residents. The facility must employ direct care staff. There must be at least one staff member who has completed first aid and CPR courses in the facility.
LNS facilities employ or contract with a nurse who is available to provide various nursing services to residents on an as-needed basis.
All ALFs must retain sufficient staff to ensure the safety and care of individual residents. There must also be staff to assist and act on the facility's evacuation and emergency management plans. Minimum staffing hours:
- Facilities up to five residents: 168 weekly staff hours
- Facilities of 6-15 residents: 212 weekly staff hours
- Facilities of 16-25 residents: 253 weekly staff hours
- Facilities of 26-35 residents: 294 weekly staff hours
- Every 20 residents over 35: 42 staff hours
All administrators, financial officers, and employees of ALFs must pass a criminal history record check via fingerprint search through the FBI and the Florida Department of Law Enforcement. This check determines if an employee or prospective employee has any disqualifying offences.
Assisted Living Staff Training Requirements
All employees must have at least 26 hours of training and a competency test. Facility administrators must complete this training in the first 90 days of becoming employed in that position and 12 hours of continuing education every two years.
All non-nursing or home health aide staff who provide direct care for residents must receive a minimum of one hour of in-service training in infection control before providing personal care to residents. They must receive three hours of in-service training within 30 days of employment covering resident behavior and needs and assisting with ADLs.
Staff providing direct care for residents who have not yet completed the core training indicated above must receive a minimum of one hour of in-service training covering residents' rights, neglect and exploitation, recognizing and reporting resident abuse, reporting major and adverse incidents, and facility emergency procedures.
All administrators of facilities licensed as an ECC facility must complete six hours of training in working with individuals with mental health diagnoses within six months of the facility obtaining an LMH license or within six months of employment in a licensed LMH facility. In addition, administrators must receive three hours of continuing education on mental health topics, including diagnosis, treatment, services, behaviors, and appropriate interventions for residents with mental health issues.
There are additional staffing requirements for any facility that advertises that it provides care for persons with dementia. The facility must have 24-hour staffing. If the facility has more than 16 residents, a minimum of one staff member must be on duty and awake 24 hours a day. If the facility has fewer than 17 residents, there must be either an awake staff member or the facility must provide a monitoring system that ensures the safety of all residents.
The facilities advertising dementia care must provide their staff with specialized training. All staff in these facilities must fulfill the core training requirements and receive an additional four hours of individual training covering the characteristics of Alzheimer’s disease, how to communicate with residents with dementia, family issues, ethical issues, and the residents’ environment. Any staff member providing direct care to residents with dementia must have an additional four hours of training (within the first nine months of employment) covering behavior management, activities for residents, assistance with ADLs, caregiver stress management, and medical information related to dementia.
The direct care staff must also receive four hours of continuing education on dementia-specific topics each year. Staff members with “incidental contact” with residents must be given general information on interacting with individuals with dementia within three months of employment.
Assisted Living Housing Requirements
Standard and LNS facilities do not need to provide residents with apartment-style units or private rooms. Facilities licensed after October 1999 may provide rooms shared by up to two people and must have bathrooms shared by no more than four residents. Facilities licensed before October 1999 may provide units for up to four residents with one toilet and sink for every six residents and bathing facilities for every eight residents.
ECC facilities must provide a private room, apartment, or semi-private room shared with one roommate of the resident’s choice. A maximum of four residents may share bathrooms with a toilet, sink, and bathtub or shower.
Facilities participating in the Managed Long-Term Care Waiver Program must offer a private room or apartment. Units can only be shared with the resident’s approval. Assistive care services provided through the state Medicaid plan do not require apartment-style units.
What Is Included With Assisted Living Care In Florida?
Before admission, each resident must have a medical evaluation by a physician. This examination will be used to develop a care plan to be reviewed with the resident and any representative, if necessary.
Health Care Services
In Florida, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 65% of communities providing skilled nursing. Many have health care specialists and on-site services, with 50% of communities offering dental care. In addition, 58% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Florida, 80% of communities conduct depression screenings, and 49% offer mental health counselling. Social work programs are also found in 51% of ALFs. Social workers can provide counselling, conduct assessments, and help ensure residents have access to all the necessary resources.
Some assisted living residents live with various medical conditions. In Florida, 47% have Alzheimer's disease or another form of dementia. In addition, 45% have high blood pressure, 30% have heart disease, 28% have depression, and 16% have diabetes.
Activities of Daily Living (ADLs) Assistance Services
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Many assisted living residents in the state receive help with their ADLs. In Florida, 17% of residents need help eating. Other commonly used services include bed transfer (38%), toileting (47%), and walking (49%). Caregivers in ALFs help 52% of residents dress, and 63% need help bathing.
Cost Of Assisted Living Care In Florida
The average cost of assisted living care in Florida is $4,000. This cost is $500 lower than the monthly national average of $4,500 per month. The cost of living in Florida is slightly more than the national average by 0.3%, with health care costs less than the national average by 2.3% and housing costs less than the national average by 1.0%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $2,350 in the Gainesville area to a high of $5,300 per month in the Naples area of Florida.
How Costs Compare In Nearby States
Living close to one of Florida’s borders may make assisted living in a neighboring state affordable. Both of Florida’s neighbors have a lower average cost of assisted living. Georgia has an average monthly cost of $3,535, and Alabama has an average cost of $3,503 per month.
How to Pay for Assisted Living
Florida Assisted Living Oversight
The Florida Department of Elder Affairs oversees operations in ALFs throughout the state. The state's Long-Term Care Ombudsman program ensures residents' rights are respected and mediates complaints regarding violations, neglect, and elder abuse.
Legal Resources for Seniors in Florida
In some cases, older adults might require legal advice or support. Resources exist throughout Florida to help people who've faced elder abuse or neglect and those who require help appealing benefit decisions.
The state provides a Senior Legal Helpline for those ages 60 and over with low incomes. The Florida Elder Law Risk Detector app also provides a tool to help determine if violations have been committed. The Alliance for Aging can also help older adults across many income levels access legal services and lawyer referrals.
Quality and Safety of Assisted Living Facilities in Florida
Assisted the state regulates living communities in Florida. A community must have a valid standard license to provide personal care services, while those providing continuing care, such as nursing or memory care services, must have a specialty license.
The state is dedicated to providing safe, reliable assisted living care for older adults. The Bureau of Health Facility Regulation accepts and investigates complaints about assisted living communities.
