Assisted living facilities provide full-time living arrangements in the least restrictive (i.e. meals, personal care services, and supportive services to older persons and adults with disabilities who are unable to live independent) and most home-like setting. Facilities can include individual apartments or rooms that a resident has alone or shares with another person. These facilities can have capacity of one resident to several hundred residents.
Hillsborough County’s ALF (Assisted Living Facility) Market comprises of 5,262 licensed private beds (of which 963 beds are Florida OSS (Florida Optional State Supplement)) located in 228 facilities. Thus, the average facility has only 23 licensed beds. It should be noted that most of these ALFs are covered homes with a typical capacity of only six licensed beds.
Florida OSS (Optional State Supplement) is a state financial assistance program provided by the Florida Department of Children & Families. OSS provides financial assistance to low income seniors that cannot live independently and therefore require residential care, either in an adult family care home, assisted living residence or a mental health treatment center. Financial assistance comes in the form of a cash payment made directly to the individual that requires care or their legal guardian. It is intended for the room and board portion of the fees charged by the residence. The eligibility requirements are similar to Medicaid however this is not a Medicaid program. The monthly income limit depends on the type of residential care into which the individual is placed. For 2014, for seniors in family care homes or assisted living, the limit is $788.40. Couples, if both are residing in the care facility, can have monthly income of up to $1576.80. If the residential care facility is for mental health, the income limits are slightly higher, $895.00 and $1790.00 for an individual and couple, respectively. There are also assets limits and the rules here are similar to Medicaid. Individuals can have up to $2,000 in resources and couples up to $3,000.
According to tis mission statement, the Agency for Health Care Administration is a State of Florida government agency that are responsible for the administration of the Florida Medicaid program, licensure and regulation of Florida’s health facilities and for providing information to Floridians about the quality of care they receive. According to the Agency for Health Care Administration, “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.
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.” There are three primary specialty licenses (Extended Congregate Care (ECC), Limited Nursing Services (LNS), and limited mental health (LMH)).
An Extended Congregate Care (ECC) license is a specialty license that enables a facility to provide, directly or through contract, services beyond those permissible under the standard license, including acts performed by licensed nurses, and supportive services defined by rule to persons who otherwise would be disqualified from continued residence in a facility licensed under this part.
The primary purpose of ECC services is to allow residents, as they become more impaired, the option of remaining in a familiar setting that they would otherwise be disqualified for based on the continued residency criteria. A facility licensed to provide ECC services may also admit an individual who exceeds the admission criteria for a facility with a standard license, if the individual is determined appropriate for admission to the ECC facility and allows individuals to “age in place” in familiar surroundings that can adequately and safely meet their continuing healthcare needs.
A Limited Nursing Services (LNS) license is a specialty license that enables a facility to provide a select number of nursing services. Residents of facilities licensed to provide LNS services are required to meet the standard ALF admission criteria. However, in addition to the nursing services permitted in standard licensed facilities, facilities holding an LNS license may provide, directly or through contract, include but are not limited to the following: Conducting passive range of motion exercises, Applying ice caps or collars, applying heat, including dry heat, hot water bottle, heating pad, moist heat, hot compresses, sitz bath and hot soaks, cutting the toenails of diabetic residents or residents with a documented circulatory problem if the written approval of the resident’s health care provider has been obtained, performing ear and eye irrigations, conducting a urine dipstick test, replacement of an established self-maintained indwelling urinary catheter, or performance of an intermittent urinary catheterizations and performing digital stool removal therapies.
Any facility intending to admit three or more mental health residents must apply for and obtain a limited mental health (LMH) license from AHCA’s Assisted Living Unit before accepting the third mental health resident. The application must be signed by the applicant, notarized, and include a statement certifying that specified staff have completed or will complete the limited mental health training.
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