What is it called?

• Assisted Living Facility
• Standard
• Extended Congregate Care
• Limited Nursing Services
• Limited Mental Health Services

What services are provided?

• Standard
• Room and board
• Personal care
• Assistance with activities of daily living
• Minimum of 6 days a week and 12 hours per week of scheduled activities
• Transportation services
• The facility may contract with a nurse to:
• Administer medications
• Take vital signs
• Observe residents
• Limited Nursing Services
• Provide any services offered by a standard facility
• Additional nursing services including:
• Range of motion exercises
• Applying ice caps or collars
• Applying heat
• Take or supervise the taking of vital signs
• Medication assistance
• Cutting toenails of diabetic or other residents with documented circulatory problems, with approval of resident’s health care provider
• Ear and eye irrigation
• Urine dipstick test
• Replacement of established, self-maintained indwelling urinary catheter, or performance of an intermittent urinary catheterization
• Prepackaged enemas
• Digital stool removal
• Routine dressing changes
• Care of stage 2 pressure sores
• Care for casts, braces and splints
• 24 hour nursing supervision for hospice patients
• Assisting, applying, caring for and monitoring the application of antiembolism stockings or hosiery
• Administration of portable oxygen
• Applying, caring for and monitoring transcutaneous elecric nerve stimulator (TENS)
• Catheter, colostomy, ileostomy care and maintenance
• Extended Congregate Care
• Services offered by a Standard facility
• Services offered by a Limited Nursing Services facility
• Nursing services permitted by a nurse’s license, the state’s residency requirements, and the facility’s written policies and procedures
• If needed:
• Total help with bathing, dressing, grooming and toileting
• Nursing assessments at least monthly (but more often when needed)
• Supervision of residents with dementia and cognitive impairments
• Health education and counseling
• Provision or arrangement for rehabilitative services
• Provision of escort services to health-related appointments
• May include:
• Supportive services such as conseling, emotional support, networking, leisure services
• Shopping services
• Assistance in developing and implementing self-directed activities
• Training to family or friends to enable them to provide supportive services
• Limited Mental Health Services
• Not specified

Who can be admitted?          

• Standard, Limited Nursing Services, and Limited Mental Health Services
• Adults who:
• Are 18 years of age
• Are able to perform ADLs with supervision or assistance (but not total assistance)
• Are free of signs and symptoms of communicable diseases
• Are able to transfer with assistance, if necessary
• Are able to take own medications with assistance from staff if needed
• Are not a danger to self or others
• Do not require licensed professional mental health services on a 24-hour-a-day basis
• Can have dietary needs met in the facility
• Are not bedridden
• Do not require oral or nasopharyngeal suctioning
• Do not need ssistance with tube feeding, monitoring of blood gases, intermittent positive pressure breathing therapy, skilled rehabilitation services, or treatment of unstable surgical incisions
• Do not require 24-hour nursing supervision
• Do not have any Stage 3or 4 pressure ulcers (residents with Stage 2 ulcers may be served if the facility has a LNS license or resident contracts for care with a home health agency or nurse)
• Limited Mental Health Services
• Adults with a mental health diagnosis
• Adults assessed as appropriate for an assisted living facility
• Extended Congregate Care
• Adults who:
• Are 18 years of age
• Are free of signs and symptoms of communicable disease
• Are able to transfer, with assistance, if necessary
• Are not a danger to self or others
• Are not bedridden
• Do not require: oral or nasopharyngeal suctioning, nasogastric tube feeding, monitoring of blood gases, intermittent positive breathing pressure, skilled rehabilitative services, or treatment of unstable surgical incisions
• Do not require 24-hour nursing supervision
• Do not have Stage 3 or 4 pressure sores

Who is inappropriate?

• Must be refused Admission
• Standard, Limited Nursing Services, and Limited Mental Health Services Residents with:
• Total dependence in activities of daily living
• Need for two-person assistance with transferring
• Stage 3 or 4 pressure sores (Stage 2 can be accommodated only if they show improvement within 30 days)
• Need for oral or nasopharyngeal suctioning
• Need for assistance with tube feeding
• Need for blood gas monitoring
• Need for intermittent positive pressure breathing therapy
• Need for skilled rehabilitation services
• Need for 24-hour nursing supervision
• Extended Congregate Care Residents with:
• Need for two-person assistance with transferring
• Stage 3 or 4 pressure sores
• Need for oral or nasopharyngeal suctioning
• Need for nasogastric tube feeding
• Need for blood gas monitoring
• Need for intermittent positive pressure breathing therapy
• Need for skilled rehabilitation services
• Need for 24-hour nursing supervision
• Can be evicted
• Standard, Limited Nursing Services, and Limited Mental Health Services Residents who:
• Are ineligible under admissions guidelines (see above)
• Are bedridden for more than 7 consecutive days
• Extended Congregate Care Residents who:
• Are ineligible under admissions guidelines (see above)
• Are bedridden for more than 14 consecutive days
• Cannot come to an agreement on a service plan with the facility
• Has needs that can no longer be met by the facility, as identified in the service plan
• Exception to eviction
• Residents of all facilities who become terminally ill may remain as long as the arrangement is mutually agreeable to the resident and the facility, and the resident receives care from a licensed hospice agency

What training is required for direct care staff?

• All Levels of Care
• Within 30 Days of Employment
• 1 hour in-service training on reporting major or adverse incidents and emergency procedures
• Training on facility's resident elopement response policies
• One-time education course on HIV and AIDS
• Either complete a Core Training Program (consisting of a minimum of 26 hours of training and a competency test), or do the following:
•       - 1 hour in-service training on resident rights, reporting abuse, neglect, exploitation  
•       - 1 hour in-service training (topics: reporting major and adverse incidents, emergency procedures)
•       - 3 hours in-service training on resident behavior and nees, providing assistance with activities of daily living
• Staff who prepare food or have not taken the core training must:
• Receive 1 hour in-service training on safe food handling 
• Unlicensed staff who assist with the administration of medication must:
• Complete initial 4-hour training and 2 hours of continuing education annually
• Extended Congregate Care Facility
• Within 6 months of employment, staff must complete:
• 2 hours training on extended congregate care
• Limited Mental Health Facility
• Staff must complete:
• 6 hours of specialized training, within 6 months of employment
• A minimum of 3 hours of continuing education biennially
• Staff who provide direct care to residents Alzheimer's Disease and Related Disorders, must complete:
• 4 hours of initial training within 3 months of employment
• "Alzheimer's Disease and Related Disorders Level II Taining" (4 hours) within 9 months
• 4 hours of continuing education annually

Is nurse staffing required?

• Extended Congregate Care Facility
• Must provide through staff or by contract services of a nurse who:
• Provides services as needed
• Develops resident service plans
• Performs monthly nursing assessments
• Limited Nursing Services Facility
• Must employ or contract with a nurse(s) to:
• Provide services as needed by residents

Is there any public payment available?

• Yes.  A Medicaid home and community-based services waiver and the Medicaid Assistive Care Services program under the Medicaid state plan cover services for low-income residents.

For More Information See:

Florida Long Term Care Ombudsman

1-888-831-0404

1-850-414-2323

http://ombudsman.myflorida.com

Department of Health

(850) 245-4444

http://www.doh.state.fl.us