Florida Creates New Assisted Living Facility Specialty License Type for Memory Care Services

Florida bill CS/CS/SB 1404 would create a new Assisted Living Facility (ALF) specialty license designation for memory care services. If enacted, certain ALFs will be required to obtain this designation to provide such services.

The bill defines a "memory care resident" as a person with Alzheimer's disease or a related dementia (ADRD) who resides in an ALF that claims or advertises that it provides specialized care, services or activities to support that resident's ADRD, regardless of whether such offerings are listed in the resident's contract. "Memory care services" means the specialized care, services or activities an ALF agrees to provide to a memory care resident to support a memory care resident's ADRD. These services do not include general support services designed to help older adults with disabilities remain in the least restrictive living environment and maintain their independence.

In addition to a standard ALF license, ALFs may currently obtain the following specialty license designations:

1. Extended Congregate Care (ECC) – nursing and support services for persons who would otherwise be disqualified from continued residence
2. Limited Nursing Services (LNS) – specified nursing services
3. Limited Mental Health (LMH) – services for individuals receiving Social Security disability income or supplemental security income due to a mental disorder, along with optional state supplementation

However, no specialty designation currently exists for memory care services, and existing regulations lack specificity, largely leaving each ALF to determine how to implement its own memory care program.

Under the bill, an ALF must obtain a memory care services specialty designation if it serves one or more memory care residents or holds itself out as providing memory care services. The designation is not required if the ALF only provides general supportive services to residents with ADRD, provided the facility complies with advertising rules that the Florida Agency for Health Care Administration (AHCA) must adopt. AHCA must adopt rules establishing minimum standards for the memory care services specialty designation by July 1, 2027. At a minimum, such rules must address the following:

• policies and procedures for providing memory care services
• standardized admittance criteria for memory care residents
• the minimum level of care, services and activities that must be provided for memory care residents
• minimum training requirements for staff
• safety requirements for memory care residents, including, but not limited to, requiring at least one awake staff member to be on duty at all hours
• physical plant requirements for a facility or parts of a facility serving memory care residents
• advertising restrictions that would prohibit an ALF without a memory care services license from using terms such as "memory care," "dementia care," "Alzheimer's care" and related variations

An ALF licensed before the effective date of AHCA's rules must obtain a memory care services license designation within six months after that date. An ALF applying on or after that date must obtain the designation before providing memory care services, serving memory care residents or advertising such services. A facility serving one or more memory care residents accepted before that date is exempt if it:

1. demonstrates to AHCA that it is unable to reasonably obtain the license
2. notifies any memory care residents the facility serves and their caregivers, if applicable, that:
   • the facility is required to obtain a memory care service license
   • the facility is unable to obtain such license
   • the memory care resident may relocate to a facility with a memory care service license, if desired
3. upon request, assists memory care resident or, if applicable, their caregivers with finding a suitable alternate facility
4. no longer accepts any new memory care residents without first obtaining a memory care services license

Currently licensed ALFs that provide memory care services or serve memory care residents should closely monitor the status of CS/CS/SB 1404. If approved by Gov. Ron DeSantis, AHCA will begin the rulemaking process to implement the new law. ALFs may participate in this process by attending a rule development workshop, submitting written comments or presenting evidence at a public hearing – opportunities that may significantly influence or shape the standards governing memory care services.