Commonly Cited Deficiencies Against Assisted Living Facilities

The Florida Agency for Health Care Administration (AHCA) licenses, oversees, and governs Assisted Living Facilities (ALFs) and their operations. AHCA regularly inspects licensed assisted living facilities. During inspection, AHCA inspectors examine the facility, its records, and its operations for any violative practices which AHCA calls deficiencies. 

Owners, operators, and administrators should be aware of the most frequently cited deficiencies that AHCA inspectors find. Deficiencies can result in fines, but may be escalated by AHCA depending on the severity, gravity, frequency, and probable effects of violations. 

Medication Assistance with Self-Administration

Failure to follow the steps required in Section 429.256, Florida Statutes, is one of the most commonly cited deficiencies found against ALFs. Section 429.256 specifically outlines the requirements for unlicensed staff assisting residents with medication.

Medication Observation Record

The Medication Observation Record (MOR) must be updated immediately after medication is offered or given. The MOR must include the name of the resident and any known allergies, the name and telephone number of the resident’s health care provider, the name, strength, and directions for use of each medications, and a chart for recording each time the medication is taken, any missed dosages, refusals, or medication errors. 

Safe Living Environment

Pursuant to Section 429.28(1)(a), Florida Statutes, ALFs must provide a safe living environment for residents. This means an environment free of hazards and ensuring that all architectural, machinal, electrical, and structural systems are maintained in good working order. 

Additionally, residents must be provided with clean, comfortable beds no less than 36 inches wide and 72 inches long, at a height that provides the resident easy access to the bed. Residents must be provided with closets, a dresser or other storage, a table or nightstand, and a comfortable chair if requested. Clean linens must be readily available. Personal laundry services must be available. 

Emergency Environment Control

Facilities must prepare a plan to address emergency environmental control in the event of loss of primary electrical power, including alternate power source and acquisition of sufficient fuel to maintain power. The plan must be submitted to and approved by the local emergency management authority. Once the plan is approved, facilities must implement policies and procedures to ensure effective activation and operation of the emergency management plan. 

Resident Care and Resident Rights

Section 429.28, Florida Statutes, provides a Resident Bill of Rights, which must be posted in full view in the facility. In addition, ALFs must have a grievance procedure for receiving and responding to resident complaints. A facility must be able to demonstrate that the grievance procedure is effective upon receipt of a complaint. ALFs must maintain a written statement of house rules and procedures.

Background Screening

Pursuant to Section 435.12(2), Florida Statutes, all employees in AHCA’s Background Screening Clearinghouse must appear on a facility’s roster, and the facility’s roster must be updated within 10 days of any changes. 

Staff In-Service Training

Facility administrators or managers must provide or arrange for in-service training to facility staff who provide direct care to residents and facility staff who prepare or serve food, if they have not taken the assisted living facility core training. AHCA provides additional requirements with respect to different types of staff and training.

Seek Experienced Lawyers to Assist you with any Deficiency

We always recommend seeking the counsel of an experienced attorney when planning the operations of an Assisted Living Facility. The main goal in operating the facility is to avoid deficiencies altogether. However, we know that managing a facility takes the help of a team and immense dedication, and sometimes minor mistakes occur. 

Our team of legal experts understands the complex considerations when it comes to owning and operating an Assisted Living Facility. We often advise clients on how to avoid deficiencies, and how to handle a deficiency should AHCA inform you of one. Our team frequently assists Assisted Living Facilities, so we understand the legal implications of our clients’ obstacles and goals.