Florida Senate - 2026 CS for CS for SB 1404
By the Committees on Fiscal Policy; and Health Policy; and
Senator Burton
594-03163-26 20261404c2
1 A bill to be entitled
2 An act relating to memory care; amending s. 429.02,
3 F.S.; defining terms; amending s. 429.07, F.S.;
4 requiring licenses for assisted living facilities that
5 provide memory care services; making technical
6 changes; creating s. 429.076, F.S.; requiring an
7 assisted living facility that serves memory care
8 residents or holds itself out as providing memory care
9 services to obtain a memory care services license;
10 providing an exception; requiring an assisted living
11 facility to maintain certain licensure and meet
12 certain requirements in order to obtain a memory care
13 services license; requiring that a memory care license
14 be renewed at the same time as the assisted living
15 facility’s standard license; requiring the Agency for
16 Health Care Administration to adopt rules governing
17 memory care services licenses by a specified date;
18 specifying requirements for such rules; requiring an
19 assisted living facility licensed on or after the
20 effective date of such rules to obtain a memory care
21 services license to carry out certain functions;
22 requiring an assisted living facility licensed before
23 the effective date of such rules to obtain a memory
24 care services license within a specified timeframe
25 after the effective date of such rules; authorizing a
26 facility that served memory care residents without a
27 memory care services license before a specified date
28 to continue to do so if certain requirements are met;
29 requiring a facility without a memory care services
30 license to meet specified requirements if a memory
31 care resident decides to remain at the facility
32 despite the absence of such license; providing
33 construction; amending s. 492.17, F.S.; providing that
34 a memory care license expires at the same time as the
35 facility’s standard license; creating s. 430.71, F.S.;
36 providing the purpose of the Florida Alzheimer’s
37 Center of Excellence; defining terms; creating the
38 center within the Department of Elderly Affairs;
39 authorizing the center to contract for services;
40 providing duties of the center; requiring the center
41 to submit an annual report to the Governor and the
42 Legislature by a specified date; specifying
43 requirements for the report; requiring the center to
44 work with specified agencies, committees, initiatives,
45 clinics, task forces, and other entities to ensure the
46 full use of the state’s infrastructure; specifying
47 eligibility requirements for services; authorizing the
48 center to provide assistance to qualified persons,
49 subject to the availability of funds and resources;
50 repealing ss. 429.177 and 429.178, F.S., relating to
51 patients with Alzheimer’s disease or other related
52 disorders and certain disclosures and special care for
53 persons with Alzheimer’s disease or other related
54 disorders, respectively, upon the adoption of certain
55 rules; providing an effective date.
56
57 Be It Enacted by the Legislature of the State of Florida:
58
59 Section 1. Present subsections (15) through (28) of section
60 429.02, Florida Statutes, are redesignated as subsections (17)
61 through (30), respectively, new subsections (15) and (16) are
62 added to that section, and subsection (12) of that section is
63 amended, to read:
64 429.02 Definitions.—When used in this part, the term:
65 (12) “Extended congregate care” means acts beyond those
66 authorized in subsection (20) (18) which may be performed
67 pursuant to part I of chapter 464 by persons licensed thereunder
68 while carrying out their professional duties, and other
69 supportive services that may be specified by rule. The purpose
70 of such services is to enable residents to age in place in a
71 residential environment despite mental or physical limitations
72 that might otherwise disqualify them from residency in a
73 facility licensed under this part.
74 (15) “Memory care resident” means a person who suffers from
75 Alzheimer’s disease or a related dementia who is a resident of
76 an assisted living facility that claims or otherwise represents
77 that it provides specialized care, services, or activities
78 specifically to support such resident’s Alzheimer’s disease or
79 related dementia, irrespective of whether such care, services,
80 or activities were listed in the resident’s contract.
81 (16) “Memory care services” means specific specialized or
82 focused care, services, or activities an assisted living
83 facility agrees to provide to a memory care resident to support
84 his or her Alzheimer’s disease or related dementia. Such
85 services do not include services, care, or activities provided
86 by the assisted living facility as supportive services, as
87 defined in subsection (29), that are optional and available to
88 all residents of the facility.
89 Section 2. Subsection (3) of section 429.07, Florida
90 Statutes, is amended to read:
91 429.07 License required; fee.—
92 (3) In addition to the requirements of s. 408.806, each
93 license granted by the agency must state the type of care for
94 which the license is granted. Licenses shall be issued for one
95 or more of the following categories of care: standard, extended
96 congregate care, limited nursing services, or limited mental
97 health, or memory care services.
98 (a) A standard license shall be issued to facilities
99 providing one or more of the personal services identified in s.
100 429.02. Such facilities may also employ or contract with a
101 person licensed under part I of chapter 464 to administer
102 medications and perform other tasks as specified in s. 429.255.
103 (b) An extended congregate care license shall be issued to
104 each facility that has been licensed as an assisted living
105 facility for 2 or more years and that provides services,
106 directly or through contract, beyond those authorized in
107 paragraph (a), including services performed by persons licensed
108 under part I of chapter 464 and supportive services, as defined
109 by rule, to persons who would otherwise be disqualified from
110 continued residence in a facility licensed under this part. An
111 extended congregate care license may be issued to a facility
112 that has a provisional extended congregate care license and
113 meets the requirements for licensure under subparagraph 2. The
114 primary purpose of extended congregate care services is to allow
115 residents the option of remaining in a familiar setting from
116 which they would otherwise be disqualified for continued
117 residency as they become more impaired. A facility licensed to
118 provide extended congregate care services may also admit an
119 individual who exceeds the admission criteria for a facility
120 with a standard license, if he or she is determined appropriate
121 for admission to the extended congregate care facility.
122 1. In order for extended congregate care services to be
123 provided, the agency must first determine that all requirements
124 established in law and rule are met and must specifically
125 designate, on the facility’s license, that such services may be
126 provided and whether the designation applies to all or part of
127 the facility. This designation may be made at the time of
128 initial licensure or relicensure, or upon request in writing by
129 a licensee under this part and part II of chapter 408. The
130 notification of approval or the denial of the request shall be
131 made in accordance with part II of chapter 408. Each existing
132 facility that qualifies to provide extended congregate care
133 services must have maintained a standard license and may not
134 have been subject to administrative sanctions during the
135 previous 2 years, or since initial licensure if the facility has
136 been licensed for less than 2 years, for any of the following
137 reasons:
138 a. A class I or class II violation;
139 b. Three or more repeat or recurring class III violations
140 of identical or similar resident care standards from which a
141 pattern of noncompliance is found by the agency;
142 c. Three or more class III violations that were not
143 corrected in accordance with the corrective action plan approved
144 by the agency;
145 d. Violation of resident care standards which results in
146 requiring the facility to employ the services of a consultant
147 pharmacist or consultant dietitian;
148 e. Denial, suspension, or revocation of a license for
149 another facility licensed under this part in which the applicant
150 for an extended congregate care license has at least 25 percent
151 ownership interest; or
152 f. Imposition of a moratorium pursuant to this part or part
153 II of chapter 408 or initiation of injunctive proceedings.
154
155 The agency may deny or revoke a facility’s extended congregate
156 care license for not meeting the criteria for an extended
157 congregate care license as provided in this subparagraph.
158 2. If an assisted living facility has been licensed for
159 less than 2 years, the initial extended congregate care license
160 must be provisional and may not exceed 6 months. The licensee
161 shall notify the agency, in writing, when it has admitted at
162 least one extended congregate care resident, after which an
163 unannounced inspection shall be made to determine compliance
164 with the requirements of an extended congregate care license. A
165 licensee with a provisional extended congregate care license
166 which demonstrates compliance with all the requirements of an
167 extended congregate care license during the inspection shall be
168 issued an extended congregate care license. In addition to
169 sanctions authorized under this part, if violations are found
170 during the inspection and the licensee fails to demonstrate
171 compliance with all assisted living facility requirements during
172 a follow-up followup inspection, the licensee shall immediately
173 suspend extended congregate care services, and the provisional
174 extended congregate care license expires. The agency may extend
175 the provisional license for not more than 1 month in order to
176 complete a follow-up followup visit.
177 3. A facility that is licensed to provide extended
178 congregate care services shall maintain a written progress
179 report on each person who receives such nursing services from
180 the facility’s staff which describes the type, amount, duration,
181 scope, and outcome of services that are rendered and the general
182 status of the resident’s health. A registered nurse, or
183 appropriate designee, representing the agency shall visit the
184 facility at least twice a year to monitor residents who are
185 receiving extended congregate care services and to determine if
186 the facility is in compliance with this part, part II of chapter
187 408, and relevant rules. One of the visits may be in conjunction
188 with the regular survey. The monitoring visits may be provided
189 through contractual arrangements with appropriate community
190 agencies. A registered nurse shall serve as part of the team
191 that inspects the facility. The agency may waive one of the
192 required yearly monitoring visits for a facility that has:
193 a. Held an extended congregate care license for at least 24
194 months;
195 b. No class I or class II violations and no uncorrected
196 class III violations; and
197 c. No ombudsman council complaints that resulted in a
198 citation for licensure.
199 4. A facility that is licensed to provide extended
200 congregate care services must:
201 a. Demonstrate the capability to meet unanticipated
202 resident service needs.
203 b. Offer a physical environment that promotes a homelike
204 setting, provides for resident privacy, promotes resident
205 independence, and allows sufficient congregate space as defined
206 by rule.
207 c. Have sufficient staff available, taking into account the
208 physical plant and firesafety features of the building, to
209 assist with the evacuation of residents in an emergency.
210 d. Adopt and follow policies and procedures that maximize
211 resident independence, dignity, choice, and decisionmaking to
212 permit residents to age in place, so that moves due to changes
213 in functional status are minimized or avoided.
214 e. Allow residents or, if applicable, a resident’s
215 representative, designee, surrogate, guardian, or attorney in
216 fact to make a variety of personal choices, participate in
217 developing service plans, and share responsibility in
218 decisionmaking.
219 f. Implement the concept of managed risk.
220 g. Provide, directly or through contract, the services of a
221 person licensed under part I of chapter 464.
222 h. In addition to the training mandated in s. 429.52,
223 provide specialized training as defined by rule for facility
224 staff.
225 5. A facility that is licensed to provide extended
226 congregate care services is exempt from the criteria for
227 continued residency set forth in rules adopted under s. 429.41.
228 A licensed facility must adopt its own requirements within
229 guidelines for continued residency set forth by rule. However,
230 the facility may not serve residents who require 24-hour nursing
231 supervision. A licensed facility that provides extended
232 congregate care services must also provide each resident with a
233 written copy of facility policies governing admission and
234 retention.
235 6. Before the admission of an individual to a facility
236 licensed to provide extended congregate care services, the
237 individual must undergo a medical examination as provided in s.
238 429.26(5) and the facility must develop a preliminary service
239 plan for the individual.
240 7. If a facility can no longer provide or arrange for
241 services in accordance with the resident’s service plan and
242 needs and the facility’s policy, the facility must make
243 arrangements for relocating the person in accordance with s.
244 429.28(1)(k).
245 (c) A limited nursing services license shall be issued to a
246 facility that provides services beyond those authorized in
247 paragraph (a) and as specified in this paragraph.
248 1. In order for limited nursing services to be provided in
249 a facility licensed under this part, the agency must first
250 determine that all requirements established in law and rule are
251 met and must specifically designate, on the facility’s license,
252 that such services may be provided. This designation may be made
253 at the time of initial licensure or licensure renewal, or upon
254 request in writing by a licensee under this part and part II of
255 chapter 408. Notification of approval or denial of such request
256 shall be made in accordance with part II of chapter 408. An
257 existing facility that qualifies to provide limited nursing
258 services must have maintained a standard license and may not
259 have been subject to administrative sanctions that affect the
260 health, safety, and welfare of residents for the previous 2
261 years or since initial licensure if the facility has been
262 licensed for less than 2 years.
263 2. A facility that is licensed to provide limited nursing
264 services shall maintain a written progress report on each person
265 who receives such nursing services from the facility’s staff.
266 The report must describe the type, amount, duration, scope, and
267 outcome of services that are rendered and the general status of
268 the resident’s health. A registered nurse representing the
269 agency shall visit the facility at least annually to monitor
270 residents who are receiving limited nursing services and to
271 determine if the facility is in compliance with applicable
272 provisions of this part, part II of chapter 408, and related
273 rules. The monitoring visits may be provided through contractual
274 arrangements with appropriate community agencies. A registered
275 nurse shall also serve as part of the team that inspects such
276 facility. Visits may be in conjunction with other agency
277 inspections. The agency may waive the required yearly monitoring
278 visit for a facility that has:
279 a. Had a limited nursing services license for at least 24
280 months;
281 b. No class I or class II violations and no uncorrected
282 class III violations; and
283 c. No ombudsman council complaints that resulted in a
284 citation for licensure.
285 3. A person who receives limited nursing services under
286 this part must meet the admission criteria established by the
287 agency for assisted living facilities. When a resident no longer
288 meets the admission criteria for a facility licensed under this
289 part, arrangements for relocating the person shall be made in
290 accordance with s. 429.28(1)(k), unless the facility is licensed
291 to provide extended congregate care services.
292 Section 3. Section 429.076, Florida Statutes, is created to
293 read:
294 429.076 Memory care services license.—An assisted living
295 facility that serves one or more memory care residents, or that
296 advertises or otherwise holds itself out as providing memory
297 care services, must obtain a memory care services license
298 pursuant to subsection (3) or subsection (4), as applicable. A
299 facility is not required to obtain a memory care services
300 license if the facility solely provides supportive services, as
301 defined in s. 429.02, for residents with Alzheimer’s disease and
302 related dementias which are optional and available to all
303 residents of the facility so long as the facility complies with
304 agency rules on advertising pursuant to paragraph (2)(h).
305 (1) To obtain a memory care services license, an assisted
306 living facility must maintain a standard assisted living
307 facility license and meet any additional minimum requirements
308 adopted by rule. A memory care services license must be renewed
309 at the same time as the facility’s standard license.
310 (2) By June 1, 2027, the agency shall adopt rules to
311 provide minimum standards for memory care services licenses.
312 Such rules must include, but are not limited to:
313 (a) Policies and procedures for providing memory care
314 services.
315 (b) Standardized admittance criteria for memory care
316 residents.
317 (c) The minimum level of care, services, and activities
318 that must be provided to memory care residents.
319 (d) Minimum training requirements for staff at a facility
320 with a memory care services license, which must meet or exceed
321 training requirements established in s. 430.5025.
322 (e) Safety requirements specific to memory care residents,
323 including, but not limited to, requiring a memory care services
324 licensee to maintain at least one awake staff member to be on
325 duty at all hours.
326 (f) Physical plant requirements for a facility, or parts of
327 a facility as specified by the licensee, serving memory care
328 residents.
329 (g) Requirements for contracts with memory care residents
330 which, in addition to the requirements established by s. 429.24,
331 must require a memory care services licensee to specify the
332 memory care services that will be provided to the memory care
333 resident.
334 (h) Specified terms or terminologies that a facility may
335 not use in its advertising without obtaining a memory care
336 services license. Such terms include, but are not limited to,
337 memory care, memory care facility, memory care services, memory
338 care residents, dementia care, dementia care facility,
339 Alzheimer’s care, and Alzheimer’s care facility. A facility that
340 is not licensed to provide memory care services may advertise
341 the supportive services, as defined in s. 429.02, it provides
342 for persons with Alzheimer’s disease and related dementias so
343 long as such advertisements do not use any terms or terminology
344 prohibited by the agency’s rules pursuant to this subsection,
345 such advertisements do not make any claim that the facility
346 provides memory care services, and the facility maintains a copy
347 of such advertisements in its records. The agency shall examine
348 all such advertisements in the facility’s records as part of its
349 licensure renewal procedure.
350 (i) Requirements that a facility must meet to continue to
351 serve memory care residents without obtaining a memory care
352 services license pursuant to subsection (5).
353 (3) An assisted living facility licensed on or after the
354 effective date of the rules required by subsection (2) must
355 obtain a memory care services license to provide memory care
356 services, serve memory care residents, or advertise or hold
357 itself out as providing memory care services or otherwise
358 serving memory care residents.
359 (4) Except as provided in subsection (5), an assisted
360 living facility licensed before the effective date of the rules
361 required by subsection (2) must obtain a memory care services
362 license within 6 months after the effective date of such rules
363 in order to begin or continue to provide memory care services,
364 serve memory care residents, or advertise or hold itself out as
365 providing such services or serving such residents.
366 (5)(a) A facility that serves one or more memory care
367 residents accepted before the effective date of the rules
368 required by subsection (2) may continue to serve such memory
369 care residents and provide memory care services to such
370 residents without obtaining a memory care services license if
371 the facility:
372 1. Demonstrates to the agency that it is unable to
373 reasonably obtain such license.
374 2. Notifies any memory care residents the facility serves
375 and their caregivers, if applicable, that:
376 a. The facility is required to obtain a memory care
377 services license;
378 b. The facility is unable to obtain such license; and
379 c. The memory care resident may relocate to a facility with
380 a memory care services license, if desired.
381 3. Upon request, assists memory care residents or, if
382 applicable, their caregivers with finding a suitable alternate
383 facility.
384 4. No longer accepts any new memory care residents without
385 first obtaining a memory care services license.
386 (b) If, after receiving the notice required by subparagraph
387 (a)2., a memory care resident or, if applicable, his or her
388 caregiver decides that the resident will remain at the facility,
389 the facility must:
390 1. Amend the resident’s contract to include the memory care
391 services that are being provided to the resident;
392 2. Maintain records pertaining to when and how such
393 services were provided to the resident; and
394 3. Provide such records to the resident, his or her
395 caregivers, or the agency upon request.
396 (c) This subsection may not be construed to exempt a
397 facility from meeting any other requirements in law or rule as
398 applicable to the facility, including, but not limited to,
399 requirements related to the appropriateness of placements for
400 residents of the facility established in s. 429.26.
401 Section 4. Subsection (1) of section 429.17, Florida
402 Statutes, is amended to read:
403 429.17 Expiration of license; renewal; conditional
404 license.—
405 (1) Limited nursing, extended congregate care, and limited
406 mental health licenses, and memory care services shall expire at
407 the same time as the facility’s standard license, regardless of
408 when issued.
409 Section 5. Section 430.71, Florida Statutes, is created to
410 read:
411 430.71 Florida Alzheimer’s Center of Excellence.—
412 (1) PURPOSE AND INTENT.—The purpose of this section is to
413 assist and support persons with Alzheimer’s disease or related
414 dementias and their caregivers by connecting them with resources
415 in their communities to address the following goals:
416 (a) To allow residents of this state living with
417 Alzheimer’s disease or related dementias to age in place.
418 (b) To empower family caregivers to improve their own well
419 being.
420 (2) DEFINITIONS.-As used in this section, the term:
421 (a) “Center” means the Florida Alzheimer’s Center of
422 Excellence.
423 (b) “Department” means the Department of Elderly Affairs.
424 (3) POWERS AND DUTIES.—
425 (a) There is created within the department the Florida
426 Alzheimer’s Center of Excellence, which shall assist in
427 improving the quality of care for persons living with
428 Alzheimer’s disease or related dementias and improving the
429 quality of life for family caregivers. The center may contract
430 for services necessary to implement this section. The center
431 shall do all of the following:
432 1. Conduct caregiver assessments to measure caregiver
433 burden.
434 2. Create personalized plans that guide caregivers to
435 community resources, empowering them with the skills, education,
436 support, and planning necessary for effective caregiving,
437 including addressing any medical, emotional, social, legal, or
438 financial challenges experienced by the person with Alzheimer’s
439 disease or a related dementia.
440 3. Educate and assist caregivers with strategies for
441 caregiving for someone with Alzheimer’s disease or a related
442 dementia and provide guidance on all aspects of home-based care,
443 including home safety, physical and mental health, legal and
444 financial preparedness, communication skills, and hands-on care
445 techniques.
446 4. Provide online educational resources for caregivers.
447 5. Track outcomes, including, but not limited to, decreased
448 hospitalizations, reduced emergency department visits, reduction
449 in falls, and reduction in caregiver burnout.
450 6. By December 1 of each year, submit a report to the
451 Governor, the President of the Senate, and the Speaker of the
452 House of Representatives which addresses the number of families
453 served, the types of services provided, and the outcomes
454 achieved.
455 (b) The center shall work with area agencies on aging as
456 defined in s. 430.203; the Alzheimer’s Disease Advisory
457 Committee established under s. 430.501; the Alzheimer’s Disease
458 Initiative established under ss. 430.501-430.504; the state
459 funded memory disorder clinics established under s. 430.502; the
460 department’s Dementia Care and Cure Initiative task forces;
461 universities; hospitals; and other available community resources
462 to ensure full use of the state’s infrastructure.
463 (4) ELIGIBILITY FOR SERVICES.—
464 (a) To qualify for assistance from the center, an
465 individual or a caregiver must meet all of the following
466 criteria:
467 1. At least one person in the household is a caregiver for
468 a person diagnosed with, or suspected to have, Alzheimer’s
469 disease or a related dementia.
470 2. The caregiver or the person diagnosed with, or suspected
471 to have, Alzheimer’s disease or a related dementia is a resident
472 of this state.
473 3. The person seeking assistance has the goal of providing
474 in-home care for the person diagnosed with, or suspected to
475 have, Alzheimer’s disease or a related dementia.
476 (b) If the person seeking assistance meets the criteria in
477 paragraph (a), the center may provide assistance to the
478 caregiving family, subject to the availability of funds and
479 resources.
480 Section 6. Effective upon the adoption of rules
481 establishing minimum standards for memory care services
482 licensees pursuant to s. 429.076, Florida Statutes, ss. 429.177
483 and 429.178, Florida Statutes, are repealed.
484 Section 7. This act shall take effect upon becoming a law.