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What is Form 1823? The health assessment for Florida assisted living

Every family moving a loved one into a Florida assisted living facility hears about Form 1823. It is the Resident Health Assessment from the Agency for Health Care Administration (AHCA), the state agency that licenses ALFs.

Who fills it out

A licensed physician, physician assistant or advanced practice registered nurse examines your loved one and records the exam. Florida rules allow the exam to be written on AHCA Form 1823 or on the practitioner's own form, as long as it covers what the rule asks for. Most families bring Form 1823 to the doctor.

When it is due

Under Florida rule 59A-36.006, the exam has to be done within 60 days before moving in, or within 30 days after. Many homes, including ours, like to have it before the move so we know how to care for your loved one from the first day.

What it covers

The form records health conditions, medications, allergies, diet, how much help the person needs with daily activities, and whether the doctor thinks assisted living is right for them.

Tips to get it done

• Ask the ALF for a blank copy and bring it to the appointment.
• Bring a current list of medications, or the bottles.
• Check that every page is signed and dated before you leave the office.
• Keep a copy for yourself.

Not sure whether your loved one needs assisted living or more care? Read assisted living vs a nursing home.

Good to know

Can our family doctor fill out Form 1823?

Yes, if they are a licensed physician, physician assistant or advanced practice registered nurse.

Do we need a new Form 1823 for a respite stay?

Mary's House asks for a Form 1823 dated within 60 days before a respite stay.