⚠️ Charging Extra? Read This First.
What Florida ALFs Must Know About Resident Contracts Under 59A-36.018
In the assisted living industry, transparency builds trust. That trust starts with the resident contract — and how you handle any charges beyond the standard rate.
Under Florida Administrative Code 59A-36.018, your facility must follow specific rules before billing residents for any services, supplies, or accommodations not included in the original agreement. Violating this rule isn’t just a paperwork issue — it’s a regulatory risk that could lead to citations, complaints, and damage to your facility’s reputation.
Let’s break down what the law requires — and what your contract must include to stay compliant.
📝 No Surprise Charges Allowed
According to 59A-36.018(3):
“The facility may not levy an additional charge for any supplies, services, or accommodations that the facility has agreed by contract to provide as part of the standard daily, weekly, or monthly rate.”
In other words:
If it’s listed in the contract as part of the regular rate — you can’t charge extra for it. Not for supplies. Not for services. Not for accommodations.
Common areas this rule impacts:
- Personal hygiene supplies
- Laundry service
- Room cleaning
- Meals
- Basic medication assistance
If your contract says it’s included, it must be provided without extra billing.
💡 Thinking of Offering Something Extra?
Let’s say a resident wants:
- Additional housekeeping
- Premium menu options
- Escort services to appointments
- Wi-Fi or cable not included in the standard package
You can offer those — but only if the following steps are followed before any charges are applied.
📃 Required: An Itemized Statement + Addendum
Here’s what the rule says:
“The resident or resident’s representative must be furnished in advance with an itemized written statement setting forth additional charges…”
That means:
- A clear list of the extra items or services
- The cost for each, broken down (not bundled)
- This must be provided before billing or providing the service
But that’s not all — the next step is often overlooked:
“An addendum must be added to the resident contract… dated and signed by the facility and the resident or resident’s legal representative…”
This addendum:
- Must be a formal part of the contract
- Must be signed and dated by both parties
- A copy must be given to the resident or their legal representative
Skipping any of these steps can lead to:
- Accusations of unauthorized billing
- Complaints to AHCA or the Ombudsman
- Immediate regulatory citations
🧾 Best Practices for Compliance
To stay protected:
✅ Make sure your original contract clearly outlines what is included in the standard rate
✅ Use a standard Resident Contract Addendum Form for any optional services
✅ Always provide written notice and pricing before offering additional services
✅ Get all addendums signed and dated by both the facility and the resident or representative
✅ File addendums with the original contract and give a copy to the resident
📎 Need Help Staying Organized?
ALF BOSS provides templates for:
- Resident contracts
- Service addendum forms
- Itemized pricing checklists
- Compliance file tracking sheets
Visit alfboss.com to access tools that keep you compliant — and prepared for your next inspection.
In assisted living, clarity equals protection.
Don’t let a small billing oversight turn into a major regulatory issue. Use proper documentation, keep communication transparent, and protect both your residents and your license.