Transportation Responsibilities in Assisted Living: Understanding 59A-36.007

Transportation Responsibilities in Assisted Living: Understanding 59A-36.007
Transportation Responsibilities in Assisted Living: Understanding 59A-36.007

Providing access to health care is a core responsibility of Assisted Living Facilities (ALFs). Transportation plays a major role in making sure residents receive the medical, dental, nursing, and mental health services they need. Florida regulations clearly outline what facilities must do—and just as importantly, what should be clearly defined in your resident contract.

Florida Administrative Code 59A-36.007 Resident Care Standards (3)(b) states:

“Provide transportation to needed medical, dental, nursing or mental health services, or arrange for transportation through family and friends, volunteers, taxi cabs, public buses, and agencies providing transportation.”

What This Means for Assisted Living Facilities

Facilities are not required to personally transport every resident, but they are responsible for ensuring transportation is available or properly arranged. Whether transportation is provided directly by the facility or coordinated through outside resources, the responsibility ultimately remains with the ALF.

Your Contract Matters — A Lot

One of the most overlooked compliance issues related to transportation is what your resident contract says.

Facilities should clearly outline:

  • Whether transportation is included or limited 
  • If there are extra fees for transportation 
  • How often transportation will be provided 
  • Any restrictions related to distance, frequency, or type of appointment 

If transportation fees or limits are not clearly disclosed in the contract, disputes with families—and potential regulatory issues—can arise quickly.

When Transportation Becomes Excessive

Some residents may develop frequent or ongoing medical needs, including multiple weekly appointments. While facilities must make reasonable efforts to meet resident needs, there may be situations where transportation demands exceed what the facility can safely or consistently provide.

If a facility is unable to continue meeting transportation needs, this should be:

  • Clearly communicated 
  • Properly documented 
  • Handled in accordance with resident rights 

In some cases, issuing a 45-day notice of discharge may be appropriate if the facility can no longer meet the resident’s needs, including transportation requirements. This should never be a surprise to the resident or family.

Communication Is Essential

Strong communication and coordination with:

  • The resident 
  • Family members 
  • Care managers or guardians 

is critical. Transportation should be planned, discussed in advance, and adjusted as needs change. Poor communication is often what turns a manageable situation into a compliance issue.

Safe Transportation Is Your Responsibility

Facilities must also ensure that transportation arrangements are safe and appropriate.

For residents with:

  • Cognitive impairment 
  • Dementia 
  • Behavioral challenges 

sending a resident alone to appointments may not be appropriate. In these situations:

  • A staff escort may be necessary, or 
  • A family member or responsible party should be involved 

Facilities are responsible for making smart, reasonable transportation decisions. If something goes wrong, the facility may still be held accountable for how transportation was arranged.