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Assisted Living's in FL| What's an ECC License?

Recently, I've been working with clients who live in neighboring states to Florida and their loved ones require a higher level assisted living/memory care facility. In Florida, our licensing can allow residents with higher levels of care to reside in an Assisted Living with a higher care license than in other states. Every state has their own regulations and guidelines for assisted living care that requires either Licensed Assisted Living or a Skilled Nursing Facility admission. Here are some more details regarding Florida's highest care license in an Assisted Living Facility (ALF).

Part 1 in the blog series, described the different types of Assisted Living Facility (ALF) Licenses that operate in the State of Florida.

To recap:

All ALF's start with a Standard License (#1) and the additional licenses are added to meet specific care needs. Limited Nursing Services (#2), Extended Congregate Care (#3), Limited Mental Health Services (#4) The ECC license expands the level of care allowed in ALF's, letting residents age in place while avoiding nursing home/skilled care placement.


In Part 2 of this blog series, I am going to discuss the most inquired type of license operating in Florida, the Extended Congregate Care License (ECC).

Extended Congregate Care (ECC) License:

A facility providing ECC services must make available the following additional services requested by the resident's service plan:

  • Total help with bathing, dressing, grooming and using the restroom.

  • Nursing assessments more frequently than monthly.

  • Hospice care CAN come help with quality of life and care measures.

  • Measurement and recording of basic vital functions and weight.

  • Dietary management including special diets, and monitoring intake and output.

  • Assistance with or administration of medications and treatments ordered by the physician.

  • If assistance with self-administration is needed the facility must inform the resident of the qualifications of staff who will be providing this assistance, and if unlicensed persons will assist written consent must be obtained.

  • Supervision of residents with dementia and cognitive impairments.

  • Health education, and health-promotion programs and preventive regimes.

  • Provision or arrangement for rehabilitative services.

  • Provision of escort services to health-related appointments.

  • Must provide a physical environment that promotes a homelike setting, provides for resident privacy, promotes resident independence, and allows sufficient congregate space.

  • Have sufficient staff available, considering evacuation needs.

  • Adopt and follow policies and procedures that maximize resident independence, dignity, choice, and decision - making.

  • The facility shall maintain a written progress report on each person who receives services which describes the type, amount, duration, scope, and outcome of services that are rendered and the general status of the resident’s health.

  • A registered nurse, or appropriate designee, representing the agency shall visit the facility at least twice a year to monitor residents who are receiving extended congregate care services.

Minimum Admission and Continued Residency Criteria For ECC Services in Florida:

  • Minimum 18 years of age

  • Free from symptoms of communicable disease

  • Able to transfer with assistance of one person

  • Not be a danger to self or others

  • Not bedridden

  • No stage 3 or 4 pressure sores (unless the resident is admitted onto hospice).

  • No airway management except CPAP or bi-pap machine

  • No nasogastric tube feeding, monitoring of blood gasses, post surgical drainage tubes or wound vacuums

  • No treatment of surgical incisions unless stabilized and plan of care developed.

  • Does not require 24 hour one-on-one supervision.


I'm a local Geriatric Care Manager and Certified Dementia Practitioner in NW Florida. I'm an expert in aging care solutions able to guide you to find the best care options for your loved one whether that is getting care in the home or finding a care housing solution in your budget and in your desired location. I can help you find the right assisted living facility for you or your loved one's care needs.

Laura Cassell, CDP

Geriatric Care Manager and Gerontologist in NWFL

Phone: 850-723-6484


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