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Click ‘Get Form’ to open the VDSS Model Form - ALF in the editor.
Begin by filling in your name in the first blank space, followed by the name of the Assisted Living Facility where information is being sent.
Sign and date the form in the designated areas to authorize the release of information.
Provide the name, address, and telephone number of your mental health service provider in the specified fields.
Enter the name of the resident and their residing location in the appropriate sections.
Indicate whether continued mental health services are needed by checking 'does' or 'does not' as applicable.
List any recommendations for continued services based on your assessment.
Assess if the resident's needs can be met in an assisted living facility and provide explanations if necessary.
Finally, recommend any specific services that should be provided by the assisted living facility before signing and dating again at the bottom.

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Who qualifies for assisted living in Florida?

65 or older. Resident of Florida. Currently enrolled in Medicare Parts A and B. Assessed by CARES to be nursing home-eligible.

What is Alf medical?

ALF is short for assisted living facility. Structured similarly to a typical apartment complex. At an ALF, residents typically receive three meals a day, housekeeping and laundry service, and various daily activity programs in addition to help with medication management.

How do I file a complaint against a nursing home in Virginia?

You can simply call the Complaint Unit at 1-800-955-1819 or you can visit their website for more information: http://www.vdh.virginia.gov/olc/complaint/. When you contact the Virginia Department of Health make sure you have the exact name of the nursing home and be prepared to share the basis of your concerns.

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Does Medicare cover assisted living?

En español | No, Medicare does not cover the cost of assisted living facilities or any other long-term residential care, such as nursing homes or memory care.

How do I file a complaint with the Virginia medical board?

Complaints can be submitted to the Enforcement Division verbally or in writing and may be submitted anonymously. Go to the Complaint page to see detailed information about the Complaint Process. For any questions contact the Enforcement Division at (804) 367-4691 or toll free at 1-800-533-1560 (VA Only).

How do I file a complaint against an assisted living facility in Virginia?

File a Complaint Verbally or Request a Complaint Form Contact the Enforcement Division at 1-800-533-1560 or (804) 367-4691.

Who oversees assisted living facilities in Virginia?

The Virginia Department of Social Services licenses two levels of care in assisted living facilities (ALFs): residential living care (minimal assistance) or assisted living care (at least moderate assistance). Facilities licensed to provide assisted living care may also provide residential care.

How do I report an assisted living facility in Virginia?

Complaints against an assisted living facility should be made to the Department of Social Services. Complaints against a licensed mental health or substance abuse treatment program should be made to the Department of Behavioral Health and Developmental Services.

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