The short answer: Often, yes. Florida law lets an assisted living facility (ALF) admit or keep a resident who is receiving hospice care, even one who is bedridden or needs round-the-clock nursing, as long as four conditions are met: the facility agrees, the resident agrees, a licensed hospice provides the additional care, and a physician agrees the resident's physical needs can be met there. A written plan must also spell out how the facility and the hospice will cover both scheduled and unscheduled needs.
That is a joint decision between your family, the facility and the hospice. It is not automatic, and the facility's agreement is the part families most often take for granted.
What does Florida law actually say?
The rule is in s. 429.26(1)(c), Florida Statutes:
"A facility may admit or retain an individual receiving hospice services if the arrangement is agreed to by the facility and the resident, additional care is provided by a licensed hospice, and the resident is under the care of a physician who agrees that the physical needs of the resident can be met at the facility. The resident must have a plan of care which delineates how the facility and the hospice will meet the scheduled and unscheduled needs of the resident, including, if applicable, staffing for nursing care."
Hospices in Florida are licensed under Part IV of Chapter 400 (s. 400.602), so a private-duty aide or an unlicensed companion service does not meet the requirement.
The phrase that matters most is unscheduled needs. Hospice nurses visit on a schedule; a pain crisis at 2 a.m. does not. Before hospice starts, ask to see in writing who responds overnight and how quickly.
Why is hospice an exception to the usual rules?
Normally, a Florida ALF "may not admit or retain a resident who is bedridden or who requires 24-hour nursing supervision" (s. 429.26(1)(d)). Florida defines bedridden as being confined to bed because of an inability to move, turn or reposition without total physical help, to transfer to a chair without total physical help, or to sit safely in a chair without help or a restraint.
Without hospice, a resident who becomes bedridden may stay for no more than 7 consecutive days, or 14 in a facility licensed for Extended Congregate Care. Those limits do not apply to a resident receiving licensed hospice services; the statute's bedridden rule begins "Except for a resident who is receiving hospice services."
The state's rule for facilities (59A-36.006) sets out what must be in place for a terminally ill resident who no longer meets the usual criteria to stay:
- the resident qualifies for, is admitted to, and consents to services from a licensed hospice;
- both the resident (or their representative) and the facility agree to continued residency;
- the hospice develops an interdisciplinary care plan that says which services the hospice provides and which the facility provides;
- documentation of all of this is kept in the resident's file.
Who provides the hands-on care, the facility or the hospice?
Both, and the split should be written down before hospice begins.
The facility keeps doing what it already does: meals, supervision, help with bathing and dressing, medication assistance and laundry. Florida's rule also says facility staff "may provide any nursing service permitted under the facility's license and total help with the activities of daily living for residents admitted to hospice" (59A-36.006).
The hospice adds its team: nurse visits for pain and symptom management, aide visits, a social worker, a chaplain, medications for pain and symptom control, and equipment such as a hospital bed or oxygen. If a hospice resident has a cardiac or respiratory arrest, facility staff must contact hospice immediately, and "the hospice procedures take precedence over those of the assisted living facility" (59A-36.009).
The weak spot is the time between hospice visits. If your parent needs turning every two hours or a two-person transfer, a small home with one caregiver overnight may not be able to manage it, and that is exactly what the physician and facility have to judge.
Does Medicare pay the assisted living bill during hospice?
No. Medicare pays for hospice care itself, not for the place where your parent lives. Medicare.gov notes that you "may have to pay for room and board if you live in a facility (like a nursing home) and choose to get hospice care," and that hospice can usually be provided "in your home or other facility where you live, like an assisted living facility or a nursing home" (Medicare.gov).
| Cost | Who pays |
|---|---|
| Hospice nurse, aide, social worker and chaplain visits | Medicare: $0 to you |
| Drugs for pain and symptom management | Medicare: up to $5 per outpatient prescription |
| Medical equipment and supplies for the terminal illness | Medicare: $0 to you |
| Inpatient respite care (up to 5 days at a time) | 5% of the Medicare-approved amount |
| Assisted living rent, meals and care fees | Your family, Medicaid or insurance |
To qualify, the hospice doctor and your parent's regular doctor must certify a life expectancy of six months or less, and your parent must choose comfort care instead of treatment to cure the illness. Coverage runs in two 90-day benefit periods followed by an unlimited number of 60-day periods, as long as the doctor keeps recertifying. For the rest of what Medicare does and doesn't cover, see Does Medicare pay for assisted living?
Does the facility's license matter?
Yes. The license sets how much nursing the facility's own staff may provide alongside hospice:
- A standard license covers personal care and supervision; facility nurses may administer medications.
- A Limited Nursing Services (LNS) license lets the facility provide nursing care to residents who don't need 24-hour supervision, and to residents who do need 24-hour nursing care and are enrolled in hospice (59A-36.022).
- An Extended Congregate Care (ECC) license is designed to let residents stay as they become more impaired, with awake staff at all hours and monthly nursing assessments.
Our guide to Florida assisted living license types explains each one and how to check which a facility holds.
Can the facility still ask my parent to move?
It can, because the arrangement depends on the facility's agreement and the physician's judgment that needs can be met there. Florida's health assessment form, which every resident must have within 60 days before or 30 days after admission, "does not guarantee admission to, continued residency in, or the delivery of services at the facility" (s. 429.26(5)). Enrolling in hospice also counts as a "significant change" under Florida's rules, which triggers a new assessment.
If a facility decides it can no longer meet your parent's needs, Florida generally requires at least 45 days' notice before ending residency, with exceptions for a physician-certified emergency move to a higher level of care (s. 429.28). The State Long-Term Care Ombudsman Program (1-888-831-0404) can help if you disagree.
The safest step is to get the facility's position in writing before you need it.
What should I ask before move-in or before hospice starts?
- Have you cared for residents on hospice through the end of life here? How often?
- Which licenses do you hold: standard, LNS or ECC?
- Which licensed hospices do you work with, and can we choose our own?
- Who is awake and on duty overnight, and how many residents does each person cover?
- How do you handle unscheduled needs between hospice visits, such as pain, falls or breathing changes?
- Does the monthly rate go up as care needs increase at the end of life?
- Under what circumstances would you ask us to move?
Smaller homes can feel more personal at the end of life: in our directory, 1,446 Florida facilities (48%) are licensed for six or fewer residents as of October 2026. Confirm overnight staffing before assuming a small home can meet unscheduled needs. Browse options in our Florida directory, and see how nursing homes compare in our nursing home vs. assisted living guide.
Decisions about whether your parent's needs can be met where they live belong to their physician and the hospice medical director. Ask early, not in the middle of a crisis.
