The AHCA 1823 form, formally called the Resident Health Assessment, is required by Florida law for anyone being admitted to an assisted living facility (ALF) or nursing home. The Agency for Health Care Administration mandates that a licensed physician, advanced registered nurse practitioner (ARNP), or physician assistant complete and sign the form. Under Florida regulations, the assessment must be conducted no more than 60 days before or 30 days after a resident's admission date.
The form covers six core assessment areas: medical history and current diagnoses, functional status and activities of daily living (ADLs) including bathing, dressing, eating, and mobility, cognitive and behavioral status, dietary and nutritional requirements, current medications and dosage, and the recommended level of care. Facilities use the completed 1823 to determine staffing ratios and create individualized care plans for each resident. Families and legal representatives are encouraged to keep copies of all completed assessments.
The 1823 form must be updated whenever a resident experiences a significant change in health condition, such as hospitalization, a new diagnosis, or a major decline in functional ability. Related forms used during the same admissions process include the resident assessment form and the AHCA 5000-3008 form. Staff at the admitting facility are responsible for retaining the completed 1823 in the resident's health record for the duration of care.
| Question | Answer |
|---|---|
| Form Name | AHCA 1823 Form (Resident Health Assessment) |
| Issuing Agency | Florida Agency for Health Care Administration (AHCA) |
| Who Completes It | Licensed physician, ARNP, or physician assistant |
| When Required | Within 60 days before or 30 days after ALF or nursing home admission |
| Form Length | 5 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 15 sec |
| Other names | form 1823 florida 2021, ahca 1823, 1823 form, form 1823, Florida resident health assessment |