The AHCA Form 1823 is the spine of every Florida ALF resident chart. It is the resident health assessment that drives the admission decision, the placement-appropriateness call, and the continued-residency review. This guide explains what the form is, who completes it, when it is required, and the gaps surveyors cite most often.
Key takeaways
- The AHCA Form 1823 is the Resident Health Assessment used to admit a resident to a Florida ALF and to confirm continued residency.
- Section 1 (Health Assessment) must be completed by a licensed health care practitioner after a face-to-face examination.
- The exam must be redone at least every three years after the initial assessment OR after a significant change, whichever comes first.
- The current admission and continued-residency rule is FAC 59A-36.006, effective November 27, 2025.
- The completed 1823 (or an equivalent medical examination form) lives in the resident record under FAC 59A-36.015(3).
What the 1823 is
The AHCA Form 1823 (Resident Health Assessment) captures the medical baseline a Florida ALF needs to admit a resident and to make decisions about appropriate placement. The form has two parts. Section 1 is the Health Assessment, completed by a licensed health care practitioner. Section 2 is the Services Offered or Arranged section, completed by the facility.
The form also produces a list of the resident's prescribed medications, allergies, special diets, and any limitations that affect activities of daily living. That data is what your MOR cross-references and what your staff use to identify a resident in distress.
When the 1823 is required
The exam underlying the 1823 has to be face to face. It has to be done at admission, then again at least every three years or after a significant change in the resident's condition, whichever comes first.
FAC 59A-36.006 (Admission Procedures, Appropriateness of Placement, Continued Residency Criteria, effective 11/27/2025)
Continued-residency criteria are the same as the admission criteria. A resident must have a face-to-face medical examination by a health care practitioner at least every 3 years after the initial assessment, or after a significant change, whichever comes first. The facility administrator is responsible for monitoring the continued appropriateness of placement of every resident at all times. For residents placed by the department or by an agency under contract, the medical examination must be conducted within the 30 days before placement. Plain-language summary, not legal advice.
"Significant change" is the phrase that does the work. A new diagnosis, a hospitalization, a change in mobility, a change in cognition, a change in continence: any of these resets the 3-year clock and requires a fresh exam. Operators who treat the 1823 as a one-time admission document miss the recurring obligation.
Where the form lives
The records rule is explicit. The completed 1823, or the practitioner's equivalent medical examination form, lives in the resident record on the premises.
FAC 59A-36.015(3) (records)
Resident records must be maintained on the premises and have to include a copy of the Resident Health Assessment form (AHCA Form 1823) or the health care practitioner's medical examination form described in FAC 59A-36.006. Plain-language summary, not legal advice.
"On the premises" matters. If the form is at the medical office or in an old folder at the previous facility, the surveyor cannot find it during the visit. That alone is a tag.
Who completes what
| Section | Who completes it | Why it matters |
|---|---|---|
| Section 1A: Health Assessment | Licensed health care practitioner (face-to-face exam required) | Establishes the medical baseline and confirms appropriateness of placement |
| Section 1B: Medications, allergies, diagnoses, ADL limitations | Practitioner | Drives the MOR, allergy alerts, and care plan |
| Section 2: Services offered or arranged | Facility | Documents how the home will meet the needs identified in Section 1 |
Three patterns that lead to citations
Pattern 1. The 1823 is older than three years
The original form is in the chart. The three-year mark passed. No fresh face-to-face exam happened. Continued residency is suspect because the placement criteria are not current. Build a chart-level reminder 60 days before every 1823's three-year anniversary.
Pattern 2. Section 1 is filled in by someone other than a licensed practitioner
A family member, a nursing-home discharge planner, or facility staff completed the medical section. The rule is specific: Section 1 requires a licensed health care practitioner and a face-to-face exam. A non-practitioner signature there is a tag.
Pattern 3. The 1823 is not on premises during the survey
The original is at the doctor's office, or the digital copy is on a system the staff cannot access in the moment. Surveyors expect to see the form during the survey. Keep a printed copy in the chart, or an electronic copy that opens in under 30 seconds.
Two operator scenarios
Pilar runs a 16-bed standard ALF in Coral Gables. Her 2025 survey found one resident with a 1823 dated three years and two months prior. The fix was straightforward: she scheduled the face-to-face exam, got the new 1823 in the chart, and added a 60-day pre-anniversary reminder for every other resident. The deficiency closed cleanly. Her 2026 survey closed with no 1823 findings.
Andre owns a 12-bed standard ALF in Tampa. A new resident moved in with a 1823 from the previous facility. The signature in Section 1 was from a social worker, not a licensed practitioner. Andre scheduled a new face-to-face exam with the resident's current provider, replaced the form, and added a one-line check to the admission packet that confirms Section 1 has a practitioner signature. He has not had the issue repeat since.
The 1823 lifecycle
| Event | What happens |
|---|---|
| Admission | 1823 completed within the window required. Section 1 by a licensed practitioner. Section 2 by the facility. |
| Significant change | Fresh face-to-face exam, fresh 1823. Resets the three-year clock. |
| Three-year anniversary | Fresh exam required even with no significant change. |
| Discharge | 1823 remains in the chart and follows the records-retention rule. |
Once the 1823 is current, it feeds three other records: the MOR (medications and allergies), the care plan (ADL limitations and services), and the significant-changes log under FAC 59A-36.007(1)(f). For more on what AHCA surveyors check across the chart, see our Florida ALF medication records guide and the Florida ALF inspection checklist.
How to handle a significant change in practice
"Significant change" is the operative phrase, but the rule does not list every trigger. Operators have to use judgment. Use this short checklist as a default test. If any of these is yes, schedule a fresh face-to-face exam and a new 1823 within the next two weeks.
- A hospitalization or emergency room visit longer than 24 hours.
- A new diagnosis added to the chart by a treating provider.
- A new prescription that changes the level of care (a new anticoagulant, a new antipsychotic, a change from oral to injectable).
- A change in mobility (new walker, new wheelchair, two or more falls in 90 days).
- A change in cognition that staff and family both notice.
- A change in continence that affects the ADL plan.
- An unintentional weight loss of 5 percent or more over 90 days.
Each yes resets the three-year clock to the new exam date. Log the trigger in the significant-changes record under FAC 59A-36.007(1)(f) the same shift you notice it, so the chart shows why the new 1823 was ordered.
One more operator scenario
Linda runs a 14-bed standard ALF in Sarasota. A resident returned from a 4-day hospital admission with a new anticoagulant order. Linda treated it as a significant change, called the resident's provider, scheduled the face-to-face exam within the week, and had a new 1823 in the chart by day 10. When AHCA surveyed the home three months later, the inspector pulled exactly that chart, saw the trigger logged on day 1, the new exam scheduled on day 3, and the new 1823 filed on day 10. The surveyor closed the chart in under two minutes.
How Marpass fits
Marpass stores the 1823 directly on the resident record, next to the MOR, the care plan, and the significant-changes log. The data inside the 1823 (medications, allergies, diagnoses, ADL limitations) is structured, not free text, so allergies and diagnoses surface as alerts during the med pass. The three-year anniversary triggers a renewal reminder 60 days out. Significant-change triggers create a linked task on the resident record. Pricing is flat per home and posted on the site.
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