The Florida assisted living license, category by category

Which state agency licenses assisted living in Lee County, Florida?

The Florida Agency for Health Care Administration (AHCA) licenses every assisted living facility (ALF) in Lee County under Part I of Chapter 429, Florida Statutes; the county and its cities handle zoning and fire code but issue no care license of their own.

AHCA's general licensing law, Part II of Chapter 408, controls how a license is applied for, renewed every two years, transferred on a sale and inspected. Day-to-day operating standards are in Florida Administrative Code chapter 59A-36. Each separate premises needs its own license, though a campus of buildings under one operator may share one.

AHCA's records for Lee County, retrieved November 6, 2026, list 84 licensed assisted living facilities with 4,769 licensed beds. Of those, 21 hold a limited nursing services license, 6 extended congregate care and 1 limited mental health, while 32 report a memory care program on their profiles.

What can a Florida ALF do with only a standard license?

A standard license allows housing, meals, supervision and personal services such as help with bathing, dressing, grooming, eating and moving around, plus assistance with self-administered medication and, if a licensed nurse is employed or contracted, administration of medication and a short list of nursing tasks.

The limit is ongoing nursing. A resident of a standard-licensed Lehigh Acres or North Fort Myers home who needs regular wound care or injections gets it from a licensed home health agency that the resident, not the building, arranges. Most of the small residential ALFs in Lee County hold a standard license only, which is not a mark against them; it simply describes the scope.

What does extended congregate care (ECC) add to a Florida ALF license?

Extended congregate care is the specialty that lets an ALF deliver nursing and supportive services beyond the standard scope, so a resident whose needs grow can stay instead of moving; a facility needs two years of licensed operation without serious sanctions to qualify, and its first ECC license is provisional.

An ECC facility writes its own continued-residency criteria within AHCA's guidelines, but no ALF of any category may keep a resident who needs round-the-clock nursing supervision. A registered nurse monitors ECC residents at least twice a year. The ECC designation can cover part of a building, which is why the AHCA profile lists a separate count of beds approved for ECC. AHCA profiles show 6 ECC-licensed ALFs in Lee County: Barrington Terrace - Ft Myers (Fort Myers), Brookdale Fort Myers Cypress Lake (Fort Myers), Cypress Cove at Healthpark Fl (Fort Myers), King's Crown-Shell Point Village (Fort Myers), The Arbor at Shell Point (Fort Myers), The Springs at Shell Point Retirement Community (Fort Myers).

What are LNS and LMH licenses on a Florida ALF?

Limited nursing services (LNS) lets the facility's own nurses perform a defined set of nursing tasks for residents who still meet standard admission criteria, while limited mental health (LMH) is required when an ALF houses one or more residents with a serious mental illness who receive optional state supplementation.

The two often appear together on larger Fort Myers buildings and separately on smaller ones. LMH facilities must keep each mental health resident's community living support plan and cooperative agreement with the mental health provider on file, and their administrator and direct-care staff take extra mental health training. Neither license says anything about quality; they define what may happen inside the building.

Is memory care a separate license category in Florida now?

It is becoming one: chapter 2026-102, Laws of Florida, created a memory care services license in s. 429.076 that any ALF serving or advertising memory care will need once AHCA adopts its rules, due by June 1, 2027, with a six-month window for facilities already licensed when the rules take effect.

Until then the older s. 429.178 standard covers ALFs that advertise special care for Alzheimer's disease. Our memory care license guide walks through what the rules must contain and what Lee County families should ask in the meantime.