Mom Was Baker Acted From Assisted Living — What Happens Next
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After a Baker Act from assisted living, five things happen in order: your parent is examined at a receiving facility for up to 72 hours, the doctors then release them, admit them voluntarily, or ask a court for involuntary services, the community has to follow written notice rules before it can end the residency, someone has to decide whether the current level of care still fits, and you decide what comes next. The Baker Act is Florida's mental health law, and it is not a punishment or a discharge. It is an examination.
Rule out the biggest worry first
Families often hear "Baker Acted" and assume their parent has been discharged from the community. The two are separate. The Baker Act, in section 394.463 of the Florida Statutes, covers an involuntary examination. Whether your parent may live in the community afterward is a question under chapter 429, the assisted living law, and we cover that below.
An examination can be started in only three ways: a judge signs an order, a law enforcement officer takes the person into custody, or a physician, clinical psychologist, psychiatric nurse, advanced practice nurse, clinical social worker, mental health counselor or marriage and family therapist signs a certificate saying they examined the person within the last 48 hours and believe the criteria are met. Assisted living staff who are worried usually call 911 or the person's doctor. They do not order the examination themselves.
Dementia and mental illness are not the same thing in this law
Florida defines mental illness in section 394.455. The definition says it does not include conditions manifested only by dementia, traumatic brain injury, intoxication, antisocial behavior or substance abuse.
That sentence matters to a family. If your mother has Alzheimer's and was taken in because she became agitated, struck a caregiver or wandered at night, those behaviors come from the dementia. On that alone she does not meet the definition. A person with dementia who also has a separate mental illness, such as severe depression or psychosis, can.
Ask the receiving facility what the doctors found, and ask for it in writing.
What the 72 hours mean
The examination period is up to 72 hours, and it starts when your parent arrives at the receiving facility. Within that time, one of four things must happen:
- Your parent is released.
- Your parent is released for voluntary outpatient treatment.
- Your parent gives informed consent and is admitted as a voluntary patient.
- A petition for involuntary services is filed with the court.
If the 72 hours end on a weekend or holiday, a petition can be filed by the next working day.
Who to call, in the order to call them
| Step | Who to call | What it settles |
|---|---|---|
| Find out where she is and who the doctor is | The receiving facility, by the name on the police report or the community | Whether she can be seen, and who to talk to |
| Give the doctors her full history | The receiving facility, with her diagnosis, medication list and the name of her primary care doctor | Whether the cause is dementia, a medication, an infection or a separate illness |
| Ask for the discharge plan | The social worker or case manager at the receiving facility | Where she goes, and which medications changed |
| Ask the community what it will do | The administrator, in writing | Whether the community plans to take her back, and on what terms |
| Dispute a refusal | State Long Term Care Ombudsman, (888) 831-0404 | Help with the 45 day notice rules, at no cost |
| Report abuse or neglect | Florida Abuse Hotline, (800) 962-2873, open 24 hours | An investigation by the Department of Children and Families |
| Ask about a different level of care | Sugarmill Manor (352) 382-2531, The Gardens (352) 794-7601 | Whether a secured memory care section fits better |
| Someone in danger or crisis | 988 Suicide and Crisis Lifeline, or 911 | Immediate help |
If your parent is in danger right now, call 911 first.
Does the community have to take her back?
Not automatically, and not never. Florida's residents' rights law, section 429.28, says a resident is entitled to at least 45 days notice of relocation or termination of residency. The reasons must be set out in writing and given to the resident or the resident's representative, and the notice must tell them they can contact the Ombudsman. If the resident has been found incapacitated by a court, the guardian gets the notice.
There are two exceptions to the 45 days. One is when a physician certifies that, for medical reasons, the resident needs an emergency move to a facility giving a more skilled level of care. The other is when the resident engages in a pattern of conduct that is harmful or offensive to other residents. A facility that ends a residency without the notice has to show good cause in court.
In plain terms: a single incident and a trip to a receiving facility do not, on their own, end a residency. A pattern of unsafe behavior, or a doctor's finding that she needs a higher level of care, can. Whether your parent's situation falls into either group is a question for the Ombudsman or an elder law attorney, not for us.
What we will tell you honestly
Here is the part that works against us. A community decides whether it can meet a resident's needs, and sometimes the honest answer after a crisis is that it cannot. Assisted living is not a psychiatric hospital. If your parent needs treatment for a mental illness, or behavior that puts others at risk, the right place may be a different setting for a while, and a community that pretends otherwise is not doing right by your parent or its other residents.
What a good community should do is tell you so in writing, early, and with its reasons. It should also work with the receiving facility's discharge planner before the 72 hours end, so your parent does not come back to a plan nobody has agreed on.
If dementia is the cause, the better question is often whether a secured memory care section would keep your parent safer and calmer than the setting where the crisis happened. Our memory care page explains how the secured section works, and our post on signs assisted living is no longer enough covers how families recognize the point.
Questions to ask on the day of discharge
- What did the doctors conclude, and is dementia the cause?
- Which medications were started, stopped or changed, and why?
- Does she need to see a geriatric psychiatrist or neurologist, and who makes that appointment?
- Is there a written discharge plan, and who has a copy?
- Has the community seen that plan and agreed to it?
Bring the answers to the community in writing. If the community says no, ask for the reasons in writing as well. The written reasons are what the Ombudsman or an attorney will need.
A Baker Act is frightening because it happens fast and the family is left outside the room. It is also a short process with set time limits and set rules. Get the paperwork, call the Ombudsman if anyone says she cannot return, and decide what comes next once the doctors have told you what they found.
Frequently asked questions
What does it mean when someone is Baker Acted from assisted living?
It means a court order, a law enforcement officer or a clinician's certificate started an involuntary mental health examination at a receiving facility. The examination lasts up to 72 hours. It is an evaluation, not a discharge from the community.
Can a person with only dementia be Baker Acted in Florida?
Florida's definition of mental illness does not include conditions manifested only by dementia. A person whose only diagnosis is dementia does not meet the criteria on that diagnosis alone, though dementia plus a separate mental illness can.
Does the assisted living have to take my parent back after a Baker Act?
A community must give at least 45 days written notice to end a residency, with set reasons. The exceptions are a physician certified emergency move to a higher level of care and a pattern of conduct harmful or offensive to other residents. Otherwise it must show good cause in court.
How long can someone be held under the Baker Act?
Up to 72 hours, counted from arrival at the receiving facility. Within that time the person is released, released for outpatient treatment, admitted voluntarily, or a petition for involuntary services is filed.
Who can help if the community refuses to take my parent back?
The Florida State Long Term Care Ombudsman helps with relocation disputes at no cost, and an elder law attorney can review the written notice and reasons.
Sources
Written by
Community Relations Director
Cameron Hernando Clark is the Community Relations Director for The Manors of Citrus. He writes this family guide to help Citrus County families make sense of assisted living and memory care, drawing on the day to day of running two family owned communities on Florida's Nature Coast.
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