Assisted living transportation policy template: scheduled trips, medical appointments, fees, and escorts

How to use this policy

Fill in the blanks, delete the clauses that do not fit your community, and hand the result to residents and families at move-in with the resident agreement. This is a fill-in document, not legal advice. Your administrator or attorney should check it against your state’s assisted living rules before you issue it.

Three points keep the policy short and usable:

• Name one person. Clause 3 asks for a single contact who takes ride requests. That is usually the resident services director, the activities director, or the transportation coordinator.
• Separate the kinds of ride. A doctor visit, a group trip to the store, and a ride outside your area have different notice rules and prices, so each gets its own clause.
• Start from your state’s rule. What the community must provide is set by state licensing. Our guide to whether assisted living provides rides to appointments covers the rules in Florida, North Carolina, Louisiana, Indiana, and California, and the section on state examples below adds three more.

If an outside ride company serves your residents, the partnership guide covers the agreement between the two of you, and the facility transportation agreement is the contract to start from.

The policy

1. Purpose and who it covers

1.1 ____ (“the community”) helps residents get to medical appointments, services, and community activities. This policy says which rides the community provides, how to ask for one, and what it costs.

1.2 It applies to every resident, including residents who pay privately and residents whose services are paid by Medicaid, a waiver program, or a health plan.

2. Rides the community provides

2.1 The community serves addresses within ____ miles of ____, or within these ZIP codes: ____. Rides beyond that area are handled under clause 8.

2.2 These rides are available:

2.3 A resident who uses a wheelchair gets the same service, at the same price, for the same trip as any other resident. The community never charges more because a ride needs a lift or a securement system.

3. Asking for a medical ride

3.1 A resident, family member, or representative asks ____ (name and role) by ____ (phone, form, or portal) at least ____ business days before the appointment.

3.2 The request gives the date and time of the appointment, the provider’s name and address, whether the resident uses a wheelchair or walker, any oxygen, whether someone will go along, and when the visit is expected to end.

3.3 The community confirms within ____ hours and tells the resident the pickup time.

3.4 A repeat appointment, such as dialysis or therapy, is set up once as a standing order and reviewed every ____ days.

3.5 Residents choose their own doctors and clinics. The community does not require use of a particular provider.

4. Pickup, waiting, and the ride home

4.1 The community schedules a pickup time for each appointment and aims to pick the resident up within ____ minutes before or after it, at the ____ entrance.

4.2 The resident arrives no more than ____ minutes before check-in.

4.3 For the ride home, the resident or the office calls ____ when the visit ends, and the community aims to pick the resident up within ____ minutes of that call. This is a will-call return.

4.4 The driver waits ____ minutes at pickup. If the resident is not ready by then, staff call the resident’s room or unit and the ride is recorded as missed.

4.5 If a visit runs long and the vehicle has to leave, the community arranges another ride home and the charge is ____.

5. Escorts and companions

5.1 Staff do not stay with a resident at an appointment unless ____.

5.2 A resident may bring a family member, aide, or companion. That person takes a seat, so tell us when you book.

5.3 The community never requires a resident with a disability to bring an attendant as a condition of getting a ride.

5.4 When a resident’s care plan calls for an escort, ____ (staff, family, or a paid companion) goes along. The charge for a staff escort is ____.

6. Wheelchairs, walkers, and oxygen

6.1 A resident who uses a wheelchair rides in ____ (the community’s accessible vehicle). If it is not available, the community books an accessible ride from ____ at the same charge the resident would have paid.

6.2 Staff secure the wheelchair with the vehicle’s securement system and put a seat belt on every rider before the vehicle moves.

6.3 A resident who carries oxygen supplies it. Staff check the gauge before departure, secure the cylinder upright, and allow no smoking or open flame in the vehicle.

7. Cancelling and missed rides

7.1 Cancel at least ____ hours before pickup by calling ____.

7.2 A ride cancelled later than that, or missed because the resident is not ready, is charged at ____ (nothing, or a stated fee).

7.3 If the community cancels or runs more than ____ minutes late, it arranges another ride at no charge.

7.4 A ride booked through the state Medicaid ride program is cancelled with that program, not with the community.

8. When the community books an outside ride company

8.1 The community books an outside medical transportation company when:

• ☐ the resident needs a wheelchair space or a stretcher the community vehicle cannot offer
• ☐ the appointment is more than ____ miles away
• ☐ the ride is same-day, after hours, or on a day the community vehicle does not run
• ☐ the vehicle or driver is not available
• ☐ the resident has a Medicaid or health plan ride benefit that should pay for the trip

8.2 The company is ____, phone ____. The charge to the resident is ____.

8.3 Staff help residents and families book rides through the resident’s Medicaid ride program or health plan when the resident qualifies.

9. Residents on a Medicaid waiver

9.1 Residents whose services are paid by a Medicaid waiver may use any ride they choose, including family, a ride company, or the program’s own ride benefit. The community supports that choice and does not require use of its van.

9.2 The community does not charge a resident for a ride that the resident’s program pays for.

10. Drivers and vehicles

10.1 Community drivers are at least 18, hold a valid license for the vehicle they drive, and have a driving record check at hire and every ____.

10.2 Residents do not drive community vehicles.

10.3 Everyone in the vehicle wears a seat belt while it moves. Drivers use a phone only hands-free.

10.4 Each vehicle carries a first aid kit and a list of emergency contacts for the residents aboard.

10.5 The community keeps current copies of the registration, insurance, inspection, and driver’s license for every vehicle it uses to carry residents.

11. Charges and changes

11.1 The monthly rate includes: ____. Everything else is charged as listed in Schedule A.

11.2 The community gives residents written notice at least ____ days before it changes a ride charge.

12. Problems and complaints

12.1 Report a problem to ____. The community answers in writing within ____ days.

12.2 Residents may also contact the state long-term care ombudsman at ____.

13. Review

This policy takes effect on ____ and is reviewed every ____ months by ____.

Schedule A: Ride charges

What three states ask a community to write down

State rules turn several clauses above into requirements. These three show how different the demands are.

• Pennsylvania (55 Pa. Code 2800.171). A residence must provide or arrange transportation on a regular weekly basis for medical and social appointments within a reasonable local area. When staff or volunteers drive, the driver must be 18 or older with a valid license and cannot be a resident, everyone wears a safety restraint, the vehicle carries a first aid kit, the driver uses only a hands-free phone, and an assistant goes along when needed. The residence keeps the registration, driver’s license, insurance, and inspection for each vehicle. If it runs its own vehicles, at least one must be accessible to wheelchair users.
• Georgia (Rule 111-8-63). The admission agreement must contain provisions for transportation for shopping, recreation, rehabilitation, and medical services, as a basic service or on a reimbursement basis. It must also give 30 days’ written notice before a rise in personal service charges and 60 days before a rise in room and board charges. Where the community provides transportation, it keeps basic emergency contact information on the residents being transported in the vehicle, and employees who may transport residents need a satisfactory driving record in their files.
• Virginia (22VAC40-73-790). The whole rule says residents shall be assisted in making arrangements for transportation as necessary. A Virginia policy can be lighter, but it still needs to say who helps and how to ask.

Pennsylvania’s timing rules show how clauses 4.1 to 4.3 can look. Take a resident with a 2:00 p.m. appointment, as an example. The residence schedules a pickup time and makes every reasonable effort to arrive within 15 minutes before or after it. A residence’s own vehicle may not drop the resident off at the appointment more than one hour before 2:00 p.m., and the residence makes every reasonable effort to pick the resident up no later than one hour after the appointment. Set your own numbers inside whatever your state allows.

Federal rules that sit behind the wheelchair, escort, and fee clauses

A community that runs a ride service residents can call for operates what Part 37 calls a demand responsive system, meaning any system of transporting people that is not a fixed route system (49 CFR 37.3). A private entity that is not primarily in the business of transporting people but operates one falls under the Department of Transportation’s ADA rules (49 CFR 37.21(a)(3)). Three clauses follow from them.

• Clauses 2.3 and 5.3. The rules bar special charges for services needed to accommodate a person with a disability and bar requiring an attendant (49 CFR 37.5(d) and (e)). The equivalent service test in 37.171 and 37.105 is explained in the partnership guide.
• Clause 6.2. The entity secures wheelchairs with the vehicle’s securement system and assists with securement systems, ramps, and lifts where necessary or on request (49 CFR 37.165). The securement guide covers what that means on the vehicle.
• Clause 10.1. A vehicle designed to transport 16 or more passengers, including the driver, is a commercial motor vehicle under 49 CFR 383.5, and so is one rated at 26,001 pounds or more. Our CDL guide covers the rest.

A waiver clause that protects the resident’s choice

Clause 9.1 comes from the settings rule for Medicaid home and community-based services. 42 CFR 441.301(c)(4) says the setting must facilitate individual choice regarding services and supports and who provides them. In a residence owned or controlled by the provider, it adds that residents run their own schedules and activities, with support. A policy that sends every waiver resident to the community van for every trip can conflict with that rule. The waiver transportation entry explains how states pay for waiver rides.

Keeping the policy current

Review the policy every year, and again whenever the state licensing rule, your vehicle, or your ride company changes. Keep a dated copy of each version with the resident agreements, and give residents the written notice your state requires before any charge goes up.

Running resident rides in HealthRide

A ride company that serves your community can run its rides on HealthRide. Staff request rides in a facility portal, follow the vehicle live, and view and pay invoices there, and residents and families can follow their driver from a text link. A weekly appointment is scheduled once and keeps repeating, which suits the standing schedule in clause 3.4. See recurring trips.