59A-3.254. Patient Rights and Care

(1) Patient Assessment. Each hospital shall develop and adopt policies and procedures to ensure an initial assessment of the patient’s physical, psychological and social status, appropriate to the patient’s developmental age, is completed to determine the need and type of care or treatment required, and the need for further assessment. The scope and intensity of the initial assessment shall be determined by the patient’s diagnosis, the treatment setting, the patient’s desire for treatment, and response to previous treatment.

(a) Such policies shall:

1. Specify the time period preceding or following admission within which the initial assessment shall be conducted;

2. Require that the initial assessment be documented in writing in the patient’s medical record;

(b) The initial assessment shall determine the need for an assessment of the patient’s nutritional and functional status, as well as discharge planning needs, when appropriate;

(c) The hospital shall have policies and procedures to ensure that periodic reassessments of the patient are conducted based on changes in either the patient’s condition, diagnosis, or response to treatment;

(d) The hospital shall ensure that care and treatment decisions are based on the patient’s identified needs and treatment priorities;

(e) An individualized treatment plan shall be developed for each patient based upon the initial assessment and other diagnostic information as appropriate.

(2) Coordination of Care. Each hospital shall develop and implement policies and procedures on discharge planning which address:

(a) Identification of patients requiring discharge planning;

(b) Initiation of discharge planning on a timely basis;

(c) Evaluation of prescription medications, ensuring the continued availability of medications for at least three days after discharge;

(d) The role of the physician, other health care givers, the patient, and the patient’s family in the discharge planning process; and

(e) Documentation of the discharge plan in the patient’s medical record including an assessment of the availability of appropriate services to meet identified needs following hospitalization.

(3) Patient and Family Education.

(a) General Provisions. Each hospital shall develop a systematic approach to educating the patient and family to improve patient outcomes by promoting recovery, speedy return to function, promoting healthy behaviors, and involving patients in their care and care decisions.

(b) Each hospital shall provide the patient and family with education specific to the patient’s assessed needs, capabilities, and readiness. Such education shall include when indicated:

1. An assessment when indicated, of the educational needs, capabilities, and readiness to learn based on cultural and religious practices, emotional barriers, desire and motivation to learn, physical and cognitive limitations, and language barriers;

2. Instruction in the specific knowledge or skills needed by the patient or family to meet the patient’s ongoing health care needs including:

a. The use of medications.

b. The use of medical equipment.

c. Potential drug or food interactions, and nutritional intervention or modified diets.

d. Rehabilitation techniques.

e. Available community resources.

f. When and how to obtain further treatment; and

g. The patient’s and family’s responsibilities in the treatment process.

3. Information about any discharge instructions given to the patient or family shall be provided to the organization or individual responsible for providing continuing care.

4. Each hospital shall plan and support the provision and coordination of patient and family education activities by ensuring that:

a. Educational resources required are identified and made available; and

b. The educational process is interdisciplinary, as appropriate to the plan of care.

(4) Patient Rights. Each hospital shall develop and adopt policies and procedures to ensure the following rights of the patient:

(a) The right to refuse treatment and life-prolonging procedures as specified under Section 765.302, F.S.;

(b) The right to formulate advance directives and designate a surrogate to make health care decisions on behalf of the patient as specified under Chapter 765, F.S. The policies shall not condition treatment or admission upon whether or not the individual has executed or waived an advance directive. In the event of conflict between the facility’s policies and procedures and the individual’s advance directive, provision should be made in accordance with Section 765.302, F.S. Policies shall include:

1. Provide each adult individual, at the time of the admission as an inpatient, with a copy of “Health Care Advance Directives – The Patient’s Right to Decide,” revised 2006, which is hereby incorporated by reference, and available at: https://www.flrules.org/Gateway/reference.asp?No=Ref-04606 and from the Agency for Health Care Administration at: https://floridahealthfinderstore.blob.core.windows.net/documents/reports-guides/documents/English-Health%20Care%20Advance%20Dir%202006.pdf or with a copy of some other substantially similar document which is a written description of Chapter 765, F.S., regarding advance directives;

2. Providing each adult individual, at the time of admission as an inpatient, with written information concerning the health care facility’s policies respecting advance directives; and

3. The requirement that documentation of the existence of an advance directive be contained in the medical record. A health care facility which is provided with the individual’s advance directive shall make the advance directive or a copy thereof a part of the individual’s medical record.

(c) The right to information about patient rights as set forth in Section 381.026, F.S., and procedures for initiating, reviewing and resolving patient complaints;

(d) The right to participate in the consideration of ethical issues that arise in the care of the patient;

(e) The right to personal privacy and confidentiality of information including access to information contained in the patient’s medical records as specified under Section 395.3025, F.S.;

(f) The right of the patient’s next of kin or designated representative to exercise rights on behalf of the patient;

(g) The right to an itemized patient bill upon request as specified under Section 395.301, F.S.;

(h) The right to be free of restraints consistent with the rights of mentally ill persons or patients as provided in Section 394.459, F.S.

(5) In addition to the provisions of this section, hospitals must comply with Section 381.026, F.S.

Rulemaking Authority 395.1055 FS. Law Implemented 395.003, 395.1055 FS. History–New 4-17-97, Formerly 59A-3.2055, Amended 10-16-14.