59A-36.023. Administrative Enforcement  


Effective on Monday, July 1, 2019
  • 1Facility staff shall cooperate with Agency personnel during surveys, complaint investigations, monitoring visits, implementation of correction plans, license application and renewal procedures and other activities necessary to ensure compliance with part I of chapter 429, F.S., and this rule chapter.

    41(1) INSPECTIONS.

    43(a) Pursuant to section 47429.34, F.S., 49the agency shall conduct a survey, investigation, or appraisal of a facility:

    611. Prior to issuance of a license;

    682. Prior to biennial renewal of a license;

    763. When there is a change of ownership;

    844. To monitor facilities licensed to provide limited nursing or extended congregate care services, or who were cited in the previous year for a Class I or Class II, or 4 or more uncorrected Class III violations;

    1215. Upon receipt of an oral or written complaint of practices that threaten the health, safety, or welfare of residents;

    1416. If the agency has reason to believe a facility is violating a provision of part III of chapter 429, F.S., or this rule chapter;

    1667. To determine if cited deficiencies have been corrected; and

    1768. To determine if a facility is operating without a license.

    187(b) The inspection shall consist of full access to and examination of the facility’s physical premises and facility records and accounts, and staff and resident records.

    213(c) Agency personnel shall interview facility staff and residents in order to determine whether the facility is respecting resident rights and to determine compliance with resident care standards. Interviews shall be conducted privately.

    246(d) Agency personnel shall respect the private possessions of residents and staff while conducting facility inspections.

    262(2) ABBREVIATED SURVEY.

    265(a) An applicant for license renewal who does not have any class I or class II violations or uncorrected class III violations, confirmed long-term care ombudsman council complaints reported to the agency by the LTCOC, or confirmed licensing complaints within the two licensing periods immediately preceding the current renewal date shall be eligible for an abbreviated biennial survey by the agency. Facilities that do not have two survey reports on file with the agency under current ownership are not eligible for an abbreviated inspection. Upon arrival at the facility, the agency shall inform the facility that it is eligible for and that an abbreviated survey will be conducted.

    373(b) Compliance with key quality of care standards described in the following statutes and rules will be used by the agency during its abbreviated survey of eligible facilities:

    4011. Section 403429.26, F.S., 405and rule 59A-36.006, F.A.C., relating to residency criteria;

    4132. Section 415429.27, F.S., 417and rule 59A-36.013, F.A.C., relating to proper management of resident funds and property;

    4303. Section 432429.28, F.S., 434and rule 59A-36.007, F.A.C., relating to respect for resident rights;

    4444. Section 446429.41, F.S., 448and rule 59A-36.007, F.A.C., relating to the provision of supervision, assistance with ADLs, and arrangement for appointments and transportation to appointments;

    4695. Section 471429.256, F.S., 473and rule 59A-36.008, F.A.C., relating to assistance with or administration of medications;

    4856. Section 487429.41, F.S., 489and rule 59A-36.010, F.A.C., relating to the provision of sufficient staffing to meet resident needs;

    5047. Section 506429.41, F.S., 508and rule 59A-36.011, F.A.C., relating to minimum dietary requirements and proper food hygiene;

    5218. Section 523429.075,524.F.S., and rule 59A-36.020, F.A.C., relating to mental health residents’ community support living plan;

    5389. Section 540429.07, F.S., 542and rule 59A-36.021, F.A.C., relating to meeting the environmental standards and residency criteria in a facility with an extended congregate care license; and

    56510. Section 567429.07, F.S., 569and rule 59A-36.022, F.A.C., relating to the provision of care and staffing in a facility with a limited nursing license.

    589(c) The agency will expand the abbreviated survey or conduct a full survey if violations which threaten or potentially threaten the health, safety, or security of residents are identified during the abbreviated survey. The facility shall be informed that a full survey will be conducted. If one or more of the following serious problems are identified during an abbreviated survey, a full biennial survey will be immediately conducted:

    6571. Violations of rule chapter 69A-40, F.A.C., relating to firesafety, that threaten the life or safety of a resident;

    6762. Violations relating to staffing standards or resident care standards that adversely affect the health or safety of a resident;

    6963. Violations relating to facility staff rendering services for which the facility is not licensed; or

    7124. Violations relating to facility medication practices that are a threat to the health or safety of a resident.

    731(3) SURVEY DEFICIENCY.

    734(a) Prior to or in conjunction with a notice of violation issued pursuant to section 749429.19 750and chapter 120, F.S., the agency shall issue a statement of deficiency for Class I, II, III, and IV violations which are observed by Agency personnel during any inspection of the facility. The deficiency statement shall be issued within ten (10) working days of the Agency’s inspection and shall include:

    8001. A description of the deficiency;

    8062. A citation to the statute or rule violated;

    8153. A time frame for the correction of the deficiency;

    8254. A request for a plan of correction which shall include time frame for correction of the deficiency; and

    8445. A description of the administrative sanction that may be imposed if the facility fails to correct the deficiency within the established time frame.

    868(b) Additional time may be granted to correct specific deficiencies if a written request is received by the agency prior to the time frame included in the agency’s statement.

    897(c) The facility’s plan of correction must be received by the agency within 10 working days of receipt of the deficiency statement and is subject to approval by the agency.

    927(4) EMPLOYMENT OF A CONSULTANT.

    932(a) Medication Deficiencies.

    9351. If a Class I, Class II, or uncorrected Class III deficiency directly relating to facility medication practices as established in rule 59A-36.008, F.A.C., is documented by agency personnel pursuant to an inspection of the facility, the agency shall notify the facility in writing that the facility must employ, on staff or by contract, the services of a pharmacist licensed pursuant to section 998465.0125, F.S., 1000or registered nurse, as determined by the agency.

    10082. The initial on-site consultant visit shall take place within 7 working days of the identification of a Class I or Class II deficiency and within 14 working days of the identification of an uncorrected Class III deficiency. The facility shall have available for review by the agency a copy of the pharmacist’s or registered nurse’s license and a signed and dated recommended corrective action plan no later than 10 working days subsequent to the initial on-site consultant visit.

    10873. The facility shall provide the agency with, at a minimum, quarterly onsite corrective action plan updates until the agency determines after written notification by the consultant and facility administrator that deficiencies are corrected and staff has been trained to ensure that proper medication standards are followed and that such consultant services are no longer required. The agency shall provide the facility with written notification of such determination.

    1155(b) Dietary Deficiencies.

    11581. If a Class I, Class II, or uncorrected Class III deficiency directly related to dietary standards as established in rule 59A-36.012, F.A.C., is documented by agency personnel pursuant to an inspection of the facility, the agency shall notify the facility in writing that the facility must employ, on staff or by contract, the services of a registered dietitian or licensed dietitian/nutritionist.

    12202. The initial on-site consultant visit shall take place within 7 working days of the identification of a Class I or Class II deficiency and within 14 working days of the identification of an uncorrected Class III deficiency. The facility shall have available for review by the agency a copy of the dietitian’s license or registration card and a signed and dated dietary consultant’s recommended corrective action plan no later than 10 working days subsequent to the initial on-site consultant visit.

    13013. The facility shall provide the agency with, at a minimum, quarterly on-site corrective action plan updates until the agency determines after written notification by the dietary consultant and facility administrator that deficiencies are corrected and staff has been trained to ensure that proper dietary standards are followed and that such consultant services are no longer required. The agency shall provide the facility with written notification of such determination.

    1370(5) ADMINISTRATIVE SANCTIONS. Administrative fines shall be imposed for Class I and Class II violations, or Class III or IV violations which are not corrected within the time frame set by the Agency, and for repeat Class III violations, as set forth in section 1414429.19, F.S.

    1416(a) The Agency shall notify facilities of the imposition of sanctions, their right to appeal the sanctions, the remedies available, and the time limit for requesting such remedies as provided under chapter 120, F.S., and part II of chapter 59-1, F.A.C.

    1457(b) When an administrative fine payment is returned from the applicant’s bank for whatever reason, the agency shall add to the amount due a service fee of $20 or 5 percent of the face amount of the check, whichever is greater, up to a maximum charge of $200. Proceeds from this fee shall be deposited in the same agency account as the fine.

    1520Rulemaking Authority 1522429.41, 1523429.42 FS. 1525Law Implemented 1527429.07, 1528429.08, 1529429.11, 1530429.12, 1531429.14, 1532429.17, 1533429.19, 1534429.256, 1535429.26, 1536429.27, 1537429.28, 1538429.34, 1539429.41, 1540429.42 FS. 1542History–New 915441545301546154792, Formerly 10A155015515.033, Amended 1015541555301556155795, 10-17-99, 1-9-02, 7-30-06, 4-15-10, 3-13-14, Formerly 156458A-5.033, 15657-1-19.