59A-8.003. Licensure Requirements  

Effective on Wednesday, July 27, 2016
  • 1(1) The issuance of a home health agency license shall be based upon compliance with Chapters 400, Part III, and 408, Part II, F.S., and Rule Chapters 59A-8 and 59A-35, F32.33A34.35C36., 37as evidenced by a signed, complete and accurate Health Care Licensing Application, Home 50Health Agency, AHCA Form 3110-1011, March 2016, incorporated by reference and available at 63http://www.flrules.org/Gateway/reference.asp?No=Ref-07060, 65and 66an inspection 68as required in Sections 72400.471(2) 73and 74408.806(7), F.S. 76Applicants for renewal of a home health agency license may submit the Health Care Licensing Online Application, Home Health Agency, AHCA Form 3110-1011OL, March 2016, incorporated by reference and available at 107http://www.flrules.org/Gateway/reference.asp?No=Ref-07061109. 110The application forms are available online at 117http://www/ahca.myflorida.com/HQAlicensureforms or, for online renewal submissions, at: http://apps.ahca.myflorida.com/SingleSignOnPortal125.

    126(2) An application for renewal of the current license must be submitted to AHCA at least 60 days prior to the date of expiration of the license, pursuant to Section 156408.806, F.S. 158It is the responsibility of the home health agency to submit an application within the specified time frames whether or not they receive separate notification from AHCA of the impending expiration of the license.

    192(3) Surveys of Home Health Agencies:

    198(a) Home health agencies will be surveyed by AHCA or an accrediting organization as defined in Rule 21559A-8.002, 216F.A.C., pursuant to Sections 220400.471(2), 221408.806 222and 223408.811, F.S. 225Home health agencies will be surveyed prior to initial licensure, and at least every 36.9 months on an unannounced basis thereafter. Follow up surveys may be conducted to verify correction of deficiencies at any time on an unannounced basis.

    264(b) It is the responsibility of the home health agency to request exemption from state licensure surveys pursuant to Section 284400.471(2), F.S., 286by submitting documentation of accreditation by an approved accrediting organization and the most recent survey from the accrediting organization to the AHCA Home Care Unit.

    311(c) Home health agencies that complete paragraph (a), will not be subject to licensure surveys by AHCA except under the following circumstances:

    3331. The home health agency has been denied accreditation, has received a preliminary determination of denial of accreditation, or has received a provisional, conditional, or deferred accreditation report from the accrediting organization on its most recent survey, or

    3712. The home health agency has received accreditation but has not authorized the release of the report to the AHCA, or has not ensured that AHCA has received the accrediting organization’s report.

    4033. The home health agency that provides only non-skilled services and is not Medicare or Medicaid certified  is no longer required to be accredited as of July 1, 2014 pursuant to Section 435400.471(2)(h), F.S. 437If the home health agency elects to give up its accreditation, the home health agency will inform AHCA by providing a copy of the letter it sent to its accrediting organization that shows the accreditation termination date.

    474(4) AHCA will conduct investigations of complaints regarding licensure violations as required in Section 488408.811, F.S.

    490(5) In addition to any other penalties imposed pursuant to this rule, the agency may assess costs related to an investigation that results in a successful prosecution, pursuant to Section 520400.484(3), F.S. 522The prosecution can be resolved by stipulation settlement or final hearing. The following costs may apply: travel costs related to the investigation; investigative time by AHCA’s surveyor or surveyors including travel time; processing time by AHCA’s professional staff and administrative support staff of Field Operations, and processing time for administrative support staff and professional staff of the AHCA Licensed Home Health Programs Unit in Tallahassee. The costs related to AHCA’s professional staff and support staff will be determined according to the hourly rate of pay for those positions.

    610(6) An application for a change of ownership shall be made on the forms prescribed by AHCA, as referenced in subsection (1) of this rule.

    635(a) The buyer or lessee must make application to AHCA for a new license at least 60 days before the date of the transfer of ownership as required by Sections 665408.807(1) 666and (2), F.S.

    669(b) At the time of the transfer of ownership all patient or client records held by the current licensee shall be transferred to the applicant.

    694(c) AHCA will accept the most recent successful licensure inspection conducted no more than 36.9 months prior to the effective date of the change of ownership as satisfaction of the inspection requirement in Section 728408.806(7), F.S. 730related to an application associated with a change in ownership of a licensed home health agency. Acceptance of the inspection does not alter the survey timeframes established in paragraph (3)(a).

    760(d) Failure to apply for a change of ownership of a licensed home health agency as required by Section 779408.806(2)(b), F.S., 781shall result in a fine pursuant to Sections 789400.474(1), 790(2)(a) and 792408.813(3)(b), F.S. 794This is also applicable to owners who incorporate and do not report this change of ownership to the home health agency.

    815(7) A licensed home health agency may operate a satellite office. A satellite office must be located in the same geographic service area as the agency’s main office and share administration, fiscal management, supervision, and service provision with the main office; it is not separately licensed. Supplies and records can be stored at a satellite office and phone business can be conducted the same as in the main office. The administrator at the main office is responsible for the staffing, patients, and operation of any satellite office. Signs and advertisements can notify the public of the satellite office location. If the agency wants to open an office outside of the geographic service area where the main office is located, the office must be separately licensed.

    940(8) A home health agency that operates a satellite office must:

    951(a) Ensure coverage of the professional staff which takes into account the projected number of clients to be served at the satellite office;

    974(b) Coordinate care and services by staff;

    981(c) Ensure supervision of the staff and provision of services in the event of staff absenteeism;

    997(d) Maintain a system of communication and integration of services between the main office and the satellite office;

    1015(e) Provide access to patient records at the satellite office;

    1025(f) Monitor the daily activities (clinical and administrative) and the management of services, as well as personnel and administrative issues at the satellite office;

    1049(g) Ensure periodic onsite visits to each satellite office by the home health agency’s administrator;

    1064(h) Make the satellite offices hours of operation available to the public if different than the hours of operation maintained by the main office.

    1088(9) A licensed home health agency may operate a drop-off site in any county within the geographic service area specified on the license. A drop-off site may be used for pick-up or drop-off of supplies or records, for agency staff to use to complete paperwork or to communicate with the main office, existing or prospective agency staff, or the agency’s existing patients or clients. Prospective patients or clients cannot be contacted and billing cannot be done from this location. The drop-off site is not a home health agency office, but merely a work station for direct care staff in large areas where the distance is too great for staff to drive back frequently to the home health agency office. Training of home health agency staff can be done at a drop-off site. A drop-off site shall not require a license. No other business shall be conducted at these locations, including housing of records. The agency name cannot appear at the location, unless required by law or by the rental contract, nor can the location appear on agency letterhead or in advertising.

    1269(10) If a change of address is to occur, or if a home health agency intends to change the counties served within the geographic service area, or open or close a satellite office, the home health agency must complete and submit the Health Care Licensing Application, Home 1316Health Agency, AHCA Form 3110-1011, March 2016, incorporated by reference in subsection (1) above, within the timeframe prescribed 1334in paragraph 133659A-35.040(2)(b), 1337F.A.C. The home health agency must submit to the AHCA Home Care Unit evidence that the location is zoned for a home health agency business for the new address or satellite office and evidence of legal right to occupy the property in accordance with Section 1382408.810(6), F.S. 1384To add or delete a drop-off site, the home health agency must complete and submit the Health Care Licensing Application, Home 1405Health Agency, AHCA Form 3110-1011, March 2016, incorporated by reference in subsection (1) above.

    1419(11) A home health agency has the following responsibility in terms of hours of operation:

    1434(a) The home health agency administrator and director of nursing, or their alternates, must be available to the public for any eight consecutive hours between 7:00 a.m. and 6:00 p.m., Monday through Friday of each week, excluding legal and religious holidays. Available to the public means being readily available on the premises or by telecommunications.

    1489(b) When the administrator and the director of nursing are not on the premises during designated business hours, a staff person must be available to answer the phone and the door and must be able to contact the administrator and the director of nursing by telecommunications. This individual can be a clerical staff person.

    1543(c) If an AHCA surveyor arrives on the premises to conduct an unannounced survey and the administrator, the director of nursing, or a person authorized to give access to patient records, are not available on the premises they, or the designated alternate, must be available on the premises within an hour of the arrival of the surveyor. A list of current patients must be provided to the surveyor within two hours of arrival if requested.

    1618(d) The home health agency shall have written policies and procedures governing 24 hour availability to licensed professional nursing staff by active patients of the home health agency receiving skilled care. These procedures shall describe an on-call system whereby designated nursing staff will be available to directly communicate with the patient. For agencies which provide only home health aide and homemaker, companion and sitter services and who provide no skilled care, written policies and procedures shall address the availability of a supervisor during hours of patient service.

    1705(e) Failure to be available or to respond will be grounds for denial or revocation of the agency license in accordance with Section 1728408.806(7)(d), F.S.

    1730(12) The initial, change of ownership and renewal fee for home health licensure is $1,705.

    1746(13) If licensure application fee checks are returned by the financial institution due to insufficient funds, the issuance of a license may be delayed, denied or revoked.

    1773(14) Upon revocation, suspension, voluntary or involuntary termination of a license, the home health agency shall return its license to AHCA. If the provider voluntarily chooses to terminate the license, the provider must notify AHCA, as required in Section 1812408.810(4)(a), F.S. 1814This includes submitting a letter to the AHCA Home Care Unit, 2727 Mahan Drive, Mail Stop #34, Tallahassee, Florida 32308, officially declaring the closure date of the home health agency.

    1844Rulemaking Authority 1846400.497, 1847408.819 FS. 1849Law Implemented 1851400.464, 1852400.471, 1853400.474, 1854400.484, 1855400.497, 1856408.806, 1857408.807, 1858408.810 FS. 1860History–New 4-19-76, Formerly 10D-68.03, Amended 4-30-86, 8-10-88, 5-30-90, 6-12-91, Formerly 10D-68.003, Amended 4-27-93, 10-27-94, 1-30-97, 1-17-00, 7-18-01, 9-22-05, 8-15-06, 3-29-07, 7-11-13, 6-16-15, 7-27-16.


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