Definitions, Licensure Procedure, Comprehensive Emergency Management Plan, Services, Surveillance, Prevention, and Control of Infection, Classification of Hospitals, Investigations and License, Life Safety and Validation Inspections, Patient Rights ...
AGENCY FOR HEALTH CARE ADMINISTRATION
Health Facility and Agency Licensing
RULE NOS.:RULE TITLES:
59A-3.065Definitions
59A-3.066Licensure Procedure
59A-3.078Comprehensive Emergency Management Plan
59A-3.110Services
59A-3.250Surveillance, Prevention, and Control of Infection
59A-3.252Classification of Hospitals
59A-3.253Investigations and License, Life Safety and Validation Inspections
59A-3.254Patient Rights and Care
59A-3.255Emergency Care
59A-3.270 Health Information Management
59A-3.273Management and Administration
59A-3.274Anatomical Gifts, Routine Inquiry
59A-3.280Child Abuse and Neglect
59A-3.281Spontaneous Fetal Demise
59A-3.300Licensure Procedure
59A-3.302Personnel
NOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 39, No. 250, December 30, 2013 issue of the Florida Administrative Register.
The following sections of the proposed rule should be changed to read:
59A-3.065 Definitions.
In addition to definitions contained in Chapters 395 and 408, Part II, F.S., the following definitions shall apply specifically to hospitals, as used in Rules 59A-3.065 – 3.303, F.A.C.:
(1) “Accepted Medical Standards” means the current professional standards pursuant to Section 766.102, F.S., which are utilized by affiliated organ procurement organizations (OPO), tissue banks and eye banks to determine the suitability of organs, tissues, and eyes for the purposes of transplantation, medical research or instruction.
(2) “Accrediting organization organizations” means a national accreditation organization that is approved by the Centers for Medicare and Medicaid Services per Title 42 Part 488.4 Code of Federal Regulations to offer a deemed status option and whose standards incorporate comparable licensure regulations as determined by the Agency. the Joint Commission on Accreditation of Healthcare Organizations, and the American Osteopathic Association.
(1) “Advanced Registered Nurse Practitioner” or “ARNP” means a person licensed in the State of Florida under the provisions of Chapter 464, F.S. to practice professional nursing and certified in advanced or specialized nursing practice.
(3) through (5) renumbered (2) through (4) No change.
(6) “Bassinet” means special accommodations with supporting services for newborn infants after transfer from the delivery or recovery suites. These accommodations are not considered hospital beds for licensing purposes except when part of an intensive neonatal care unit approved pursuant to Chapter 59C-1, F.A.C.
(7) “Biomedical waste” means any solid or liquid waste which may present a threat of infection to humans, as defined in Chapter 64E-16, F.A.C
(8) through (10) renumbered (5) through (7) No change.
(11) “Child protection team” means a team of professionals established by the Department of Health and Rehabilitative Services to receive referrals from the single intake and protective services staff of the children, youth and families program and to provide specialized and supportive services to the program in processing child abuse and neglect cases. A child protection team shall provide consultation to other persons on child abuse and neglect cases pursuant to Section 39.303, F.S.
(12) through (15) renumbered (8) through (11) No change.
(16) “Directly involved” for the purposes of reporting of adverse incidents to the Aagency means any employee or independent contractor of a hospital or member of a hospital’s medical staff who could exercise control over the event which is reportable as an adverse or untoward incident.
(17) “District intake counselor” means Department of Children and Families’ Health and Rehabilitative Services’ staff responsible for the investigation of suspected abuse or neglect.
(18) through (20) renumbered (12) through (14) No change.
(21) “Emergency department” means for the purposes of Section 395.1041, F.S., any department of any general hospital when a request is made for emergency services and care for any emergency medical condition which is within the service capability of the hospital.
(22) through (24) renumbered (15) through (17) No change.
(25) “General acute care hospital” means a general hospital which has an average length of stay of 25 days or less for all inpatient beds.
(26) through (28) renumbered (18) through (20) No change.
(29) “Hospital” means any establishment that:
(a) Offers services more intensive than those required for room, board, personal services, and general nursing care, and offers facilities and beds for use beyond 24 hours by individuals requiring diagnosis, treatment, or care for illness, injury, deformity, infirmity, abnormality, disease or pregnancy; and
(b) Regularly makes available at least clinical laboratory services, diagnostic x-ray services, and treatment facilities for surgery or obstetrical care, or other definitive medical treatment of similar extent. However, the provisions of this chapter shall not apply to any institution conducted by or for the adherents of any well-recognized church or religious denomination that depends exclusively upon prayer or spiritual means to heal, care for, or treat any person.
(30) “Hospital emergency services” means: For the purposes of Section 395.1041, F.S., hospital emergency services are any services within the service capability of the hospital.
(21)(31) No change.
(22)(32) “Intensive residential treatment programs facility for children and adolescents (IRTF)” or “intensive residential treatment facilities” or “IRTF” means a specialty hospital restricted to providing intensive residential treatment programs for children and adolescents as defined in Section 395.002(15), F.S. accredited by an accrediting organization which provides 24-hour care and which has the primary functions of diagnosis and treatment of patients under the age of 18 having psychiatric disorders in order to restore them to an optimal level of functioning.
(33) through (42) renumbered (23) through (32) No change.
(43) “Parts” means any organs, tissues, fluids or other portions of a human body including the organs or tissues described in subsections (39) (34) and (66) (57) of this section, as well as bone, arteries and blood.
(44) “Patient grievance” means any written complaint by a patient relating to patient care or the quality of medical services, except for those matters pertaining to the cost of care.
(45) through (46) renumbered (33) through (34) No change.
(35) “Physician Assistant” or “PA” means a person who is licensed to perform medical services delegated by the supervising physician pursuant to Chapter 458 or 459, F.S.
(47) through (52) renumbered (36) through (41) No change.
(53) “Psychiatric program” means psychiatric or substance abuse programs.
(54) through (58) renumbered (42) through (46) No change.
(59) “Relieve or eliminate the emergency medical condition” means, for the purposes of Sections 395.002 and 395.1041, F.S., provision of care, treatment or surgery consistent with the applicable standard of care, by a physician, necessary to either eliminate the emergency medical condition or to eliminate the likelihood that the emergency medical condition will deteriorate or recur without further medical attention within a reasonable period of time.
(47)(60) “Routine Inquiry Form” means a reporting document developed by the hospital that is used to indicate that a request for donation of organs, tissues, or eyes was made.
(61) through (63) renumbered (48) through (50) No change.
(64) “Specialty hospital” means any facility which meets the provisions of subsection (25), and which regularly makes available either:
(a) The range of medical services offered by general hospitals, but restricted to a defined age or gender group of the population;
(b) A restricted range of services appropriate to the diagnosis, care, and treatment of patients with specific categories of medical or psychiatric illnesses or disorders; or
(c) Intensive residential treatment programs for children and adolescents as defined in subsection (32).
(65) through (67) renumbered (51) through (53) No change.
(68) “Transfer” means, for the purposes of Section 395.1041, F.S., the movement, including the discharge, of an individual from a hospital’s facilities at the direction of any person employed by, or affiliated or associated, directly or indirectly with, the hospital who has the authority to do so under the hospital’s policies and procedures, but does not include such a movement of an individual who has been declared dead or who leaves the facility without permission or against medical advice.
(54)(69) No change.
Rulemaking Authority 395.1055 FS. Law Implemented 381.0031, 381.0098, 395.001, 395.002, 395.1023, 395.1025, 395.1055, 408.035, 408.036, 415.1034 FS. History–New 9-4-95, Formerly 59A-3.201, Amended__________.
59A-3.066 Licensure Procedure.
(1) No change.
(2) All persons requesting licensure for the operation of a hospital under the provisions of Chapter 395, F.S., shall make application to the Agency on Health Care Licensing Application, Hospitals, AHCA Form 3130-8001, September 2013, which is incorporated by reference, and shall receive a standard or provisional license prior to the acceptance of patients for care or treatment. The form is available at: http//www.flrules.org/Gateway/reference.asp?No=Ref-XXXXX and available from the Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop 31, Tallahassee, Florida 32308, or at the web address at: http://ahca.myflorida.com/HQAlicensureforms.shtml.
(2)(a) through (b)5. No change.
6. Evidence of approval from the Agency’s Office of Plans and Construction for any physical plant requirements as required by Section 395.0163, F.S.; and Approval for licensure from the Aagency’s Office of Plans and Construction; and
7. Evidence of medical malpractice insurance through the Patient Compensation Fund or other means of demonstrating financial responsibility as provided for under Section Chapter 766.105, F.S.
8. through (2)(d)1. No change.
2. Evidence of medical malpractice insurance through the Patient Compensation Fund or other means of demonstrating financial responsibility as provided for under Section Chapter 766.105, F.S.
(e) through 2. No change.
(f) Evidence of medical malpractice insurance through the Patient Compensation Fund or other means of demonstrating financial responsibility as provided for under under Section Chapter 766.105, F.S., must be submitted annually to the Agency.
(g) through (i) No change.
(3) A license fee of $1,565.13 per hospital, or $31.46 per licensed bed, whichever is greater, shall accompany an application for an initial, biennial renewal, or change of ownership license. An application for the addition of beds to a license shall be accompanied by a license fee of $31.46 per additional bed. All permanent additions to the constructed bed capacity occurring after the issuance of the license shall require licensure prior to occupancy. The license fee shall be made payable to the Agency for Health Care Administration. No license shall be issued without payment of the requisite fee, and, if the request for licensure is withdrawn, the license fee is not refundable. Where licenses are denied in whole or part, the license fee is not refundable. Those hospitals operated by the Department of Health, Department of Children and Families, and the Department of Corrections are not required to pay a license fee.
(4) through (8) No change.
(9) The Agency shall issue a provisional license for any hospital in compliance with Chapter 395, Part I the statute and Rules 69A-3.012 and 59A-3.065, F.A.C. Provisional licenses are issued only after the Agency is satisfied that preparations are being made by the hospital to qualify for standard license, and that the health and safety of patients will not be endangered during the interim. Any new hospital will be issued a provisional license prior to opening date, provided plans and specifications for the building have been approved by the licensing agency and the hospital has been inspected and found to meet construction standards and health and safety inspections.
(a) A provisional license shall be granted for a period of no more than one (1) year and shall expire automatically at the end of its term. A provisional license may not be renewed.
(b) A standard license may be issued after the proposed hospital becomes operational and a reinspection has been made to determine compliance with the rule set forth herein.
(10) through (12)(c) No change.
(13)(a) All hospitals shall comply with the Agency requirements for data submission as authorized under Section 395.1055, F.S. and Chapters 408, F.S. This data, which does not have to be resubmitted to the Agency’s hospital licensing office as a provision of this part, includes:
1. through (b) No change.
Rulemaking Authority 395.003, 395.004,395.1055, 408.033, 408.819 FS. Law Implemented 395.003, 395.004, 395.0161, 395.1055, 408.035, 408.036, 408.805, 408.806, 408.809, 408.811 FS. History–New 9-4-95, Amended 6-18-96, Formerly 59A-3.203, Amended_________.
59A-3.078 Comprehensive Emergency Management Plan.
(1) No change.
(2) The emergency management plan shall be developed in conjunction with other agencies and providers of health care services within the local community pursuant to Section 395.1055(1)(c), 252.32(2), F.S., and in accordance with the “Emergency Management Planning Criteria for Hospitals,” AHCA Form 3130-8005-September 94, which is incorporated by reference. The form is available from the Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop 31, Tallahassee, Florida 32308. At a minimum, Tthe plan shall include:
(a) Provisions for internal and external disasters and emergencies, pursuant to Section 252.34, F.S.;
(b) through (8) No change.
(9) A facility with significant structural damage shall relocate patients until approval is received from the Agency’s Office of Plans and Construction that the facility can be safely reoccupied, in accordance with Rule 59A-3.080 69A-3.012, F.A.C.
(10) No change.
59A-3.110 Intensive Residential Treatment Facilities Services.
Services shall be designed to meet the needs of the emotionally disturbed patient and must conform to stated purposes and objectives of the program.
(1) Intake and Admission. Every IRTF shall develop written policies and procedures governing the facilities intake and admissions process.
(a) through (g) No change.
(2) Assessment and Treatment Planning Including Discharge. Every IRTF shall develop written 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. These policies and procedures shall include the assessment process as well as treatment planning including discharge planning, and include methods for involving family members or significant others (i.e., guardians, counselors, friends) in assessment, treatment, discharge, and follow-up care plans.
(a) No change.
1. Physical. Subparagraphs a., b. and c. must be completed by a physician, ARNP or PA on the staff of the facility prior to admission or within 24 hours after admission.
a. through g. No change.
h. Review of immunization status and completion according to the U.S. Public Health Service Advisory Committee on Immunization Practices and the Committee on Control of Infectious diseases of the American Academy of Pediatrics;
i. through l. No change.
m. If any of the physical health assessments indicate the need for further testing or definitive treatment, arrangements shall be made to carry out or obtain the necessary evaluations or treatment by clinicians, or physicians, ARNPs or PAs trained as applicable, and plans for these treatments shall be coordinated with the patient’s overall treatment plan.
2. through (c)1. No change.
(3) Staff Coverage. Every IRTF shall develop written policies and procedures to ensure the program is staffed with appropriately trained and qualified individuals to meet the needs of the patients. There shall be a master clinical staffing pattern which provides for adequate clinical staff coverage at all times.
(a) through (d) No change.
(4) Program Activities. Every IRTF must develop an organizational chart with a description of each unit or department and its services, goals, policies and procedures, its relationship to other services and departments and how these are to contribute to the priorities and goals of the program, and ways in which the program carries out any community education consultation programs. Program goals of the facility shall include those activities designed to promote the physical and emotional growth and development of the patients, regardless of pathology or age level. There should be positive relationships with general community resources, and the facility staff shall enlist the support of these resources to provide opportunities for patients to participate in normal community activities as they are able. All labeling of vehicles used for transportation of patients shall be such that it does not call unnecessary attention to the patients.
(a) through (e)1. No change.
2. Children or adolescents placed in the special hospital by a public agency or at the expense of a public agency shall receive education consistent with the requirements of Chapter 6A-15 or Chapter 6A-6, F.A.C., as applicable.
(f) through (5)(a) No change.
1. Insofar as Rules 59A-3.110 and 59A-3.300 through 59A-3.303, F.A.C., are intended to establish minimum requirements for intensive residential treatment facilities for children and adolescents that have a primary purpose of treating emotional and mental disorders, such facilities are not required to establish and maintain medical buildings and equipment required of general or specialty hospitals as specified in Rules 59A-3.080 through 59A-3.281, F.A.C. Services which require such specialized buildings and equipment may be obtained from outside health care providers by written agreement or contract. This shall not preclude the facility from maintaining a medical services area or building which does not meet the requirements of Rules 59A-3.065 through 59A-3.281, F.A.C., for the purpose of isolating patients with contagious diseases, conducting physical examinations, providing preventive medical care services, or providing first aid services.
2. No change.
(b) Patients who are physically ill may be cared for on the grounds of the facility if medically feasible as determined by a physician, ARNP or PA. If medical isolation is necessary, there shall be sufficient and qualified staff available to provide care and attention.
(c) through (6)(a) No change.
(b) There shall be a physician on call twenty-four (24) hours a day; his/her name and where he/she can be reached shall be clearly posted in accessible places for program staff.
(c) All staff providing direct patient care All direct service program staff must maintain current first aid certificate.
(d) through (8)(a)1. No change.
2. All laboratory tests shall be ordered by a licensed practitioner in accordance with Section 483.041(7), F.S. physician.
3. through (10) No change.
(10)(a) Content. All clinical records shall contain all pertinent clinical information and each record shall include but not be limited to:
1. through (c)6. No change.
(d) Discharge Summary. The discharge summary shall include the initial formulation and diagnosis, clinical resume, final formulation and final primary and secondary diagnoses, the psychiatric and physical categories. The final formulation shall reflect the general observations and understanding of the patient’s condition during appraisal of the fundamental needs of the patients. The relevant discharge diagnoses shall be recorded and coded in the standard nomenclature of the current “Diagnostic and Statistical Manual of Mental Disorders” published by the American Psychiatric Association, and the latest edition of the “International Classification of Diseases” regardless of the use of other additional classification systems. Records of discharged patients shall be completed following discharge within a reasonable length of time, and not to exceed 15 days. In the event of death, a summation statement shall be added to the record either as a final progress note or as a separate resume. This final note shall take the form of a discharge summary and shall include circumstances leading to death. All discharge summaries must be signed by a staff or consultant physician.
(e) through (11)(b)2. No change.
59A-3.250 Surveillance, Prevention, and Control of Infection.
(1) Each hospital shall establish an infection control program involving members of the organized medical staff, the nursing staff, other professional staff as appropriate, and administration. The program shall comply with the requirements in Sections 381.0098 and 395.1011, F.S. and shall provide for:
(a) through (2) No change.
(3) The policies and procedures devised by the infection control program shall be approved by the governing body, and shall contain at least the following:
(a) through (c) No change.
(d) Specific policies related to the handling and disposal of biomedical waste as required by in accordance with Chapter 64E-16, F.A.C, OSHA 29 CFR Part 1910.1030, Bloodborne Pathogens .
(e) through (h) No change.
(i) A requirement that all cases of communicable diseases as set forth in Chapter 64D-3, F.A.C., be promptly and properly reported as required by in accordance with the provisions of that rule.
(4) through (5) No change.
59A-3.252 Classification of Hospitals.
(1) No change.
(a) Class I or general hospitals which includes:;
1. No change.
2. Long term care hospitals, which meet the provisions of subsection 59A-3.065(23)(34), F.A.C.; and
3. No change.
(b) Class II specialty hospitals offering the range of medical services offered by general hospitals, but restricted to a defined age or gender group of the population which includes:;
1. through 2. No change.
(c) Class III specialty hospitals offering a restricted range of services appropriate to the diagnosis, care, and treatment of patients with specific categories of medical or psychiatric illnesses or disorders which include:;
1. through 2. No change.
3. Specialty psychiatric hospitals, which may include beds licensed to offer Intensive Residential Treatment programs; and
4. Specialty substance abuse hospitals, which may include beds licensed to offer Intensive Residential Treatment programs; and
(d) through (5)(e) No change.
Rulemaking Authority 395.1055 FS. Law Implemented 395.002, 395.1055, 408.035, 408.036 FS. History–New 9-4-95, Formerly 59A-3.202, Amended_________.
59A-3.253 Investigations and License, Life Safety and Validation Inspections.
(1) through (2)(d) No change.
(3) ACCREDITED HOSPITALS. – The Agency shall accept the report of an accrediting organization in lieu of an annual licensure inspection for accredited hospitals and for hospitals seeking accreditation, provided that the standards included in the report demonstrate that the hospital is in compliance with state licensure requirements, found in Chapters 395 and 408, F.S., and Chapters 59A-3 and 59A-35, F.A.C., and the hospital does not meet the criteria specified under subparagraphs (c) 1. and 2.
(a) through (9) No change.
Rulemaking Authority 395.0161, 395.1055, 408.819 FS. Law Implemented 395.003, 395.0161, 395.1055, 395.1065, 408.811 408.035, 408.036 FS. History–New 9-4-95, Formerly 59A-3.204 Amended 5-16-06,________.
59A-3.254 Patient Rights and Care.
(1) through (4)(b) No change.
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 effective 1-11-93, which is hereby incorporated by reference, and available at: http//www.flrules.org/Gateway/reference.asp?No=Ref-XXXXX 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. through (h) No change.
(5) In addition to the provisions of this section, hospitals must comply with Section 381.026, F.S., which remains in effect.
Rulemaking Authority 395.003, 395.1055 FS. Law Implemented 395.003, 395.1055 FS. History–New 4-17-97, Formerly 59A-3.2055, Amended_________.
59A-3.255 Emergency Care.
(1) No change.
(2) TRANSFER PROCEDURES. Each hospital providing emergency services and care shall establish policies and procedures which incorporate the requirements of Chapter 395, F.S., relating to emergency services. The policies and procedures shall incorporate at a minimum:
(a) through (e) No change.
(f) A copy of Section 395.1041, F.S., Access to Emergency Services and Care, and a copy of this rule these rules.
(g) through (4)(a) No change.
(b) If a hospital has determined that it is unable to provide a service on a 24 hour per day, 7 day per week basis, either directly or indirectly through arrangement with another hospital or physician(s), the hospital must file an application with the Agency to request a service exemption. The application must identify the service for which the hospital is requesting an exemption. This information shall be submitted to the Agency on the Emergency Services Exemption Request, AHCA Form 3000-1, Emergency Services Exemption Request, November 2013 which is incorporated by reference and available at http//www.flrules.org/Gateway/reference.asp?No=Ref-XXXXX and available from the Agency at http://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Hospital_Outpatient/hospital.shtml. The Agency will make a determination of exemption status pursuant to the procedures in paragraph (5) of this rule and notify the hospital of the determination within 45 days of receipt of the request.
(c) through (5)(a) No change.
(b) Upon receipt of an application, the Agency shall publish, in the next available Florida Administrative Register Weekly, notice of receipt of the application, identifying the applicant and the service(s) for which exemption is requested. Comments submitted within 15 days of the date of publication will be considered by the Agency prior to making a determination of exemption status.
(c) through (6)(g)4.q. No change.
(h) Hospital personnel and physicians shall report any apparent violations of emergency access requirements under Section 395.1041, F.S., to the Agency, and shall include all relevant information. Reports shall be made within 30 days following the occurrence. Medical personnel reasonably believed by the Agency to be in violation of these rules will immediately be referred by the Agency to their respective licensing boards. Violations include failure to report when on-call or intentionally misrepresenting the patient’s condition in cases of medically necessary transfers or in determining the presence or absence of an emergency medical condition or rendering appropriate emergency services and care, or failure or refusal to sign a certificate of transfer as required by this section.
(7) Each hospital offering emergency services and care shall have the capability to communicate via two-way radio with licensed EMS providers and their primary communications centers. The two-way radio communications system must meet the following provisions as required by Section 401.021, F.S.
(a) through (b) No change.
Rulemaking Authority 395.1031, 395.1041, 395.1055 FS. Law Implemented 395.1031, 395.1041, 395.1055, 401.024 FS. History–New 9-4-95, Formerly 59A-3.207, Amended_________.
59A-3.270 Health Information Management.
(1) through (2) No change.
(a) The tracking system must be kept separate from patients’ medical records, and shall include at a minimum:
1. through (b) No change.
(3) Each hospital shall maintain a current and complete medical record for every patient seeking care or service. The medical record shall contain information required for completion of birth, death and still birth certificates, and shall, at a minimum contain the following information:
(a) through (o) No change.
(p) Physician, ARNP, PA and nurse progress notes;
(q) through (4)(c) No change.
(5) Medical records for ambulatory care patients shall consist of the information specified in paragraph subsections 59A-3.2085(7)(i), F.A.C.
(6) No change.
(7) Patient records shall have a privileged and confidential status and shall not be disclosed without the consent of the person to whom they pertain unless disclosed in accordance with pursuant to Section 395.3025(4), F.S., but appropriate disclosure may be made without such consent to:
(a) Hospital personnel for use in connection with the treatment of the patient;
(b) Hospital personnel only for internal hospital administrative purposes associated with the treatment, including risk management and quality assurance functions;
(c) The Agency for Health Care Administration; or
(d) In any civil or criminal action, unless otherwise prohibited by law, upon the issuance of a subpoena from a court of competent jurisdiction and proper notice by the party seeking such records to the patient or his legal representative.
(8) The Department of Health and Rehabilitative Services may examine patient records of a licensed facility for the purpose of epidemiological investigations, provided that the unauthorized release of information by agents of the department which would identify an individual patient constitutes a misdemeanor of the second degree, punishable as provided in Sections 775.082 or 775.083, F.S.
(8)(9) No change.
(a) No change.
(b) Disclosure of the medical records of inmates of any institution, facility or program of the Department of Corrections shall be made in conformance with Chapter 945.10, F.S., and applicable rules adopted thereunder.
(9)(10) Each hospital operated by the Department of Children and Families and the Department of Corrections shall use a problem oriented medical record for each patient, which shall be initiated at the time of intake or admission and which shall contain all pertinent information required by this section.
(10)(11) Each problem oriented medical record maintained by hospitals operated by the Department of Children and Families and the Department of Corrections shall be standardized within each hospital and shall be capable of providing easy comparison of basic information on medical records at all such hospitals. Each problem oriented medical record maintained by these hospitals shall contain at least the following information:
(10)(11) No change.
(11)(12) The discharge summary of each problem oriented medical record in hospitals operated by the Department of Children and Families and the Department of Corrections shall be completed, signed and dated within 15 days following the patient’s discharge. The summary shall include:
(a) through (e) No change.
59A-3.273 Management and Administration.
(1) through (3)(a)12. No change.
13. Dissemination and enforcement of a policy prohibiting the use of smoking materials in hospital buildings and procedures for exceptions authorized for patients by a PA, ARNP or physician’s written authorization;
14. through (e) No change.
59A-3.274 Anatomical Gifts, Routine Inquiry.
(1) through (2)(e) No change.
(f) Training regarding the administrative rules and guidelines promulgated by the Agency for the purpose of implementing the Routine Inquiry provisions of the Anatomical Gift Act, in accordance with Section 765.522, F.S.
(3) through (d) No change.
(e) The hospital shall work with the affiliated OPO, tissue bank, and eye bank to evaluate the patient as a potential organ, tissue, or eye donor in accordance with Section 765.522, F.S. The medical acceptability of such organs, tissues, and eyes shall be determined according to the medical standards of the affiliated procurement agency. The hospital administrator may designate personnel of the affiliated OPO, tissue bank, or eye bank who shall make the request for donation. Where non-hospital personnel are designated to make the request for organ, tissue or eye donation, the affiliated OPO, tissue bank, or eye bank shall be given the opportunity to approach the next of kin about donation and shall utilize the following procedure when approaching the next of kin:
1. through (4)(a)1. No change.
2. The appropriate next of kin is in a violent state, or cannot be found after a reasonable search; or
Rulemaking Authority 765.522, 873.01(3)(a) FS. Law Implemented 765.522, 873.01(3)(a) FS. History–New 9-4-95, Formerly 59A-3.219, Amended__________.
59A-3.280 Child Abuse and Neglect.
(1) Every licensed hospital admitting or treating shall adopt and incorporate a policy that requires every staff member to report any case of actual or suspected child abuse or neglect pursuant to Chapter Section 39.201, F.S.
(1)(a) through (b) No change.
(2) Physician Liaison. Each hospital admitting or treating children shall designate, at the request of the Department of Children and Family Services, a staff physician, ARNP or PA to act as a liaison between the hospital, the child protective investigator and the child protection team.
(3) through (4) No change.
Rulemaking Authority 395.1055 FS. Law Implemented 39.303, 395.002, 395.1023, 395.1055 FS. History–New 4-17-97, Formerly 59A-3.0465, Amended__________.
59A-3.281 Spontaneous Fetal Demise.
No change.
Rulemaking Authority 383.33625(6), 395.1055 FS. Law Implemented 383.33625, 395.1055(1)(b), 395.3025(4)(c) FS. History–New 4-27-06, Amended__________.
59A-3.300 Licensure Procedure for Intensive Residential Treatment Facilities.
Facilities desiring licensure under this rule shall follow the procedure as described in Rule 59A-3.066, F.A.C., and shall comply with the provisions of Rules 59A-3.110 and 59A-3.301 through 59A-3.312 59A-3.303, F.A.C., which establishes the minimum standards for licensure as a Class IV specialty hospital. These rules emphasize the programmatic requirements designed to meet the needs of the patient in a safe therapeutic environment and are intended to be used in licensing intensive residential treatment facilities for children and adolescents as specialty hospitals pursuant to Section 395.002(15), F.S. Unless otherwise specified, Rules 59A-3.110 and 59A-3.301 through 59A-3.312 59A-3.303, F.A.C., supersede the requirements of Rules 59A-3.2085, 59A-3.254, 59A-3.255, and 59A-3.278, F.A.C., 59A-3.255 59A-3.205 through 59A-3.232, for the purpose of licensing intensive treatment facilities for children and adolescents as specialty hospitals.
Rulemaking Authority 395.003, 395.004, 395.0161, 395.1055, 408.819 FS. Law Implemented 395.002, 395.003, 395.004, 395.0161, 395.0191, 395.1055 FS. History–New 2-15-82, Amended 8-14-86, Formerly 10D-28.101, Amended 9-4-95, 4-17-97, Formerly 59A-3.101, Amended__________.
59A-3.302 Personnel for Intensive Residential Treatment Facilities.
(1) through (c) No change.
(d) Mental health professionals shall include, but are not limited to, psychiatrists, psychologists, and social workers. These persons, if not on a full-time basis, must be on a continuing consulting basis. The authority and participation of such mental health professionals shall be such that they are able to assume responsibility for supervising and reviewing the needs of the patients and the services being provided. Such individuals shall participate in specific functions, e.g., assessment, treatment planning, treatment plan and individual case reviews, and program planning and policy and procedure development and review.
(e) Other professional and paraprofessional staff shall include, but not be limited to, physicians, registered nurses, educators and 24-hour a day mental assistants. Also included on a regular staff basis, or as consultants on a continuing basis, shall be activity staff and vocational counselors; and
(f) through (3)(b) No change.
(c) Accurate and complete personnel records shall be maintained on each employee. Content shall be established to include but not be limited to the following:
1. through 5. No change.
(4) Staff Development. The program must provide opportunities and motivation for continuing education or training continuous staff training to enable each member to add to his knowledge and skills and thus improve the quality of services offered. This must be documented in the employee personnel file.
(a) No change.
(b) There shall be appropriate orientation and training programs available for all new employees.
Rulemaking Authority 395.003, 395.1055 FS. Law Implemented 395.002, 395.003, 395.1055 FS. History–New 2-15-82, Formerly 10D-28.106, 59A-3.106, Amended_________.
The following changes have been made to the Application Checklist on the Health Care Licensing Application, Hospitals, AHCA Form 3130-8001, Revised September 2013:
Page 1
The words “late fine” have been changed to “late fee”.
Pg. 1, Section A.:
The words “or provisional certificate of authority” have been added.
Page 2, Section C
A statutory reference (Section 408.033(2)(b)3., F.S., was added.
The following changes have been made to the Health Care Licensing Application, Hospitals, AHCA Form 3130-8001, Revised September 2013:
Pg. 4, Section 5. Required Disclosure:
In sub-section A., (5) has been removed from 408.809, F.S.
In sub-section C., the second and third questions have been removed and replaced with the following:
“(Yes/No) Terminated for cause from the Medicare program or a state Medicaid program.
If yes, has applicant been in good standing with the Medicare program or a state Medicaid program for the most recent 5 years and the termination occurred at least 20 years before the date of the application. (Yes/No)”
Page 9, Section 12
Language was revised in the fourth sentence. Changed to: Hospital has an Emergency 2 Way Radio System pursuant to Section 395.1031, F.S.
On Pg. 10, Section 10. Affidavit
In the first paragraph, (5) has been removed from 408.809, F.S.
The second paragraph has been replaced with the words “In addition, I attest that all employees subject to Level 2 screening standards are in compliance with section 435.05(2), F.S.”
The following changes have been made to the Application Checklist on the Emergency Services Exemption Request, AHCA Form 3000-1, November 2013
Page 1
The reference to Chapters 395.1041(3)(d)3, F.S., and Chapter 59A-3.255(4), F.A.C. have been changed to section 395.1041(3)(d)3, F.S., and rule 59A-3.255(4), F.A.C.
Page 1, Section A. General Instructions
The form name has been changed to Emergency Services Exemption Request, AHCA Form 3000-1, November 2013
