The purpose of the proposed rule amendments is to protect the health, safety, security and well-being of residents living in ADULT FAMILY-CARE HOMES. The amendments add language to the resident health assessment form, incorporated by reference in ...

DEPARTMENT OF ELDER AFFAIRS
Federal Aging Programs

RULE NO: RULE TITLE
58A-14.0061: Admission and Appropriateness of Placement
58A-14.0062: Residency Agreement
58A-14.007: Standards and Practices for Care and Services
58A-14.0085: Records
PURPOSE AND EFFECT: The purpose of the proposed rule amendments is to protect the health, safety, security and well-being of residents living in ADULT FAMILY-CARE HOMES. The amendments add language to the resident health assessment form, incorporated by reference in the rule, where a resident’s health care practitioner must certify if a resident may be left without supervision in an adult family-care home (AFCH) for up to 2 hours in a 24-hour period; add language to the residency agreement and care and services standards regarding the level of supervision provided by the AFCH, the conditions required if the health care practitioner certifies that a resident may be left without supervision in an AFCH, the requirement that the health care practitioner provide an annual reassessment of his or her initial determination that a resident may be left without supervision in an AFCH, and the need for the practitioner’s certification to be included in the resident’s record; and add language regarding cardiopulmonary resuscitation.
SUMMARY: Additional language regarding the resident health assessment form certifying whether or not a resident may be left without supervision in an AFCH for up to 2 hours in a 24-hour period; additional language in the residency agreement to include the level of supervision provided; additional language regarding the conditions under which a resident may be left without supervision in an AFCH, the requirement that the health care practitioner provide an annual reassessment whether a resident may be left without supervision in an AFCH, and documentation of such determination included in the resident’s record; and language regarding cardiopulmonary resuscitation.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 429.67, 429.73, 429.75, 429.81 FS.
LAW IMPLEMENTED: 429.65, 429.67, 429.71, 429.73, 429.75, 429.81, 429.85 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE,TIME AND PLACE SHOWN BELOW(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
DATE AND TIME: January 30, 2008, 9:30 a.m. – 11:30 a.m. EST.
PLACE: Department of Elder Affairs, 4040 Esplanade Way, Conference Room 225F, Tallahassee, Florida 32399-7000
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 72 hours before the workshop/meeting by contacting: Jim Crochet, Department of Elder Affairs, Office of the General Counsel, 4040 Esplanade Way, Tallahassee, Florida 32399-7000; Telephone [phone], SunCom 994-2000; E-mail address: [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Jim Crochet, Department of Elder Affairs, Office of the General Counsel, 4040 Esplanade Way, Tallahassee, Florida 32399-7000; telephone [phone], Suncom 994-2000; E-mail address: [e-mail].
COPIES OF THE AGENDA, PROPOSED RULES AND FORM INCORPORATED BY REFERENCE MAY BE OBTAINED FROM THE DEPARTMENT’S WEB SITE AT: http://elderaffairs.state.fl.us, UNDER THE HEADING ENTITLED “DOEA Rulemaking, Adult Family-Care Homes.”

THE FULL TEXT OF THE PROPOSED RULE IS:

58A-14.0061 Admission and Appropriateness of Placement.

(1) No change.

(a) through (l) No change.

(2) HEALTH ASSESSMENT. Prior to admission to an AFCH, the individual must be examined by a health care provider using AHCA the Resident Health Assessment, DOEA Form 3110-1023 (AFCH-1110), 01/08, Resident Health Assessment for Adult Family-Care Homes (AFCH), January 2008 August 2003, which is incorporated by reference, and available from the Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop 30 Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, FL 32308 32399-7000. The form may also be obtained from the agency’s Web site at http://ahca.myflorida.com/MCHQ/Long_Term_Care/Assisted_living/afc/Res_Health_Assmnt.pdf Previous versions of this form completed up to 6 months after the effective date of this rule, January 1 2004 are acceptable.

(3) No change.

(4) CARDIOPULMONARY RESUSCITATION: Prior to admission to an AFCH, a statement must be provided to the individual regarding the adult family-care home’s policy regarding withdrawing or withholding of cardiopulmonary resuscitation pursuant to Section 429.73(3), F.S. The policy shall include language which specifies that the provider must contact “911” in the event of cardiopulmonary distress.

(4) through (5) renumbered (5) through (6) No change.

Specific Authority 429.73 FS. Law Implemented 429.65, 429.73, 429.85 FS. History–New 2-2-95, Formerly 10A-14.0061, Amended 9-19-96, 6-6-99, 1-1-04,_________.

 

58A-14.0062 Residency Agreement.

(1) No change.

(2) The residency agreement must include the following:

(a) through (e) No change.

(f) A statement regarding the level of supervision to be provided.

(3) No change.

Specific Authority 429.81 FS. Law Implemented 429.81, 429.85 FS. History–New 6-6-99, Amended________.

 

58A-14.007 Standards and Practices for Care and Services.

The adult family-care home provider shall ensure the provision of the following in accordance with Part II of Chapter 429, F.S., this rule chapter, and the residency agreement:

(1) No change.

(2) SUPERVISION.

(a) The AFCH provider shall provide general supervision twenty-four (24) hours per day, except as provided in paragraph (a) of this subsection. General supervision means the provider or designee is which includes being aware of the resident’s general whereabouts and well-being while the resident is on the premises of the AFCH. The provider is responsible for determining the level of supervision necessary in order to ensure the resident’s safety and security as well as to, and reminding the resident of any important tasks or activities, including appointments, as needed by the resident. The provider is responsible for determining and providing adequate supervision however; under circumstances shall a resident be left unattended for more than 2 hours.

(a) A resident may be left without supervision in an AFCH for up to 2 hours in a 24-hour period if his or her health care provider submits written certification that doing so will not compromise the resident’s health, safety, security or well-being.

1. The certification is included in Section H of AHCA Form 3110-1023 (AFCH-1110) 01/08, incorporated by reference in subsection 58A-14.0061(2), F.A.C.

2. After the effective date of this rule, the provider shall have up to six (6) months for completing section H on this form for all current residents.

(b) The health care provider’s certification must be completed annually from the date of the original assessment, or sooner, if a significant change occurs pursuant to subsection (4) of this rule or there is a compelling reason why the resident should not be left without supervision in the AFCH.

(c) The provider must be accessible by telephone or pager or other appropriate means so that the resident is able to communicate with him or her during the period that the resident is left without supervision in the AFCH.

(3) INCIDENT REPORTING.

(b) Any major incident and the action taken in response to that incident must be documented in the resident’s record. A major incident includes:

(a)1. An injury to a resident which requires assessment and treatment by a health care provider. The resident’s record must include a description of the circumstances under which the injury occurred.

(b)2. Determining that Aa resident is missing. Whenever a resident is determined to be missing, the provider, relief person, or staff-in-charge shall notify the local law enforcement agency within 1 hour. The resident’s representative, next-of-kin, and case manager shall be notified within 4 hours or within a time frame previously agreed upon in writing between the provider and the resident’s representative, next-of-kin, or case manager.

(c)3. Any event, such as a fire, natural disaster, or other occurrence, which results in the disruption of the AFCH’s normal activities.

(d)4. The death of a resident. The resident’s representative, next-of-kin, and case manager, and law enforcement must be notified immediately upon discovery of the death within 4 hours of death or within a time frame previously agreed upon in writing between the provider and the resident’s representative, next-of-kin, or case manager.

(4)(3) HEALTH MONITORING. The AFCH provider shall be responsible for observing, recording and reporting any significant changes in the resident’s normal appearance, behavior or state of health to the resident’s health care provider, and representative, and or case manager. Significant changes include a sudden or major shift in behavior or mood; or a deterioration in health status, such as unplanned weight change, stroke, heart condition, a stage 2 pressure sore. Ordinary day-to-day fluctuations in functioning and behavior, short-term illness such as a cold, or the gradual deterioration in the ability to carry out the activities of daily living that accompanies the aging process are not considered significant changes. As part of health monitoring, residents must shall be weighed on a monthly basis.

(4) through (6) renumbered (5) through (7) No change.

Specific Authority 429.73 FS. Law Implemented 429.73, 429.85 FS. History–New 5-14-86, Amended 2-2-95, Formerly 10A-14.007, Amended 9-19-96, 6-6-99,________.

 

58A-14.0085 Records.

(1) RESIDENT RECORDS. The AFCH provider shall maintain a separate record for each resident on the premises and available for inspection by the agency.

(a) The record shall, at a minimum, contain:

1. AHCA Form 3110-1023 (AFCH-1110) 01/08, The Resident Health Assessment for Adult Family-Care Homes  (AFCH), DOEA Form 1110, required by Rule 58A-14.0061, F.A.C. A completed and signed form faxed by the health care provider shall be acceptable. The resident’s health care provider’s certification whether he or she may be left without supervision in the AFCH for up to 2 hours in a 24-hour period (Section H of the form) must be completed and included pursuant to paragraphs (a) and (b) of subsection 58A-14.007(2), F.A.C.

2. through 13. No change.

(b) No change.

(2) through (3) No change.

Specific Authority 429.67, 429.73, 429.75, 429.81 FS. Law Implemented 429.67, 429.73, 429.75, 429.81, 429.85 FS. History– New 6-6-99, Amended 7-30-06,_________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Jim Crochet
NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: E. Douglas Beach, Ph.D., Secretary
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 21, 2007
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: November 2, 2007