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 define the term “unattended” as it pertains to residents; add ...

 

DEPARTMENT OF ELDER AFFAIRS
Federal Aging Programs

RULE NO: RULE TITLE
58A-14.002: Definitions
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 define the term “unattended” as it pertains to residents; add language to the resident health assessment form, incorporated by reference in the rule, where a resident’s health care practitioner may certify that the resident may be left unattended, and if so, for what period of time; add language to the residency agreement and care and services standards regarding the level of supervision provided, the conditions required if the health care practitioner certifies that the resident may be left unattended, the need for the health care practitioner’s annual reassessment regarding such a determination and the need for the practitioner’s certification to be include in the resident’s record.
SUBJECT AREA TO BE ADDRESSED: Definition of the term “unattended”; additional language regarding the resident health assessment form certifying whether or not a resident may be left unattended and for how long a period of time; 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 unattended, the requirement that the health care practitioner provide an annual reassessment whether a resident may be left unattended and documentation of such determination to be included in the resident’s record.
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.
A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: November 29, 2007, 9:00 a.m. – 12:00 Noon 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, Suite 315, Tallahassee, Florida 32399-7000; Telephone Number: [phone], SunCom 994-2000; Email 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 DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Jim Crochet, Department of Elder Affairs, Office of the General Counsel, 4040 Esplanade Way, Suite 315, Tallahassee, Florida 32399-7000; Telephone Number: [phone], SunCom 994-2000; Email address: [e-mail]. INTERESTED PARTIES MAY OBTAIN A COPY OF THE WORKSHOP AGENDA, DRAFT RULE AMENDMENTS AND THE ASSESSMENT FORM INCORPORATED BY REFERENCE ON THE DEPARTMENT'S WEB SITE AT: http://elderaffairs.state.fl.us UNDER THE HEADING ENTITLED “DOEA RULEMAKING, ADULT FAMILY-CARE HOMES.”

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

58A-14.002 Definitions.

The following terms or phrases are defined in Section 429.65, F.S., and are applicable to this rule chapter: activities of daily living (ADLs), adult family-care home (AFCH), agency (AHCA), aging in place, appropriate placement, chemical restraint, department, disabled adult, frail elder, personal services or personal care, provider, relative, relief person, and resident. Additional definitions applicable to this rule chapter are as follows:

(1) through (19) No change.

(20) “Unattended” means the resident is not supervised, looked after or watched by the provider, relief person or staff.

Specific Authority 429.67, 429.73 FS. Law Implemented 429.65, 429.67, 429.71, 429.73 FS. History–New 5-14-86, Amended 2-2-95, Formerly 10A-14.002, Amended 9-19-96, 6-6-99,________.

 

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 the Resident Health Assessment, DOEA Form AFCH-1110, Resident Health Assessment, December 2007 August 2003, which is incorporated by reference, and available from the Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, FL 32399-7000. The form may also be obtained from the department’s Web site at (entire hyperlink). Previous versions of this form completed up to 6 months after the effective date of this rule, January 1 2004 are acceptable.

(3) 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 both on and off 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 not be left unattended unless his or her health care provider submits written certification that the resident may be left unattended for a specified period of time, if applicable, without compromising the resident’s health, safety, security or well-being.

(b) The health care provider’s certification must be completed annually from the date of the original assessment referenced in subsection 58A-14.0061(2), F.A.C., 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 unattended.

(c) The provider must be accessible by telephone or pager or other appropriate means so that the resident is able to communicate with the provider during the period that he or she is left unattended.

(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 must be notified immediately 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 or case manager. Significant changes include a sudden or major shift in behavior or mood; 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 shall be weighed on a monthly basis.

(5)(4) FOOD SERVICE.

(a) through (h) No change.

(6)(5) NURSING SERVICES. In order to permit the resident to age in place, any nursing service needed by the resident can be provided or arranged for by the provider, or the resident or the resident’s representative may directly contract with a licensed home health agency or nurse to provide these services, provided that:

(a) through (b) No change.

(7)(6) ADDITIONAL SERVICES. The adult family-care home provider shall also ensure the provision of the following:

(a) through (f) 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. through 13. No change.

14. The resident health care provider’s certification pursuant to subsection 58A-14.007(2), F.A.C., if applicable.

(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,________.