Definitions, Licensure Requirements, Licensure Procedure, Scope of Services, Personnel, Personnel Policies, Acceptance of Patients or Clients, Plan of Care, Clinical Records, Advance Directives, Emergency Management Plans

AGENCY FOR HEALTH CARE ADMINISTRATION
Health Facility and Agency Licensing

Rule No.: RULE TITLE
59A-8.002: Definitions
59A-8.003: Licensure Requirements
59A-8.004: Licensure Procedure
59A-8.008: Scope of Services
59A-8.0095: Personnel
59A-8.0185: Personnel Policies
59A-8.020: Acceptance of Patients or Clients
59A-8.0215: Plan of Care
59A-8.022: Clinical Records
59A-8.0245: Advance Directives
59A-8.027: Emergency Management Plans

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. 36 No. 28, July 16, 2010 issue of the Florida Administrative Weekly.

The deletion of subsection 59A-8.0185, F.A.C., is in response to written comments received from the staff of the Joint Administrative Procedures Committee. subsection 59A-8.004(4), F.A.C., is deleted because the contents are now in subsection 59A-35.060(1)(m), F.A.C. Other changes are made in response to comments from the public hearing held on September 9, 2010 and requirements in 2010-279, Laws of Florida. The Statement of Estimated Regulatory Costs is revised due to changes in this notice and previous change notices, written comments from the Small Business Regulatory Advisory Council, and Chapter 2010-279, Laws of Florida.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: A revised statement of estimated regulatory costs has been prepared and is available from the proposed rule contact person, Anne Menard at [e-mail] or by fax [phone]. The following is a summary of the SERC:

As of December 7, 2010, there were 2,324 licensed home health agencies in Florida. These agencies will be required to comply with the rule as well as any new agencies that are licensed in the coming years. There have been changes to the proposed rules filed in three prior change notices as well as this notice. Many items with costs, including photo identification badges and health statements, have been removed. There will be costs to home health agencies for some of the remaining rule items as estimated by the Agency for Health Care Administration in its Statement of Estimated Regulatory Costs. However, none of the remaining proposed rules will increase aggregate regulatory costs beyond the limit in Chapter 2010-279, Laws of Florida, effective November 17, 2010. The Agency for Health Care Administration will incur the cost of rulemaking, as well the costs associated with enforcing the proposed changes. There is no cost to local government for the revisions in these rules since none of these changes affect local government entities.

59A-8.004

(4) If the applicant is a limited liability company, the name and address of each member, its legal name, and the business name and address must be identified. For initial and change of ownership applicants and name changes, a current authorization for the limited liability company from the Department of State, the operating agreement and the articles of organization pursuant to Chapter 608, F.S.must be submitted.

59A-8.0095 Personnel.

(5) Home Health Aide and Certified Nursing Assistant.

(m) Responsibilities of the home health aide and CNA shall include:

4. Keeping records by date and time of visit for filing in the client’s record of personal health care activities other tasks performed for each client. A checklist or other format may be used. Records may be kept electronically. Each home health agency will demonstrate a process to verify that services were provided.

(12) Homemakers and Companions.

(a) The homemaker shall:

5. Report to the appropriate supervisor any incidents or problems related to his work or to the caregiver and make a note in the work record.;

7. Maintain chronological work records by time of visit and date to be filed in the client’s record. A checklist or other format may be used. Records may be kept electronically. Each home health agency will demonstrate a process to verify that services were provided.

(b) The companion shall:

6. Maintain a chronological written record of services; by time of visit and date to be filed in the client’s record. A checklist or other format may be used. Records may be kept electronically. Each home health agency will demonstrate a process to verify that services were provided;

 

59A-8.0185 Personnel Policies.

Rulemaking Authority 400.497 FS. Law Implemented 400.471, 400.497 FS. History–New 10-27-94, Amended 1-17-00, 7-18-01, 9-22-05, 8-15-06, Repealed________.

 

59A-8.0215 Plan of Care and Service Provision Plan.

(3) A service provision plan shall be prepared for clients that receive only services from a home health aide, certified nursing assistant, homemaker or companion and do not receive skilled services as required in Section 400.491, F.S. This can be a checklist or other format as determined by the home health agency. When the client or patient also receives skilled services, a plan of care is done that includes all services and a service provision plan is not done.

(4) The service provision plan shall include, but is not limited to, the following:

(a) The frequency of visits as agreed to by the client or his or her responsible party. The plan may include a statement that additional or fewer visits will be arranged at the direction of the client. When clients have personal care needs that are dependent on home health aide or certified nursing assistant visits at specific times of the day, the plan will include the sagreed upon specified times for the visits with the frequency.

(b) A description or list of the tasks to be performed for the services to be provided during the visits visit.

(c) Whether a home health aide, certified nursing assistant, homemaker or companion will provide the services.

(6) All plans of care and service provision plans are individualized based on each patient or client’s needs, strengths, limitations and goals.

59A-8.022 Clinical Records and Service Records.

(6) Service records for clients receiving only home health aide, certified nursing assistant, homemaker and companion services may be paper or electronic and must contain, at a minimum, the following:

(a) Client Identification sheet for the client with name, address, telephone number, date of birth, sex, caregiver, next of kin or guardian;

(b) Service provision plan, notes of any changes in the plan, and all subsequent updates and written agreement required in Section 400.487, F.S.;

(c) Service notes or checklists, signed and dated by the staff member providing the service which shall include the information in subsection 59A-8.0095(5) or (12), F.A.C., depending on the services provided:

(d) Home visits to clients for supervision of staff providing services, if such visits are made;

(e) The Termination summary including the date of last visit and the reason for termination of service.

(7) Home health agencies that provide services under contract to patients or clients admitted by another home health agency are expected to have a paper or electronic copy of the records of visits made by their staff and a copy of the plan of care or service provision plan created by the admitting agency for each patient or client