The purpose of the rule revisions is to conform the rules and Comprehensive Emergency Management Plan format to changes made by the 2006 Florida Legislature in Chapters 2006-71 and 2006-192, Laws of Florida; to clarify language regarding financial ...

 

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-8.0086: Denial, Suspension, Revocation of License and Imposition of Fines
59A-8.022: Clinical Records
59A-8.027: Emergency Management Plans
PURPOSE AND EFFECT: The purpose of the rule revisions is to conform the rules and Comprehensive Emergency Management Plan format to changes made by the 2006 Florida Legislature in Chapters 2006-71 and 2006-192, Laws of Florida; to clarify language regarding financial instability; to revise the Affidavit of Compliance with Screening Requirement form to add level 2 screening and annual submission as required in Section 435.04, F.S.; and to remove the time frame for clinical records retention since it is stated in 400.491, F.S. The effect will be updated rules with uniform licensure procedures that conform to state laws; a revised Comprehensive Emergency Management Plan format that includes the means by which the same type and quantity of services received in the home will be provided to patients evacuated to special needs shelters; and an updated Affidavit of Compliance with Screening Requirement form for administrators to attest to completion of both level 1 and level 2 screening for staff as required in law.

SUMMARY: The rules are being updated due to the changes to Chapter 400, Part III, Florida Statutes made by the 2006 Florida Legislature in Chapters 2006-71 and 2006-192, Laws of Florida. The changes in the rules for Chapter 2006-71, Laws of Florida, are: revising Rule 59A-8.027, F.A.C., and the Comprehensive Emergency Management Plan format to include the means by which the same type and quantity of services will be provided to special needs patients in shelters that they received prior to the evacuation; removing the Department of Health as the reviewer of multi-county plans as requested by the Department and referring to the contact designated by the Department for plan reviews; and adding the requirement for documentation of efforts made to deliver the same type and quantity of services in the patient record if the home health agency is unable to continue services. The following revisions were made to comply with Chapter 2006-192, Laws of Florida: the change of ownership definition was deleted in Rule 59A-8.002, F.A.C., since the definition is now in Section 408.803, F.S.; the time frame for applicants to respond to letters of omission was changed to 21 days from 30 days in Rule 59A-8.0086, F.A.C.; and the legal right to occupy property was added to address change requirements in Rule 59A-8.003, F.A.C. Legal references from Chapter 408, Part II, F.S., replaced Chapter 400, Part III, F.S., references in sections of the rules pertaining to initial, renewal and change of ownership licensure applications; surveys; voluntary relinquishment of license; injunctions; level 2 background screening for administrators and financial officers; and financial instability. Legal references from Chapter 408, Part II, F.S., were inserted in sections of the rule pertaining to administrative fines, denials and moratoriums in addition to the Chapter 400, Part III, F.S., references. Other changes include clarification of requirements when financial instability is found; revision of the Affidavit of Compliance with Screening Requirement form to add level 2 and annual submission per Section 435.04, F.S.; removal of the time frame for clinical record retention since it is stated in Section 400.491, F.S.; and assign new form number to the revised Comprehensive Emergency Management Plan for Home Health Agencies as the original form number duplicated an existing Agency form.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COST: 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: 400.491, 400.497 FS.
LAW IMPLEMENTED: 400.497, 408.806, 408.807, 408.809, 408.810, 408.811, 408.813, 408.814, 408.815, 408.816 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAW.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULES IS: Jan Benesh, Licensed Home Health Programs Unit, Bureau of Health Facility Regulation, Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop 34, Tallahassee, Florida 32308, [e-mail] or by phone at [phone]

 

THE FULL TEXT OF THE PROPOSED RULES IS:

59A-8.002 Definitions.

(1) through (5) No change.

(6) “Change of Ownership” means when a home health agency is purchased by a new corporation or partnership from the entity which currently holds the home health agency license. A one hundred percent stock purchase of the current corporate or partnership owner, or a change in the principals in the existing corporation or partnership, does not constitute a change of ownership, if that corporation or partnership continues to be the owner of the home health agency. If a person or persons own the home health agency, rather than a corporation or partnership, a change of ownership takes place when those individuals(s) sell the home health agency to other individual(s), or when the form of ownership changes from individual ownership to a business entity.

(6) through (38) renumbered (5) through (37) No change.

Specific Authority 400.497 FS. Law Implemented 400.462, 400.487 FS. History–New 4-19-76, Formerly 10D-68.02, Amended 4-30-86, 8-10-88, 5-30-90, 5-27-92, Formerly 10D-68.002, Amended 4-27-93, 10-27-94, 1-17-00, 7-18-01, 9-22-05, 8-15-06,_______.

 

59A-8.003 Licensure Requirements.

(1) The issuance of an initial license shall be based upon compliance with Chapter 400, Part III IV, F.S., and this rule as evidenced by a signed and notarized, complete and accurate home health agency application, as referenced in subsection 59A-8.004(1), F.A.C., and the results of a survey conducted by the AHCA.

(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 408.806(2) Section 400.471(7), F.S. It 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. Home health agencies that apply for renewal of their licenses will be surveyed pursuant to Section 408.811 400.484, F.S., based on the extent of compliance on previous surveys and complaint investigations with these rules and state laws. Home health agencies will be surveyed on an unannounced basis at least every 36 months. Area offices may do follow up surveys to check on correction of deficiencies at any time on an unannounced basis. An exit conference will be conducted to report the findings and to receive additional information or clarification concerning the survey.

(3) through (5) No change.

(6) An application package for a change of ownership shall be made on a form prescribed by AHCA, as referenced in subsection 59A-8.004(1), F.A.C.

(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 408.807(1) and (2) 400.471(7), F.S.

(b) No change.

(c) Failure to apply for a change of ownership of a licensed home health agency as required by Section 408.806(2) (b) and 400.471, F.S., shall result in a fine set and levied by AHCA pursuant t days advance notice in writing to the AHCA Licensed Home Health Programs Unit in Tallahassee and the AHCA area office. The home health agency must submit to the AHCA Licensed Home Health Programs Unit a certificate of occupancy, certificate of use, or evidence that the location is zoned for a home health agency business for the new address and evidence of legal right to the property in accordance with Section 408.810(6), F.S. Failure to notify AHCA within the time frame will result in a $500 fine, pursuant to Sections 408.813 and 400.474(1), F.S. Emergency relocations must be reported within seven days, with the reason for the relocation documented, to avoid a penalty assessment. An emergency relocation can be due to any of the following situations: 1) an eviction notice; 2) environmental conditions on or near the site which are not conducive to the health and well being of staff and clients, including a fire or flooding; 3) an element near the site which would make the premises harmful or dangerous; 4) circumstances arising from or caused by weather conditions and/or a natural disaster; or 5) a change in property zoning that requires the home health agency to move.

(10) through (12) No changes.

(13) 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 408.810(4)(a), F.S. This includes by submitting a letter to the address: AHCA Licensed Home Health Programs Unit, 2727 Mahan Drive – Mail Stop 34, Tallahassee, FL 32308, officially declaring the closure date of the home health agency.

Specific Authority 400.497 FS. Law Implemented 400.464, 400.471, 400.474, 400.484, 400.497 FS. History–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,_________.

 

59A-8.004 Licensure Procedure.

(1) An application for licensure, initial, change of ownership, or renewal, shall be made on a form prescribed by the AHCA: Home Health Agency Application for Initial Licensure, form number, AHCA 3110-1001, Revised July 2005; Application for Renewal of Licensure, form number, AHCA 3110-1011, January 2006; and Application for Change of Ownership, form number AHCA 3110-1012, July 2005, all incorporated by reference. These forms may be obtained at the AHCA web site, http://ahca.myflorida.com under “Licensing & Certification” and then under, Home Health Agency. If the requestor is unable to obtain the documents from the web site, the forms may be obtained from the AHCA Licensed Home Health Programs Unit by contacting [phone], and sending a check or money order to cover the Agency’s costs for the copying and mailing.

(2) The A corporate applicant shall identify the state of incorporation, its legal name, its business name, and the names and addresses of corporate officers and directors, the name and address of each person having at least a 5% equity interest in the entity corporation and other information as required in Section 408.806(1), F.S. For initial and change of ownership applications and corporate name changes, a current certificate of status or authorization pursuant to Chapter 607, F.S., is required.

(3) through (5) No change.

(6) An applicant for renewal of a license shall not be required to provide proof of financial ability to operate, unless the applicant has demonstrated financial inability to operate, as defined in subsection 59A-8.002(16), F.A.C. If an agency a licensee has shown signs of financial instability at any time, pursuant to Section 408.810(8), F.S., AHCA shall require the applicant for renewal of license to provide proof of financial ability to operate, by submitting schedules 2 through 7 of AHCA Form 3110-1013, December 2004, described in subsection (5) above., and documentation of correction of the financial instability, to include evidence of the payment of any bad checks, delinquent bills or liens. If complete payment cannot be made, evidence must be submitted of partial payment along with a plan for payment of any liens or delinquent bills. If the lien is with a government agency or repayment is ordered by a federal, state, or district court, an accepted plan of repayment must be provided.

(7) The applicant shall submit a signed affidavit with the application and annually thereafter as required in Sections 400.512 and 435.04(5), F.S., from the administrator affirming that the administrator, the financial officer, and all direct and contract personnel who enter the home in the capacity of their employment have been screened for good moral character. This Aaffidavit of Compliance with Screening Requirements, form number AHCA 3110 1014, Revised December 2006, incorporated by reference, also confirms that all remaining personnel, who enter the home in the capacity of their employment, have worked continuously for the home health agency since before October 1, 2000.

(8) New administrators and financial officers employees may work on probationary status, once they have submitted the documents described in subsection (9) or (10) below, including a signed and notarized copy of the Affidavit of Compliance with Background Screening Requirements, AHCA 3100-0008, December 2006, incorporated by reference Good Moral Character, AHCA 3110-0001, December 2004, pending a determination of compliance with minimum standards set forth in Chapter 435, F.S. New direct or contract personnel who enter the home in the capacity of their employment may work on probationary status, once they have submitted the documents described in subsection (10) below, including a signed and notarized copy of the Affidavit of Good Moral Character, AHCA 3110 0001, Revised December 2006, incorporated by reference, pending a determination of compliance with minimum standards set forth in Chapter 435, F.S.

(9) Background sScreening for good moral character for the administrator and the financial officer shall be in accordance with level 2 standards for screening set forth in Section 408.809 400.471(4), F.S. The fingerprint card for level 2 screening for the administrator and the financial officer can be obtained from the Agency for Health Care Administration, Licensed Home Health Programs Unit, by calling [phone] or sending a request by fax to [phone]. The completed fingerprint card should be submitted with a check or money order to cover the cost of the screening to the Agency for Health Care Administration, Licensed Home Health Programs Unit, 2727 Mahan Drive, Mail Stop 34, Tallahassee, Florida 32308.

(10) through (12) No change.

Specific Authority 400.497 FS. Law Implemented 400.471, 400.512, 408.810 FS. History–New 4-19-76, Formerly 10D-68.04, Amended 4-30-86, 8-10-88, 5-30-90, 6-12-91, 10-6-91, Formerly 10D-68.004, Amended 4-27-93, 10-27-94, 1-30-97, 1-17-00, 7-18-01, 9-22-05, 8-15-06,________.

 

59A-8.0086 Denial, Suspension, Revocation of License and Imposition of Fines.

(1) The AHCA shall deny, suspend or revoke an application for license, or impose a fine,

(a) If the applicant fails to submit all the information required in the application within 21 30 days of being notified in accordance with Section 408.806(3), F.S., by AHCA Licensed Home Health Programs Unit of the omissions in the application, the application shall be denied.

(b) through (e) No change.

(2) No change.

(3) This provision does not restrict AHCA from imposing an administrative fine, revoking the license or issuing a moratorium in accordance with Sections 400.484(2)(b), 408.814 and 408.815, F.S.

(4) If the AHCA finds that a violation of these rules creates an emergency threatening the health and safety of its patients, the AHCA shall suspend the license by emergency order under Chapter 120, F.S., and Section 408.814, F.S., and may institute injunctive proceedings in accordance with Section 408.816, F.S.

Specific Authority 400.497 FS. Law Implemented 120.59, 400.474, 400.484 FS. History–New 10-27-94, Amended 1-17-00, 7-18-01, 9-22-05, 8-15-06,_________.

 

59A-8.022 Clinical Records.

(1) through (3) No change.

(4) All clinical records must be retained by the home health agency as required in Section 400.491, F.S for a period of five years following the termination of service. Retained records can be stored as hard paper copy, microfilm, computer disks or tapes and must be retrievable for use during unannounced surveys as required in Section 408.811, F.S.

(5) through (6) No change.

Specific Authority 400.497 FS. Law Implemented 400.491, 400.494, 400.497 FS. History–New 4-19-76, Amended 2-2-77, Formerly 10D-68.22, Amended 4-30-86, 8-10-88, Formerly 10D-68.022, Amended 10-27-94, 1-17-00, 7-18-01, 9-22-05, 8-15-06,________.

 

59A-8.027 Emergency Management Plans.

(1) Pursuant to Section 400.492, F.S., each home health agency shall prepare and maintain a written comprehensive emergency management plan, in accordance with criteria shown in the “Emergency Management Planning Format for Home Health Agencies,” AHCA Form 3110-10221006, Revised December 20065, incorporated by reference. This document is available from the Agency for Health Care Administration at http://ahca.myflorida.com and shall be used as the format for the home health agency’s emergency management plan. The plan shall describe how the home health agency establishes and maintains an effective response to emergencies and disasters.

(2) The plan, once completed, will be forwarded electronically for approval to the Office of Public Health Nursing, Department of Health by multi-county agencies or to the contact designated by the Department of Health for single county agencies.

(3) through (7) No change.

(8) On admission, each home health agency shall, pursuant to Section 252.355, F.S., inform patients and patient caregivers of the home health agency’s procedures during and immediately following an emergency and inform patients of the special needs registry maintained by their county Emergency Management office. The home health agency must document in the patient’s file if the patient plans to evacuate or remain at home; if during the emergency the patient’s caregiver can take responsibility for services normally provided by the home health agency; or if the home health agency needs to continue services to the patient. If the patient is a resident of an assisted living facility or an adult family care home, the home health agency must contact the assisted living facility or adult family care home administrator or designated emergency management personnel and find out the plan for evacuation of the resident in order to document the resident’s plans in the home health agency’s file for the patient. If it is determined the home health agency needs to provide continued services, it will be the responsibility of the home health agency to provide the same type and quantity of care for the patient in the special needs shelter during and after the emergency, equal to the care received prior to the shelter assignment as specified in Section 400.492, F.S., except in certain situations as specified in Section 400.492(3), F.S.

(9) through (11) No change.

(12) When a home health agency is unable to continue services to special needs patients registered under Section 252.355, F.S., that patient’s record must contain documentation of the efforts made by the home health agency to comply with their emergency management plan in accordance with Section 400.492(3), F.S.  Documentation includes, but is not limited to, contacts made to the patient’s caregivers, if applicable; contacts made to the assisted living facility and adult family care home, if applicable; and contacts made to local emergency operation centers to obtain assistance in reaching patients and contacts made to other agencies which may be able to provide temporary services.

(13)(12) Each home health agency is required to collect registration information for special needs patients who will need continuing care or services during a disaster or emergency, pursuant to Section 252.355, F.S.  This registration information shall be submitted, when collected, to the county Emergency Management office, or on a periodic basis as determined by the home health agency’s county Emergency Management office.

(14)(13) Home health agency staff shall educate patients registered with the special needs registry that special needs shelters are an option of last resort and that services may will not be equal to what they have received in their homes.

(14) through (39) renumbered (15) through (40) No change.

Specific Authority 400.492, 400.497 FS. Law Implemented 400.492, 400.497 FS. History–New 7-18-01, Amended 8-15-06,_________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Jan Benesh

NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Jeffrey N. Gregg

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 19, 2006

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: October 27, 2006