AGENCY FOR HEALTH CARE ADMINISTRATION
Health Facility and Agency Licensing
RULE NOS.:RULE TITLES:
59A-17.102Licensure
59A-17.119Facility Life Safety and Building Code Requirements
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. 40, No. 60, March 27, 2014 issue of the Florida Administrative Register.
The following sections of the proposed rule will be changed to read:
59A-17.102 Licensure.
(1) An initial, renewal, or change of ownership applicant for licensure as a transitional living facility shall use the Health Care Licensing Application, Transitional Living Facilities, AHCA Form 3110-9001, July 2014 September 2013, which is incorporated by reference and is available at http//www.flrules.org/Gateway/reference.asp?No=Ref-XXXXX. This form can be obtained by written request addressed to Agency for Health Care Administration, Long Term Care Section, 2727 Mahan Drive, Tallahassee, Florida 32308 or online at http://ahca.myflorida.com/HQAlicensureforms http://ahca.myflorida.com/MCHQ/Corebill/index.shmtl. The license application shall be accompanied by the nonrefundable base biennial license fee of $4,588.00, plus $90.00 per bed and shall conform to the annual adjustment authorized in Section 408.805, F.S.
(2) Prior to issuance of the initial license for a transitional living facility, the Agency for Health Care Administration shall receive notification from the Brain and Spinal Cord Injury Program with the Department of Health that the facility meets the service requirements adopted by the Department Division as required in Section 400.805(2)(c), Florida Statutes.
59A-17.119 Facility Life Safety, Building Code Requirements and Physical Plant Standards.
No change.
The following changes have been made to the Application Checklist on the Health Care Licensing Application, Transitional Living Facilities, AHCA Form 3110-9001, September 2013:
Pg. 1-2, Footer:
The form revision date was updated to remove the word “Revised” from the revision date and to change the revision date from “September 2013” to “July 2014”.
On Pg. 1
The Agency logo has been updated.
The following changes have been made to the Health Care Licensing Application, Transitional Living Facilities, AHCA Form 3110-9001, September 2013:
Pg. 1-6, Footer:
The form revision date was updated to remove the word “Revised” from the revision date and to change the revision date from “September 2013” to “July 2014”.
On Pg. 1
The Agency logo has been updated.
On Pg. 6, Section 7. Affidavit
The section has been renumbered from “7” to “8” and the section title has been changed from “Affidavit” to “Attestation”.
The statements in this section have been replaced with the following:
I, _______________________, under penalty of perjury, attest as follows:
(1) Pursuant to Section 837.06, Florida Statutes, I have not knowingly made a false statement with the intent to mislead the Agency in the performance of its official duty.
(2) Pursuant to Section 408.815, Florida Statutes, I acknowledge that false representation of a material fact in the license application or omission of any material fact from the license application by a controlling interest may be used by the Agency for denying and revoking a license or change of ownership application.
(3) Pursuant to Section 408.806, Florida Statutes, the applicant is in compliance with the provisions of Section 408.806 and Chapter 435, Florida Statutes.
(4) Pursuant to Sections 408.809 and 435.05, Florida Statutes, every employee of the applicant required to be screened has attested, subject to penalty of perjury, to meeting the requirements for qualifying for employment pursuant to Chapter 408, Part II, and Chapter 435, Florida Statutes, and has agreed to inform the employer immediately if arrested for any of the disqualifying offenses while employed by the employer.
(5) Pursuant to Section 435.05, Florida Statutes, the applicant has conducted a level 2 background screening through the Agency on every employee required to be screened under Chapter 408, Part II, or Chapter 435, Florida Statutes, as a condition of employment and continued employment and that every such employee has satisfied the level 2 background screening standards or obtained an exemption from disqualification from employment.
