The Board proposes the rule amendments for the purpose of implementing Chapter 2023-250, Laws of Florida (2023) (Senate Bill 558) and to update, clarify and remove unnecessary provisions.

 

DEPARTMENT OF HEALTH

Board of Nursing

RULE NOS.:RULE TITLES:

64B9-16.001Definitions

64B9-16.002Supervision by Licensed Practical Nurses in Nursing Home Facilities

64B9-16.004Delegation of Tasks Prohibited

PURPOSE AND EFFECT: The Board proposes the rule amendments for the purpose of implementing Chapter 2023-250, Laws of Florida (2023) (Senate Bill 558) and to update, clarify and remove unnecessary provisions.

SUMMARY: The rule amendment will implement Chapter 2023-250, Laws of Florida.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: During discussion of the economic impact of this rule at its Board meeting, the Board, based upon the expertise and experience of its members, determined that a Statement of Estimated Regulatory Costs (SERC) was not necessary and that the rule will not require ratification by the Legislature. No person or interested party submitted additional information regarding the economic impact at that time.

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.

RULEMAKING AUTHORITY: 400.23(3)(c) FS.

LAW IMPLEMENTED: 400.23(3)(c) FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Joe Baker, Jr., Executive Director, Board of Nursing, 4052 Bald Cypress Way, Bin #C02, Tallahassee, Florida 32399; [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64B9-16.001 Definitions.

As used in this chapter, the following mean:

(1) through (2) No change.

(3) Nursing services are acts that require knowledge and skill based on biological, social, behavioral, and nursing science. Only specified nursing acts can be performed by CNAs and UPs. RNs and LPNs can perform nursing acts as stated in Section 464.003, F.S.

(3)(4) “Supervision” is the provision of guidance and periodic inspection by the nurse for the accomplishment of a nursing task or activity, provided the nurse is qualified and legally entitled to perform such a task or activity. Supervision may be provided by an LPN to another LPN, QMA, CNA, or unlicensed personnel.

(4) “Direct Supervision" means the supervisor is on the premises but not necessarily immediately physically present where the tasks and activities are being performed.

(5) “General supervision” means the registered nurse is not on the premises but accessible by two-way communication, is able to respond to an inquiry when made, and is readily available for consultation.

(6) “Immediate supervision” means the supervisor is on the premises and is physically present where the tasks and activities are being performed.

(7) “Indirect supervision” means the registered nurse is not on the premises but is accessible by two way communication, is able to respond to an inquiry when made, and is readily available for consultation.

(8) through (10) renumbered as (5) through (7) No change.

(8) “Qualified medication aide” (QMA) is a certified nursing assistant who meets the requirements in Sections 400.211(5) and 464.2035, F.S., and who has completed training and demonstrated competency to administer medications and perform associated tasks for residents of a nursing home facility.

Rulemaking Authority 400.23(3)(d) (c) FS. Law Implemented 400.211(5), 400.23(3)(d)(c) FS. History–New 3-26-02, Amended_______________.

 

64B9-16.002 Supervision by Licensed Practical Nurses in Nursing Home Facilities.

(1) through (3) No change.

(4) Tasks and activities shall be delegated by the LPN to the QMA, CNA, or UP based on the following:

(a) through (b) No change.

(c) The task/activity is of a routine, repetitive nature and shall not require the QMA, CNA, or UP to exercise nursing knowledge, judgment, or skill.

(d) The QMA, CNA, or UP can and will perform the task/activity with the degree of care and skill that would be expected of the nurse.

Rulemaking Authority 400.23(3)(d)(c) FS. Law Implemented 400.211(5), 400.23(3)(d)(c) FS. History–New 3-26-02, Amended  .

 

64B9-16.004 Delegation of Tasks Prohibited.

The licensed practical nurse, under the direction of the appropriate licensed professional as defined in Section 464.003(1819), F.S. shall not delegate:

(1) No change.

(2) Those activities for which the LPN, QMA, CNA, licensed practical nurse, certified nursing assistant or UP has not demonstrated competence.

Rulemaking Authority 400.23(3)(c)(d) FS. Law Implemented 400.211(5), 400.23(3)(c)(d) FS. History–New 3-26-02, Amended  .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Board of Nursing

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Nursing

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 8, 2023

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: September 27, 2023