AGENCY FOR HEALTH CARE ADMINISTRATION
Health Facility and Agency Licensing
RULE NO.:RULE TITLE:
59A-13.004License Procedure
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. 39, No. 247, December 23, 2013 issue of the Florida Administrative Register.
The following sections of the proposed rule will be changed to read:
LAW IMPLEMENTED: 400.905, 400.906, 400.9065, 400.914, 408.805, 408.806, 408.810 FS.
59A-13.004 License Procedure.
(2) Application for a license to operate a PPEC center must be made on the Health Care Licensing Application, Prescribed Pediatric Extended Care Centers, AHCA Form 3110-8002, September 2013, hereby incorporated by reference, which must be submitted by the owner or administrator to the Agency. This form is available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXXX and available from the Agency for Health Care Administration, 2727 Mahan Drive, MS-33, Tallahassee, Florida 32308, or at the web address at: http://ahca.myflorida.com/HQAlicensureforms. In addition to a completed application, applicants for initial, renewal and change of ownership must submit the following:
The following changes have been made to the Application Checklist on the Health Care Licensing Application, Pediatric Extended Care Center Centers, AHCA Form 3110-8002, Revised September 2013:
Pg. 1-3, Footer:
The website where the form is made available was updated to read, “http://ahca.myflorida.com/HQAlicensureforms”
On Pg. 1
The words “late fine” have been changed to “late fee”.
The website where the form is made available was updated to read, “http://ahca.myflorida.com/HQAlicensureforms”
On Pg. 1, Section A:
The words “or provisional certificate of authority” have been added.
On Pg. 2, Section B:
The form version July 2007 has been changed to 2009.
On Pg. 2, Sections D.1. and D.2.:
Section 6 has been changed to 8.
The following changes have been made to the Health Care Licensing Application, Pediatric Extended Care Centers Center, AHCA Form 3110-8002, Revised September 2013:
Pg. 1-5, Footer:
The website where the form is made available was updated to read, “http://ahca.myflorida.com/HQAlicensureforms”
On Pg. 2, Section 2. Application Fees:
The action item “Late fee, if applicable” and the fee description, “Contact Licensure unit for details” have been removed from the fee table.
On Pg. 4, Section 5. Required Disclosure:
In section A., (5) has been removed from Section 408.809, F.S.
In section C., the second and third questions have been removed and replaced with the following:
“(Yes/No) Terminated for cause from the Medicare program or a state Medicaid program.
If yes, has applicant been in good standing with the Medicare program or a state Medicaid program for the most recent 5 years and the termination occurred at least 20 years before the date of the application. (Yes/No)”
On Pg. 5, Section 8. Affidavit
In the first paragraph, (5) has been removed from Section 408.809, F.S.
The second paragraph has been replaced with the words “In addition, I attest that all employees subject to Level 2 screening standards are in compliance with Section 435.05(2), F.S.”
