Definitions, Staffing Standards, Staff Training Requirements and Competency Test, Alzheimer's Disease or Related Disorders Training Provider and Curriculum Approval, Fiscal Standards, Physical Plant Standards, Records, Adverse Incident Report, ...  

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    DEPARTMENT OF ELDER AFFAIRS

    Federal Aging Programs

    RULE NOS.:RULE TITLES:

    58A-5.0131Definitions

    58A-5.019Staffing Standards

    58A-5.0191Staff Training Requirements

    58A-5.0194Alzheimer’s Disease or Related Disorders Training Provider and Curriculum Approval

    58A-5.021Fiscal Standards

    58A-5.023Physical Plant Standards

    58A-5.024Records

    58A-5.0241Adverse Incident Report

    58A-5.026Emergency Management

    58A-5.030Extended Congregate Care Services

    58A-5.035Waivers

    NOTICE OF CHANGE

    In accordance with subparagraph 120.54(3)(d)1., F.S., notice is hereby given that the following changes have been made to the proposed rules published on November 27, 2013 in Vol. 39, No. 231, of the Florida Administrative Register. The changes are in response to input received from the public at a public hearing held on December 19, 2013, in addition to comments and suggestions made by the Joint Administrative Procedures Committee. No additional hearings were timely requested pursuant to Section 120.54(3)(c)1., F.S. The Department considered the testimony of the parties at the hearing, as well as suggestions made by the Joint Administrative Procedures Committee, and determined that the following changes are appropriate.

    Rules 58A-5.0131, 58A-5.0182, 58A-5.019, 58A-5.0191, 58A-5.0194, 58A-5.021, 58A-5.023, 58A-5.024, 58A-5.0241, 58A-5.026, 58A-5.030, and 58A-5.035, F.A.C., are amended to read:

     

    58A-5.0131 Definitions.

    In addition to the terms defined in Section 429.02, F.S., the following definitions are applicable in this rule chapter:

    (1) through (11) No change.

    (12) “Direct Care Staff” means Sstaff in Regular Contact or Staff in Direct Contact with residents that provide providing personal or nursing services to residents, including administrators and managers or supervising staff providing such services.

    (13) through (33) No change.

    (34) “Staff in Regular Contact” or “Staff in Direct Contact” means all staff who do not provide direct care to residents, but whose duties may require them to interact with residents on a daily basis.

    (35) through (37) No change.

    Rulemaking Authority 429.23, 429.41 FS. Law Implemented, 429.07, 429.075, 429.11, 429.14, 429.19, 429.41, 429.47, 429.52 FS. History–New 9-30-92, Formerly 10A-5.0131, Amended 10-30-95, 6-2-96, 4-20-98, 10-17-99, 1-9-02, 7-30-06, 4-15-10,_________.

     

    58A-5.019 Staffing Standards.

    (1) through (1)(c) No change.

    (d) An individual serving as a manager must satisfy the same qualifications, background screening, core training and competency test requirements, and continuing education requirements of an administrator pursuant to paragraph (1)(a) of this rule. Managers who attended the core training program prior to July 1, 1997 April 20, 1998, are not required to take the competency test unless specified elsewhere in this rule. In addition, a manager may not serve as a manager of more than a single facility, except as provided in paragraph (1)(c) of this rule, and may not simultaneously serve as an administrator of any other facility.

    (1)(e) No change.

    (2) STAFF.

    (a) Within 30 days after beginning employment, newly hired staff must submit a written statement from a health care provider documenting that the individual does not have any signs or symptoms of Tuberculosis, Methicillin Resistant Staphylococcus Aureus, Scabies or any other communicable disease. The examination performed by the health care provider must have been conducted no earlier than 6 months before submission of the statement. Newly hired staff does not include an employee transferring without a break in service from one facility to another when the facility is under the same management or ownership.

    1. Evidence of a negative tuberculosis examination must be documented on an annual basis. Signed Ddocumentation provided by the Florida Department of Health or a licensed health care provider certifying that there is a shortage of tuberculosis testing materials a test is not required shall satisfy the annual tuberculosis examination requirement. An individual with a positive tuberculosis test must submit a health care provider’s statement that the individual does not constitute a risk of communicating tuberculosis.

    (2)(a)2. through (3) No change.

    Rulemaking Authority 429.275, 429.41, 429.52FS. Law Implemented 429.174, 429.176, 429.41, 429.52 FS. History–New 5-14-81, Amended 1-6-82, 9-17-84, Formerly 10A-5.19, Amended 10-20-86, 6-21-88, 8-15-90, 9-30-92, Formerly 10A-5.019, Amended 10-30-95, 4-20-98, 11-2-98, 10-17-99, 7-30-06, 4-15-10,_________.

     

    58A-5.0191 Administrator, Manager, and Staff Training Requirements.

    Administrators, managers, and staff must satisfy the minimum training, testing, continuing education, and documentation requirements as specified in this rule.

    (1) through (2) No change.

    (3) STAFF INTERACTING WITH RESIDENTS. Direct care staff, other than administrators and managers who have satisfied the training requirements of subsection (1) of this rule, must satisfy the training requirements as stated below in subparagraphs (3)(a) through (3)(c)1. Additionally, staff in direct regular contact with residents in a facility with a limited mental health license who have regular contact with residents must satisfy the training specified in subparagraph (3)(c)2. below.

    (3)(a) through (3)(c)(1) No change.

    2. Limited Mental Health. Direct care staff and staff in direct regular contact with mental health residents must complete a minimum of 6 hours of training in working with individuals with mental health diagnoses within 6 months of the facility’s receiving an initial limited mental health license, or within 90 days of beginning employment in a facility with an existing limited mental health license. The training must be received from providers as set forth in subparagraph (5)(d)8. of this rule.

    (4) through (4)(a)5. No change.

    (b) Assistance With Self-Administered Medication Training. Unlicensed persons as defined in Section 429.256(1)(b), F.S., who provide assistance with self-administered medications as described in Rule 58A-5.0185, F.A.C., must complete a minimum of 4 6 hours of training provided by a registered nurse, licensed pharmacist, or department staff before assuming this responsibility. Training must include demonstrations of proper techniques and provide opportunities for hands-on learning through practice exercises. Unlicensed persons who have received a training certificate demonstrating successful completion of a 4 hour course before July 1, 2014 are not required to take the 6 hour training.

    (4)(b)1. No change.

    2. A training certificate will be issued to a trainee after successfully demonstrating the ability to provide assistance with self-administration, including the ability to:

    a. Read and understand a prescription label;

    b. Assist with forms of oral; topical; and topical ophthalmic, otic, and nasal dosages, including solutions, suspensions, sprays, and inhalers;

    c. Measure liquid medications, break scored tablets, and crush tablets in accordance with prescription directions;

    d. Recognize the need to obtain clarification of an “as needed” prescription order;

    e. Recognize a medication order that requires judgment or discretion, and to advise the resident, resident’s health care provider, or facility administrator or manager of the unlicensed individual’s inability to assist in the administration of such orders;

    f. Complete a medication observation record;

    g. Retrieve and store medication; and

    h. Recognize the general signs of adverse reactions to medications and report such reactions.

    (4)(c) through (5)(c) No change.

    (d) Continuing Education Providers. Continuing education may be obtained either online or in person and must be obtained from courses or workshops offered by providers as specified below.

    1. Core trainers registered with the department, pursuant to Rules 58T-1.207 and 58T-1.209, F.A.C.;

    2. through (6) No change.

    Rulemaking Authority 429.178, 429.41, 429.52 FS. Law Implemented 429.07, 429.075, 429.178, 429.256, 429.41, 429.52 FS. History–New 9-30-92, Formerly 10A-5.0191, Amended 10-30-95, 6-2-96, 4-20-98, 11-2-98, 10-17-99, 7-5-05, 7-30-06, 10-9-06, 7-1-08, 4-15-10,_________.

     

    58A-5.0194 Alzheimer’s Disease or Related Disorders Training Provider and Curriculum Approval.

    (1)(a) No change.

    (b) ADRD Training Curricula. Applicants seeking approval of ADRD curricula must complete DOEA form ALF/ADRD-002, Application for Alzheimer’s Disease or Related Disorders Training Three-Year Curriculum Certification, dated November 2013, which is incorporated by reference and available at the Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, Florida 32399-7000 and online at http://trainingonaging.cbcs.usf.edu/data/doea_alf_curriculum.pdf. Approval of the curriculum will be granted based on how well the curriculum addresses the subject areas referenced in subparagraph 58A-5.0191(4)(a)3. and paragraph 58A-5.0191(4)(a), subsection (5), F.A.C. Curriculum approval will be granted for 3 years. After 3 years the curriculum must be resubmitted to the department or its designee for approval.

    (2) through (4) No change.

    (5) ADRD training providers satisfying the requirements of Sections 400.1755, F.S., relating to nursing homes, and 400.6045, F.S., relating to hospices, will satisfy the Level 1 and Level 2 training provider requirements of subparagraph 58A-5.0191(4)(a)3. and paragraph 58A-5.0191(4)(a), subsection (5), F.A.C. this rule. ADRD training curricula satisfying the requirements of Section 400.1755, F.S., relating to nursing homes, and 400.6045, F.S., relating to hospices, will satisfy the Level 1 curriculum requirements of subparagraph 58A-5.0191(4)(a)3. this rule.

    Rulemaking Authority 429.178 FS. Law Implemented 429.178 FS. History–New_________.

     

    58A-5.021 Fiscal Standards.

    (1) through (2) No change.

    (3) SURETY BONDS. Pursuant In addition to the requirements of Section 429.27(2), F.S.:

    (a) No change.

    (b) The following additional bonding requirements apply to facilities serving residents receiving OSS:

    1. If serving as representative payee for a resident receiving OSS, the minimum bond proceeds must equal twice the value of the residents monthly aggregate income, which must include any supplemental security income or social security disability income plus the OSS payments, including the personal needs allowance.

    2. If holding a power of attorney for a resident receiving OSS, the minimum bond proceeds must equal twice the value of the resident’s monthly aggregate income, which must include any supplemental security income or social security disability income; the OSS payments, including the personal allowance; plus the value of any property belonging to a resident held at the facility.

    (3)(c) through (4) No change.

    Rulemaking Authority 429.24, 429.27, 429.275, 429.41 FS. Law Implemented 429.24, 429.27, 429.275 FS. History–New 5-14-81, Amended 1-6-82, 9-17-84, Formerly 10A-5.21, Amended 6-21-88, 8-15-90, 9-30-92, Formerly 10A-5.021, Amended 10-30-95, 6-2-96, 10-17-99,_________.

     

    58A-5.023 Physical Plant Standards.

    (1) NEW FACILITIES. Newly constructed facilities to be licensed as assisted living facilities, and existing structures, not previously licensed as assisted living facilities, to be converted to assisted living facilities, as well as any subsequent additions, modifications, alterations, renovations or refurbishing of such facilities are required by governmental entities other than the Department of Elder Affairs to adhere to certain building code and fire safety standards. Such standards may be found in, must adhere to the following standards:

    (1)(a) through (4) No change.

    Rulemaking Authority 429.41 FS. Law Implemented 429.27, 429.28, 429.41 FS. History–New 5-14-81, Amended 1-6-82, 5-19-83, 9-17-84, Formerly 10A-5.23, Amended 10-20-86, 6-21-88, 8-15-90, 9-30-92, Formerly 10A-5.023, Amended 10-30-95, 6-2-96, 10- 17-99, 7-30-06, 4-15-10,_________.

     

    58A-5.024 Records.

    (1) No change.

    (2) STAFF RECORDS.

    (a) Personnel records for each staff member must contain, at a minimum, a copy of the employment application, with references furnished, and documentation verifying freedom from signs or symptoms of Tuberculosis, Methicillin Resistant Staphylococcus Aureus, Scabies or any other communicable disease. In addition, records must contain the following, as applicable:

    (2)(a)1. through (4) No change.

    Rulemaking Authority 429.275, 429.41 FS. Law Implemented 429.24, 429.255, 429.256, 429.26, 429.27, 429.275, 429.35, 429.41, 429.52 FS. History–New 5-14-81, Amended 1-6-82, 5-19-83, 9-17-84, Formerly 10A-5.24, Amended 10-20-86, 6-21-88, 8-15-90, 9-30-92, Formerly 10A-5.024, Amended 10-30-95, 4-20-98, 11-2-98, 10-17-99, 7-30-06, 10-9-06,_________.

     

    58A-5.0241 Adverse Incident Report.

    (1) INITIAL ADVERSE INCIDENT REPORT. The preliminary adverse incident report required by Section 429.23(3), F.S., must be submitted within 1 business day after the incident pursuant to Rule 59A-35.110, F.A.C., which requires online reporting. The Initial Adverse Incident Report is in addition to, and does not replace, other reporting requirements specified in Florida Statutes.

    (2) No change.

    Rulemaking Authority 429.23 FS. Law Implemented 429.23 FS. History–New 1-9-02, Amended 7-30-06,_________.

     

    58A-5.026 Emergency Management.

    (1) through (2) No change.

    (3) PLAN IMPLEMENTATION. In the event of an internal or external disaster, the facility must implement the facility’s emergency management plan in order to meet the requirements of Part I, Chapter 252, F.S.

    (3)(a) through (5) No change.

    Rulemaking Authority 429.41 FS. Law Implemented 429.41 FS. History–New 10-17-99, Amended 7-30-06,_________.

     

    58A-5.030 Extended Congregate Care Services.

    (1) through (4)(a)1. No change.

    2. A nursing home administrator licensed under Chapter 468, F.S. is qualified under this paragraph exempt from the educational requirements referenced in paragraph (4)(a).

    (4)(b) through (10) No change.

    Rulemaking Authority 429.07, 429.41 FS. Law Implemented 429.07, 429.255, 429.26, 429.28, 429.41 FS. History–New 9-30-92, Formerly 10A-5.030, Amended 10-30-95, 6-2-96, 4-20-98, 11-2-98, 10-17-99, 7-30-06,_________.

     

    58A-5.035 Waivers.

    (1) No change.

    (2) Tthe In accordance with Section 120.542(6), F.S., agency must post notice of the request in the Florida Administrative Register within 15 days of receipt of the request. The agency must make any requests for additional information within 30 days of receipt of the request. If additional information is provided, the agency may request clarification of only that information no later than 30 days following receipt of the information. The agency must grant or deny process the waiver request within 90 days after receipt of the original request, the last piece of additional information timely requested by the agency, or the requestor’s written request to finish processing the waiver request pursuant to the time frame referenced in Section 120.542(8), F.S.

    (3) No change.

    (4) The agency must grant or deny the request for waiver and enter an order summarizing the facts relied on, and reasons supporting its decision. The agency must provide notice of its order in the Florida Administrative Register as described in Section 120.542(8), F.S. The notice shall contain the name of the requestor, the date the request was filed, the rule number and nature of the rule from which the waiver is sought, a reference to the place and date of publication of the notice of the request, the date of the order denying or approving the or waiver, the general basis for the agency decision, and an explanation of how a copy of the order may be obtained. The requestor must be advised that a denial of the request may be reviewed as provided in subsection (5) of this rule.

    (5) No change.

    Rulemaking Authority 429.41 FS. Law Implemented 429.41 FS. History–New 9-30-92, Formerly 10A-5.035, Amended 10-30-95, 7-1-08,________.