Definitions, Licensure Requirements, Procedures, and Fees, Registration Policies, Supplemental Staffing for Health Care Facilities, Emergency Management Plans, Certified Nursing Assistant and Home Health Aide

AGENCY FOR HEALTH CARE ADMINISTRATION
Health Facility and Agency Licensing

RULE NO: RULE TITLE
59A-18.002: Definitions
59A-18.004: Licensure Requirements, Procedures, and Fees
59A-18.005: Registration Policies
59A-18.017: Supplemental Staffing for Health Care Facilities
59A-18.018: Emergency Management Plans
59A-18.0081: Certified Nursing Assistant and Home Health Aide

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.32,No.06, February 10, 2006 issue of the Florida Administrative Weekly.

The changes are made to address comments received from the Joint Administrative Procedures Committee.

The changes are as follows:

59A-18.002 Definitions.

When used in this rule, unless the context otherwise requires, the term:

(1)“Administrator” means managing employee, or other similarly titled individual who is responsible for the daily operation of the nurse registry, pursuant to s. 400.506 and 400.512, F.S.

(1) through (13) renumbered (2) through (14) No changes.

 

59A-18.004 Licensure Requirements, Procedures, and Fees

1.  Paragraph (2) shall now read:

(2) The license shall be displayed in a conspicuous place in public view within the licensed premises. The registry license is not transferable. Sale of the licensed nurse registry, assignment, lease or other transfer, whether voluntary or involuntary, shall require relicensure by the new owner prior to taking over the operation, pursuant to Section 400.506(8), F.S. The prospective owner shall submit, at least 60 days prior to the effective date of the change, an application for a new license.

 

2.  Paragraph (4) shall now read:

(4) An initial licensure application shall include: Initial licensure - An application for an initial license to operate a nurse registry shall be submitted for a new operation or change of licensee accompanied by a non-refundable license fee of $2,000 for each site in operation to be licensed, and must be submitted and signed under oath on AHCA Form 3110-7001, Nurse Registry Application for Initial License, Revised December 2005, which is incorporated by reference, provided by the agency, and shall include:

(a) through (h) No changes

A signed Aaffidavit of Compliance with Screening Requirements, AHCA Form 3110-1014, Revised May 2006, incorporated by reference, from the administrator, pursuant to Section 400.512(2), F.S. stating that the administrator, the financial officer, and each contractor who was registered with the nurse registry on or after October 1, 2000 has been screened for good moral character and that the remaining contractors pursuant to Section 400.512(2), F.S. have been continuously registered with the nurse registry since before October 1, 2000, pursuant to Section 400.512(2), F.S.

Screening for good moral character for the administrator, or similarly titled individual who is responsible for the daily operation of the nurse registry, and for the financial officer, or similarly titled individual who is responsible for the financial operation of the nurse registry, including billings for patient care and services, shall be in accordance with level 2 standards for screening set forth in Chapter 435 and in accordance with Section 400.506(2), F.S. The fingerprint card for level 2 screening for the administrator and the financial officer can be obtained from, and must be submitted to, the Agency for Health Care Administration, Licensed Home Health Programs Unit, 2727 Mahan Drive, Mail Stop 34, Tallahassee, Florida 32308. Screening processing fees for level 2 screening shall be made payable to the Agency for Health Care Administration.

Level 1 screening, in accordance with screening standards as provided in chapter 435, F.S., and as required in Section 400.512, F.S., for good moral character for each contractor shall consist of:

                a. and b. No changes

(j) through (m) No changes

 

3.  Paragraph (12) is deleted.

(12) If a change of address is to occur, the nurse registry must provide 14 days advance notice in writing to the AHCA Licensed Home Health Programs Unit in Tallahassee and the AHCA field office. The nurse registry must submit to the AHCA Licensed Home Health Programs Unit evidence of compliance with local zoning authorities for the new location. Emergency relocations must be reported within seven days, with the reason for the relocation documented. An emergency relocation can be due to any of the following situations:

a. an eviction notice;

b. 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;

c. an element near the site which would make the premises harmful or dangerous;

d. circumstances arising from or caused by weather conditions and/or a natural disaster; or

e. a change in property zoning that requires the nurse registry to move.

 

59A-18.005 Registration Policies

 

1.  Paragraph (6) shall now read:

(6) Prior to contact with patients, each new independent contractor referred for client care must furnish to the registry a statement from a health care professional licensed under Chapter 458, F.S., or Chapter 459, F.S., a physician’s assistant, or an advanced registered nurse practitioner (ARNP) or a registered nurse licensed under Chapter 464, F.S., under the supervision of a licensed physician, or acting pursuant to an established protocol signed by a licensed physician, based upon an examination within the last six months, that the contractor is in reasonably good health and appears to be free from apparent signs or symptoms of a communicable disease including tuberculosis, pursuant to Section 381.0011(4), F.S.. If any independent contractor is later found to have, or is suspected of having, a communicable disease, he or she shall immediately cease to be referred as an independent contractor. If the independent contractor later provides a statement from a health care professional that such condition no longer exists, then the nurse registry can again refer patients to the independent contractor. It is the responsibility of the independent contractor to ensure that patients are not placed at risk by immediately removing him or herself as a caregiver if he or she is found to have or is suspected of having a communicable disease. In the event that an independent contractor refuses to remove him or herself, the nurse registry shall report the situation to the county health department as an immediate threat to health, welfare and safety. A new contractor who has been a contractor of another nurse registry or employed by a home health agency  may provide a copy of his health care statement from the files of the former nurse registry or home health agency provided that the statement was not issued more than 1 year prior and that the contractor has not had a break in service of more than 90 days. Medical information is confidential and must not be disclosed without the specific consent of the person to whom it pertains. The written request to release medical information must be kept on file. 

 

2.  Paragraph (8) shall now read:

(8) Registration folders on each independent contractor must contain the information required in s. 400.506(12), F.S.:

(a) through (c) No changes

(d) Evidence of HIV/AIDS training specified by the respective licensing board and that each non-licensed contractor received a continuing education course biennially on HIV and AIDS pursuant to Section 381.0035, F.S.   Each nurse registry shall establish a system for the recording and follow-up of complaints involving individuals they refer, and such records shall be kept in the individual’s registration file or retained in the central files of the nurse registry.

 

59A-18.0081 Certified Nursing Assistant and Home Health Aide.

1.  Paragraph (11) shall now read:

(11) C.N.A.’s and home health aides referred by nurse registries must have received a continuing education course biennially on HIV and AIDS, pursuant to Section 381.0035, F.S.; and training to maintain a current CPR certification.

 

2.  Paragraph (12) shall now read:

(12) C.N.A.’s and home health aides referred by nurse registries may assist with self-administration of medication as described in Section 400.488, F.S.

(a) through (c) No changes

(d) In cases where a home health aide or a C.N.A. will provide assistance with self-administered medications as described in Section 400.488, F.S., and paragraph (e) below, a review of the medications for which assistance is to be provided shall be conducted by a registered nurse or licensed practical nurse to ensure the C.N.A. and home health aide is able to assist in accordance with their training and with the medication preion. The patient or the patient's surrogate, guardian, or attorney in fact caregiver must give written consent for a home health aide or C.N.A. to provide assistance with self-administered medications, as required in Section 400.488(2), F.S.

(e) No changes.

 

59A-18.017 Supplemental Staffing for Health Care Facilities

1.  Paragraph (8) shall now read:

(8) If a nurse registry refers contractors to provide staffing service to a nursing home and the contractor has not lived in Florida for 5 years, maintained continuous residency within the state for the 5 years immediately preceeding the date of the request for staffing, that contractor will be required to undergo a level 2 background screening as required by Section 400.215, F.S.

 

59A-18.018 Emergency Management Plans

1.  Paragraph (6) shall now read:

(6) Nurse registries shall assist patients who would need assistance and sheltering during evacuations because of physical, mental, or sensory disabilities in registering with the local emergency management agency, as required in Section 400.506(15), F.S.make available to patients information gathered from the county emergency management offices including the procedures and documents required for assisting patients with registration for special needs shelters.

(a) Upon initial contract for services, and at a minimum on an annual basis, each nurse registry shall, pursuant to Sections 400.506(15) and 252.355, F.S., inform patients and patient caregivers, by the best method possible as it pertains to the person’s disability, and patient caregivers of the special needs registry and procedures for registration at the special needs registry maintained by their county emergency management office.

(b) and (c) No changes

(d) This registration information, when collected, shall be submitted, pursuant to Sections 252.355 and 400.506(15) and (16)(b) and (c), F.S., to the county emergency management office, or on a periodic basis as determined by the registry’s county emergency management office.

 

 

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE 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].