AGENCY FOR HEALTH CARE ADMINISTRATION
Health Facility and Agency Licensing
RULE NOS.:RULE TITLES:
59A-36.007Resident Care Standards
59A-36.008Medication Practices
59A-36.028ALF Minimum Core Training Curriculum 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. 47 No. 121, June 23, 2021 issue of the Florida Administrative Register.
The following sections of the proposed rules will be changed to read:
59A-36.007 Resident Care Standards.
An assisted living facility must provide care and services appropriate to the needs of residents accepted for admission to the facility.
(1) through (4) No change
(5) NURSING SERVICES.
(a) Pursuant to section 429.255, F.S., the facility may employ or contract with a nurse to:
1. Take or supervise the taking of vital signs,
2. Manage pill-organizers and administer medications as described in rule 59A-36.008, F.A.C.,
3. Give prepackaged enemas pursuant to a physician’s order; and,
4. Maintain nursing progress notes.
(b) Pursuant to section 429.255(2), F.S., the nursing services listed in paragraph (a), may also be delivered in the facility by family members or friends of the resident provided the family member or friend does not receive compensation for such services.
(5)(6) RESIDENT RIGHTS AND FACILITY PROCEDURES.
(a) through (c) No change
(d) The facility must have a written statement of its house rules and procedures that must be included in the admission package provided pursuant to rule 59A-36.006, F.A.C. The rules and procedures must at a minimum address the facility’s policies regarding:
1. Resident responsibilities;
2. Alcohol and tobacco use;
3. Medication storage;
4. Resident elopement;
5. Reporting resident abuse, neglect, and exploitation;
6. Administrative and housekeeping schedules and requirements;
7. Infection control, sanitation, and standard universal precautions;
8. The requirements for coordinating the delivery of services to residents by third party providers.
9. Assistive devices; and
10. Physical restraints.
(e) through (f) No change
(g) In addition to the requirements of section 429.41(1)(k), F.S., the use of physical restraints by a facility on a resident must be reviewed by the resident’s physician annually. Any device, including half-bed rails, which the resident chooses to use and can remove or avoid without assistance, is not considered a physical restraint.
(6)(7) THIRD PARTY SERVICES.
(a) through (b) No change
(c) The administrator or designee must ensure that:
1. Care coordination includes documented communications about the resident’s condition and response to treatment or services ordered by the physician which may impact the resident’s appropriateness for continued residency in the facility;
2. Communications occur at least once every 30 days and whenever there is a significant change in the resident’s condition; and
3. If physician ordered treatments or services occur less often than once a month, communications must be conducted according to the ordered treatment or service schedule and whenever there is a significant change in the resident’s condition.
4. When communication with the third party provider is unsuccessful, at least two attempts at communication on two separate days must be documented. Documentation must include the name of the person from the third party provider with whom contact was attempted, the method of communication, and the date and time of the attempts. This documentation must be included in the resident’s record in accordance with the timeframes in subsection 59A-36.007(6)(c)2. and 3.
(d) No change
(7)(8) ELOPEMENT STANDARDS.
(a) through (b) No change
(c) Facility Resident Elopement Drills. The facility must conduct and document resident elopement drills pursuant to sections 429.41(1)(k)(a)3. and 429.41(1)(l), F.S.
(8)(9) PHYSICAL RESTRAINTS. Residents for whom a physician has prescribed a physical restraint must have a written care plan for the use of the physical restraint. The care plan must be developed within 14 days of the device being prescribed, and prior to use on the resident.
(a) The care plan must specify:
1. The device prescribed for use,
2. The maximum amount of time the resident is to have the restraint applied or in use in a 24-hour period each day, and,
3. In what manner and frequency staff will monitor, observe, and report to the physician any injuries, increase in agitation, signs and symptoms of depression, or decline in mobility or function related to the use of the prescribed restraint.
(b) through (c) No change
(10) through (13) renumbered (9) through (12)
Rulemaking Authority 429.41 FS. Law Implemented 429.255, 429.26, 429.28, 429.41 FS. History–New 9-17-84, Formerly 10A-5.182, Amended 10-20-86, 6-21-88, 8-15-90, 9-30-92, Formerly 10A-5.0182, Amended 10-30-95, 4-20-98, 11-2-98, 10-17-99, 7-30-06, 10-9-06, 4-15-10, 4-17-14, 5-10-18, Formerly 58A-5.0182, 7-1-19, Amended .
59A-36.008 Medication Practices.
Pursuant to sections 429.255 and 429.256, F.S., and this rule, licensed facilities may assist with the self-administration or administration of medications to residents in a facility. A resident may not be compelled to take medications but may be counseled in accordance with this rule.
(1) through (2) No change
(3) ASSISTANCE WITH SELF-ADMINISTRATION.
(a) No change.
(b) In addition to the specifications of section 429.256(3), F.S., assistance with self-administration of medication includes, orally advising the resident of the name and dosage of the medication and verbally prompting a resident to take medications as prescribed.
(c) through (e) No change.
(f) Assistance with self-administration of medication does not include the activities detailed in section 429.256(4), F.S.
1. As used in section 429.256(4)(g), F.S., the term “competent resident” means that the resident is cognizant of when a medication is required and understands the purpose for taking the medication.
(g)2. As used in section 429.256(4)(h), F.S., the terms “judgment” and “discretion” mean interpreting vital signs and evaluating or assessing a resident’s condition.
(g) renumbered (h)
(4) through (9) No change
Rulemaking Authority 429.256, 429.41 FS. Law Implemented 429.255, 429.256, 429.41 FS. History–New 10-17-99, Amended 7-30-06, 4-15-10, 10-14-10, 3-13-14, 5-10-18, Formerly 58A-5.0185, 7-1-19 Amended .
59A-36.028 ALF Minimum Core Training Curriculum Requirements.
(1) through (2) no change
(3) CANCELLATION OF CORE REGISTRATION. The Agency may cancel the core registration and remove any ALF core training provider from the approved list who fails to:
(a) Submit a Comply with submission of core training schedule within 10 business days after of the request;
(b) Comply with corrective action plan issued by the Agency within 45 calendar days after the notification;
(c) No change
(d) Conduct an ALF core training session in the preceding calendar year for twelve consecutive months; or
(e) No change
(4)(9) This rule is in effect for five years from its effective date.
Rulemaking Authority 429.52 FS. Law Implemented 429.52 FS. History–New 6-15-09, Formerly 58T-1.205, 7-1-19. Amended _______.
