The purpose is to revise obsolete rule references and definitions and update and clarify dietary standards and remove duplicative statutory language.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Health Facility and Agency Licensing

RULE NOS.:RULE TITLES:

59A-17.101Definitions

59A-17.118Dietary and Nutrition Services

59A-17.119Facility Life Safety, Building Code Requirements and Physical Plant Standards

PURPOSE AND EFFECT: The purpose is to revise obsolete rule references and definitions and update and clarify dietary standards and remove duplicative statutory language.

SUMMARY: The Agency proposes to amend Rule 59A-17.101 to delete obsolete definitions and include licensure language; Rule 59A-17.118 to reflect current nutrition standards that are consistent with the Older Americans Act and other federal nutrition programs, and Rule 59A-17.119 to remove duplicative statutory language.

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: No SERC was prepared, the Agency prepared a checklist for each rule to determine the necessity for a SERC.

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: 400.9982, FS.

LAW IMPLEMENTED: 400.9982, 400.9972, FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW (IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):

DATE AND TIME: November 7, 2017, 2:30 p.m. - 4:00 p.m.

PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room B, Tallahassee, FL 32308

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 3 days before the workshop/meeting by contacting: Jacqueline Williams, Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop #33, Tallahassee, FL 32308 or [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Jacqueline Williams, Agency for Health Care Administration, 2727 Mahan Drive, Mail Stop #33, Tallahassee, FL 32308 or [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

59A-17.101 Licensure Definitions.

(1) Definitions.

(1) AHCA. Agency for Health Care Administration, State licensure authority.

(2) DVR. The Division of Vocational Rehabilitation of the Florida Department of Labor and Employment Security.

(a)(3) Facility. A free-standing building, a complex of adjoined buildings, pods, or wings, or a complex of separate or adjoined buildings located within one campus.

(4) Organization. The governing body or owner of a facility applying for a license to operate a Transitional Living Facility.

(b)(5) ClientResident. A person with a spinal-cord or head injury, as specified in section 400.9973(3), who is housed in a Transitional Living Facility.

(6) Transitional Living Facility (TLF). Means a related health care facility which provides specialized health care services, including, rehabilitative services, community reentry training, aids for independent living, and counseling to persons with spinal-cord injuries and persons with head-injuries.

(2) Licensure.

(a) An initial, renewal, or change of ownership applicant for licensure as a transitional living facility shall use the Health Care Licensing Application, Transitional Living Facilities, AHCA Form 3110-9001, March 2017, which is incorporated by reference and is available at http://www.flrules.org/Gateway/reference.asp?No=Ref-04457.

(b) The application forms are available online at http://www.ahca.myflorida.com/HQAlicensureforms or, for online renewal submissions, at: http://apps.ahca.myflorida.com/SingleSignOnPortal.

Rulemaking Authority 400.9982, 400.805 FS. Law Implemented 400.9972 400.805, FS. History–New 9-28-92, Amended 10-19-94, ________________.

 

59A-17.118 Dietary and Nutrition Services.

(1) The licensee must facility shall ensure proper nutritional care for its clients residents, whether provided by the licensee facility or a third party, and shall provide education and training in proper nutrition and planning and preparation of meals consistent with the individualized client resident rehabilitation plan. The facility must comply with the requirements of the Department of Health in Rule 64E-12.004, F.A.C.

(2) Meals provided by the licensee must be planned based on the current USDA Dietary Guidelines for Americans, and the current daily US Dietary Reference Intakes established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences.  Menus must be planned to offer clients a variety of food choices and to accommodate their religious, cultural and ethnic needs. The Recommended Dietary Allowances established by the Food and Nutrition Board–National Research Council, adjusted for age, sex, and activity level, shall be the standard used to evaluate meals.

(3) Menu items may be substituted with items of comparable nutritional value based on the seasonal availability of fresh produce or the preferences of the clients No more than 14 hours shall lapse between the end of an evening meal and the beginning of the following morning meal containing a protein food. Intervals between other meals shall be not less than four hours no more than 6 hours.

(4) Regular and therapeutic menus must Menus shall be dated, and planned at least one week in advance for both regular and therapeutic diets. Clients must be encouraged to participate in menu planning.  Planned menus must be posted or easily available to clients.  Regular and therapeutic menus as served, with substitutions noted before or when the meal is served, must be corrected as served and kept on file in the facility for six 6 months. Portion sizes must be indicated on the menus or on a separate sheet.

(5) Therapeutic diets must be prepared and served as ordered by the health care provider.

(6) All regular and therapeutic menus to be used by the licensee must be reviewed annually by a licensed dietitian and/or nutritionist to ensure the meals meet the nutritional standards established in this rule. The annual review must be documented in the facility files and include the original signature of the reviewer, license number, and date reviewed.

(7) Food must be served attractively at safe and palatable temperatures. All clients must be encouraged to eat at tables in the dining areas. A supply of eating ware sufficient for all clients must be on hand, including adaptive equipment if needed by any client.

(8) No more than 14 hours shall lapse between the end of an evening meal and the beginning of the following morning meal containing a protein food. Intervals between other meals shall be not less than four hours and no more than 6 hours.  For clients without access to kitchen facilities, snacks must be offered at least once per day. Snacks are not considered to be meals for the purposes of calculating the time between meals.

(9)(5) A one week supply of non-perishable food based on the number of weekly meals the licensee facility has contracted to serve, must shall be on hand at all times.

(10) When food service is provided by the licensee, the administrator, or an individual designated in writing by the administrator, must be responsible for total food services and the day-to-day supervision of food services staff.

(11) When food service is contracted by the facility, the facility must ensure that the contracted food service meets all dietary standards imposed by subsection 64E-12.004(4), F.A.C., as required by the Department of Health and this rule.  The facility must maintain:

(a) A copy of the current contract between the licensee and the food service contractor.

(b) A copy of the annually issued certificate or license authorizing the operation of the food service contractor issued by the applicable regulating agency. The license or certificate must provide documentation of the food service contractor’s compliance with food service regulatory requirements.

Rulemaking Authority 400.9982 400.805 FS. Law Implemented 400.9982 400.805(3)  FS. History–New 9-28-92, Amended 10-19-94, 5-14-15, _______________.

 

59A-17.119 Facility Life Safety, Building Code Requirements and Physical Plant Standards.

(1) The facility must ensure the health, safety, and well-being of residents. The facility must make available proof of compliance with local codes and ordinances governing fire and safety standards.

(2) The licensee must provide a safe, clean, comfortable, and homelike environment, which allows the client resident to use his or her personal belongings to the extent possible.

(3) Each East transitional living facility licensee must establish and implement written policies designed to maintain the physical plant and overall transitional living facility environment to assure the safety and well-being of clients residents.

Rulemaking Authority 400.9982 400.805 FS. Law Implemented 400.9982 400.805 FS. History–New 9-28-92, Amended 10-19-94, 8-28-14, ________________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Jacqueline Williams

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Justin M. Senior

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: September 28, 2017

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: June 23, 2017