59A-8.003. Licensure Requirements

(1) The issuance of a home health agency license shall be based upon compliance with Chapters 400, Part III, and 408, Part II, F.S., and rule Chapters 59A-8 and 59A-35, F.A.C., and an inspection as required in Sections 400.471(2) and 408.806(7), F.S. An application for initial, change of ownership, or renewal licensure, or for the addition of skilled services by a home health agency that is currently licensed to provide services other than skilled services, shall be submitted on the Health Care Licensing Application, Home Health Agency, AHCA Form 3110-1011, April 2019, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-12455, and accompanied by the Health Care Licensing Application Addendum referenced in subsection 59A-35.060(1), F.A.C. Applicants for renewal of a home health agency license or for a change during the licensure period may submit the Health Care Licensing Online Application, Home Health Agency, AHCA Form 3110-1011OL, April 2019, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-12456. The application forms are available online at http://www/ahca.myflorida.com/HQAlicensureforms or, for online renewal or change during the licensure period submissions, at: http://apps.ahca.myflorida.com/SingleSignOnPortal.

(2) Surveys of Home Health Agencies:

(a) Home health agencies will be surveyed by AHCA or an accrediting organization as defined in rule 59A-8.002, F.A.C., pursuant to dections 400.471(2), 408.806 and 408.811, F.S. Home health agencies will be surveyed prior to initial licensure, and at least every 36.9 months on an unannounced basis thereafter. Follow up surveys may be conducted to verify correction of deficiencies at any time on an unannounced basis.

(b) It is the responsibility of the home health agency to request exemption from state licensure surveys pursuant to section 400.471(2), F.S., by submitting documentation of accreditation by an approved accrediting organization and the most recent accreditation survey report from the accrediting organization to the AHCA Laboratory and In-Home Services Unit.

(c) Home health agencies that complete paragraph (a), will not be subject to licensure surveys by AHCA except under the following circumstances:

1. The home health agency has been denied accreditation, has received a preliminary determination of denial of accreditation, or has received a provisional, conditional, or deferred accreditation report from the accrediting organization on its most recent survey, or

2. The home health agency has received accreditation but has not authorized the release of the accreditation survey report to the AHCA, or has not ensured that AHCA has received the accrediting organization’s survey report.

3. If the home health agency elects to give up its accreditation, the home health agency will inform AHCA by providing a copy of the letter it sent to its accrediting organization that shows the accreditation termination date.

(3) AHCA will conduct investigations of complaints regarding licensure violations as required in section 408.811, F.S.

(4) An application for a change of ownership shall be made on the forms prescribed by AHCA, as referenced in subsection (1) of this rule.

(a) At the time of the transfer of ownership all patient or client records held by the current licensee shall be transferred to the applicant.

(b) AHCA will accept the most recent successful licensure inspection conducted no more than 36.9 months prior to the effective date of the change of ownership as satisfaction of the inspection requirement in section 408.806(7), F.S. related to an application associated with a change in ownership of a licensed home health agency. Acceptance of the inspection does not alter the survey timeframes established in paragraph (3)(a).

(c) Failure to apply for a change of ownership of a licensed home health agency as required by section 408.806(2)(b), F.S., shall result in a fine pursuant to sections 400.474(1), (2)(a) and 408.813(3)(b), F.S. This is also applicable to owners who incorporate and do not report this change of ownership to the home health agency.

(5) A licensed home health agency may operate a satellite office. A satellite office must be located in the same geographic service area as the agency’s main office and share administration, fiscal management, supervision, and service provision with the main office; it is not separately licensed. Supplies and records can be stored at a satellite office and phone business can be conducted the same as in the main office. The administrator at the main office is responsible for the staffing, patients, and operation of any satellite office. Signs and advertisements can notify the public of the satellite office location. If the agency wants to open an office outside of the geographic service area where the main office is located, the office must be separately licensed.

(6) A home health agency that operates a satellite office must:

(a) Ensure coverage of the professional staff which takes into account the projected number of clients to be served at the satellite office;

(b) Coordinate care and services by staff;

(c) Ensure supervision of the staff and provision of services in the event of staff absenteeism;

(d) Maintain a system of communication and integration of services between the main office and the satellite office;

(e) Provide access to patient records at the satellite office;

(f) Monitor the daily activities (clinical and administrative) and the management of services, as well as personnel and administrative issues at the satellite office;

(g) Ensure periodic onsite visits to each satellite office by the home health agency’s administrator;

(h) Make the satellite office’s hours of operation available to the public if different than the hours of operation maintained by the main office.

(7) A licensed home health agency may operate a drop-off site in any county within the geographic service area specified on the license. A drop-off site may be used for pick-up or drop-off of supplies or records, for agency staff to use to complete paperwork or to communicate with the main office, existing or prospective agency staff, or the agency’s existing patients or clients. Prospective patients or clients cannot be contacted and billing cannot be done from this location. The drop-off site is not a home health agency office, but merely a work station for direct care staff in large areas where the distance is too great for staff to drive back frequently to the home health agency office. Training of home health agency staff can be done at a drop-off site. A drop-off site shall not require a license. No other business shall be conducted at these locations, including housing of records. The agency name cannot appear at the location, unless required by law or by the rental contract, nor can the location appear on agency letterhead or in advertising.

(8) If a change of address is to occur, or if a home health agency intends to change the counties served within the geographic service area, or open or close a satellite office or drop-off site, the home health agency must complete and submit the Health Care Licensing Application, Home Health Agency, AHCA Form 3110-1011, April 2019 or the Health Care Licensing Online Application, Home Health Agency, AHCA Form 3110-1011OL, April 2019, incorporated by reference in subsection (1), above, within the timeframe prescribed in paragraph 59A-35.040(2)(b), F.A.C. For an address change of the main office or satellite office, the home health agency must submit to the AHCA evidence that the location is zoned for a home health agency business for the new address and evidence of legal right to occupy the property in accordance with Section 408.810(6), F.S.

(9) A home health agency has the following responsibility in terms of hours of operation:

(a) The home health agency administrator and director of nursing, or their alternates, must be available to the public for any eight consecutive hours between 7:00 a.m. and 6:00 p.m., Monday through Friday of each week, excluding legal and religious holidays. Available to the public means being readily available on the premises or by telecommunications.

(b) When the administrator and the director of nursing are not on the premises during designated business hours, a staff person must be available to answer the phone and the door and must be able to contact the administrator and the director of nursing by telecommunications. This individual can be a clerical staff person.

(c) If an AHCA surveyor arrives on the premises to conduct an unannounced survey and the administrator, the director of nursing, or a person authorized to give access to patient records, are not available on the premises they, or the designated alternate, must be available on the premises within an hour of the arrival of the surveyor. A list of current patients must be provided to the surveyor within two hours of arrival if requested.

(d) The home health agency shall have written policies and procedures governing 24 hour availability to licensed professional nursing staff by active patients of the home health agency receiving skilled care. These procedures shall describe an on-call system whereby designated nursing staff will be available to directly communicate with the patient. A home health agency that does not provide skilled services shall have written policies and procedures which address the availability of a registered nurse supervisor during hours of patient service.

(e) Failure to be available or to respond during a survey or inspection will be grounds for denial or revocation of the agency license in accordance with Section 408.806(7), F.S.

(10) Upon revocation, suspension, voluntary or involuntary termination of a license, the home health agency shall return its license to AHCA. If the provider voluntarily chooses to terminate the license, the provider must notify AHCA, as required in Section 408.810(4)(a), F.S. This includes submitting a letter to the AHCA Laboratory and In-Home Services Unit, 2727 Mahan Drive, Mail Stop #32, Tallahassee, Florida 32308, officially declaring the closure date of the home health agency.

Rulemaking Authority 400.497, 408.819 FS. Law Implemented 400.464, 400.471, 400.474, 400.484, 400.497, 408.806, 408.807, 408.810 FS. History–New 4-19-76, Formerly 10D-68.03, Amended 4-30-86, 8-10-88, 5-30-90, 6-12-91, Formerly 10D-68.003, Amended 4-27-93, 10-27-94, 1-30-97, 1-17-00, 7-18-01, 9-22-05, 8-15-06, 3-29-07, 7-11-13, 6-16-15, 7-27-16, 1-5-21.