Agency for Health Care Administration - Floridab.ahca.myflorida.com/MCHQ/Health_Facility... · Agency for Health Care Administration ASPEN: ... The requirements of part II of chapter

Agency for Health Care Administration

ASPEN: Regulation Set (RS)

Page 1 of 92Printed 10/15/2015

Aspen State Regulation Set: D 2.01 Adult Day Care (Licensure)

ST - D0000 - INITIAL COMMENTS

Type Memo Tag

Statute or Rule

Title INITIAL COMMENTS

Interpretive GuidelineRegulation Definition

These guidelines are meant solely to provide guidance to surveyors in the survey process.

ST - D0001 - GENERAL LICENSURE STANDARD

Type Rule

Statute or Rule 429.907(1-4)

Title GENERAL LICENSURE STANDARD


429.907 (1) The requirements of part II of chapter 408

apply to the provision of services that require licensure

pursuant to this part and part II of chapter 408 and to

entities licensed by or applying for such licensure from

the Agency for Health Care Administration pursuant to

this part. A license issued by the agency is required in

order to operate an adult day care center in this state.

(2)(a) Except as otherwise provided in this subsection,

separate licenses are required for centers operated on

separate premises, even though operated under the

same management. Separate licenses are not required

for separate buildings on the same premises.

(b) If a licensed center becomes wholly or substantially

unusable due to a disaster or due to an emergency as

those terms are defined in s. 252.34:

1. The licensee may continue to operate under its

current license in premises separate from that

authorized under the license if the licensee has:

Surveyor Probes:

Examine the center license:

1. Is it current?

2. Is the license displayed in a conspicuous place?

NOTE: Shared areas between assisted living facility and ADCC are surveyed with assisted living facility .

If the center is not licensed, notify the center operator that operating without a license is a 2nd degree

misdemeanor. Failure to apply for a license within 10 days notification will result in the Agency obtaining

an injunction to close the center.

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a. Specified the location of the premises in its

comprehensive emergency management plan submitted

to and approved by the applicable county emergency

management authority; and

b. Notified the agency and the county emergency

management authority within 24 hours of operating in

the separate premises.

2. The licensee shall operate the separate premises only

while the licensed center ' s original location is

substantially unusable and for up to 180 days. The

agency may extend use of the alternate premises

beyond the initial 180 days. The agency may also review

the operation of the disaster premises quarterly.

(3) In accordance with s. 408.805, an applicant or

licensee shall pay a fee for each license application

submitted under this part and part II of chapter 408. The

amount of the fee shall be established by rule and may

not exceed $150.

(4) County-operated or municipally operated centers

applying for licensure under this part are exempt from

the payment of license fees.

ST - D0002 - Governing Body

Type Rule

Statute or Rule 58A-6.006(1)

Title Governing Body


(1) The Center shall have a Governing Authority which

shall establish policies in compliance with this rule

chapter. Governing Authority, as defined in this rule

chapter, may consist of one or more people, and

designation of its membership or composition shall be

determined by the owner or operator. The Governing

Authority shall be responsible for ensuring compliance

with standards requiring that:

(a) Admission criteria shall be determined by the Owner,

Surveyor Probes:

Surveyor should ask to see center's written policies and procedures.

Review governing body by-laws for documentation of governing body responsibility to the center.

Review governing body minutes for documentation of governing body involvement in the organization and

operations of the center.

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Operator, or Governing Authority and it may limit

Participant eligibility to adults with Functional

Impairments, in need of a protective environment or a

program of therapeutic social and health activities and

services as defined in this rule chapter. The Owner or

Operator will assure that the admission of each

Participant shall be review within the confines of

specific requirements set forth below:

1. Within forty-five days prior to admission to the center,

each person applying to be a participant shall provide a

statement signed by a physician, a Florida licensed

health care provider under the direct supervision of a

physician, physician or a county public health unit

documenting freedom from tuberculosis in the

communicable form and documenting freedom from

signs and symptoms of other communicable disease.

Any participant who is diagnosed as having a

communicable disease shall be excluded from

participation until deemed non-infectious. However,

participants who have Human Immunodeficiency Virus

(HIV) infection may be admitted to the center, provided

that they would otherwise be eligible according to this

rule.

2. No participant shall be admitted or retained in a

center if the required services from the center are

beyond those that the center is licensed to provide.

3. No participant who requires medication during the

time spent at the center and who is incapable of

self-administration of medications shall be admitted or

retained unless there is a person licensed according to

Florida law to administer medications who will provide

this service. A person licensed according to Florida law

includes a physician licensed under Chapters 458 and

459, F.S., an advanced registered nurse practitioner, a

dentist, a registered nurse, licensed practical nurse, or a

physician ' s assistant.

(b) Provision is made for a safe physical plant equipped

and staffed to maintain the center and services provided

as defined in this rule chapter.

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ST - D0003 - Owner/Oper/Designee on Premises

Type Rule


Title Owner/Oper/Designee on Premises


The governing authority shall ascertain that the owner or

operator or the designated responsible person shall be

on the premises during the center's hours of operation.

If the operator is away from the center, there is a designated responsible person who is on the premises

and in charge of center operations.

Surveyor Probes:

Review governing body by-laws for documentation of designation of an operator who is responsible for

the daily operation of the center.

Review organizational charts for documentation of line authority, with the operator in charge of center

operation.

Review operators job description for verification that roles and responsibilities are included.

Is the owner/operator or designated responsible person at the center during the visit?

ST - D0005 - Closure-Notification(s)

Type Rule

Statute or Rule 429.925

Title Closure-Notification(s)


When a center voluntarily discontinues operation, the

Agency is notified in writing at least 60 days prior to the

discontinuance of operation. The center also informs

each participant, guardian or responsible person of the

fact and the proposed time of such a discontinuance.

The center should have written proof of notification to the Agency and participants .

Surveyor Probes:

Review Agency and participant notifications.

ST - D0006 - AdvertisingoRegSet.rpt





Type Rule

Statute or Rule 429.917(2)

Title Advertising


A center licensed under this part which claims that it

provides special care for persons who have Alzheimer '

s disease or other related disorders must disclose in its

advertisements or in a separate document those

services that distinguish the care as being especially

applicable to, or suitable for, such persons. The center

must give a copy of all such advertisements or a copy of

the document to each person who requests information

about the center and must maintain a copy of all such

advertisements and documents in its records. The

agency shall examine all such advertisements and

documents in the center ' s records as part of the

license renewal procedure. An adult day care center

may not claim to be licensed or designated to provide

specialized Alzheimer ' s services unless the adult day

care center ' s license has been designated as such

pursuant to s. 429.918

Applicable advertising may include brochures, highway signs (billboards), newspaper ads, internet, and

listing or ads under adult day care centers in the telephone yellow pages, radio, and television

announcements.

Licensed hospitals, nursing homes or assisted living facilities that do not hold themselves out to the public

as an adult day care center may provide services such as social, health, therapeutic, recreational,

nutritional, or respite services during the day to non-residents.

Surveyor Probes:

Review the latest telephone directory, area newspaper, center brochures, etc. to determine compliance.

ST - D0007 - Definitions

Type Memo Tag

Statute or Rule 429.901; 429.918(2)(a & c & d) 58A-6.002

Title Definitions


429.901 Definitions.-As used in this part, the term:

(1) "Adult day care center" or "center" means any

building, buildings, or part of a building, whether

operated for profit or not, in which is provided through its

ownership or management, for a part of a day, basic

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services to three or more persons who are 18 years of

age or older, who are not related to the owner or

operator by blood or marriage, and who require such

services.

(2) "Agency" means the Agency for Health Care

Administration.

(3) "Basic services" include, but are not limited to,

providing a protective setting that is as noninstitutional

as possible; therapeutic programs of social and health

activities and services; leisure activities; self-care

training; rest; nutritional services; and respite care.

(4) "Department" means the Department of Elderly

Affairs.

(6) "Operator" means the licensee or person having

general administrative charge of an adult day care

center.

(7) "Owner" means the licensee of an adult day care

center.

(8) "Participant" means a recipient of basic services or

of supportive and optional services provided by an adult

day care center.

(9) "Supportive and optional services" include, but are

not limited to, speech, occupational, and physical

therapy; direct transportation; legal consultation;

consumer education; and referrals for followup services.

429.918 Licensure designation as a specialized

Alzheimer ' s services adult day care center.-

(2) As used in this section, the term:

(a) "ADRD participant" means a participant who has a

documented diagnosis of Alzheimer ' s disease or a

dementia-related disorder (ADRD) from a licensed

physician, licensed physician assistant, or a licensed

advanced registered nurse practitioner.

(c) "Specialized Alzheimer' s services" means

therapeutic, behavioral, health, safety, and security

interventions; clinical care; support services; and

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educational services that are customized for the

specialized needs of a participant ' s caregiver and the

participant who is affected by Alzheimer ' s disease or an

irreversible, degenerative condition resulting in

dementia.

(d) "Therapeutic activity" means an individual or group

activity that is intended to promote, maintain, or enhance

the ADRD participant' s physical, cognitive, social,

spiritual, or emotional health.

58A-6.002 Definitions.

(1) The following terms are defined in Section 429.901,

F.S., and are applicable to this rule chapter: adult day

care center or center, agency, basic services,

department, multiple or repeated violations, operator,

owner, participant, and supportive and optional services.

(2) Additional definitions applicable in this rule chapter

are as follows:

(a) "Activities of Daily Living" or "ADL" shall mean the

functions or tasks for self-care and shall include:

ambulation, bathing, dressing, eating, grooming,

transferring, and toileting, self-administration of

medications, and other personal hygiene activities.

(e) "Participant Capacity" shall mean the number of

Participants for which a Center is licensed to provide

care to at any given time and shall be based upon

required net floor space.

(g) "Congregate Space" shall mean climatically

controlled living rooms, dining rooms, specialized activity

rooms, or other rooms to be commonly used by all

Participants.

(h) "Daily Attendance" shall mean the number of

Participants who, during any one calendar day, attend

the Center. This count is not dependent upon, nor does

it include, the number of types of services a Participant

receives, but is an actual, individual, and unduplicated

census count.

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(i) "Functional impairment" means a physical, mental, or

social condition or cognitive deficit which restricts an

individual' s ability to perform the tasks and activities of

daily living and which impedes the individual' s capability

for self-care and independent living without assistance

or supervision from others on a recurring or continuous

basis for extended periods of time.

(k) "Major Incident" shall mean any incident for which

the Agency, Center, Staff member or other person

associated with the Center may be liable, or which has

resulted in serious injury, death or extensive property

damage. Major Incidents include, but are not limited to,

the following:

1. Death of a Participant from other than natural causes,

while in the care of the Center;

2. Threats or occurrences of riots, bombings, or other

extreme violence,;

3. Disappearance of a Participant, from the Center;

4. Assaults or batteries on or by a Participant, resulting

in severe injury or death, including, but not limited to,

sexual assaults or rape;

5. Property damage from any cause that would interrupt

routine operations or disrupt service delivery,;

6. Auto accidents with injuries involving participants;

7. Involuntary Center closure;

8. Incidents of abuse, neglect, exploitation or fraud,;

9. Employee work conduct which results in a criminal

law violation;

10. Attempted suicide by a participant while under

Center supervision.

(m) "Operator" shall mean an individual who has daily

administrative charge of an Adult Day Care Center and

who shall be designated in writing as such by the owner

or Governing Authority. An Operator of a Specialized

Alzheimer ' s Services Adult Day Care Center must meet

the educational or experiential requirements in Section

429.918(5), F.S.

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(n) "Orientation and Training Plan" shall mean a written

plan developed and reviewed at least annually, and

implemented throughout the year, which describes a

coordinated program for Staff training for each service

and for orientation of each new Staff member on Center

policies, procedures, assigned duties and

responsibilities,. The orientation and training provided

for by the Orientation and Training Plan shall begin no

later than the first day of employment.

(o) "Over the Counter Products" or "OTC Products"

shall mean medications and related products that can

be purchased legally without a prescription, including,

but not limited to, medications, vitamins, nutritional

supplements and nutraceuticals.

(p) "Participant Care Plan" shall mean a written record

documenting adult day health services, as required by

paragraph 58A-6.010(6)(d), F.A.C.

(q) "Participant File" shall mean a record, prepared and

kept by the Center which shall include: a Participant

Care Plan, documenting adult day health services

provided to the Participant, if any; medical and social

history or copies of an examination completed by a

physician; diagnosis; disabilities and limitations;

rehabilitation potential; short and long-term goals;

recommended activities; orders for medication or

modified diet, including Supervision of Self-administered

Medication; special needs for health or safety; permitted

levels of physical activity; frequency of attendance at the

Center; and notes as required in this rule chapter.

(s) "Respite Care" or "Respite" in an Adult Day Care

Center is defined as a service provided to relieve the

caregiver.

(t) "Responsible Person" shall mean any person who

has assumed the responsibility to manage the affairs

and protect the rights of any Participant of a Center. The

Responsible Person is not a legal entity, but may be a

caregiver or friend and shall in no case be affiliated with

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the facility, its operations, or its personnel, unless so

ordered by a court.

(u) "Significant Change" shall mean: a deterioration or

improvement in ability to carry out Activities of Daily

Living; a deterioration in behavior or mood to the point

where daily problems arise, or an improvement to the

point that these problems are eliminated; or a

substantial deterioration in health status or reversal of

such condition. Ordinary day-to-day fluctuations in

functioning and behavior and acute short-term illness

such as a cold are not considered Significant Changes

unless such fluctuations persist to the extent that a trend

is established.

(v) "Staff " shall mean any employee, independent

contractor, or volunteer included in the minimum Staff

ratio, who provides direct or indirect services to the

Participants and volunteers who are included in the

minimum staff ratio.

(w) "Staff Providing Direct Care for ADRD Participants"

means Staff providing personal or Specialized

Alzheimer' s Services to ADRD Participants or

Participants with dementia-related disorders, including,

but not limited to, Owners, Operators, and Assistant

Operators providing such services.

(x) "Staff in Direct Contact with ADRD Participants"

means all Staff who are not Staff Providing Direct Care

to ADRD Participants or Participants with

dementia-related disorders, but whose duties may

require them to interact with ADRD Participants or

Participants with dementia-related disorders on a daily

basis.

(y) "Supervision of Self-administered Medication" shall

mean the performance of the following tasks: reminding

Participants to take medication at the time indicated on

the prescription; opening or closing medication

container(s) or assisting in the opening of prepackaged

medication; reading the medication label to Participants;

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observing Participants while they take medication;

checking the self-administered dosage against the label

of the container; reassuring Participants that they have

obtained and are taking the dosage as prescribed;

keeping daily records of when Participants received

supervision pursuant to this subsection; and immediately

reporting apparent adverse effects on a Participant ' s

condition to the Participant' s physician and responsible

person. No Center is required to provide Supervision of

Self-administered Medication to Participants who are

capable of administering their own medication.

(z) "Supervision of Staff" shall mean guidance by a

qualified person for a Staff member' s performance of

job-related functions and activities, with initial direction

and periodic on-site inspection of the performance.

Supervision of Participants shall mean guidance and

care necessary for the health, safety and well-being of

Participants.

(aa) "Supportive and Optional Services" shall mean

optional activities and services provided by a Center, in

accordance with Rule 58A-6.010, F.A.C.

(bb) "Transportation Services" shall mean the

conveyance of Participants between the Center and a

designated location, as well as to and from services

provided directly or indirectly by the Center. No

Participant' s transportation to and from a designated

location and the Center shall exceed two hours if the

transportation is provided or arranged by the Center.

(cc) "Volunteer" shall mean an individual not on the

payroll of the Adult Day Care Center, whose

qualifications shall be determined by the Center, for

whom a written job description and Orientation and

Training Plan shall be provided and implemented.

ST - D0100 - Fiscal Standard - Participant Funds

Statute or Rule 58A-6.012(1-3)

Title Fiscal Standard - Participant Funds

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Type Rule


(1) The center shall establish and maintain a record of

all funds held in trust, if any, and the participant funds

shall be kept separate from the center funds. Such

funds shall be used or expended only at the request of

the participant, the participant ' s representative,

designee, surrogate, guardian, or attorney-in-fact, if

applicable.

(2) The center shall furnish at least annually, a complete

verified statement of such funds or property to the

participant or to the guardian or responsible person,

detailing the amount and items received with sources

and disposition. Such a report also shall be made at

termination or transfer from the center.

(3) Any agency, governmental or private, contributing

funds or property to the account of a participant, shall,

upon request, be entitled to receive such a statement

annually and upon termination or transfer.

The word verified as it pertains to statements would mean that the center has a copy of the statement

that was given/sent to the participant, guardian, or responsible person.

Any agency, governmental or private, contributing funds or property to the account of a participant, is

entitled to receive the annual statement upon request.

58A-6.012(3), F.A.C.

Surveyor Probes:

Surveyors should question the center operator, staff, and participants concerning the handling of

participants' funds/property, and ask to see applicable accounting records.

Contact may also be made with any guardians to see if the center handles monies for their clients.

Interview participants to determine if the facility is providing satisfactory reporting.

ST - D0101 - Fiscal Std- Current Signed Agreement On File

Type Rule


Title Fiscal Std- Current Signed Agreement On File


If the Center accepts fee-for-service Participants, there

shall be a signed agreement documenting the amount of

fee, hours and days of attendance, services to be

provided, and frequency of payment. This agreement

shall be signed by the Owner, Operator, or the Owner or

Operator ' s designee, the Participant or Responsible

Person, and recorded in the Participant ' s File. Financial

records shall be maintained and shall be current through

the last payment period.

The fee-for-service agreement must be current through the last payment period. The agreement is signed

by the owner or operator, participant, or responsible person. 58A-6. 011(6), F.A.C. Make sure all

agreements contain items a through d.

Surveyor Probes:

Review fee-for-service participants' records for documentation that the required information is included

and ask for fee-for-service fee schedule.

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ST - D0102 - Fiscal Std - Liability Insurance Coverage

Type Rule

Statute or Rule 429.909(2)(c), 58A-6.003(2)(b), -6.012(4

Title Fiscal Std - Liability Insurance Coverage


429.909 Application for license.-In addition to all

provisions of part II of chapter 408, the applicant for

licensure must furnish a description of the physical and

mental capabilities and needs of the participants to be

served and the availability, frequency, and intensity of

basic services and of supportive and optional services to

be provided and proof of adequate liability insurance

coverage.

58A-6.003(5)(b)

(b) Documentation of adequate liability insurance

coverage, as defined in Section 624.605, F.S., that

remains in force at all times. Such documentation must

be issued by the insurance company and must include

the name and street address of the Center, a reference

that the facility is an Adult Day Care Center, the Center '

s licensed capacity, and the dates of coverage.

58A-6.012(4)

Centers shall maintain liability insurance coverage in

force at all times. On the renewal date of the center ' s

policy or whenever a center changes policies, the center

shall file documentation with the AHCA, ADC Program,

2727 Mahan Drive, Tallahassee, FL 32308. Such

documentation shall be issued by the insurance

company, shall include the name of the center, dates of

coverage and shall meet the criteria of this chapter.

Surveyor Probes:

Review the centers liability insurance policy or certificate and verify dates of coverage to ensure the

center maintains current liability insurance coverage.

Contact the insurance agent if there is a question regarding whether or not the policy is current.

ST - D0201 - Center Record Standard

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Type Rule


Title Center Record Standard


(3) The Operator shall be responsible for the recording,

reporting and availability of Participant data, including

those records required for each Center Participant, and

program data, including those records required for

services made available to and provided to Participants

by the Adult Day Care Center. Such records shall

include:

(a) Number of Participants enrolled to current date;

(b) Average Daily Attendance as defined in this rule

chapter, based upon attendance through the end of the

preceding month;

(c) Hours of travel time current through the previous

month, if Transportation Services are provided or

arranged by the Center.

(d) Business hours of operation shall be posted in a

conspicuous place. Business hours shall mean a time

period established by the Center, as defined in its

policies, and shall be no less than five hours per day on

week days of Center operation and may include a

reduced schedule of weekend hours.

Surveyor Probes:

Review centers' participant data records as identified in items a through d.

Ascertain whether business hours are clearly posted.

ST - D0202 - Record of Staff Assignments

Type Rule


Title Record of Staff Assignments


A record shall be kept of staff assignments. Surveyor Probes:

Review governing authority policies and procedures for documentation of staff assignments .

Review personnel records for verification of staff assignments .

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ST - D0203 - Record of Major Incidents

Type Rule


Title Record of Major Incidents


(7) A written record shall be kept of Major Incidents

affecting Participants, Staff, Volunteers or the program

of the Center.

(8) Major Incidents, as defined in this rule chapter shall

be reported immediately to the Agency ' s Complaint

Administration Unit at the following website:

http://ahca.myflorida.com/MCHQ/Field_Ops/CAU.shtml.

Reports shall be made by the individual having first-hand

knowledge of the incident and performing functions and

responsibilities as an authorized agent and may include

paid, emergency and temporary Staff, Volunteers and

student interns.

Each major incident must be reported immediately to the appropriate field office .

Surveyor Probes:

Review major incident reports.

Interviews with residents and staff may provide information about recent incidents , which should then be

compared against prepared reports.

Observe residents, noting any other concerns. which may indicate a recent incident.

ST - D0204 - Comprehensive Emergency Management Plan

Type Rule


Title Comprehensive Emergency Management Plan


(10) Pursuant to Section 429.929(1)(g), F.S., as a part of

the licensure process, each Center shall develop and

follow a written Comprehensive Emergency

Management Plan for emergency care during an internal

or external disaster in accordance with Emergency

Management Planning Criteria for Adult Day Care

Facilities, dated July 2001, incorporated by reference. A

copy of the July 2001 Emergency Management Planning

Surveyor Probes:

The surveyor should ensure that the center has a Comprehensive Emergency Management Plan

reviewed by the local emergency management office.

Where is the Plan located?

The Plan shall be available for immediate access by center staff . Ask employees if they know where the

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Criteria for Adult Day Care Facilities may be obtained

from the Agency ' s Website at:

http://www.fdhc.state.fl.us/MCHQ/Health_Facility_Regul

ation/Assisted_Living/docs/adcc/ADCC_CEMP_2008.pd

f.

(a) The Comprehensive Emergency Management Plan

shall include the following:

1. Provisions for both internal and external disasters and

emergencies which could include hurricanes, tornadoes,

fires, power outages, floods, bomb threats, acts of

terrorism, bio-terrorism, hazardous materials and

nuclear disasters.

2. Provisions for care and services to Participants during

the emergency including: pre-disaster or preparation,

notification of family members or responsible parties,

securing the Center, supplies, staffing and emergency

equipment.

3. Provisions for care and services, including emergency

evacuation transportation, to Participants who must

remain in the Center and those who must evacuate

during the emergency.

4. Identification of Staff positions responsible for

implementing each aspect of the Plan.

5. Identification of and coordination with designated

agencies including the Red Cross and the local

emergency management agency.

6. Post-disaster activities including responding to family

inquiries, obtaining necessary emergency medical

attention or intervention for Participants, transportation

and re-entry to the Center.

(b) The Plan shall be available for immediate access by

Center Staff.

(c) The initial Plan shall be reviewed by the local

Emergency Management Agency to ensure compliance

with the Emergency Management Planning Criteria for

Adult Day Care Facilities, dated July 2001.

(d) The local emergency management agency has 60

Plan is located and how to implement the Plan.

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days in which to review and determine if the Plan

satisfies the Emergency Management Planning Criteria

or advise the Center of necessary revisions. Any

revisions must be made and resubmitted to the local

emergency management agency within 30 days of

receiving notification from the local emergency

management agency that the Plan must be revised.

(e) The Center shall review and update its Plan on an

annual basis. The Plan shall be submitted annually, or

more often if needed, to the local emergency

management agency

ST - D0207 - Emergency Treatment

Type Rule


Title Emergency Treatment


In case of emergency, such as acute illness, if family or

responsible person cannot be reached, a signed release

shall be on file stating that the participant may be sent to

the nearest hospital emergency room for treatment.

Surveyor Probes:

Review adult day care center procedure. Is the owner or operator aware of the requirement for obtaining

the signed release?

Review participant records for documentation that the signed release is on file for each participant.

ST - D0209 - Central Abuse Registry Poster

Type Rule


Title Central Abuse Registry Poster


The Governing Authority shall establish policies and

procedures to facilitate reporting of abuse, neglect or

exploitation as defined in Section 415.102, F.S. and in

Surveyor Probes:

Verify copy of central Abuse Registry poster is in full view and is freely accessible to all participants .

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accordance with Section 415.103, F.S., and shall ensure

that the statewide toll free telephone number of the

Department of Children and Families central abuse

hotline, accompanied by the words " To Report the

Abuse, Neglect, or Exploitation of an Elderly or Disabled

Person, Please Call the Toll Free Number

1(800)96-ABUSE " is posted in a prominent place in the

Center and made clearly visible.

ST - D0300 - PARTICIPANT RECORD STANDARD

Type Rule

Statute or Rule 58A-6.007(3)(a-q)

Title PARTICIPANT RECORD STANDARD


(3) Participant care, policies, and procedures shall

ensure that, as a minimum, all Participants admitted to

the Center:

(a) Are informed of provisions for service as evidenced

by written acknowledgment from the Participant or

responsible party prior to or at the time of admission,

given a statement or summary statement of the Center '

s policies and procedures, given an explanation of the

Participant ' s responsibility to comply with these policies

and procedures and to respect the personal rights and

private property of other Participants;

(b) Are informed, and are given a written statement prior

to or at the time of admission and during stay, of

services available at the Center, and any related

charges, including charges for services that are not

provided free, not covered by third party payments, or

not covered by the facility ' s basic per diem rate. This

statement shall include the payment, fee, deposit, and

refund policy of the Center;

(c) Are promptly informed of substantive changes in

policies, procedures, services, and rates;

(d) Are informed during the admission process, in

The document is explained to the participant as appropriate. If the participant does not read or

understand English, the information should be explained in a language understood by the individual.

Surveyor Probes:

Review participant records for documentation of written acknowledgment from the participant or

responsible party that the statement was provided.

Review the center's policies and procedures to verify each point is covered.

Interview participants to determine their awareness of specific policies and procedures.

oRegSet.rpt





writing, of the Center ' s Comprehevsive Emergency

Management Plan;

(e) Are informed during the admission process of the

local emergency management agency ' s registry of

disabled persons who need assistance during

evacuations or when in shelters because of physical or

mental handicaps and the assistance provided by

Center staff to register such persons with the local

emergency management agency;

(f) Are allowed to retain the services of their personal

physician at their own expense or under a health care

plan; are informed of the services provided by the

Center, and are offered the opportunity to participate in

the planning of their care;

(g) Are free from abuse, neglect, and exploitation as

defined in Section 415.102, F.S., and free from chemical

and physical restraints. Drugs and other medications

shall not be used for punishment, convenience of Staff,

or in quantities that interfere with a Participant ' s

rehabilitation or Activities of Daily Living;

(h) Are given privacy in the treatment of their personal

and medical records;

(i) Are treated with consideration, respect, and full

recognition of their dignity, individuality, and right to

privacy;

(j) Are not required to perform services for the Center;

(k) Are permitted to associate and communicate

privately with persons of their choice, join with other

Participants or individuals within or outside the Center to

work for improvements in Participant care, and, upon his

or her request, shall be given assistance in the reading

and writing of correspondence;

(l) Are permitted to participate in social, religious,

community, or group activities of their choice while at the

Center;

(m) Are permitted to exercise civil and religious liberties,

including the right to independent personal decisions. No

oRegSet.rpt





religious beliefs or practices, or any attendance at

religious services, shall be imposed upon any

Participant. The Center shall encourage and assist in

the exercise of these rights;

(n) Are not the object of discrimination with respect to

participation in activities which include recreation, meals,

leisure, other social activities because of age, race,

religion, sex, or nationality as defined in Title VI of the

Civil Rights Act of 1964, or the Americans with

Disabilities Act of 1990;

(o) Are not deprived of any constitutional, civil, or legal

right solely by reason of admission to the Center;

(p) For protection of the Participants, are allowed to

discharge themselves from the Center upon

presentation of a request, preferably in writing; or, if the

Participant is an adjudicated mental incompetent, upon

the written consent of his next of kin, or sponsor or,

guardian, or responsible person. However, if assessed

by social workers, center Staff, or responsible persons

at the time of intake as confused, the Participant shall

not be allowed to discharge himself until after the Center

notifies the Participant ' s guardian, spouse, or person

having durable power of attorney;

(q) Are informed of the right to report abusive,

neglectful, exploitative or fraudulent practices

ST - D0301 - Particip. Record

Type Rule

Statute or Rule 58A-6.011(2)(a-g)

Title Particip. Record


(2) The Participant File shall include a Participant Data

Sheet which shall be completed for each Participant

within forty-five days prior to or twenty-four hours after

admission to the Center and which shall include:

(a) Full name, birthday, address;

Responsible person means any person who has assumed the responsibility to manage the affairs and

protect the rights of any participant in the center. The responsible person is not a legal entity, but may be

a caregiver or friend and shall in no case be affiliated with the center , its operations or the personnel,

unless court ordered.

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(b) Date admitted as a Participant and services to be

provided;

(c) Next of kin, and address and phone number of such

person;

(d) Guardian or Responsible Person and address and

phone number of that person;

(e) Medicaid and Medicare identification and other

health insurance numbers;

(f) Emergency contact person, home or office address

and phone numbers of such person;

(g) Name and telephone number of attending physician

to be contacted when there appears to be significant

deviation from normal appearance or state of well-being

of a Participant; physician ' s or hospital discharge

statement no older than forty-five days indicating

prescribed medications and dosage which is updated as

changes are made by physicians or, until a statement is

received, a dated and signed statement by the

Participant, guardian or responsible person, stating that

specific medication may be given as ordered by the

attending physician; notation of physical and emotional

conditions requiring care and medications administered;

diet and mobility restrictions; and a statement that the

Participant is free from tuberculosis in a communicable

form;

Surveyor Probes:

Review participant files for documentation of compliance and explanation for missing information.

ST - D0302 - Particip. Record - Signature

Type Rule


Title Particip. Record - Signature


Documentation shall be made of services, medication

and special diets provided or administered to the

Participants and shall be kept current in the Participant '

s File. Such documentation shall consist of a written,

signed and dated notation or statement.

Review the participant's file for the written documentation. Ensure that the documentation is signed and

dated.

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ST - D0303 - Particip. Record Std

Type Rule

Statute or Rule 58A-6.011(2)(h-i)

Title Particip. Record Std


(h) The Participant File shall be updated when there is a

Significant Change in the Participant, or at least

quarterly;

(i) The Owner or Operator or Staff designated by the

Owner or Operator shall review and approve each

Participant care plan.

ST - D0304 - Policy and Procedures

Type Rule


Title Policy and Procedures


(1) The center shall make a statement or summary

statement of policies and procedures for participant care

available to participants, to the responsible person, to

the public, and to each member of the center staff. The

statement or summary statement shall be displayed in a

conspicuous place in the facility.

ST - D0305 - ADRD Participant Files

Type Rule


Title ADRD Participant Files

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(8)(a) An ADRD participant ' s file must include a data

sheet, which must be completed within 45 days before

or within 24 hours after admission to an adult day care

center having a license designated under this section.

The data sheet must contain:

1. Information regarding the status of the ADRD

participant ' s enrollment in an identification or

wandering-prevention program, including the name of

the program; and

2. A current photograph of the ADRD participant.

(b) Dementia-specific services shall be documented in

the ADRD participant ' s file.

(c) Notes regarding services provided to the ADRD

participant must be entered at least monthly in the

ADRD participant ' s file, and must indicate the ADRD

participant ' s status or progress toward achieving

identified goals. Additional notes must be entered more

frequently if indicated by the ADRD participant ' s

condition.

(d) An ADRD participant, or the participant ' s caregiver,

shall annually provide the center with updated medical

documentation required under subparagraphs (7)(a)3.

and 4., and the center must place that documentation in

the ADRD participant ' s file.

Surveyor Probe:

This applies to facilities with the ADRD specialization as defined in tag 306.

ST - D0306 - ADRD participant

Type Rule


Title ADRD participant


(9) An adult day care center having a license designated

under this section must give to each person who enrolls

as an ADRD participant in the center, or the caregiver, a

copy of the ADRD participant ' s plan of care, as well as

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information regarding resources to assist in ensuring the

safety and security of the ADRD participant, which must

include, but need not be limited to, information

pertaining to driving for those persons affected by

dementia, available technology on wandering-prevention

devices and identification devices, the Silver Alert

program in this state, and dementia-specific safety

interventions and strategies that can be used in the

home setting.

ST - D0400 - ADMISSION CRITERIA STANDARD

Type Rule

Statute or Rule 58A-6.006(1)(a), 58A-6.006(1)(a)2

Title ADMISSION CRITERIA STANDARD


58A-6.006(1)(a),

Admission criteria shall be determined by the Owner,

Operator or Governing Authority and it may limit

Participant eligibility to adults with Functional

Impairments, in need of a protective environment or a

program of therapeutic social and health activities and

services as defined in this rule chapter. The Operator

will assure that the admission of each Participant shall

be reviewed within the confines of specific requirements

set forth below:

58A-6.006(1)(a)2

No Participant shall be admitted or retained in a Center

if he or she requires services from the Center that are

beyond those that the Center is licensed to provide.

It is the responsibility of the owner or operator to continually observe the participants to determine that

they meet the criteria for participation in the center.

Surveyor Probes:

During tour of center, observe participants interaction and involvement in center's activities.

ST - D0401 - Admission Criteria Std

Statute or Rule 58A-6.006(1)(a)1

Title Admission Criteria Std

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Type Rule


Within forty-five days prior to admission to the Center,

each person applying to be a Participant shall provide a

statement signed by a physician licensed under

Chapters 458 and 459, F.S., a Florida licensed health

care provider under the direct supervision of a physician,

or a county public health unit. The statement must be

signed within forty-five days prior to admission to the

Center, and must state that the applicant is free from

tuberculosis in the communicable form and free from

signs and symptoms of any other communicable

disease. Any Participant who is diagnosed as having a

communicable disease shall be excluded from

participation until deemed non-infectious. However,

Participants who have Human Immunodeficiency Virus

(HIV) infection may be admitted to the Center, provided

that they would otherwise be eligible according to this

rule.

Surveyor Probes:

Review participants' records to verify the presence of a completed and dated medical statement.


Type Rule

Statute or Rule 58A-6.006(1)(a)3



No Participant who requires medication during the time

spent at the Center and who is incapable of

self-administration of medication shall be admitted or

retained unless there is a Staff member licensed

according to Florida law to administer medications who

will provide this service. A person licensed according to

Florida law includes: a physician licensed under

Chapters 458 and 459, F.S.; an advanced registered

nurse practitioner, certified under Chapter 464, F.S.; a

Surveyor Probes:

The surveyor will review the participant's file and interview and observe the participants to determine their

appropriateness for continued participation.

Staff should also be interviewed to determine the services the participant requires .

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dentist, licensed under Chapter 466, F.S.; a registered

nurse, or licensed practical nurse, licensed under

Chapter 464, F.S.; or a physician ' s assistant. ,

licensed under Chapter 458, F.S.


Type Rule




(4) The Center shall not be required to accept or retain

any applicant or Participant whose behavior and physical

limitations are deemed hazardous to the safety of the

individual or other Participants. Such conditions shall

constitute a basis for termination of Center participation.

Participation may be terminated after reasonable

alternatives have failed, and upon written notification of

the Participant, guardian and responsible person.

Fifteen calendar days shall be allowed for arranging for

alternative services for the Participant except in cases of

emergency as determined by the Governing Authority or

Operator of the center.

(5) All ADRD Participants involuntarily discharged from a

Center designated as a Specialized Alzheimer ' s

services adult day care center pursuant to Section

429.918, F.S., must be:

(a) Informed of any Significant Change in the ADRD

participant ' s condition such as a deterioration or

improvement in the ability to carry out Activities of Daily

Living; a deterioration in behavior or mood to the point

where daily problems arise or an improvement to the

point that these problems are eliminated; or a

substantial deterioration in health status or reversal of

such status, as documented in the ADRD Participant ' s

case file notes;

(b) Informed that the Center is unable to meet the ADRD

Surveyor Probes:

Interview operator and review records of participants who have been terminated from participation at the

center.

oRegSet.rpt





Participant ' s needs, as determined by the Owner or

Operator;

(c) Provided with an appropriate discharge plan,

including suggested transition options for the ADRD

Participant to facilitate and ensure continuity of care.

Fifteen (15) calendar days shall be allowed for arranging

for alternative services for the ADRD Participant except

in cases of emergency as determined by the Governing

Authority of the Center.

(d) Informed of monthly health assessments and

monthly updates, in each ADRD Participant ' s file

regarding the ADRD Participant ' s status or progress

toward meeting the goals indicated in his or her

individualized plan of care .

ST - D0404 - ADRD Participant

Type Rule


Title ADRD Participant


(7)(a) An ADRD participant admitted to an adult day care

center having a license designated under this section, or

the caregiver when applicable, must:

1. Require ongoing supervision to maintain the highest

level of medical or custodial functioning and have a

demonstrated need for a responsible party to oversee

his or her care.

2. Not actively demonstrate aggressive behavior that

places himself, herself, or others at risk of harm.

3. Provide the following medical documentation signed

by a licensed physician, licensed physician assistant, or

a licensed advanced registered nurse practitioner:

a. Any physical, health, or emotional conditions that

require medical care.

b. A listing of the ADRD participant ' s current prescribed

and over-the-counter medications and dosages, diet

Review records for ADRD participants

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restrictions, mobility restrictions, and other physical

limitations.

4. Provide documentation signed by a health care

provider licensed in this state which indicates that the

ADRD participant is free of the communicable form of

tuberculosis and free of signs and symptoms of other

communicable diseases.

(b) Before admitting an ADRD participant to an adult day

care center that has a license designated under this

section, the center shall determine whether:

1. The medical, psychological, safety, and behavioral

support and intervention required by the ADRD

participant can be provided by the center.

2. The resources required to assist with the ADRD

participant ' s acuity level of care and support needed

can be provided or coordinated by the center.

ST - D0500 - STAFFING STANDARD

Type Rule

Statute or Rule 58A-6.006(3), 58A-6.006(6),

Title STAFFING STANDARD


(3) Each Center shall be under the administrative control

of the Operator or Assistant Operator. The owner or

Operator may supervise more than one Center, provided

that a qualified, responsible Assistant Operator, duly

appointed in writing, is in charge of each facility during

the Operator 's absence.

(6) The Owner or Operator shall also be responsible for

the administration of all components of the facility and

accountable for the implementation and enforcement of

all policies and procedures, standards of care, and

program development in accordance with the social,

physical and mental capabilities and needs of the

Participants served.

Surveyor Probes:

If the owner or operator is not present, the designated person must be present.

Operators who supervise other centers should be questioned regarding the number of other centers.

oRegSet.rpt





ST - D0501 - Staffing Std - Policies and Procedures

Type Rule


Title Staffing Std - Policies and Procedures


(1) The center shall make a statement or summary

statement of policies and procedures for participant care

available to participants, to the responsible person, to

the public, and to each member of the center staff ...

(2),The center staff shall be trained to implement these

policies and procedures, as specified in the staff

orientation and training plan.

Surveyor Probes:

Review the plan for content and evidence of an annual review.

Review staff files for evidence of training.

Interview staff to determine their knowledge of and awareness of the center 's policies, procedures, and

their job responsibilities.

Refer to policies listed in tag 0300.

ST - D0502 - Staff Ratio

Type Rule

Statute or Rule 58A-6.006(8)(a,d,e)

Title Staff Ratio


(a) A minimum staff ratio of one staff member who

provides direct services for every six participants shall

be present in the center at all times.

(d) The owner or operator may serve in dual capacity as

a registered nurse, occupational therapist, physical

therapist, speech-language pathologist, or social worker,

if licensed as required by Florida law and qualified to

provide such services.

(e) The owner or operator may be counted as one of the

required staff members provided the owner or operator

provides direct services and is included in the work

The work schedule should reflect the staffing pattern maintained by the center for a given time period ,

(i.e., week, month, etc.).

Surveyor Probes:

Obtain the number of participants from center operator or designee to determine the required staffing

pattern.

Compare written work schedule to staff on duty at survey.

Review staffing patterns.

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schedule for the center. However, the owner or operator

shall not be counted more than once in the

staff/participant ratio, calculated on the basis of daily

census.

ST - D0503 - Staffing Std - First Aid/CPR

Type Rule

Statute or Rule 58A-6.006(8)(b)

Title Staffing Std - First Aid/CPR


No less than two staff members, one of whom has a

certification in an approved first aid course and CPR,

shall be present in the center at all times.

A Florida licensed registered nurse (RN), licensed practical nurse (LPN), emergency medical technician

(EMT), or advanced registered nurse practitioner (ARNP) is exempt from additional certification.

Surveyor Probes:

Review employment application, continuing education, certificates, and copies of licenses on file.

Compare the written work schedule against documentation in employee's files for current certification in

first aid/CPR.

ST - D0504 - Staffing Std - Communicable Diseases

Type Rule

Statute or Rule 58A-6.006(5)(b)9

Title Staffing Std - Communicable Diseases


A statement from a Florida licensed health care provider

under the direct supervision of a physician, physician or

a county public health unit that the employee is free from

tuberculosis in a communicable form and apparent signs

and symptoms of other communicable diseases within

45 days prior to beginning work in the center. In

accordance with Section 760.50, F.S., a center shall not

Documentation of lab reports does not meet this requirement.

The written statement must be from a Florida licensed health care provider.

Surveyor Probes:

Identify and review the files of employees to determine if documentation is received 45 days or less prior

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exclude a potential employee who is infected with

human immunodeficiency virus who would otherwise

meet the conditions of employment.

to employee hire/start date.

ST - D0505 - Staffing Std

Type Rule

Statute or Rule 58A-6.006(4), 58A-6.006(8)(c)

Title Staffing Std


58A-6.006(4),

The center shall employ qualified staff to provide the

services, personal assistance and safety measures

required by the participants.

58A-6.006(8)(c)

At all times staffing shall be maintained to meet the

needs of the Participants as required by the Participant

Files, including Centers which serve persons with

Alzheimer ' s disease and related disorders, persons

with physical handicaps, or other special target

populations

Surveyor Probes:

Determine from observations, interview of participants and staff of the center, if unmet needs are present.

ST - D0506 - Staffing Std - Cleanliness and Hygiene

Type Rule

Statute or Rule 58A-6.006(7)(a)

Title Staffing Std - Cleanliness and Hygiene


(7) The owner or operator shall assure that each

employee shall:

(a) Maintain personal cleanliness and hygiene;

Surveyor Probes:

Observe staff.

ST - D0507 - Staffing Std - Personnel File

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Type Rule


Title Staffing Std - Personnel File


(5) The owner or operator shall:

(b) Establish and maintain a personnel file for each Staff

member to include:

1. Name, home address, phone number;

2. Education and experience;

3. Job assignment;

4. Evaluation of performance at least yearly;

5. Dates of employment and termination;

6. Character references, including former employers and

supervisors;

7. A signed statement from a Florida licensed physician,

a Florida licensed health care provider under the direct

supervision of a physician, or a county public health unit,

that the employee is free from tuberculosis in a

communicable form, and free from apparent signs and

symptoms of other communicable diseases. The

statement must be signed no less than forty-five days

prior to beginning work in the Center.

8. Training certificates or copies of training certificates

as required by subsection 58A-6.016(7), F.A.C.

ST - D0508 - Staffing Std - Job Descriptions

Type Rule

Statute or Rule 58A-6.006(5)(a)

Title Staffing Std - Job Descriptions


(5) The owner or operator shall:

Develop a written job description for each staff member

containing a list of qualifications, duties, responsibilities

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and accountability required of each staff member.

ST - D0509 - Staffing Std - Background Screening

Type Rule

Statute or Rule 58A-6.003(5)(c)

Title Staffing Std - Background Screening


Proof of compliance with background screening

requirements pursuant to Sections 408.809 and

429.919, F.S.

Surveyor Probes:

If surveyor verifies through Background Screening unit that an employee has not completed a level II

background screen, cite Z815.

This tag is cited for lack of documentation in staff records .

ST - D0510 - Staffing Std - Level 2 Background

Type Rule


Title Staffing Std - Level 2 Background


Every employee must attest, subject to penalty of

perjury, to meeting the requirements for qualifying for

employment pursuant to this chapter and agreeing to

inform the employer immediately if arrested for any of

the disqualifying offenses while employed by the

employer.

Surveyor Probes:

Is AHCA Recommended Form 3100-0008, August 2010, Affidavit of Compliance with Background

Screening Requirements, in the employee ' s personnel file?

ST - D0511 - Staffing Std - Unacceptable Conduct

Type Rule


Title Staffing Std - Unacceptable Conduct

oRegSet.rpt






Refrain from abusive, immoral or other unacceptable

conduct such as use of alcohol, illegal use of narcotics

or other impairing drugs, and behavior or language

which may be injurious to participants;

Surveyor Probes:

Interview operator regarding the center's policy regarding employee behavior and conduct. Ask

participants about staff behavior and conduct.


Type Rule


Title Staffing Std


(9) Center staff whose conduct constitutes abuse,

neglect, or exploitation of a participant shall immediately

be terminated from employment and shall be reported to

the Department of Children and Families in accordance

with Section 415.103, F.S.

(10) No administrator who has been terminated

pursuant to the provisions of subsection (9) shall accept

employment in an adult day care center and no owner or

operator of a center shall knowingly employ any person

who has been terminated pursuant to subsection (9).

Chapter 415, F.S., requires that such individuals be immediately reported to the Florida Abuse Registry ,

(1-800-96-ABUSE)

Chapter 429.911, F.S., authorizes the Agency to deny, suspend, or revoke the ADCC license when the

center has retained employees who did not pass the required background screening.


Type Rule

Statute or Rule 419.918(5); 58A-6.010(6)(c)

Title Staffing Std


429.918

(5)(a) The operator of an adult day care center having a

license designated under this section, and the operator '

If the facility only provides basic services, this education requirement is does not apply.

oRegSet.rpt





s designee, as applicable, hired on or after July 1, 2012,

shall:

1. Have at least a bachelor ' s degree in health care

services, social services, or a related field, 1 year of staff

supervisory experience in a social services or health

care services setting, and a minimum of 1 year of

experience in providing services to persons who have

dementia;

2. Be a registered or practical nurse licensed in this

state, have 1 year of staff supervisory experience in a

social services or health care services setting, and have

a minimum of 1 year of experience in providing services

to persons who have dementia; or

3. Have 5 years of staff supervisory experience in a

social services or health care services setting and a

minimum of 3 years of experience in providing services

to persons who have dementia.

(b) The owner must sign an affidavit under penalty of

perjury stating that he or she has verified that the

operator, and the operator ' s designee, if any, have

completed the education and experience requirements

of this subsection.

58A-6.010(6)(c)

(c) In addition to the minimum staffing required in

Chapter 58A-6, F.A.C., provide the following Staff:

1. The Operator shall: have a minimum of a Bachelor ' s

degree in a health or social services or related field, with

one year of supervisory experience in a social or health

service setting; hold a registered nurse license with one

year of supervisory experience; or have 5 years of

supervisory experience in a social or health service

setting.

2. A registered nurse (RN) or licensed practical nurse

(LPN) shall be on-site during the primary hours of

program operation and on-call during all hours the

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Center is open. Arrangements shall be formalized for

obtaining the services of an LPN or RN in anticipation of

potential absences, planned and unplanned, of the

regular nursing Staff.

3. A social worker with a minimum of a Bachelor ' s

degree in social work, or a case worker with a minimum

of a Bachelor ' s degree in sociology, psychology,

nursing, or gerontology, or a Bachelor ' s degree with at

least 2two years of experience in a human service field.

Services provided by program aides in this service area

must be provided under the direct supervision of a social

worker or case manager who meets or exceeds these

standards (e.g., a Master ' s degree in a related field).

4. An activity director or Recreational Therapist with a

Bachelor ' s degree in a social or health service field or

an Associate ' s degree in a related field plus 2 years of

experience. All services provided by program aides must

be provided under the direct supervision of the activity

director or recreation therapist. The recreation therapist

may be retained as a consultant.

ST - D0514 - ADRD Employee Requirements

Type Rule

Statute or Rule 429.918(6)(a)2

Title ADRD Employee Requirements


2. Upon beginning employment with the center, each

employee must receive and review basic written

information about interacting with ADRD participants

ST - D0515 - Dementia-Specific Training

Statute or Rule 429.917(1)(b), 58A-6.015(1)(a)

Title Dementia-Specific Training

oRegSet.rpt





Type Rule


429.917(1)(b),

(b) In addition to the information provided under

paragraph (a), newly hired adult day care center

personnel who are expected to, or whose

responsibilities require them to, have direct contact with

participants who have Alzheimer ' s disease or

dementia-related disorders must complete initial training

of at least 1 hour within the first 3 months after

beginning employment. The training must include an

overview of dementias and must provide instruction in

basic skills for communicating with persons who have

dementia.

58A-6.015(1)(a)

(a) All Staff in Direct Contact with ADRD Participants

and Staff Providing Direct Care for ADRD Participants

shall receive one initial hour of training within ninety

days of employment, which shall satisfy the requirement

referenced in Section 429.917(1)(b), F.S. The

curriculum for the initial one-hour training shall address

the following subject areas:

1. Understanding Alzheimer ' s Disease and Related

Disorders;

2. Characteristics of Alzheimer ' s Disease and Related

Disorders; and,

3. Communicating with Participants with Alzheimer ' s

Disease or Related Disorders.

58A-6.015(2-3)

(2) An Adult Day Care Center Staff member who has successfully completed training and continuing

education consistent with the requirements of Section 429.178, F.S., or completed training consistent with

the requirements of Sections 400.1755 or 400.6045, F.S., shall be considered as having met the training

requirements of this rule.

(3) All training required by this rule and Section 429.917, F.S., must be completed only once for each

applicable employee .

ST - D0516 - Staff Training

Type Rule

Statute or Rule 429.917(1)(a-c), 419.918;58A-6.015(1)(b)

Title Staff Training

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429.917

(1) An adult day care center licensed under this part

must provide the following staff training:

(a) Upon beginning employment with the facility, each

employee must receive basic written information about

interacting with participants who have Alzheimer ' s

disease or dementia-related disorders.

(b) In addition to the information provided under

paragraph (a), newly hired adult day care center

personnel who are expected to, or whose

responsibilities require them to, have direct contact with

participants who have Alzheimer ' s disease or

dementia-related disorders must complete initial training

of at least 1 hour within the first 3 months after

beginning employment. The training must include an

overview of dementias and must provide instruction in

basic skills for communicating with persons who have

dementia.

(c) In addition to the requirements of paragraphs (a) and

(b), an employee who will be providing direct care to a

participant who has Alzheimer ' s disease or a

dementia-related disorder must complete an additional 3

hours of training within 9 months after beginning

employment. This training must include, but is not

limited to, the management of problem behaviors,

information about promoting the participant ' s

independence in activities of daily living, and instruction

in skills for working with families and caregivers.

58A-6.015(1)(b)

(b) All Staff Providing Direct Care for ADRD Participants

shall receive three hours of additional training, within

nine months of employment, which shall satisfy the

requirement referenced in Section 429.917(1)(c), F.S.

The curriculum for the three hours of additional training

must address the following subject areas as they apply

to Alzheimer ' s Disease and Related Disorders:

This training is required for an employee hired on or after July 1, 2004.

Upon completion of training, the trainee must be issued a certificate by the approved training provider.

The certificate must include the title of the training, the DOEA curriculum approval number, the number of

hours of training, the participant's name, dates of attendance, location, the training provider's name, the

DOEA training provider's approval number, and dated signature. The training provider's signature on the

certificate serves as documentation that the training provider has verified that the trainee has completed

the required training.

Training certificates or copies of certificates must be documented in the center 's personnel files.

Alzheimer's Disease or Related Disorders training and training providers must be approved by DOEA or

its designee.

An ADCC employee who has successfully completed Alzheimer's disease or other related disorders

training and continuing education requirements for ALFs pursuant to Section 429.178, F.S., or completed

Alzheimer's disease or related disorders training for nursing homes specified in s. 400.1755, F.S., or for

hospices under s. 400.6045, F.S., meets the training standard for ADCCs.

Health care practitioner (e.g., physicians, nurses) required continuing education hours are counted toward

meeting the 3 hours of additional Alzheimer's disease training.

The employee is not required to repeat this training if the employee changes employment to a different

adult day care center or to an assisted living facility, nursing home, home health agency, or hospice.

Surveyor Probes:

Select a sample of staff providing direct care to participants having Alzheimer 's disease or related

disorders. Determine employment dates for sample staff selected.

Review personnel files for a certificate documenting completion of required training within time frame.

58A-6.015(2-3)

(2) An Adult Day Care Center Staff member who has successfully completed training and continuing

education consistent with the requirements of Section 429.178, F.S., or completed training consistent with

the requirements of Sections 400.1755 or 400.6045, F.S., shall be considered as having met the training

requirements of this rule.

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1. Behavior management;

2. Assistance with Activities of Daily Living to promote

the patient ' s independence;

3. Activities for Participants;

4. Stress management for the caregiver;

5. Family issues;

6. Participant environment; and,

7. Ethical issues

58A-6.0151 Specialized Alzheimer ' s Services Adult Day

Care Center Staff Training Requirements.

(1) The following terms are defined in Section 429.918,

F.S., and are applicable to this rule section: ADRD

Participant, Dementia, Specialized Alzheimer ' s

Services, and Therapeutic Activity.

(2) Within three months of employment, all Staff in

Direct Contact with ADRD Participants and all Staff

Providing Direct Care for ADRD Participants at a Center

designated as a Specialized Alzheimer ' s services adult

day care center pursuant to Section 429.918, F.S., and

hired on or after July 1, 2012, must obtain four hours of

Alzheimer ' s disease and related disorders training

pursuant to subsection 58A-6.015(1), F.A.C.

(3) Within six months of employment, all Staff Providing

Direct Care for ADRD Participants at a Center

designated as a Specialized Alzheimer ' s services adult

day care center pursuant to Section 429.918, F.S., and

hired on or after July 1, 2012, must obtain an additional

four hours of dementia-specific training approved by the

Department. The curriculum for the additional four hours

of training must address the following subject areas as

they apply to Alzheimer ' s disease and related

disorders:

a. Understanding brain disease;

b. Normal brain functions and normal aging;

c. Understanding treatable and irreversible dementia;

d. Mental status tests;

(3) All training required by this rule and Section 429.917, F.S., must be completed only once for each

applicable employee .

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e. Communication and the effects of damage to brain

cells;

f. Influences on behavior and brain deterioration;

g. Interventions;

h. Physical causes and pain indications;

i. Common Alzheimer ' s disease and related disorders

medications & side effects;

j. Malnutrition and dehydration;

k. Activities of daily living ? routines and schedules;

l. Validation therapy;

m. Safety ? new and proven technologies;

n. Caregiver stress management ? physical, emotional,

and financial; burden tests.

(4) All training providers and their curricula must be

approved by the Department or its designee pursuant to

Rule 58A-6.016, F.A.C., prior to the commencement of

training activities pursuant to this rule.

(5) All Staff Providing Direct Care for ADRD Participants

shall participate in four hours of continuing education

annually in topics related to Alzheimer ' s disease and

related disorders.

(6) All training required by this rule and Section 429.918,

F.S., must be completed only once for each applicable

employee.

ST - D0601 - MEDICATION STANDARD

Type Rule

Statute or Rule 58A-6.002(2)(w)

Title MEDICATION STANDARD


" Supervision of self-administered medication " shall

mean reminding participants to take medication at the

time indicated on the prescription; opening or closing

medication container(s) or assisting in the opening of

prepackaged medication; reading the medication label to

participants; observing participants while they take oRegSet.rpt





medication; checking the self-administered dosage

against the label of the container; reassuring participants

that they have obtained and are taking the dosage as

prescribed; keeping daily records of when participants

received supervision pursuant to this subsection; and

immediately reporting apparent adverse effects on a

participant ' s condition to the participant ' s physician

and responsible person. Supervision of

self-administered medication shall not be construed to

mean that a center shall provide such supervision to

participants who are capable of administering their own

medication.

ST - D0602 - Medication Administration

Type Rule

Statute or Rule 58A-6.013(12)(b, k)

Title Medication Administration


(b) Participants who can self-administer medications

may bring and be responsible for their own medications.

(k) In no instance shall medication be administered by a

person other than one licensed, according to Florida

law, to administer medication including a physician, a

dentist, a nurse, or a physician ' s assistant .

In a center where participants cannot self-administer medications and require the administration of

medications, a licensed person would be defined as a person licensed to administer medication, i.e., a

licensed physician, advanced registered nurse practitioner, a dentist, a registered nurse, licensed

practical nurse or a physician's assistant.

ST - D0603 - Medication Storage

Type Rule

Statute or Rule 58A-6.013(12)(c-e)

Title Medication Storage


(c) Medications shall be centrally stored when:

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1. The preservation of medicines requires refrigeration;

2. Medication is determined, and documented by the

physician, to be hazardous if kept in the personal

possession of the person for whom it was prescribed;

3. Because of physical arrangements and the conditions

or habits of other persons in the center, the medications

are determined by the operator or physician to be a

safety hazard to others .

(d) Centrally stored medications shall be:

1. Kept in a locked cabinet or container; and

refrigerated, if required;

2. Accessible only to the authorized staff responsible for

distribution of medication;

3. Located in an area free from dampness and abnormal

temperatures.

(e) Each container of medication shall be labeled

according to state law, and shall include the name of the

person for whom it is prescribed, the name of the drug,

and instructions for use.

ST - D0604 - Medication Std

Type Rule

Statute or Rule 58A-6.013(12)(f)

Title Medication Std


No person other than the dispensing pharmacist shall:

1. Alter the prescription label;

2. Transfer medication from one storage container to

another.

Surveyor Probes:

Observe medication containers to ensure they appear to be original pharmacy containers.


Statute or Rule 58A-6.013(12)(g)


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Type Rule


(g) Prescription medications which are not taken with the

person upon discharge shall be destroyed or disposed

of by the Operator or designee in the presence of one

other Staff member.

Surveyor Probes:

Review records of participants who have been discharged for notation of drug disposition in their file.

Examine medication cabinets for drugs prescribed for participants that have been discharged.


Type Rule

Statute or Rule 58A-6.013(12)(h)



There shall be a Staff person available at all times who

has access to the centrally stored medications and is

responsible for the distribution thereof.

ST - D0700 - Planned Activities

Type Rule


Title Planned Activities


Each Center shall offer a planned program of varied

activities and services promoting and maintaining the

health of Participants and encouraging leisure activities.

Opportunities for interaction and communication among

Participants shall be available on a daily basis at each

Center in order to enhance the Participant's well-being

and to maximize individual functioning. Such activities

and services shall be available during at least 60 percent

of the time the Center is open to Participants and shall

Surveyor Probes:

Observe center activities. Interview participants and staff to verify that activities are taking place .

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be documented in accordance with subsection (5).

ST - D0701 - Activity Schedule

Type Rule


Title Activity Schedule


A monthly schedule of daily activities shall be maintained

on a current basis and displayed in a conspicuous place.

Verify that the center has an up-to-date activities calendar. Observe center activities. Interview

participants and staff to verify that scheduled activities are taking place .

ST - D0702 - Consultation and Referral Services

Type Rule


Title Consultation and Referral Services


The center shall provide for family consultation or

referral service to community agencies, clinics, or

physicians when the participant or family is observed to

be in need of intensive counseling, health, or mental

health services.

Surveyor Probes:

Interview staff for understanding of procedures for consultation and referral services .

ST - D0704 - Therapy

Type Rule


Title Therapy


(2) Speech therapy provided by or under the supervision

of an individual licensed under Chapter 468, Part I, F.S.,

Surveyor Probes:

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who has a certification of clinical competence from the

American Speech and Hearing Association, and who

has completed the equivalent education requirements

and work experience necessary for certification, or who

has completed the academic program and is acquiring

supervised work experience to qualify for the certificate.

Progress notes shall be maintained and must be written

in the Participant ' s File and signed by the speech

therapist as services are provided.

(3) Physical therapy must be provided by, or under the

supervision of, an individual who is a graduate of a

program of physical therapy approved by both the

Council on Medical Education of the American Medical

Association and the American Therapy Association, or

the equivalent, and licensed by the State. Progress

notes shall be maintained and must be written in the

Participant ' s File and signed by the physical therapist

as services are provided.

(4) Occupational therapy as an adjunct to treatment of

persons with physical and mental limitations must be

provided by, or under the supervision of, an individual

who is registered by the American Occupational Therapy

Association; or a graduate of a program approved by the

Council on Medical Education of the American Medical

Association and engaged in the supplemental clinical

experience required before registration by the American

Occupational Therapy Association. Progress notes shall

be written in the Participant ' s File and signed by the

occupational therapist as services are provided.

Review license(s) or certification(s) or registration(s).

ST - D0705 - Particip. Svcs Std

Type Rule

Statute or Rule 58A-6.010(6)(a-b)

Title Particip. Svcs Std


(6) Adult day health care services for disabled adults or oRegSet.rpt





aged persons, provided the Center complies with the

following:

(a) Make services available for a minimum of five hours

per day five days per week, excluding legal holidays as

posted by the facility;. For purposes of this subsection,

legal holiday shall mean any day which, by the laws of

this state or the United States, is designated or

recognized as a legal or public holiday or any day on

which businesses or institutions are customarily closed.

(b) Provide or coordinate, in addition to the Basic

Services specified in Rule 58A-6.009, F.A.C., and

Supportive and Optional Services, pursuant to

subsections (1), (2), (3), (4) and (5), the following adult

day health care services:

1. Medical screening emphasizing prevention and

continuity of care which includes routine blood pressure

checks or blood glucose diabetic maintenance checks;

2. Nursing services including a configuration of services

at different levels of intensity as determined by the

nursing assessment, Participant Care Plan, and

physician ' s orders. Services shall include:

a. Health education and counseling including nutritional

advice, liaison with the Participant ' s personal physician,

and notification of the Participant's physician, as well as

the caregiver or family of any changes in the

Participant's health status;

b. Coordination of the provision of other health services

provided outside the Center;

c. Supervision of health services provided by program

aides.

3. Social services including: counseling for Participants'

families and caregivers; compilation of a social history

and psychosocial assessment of formal and informal

support systems; mental and emotional status; caregiver

data; information on planning for discharge; and referral

for persons not appropriate for adult day care.

4. Additional medical services such as dental,

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ophthalmological, optometric, hearing aid, or laboratory

services.

5. Transportation Services to and from the adult day

health care services.

ST - D0706 - Particip. Svcs Std

Type Rule

Statute or Rule 58A-6.010(6)(d)

Title Particip. Svcs Std


Documentation of services provided under this section

must be in the participants ' files. Participant care plans

must be reviewed at least quarterly by a multidisciplinary

team. At a minimum, narrative nursing, social work, and

activity notes must be entered in the participant ' s

record quarterly indicating the participant ' s progress

toward achieving health goals. More frequent notes are

required if indicated by the participant ' s condition.

ST - D0708 - Alzheimer¿s Services

Type Rule

Statute or Rule 429.918(3)(a)

Title Alzheimer¿s Services


The adult day care center must notify the agency at least

30 days prior to initial licensure under s. 429.907 or, if

already licensed, at least 6 months prior to the expiration

of a license issued under s. 429.907, that the adult day

care center is seeking a designation as a specialized

Alzheimer ' s services adult day care center.

Observe participants for appropriateness for daycare setting.

ST - D0709 - Nursing staff Requirements

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Type Rule

Statute or Rule 429.918(6)(a)1

Title Nursing staff Requirements


A registered nurse or licensed practical nurse must be

on site daily for at least 75 percent of the time that the

center is open to ADRD participants. Each licensed

practical nurse who works at the center must be

supervised in accordance with chapter 464.

Surveyor Probes:

Review the nurse credentials and facility schedule.

ST - D0801 - Food Service

Type Rule

Statute or Rule 58A-6.009(2)(d4-e)

Title Food Service


(d)(4)4. Menus not approved by or meeting the

requirements of Title III-C of the Older Americans Act or

the Adult Care Food Program of USDA shall be

reviewed by a registered or Florida licensed dietitian or a

dietetic technician supervised by a registered or Florida

licensed dietitian to ensure that the menus are

commensurate with the Dietary Reference Intakes as

referenced in the DGA, adjusted for age, sex and

activity. Documentation of review of the menus shall be

maintained in the Center files and shall include the

signature and registration or license number of the

reviewer and date reviewed. Menus shall be kept on file

for one year and shall be accessible to Participants and

families of Participants.

(e) If food is catered from outside sources, no

warewashing may take place on-site. Catered food,

The most recent Food Service inspection report(s) should be on file or posted within the center. If

deficiencies were cited, the facility should have a copy of an inspection report verifying correction of

deficiencies.

Surveyor Probes:

Examine menus to determine if requirements are satisfied.

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once delivered to an Adult Day Care Center, must be

adequately protected. In order to provide catered meals

through a third party, there must be a formal contract

betwe

ST - D0802 - Nutrition/Diet. Std

Type Rule

Statute or Rule 429.929(1)(f), 58A-6.009(2)(a)

Title Nutrition/Diet. Std


58A-6.009(1)(f)

(f) Nutritional services or food provided or prepared in a

central location in a center or by formal agreement with

a third party; the activities performed and the resources

utilized in the planning, processing, preparing, and

serving of meals or snacks; nutritional education; and

nutritional counseling;

58A-6.009(2)(a)

Participants attending or in transit to the Center for four

or more hours daily shall be served a meal which shall

adhere to the U.S. Department of Health and Human

Services and U.S. Department of Agriculture ' s Dietary

Guidelines for Americans 2010 (DGAs) and provides at

least one-third of the Dietary Reference Intakes as

referenced in the DGAs, adjusted for age, sex and

activity. Modified diets, if required, shall meet these

nutritional standards to the extent medically possible.

Menus approved and provided by Title III-C of the Older

Americans Act or the Adult Care Food Program of USDA

shall be evidence of meeting the one-third of the Dietary

Reference Intakes requirement.

Surveyor Probes:

Determine meal times by observing a meal and by asking participants.

ST - D0803 - Snack Requirement

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Type Rule

Statute or Rule 58A-6.009(2)(c)

Title Snack Requirement


Participants in the center 3 hours before the noon meal

or 2 hours after the noon meal must be provided a

snack consisting of at least 2 servings from the following

four food groups: milk, bread or bread alternate, meat or

meat alternate, and vegetables or fruits.

Surveyor Probes:

Determine snack time by observing snack interval and by asking participants.

ST - D0804 - Kitchen Assignments

Type Rule

Statute or Rule 58A-6.009(2)(f)

Title Kitchen Assignments


(f) Duty Assignments for the people designated by the

Owner or Operator as responsible for food service shall

be posted in the kitchen area in Centers having five or

more food service Staff.

Surveyor Probes:

Check to see where duty assignments are posted; review against what the employees are doing to see if

they are valid.

ST - D0805 - Catered Food

Type Rule

Statute or Rule 58A-6.009(2)(e)

Title Catered Food


If food is catered from outside sources, no warewashing

may take place on-site. Catered food, once delivered to

an Adult Day Care Center, must be adequately

protected. In order to provide catered meals through a

Surveyor Probes:

Is there a formal contract between the center and the food service provider?

oRegSet.rpt





third party, there must be a formal contract between the

Center and the third party provider containing

assurances that the provider will meet all food service

and dietary standards.

ST - D0806 - Modified diets

Type Rule


Title Modified diets


Modified diets or diets based on the normal diet and

designed to meet the requirements of a given situation

such as altering individual nutrients, caloric values,

consistency, flavor, techniques of service or preparation,

content of specific foods, or a combination of these

factors, may be provided as an optional service. When

modified diets are provided, a physician ' s written or

documented oral order for each participant receiving a

modified diet shall be on file. A menu including types and

amounts of food to serve will be on file in the food

service area. Diets shall be prepared and served as

ordered by the physician.

Surveyor Probes:

Review participant files for physician diet orders.

Interview food service personnel to see if they are aware of the diet order.

Observe food being prepared to see if it matches the diet that has been ordered.

Modified diets are an optional service. However, if ordered by a physician and provided by the center, all

requirements must be met.

ST - D0900 - MAINTENANCE AND HOUSEKEEPING STANDARD

Type Rule


Title MAINTENANCE AND HOUSEKEEPING

STANDARD


58A-6.013(15), F.A.C.

(15) Every Center shall be maintained for the comfort

and safety of the Participants and shall have an effective

written maintenance plan that ensures preventive

Surveyor Probes:

Review maintenance plan for verification of written policy and procedures.

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maintenance as well as immediate attention to and

correction of hazardous or potentially hazardous

conditions. The plan shall provide for:

(a) Keeping the building in good repair and free of

hazards such as: cracks in floors, walls, or ceilings;

warped or loose boards, tile, linoleum, handrails or

railings,; broken window panes,; and any similar

hazards.

(b) Keeping all heating, air conditioning, electrical,

mechanical, water supply, fire protection and sewage

disposal systems in a safe and functioning condition.

Electrical wiring cords and appliances shall be

maintained in a safe condition. Emergency generators,

where existing, shall be tested monthly.

(c) Keeping all plumbing fixtures in good repair, properly

functioning and satisfactorily provided with protection to

prevent infiltration and contamination of the water

supply.

(d) Painting the interior and exterior of the building as

needed to keep it reasonably attractive. Loose, cracked

or peeling wallpaper or paint shall be promptly replaced

or repaired to provide a satisfactory finish.

(e) Keeping all furniture and furnishings clean and in

good repair.

(f) Keeping the grounds and buildings in a safe, sanitary

and presentable condition. Grounds and buildings shall

be kept free from refuse, litter, and insect and rodent

breeding areas.

Observation through tour of interior and exterior and participant interviews.

ST - D1000 - PHYSICAL PLANT STANDARD

Type Rule


Title PHYSICAL PLANT STANDARD


All areas used by Participants shall be suitably lighted

and ventilated and maintained at a minimum inside

Surveyor Probes:

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temperature of 72 degrees Fahrenheit, when outside

temperatures are 65 degrees Fahrenheit or below, and

all areas used by Participants must not exceed 90

degrees Fahrenheit. Mechanical cooling devices must

be provided when indoor temperatures exceed 84

degrees Fahrenheit. The facility shall have a

thermometer which accurately identifies the

temperature.

Tour facility and interview participants about the comfort level . Complaints may warrant further

investigation.

ST - D1001 - Net Floor Space

Type Rule


Title Net Floor Space


(1) The Center shall provide adequate, safe and sanitary

facilities appropriate for the services provided by the

Center and for the needs of the Participants. All Centers

receiving federal funds shall meet regulations for access

to the handicapped in compliance with the Americans

With Disabilities Act of 1990.

(2) The Participant Capacity shall be determined by the

total amount of Net Floor Space available for all of the

Participants. Centers licensed prior to the effective date

of this rule shall provide 30 square feet of net floor area

per Participant. For Centers initially licensed after

November 9, 1995, there shall not be less than 45

square feet of net floor area per Participant. Centers

shall be required to provide additional floor space for

special target populations to accommodate activities

required by Participant care plans. A change in space

usage that increases or decreases the Participant

Capacity must continue to comply with all requirements

of Part III of Chapter 429, F.S., and this rule.

(3) The Participant Capacity of facilities that are exempt

from licensure as an Adult Day Care Center pursuant to

Section 429.905, F.S., shall be determined by the total

Surveyor Probes:

Review center floor plan with square footage measurement. If in doubt measure.

Length (Inches) x Width (inches)= total (inches) /144= total /35

245 x 287 = 70315/144= 488/35= 35 participants

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amount of Congregate Space available to the

Participants. Such Facilities shall utilize separate space

over and above the minimum requirement needed to

meet their own licensure certification approval

requirements. .

ST - D1002 - Bathrooms

Type Rule


Title Bathrooms


Bathrooms shall be ventilated and have hot and cold

running water, supplying hot water at a minimum of 105

degrees Fahrenheit and a maximum of 115 degrees

Fahrenheit. Facilities licensed prior to the effective date

of this rule are exempt from the requirement for hot

running water only.

ST - D1003 - Laundry

Type Rule


Title Laundry


Centers that provide their own laundry services shall

have a sufficient area and the appropriate equipment for

the laundry to be processed by the center.

Surveyor Probes:

During the tour and interviews, question participants regarding laundry procedures, complaints, etc.

ST - D1004 - Resting Space


Title Resting Space

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Type Rule


Each Participant shall be provided with adequately

padded, clean, comfortable seating, with support

meeting the needs of each Participant. Rest areas shall

be provided for at least one-fourth of the Participants

who are present for four or more hours a day, or as

needed by the Particpants. Seating options may include:

(a) Bed and mattress, or

(b) Recliner, or

(c) Sofa, or

(d) Chair with back and arm support.

Surveyor Probes:

During the tour, determine if rest areas are available for participants.

ST - D1005 - Fire safety protection

Type Rule


Title Fire safety protection


(11) Fire safety protection shall be governed by the local

fire code applicable to Adult Day Care Centers. In areas

where no local fire code applies, the standards

contained in Chapter 69A-40, F.A.C., Uniform Fire

Safety Standards for Assisted Living Facilities, may be

used to determine compliance with fire safety standards.

In every instance, a Center shall comply with local and

state standards before a license may be issued.

(a) A fire evacuation drill shall be conducted once a

month for the Staff and once every three months for

Participants;

(b) A written record of each fire drill, indicating the date,

hour and general description of each drill, the extent of

Staff involvement, and the name of the person in charge

shall be maintained and available for review;

(c) Evacuation routes shall be posted conspicuously in

Surveyor Probes:

Review the latest fire safety inspection to ensure the center has received a satisfactory inspection.

Review the records of each fire drill to ensure the fire drills are being conducted as required.

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the Center.

ST - D1006 - Center Requirements

Type Rule


Title Center Requirements


Center facilities shall consist of, but not be limited to, the

following:

(a) Bathrooms;

(b) Dining areas;

(c) Kitchen areas;

(d) Rest areas;

(e) Recreation and leisure time areas.

ST - D1007 - Private Areas

Type Rule


Title Private Areas


A private area shall be available for the provision of first

aid, special care and counseling services when

provided, or as necessary for other services required by

participants. This area shall be appropriately furnished

and equipped

ST - D1008 - Storage

Type Rule


Title Storage

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Medicines, cleaning supplies, flammables and other

potentially poisonous or dangerous supplies shall be

stored out of the participant's reach, and in such manner

as to ensure the safety of participants.

ST - D1009 - Physicial Plant Maintenance

Type Rule


Title Physicial Plant Maintenance


The center shall have available and shall make

accessible to the AHCA written policies and procedures

for the cleaning of the physical plant and equipment and

for its maintenance.

ST - DZ800 - Applicability; Definitions

Type Rule

Statute or Rule 408.802-803; 59A-35.030; 59A-35.090(1)

Title Applicability; Definitions


408.802 Applicability.-

The provisions of this part apply to the provision of

services that require licensure as defined in this part and

to the following entities licensed, registered, or certified

by the agency, as described in chapters 112, 383, 390,

394, 395, 400, 429, 440, 483, and 765:

(1) Laboratories authorized to perform testing under the

Drug-Free Workplace Act, as provided under ss.

112.0455 and 440.102.

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(2) Birth centers, as provided under chapter 383.

(3) Abortion clinics, as provided under chapter 390.

(4) Crisis stabilization units, as provided under parts I

and IV of chapter 394.

(5) Short-term residential treatment facilities, as

provided under parts I and IV of chapter 394.

(6) Residential treatment facilities, as provided under

part IV of chapter 394.

(7) Residential treatment centers for children and

adolescents, as provided under part IV of chapter 394.

(8) Hospitals, as provided under part I of chapter 395.

(9) Ambulatory surgical centers, as provided under part I

of chapter 395.

(10) Mobile surgical facilities, as provided under part I of

chapter 395.

(11) Health care risk managers, as provided under part I

of chapter 395.

(12) Nursing homes, as provided under part II of chapter

400.

(13) Assisted living facilities, as provided under part I of

chapter 429.

(14) Home health agencies, as provided under part III of

chapter 400.

(15) Nurse registries, as provided under part III of

chapter 400.

(16) Companion services or homemaker services

providers, as provided under part III of chapter 400.

(17) Adult day care centers, as provided under part III of

chapter 429.

(18) Hospices, as provided under part IV of chapter 400.

(19) Adult family-care homes, as provided under part II

of chapter 429.

(20) Homes for special services, as provided under part

V of chapter 400.

(21) Transitional living facilities, as provided under part

XI of chapter 400.

(22) Prescribed pediatric extended care centers, as

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provided under part VI of chapter 400.

(23) Home medical equipment providers, as provided

under part VII of chapter 400.

(24) Intermediate care facilities for persons with

developmental disabilities, as provided under part VIII of

chapter 400.

(25) Health care services pools, as provided under part

IX of chapter 400.

(26) Health care clinics, as provided under part X of

chapter 400.

(27) Clinical laboratories, as provided under part I of

chapter 483.

(28) Multiphasic health testing centers, as provided

under part II of chapter 483.

(29) Organ, tissue, and eye procurement organizations,

as provided under part V of chapter 765.

408.803 Definitions.-As used in this part, the term:

(1) "Agency" means the Agency for Health Care

Administration, which is the licensing agency under this

part.

(2) "Applicant" means an individual, corporation,

partnership, firm, association, or governmental entity

that submits an application for a license to the agency.

(3) "Authorizing statute" means the statute authorizing

the licensed operation of a provider listed in s. 408.802

and includes chapters 112, 383, 390, 394, 395, 400,

429, 440, 483, and 765.

(4) "Certification" means certification as a Medicare or

Medicaid provider of the services that require licensure,

or certification pursuant to the federal Clinical Laboratory

Improvement Amendment (CLIA).

(5) "Change of ownership" means:

(a) An event in which the licensee sells or otherwise

transfers its ownership to a different individual or entity

as evidenced by a change in federal employer

oRegSet.rpt





identification number or taxpayer identification number;

or

(b) An event in which 51 percent or more of the

ownership, shares, membership, or controlling interest

of a licensee is in any manner transferred or otherwise

assigned. This paragraph does not apply to a licensee

that is publicly traded on a recognized stock exchange.

A change solely in the management company or board

of directors is not a change of ownership.

(6) "Client" means any person receiving services from a

provider listed in s. 408.802.

(7) "Controlling interest" means:

(a) The applicant or licensee;

(b) A person or entity that serves as an officer of, is on

the board of directors of, or has a 5-percent or greater

ownership interest in the applicant or licensee; or

(c) A person or entity that serves as an officer of, is on


ownership interest in the management company or other

entity, related or unrelated, with which the applicant or

licensee contracts to manage the provider.

The term does not include a voluntary board member.

(8) "License" means any permit, registration, certificate,

or license issued by the agency.

(9) "Licensee" means an individual, corporation,

partnership, firm, association, governmental entity, or

other entity that is issued a permit, registration,

certificate, or license by the agency. The licensee is

legally responsible for all aspects of the provider

operation.

(10) "Moratorium" means a prohibition on the

acceptance of new clients.

(11) "Provider" means any activity, service, agency, or

facility regulated by the agency and listed in s. 408.802.

(12) "Services that require licensure" means those

services, including residential services, that require a

valid license before those services may be provided in

oRegSet.rpt





accordance with authorizing statutes and agency rules.

(13) "Voluntary board member" means a board member

or officer of a not-for-profit corporation or organization

who serves solely in a voluntary capacity, does not

receive any remuneration for his or her services on the

board of directors, and has no financial interest in the

corporation or organization.

59A-35.030 Definitions.

(1) "Address of record" means the location that is

printed on the license and is the address at which the

provider is licensed to operate. In the event a license

displays multiple locations including branch offices,

satellite offices, or off-site locations, the address of

record is the main or principle office address.

(2) "Agency notification" or "Agency request" means the

Agency sends notification by:

(a) Mail or personal delivery to the address of record for

a licensee or applicant,

(b) Mail to an alternative mailing address if requested by

the licensee or applicant, or

(c) Electronic mail if an electronic mail address has been

provided.

(3) "Days" means calendar days.

(4) "Management company" means an entity retained

by a licensee to administer or direct the operation of a

provider. This does not include an entity that serves

solely as a lender or lien holder.

59A-35.090 Background Screening.

(1) Definitions:

(a) "Arrest Report" means the detailed narrative written

by the arresting law enforcement officer explaining the

circumstances of the arrest.

(b) "Disposition" means the sentencing or other final

settlement of a criminal case which shall include,

oRegSet.rpt





regardless of adjudication, a plea of nolo contendere or

guilty, or a conviction by a judge or jury.

(c) "Disqualifying Offense" means any criminal offense

prohibited in Section 435.04 or 408.809(5), F.S.

(d) "Exemption from Disqualification" means an

exemption granted by the Agency following a review of

the Application for Exemption, AHCA Form 3110-0019,

May 2015, hereby incorporated by reference, and

available at

<http://www.flrules.org/Gateway/reference.asp?No=Ref-

05435>, and an informal teleconference, during which

the individual must present clear and convincing

evidence to support a reasonable belief that he or she

has been rehabilitated and does not present a danger to

the health, safety, and welfare of the patient or individual

as described in Section 435.07, F.S.

(e) "FBI" means the Federal Bureau of Investigation.

(f) "FDLE" means the Florida Department of Law

Enforcement.

(g) "Level 2 Screening" means an assessment of the

criminal history record obtained through a fingerprint

search through the FDLE and FBI to determine whether

screened individuals have any disqualifying offenses

pursuant to Section 435.04 or 408.809(5), F.S. An

analysis and review of court dispositions and arrest

reports may be required to make a final determination.

(h) "Livescan Service Provider" means an entity that

scans fingerprints electronically and submits them to

FDLE.

ST - DZ802 - License or Application Denial; Revocation

Type Rule

Statute or Rule 408.815 FS

Title License or Application Denial; Revocation


408.815 License or application denial; revocation.- The program unit is responsible for issuing notification of enforcement action for licensure actions.oRegSet.rpt





(1) In addition to the grounds provided in authorizing

statutes, grounds that may be used by the agency for

denying and revoking a license or change of ownership

application include any of the following actions by a

controlling interest:

(a) False representation of a material fact in the license

application or omission of any material fact from the

application.

(b) An intentional or negligent act materially affecting the

health or safety of a client of the provider.

(c) A violation of this part, authorizing statutes, or

applicable rules.

(d) A demonstrated pattern of deficient performance.

(e) The applicant, licensee, or controlling interest has

been or is currently excluded, suspended, or terminated

from participation in the state Medicaid program, the

Medicaid program of any other state, or the Medicare

program.

(2) If a licensee lawfully continues to operate while a

denial or revocation is pending in litigation, the licensee

must continue to meet all other requirements of this part,

authorizing statutes, and applicable rules and file

subsequent renewal applications for licensure and pay

all licensure fees. The provisions of ss. 120.60(1) and

408.806(3)(c) do not apply to renewal applications filed

during the time period in which the litigation of the denial

or revocation is pending until that litigation is final.

(3) An action under s. 408.814 or denial of the license of

the transferor may be grounds for denial of a change of

ownership application of the transferee.

(4) Unless an applicant is determined by the agency to

satisfy the provisions of subsection (5) for the action in

question, the agency shall deny an application for a

license or license renewal based upon any of the

following actions of an applicant, a controlling interest of

the applicant, or any entity in which a controlling interest

of the applicant was an owner or officer when the

oRegSet.rpt





following actions occurred:

(a) A conviction or a plea of guilty or nolo contendere to ,

regardless of adjudication, a felony under chapter 409,

chapter 817, chapter 893, 21 U.S.C. ss. 801-970, or 42

U.S.C. ss. 1395-1396, Medicaid fraud, Medicare fraud,

or insurance fraud, unless the sentence and any

subsequent period of probation for such convictions or

plea ended more than 15 years before the date of the

application; or

(b) Termination for cause from the Medicare program or

a state Medicaid program, unless the applicant has been

in good standing with the Medicare program or a state

Medicaid program for the most recent 5 years and the

termination occurred at least 20 years before the date of

the application.

ST - DZ803 - License Required; Display

Type Rule


Title License Required; Display


408.804 License required; display.-

(1) It is unlawful to provide services that require

licensure, or operate or maintain a provider that offers or

provides services that require licensure, without first

obtaining from the agency a license authorizing the

provision of such services or the operation or

maintenance of such provider.

(2) A license must be displayed in a conspicuous place

readily visible to clients who enter at the address that

appears on the license and is valid only in the hands of

the licensee to whom it is issued and may not be sold,

assigned, or otherwise transferred, voluntarily or

involuntarily. The license is valid only for the licensee,

provider, and location for which the license is issued.

(3) Any person who knowingly alters, defaces, or

- Check to see that the license is for the facility and location where it is displayed. Contact the appropriate

licensure unit if there are questions about the license.

- During tour determine if the license is displayed in a consipicuous location.

- If applicable, check to make sure the category of testing being done is reflected on the license, the

ownership given on the face of the license is accurate, that the location of the facility is the address

printed on the license, and that the license is properly displayed. Look at Z0827 Unlicensed Activity-

408.12, F.S. as unlicensed activity should be cited if there has been a change of ownership, or for clinical

laboratories, testing outside of the specialty/subspecialties printed on the license are being performed.

- Regarding Nursing Homes, refer to 400.062(2) which states:

Separate licenses shall be required for facilities maintained in separate premises, even though operated

under the same management. However, a separate license shall not be required for separate buildings

on the same grounds.

- Regarding Labs, refer to 59A-7.021(3) which states:

Separate licensure shall be required for all laboratories maintained on separate premises, as defined

under subsection 59A-7.020(27), F.A.C., including mobile laboratory units, even though operated under oRegSet.rpt





falsifies a license certificate issued by the agency, or

causes or procures any person to commit such an

offense, commits a misdemeanor of the second degree,

punishable as provided in s. 775.082 or s. 775.083. Any

licensee or provider who displays an altered, defaced, or

falsified license certificate is subject to the penalties set

forth in s. 408.815 and an administrative fine of $1,000

for each day of illegal display.

the same management. Separate licensure shall not be required for separate buildings on the same or

adjoining grounds.

ST - DZ806 - Change of Address

Type Rule

Statute or Rule 59A-35.040(2-5), FAC

Title Change of Address


(2) Any request to amend a license must be received by

the Agency in advance of the requested effective date as

detailed below. Requests to amend a license are not

authorized until the license is issued.

(a) Requests to change the address of record must be

received by the Agency 60 to 120 days in advance of the

requested effective date for the following provider types :

1. Birth Centers, as provided under Chapter 383, F.S.;

2. Abortion Clinics, as provided under Chapter 390, F.S.;

3. Crisis Stabilization Units, as provided under Parts I

and IV of Chapter 394, F.S.;

4. Short Term Residential Treatment Units, as provided

under Parts I and IV of Chapter 394, F.S.

5. Residential Treatment Facilities, as provided under

Part IV of Chapter 394, F.S.;

6. Residential Treatment Centers for Children and

Adolescents, as provided under Part IV of Chapter 394,

F.S.;

7. Hospitals, as provided under Part I of Chapter 395,

F.S.;

8. Ambulatory Surgical Centers, as provided under Part I

of Chapter 395, F.S.;

- The licensure unit handles change of address, but surveyors may find that the provider has moved and

therefore could cite this.

oRegSet.rpt





9. Nursing Homes, as provided under Part II of Chapter

400, F.S.;

10. Hospices, as provided under Part IV of Chapter 400,

F.S.;

11. Homes for Special Services as provided under Part

V of Chapter 400, F.S.;

12. Transitional Living Facilities, as provided under Part

V of Chapter 400, F.S.;

13. Prescribed Pediatric Extended Care Centers, as

provided under Part VI of Chapter 400, F.S.;

14. Intermediate Care Facilities for the Developmentally

Disabled, as provided under Part VIII of Chapter 400,

F.S.;

15. Assisted Living Facilities, as provided under Part I of

Chapter 429, F.S.;

16. Adult Family-Care Homes, as provided under Part II


17. Adult Day Care Centers, as provided under Part III of

Chapter 429, F.S.

(b) Requests to change the address of record must be

received by the Agency 21 to 120 days in advance of the

requested effective date for the following provider types :

1. Drug Free Workplace Laboratories as provided under

Sections 112.0455 and 440.102, F.S.;

2. Mobile Surgical Facilities, as provided under Part I of

Chapter 395, F.S.;

3. Health Care Risk Managers, as provided under Part I


4. Home Health Agencies, as provided under Part III of

Chapter 400, F.S.;

5. Nurse Registries, as provided under Part III of

Chapter 400, F.S.;

6. Companion Services or Homemaker Services

Providers, as provided under Part III of Chapter 400,

F.S.;

7. Home Medical Equipment Providers, as provided

under Part VII of Chapter 400, F.S.;

oRegSet.rpt





8. Health Care Services Pools, as provided under Part

IX of Chapter 400, F.S.;

9. Health Care Clinics, as provided under Part X of

Chapter 400, F.S., including certificate of exemption;

10. Clinical Laboratories, as provided under Part I of

Chapter 483, F.S.;

11. Multiphasic Health Testing Centers, as provided

under Part II of Chapter 483, F.S.;

12. Organ and Tissue Procurement Agencies, as

provided under Chapter 381, F.S.

(c) All other requests to amend a license including but

not limited to services, licensed capacity, and other

specifications which are required to be displayed on the

license by authorizing statutes or applicable rules must

be received by the Agency 60 to 120 days in advance of

the requested effective date. This deadline does not

apply to a request to amend hospital emergency

services defined in Section 395.1041(2), F.S.

(3) Failure to submit a timely request shall result in a

$500 fine.

(4) A licensee is not authorized to operate in a new

location until a license is obtained which specifies the

new location. Failure to amend a license prior to a

change of the address of record constitutes unlicensed

activity.

(5) The licensee shall return the license certificate to the

Agency upon the rendition of a final order revoking,

cancelling or denying a license, and upon the voluntary

discontinuance of operation.

ST - DZ809 - Proof of Financial Ability to Operate

Type Rule

Statute or Rule 59A-35.062(3)(e)&(7);408.803(7);408.810(

Title Proof of Financial Ability to Operate


59A-35.062(3)(e) FAC Proof of Financial Ability to - This standard would be used by surveyors if evidence of financial instability is found and the licensee or oRegSet.rpt





Operate.

"Financial instability" means the provider cannot meet its

financial obligations. Evidence such as the issuance of

bad checks, an accumulation of delinquent bills, or

inability to meet current payroll needs shall constitute

prima facie evidence that the ownership of the provider

lacks the financial ability to operate. Evidence shall also

include the Medicare or Medicaid program's indications

or determination of financial instability or fraudulent

handling of government funds by the provider.

408.803(7) FS Definitions.

"Controlling interest" means:

(a) The applicant or licensee;

(b) A person or entity that serves as an officer of, is on


ownership interest in the applicant or licensee; or

(c) A person or entity that serves as an officer of, is on


ownership interest in the management company or other

entity, related or unrelated, with which the applicant or

licensee contracts to manage the provider.

The term does not include a voluntary board member.

408.810 FS

(8) Upon application for initial licensure or change of

ownership licensure, the applicant shall furnish

satisfactory proof of the applicant's financial ability to

operate in accordance with the requirements of this part,

authorizing statutes, and applicable rules. The agency

shall establish standards for this purpose, including

information concerning the applicant's controlling

interests. The agency shall also establish documentation

requirements, to be completed by each applicant, that

show anticipated provider revenues and expenditures,

the basis for financing the anticipated cash-flow

requirements of the provider, and an applicant's access

any controlling interest in the licensee withholds information from the surveyor.

- The financial schedules and documentation of correction of the financial instability are submitted to the

AHCA Home Care Unit in the state office and reviewed by AHCA state office financial reviewers in the

Financial Analysis Unit. Further administrative action may be taken by the state office .

- This standard applies to the following provider types:

· Nursing Home Facilities, as specified in Part II, Chapter 400, F.S.;

· Assisted Living Facilities, as specified in Part I, Chapter 429, F.S.;

· Home Health Agencies, as specified in Part III, Chapter 400, F.S.;

· Hospices, as specified in Part IV, Chapter 400, F.S.;

· Adult Day Care Centers, as specified in Part III, Chapter 429, F.S.;

· Prescribed Pediatric Extended Care Centers, as specified in Part VI, Chapter 400, F.S.;

· Home Medical Equipment Providers, as specified in Part VII, Chapter 400, F.S.;

· Intermediate Care Facilities for the Developmentally Disabled, as specified in Part VIII, Chapter 400,

F.S.;

· Health Care Clinics, as specified in Part X, Chapter 400, F.S.;

- The standard applies to Nurse Registries as specified in 59A-18.004(7) which states:

- An application for renewal of a license shall not be required to provide proof of financial ability to

operate, unless the applicant has demonstrated financial instability at any time, pursuant to Section

408.810, F.S., in which case AHCA shall require the applicant for renewal to provide proof of financial

ability to operate by submitting information as described in 59A-35.062(7)(b), F.A.C. and documentation

of correction of the financial instability, to include evidence of the payment in full of any bad checks,

delinquent bills or liens and all associated fees, costs, and changes related to the instability. If complete

payment cannot be made, evidence must be submitted of partial payment along with a plan for payment

of any liens or delinquent bills. If the lien is with a government agency or repayment is ordered by a

federal, state, or district court, an accepted plan of repayment must be provided. If the licensed nurse

registry has demonstrated financial instability as outlined above at any time the AHCA will request proof of

financial ability to operate.

- None of the Hospital Unit Programs nor the Lab Unit Programs would have this requirement.

oRegSet.rpt





to contingency financing. A current certificate of

authority, pursuant to chapter 651, may be provided as

proof of financial ability to operate. The agency may

require a licensee to provide proof of financial ability to

operate at any time if there is evidence of financial

instability, including, but not limited to, unpaid expenses

necessary for the basic operations of the provider.

59A-35.062 FS

(7) An applicant for renewal of a license shall not be

required to provide proof of financial ability to operate,

unless the licensee or applicant has demonstrated

financial instability. If an applicant or licensee has shown

signs of financial instability, as provided in Section

408.810(9), F.S., at any time, the Agency may require

the applicant or licensee to provide proof of financial

ability to operate by submission of:

(a) AHCA Form 3100-0009, July 2009, Proof of Financial

Ability Form, that includes a balance sheet and income

and expense statement for the next 2 years of operation

which provide evidence of having sufficient assets,

credit, and projected revenues to cover liabilities and

expenses, and

(b) Documentation of correction of the financial

instability, including but not limited to, evidence of the

payment of any bad checks, delinquent bills or liens. If

complete payment cannot be made, evidence must be

submitted of partial payment along with a plan for

payment of any liens or delinquent bills. If the lien is with

a government agency or repayment is ordered by a

federal or state court, an accepted plan of repayment

must be provided.

ST - DZ812 - Change of Ownership

Type Rule

Statute or Rule 408.803(5); 408.807 FS

Title Change of Ownership

oRegSet.rpt






408.803(5) FS

"Change of ownership" means:

(a) An event in which the licensee sells or otherwise

transfers its ownership to a different individual or entity

as evidenced by a change in federal employer

identification number or taxpayer identification number;

or

(b) An event in which 51 percent or more of the

ownership, shares, membership, or controlling interest

of a licensee is in any manner transferred or otherwise

assigned. This paragraph does not apply to a licensee

that is publicly traded on a recognized stock exchange.

A change solely in the management company or board

of directors is not a change of ownership.

408.807 Change of ownership.-Whenever a change of

ownership occurs:

(1) The transferor shall notify the agency in writing at

least 60 days before the anticipated date of the change

of ownership.

(2) The transferee shall make application to the agency

for a license within the timeframes required in s.

408.806.

(3) The transferor shall be responsible and liable for:

(a) The lawful operation of the provider and the welfare

of the clients served until the date the transferee is

licensed by the agency.

(b) Any and all penalties imposed against the transferor

for violations occurring before the date of change of

ownership.

(4) Any restriction on licensure, including a conditional

license existing at the time of a change of ownership,

shall remain in effect until the agency determines that

the grounds for the restriction are corrected.

(5) The transferee shall maintain records of the

transferor as required in this part, authorizing statutes,

- This tag may be cited for unreported changes of ownership.

oRegSet.rpt





and applicable rules, including:

(a) All client records.

(b) Inspection reports.

(c) All records required to be maintained pursuant to s.

409.913, if applicable.

ST - DZ813 - esults of Screening & Notification In File

Type Rule

Statute or Rule 59A-35.090(3)(c), FAC

Title esults of Screening & Notification In File


59A-35.090(3) Results of Screening and Notification.

(c) The eligibility results of employee screening and the

signed Attestation referenced in subsection

59A-35.090(2), F.A.C., must be in the employee's

personnel file, maintained by the provider.

ST - DZ814 - Background Screening Clearinghouse

Type Rule

Statute or Rule 435.12(2)(b-d), FS

Title Background Screening Clearinghouse


435.12(2) Care Provider Background Screening

Clearinghouse.-

(b) Until such time as the fingerprints are enrolled in the

national retained print arrest notification program at the

Federal Bureau of Investigation, an employee with a

break in service of more than 90 days from a position

that requires screening by a specified agency must

submit to a national screening if the person returns to a

position that requires screening by a specified agency.

(c) An employer of persons subject to screening by a

Review employee files for verification that any break in service was less than 90 days or a new screening

was completed.

Verify that the facility has an updated employee roster listed in the clearinghouse .

oRegSet.rpt





specified agency must register with the clearinghouse

and maintain the employment status of all employees

within the clearinghouse. Initial employment status and

any changes in status must be reported within 10

business days.

(d) An employer must register with and initiate all

criminal history checks through the clearinghouse before

referring an employee or potential employee for

electronic fingerprint submission to the Department of

Law Enforcement. The registration must include the

employee's full first name, middle initial, and last name;

social security number; date of birth; mailing address;

sex; and race. Individuals, persons, applicants, and

controlling interests that cannot legally obtain a social

security number must provide an individual taxpayer

identification number.

ST - DZ815 - Background Screening; Prohibited Offenses

Type Rule

Statute or Rule 408.809; 435.02(2); 435.06 FS

Title Background Screening; Prohibited Offenses


408.809 Background screening; prohibited offenses.-

(1) Level 2 background screening pursuant to chapter

435 must be conducted through the agency on each of

the following persons, who are considered employees

for the purposes of conducting screening under chapter

435:

(a) The licensee, if an individual.

(b) The administrator or a similarly titled person who is

responsible for the day-to-day operation of the provider.

(c) The financial officer or similarly titled individual who is

responsible for the financial operation of the licensee or

provider.

(d) Any person who is a controlling interest if the agency

has reason to believe that such person has been

- Employees and independent contractors hired or contracted before August 1, 2010, must be screened

according to the schedule in 408.809(5), F.S. included in this standard.

- Persons already hired or under contract before August 1, 2010 would have received level 1 screening.

- Employees and contractors who do not meet the background screening requirements cannot be

retained in a direct care capacity, unless an exemption from disqualification has been approved by AHCA

or the Department of Health (when a licensed or certified health care professional or certified nursing

assistant).

- The employee or contractor with a disqualifying offense must have a copy of an exemption [granted by

either DOH or AHCA] in their personnel file before the employee or contractor can be hired.

- There is a new staggered schedule:

(a) Individuals for whom the last screening was conducted on or before December 31, 2004, must be

rescreened by July 31, 2013.

(b) Individuals for whom the last screening conducted was between January 1, 2005, and December 31,

2008, must be rescreened by July 31, 2014.oRegSet.rpt





convicted of any offense prohibited by s. 435.04. For

each controlling interest who has been convicted of any

such offense, the licensee shall submit to the agency a

description and explanation of the conviction at the time

of license application.

(e) Any person, as required by authorizing statutes,

seeking employment with a licensee or provider who is

expected to, or whose responsibilities may require him

or her to, provide personal care or services directly to

clients or have access to client funds, personal property,

or living areas; and any person, as required by

authorizing statutes, contracting with a licensee or

provider whose responsibilities require him or her to

provide personal care or personal services directly to

clients. Evidence of contractor screening may be

retained by the contractor's employer or the licensee.

(3) All fingerprints must be provided in electronic format.

Screening results shall be reviewed by the agency with

respect to the offenses specified in s. 435.04 and this

section, and the qualifying or disqualifying status of the

person named in the request shall be maintained in a

database. The qualifying or disqualifying status of the

person named in the request shall be posted on a

secure website for retrieval by the licensee or

designated agent on the licensee's behalf.

(4) In addition to the offenses listed in s. 435.04, all

persons required to undergo background screening

pursuant to this part or authorizing statutes must not

have an arrest awaiting final disposition for, must not

have been found guilty of, regardless of adjudication, or

entered a plea of nolo contendere or guilty to, and must

not have been adjudicated delinquent and the record not

have been sealed or expunged for any of the following

offenses or any similar offense of another jurisdiction :

(a) Any authorizing statutes, if the offense was a felony.

(b) This chapter, if the offense was a felony.

(c) Individuals for whom the last screening conducted was between January 1, 2009, through July 31,

2011, must be rescreened by July 31, 2015.

- An employer may hire an employee to a position that requires background screening before the

employee completes the screening process for training and orientation purposes. However, the employee

may not have direct contact with vulnerable persons until the screening process is completed and the

employee demonstrates that he or she exhibits no behaviors that warrant the denial or termination of

employment.

- Individuals may be provisionally employed in positions requiring background screening. They may be in

training or orientation, but may NOT have access to residents/patients until the background screening

process is completed.

- An employer of persons subject to screening by a specified agency must register with the clearinghouse

and maintain the employment status of all employees within the clearinghouse. Initial employment status

and any changes in status must be reported within 10 business days.

- If an individual is in the Clearinghouse and are working then they must be on that provider's employee

roster within 10 days of their hire date. The same for once a person is no longer working for that provider.

If they are in the Clearinghouse then their status in the employee roster must be updated within 10 days

of a change.

Surveyor Probes:

- Level 2 includes FDLE and FBI screening.

- Staff who do not have access to client property, funds, or living areas or who do not have contact with

clients are not required to be screened.

- If an employee or contractor's responsibility requires him or her to have contact with clients, a Level 2

background screening is required.

- Was the employee or contractor hired on or after August 1, 2010?

- Does the licensee have evidence of contractor and employee screening?

oRegSet.rpt





(c) Section 409.920, relating to Medicaid provider fraud.

(d) Section 409.9201, relating to Medicaid fraud.

(e) Section 741.28, relating to domestic violence.

(f) Section 777.04, relating to attempts, solicitation, and

conspiracy to commit an offense listed in this

subsection.

(g) Section 817.034, relating to fraudulent acts through

mail, wire, radio, electromagnetic, photoelectronic, or

photooptical systems.

(h) Section 817.234, relating to false and fraudulent

insurance claims.

(i) Section 817.481, relating to obtaining goods by using

a false or expired credit card or other credit device, if the

offense was a felony.

(j) Section 817.50, relating to fraudulently obtaining

goods or services from a health care provider.

(k) Section 817.505, relating to patient brokering.

(l) Section 817.568, relating to criminal use of personal

identification information.

(m) Section 817.60, relating to obtaining a credit card

through fraudulent means.

(n) Section 817.61, relating to fraudulent use of credit

cards, if the offense was a felony.

(o) Section 831.01, relating to forgery.

(p) Section 831.02, relating to uttering forged

instruments.

(q) Section 831.07, relating to forging bank bills, checks,

drafts, or promissory notes.

(r) Section 831.09, relating to uttering forged bank bills,

checks, drafts, or promissory notes.

(s) Section 831.30, relating to fraud in obtaining

medicinal drugs.

(t) Section 831.31, relating to the sale, manufacture,

delivery, or possession with the intent to sell,

manufacture, or deliver any counterfeit controlled

substance, if the offense was a felony.

(u) Section 895.03, relating to racketeering and

oRegSet.rpt





collection of unlawful debts.

(v) Section 896.101, relating to the Florida Money

Laundering Act.

If, upon rescreening, a person who is currently employed

or contracted with a licensee as of June 30, 2014, and

was screened and qualified under ss. 435.03 and

435.04, has a disqualifying offense that was not a

disqualifying offense at the time of the last screening,

but is a current disqualifying offense and was committed

before the last screening, he or she may apply for an

exemption from the appropriate licensing agency and, if

agreed to by the employer, may continue to perform his

or her duties until the licensing agency renders a

decision on the application for exemption if the person is

eligible to apply for an exemption and the exemption

request is received by the agency no later than 30 days

after receipt of the rescreening results by the person.

(5) A person who serves as a controlling interest of , is

employed by, or contracts with a licensee on July 31,

2010, who has been screened and qualified according to

standards specified in s. 435.03 or s. 435.04 must be

rescreened by July 31, 2015, in compliance with the

following schedule. If, upon rescreening, such person

has a disqualifying offense that was not a disqualifying

offense at the time of the last screening, but is a current

disqualifying offense and was committed before the last

screening, he or she may apply for an exemption from

the appropriate licensing agency and, if agreed to by the

employer, may continue to perform his or her duties until

the licensing agency renders a decision on the

application for exemption if the person is eligible to apply

for an exemption and the exemption request is received

by the agency within 30 days after receipt of the

rescreening results by the person. The rescreening

schedule shall be:

(a) Individuals for whom the last screening was

conducted on or before December 31, 2004, must be

oRegSet.rpt





rescreened by July 31, 2013.

(b) Individuals for whom the last screening conducted

was between January 1, 2005, and December 31, 2008,

must be rescreened by July 31, 2014.

(c) Individuals for whom the last screening conducted

was between January 1, 2009, through July 31, 2011,

must be rescreened by July 31, 2015.

(6) The costs associated with obtaining the required

screening must be borne by the licensee or the person

subject to screening. Licensees may reimburse persons

for these costs. The Department of Law Enforcement

shall charge the agency for screening pursuant to s.

943.053(3). The agency shall establish a schedule of

fees to cover the costs of screening.

(7)(a) As provided in chapter 435, the agency may grant

an exemption from disqualification to a person who is

subject to this section and who:

1. Does not have an active professional license or

certification from the Department of Health; or

2. Has an active professional license or certification from

the Department of Health but is not providing a service

within the scope of that license or certification.

(b) As provided in chapter 435, the appropriate

regulatory board within the Department of Health, or the

department itself if there is no board, may grant an

exemption from disqualification to a person who is

subject to this section and who has received a

professional license or certification from the Department

of Health or a regulatory board within that department

and that person is providing a service within the scope

of his or her licensed or certified practice.

(8) The agency and the Department of Health may adopt

rules pursuant to ss. 120.536(1) and 120.54 to

implement this section, chapter 435, and authorizing

statutes requiring background screening and to

implement and adopt criteria relating to retaining

fingerprints pursuant to s. 943.05(2).

oRegSet.rpt





(9) There is no reemployment assistance or other

monetary liability on the part of, and no cause of action

for damages arising against, an employer that, upon

notice of a disqualifying offense listed under chapter 435

or this section, terminates the person against whom the

report was issued, whether or not that person has filed

for an exemption with the Department of Health or the

agency.

435.06 Exclusion from employment.-

(1) If an employer or agency has reasonable cause to

believe that grounds exist for the denial or termination of

employment of any employee as a result of background

screening, it shall notify the employee in writing, stating

the specific record that indicates noncompliance with the

standards in this chapter. It is the responsibility of the

affected employee to contest his or her disqualification

or to request exemption from disqualification. The only

basis for contesting the disqualification is proof of

mistaken identity.

(2)(a) An employer may not hire, select, or otherwise

allow an employee to have contact with any vulnerable

person that would place the employee in a role that

requires background screening until the screening

process is completed and demonstrates the absence of

any grounds for the denial or termination of employment.

If the screening process shows any grounds for the

denial or termination of employment, the employer may

not hire, select, or otherwise allow the employee to have

contact with any vulnerable person that would place the

employee in a role that requires background screening

unless the employee is granted an exemption for the

disqualification by the agency as provided under s.

435.07.

(b) If an employer becomes aware that an employee has

been arrested for a disqualifying offense, the employer

must remove the employee from contact with any

oRegSet.rpt





vulnerable person that places the employee in a role that

requires background screening until the arrest is

resolved in a way that the employer determines that the

employee is still eligible for employment under this

chapter.

(c) The employer must terminate the employment of any

of its personnel found to be in noncompliance with the

minimum standards of this chapter or place the

employee in a position for which background screening

is not required unless the employee is granted an

exemption from disqualification pursuant to s. 435.07.

(d) An employer may hire an employee to a position that

requires background screening before the employee

completes the screening process for training and

orientation purposes. However, the employee may not

have direct contact with vulnerable persons until the

screening process is completed and the employee

demonstrates that he or she exhibits no behaviors that

warrant the denial or termination of employment.

(3) Any employee who refuses to cooperate in such

screening or refuses to timely submit the information

necessary to complete the screening, including

fingerprints if required, must be disqualified for

employment in such position or, if employed, must be

dismissed.

(4) There is no reemployment assistance or other

monetary liability on the part of, and no cause of action

for damages against, an employer that, upon notice of a

conviction or arrest for a disqualifying offense listed

under this chapter, terminates the person against whom

the report was issued or who was arrested, regardless

of whether or not that person has filed for an exemption

pursuant to this chapter.

435.02 Definitions.-For the purposes of this chapter, the

term:

(2) "Employee" means any person required by law to be

oRegSet.rpt





screened pursuant to this chapter, including, but not

limited to, persons who are contractors, licensees, or

volunteers.

ST - DZ816 - Background Screening-Compliance Attestation

Type Rule

Statute or Rule 408.809(2)(a-c) FS

Title Background Screening-Compliance Attestation


(2) Every 5 years following his or her licensure,

employment, or entry into a contract in a capacity that

under subsection (1) would require level 2 background

screening under chapter 435, each such person must

submit to level 2 background rescreening as a condition

of retaining such license or continuing in such

employment or contractual status. For any such

rescreening, the agency shall request the Department of

Law Enforcement to forward the person's fingerprints to

the Federal Bureau of Investigation for a national

criminal history record check unless the person's

fingerprints are enrolled in the Federal Bureau of

Investigation ' s national retained print arrest notification

program. If the fingerprints of such a person are not

retained by the Department of Law Enforcement under

s. 943.05(2)(g) and (h), the person must submit

fingerprints electronically to the Department of Law

Enforcement for state processing, and the Department

of Law Enforcement shall forward the fingerprints to the

Federal Bureau of Investigation for a national criminal

history record check. The fingerprints shall be retained

by the Department of Law Enforcement under s.

943.05(2)(g) and (h) and enrolled in the national retained

print arrest notification program when the Department of

Law Enforcement begins participation in the program.

The cost of the state and national criminal history

records checks required by level 2 screening may be

- Is AHCA Recommended Form 3100-0008, September 2013, Affidavit of Compliance with Background

Screening Requirements, in the employee's personnel file?

- Or, does the employee have a similar document attesting under penalty of perjury that they are in

compliance with Chapter 435, F.S.

oRegSet.rpt





borne by the licensee or the person fingerprinted. Until a

specified agency is fully implemented in the

clearinghouse created under s. 435.12, the agency may

accept as satisfying the requirements of this section

proof of compliance with level 2 screening standards

submitted within the previous 5 years to meet any

provider or professional licensure requirements of the

agency, the Department of Health, the Department of

Elderly Affairs, the Agency for Persons with Disabilities,

the Department of Children and Families, or the

Department of Financial Services for an applicant for a

certificate of authority or provisional certificate of

authority to operate a continuing care retirement

community under chapter 651, provided that:

(a) The screening standards and disqualifying offenses

for the prior screening are equivalent to those specified

in s. 435.04 and this section;

(b) The person subject to screening has not had a break

in service from a position that requires level 2 screening

for more than 90 days; and

(c) Such proof is accompanied, under penalty of perjury,

by an attestation of compliance with chapter 435 and

this section using forms provided by the agency.

ST - DZ817 - Minimum Licensure Requirement - Inform AHCA

Type Rule

Statute or Rule 408.810(3-4) FS; 59A-35.100(1) FAC

Title Minimum Licensure Requirement - Inform AHCA


408.810 Minimum licensure requirements.-In addition to

the licensure requirements specified in this part,

authorizing statutes, and applicable rules, each applicant

and licensee must comply with the requirements of this

section in order to obtain and maintain a license.

(3) Unless otherwise specified in this part, authorizing

- Refer to s.408.820, F.S. regarding the Exemptions for this regulation.

- Regarding Nursing Homes, note that the closing of a nursing facility (408.810(4)(a)) must comply with

400.18(1), F.S. instead which states:

(1) Whenever a licensee voluntarily discontinues operation, and during the period when it is preparing for

such discontinuance, it shall inform the agency not less than 90 days prior to the discontinuance of

operation. The licensee also shall inform the resident or the next of kin, legal representative, or agency

acting on behalf of the resident of the fact, and the proposed time, of such discontinuance and give at oRegSet.rpt





statutes, or applicable rules, any information required to

be reported to the agency must be submitted within 21

calendar days after the report period or effective date of

the information, whichever is earlier, including, but not

limited to, any change of:

(a) Information contained in the most recent application

for licensure.

(b) Required insurance or bonds.

(4) Whenever a licensee discontinues operation of a

provider:

(a) The licensee must inform the agency not less than

30 days prior to the discontinuance of operation and

inform clients of such discontinuance as required by

authorizing statutes. Immediately upon discontinuance

of operation by a provider, the licensee shall surrender

the license to the agency and the license shall be

canceled.

(b) The licensee shall remain responsible for retaining

and appropriately distributing all records within the

timeframes prescribed in authorizing statutes and

applicable rules. In addition, the licensee or, in the event

of death or dissolution of a licensee, the estate or agent

of the licensee shall:

1. Make arrangements to forward records for each client

to one of the following, based upon the client's choice:

the client or the client's legal representative, the client's

attending physician, or the health care provider where

the client currently receives services; or

2. Cause a notice to be published in the newspaper of

greatest general circulation in the county in which the

provider was located that advises clients of the

discontinuance of the provider operation. The notice

must inform clients that they may obtain copies of their

records and specify the name, address, and telephone

number of the person from whom the copies of records

may be obtained. The notice must appear at least once

a week for 4 consecutive weeks.

least 90 days' notice so that suitable arrangements may be made for the transfer and care of the resident.

In the event any resident has no such person to represent him or her, the licensee shall be responsible

for securing a suitable transfer of the resident before the discontinuance of operation. The agency shall

be responsible for arranging for the transfer of those residents requiring transfer who are receiving

assistance under the Medicaid program.

oRegSet.rpt





59A-35.100 Minimum Licensure Requirements.

Provider location. A licensee must maintain proper

authority for operation of the provider at the address of

record. If such authority is denied, revoked or otherwise

terminated by the local zoning or code enforcement

authority, the Agency may deny or revoke an application

or license, or impose sanctions.

ST - DZ818 - Minimum Licensure Requirement - Client Notice

Type Rule

Statute or Rule 408.810(5) FS

Title Minimum Licensure Requirement - Client Notice


408.810 Minimum licensure requirements.

In addition to the licensure requirements specified in this

part, authorizing statutes, and applicable rules, each

applicant and licensee must comply with the

requirements of this section in order to obtain and

maintain a license.

(5)(a) On or before the first day services are provided to

a client, a licensee must inform the client and his or her

immediate family or representative, if appropriate, of the

right to report:

1. Complaints. The statewide toll-free telephone number

for reporting complaints to the agency must be provided

to clients in a manner that is clearly legible and must

include the words: "To report a complaint regarding the

services you receive, please call toll-free (phone

number)."

2. Abusive, neglectful, or exploitative practices. The

statewide toll-free telephone number for the central

abuse hotline must be provided to clients in a manner

that is clearly legible and must include the words: "To

report abuse, neglect, or exploitation, please call toll-free

During observation, interview and record review determine if client, immediate family or representative

have been informed of the right to report.


oRegSet.rpt





(phone number)."

3. Medicaid fraud. An agency-written description of

Medicaid fraud and the statewide toll-free telephone

number for the central Medicaid fraud hotline must be

provided to clients in a manner that is clearly legible and

must include the words: "To report suspected Medicaid

fraud, please call toll-free (phone number)."

The agency shall publish a minimum of a 90-day

advance notice of a change in the toll-free telephone

numbers.

(b) Each licensee shall establish appropriate policies

and procedures for providing such notice to clients.

ST - DZ819 - Minimum Licensure Req - Financial Viability

Type Rule


Title Minimum Licensure Req - Financial Viability


408.810 FS

(9) A controlling interest may not withhold from the

agency any evidence of financial instability, including,

but not limited to, checks returned due to insufficient

funds, delinquent accounts, nonpayment of withholding

taxes, unpaid utility expenses, nonpayment for essential

services, or adverse court action concerning the

financial viability of the provider or any other provider

licensed under this part that is under the control of the

controlling interest. A controlling interest shall notify the

agency within 10 days after a court action to initiate

bankruptcy, foreclosure, or eviction proceedings

concerning the provider in which the controlling interest

is a petitioner or defendant. Any person who violates this

subsection commits a misdemeanor of the second

degree, punishable as provided in s. 775.082 or s.

775.083. Each day of continuing violation is a separate

offense.


oRegSet.rpt





ST - DZ821 - Reporting Requirements; Electronic Submission

Type Rule

Statute or Rule 59A-35.110 FAC

Title Reporting Requirements; Electronic Submission


59A-35.110 Reporting Requirements; Electronic

Submission.

(1) During the two year licensure period, any change or

expiration of any information that is required to be

reported under Chapter 408, Part II, F.S., or authorizing

statutes for the provider type as specified in Section

408.803(3), F.S., during the license application process

must be reported to the Agency within 21 days of

occurrence of the change, including:

(a) Insurance coverage renewal,

(b) Bond renewal,

(c) Change of administrator or the similarly titled person

who is responsible for the day-to-day operation of the

provider,

(d) Annual sanitation inspections,

(e) Fire inspections,

(f) Approval of revisions to emergency management

plans.

(2) Electronic submission of information.

(a) The following required information must be reported

through the Agency's Internet site at

http://www.ahca.myflorida.com/reporting/index.shtml:

1. Nursing homes:

a. Semi-annual staffing ratios required pursuant to

Section 400.141(1)(o), F.S. and Rule 59A-4.103, F.A.C.

b. Adverse incident reports required pursuant to

Sections 400.147(7) and (8), F.S. and Rule 59A-4.123,

F.A.C.

c. Liability claim reports required pursuant to Section

400.147(10), F.S. and Rule 59A-4.123, F.A.C.

- Regarding 59A-35.110(1)(f), this does not apply to Home Care Unit programs since there is a different

process through the Department of Health in chapter 400 Part III & IV, F.S.

- Regarding 59A-35.110(2), this only applies to nursing homes and assisted living facilities.

oRegSet.rpt





2. Assisted living facilities:

a. Adverse incident reports required pursuant to

Sections 429.23(3) and (4), F.S. and Rule 58A-5.0241,

F.A.C.

b. Liability claim reports required pursuant to Section

429.23(5), F.S. and Rule 58A-5.0242, F.A.C.

(b) The licensee must retain the receipt issued from the

Internet site indicating that their transaction was

accepted.

(c) If the Agency's Internet site is temporarily out of

service, the required reports may be submitted by mail

or facsimile as follows:

1. Semi-annual staffing ratios and liability claim reports

are sent to the Agency for Health Care Administration,

Central Systems Management Unit, 2727 Mahan Drive,

MS #47, Tallahassee, FL 32308 or facsimile to (850)

487-0470.

2. Adverse incident reports are sent to the Agency for

Health Care Administration, Florida Center for Health

Information and Policy Analysis, 2727 Mahan Drive, MS

#16, Tallahassee, FL 32308 or facsimile to (850)

922-2217.

ST - DZ824 - Right of Inspection; Inspection Reports

Type Rule

Statute or Rule 408.811 FS; 59A-35.120 FAC

Title Right of Inspection; Inspection Reports


408.811 Right of inspection; copies; inspection reports;

plan for correction of deficiencies.- (1) An authorized

officer or employee of the agency may make or cause to

be made any inspection or investigation deemed

necessary by the agency to determine the state of

compliance with this part, authorizing statutes, and

applicable rules. The right of inspection extends to any

business that the agency has reason to believe is being oRegSet.rpt





operated as a provider without a license, but inspection

of any business suspected of being operated without the

appropriate license may not be made without the

permission of the owner or person in charge unless a

warrant is first obtained from a circuit court. Any

application for a license issued under this part,

authorizing statutes, or applicable rules constitutes

permission for an appropriate inspection to verify the

information submitted on or in connection with the

application. (a) All inspections shall be unannounced,

except as specified in s. 408.806. (b) Inspections for

relicensure shall be conducted biennially unless

otherwise specified by authorizing statutes or applicable

rules. (2) Inspections conducted in conjunction with

certification, comparable licensure requirements, or a

recognized or approved accreditation organization may

be accepted in lieu of a complete licensure inspection.

However, a licensure inspection may also be conducted

to review any licensure requirements that are not also

requirements for certification. (3) The agency shall have

access to and the licensee shall provide, or if requested

send, copies of all provider records required during an

inspection or other review at no cost to the agency,

including records requested during an offsite review. (4)

A deficiency must be corrected within 30 calendar days

after the provider is notified of inspection results unless

an alternative timeframe is required or approved by the

agency. (5) The agency may require an applicant or

licensee to submit a plan of correction for deficiencies. If

required, the plan of correction must be filed with the

agency within 10 calendar days after notification unless

an alternative timeframe is required. (6)(a) Each

licensee shall maintain as public information, available

upon request, records of all inspection reports pertaining

to that provider that have been filed by the agency

unless those reports are exempt from or contain

information that is exempt from s. 119.07(1) and s.

oRegSet.rpt





24(a), Art. I of the State Constitution or is otherwise

made confidential by law. Effective October 1, 2006,

copies of such reports shall be retained in the records of

the provider for at least 3 years following the date the

reports are filed and issued, regardless of a change of

ownership. (b) A licensee shall, upon the request of any

person who has completed a written application with

intent to be admitted by such provider, any person who

is a client of such provider, or any relative, spouse, or

guardian of any such person, furnish to the requester a

copy of the last inspection report pertaining to the

licensed provider that was issued by the agency or by an

accrediting organization if such report is used in lieu of a

licensure inspection. 59A-35.120 Inspections. (1)

When regulatory violations are identified by the Agency:

(a) Deficiencies must be corrected within 30 days of the

date the Agency sends the deficiency notice to the

provider, unless an alternative timeframe is required or

approved by the Agency. (b) The Agency may conduct

an unannounced follow-up inspection or off-site review

to verify correction of deficiencies at any time. (2) If an

inspection is completed through off-site record review,

any records requested by the Agency in conjunction with

the review, must be received within 7 days of request

and provided at no cost to the Agency. Each licensee

shall maintain the records including medical and

treatment records of a client and provide access to the

Agency. (3) Providers that are exempt from Agency

inspections due to accreditation oversight as prescribed

in authorizing statutes must provide: (a) Documentation

from the accrediting agency including the name of the

accrediting agency, the beginning and expiration dates

of the provider's accreditation, accreditation status and

type must be submitted at the time of license

application, or within 21 days of accreditation. (b)

Documentation of each accreditation inspection

including the accreditation organization's report of

oRegSet.rpt





findings, the provider's response and the final

determination must be submitted within 21 days of final

determination or the provider is no longer exempt from

Agency inspection.

ST - DZ827 - Unlicensed Activity

Type Rule


Title Unlicensed Activity


408.812 Unlicensed activity.-

(1) A person or entity may not offer or advertise services

that require licensure as defined by this part, authorizing

statutes, or applicable rules to the public without

obtaining a valid license from the agency. A

licenseholder may not advertise or hold out to the public

that he or she holds a license for other than that for

which he or she actually holds the license.

(2) The operation or maintenance of an unlicensed

provider or the performance of any services that require

licensure without proper licensure is a violation of this

part and authorizing statutes. Unlicensed activity

constitutes harm that materially affects the health,

safety, and welfare of clients. The agency or any state

attorney may, in addition to other remedies provided in

this part, bring an action for an injunction to restrain

such violation, or to enjoin the future operation or

maintenance of the unlicensed provider or the

performance of any services in violation of this part and

authorizing statutes, until compliance with this part,

authorizing statutes, and agency rules has been

demonstrated to the satisfaction of the agency.

(3) It is unlawful for any person or entity to own, operate,

or maintain an unlicensed provider. If after receiving

notification from the agency, such person or entity fails

to cease operation and apply for a license under this

- This tag can be cited in conjunction with Z0803 License Required; Display,- 408.804 F.S.

- License required when the provider is offering services not authorized and printed on the face of the

license, when the licensed owner is not operating and it is being operated by another entity that is not

licensed to operate.

- It may also be cited if the Agency has notified the provider to cease unlicensed activity and the provider

continues to operate.

oRegSet.rpt





part and authorizing statutes, the person or entity shall

be subject to penalties as prescribed by authorizing

statutes and applicable rules. Each day of continued

operation is a separate offense.

(4) Any person or entity that fails to cease operation

after agency notification may be fined $1,000 for each

day of noncompliance.

(5) When a controlling interest or licensee has an

interest in more than one provider and fails to license a

provider rendering services that require licensure, the

agency may revoke all licenses and impose actions

under s. 408.814 and a fine of $1,000 per day, unless

otherwise specified by authorizing statutes, against each

licensee until such time as the appropriate license is

obtained for the unlicensed operation.

(6) In addition to granting injunctive relief pursuant to

subsection (2), if the agency determines that a person or

entity is operating or maintaining a provider without

obtaining a license and determines that a condition

exists that poses a threat to the health, safety, or welfare

of a client of the provider, the person or entity is subject

to the same actions and fines imposed against a

licensee as specified in this part, authorizing statutes,

and agency rules.

(7) Any person aware of the operation of an unlicensed

provider must report that provider to the agency.

ST - DZ828 - Administrative Fines; Violations

Type Rule


Title Administrative Fines; Violations


(3) The agency may impose an administrative fine for a

violation that is not designated as a class I, class II,

class III, or class IV violation. Unless otherwise specified

by law, the amount of the fine may not exceed $500 for

The Central Office program unit is responsible for preparation of requests for sanctions for licensure

actions.

oRegSet.rpt





each violation. Unclassified violations include:

(a) Violating any term or condition of a license.

(b) Violating any provision of this part, authorizing

statutes, or applicable rules.

(c) Exceeding licensed capacity.

(d) Providing services beyond the scope of the license.

(e) Violating a moratorium imposed pursuant to s.

408.814.

ST - DZ829 - Moratorium; Emergency Suspension

Type Rule


Title Moratorium; Emergency Suspension


408.814 Moratorium; emergency suspension.-

(1) The agency may impose an immediate moratorium

or emergency suspension as defined in s. 120.60 on any

provider if the agency determines that any condition

related to the provider or licensee presents a threat to

the health, safety, or welfare of a client.

(2) A provider or licensee, the license of which is denied

or revoked, may be subject to immediate imposition of a

moratorium or emergency suspension to run

concurrently with licensure denial, revocation, or

injunction.

(3) A moratorium or emergency suspension remains in

effect after a change of ownership, unless the agency

has determined that the conditions that created the

moratorium, emergency suspension, or denial of

licensure have been corrected.

(4) When a moratorium or emergency suspension is

placed on a provider or licensee, notice of the action

shall be posted and visible to the public at the location of

the provider until the action is lifted.

Determine through observations if the facility has posted the moratorium visible to the public.

ST - DZ830 - Emergency Management Planning

oRegSet.rpt





Type Rule


Title Emergency Management Planning


408.821 Emergency management planning; emergency

operations; inactive license.-

(1) A licensee required by authorizing statutes to have

an emergency operations plan must designate a safety

liaison to serve as the primary contact for emergency

operations.

(2) An entity subject to this part may temporarily exceed

its licensed capacity to act as a receiving provider in

accordance with an approved emergency operations

plan for up to 15 days. While in an overcapacity status,

each provider must furnish or arrange for appropriate

care and services to all clients. In addition, the agency

may approve requests for overcapacity in excess of 15

days, which approvals may be based upon satisfactory

justification and need as provided by the receiving and

sending providers.

(3)(a) An inactive license may be issued to a licensee

subject to this section when the provider is located in a

geographic area in which a state of emergency was

declared by the Governor if the provider:

1. Suffered damage to its operation during the state of

emergency.

2. Is currently licensed.

3. Does not have a provisional license.

4. Will be temporarily unable to provide services but is

reasonably expected to resume services within 12

months.

(b) An inactive license may be issued for a period not to

exceed 12 months but may be renewed by the agency

for up to 12 additional months upon demonstration to the

agency of progress toward reopening. A request by a

licensee for an inactive license or to extend the

- Four of the Home Care programs have major state laws that have extensive emergency management

requirements - home health agencies, hospices, nurse registries and home medical equipment providers

- and their associated regulation sets have specific standards.

oRegSet.rpt





previously approved inactive period must be submitted

in writing to the agency, accompanied by written

justification for the inactive license, which states the

beginning and ending dates of inactivity and includes a

plan for the transfer of any clients to other providers and

appropriate licensure fees. Upon agency approval, the

licensee shall notify clients of any necessary discharge

or transfer as required by authorizing statutes or

applicable rules. The beginning of the inactive licensure

period shall be the date the provider ceases operations.

The end of the inactive period shall become the license

expiration date, and all licensure fees must be current,

must be paid in full, and may be prorated. Reactivation

of an inactive license requires the prior approval by the

agency of a renewal application, including payment of

licensure fees and agency inspections indicating

compliance with all requirements of this part and

applicable rules and statutes.

(4) The agency may adopt rules relating to emergency

management planning, communications, and

operations. Licensees providing residential or inpatient

services must utilize an online database approved by the

agency to report information to the agency regarding the

provider's emergency status, planning, or operations.

oRegSet.rpt

Documents

Agency for Health Care Administration - Floridab.ahca.myflorida.com/MCHQ/Health_Facility... · Agency for Health Care Administration ASPEN: ... The requirements of part II of chapter