At the time of inspection, a continuing care facility or retirement community that uses this option must demonstrate through staffing records that minimum staffing requirements for the facility were met. Licensed nurses and certified nursing assistants who work in the facility may be used to provide services elsewhere on campus if the facility exceeds the minimum number of direct care hours required per resident per day and the total number of residents receiving direct care services from a licensed nurse or a certified nursing assistant does not cause the facility to violate the staffing ratios required under s.
Compliance with the minimum staffing ratios must be based on the total number of residents receiving direct care services, regardless of where they reside on campus. If the facility receives a conditional license, it may not share staff until the conditional license status ends. The agency may adopt rules for the documentation necessary to determine compliance with this provision. In making rules to implement this paragraph, the agency shall be guided by standards recommended by nationally recognized professional groups and associations with knowledge of dietetics. The records must be open to agency inspection.
The licensee shall maintain clinical records on each resident in accordance with accepted professional standards and practices, which must be complete, accurately documented, readily accessible, and systematically organized. Such information contained in the records may include, but is not limited to, disciplinary matters and any reason for termination. Any facility releasing such records pursuant to this part shall be considered to be acting in good faith and may not be held liable for information contained in such records, absent a showing that the facility maliciously falsified such records.
A facility that has failed to comply with state minimum-staffing requirements for 2 consecutive days is prohibited from accepting new admissions until the facility has achieved the minimum-staffing requirements for 6 consecutive days. For the purposes of this subparagraph, any person who was a resident of the facility and was absent from the facility for the purpose of receiving medical care at a separate location or was on a leave of absence is not considered a new admission.
A facility that does not have a conditional license may be cited for failure to comply with the standards in s. A facility that has a conditional license must be in compliance with the standards in s. The notification must occur within 30 days after the acknowledgment of such signs by facility staff. If an underlying condition is determined to exist, the facility shall, with the appropriate health care provider, arrange for the necessary care and services to treat the condition.
A licensed nurse, licensed speech or occupational therapist, or a registered dietitian must conduct training of dining and hospitality attendants. A person employed by a facility as a dining and hospitality attendant must perform tasks under the direct supervision of a licensed nurse.
In lieu of such coverage, a state-designated teaching nursing home and its affiliated assisted living facilities created under s. The certified nursing assistant who is caring for the resident must complete this record by the end of his or her shift. This record must indicate assistance with activities of daily living, assistance with eating, and assistance with drinking, and must record each offering of nutrition and hydration for those residents whose plan of care or assessment indicates a risk for malnutrition or dehydration. Subject to these exemptions, any consenting person who becomes a resident of the facility after November 30 but before March 31 of the following year must be immunized within 5 working days after becoming a resident.
Immunization shall not be provided to any resident who provides documentation that he or she has been immunized as required by this paragraph. This paragraph does not prohibit a resident from receiving the immunization from his or her personal physician if he or she so chooses. A resident who chooses to receive the immunization from his or her personal physician shall provide proof of immunization to the facility. The agency may adopt and enforce any rules necessary to comply with or implement this paragraph.
If indicated, the resident shall be vaccinated or revaccinated within 60 days after admission in accordance with the recommendations of the United States Centers for Disease Control and Prevention, subject to exemptions for medical contraindications and religious or personal beliefs. Immunization may not be provided to a resident who provides documentation that he or she has been immunized as required by this paragraph.
A resident may elect to receive the immunization from his or her personal physician and, if such election is made, the resident shall provide proof of the immunization to the facility. Facility staff and facilities are not subject to criminal prosecution or civil liability, or considered to have engaged in negligent or unprofessional conduct, for withholding or withdrawing cardiopulmonary resuscitation pursuant to such order.
The absence of an order not to resuscitate executed pursuant to s. Such records must include any medical records and records concerning the care and treatment of the resident performed by the facility, except for progress notes and consultation report sections of a psychiatric nature. The facility shall provide the requested records within 14 working days after receipt of a request relating to a current resident or within 30 working days after receipt of a request relating to a former resident.
A surviving spouse. If there is no surviving spouse, a surviving child of the resident. If there is no surviving spouse or child, a parent of the resident. The facility shall allow a person who is authorized to act on behalf of the resident to examine the original records, microfilms, or other suitable reproductions of the records in its possession upon any reasonable terms imposed by the facility to ensure that the records are not damaged, destroyed, or altered.
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The risk management and quality assurance committee shall meet at least monthly. Such education and training of all nonphysician personnel must be part of their initial orientation; and. At least 1 hour of such education and training must be provided annually for all nonphysician personnel of the licensed facility working in clinical areas and providing resident care. The risk manager shall have free access to all resident records of the licensed facility.
The incident reports are part of the workpapers of the attorney defending the licensed facility in litigation relating to the licensed facility and are subject to discovery, but are not admissible as evidence in court. A person filing an incident report is not subject to civil suit by virtue of such incident report. As a part of each internal risk management and quality assurance program, the incident reports shall be used to develop categories of incidents which identify problem areas.
Once identified, procedures shall be adjusted to correct the problem areas. Brain or spinal damage;. Permanent disfigurement;. Fracture or dislocation of bones or joints;. A limitation of neurological, physical, or sensory function;. Any condition that required medical attention to which the resident has not given his or her informed consent, including failure to honor advanced directives;.
An event that is reported to law enforcement or its personnel for investigation; or. The facility must complete the investigation and submit a report to the agency within 15 calendar days after the adverse incident occurred. The agency shall develop a form for the report which must include the name of the risk manager, information regarding the identity of the affected resident, the type of adverse incident, the initiation of an investigation by the facility, and whether the events causing or resulting in the adverse incident represent a potential risk to any other resident.
The report is confidential as provided by law and is not discoverable or admissible in any civil or administrative action, except in disciplinary proceedings by the agency or the appropriate regulatory board. The agency may investigate, as it deems appropriate, any such incident and prescribe measures that must or may be taken in response to the incident. The agency shall review each report and determine whether it potentially involved conduct by the health care professional who is subject to disciplinary action, in which case the provisions of s. This subsection does not limit discovery of, access to, or use of facility records, including those records from which the credentialing organization gathered its information.
These programs have maintained the highest practicable level of good health and have the potential to reduce the incidence of preventable illnesses among long-stay residents of nursing homes, thereby increasing the quality of care for residents and reducing the number of lawsuits against nursing homes. Such models are operated at no cost to the state.
It is the intent of the Legislature that the Agency for Health Care Administration replicate such oversight for Medicaid recipients in poor-performing nursing homes and in assisted living facilities and nursing homes that are experiencing disproportionate numbers of lawsuits, with the goal of improving the quality of care in such homes or facilitating the revocation of licensure. The agency and the Office of Public and Professional Guardians shall give such residents priority for publicly funded guardianship services.
Each party to the contract is entitled to a duplicate original thereof, printed in boldfaced type, and the licensee shall keep on file all contracts which it has with residents. The licensee may not destroy or otherwise dispose of any such contract until 5 years after its expiration or such longer period as may be provided in the rules of the agency. Microfilmed records or records reproduced by a similar process of duplication may be kept in lieu of the original records.
The licensee shall attach to the contract a list of services and supplies available but not covered by the per diem rate of the facility or by Titles XVIII and XIX of the Social Security Act and the standard charge to the resident for each item. The licensee shall provide written notification to each party to the contract of any changes in any attachment thereto, no fewer than 14 days in advance of the effective date of those changes.
The agency shall specify by rule an alternative method for notification of changes in the cost of supplies. If the resident is a party to the contract, the licensee shall provide him or her with a written and oral notification of the changes.
Whenever necessary for the protection of valuables, or in order to avoid unreasonable responsibility therefor, the licensee may require that such valuables be excluded or removed from the facility and kept at some place not subject to the control of the licensee. The facility shall develop policies and procedures to minimize the risk of theft or loss of the personal property of residents.
Funds held in trust shall be kept separate from the funds and property of the facility; shall be deposited in a bank, savings association, trust company, or credit union located in this state and, if possible, located in the same district in which the facility is located; shall not be represented as part of the assets of the facility on a financial statement; and shall be used or otherwise expended only for the account of the resident. The bond shall be executed by the licensee as principal and by a surety company authorized and licensed to do business in the state as surety.
The bond shall be conditioned upon the faithful compliance of the licensee with the provisions of this section and shall run to the agency for the benefit of any resident injured by the violation by the licensee of the provisions of this section. Such bond or certificate shall be filed with the agency as provided in subparagraph 1. Any surety company which cancels or does not renew the bond of any licensee shall notify the agency, in writing, not less than 30 days in advance of such action, giving the reason for the cancellation or nonrenewal.
Funds contained in the pool shall run to any resident suffering financial loss as a result of the violation by the licensee of the provisions of this section. The agency shall promulgate rules with regard to the establishment, organization, and operation of such self-insurance pools. Such rules shall include, but shall not be limited to, requirements for monetary reserves to be maintained by such self-insurers to assure their financial solvency.
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Copies of the application, along with written documentation of related correspondence with an insurance agency or group, shall be maintained by the licensee for review by the agency and the State Long-Term Care Ombudsman Program. In any event, the licensee shall furnish such a statement annually and upon the discharge or transfer of a resident.
Any governmental agency or private charitable agency contributing funds or other property on account of a resident also shall be entitled to receive such statement annually and upon discharge or transfer and such other report as it may require pursuant to law. In the event the resident has no spouse or adult next of kin or such person cannot be located, funds due to the resident shall be placed in an interest-bearing account in a bank, savings association, trust company, or credit union located in this state and, if possible, located within the same district in which the facility is located, which funds shall not be represented as part of the assets of the facility on a financial statement, and the licensee shall maintain such account until such time as the trust funds are disbursed pursuant to the provisions of the Florida Probate Code.
In the event the resident has no spouse or adult next of kin or such person cannot be located, property being held in trust shall be safeguarded until such time as the property is disbursed pursuant to the provisions of the Florida Probate Code. The trust funds and property of deceased residents shall be kept separate from the funds and the property of the licensee and from the funds and property of the residents of the facility. In the event the trust funds of the deceased resident are not disbursed pursuant to the provisions of the Florida Probate Code within 2 years of the death of the resident, the trust funds shall be deposited in the Health Care Trust Fund and expended as provided for in s.
Any other property of a deceased resident held in trust by a licensee which is not disbursed in accordance with the provisions of the Florida Probate Code shall escheat to the state as provided by law. The initial billing shall contain a statement of specific services received and expenses incurred for such items of service, enumerating in detail the constituent components of the services received within each department of the nursing home and including unit price data on rates charged by the nursing home as may be prescribed by the agency.
The person receiving a statement pursuant to this section shall be fully and accurately informed as to each charge and service provided by the institution preparing the statement. The amount of the service or handling charge, if any, shall be set forth clearly in the bill to the resident. However, this may not be construed to prohibit the offer or receipt of contributions or donations to a nursing home which are not related to the care of a specific resident. Contributions solicited or received in violation of this subsection shall be grounds for denial, suspension, or revocation of a license for any nursing home on behalf of which such contributions were solicited.
The nursing or physician assessments may take the place of all other assessments required for full-time residents. If multiple admissions for a single person for respite care are anticipated, the original contract is valid for 1 year after the date the contract is executed. Funds or property of the resident are not to be considered trust funds subject to the requirements of s. However, each single stay may not exceed 14 days. If a stay exceeds 14 consecutive days, the facility must comply with all assessment and care planning requirements applicable to nursing home residents. To ensure continuity of care and services, the resident may retain his or her personal physician and shall have access to medically necessary services such as physical therapy, occupational therapy, or speech therapy, as needed.
The facility shall arrange for transportation of the resident to these services, if necessary. This training must include, but is not limited to, an overview of dementias and must provide basic skills in communicating with persons with dementia. The department must approve training offered in a variety of formats, including, but not limited to, Internet-based training, videos, teleconferencing, and classroom instruction.
The department shall keep a list of current providers who are approved to provide initial and continuing training. The department shall adopt rules to establish standards for the trainers and the training required in this section. The certificate is evidence of completion of training in the identified topic, and the employee or direct caregiver is not required to repeat training in that topic if the employee or direct caregiver changes employment to a different facility or to an assisted living facility, home health agency, adult day care center, or adult family-care home. The direct caregiver must comply with other applicable continuing education requirements.
Such liability shall continue in succession until the debt is ultimately paid or otherwise resolved. It shall be the burden of the transferee to determine the amount of all such readily identifiable overpayments from the Agency for Health Care Administration, and the agency shall cooperate in every way with the identification of such amounts. Readily identifiable overpayments shall include overpayments that will result from, but not be limited to: 1. Medicaid rate changes or adjustments;. Any depreciation recapture;. Any recapture of fair rental value system indexing; or.
Audits completed by the agency. A leasehold licensee may meet the requirements of subparagraph 1. If a preceding month average is not available, projected Medicaid payments may be used. The fee shall be deposited into the Grants and Donations Trust Fund and shall be accounted for separately as a Medicaid nursing home overpayment account. These fees shall be used at the sole discretion of the agency to repay nursing home Medicaid overpayments or for enhanced payments to nursing facilities as specified in the General Appropriations Act or other law. Payment of this fee shall not release the licensee from any liability for any Medicaid overpayments, nor shall payment bar the agency from seeking to recoup overpayments from the licensee and any other liable party.
As a condition of exercising this lease bond alternative, licensees paying this fee must maintain an existing lease bond through the end of the month term period of that bond. The agency is herein granted specific authority to promulgate all rules pertaining to the administration and management of this account, including withdrawals from the account, subject to federal review and approval.
This provision shall take effect upon becoming law and shall apply to any leasehold license application. The financial viability of the Medicaid nursing home overpayment account shall be determined by the agency through annual review of the account balance and the amount of total outstanding, unpaid Medicaid overpayments owing from leasehold licensees to the agency as determined by final agency audits.
By March 31 of each year, the agency shall assess the cumulative fees collected under this subparagraph, minus any amounts used to repay nursing home Medicaid overpayments and amounts transferred to contribute to the General Revenue Fund pursuant to s. The leasehold licensee may meet the bond requirement through other arrangements acceptable to the agency. The agency is herein granted specific authority to promulgate rules pertaining to lease bond arrangements. All existing nursing facility licensees, operating the facility as a leasehold, shall acquire, maintain, and provide proof to the agency of the month bond required in subparagraph 1.
It shall be the responsibility of all nursing facility operators, operating the facility as a leasehold, to renew the month bond and to provide proof of such renewal to the agency annually. A lease agreement required as a condition of bond financing or refinancing under s. 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. The survey shall be conducted every 6 months for the next 2-year period if the facility has been cited for a class I deficiency, has been cited for two or more class II deficiencies arising from separate surveys or investigations within a day period, or has had three or more substantiated complaints within a 6-month period, each resulting in at least one class I or class II deficiency.
In addition to any other fees or fines in this part, the agency shall assess a fine for each facility that is subject to the 6-month survey cycle. The agency may adjust this fine by the change in the Consumer Price Index, based on the 12 months immediately preceding the increase, to cover the cost of the additional surveys. The agency shall verify through subsequent inspection that any deficiency identified during inspection is corrected.
However, the agency may verify the correction of a class III or class IV deficiency unrelated to resident rights or resident care without reinspecting the facility if adequate written documentation has been received from the facility, which provides assurance that the deficiency has been corrected. The giving or causing to be given of advance notice of such unannounced inspections by an employee of the agency to any unauthorized person shall constitute cause for suspension of not fewer than 5 working days according to the provisions of chapter However, the agency shall conduct unannounced onsite reviews every 3 months of each facility while the facility has a conditional license.
Deficiencies related to physical plant do not require followup reviews after the agency has determined that correction of the deficiency has been accomplished and that the correction is of the nature that continued compliance can be reasonably expected. The agency may provide electronic access to inspection reports as a substitute for sending copies. The Nursing Home Guide shall explain that this state offers alternative programs that permit qualified elderly persons to stay in their homes instead of being placed in nursing homes and shall encourage interested persons to call the Comprehensive Assessment Review and Evaluation for Long-Term Care Services CARES Program to inquire if they qualify.
The Nursing Home Guide shall list available home and community-based programs which shall clearly state the services that are provided and indicate whether nursing home services are included if needed. A list by name and address of all nursing home facilities in this state, including any prior name by which a facility was known during the previous month period. Whether such nursing home facilities are proprietary or nonproprietary. The name of the owner or owners of each facility and whether the facility is affiliated with a company or other organization owning or managing more than one nursing facility in this state.
The total number of beds in each facility and the most recently available occupancy levels. The number of private and semiprivate rooms in each facility. The religious affiliation, if any, of each facility. The languages spoken by the administrator and staff of each facility. Recreational and other programs available at each facility. Special care units or programs offered at each facility.
Whether the facility is a part of a retirement community that offers other services pursuant to part III of this chapter or part I or part III of chapter Survey and deficiency information, including all federal and state recertification, licensure, revisit, and complaint survey information, for each facility. For noncertified nursing homes, state survey and deficiency information, including licensure, revisit, and complaint survey information shall be provided. The licensure status history of each facility.
The rating history of each facility. The regulatory history of each facility, which may include federal sanctions, state sanctions, federal fines, state fines, and other actions. Whether the facility currently possesses the Gold Seal designation awarded pursuant to s. Internet links to the Internet sites of the facilities or their affiliates.
Copies of the reports shall be retained in the records for not less than 5 years following the date the reports are filed or issued. The watch list must identify each facility that met the criteria for a conditional licensure status and each facility that is operating under bankruptcy protection. Each facility must submit this information to the agency by electronic transmission when available.
A concise summary of the last inspection report pertaining to the nursing home and issued by the agency, with references to the page numbers of the full reports, noting any deficiencies found by the agency and the actions taken by the licensee to rectify the deficiencies and indicating in the summaries where the full reports may be inspected in the nursing home.
A copy of all of the pages that list the facility in the most recent version of the Nursing Home Guide. The facility shall verify the employment history unless, through diligent efforts, such verification is not possible. Techniques for assisting with eating and proper feeding;. Principles of adequate nutrition and hydration;. Techniques for assisting and responding to the cognitively impaired resident or the resident with difficult behaviors;. Techniques for caring for the resident at the end-of-life; and.
Recognizing changes that place a resident at risk for pressure ulcers and falls; and. This reimbursement is not subject to any rate ceilings or payment targets in the Medicaid Reimbursement plan. It is further intended that reasonable efforts be made to accommodate the needs and preferences of residents to enhance the quality of life in a nursing home. In addition, efforts shall be made to minimize the paperwork associated with the reporting and documentation requirements of these rules. In making such rules, the agency shall be guided by criteria recommended by nationally recognized reputable professional groups and associations with knowledge of such subject matters.
The agency shall update or revise such criteria as the need arises. The agency may require alterations to a building if it determines that an existing condition constitutes a distinct hazard to life, health, or safety. In performing any inspections of facilities authorized by this part or part II of chapter , the agency may enforce the special-occupancy provisions of the Florida Building Code and the Florida Fire Prevention Code which apply to nursing homes.
Residents or their representatives shall be able to request a change in the placement of the bed in their room, provided that at admission they are presented with a room that meets requirements of the Florida Building Code. In addition, the bed placement may not be used as a restraint. Each facility shall maintain a log of resident rooms with beds that are not in strict compliance with the Florida Building Code in order for such log to be used by surveyors and nurse monitors during inspections and visits.
A resident or resident representative who requests that a bed be moved shall sign a statement indicating that he or she understands the room will not be in compliance with the Florida Building Code, but they would prefer to exercise their right to self-determination. Any facility that offers this option must submit a letter signed by the nursing home administrator of record to the agency notifying it of this practice with a copy of the policies and procedures of the facility.
The agency is directed to provide assistance to the Florida Building Commission in updating the construction standards of the code relative to nursing homes. The agency shall adopt rules establishing minimum criteria for the plan after consultation with the Division of Emergency Management. At a minimum, the rules must provide for plan components that address emergency evacuation transportation; adequate sheltering arrangements; postdisaster activities, including emergency power, food, and water; postdisaster transportation; supplies; staffing; emergency equipment; individual identification of residents and transfer of records; and responding to family inquiries.
The comprehensive emergency management plan is subject to review and approval by the local emergency management agency. During its review, the local emergency management agency shall ensure that the following agencies, at a minimum, are given the opportunity to review the plan: the Department of Elderly Affairs, the Department of Health, the Agency for Health Care Administration, and the Division of Emergency Management. Also, appropriate volunteer organizations must be given the opportunity to review the plan.
The local emergency management agency shall complete its review within 60 days and either approve the plan or advise the facility of necessary revisions. The agency shall adopt rules providing minimum staffing requirements for nursing home facilities. These requirements must include, for each facility: a. A minimum weekly average of certified nursing assistant and licensed nursing staffing combined of 3.
As used in this sub-subparagraph, a week is defined as Sunday through Saturday. A minimum certified nursing assistant staffing of 2. A facility may not staff below one certified nursing assistant per 20 residents. A minimum licensed nursing staffing of 1. A facility may not staff below one licensed nurse per 40 residents. Nursing assistants employed under s. Each nursing home facility must document compliance with staffing standards as required under this paragraph and post daily the names of staff on duty for the benefit of facility residents and the public.
The agency shall recognize the use of licensed nurses for compliance with minimum staffing requirements for certified nursing assistants if the nursing home facility otherwise meets the minimum staffing requirements for licensed nurses and the licensed nurses are performing the duties of a certified nursing assistant.
Unless otherwise approved by the agency, licensed nurses counted toward the minimum staffing requirements for certified nursing assistants must exclusively perform the duties of a certified nursing assistant for the entire shift and not also be counted toward the minimum staffing requirements for licensed nurses. The hours of a licensed nurse with dual job responsibilities may not be counted twice.
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For persons under 21 years of age who require skilled care: a. A minimum combined average of 3. No more than 1. One registered nurse must be on duty on the site 24 hours per day on the unit where children reside. For persons under 21 years of age who are medically fragile: a. A minimum combined average of 5. This procedure does not preclude the State Long-Term Care Ombudsman Program or local long-term care ombudsman council from requesting the agency to conduct a followup visit to the facility.
The agency shall base its evaluation on the most recent inspection report, taking into consideration findings from other official reports, surveys, interviews, investigations, and inspections. In addition to license categories authorized under part II of chapter , the agency shall assign a licensure status of standard or conditional to each nursing home. If the facility has no class I, class II, or class III deficiencies at the time of the followup survey, a standard licensure status may be assigned. A list of the deficiencies of the facility shall be posted in a prominent place that is in clear and unobstructed public view at or near the place where residents are being admitted to that facility.
Licensees receiving a conditional licensure status for a facility shall prepare, within 10 working days after receiving notice of deficiencies, a plan for correction of all deficiencies and shall submit the plan to the agency for approval. Establish uniform procedures for the evaluation of facilities. Provide criteria in the areas referenced in paragraph c. Address other areas necessary for carrying out the intent of this section.
The scope shall be cited as isolated, patterned, or widespread. An isolated deficiency is a deficiency affecting one or a very limited number of residents, or involving one or a very limited number of staff, or a situation that occurred only occasionally or in a very limited number of locations. A patterned deficiency is a deficiency where more than a very limited number of residents are affected, or more than a very limited number of staff are involved, or the situation has occurred in several locations, or the same resident or residents have been affected by repeated occurrences of the same deficient practice but the effect of the deficient practice is not found to be pervasive throughout the facility.
The condition or practice constituting a class I violation shall be abated or eliminated immediately, unless a fixed period of time, as determined by the agency, is required for correction. The fine amount shall be doubled for each deficiency if the facility was previously cited for one or more class I or class II deficiencies during the last licensure inspection or any inspection or complaint investigation since the last licensure inspection.
A fine must be levied notwithstanding the correction of the deficiency. A fine shall be levied notwithstanding the correction of the deficiency. A citation for a class III deficiency must specify the time within which the deficiency is required to be corrected. If a class III deficiency is corrected within the time specified, a civil penalty may not be imposed. If the class IV deficiency is isolated, no plan of correction is required.
In addition to the requirements of ss. The agency may be granted one day extension for the review period, if the director of the agency so approves. If the agency fails to act within the specified time, it shall be deemed to have approved the plans and specifications. When the agency disapproves plans and specifications, it shall set forth in writing the reasons for disapproval. Conferences and consultations may be provided as necessary. The agency may also collect a fee, not to exceed 1 percent of the estimated construction cost or the actual cost of review, whichever is less, for the portion of the review which encompasses initial review through the initial revised construction document review.
The agency is further authorized to collect its actual costs on all subsequent portions of the review and construction inspections. Initial fee payment shall accompany the initial submission of plans and specifications. Any subsequent payment that is due is payable upon receipt of the invoice from the agency. Notwithstanding any other law to the contrary, all money received by the agency pursuant to this section shall be trust funds, to be held and applied solely for the operations required under this section.
This program shall be known as the Gold Seal Program. The panel shall be composed of three persons appointed by the Governor, to include a consumer advocate for senior citizens and two persons with expertise in the fields of quality management, service delivery excellence, or public sector accountability; three persons appointed by the Secretary of Elderly Affairs, to include an active member of a nursing facility family and resident care council and a member of the University Consortium on Aging; a representative of the State Long-Term Care Ombudsman Program; one person appointed by the Florida Life Care Residents Association; one person appointed by the State Surgeon General; two persons appointed by the Secretary of Health Care Administration; one person appointed by the Florida Association of Homes for the Aging; and one person appointed by the Florida Health Care Association.
Vacancies on the panel shall be filled in the same manner as the original appointments. Any member of the panel who is employed by a nursing facility in any capacity shall be prohibited from participating in reviewing or voting on recommendations involving the facility by which the member is employed or any facility under common ownership with that facility. The activities of the panel shall be supported by staff of the Department of Elderly Affairs and the Agency for Health Care Administration. The panel shall determine the procedure or procedures for measuring the quality of care.
Such standards must include, but not be limited to, criteria for the use of financial statements that are prepared in accordance with generally accepted accounting principles and that are reviewed or audited by certified public accountants. A nursing home that is part of the same corporate entity as a continuing care facility licensed under chapter which meets the minimum liquid reserve requirements specified in s. A nursing home that is part of a corporate entity operating nursing homes, assisted living facilities, or independent living facilities, or a combination thereof, satisfies the financial soundness and stability requirement if the nursing home submits a consolidated corporate financial statement to the agency and demonstrates that the corporate entity in its entirety meets the financial standards adopted by the agency.
The panel shall review nominees and make a recommendation to the Governor for final approval and award. The decision of the Governor is final and is not subject to appeal. The agency shall establish by rule the frequency of review for designation as a Gold Seal Program facility and under what circumstances a facility may be denied the privilege of using this designation.
The designation of a facility as a Gold Seal Program facility is not transferable to another license, except when an existing facility is being relicensed in the name of an entity related to the current licenseholder by common ownership or control, and there will be no change in the management, operation, or programs at the facility as a result of the relicensure.
Gold Seal Program facilities may be surveyed for certification and relicensure every 2 years, so long as they maintain the standards associated with retaining the Gold Seal.
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Alerting or advising a facility of the actual or approximate date of such inspection shall be a per se violation of this subsection. Each day of a continuing violation is a separate offense. The board must approve the educational content of such clinic or seminar if it is intended to satisfy the educational requirements of the board. Each member of a nursing home survey team who is a health professional licensed under chapter shall earn not less than 30 percent of required continuing education credits in geriatric care. The Legislature finds and declares that routine health care provided on an outpatient basis is one such program, the availability of which would fill an unmet need, improve the quality and quantity of health care available to elderly persons while minimizing the cost of such care, and reduce the incidence of unnecessary or premature institutionalization of elderly persons.
The purpose of this section and s. The Legislature intends that existing and available nursing facility treatment rooms be used for geriatric outpatient nurse clinics in order that the cost of such programs be kept low. A companion may not provide hands-on personal care to a client. A homemaker may not provide hands-on personal care to a client. The term does not include an entity that provides services using only volunteers or only individuals related by blood or marriage to the patient or client.
A license issued by the agency is required in order to operate a home health agency in this state. A license issued on or after July 1, , must specify the home health services the organization is authorized to perform and indicate whether such specified services are considered skilled care. The provision or advertising of services that require licensure pursuant to this part without such services being specified on the face of the license issued on or after July 1, , constitutes unlicensed activity as prohibited under s.
The counties where the related offices are operating within the health service planning district must be specified on the license in the main office. The holder of a license issued under this part may not advertise or indicate to the public that it holds a home health agency or nurse registry license other than the one it has been issued.
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 home health agency or the provision of home health services in violation of this part or part II of chapter , until compliance with this part or the rules adopted under this part has been demonstrated to the satisfaction of the agency.
A violation of paragraph a or s. Any person who commits a second or subsequent violation commits a misdemeanor of the first degree, punishable as provided in s. Each day of continuing violation constitutes a separate offense. Each day of continued operation is a separate offense. The Department of Elderly Affairs. The Department of Health, a community health center, or a rural health network that furnishes home visits for the purpose of providing environmental assessments, case management, health education, personal care services, family planning, or followup treatment, or for the purpose of monitoring and tracking disease.
Services provided to persons with developmental disabilities, as defined in s. Companion and sitter organizations that were registered under s. The Department of Children and Families. This exemption does not entitle an individual to perform home health services without the required professional license. A certificate of exemption is valid for a period of not more than 2 years and is not transferable.
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An applicant may not project an operating margin of 15 percent or greater for any month in the first year of operation. All documents required under this paragraph must be prepared in accordance with generally accepted accounting principles and compiled and signed by a certified public accountant.
A home health agency that does not provide skilled care is exempt from this paragraph. Notwithstanding s. Such accreditation must be continuously maintained by the home health agency to maintain licensure. The agency shall accept, in lieu of its own periodic licensure survey, the submission of the survey of an accrediting organization that is recognized by the agency if the accreditation of the licensed home health agency is not provisional and if the licensed home health agency authorizes releases of, and the agency receives the report of, the accrediting organization.
However, state, county, or municipal governments applying for licenses under this part are exempt from the payment of license fees. A pattern may be demonstrated by a showing of at least three fraudulent entries or documents;. A pattern may be demonstrated by a showing of at least three billings for services not provided within a month period;. A pattern may be demonstrated by a showing of at least three incidents, regardless of the patient or service, in which the home health agency did not provide a service specified in a written agreement or plan of care during a 3-month period;.
A pattern may be demonstrated by a showing of at least two such medically unnecessary services within one Medicaid program integrity audit period;. A pattern may be demonstrated by a showing of at least three billings for services not provided within a month period.
The fine must be imposed for each incident that is falsely billed. A pattern may be demonstrated by a showing of at least three incidences, regardless of the patient or service, where the home health agency did not provide a service specified in a written agreement or plan of care during a 3-month period. The agency shall impose the fine for each occurrence. The agency may also impose additional administrative fines under s.
Another home health agency with which it has formal or informal patient-referral transactions or arrangements; or. A health services pool with which it has formal or informal patient-referral transactions or arrangements,. The contract must: 1. Be in writing and signed by both parties;. Provide for remuneration that is at fair market value for an hourly rate, which must be supported by invoices submitted by the medical director describing the work performed, the dates on which that work was performed, and the duration of that work; and.
Be for a term of at least 1 year. A physician, and the home health agency is in violation of paragraph g or paragraph h ;. An immediate family member of the physician,. A pattern may be demonstrated by a showing of at least two such medically unnecessary services within one Medicaid program integrity audit period. If the home health agency is licensed under this chapter and is part of a retirement community that provides multiple levels of care, an employee of the retirement community may administer the home health agency and up to a maximum of four entities licensed under this chapter or chapter which all have identical controlling interests as defined in s.
An administrator may serve as a director of nursing for up to the number of entities authorized in subsection 2 only if there are 10 or fewer full-time equivalent employees and contracted personnel in each home health agency. Up to two licensed home health agencies if the agencies have identical controlling interests as defined in s. Up to five licensed home health agencies if: a. All of the home health agencies have identical controlling interests as defined in s. All of the home health agencies are located within one agency geographic service area or within an immediately contiguous county; and.
Each home health agency has a registered nurse who meets the qualifications of a director of nursing and who has a written delegation from the director of nursing to serve as the director of nursing for that home health agency when the director of nursing is not present. A home health agency that provides skilled nursing care and the director of nursing of a home health agency must notify the agency within 10 business days after termination of the services of the director of nursing for the home health agency.
A home health agency that provides skilled nursing care must notify the agency of the identity and qualifications of the new director of nursing within 10 days after the new director is hired. If a home health agency that provides skilled nursing care operates for more than 30 calendar days without a director of nursing, the home health agency commits a class II deficiency. In addition to the fine for a class II deficiency, the agency may issue a moratorium in accordance with s. The agency may not take administrative action against a home health agency if the director of nursing fails to notify the department upon termination of services as the director of nursing for the home health agency.
The department must consider for approval training offered in a variety of formats. The department shall keep a list of current providers who are approved to provide the 2-hour training. The department shall adopt rules to establish standards for the employees who are subject to this training, for the trainers, and for the training required in this section. The sheer scope of duties requires a far-reaching reference for staying abreast of the latest innovations and best practices.
The Facility Management Handbook is that one essential book. Insightful overviews, case studies, and practical guidelines pave the way for successful planning, budgeting, real estate transactions, construction, emergency preparedness, security, operations, maintenance, and more. This thoroughly revised fourth edition examines cutting-edge technologies and includes new information on Building Information Modeling BIM , contracting and project management methods, FASB and IASB requirements, distributed working, and sustainability reporting. Balancing an in-depth look at the fundamentals with a view toward what the future holds, the book is essential reading for every facility management professional.
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