CHAPTER 59A8 MINIMUM STANDARDS FOR HOME HEALTH AGENCIES.docx
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CHAPTER59A8MINIMUMSTANDARDSFORHOMEHEALTHAGENCIES
CHAPTER59A-8MINIMUMSTANDARDSFORHOMEHEALTHAGENCIES
59A-8.002Definitions.
59A-8.0025TelephoneReporting.
59A-8.003LicensureRequirements.
59A-8.004LicensureProcedure.
59A-8.007GeographicServiceArea.
59A-8.008ScopeofServices.
59A-8.0086Denial,Suspension,RevocationofLicenseandImpositionofFines.
59A-8.0095Personnel.
59A-8.0185PersonnelPolicies.
59A-8.020AcceptanceofPatientsorClients.
59A-8.0215PlanofCare.
59A-8.022ClinicalRecords.
59A-8.0245AdvanceDirectives.
59A-8.027EmergencyManagementPlans.
59A-8.002Definitions.
(1)“Accreditingorganization”meanstheCommunityHealthAccreditationProgramortheJointCommissiononAccreditationofHealthcareOrganizations.
(2)“AHCA”meansAgencyforHealthCareAdministration.
(3)“Assistancewithactivitiesofdailyliving”meansacertifiednursingassistantorahomehealthaideprovidestothepatientindividualassistancewithactivitiesofdailyliving,includingthefollowing:
(a)Ambulation.Providingphysicalsupporttoenablethepatienttomoveaboutwithinoroutsideofthepatient’splaceofresidence.Physicalsupportincludesholdingthepatient’shand,elbow,underthearm,orholdingontoasupportbeltwornbythepatienttoassistinprovidingstabilityordirectionwhilethepatientambulates.
(b)Bathing.Helpingthepatientinandoutofthebathtuborshowerbeingavailablewhilethepatientisbathing.Canalsoincludewashinganddryingthepatient.
(c)Dressing.Helpingpatients,whorequireassistanceindressingthemselves,putonandremoveclothing.
(d)Eating.Helpingwithfeedingpatientswhorequireassistanceinfeedingthemselves.
(e)Personalhygiene.Helpingthepatientwithshaving.Assistingwithoral,hair,skinandnailcare.
(f)Toileting.Remindingthepatientaboutusingthetoilet,assistinghimtothebathroom,helpingtoundress,positioningonthecommode,andhelpingwithrelatedpersonalhygiene,includingassistancewithchangingofanadultbrief.Alsoincludesassistingwithpositioningthepatientonthebedpan,andhelpingwithrelatedpersonalhygiene.
(g)Assistancewithphysicaltransfer.Providingverbalandphysicalcueing,physicalassistance,orbothwhilethepatientmovesfromonepositiontoanother,forexamplebetweenthefollowing:
abed,chair,wheelchair,commode,bathtuborshower,orastandingposition.Transfercanalsoincludeuseofamechanicallift,ifahomehealthaideistrainedinitsuse.
(h)Assistancewithself-administeredmedication,asdefinedinsubsection59A-8.0095(5),F.A.C.
(4)“Caregiver”meansapersonwhohasbeenentrustedwithorhasassumedtheresponsibilityforfrequentandregularcareoforservicestoadisabledadultoranelderlypersononatemporaryorpermanentbasisandwhohasacommitment,agreement,orunderstandingwiththatpersonorthatperson’sguardianthatacaregiverroleexists.Caregiversinclude,forexample,relatives,householdmembers,guardians,friends,neighbors,andemployeesandvolunteersoffacilities.
(5)“Casemanagement”meanstheinitialassessmentofthepatientandcaregiverforappropriatenessofandacceptanceforhomehealthservices;establishmentandperiodicreviewofaplanofcare;implementationofmedicaltreatmentwhenordered;referral,follow-up,provisionof,evaluationofandsupervisionofcare;coordinationofservicesgivenbyotherhealthcareproviders;anddocumentationofallactivitiesandfindings.
(6)“DCF”meanstheDepartmentofChildrenandFamilyServices.
(7)“Dieteticsandnutritionpractice”meansassessingnutritionneedsandstatususingappropriatedata;recommendingdietaryregimens,nutritionsupport,andnutrientintake;improvingthepatient’shealthstatusthroughnutritioncounselingandeducation.
(8)“Dietitian/Nutritionist”meansapersonlicensedtoengageindieteticsandnutritionpracticepursuanttoChapter468,F.S.
(9)“Directemployee”meansoneofthefollowingpaysthewithholdingtaxesfortheemployee:
thehomehealthagency;amanagementcompanywhichhasacontracttomanagethehomehealthagency;oranemployeeleasingcompanywhichhasacontractwiththehomehealthagencytohandlethepayrollandpayrolltaxesforthehomehealthagency.
(10)“Drop-offsite”meansanylocationinanycountywithinthegeographicserviceareaofthemainoffice,pursuanttosubsection59A-8.003(8),F.A.C.
(11)“EmergencyManagementPlan”meansacomprehensiveplandevelopedbythehomehealthagencydescribinghowtheagencywillprepareforandrespondinanemergency,pursuanttoRule59A-8.027,F.A.C.
(12)“Employeeleasingcompany”meansacompanylicensedandregulatedunderChapter468,PartXI,F.S.Aleasingcompanyhandlesthepayrollandtaxesonleasedemployees.Whileanemployeeleasingcompanypaysthewithholdingtaxes,theemployeeisstillconsideredadirectemployee,asdefinedinSection468.534,F.S.,ofthehomehealthagency.
(13)“FBI”meanstheFederalBureauofInvestigation.
(14)“FDLE”meanstheFloridaDepartmentofLawEnforcement.
(15)”Financialinstability”meansthehomehealthagencycannotmeetitsfinancialobligation.Evidencesuchastheissuanceofbadchecksoranaccumulationofdelinquentbillsshallconstituteprimafacieevidencethattheownershipofthehomehealthagencylacksthefinancialabilitytooperate.EvidencealsoincludestheMedicareorMedicaidprogram’sindicationsordeterminationoffinancialinstabilityorfraudulenthandlingofgovernmentfundsbythehomehealthagency.
(16)“Full-timeequivalent”meanswhenanemployeeworksbetween37to40hoursperweek.
(17)“Geographicservicearea”meansthearea,asspecifiedonthelicense,inwhichthehomehealthagencymaysenditspersonneltoprovidehomehealthservicestopatientsintheirplacesofresidence.
(18)“Homeinfusiontherapyservices”meansteaching,assessment,evaluationandclinicalservicesrelatedtotheadministrationofintravenoussubstancesprovidedbyaprofessionallicensedunderChapter464,458or459,F.S.
(19)“Licensednurse,”asdefinedinSections464.003(4)and464.003(5),F.S.,meansaregisterednurselicensedtopracticeprofessionalnursingoralicensedpracticalnurselicensedtopracticenursingunderthedirectionofaphysicianorregisterednursepursuanttoChapter464,F.S.
(20)“Mainoffice”meanstheprimaryofficeestablishedinthecountywhichhousesallcomponentsofthehomehealthagencyincludingtheadministration,fiscalmanagement,serviceprovisionandsupplies.
(21)“Nutritionassessment”meanstheevaluationofthenutritionneedsofthepatientusingappropriatedatatodeterminenutrientneedsorstatusandmakenutritionrecommendationsforthepatient.
(22)“Nutritioncounseling”meansadvisingandassistingthepatientonappropriatenutritionintakebyintegratinginformationfromthenutritionassessment.
(23)“Occupationaltherapist”meansapersonlicensedtopracticeoccupationaltherapypursuanttoChapter468,F.S.
(24)“Occupationaltherapyassistant”meansapersonlicensedtoassistinthepracticeofoccupationaltherapypursuanttoChapter468,F.S.
(25)“Patient”meansanindividualwhoreceiveshomehealthservicesinone’splaceofresidence.
(26)“PlanofCare”meansacoordinatedplan,whichincludesthetreatmentorders,preparedbythecasemanagerincollaborationwitheachprofessionaldisciplineprovidingservicetothepatientandcaregiver.
(27)“Physicaltherapist”meansapersonlicensedtopracticephysicaltherapypursuanttoChapter486,F.S.
(28)“Physicaltherapyassistant”meansapersonlicensedtoassistinthepracticeofphysicaltherapypursuanttoChapter486,F.S.
(29)“Physician”meansadoctorofmedicine,osteopathy,podiatry,orchiropracticlegallyauthorizedtopracticeinthestatepursuanttoChapter458,459,460,or461,F.S.PhysiciansworkinginVeteransAdministrationhospitalsandclinicsareexemptfromstatelicensureaccordingtoChapter458,F.S.
(30)“Providingoneservicedirectly”meanstheagencymustprovideoneservice,inpart,bydirectemployees.
(31)“Qualityassuranceplan”meansaplanwhichisdevelopedandimplementedbyahomehealthagencytoreviewandevaluatetheeffectivenessandappropriatenessofserviceprovisiontopatientsand,uponidentificationofproblems,requiresspecificactiontocorrecttheproblemsanddeficiencies.
(32)“Respiratorytherapist”meansapersonlicensedtopracticerespiratorytherapypursuanttoChapter468,F.S.
(33)“Satelliteoffice”meansasecondaryofficeestablishedinthesamecountyasthemainoffice,pursuanttosubsection59A-8.003(7),F.A.C.
(34)“SocialWorker”meansapersonwhohasadegreeinsocialworkandwhoworkswithpatientsandfamiliestohelpthemadjusttothesocialandemotionalfactorsrelatedtothepatient’shealthproblems.
(35)“Specialneedspatients”pursuanttoSection252.355,F.S.,meansthosepersonswhohavephysicalormentalconditionsthatrequirelimitedmedicalandnursingoversightduringemergencyevacuations.Theyaremedicallydependentindividualswhoarenotacutelyill.
(36)“Specialneedsregistry”pursuanttoSection252.355,F.S.,meansaregistrymaintainedbythelocalemergencymanagementagencyofpersonswhoneedassistanceduringevacuationsandshelteringbecauseofphysicalormentalhandicaps.
(37)“Speechpathologist”meansapersonlicensedtopracticespeechpathologyoraudiologypursuanttoChapter468,F.S.
(38)“Treatmentorders”meanswrittenorderssignedbyaphysician,physicianassistant,oradvancedregisterednursepractitioner,actingwithinhisorherrespectivescopeofpractice,whichauthorizestheprovisionofcareortreatmenttoapatientinhisplaceofreside