Florida Regulations 59A-8.0248: Excellence in Home Health
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(1) Excellence in Home Health Award.
(a) To be considered for an Excellence in Home Health Award, a home health agency licensee eligible under Florida Statutes § 400.52(3), must apply using the Excellence in Home Health Award Application, AHCA Form 3110-9002, January 2023, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15408 or at http://www.ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Lab_HomeServ/HHA/index.shtml.
(b) Unless an exception is noted pursuant to Florida Statutes § 400.52(5), an awarded licensee may use the Excellence in Home Health designation in advertising and marketing. Use of the Excellence in Home Health designation in advertising and marketing must include the effective and expiration date of the award and be used expressly for the awarded licensee. Within 90 days after termination or expiration of the award, the Excellence in Home Health designation must be removed from all advertising and marketing materials.
(2) Initial application. An applicant for initial Excellence in Home Health award may apply during the following reivew periods:
(a) Review Period 1 requires initial applications be submitted to AHCA by March 15. Application reviews will be concluded by May 15 to determine those licensees to be considered for the Excellence in Home Health award designation. The award decisions will be issued no later than June 15.
(b) Review Period 2 requires initial applications be submitted to AHCA by September 15 to be eligible for review during this period. Application reviews will be concluded by November 15 to determine those licensees to be considered for the Excellence in Home Health award designation. The award decisions will be issued no later than December 15.
(c) Renewal application. An applicant for renewal of an Excellence in Home Health award designation must submit a completed application in conjunction with the home health agency’s license renewal application.
1. Pursuant to section 400.52(4), the Excellence in Home Health award designation expires on the same date as the home health agency’s license.
2. The award designation will not be issued until all the requirements for relicensure pursuant to Chapters 400, Part III, 408, Part II, F.S., and applicable rules have been met.
(d) Upon receipt of an application for an award, AHCA will examine the application and notify the applicant in writing of any apparent errors or omissions and request any additional information required.
(e) Requested information omitted from an Excellence in Home Health award application must be filed with the agency within 21 days after the agency’s request for omitted information or the application will be deemed incomplete and will be withdrawn from further consideration.
(f) If the applicant is approved for the Excellence in Home Health award, the applicant’s home health agency license will be issued specifying the award designation.
(3) Minimum Award Criteria. In addition to the requirements of Florida Statutes § 400.52(3), and the application form required by section (1)(a) of this rule, applicants for the Excellence in Home Health award must submit documentation demonstrating they meet and maintain the following:
(a) Development, maintenance and implementation of a Continuous Quality Improvement (CQI) program consistent with national industry standards that includes, at minimum:
1. Evidence-based practices that address reduction of preventable, unplanned patient or client emergency care for wound infections resulting from, related to, or identified during the provision of home health services.
2. Evidence-based practices that address reduction of preventable, unplanned patient or client admission or readmission to an acute care hospital resulting from, related to, or identified during the provision of home health services.
3. Evidence-based practices that address patient improvement in the activities of daily living resulting from, related to, or identified during the provision of home health services.
4. Evidence-based practices that address reduction of preventable medication errors resulting from, related to, or identified during the provision of home health services.
5. Evidence of a survey process to assess patient or client willingness to recommend the home health agency to family and friends.
6. Evidence of a survey process to assess patient or client satisfaction with communication and interaction between the home health agency and the patient or client and/or their representative(s).
7. Development of Quantitative metric tools to capture and calculate data, and assess risk for 1. through 6. above.
(b) Quantitative metric tools required by subsection (a)7. must include, at a minimum, quality measures to calculate the required data for the most recent 12 month period ending on the last business day of the most recent calendar quarter prior to application for the award. Data must demonstrate the applicant ranks within the following ranges compared to the current state-wide average:
1. Average quality score which is at or above the top 95th percentile state-wide for prevention of, unplanned patient or client emergency care for wound infections resulting from, related to, or identified during the provision of home health services.
2. Average quality score which is at or above the top 95th percentile state-wide for prevention of, unplanned patient or client admission or readmission to an acute care hospital resulting from, related to, or identified during the provision of home health services.
3. Average quality score which is at or above the top 95th percentile state-wide for patient improvement in the activities of daily living resulting from, related to, or identified during the provision of home health services.
4. Average quality score which is at or above the top 98th percentile state-wide for prevention of medication errors resulting from, related to, or identified during the provision of home health services.
5. Average quality score which is at or above the top 90th percentile state-wide survey of patient or client willingness to recommend the home health agency to family and friends.
6. Average quality score which is at or above the top 95th percentile state-wide for survey of patient or client satisfaction with the communication and interaction between the home health agency and the patient or client and/or their representative(s).
(c) Evidence of targeted employee in-service training by the home health agency.
(d) Evidence of the employee satisfaction process which demonstrates that information is obtained from employees concerning satisfaction with the home health agency.
(e) Stable Workforce. For the purposes of this rule, the term “”direct care worker”” means a certified nursing assistant, a home health aide, a personal care assistant, a companion services or homemaker services provider, or another individual who provides personal care as defined in Florida Statutes § 400.462, to individuals who are elderly, developmentally disabled, or chronically ill. An applicant for the Excellence in Home Health Award must demonstrate a stable workforce according to the following:
1. Have a turnover rate no greater than 50 percent for the most recent 12 month period ending on the last workday of the most recent calendar quarter prior to submission of an application. The turnover rate is the total number of terminations or resignations of direct care workers and licensed nurses during the quarter divided by the number of direct care workers and licensed nurses employed at the end of the quarter; or
2. Have a stability rate indicating that at least 50 percent of its staff have been employed at the home health agency for at least one year. The stability rate is the total number of direct care workers and licensed nurses that have been employed for more than 12 months, divided by the total number of direct care workers and licensed nurses employed at the end of the quarter.
3. An applicant must submit evidence of an effective recruitment and retention program.
(4) An accredited home health agency applying for the award must submit with the application the most recent accreditation survey report, including any plan of correction and follow up survey reports as evidence of compliance history.
(5) Termination.
(a) Termination of the Excellence in Home Health Designation. An awarded licensee that fails to maintain eligibility pursuant to Florida Statutes § 400.52(3), will be terminated from participation in the Excellence in Home Health Program and their award designation will be revoked.
(b) A licensee that has been terminated from the Excellence in Home Health program may reapply within the timeframes specified in section (2) of this rule and must meet all conditions necessary to be reconsidered for an Excellence in Home Health award.
(c) Denial of Excellence in Home Health Applicants. Prior to issuance of the award, any occurrence of the following will disqualify the licensee from continuing as an Excellence in Home Health applicant from the award process and the application will be denied:
1. The applicant fails to maintain eligibility pursuant to Florida Statutes § 400.52(3);
2. The applicant fails to maintain the minimum award criteria according to section (3) of this rule; and/or
3. The applicant fails to apply within the timeframes specified in section (2) of this rule.
(d) If the applicant meets criteria for denial at any time during the review process outlined in section (2) of this rule, AHCA will offer the opportunity for the applicant to withdraw the application.
Rulemaking Authority 400.52 FS. Law Implemented Florida Statutes § 400.52. History-New 7-25-23.
Terms Used In Florida Regulations 59A-8.0248
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
(b) Unless an exception is noted pursuant to Florida Statutes § 400.52(5), an awarded licensee may use the Excellence in Home Health designation in advertising and marketing. Use of the Excellence in Home Health designation in advertising and marketing must include the effective and expiration date of the award and be used expressly for the awarded licensee. Within 90 days after termination or expiration of the award, the Excellence in Home Health designation must be removed from all advertising and marketing materials.
(2) Initial application. An applicant for initial Excellence in Home Health award may apply during the following reivew periods:
(a) Review Period 1 requires initial applications be submitted to AHCA by March 15. Application reviews will be concluded by May 15 to determine those licensees to be considered for the Excellence in Home Health award designation. The award decisions will be issued no later than June 15.
(b) Review Period 2 requires initial applications be submitted to AHCA by September 15 to be eligible for review during this period. Application reviews will be concluded by November 15 to determine those licensees to be considered for the Excellence in Home Health award designation. The award decisions will be issued no later than December 15.
(c) Renewal application. An applicant for renewal of an Excellence in Home Health award designation must submit a completed application in conjunction with the home health agency’s license renewal application.
1. Pursuant to section 400.52(4), the Excellence in Home Health award designation expires on the same date as the home health agency’s license.
2. The award designation will not be issued until all the requirements for relicensure pursuant to Chapters 400, Part III, 408, Part II, F.S., and applicable rules have been met.
(d) Upon receipt of an application for an award, AHCA will examine the application and notify the applicant in writing of any apparent errors or omissions and request any additional information required.
(e) Requested information omitted from an Excellence in Home Health award application must be filed with the agency within 21 days after the agency’s request for omitted information or the application will be deemed incomplete and will be withdrawn from further consideration.
(f) If the applicant is approved for the Excellence in Home Health award, the applicant’s home health agency license will be issued specifying the award designation.
(3) Minimum Award Criteria. In addition to the requirements of Florida Statutes § 400.52(3), and the application form required by section (1)(a) of this rule, applicants for the Excellence in Home Health award must submit documentation demonstrating they meet and maintain the following:
(a) Development, maintenance and implementation of a Continuous Quality Improvement (CQI) program consistent with national industry standards that includes, at minimum:
1. Evidence-based practices that address reduction of preventable, unplanned patient or client emergency care for wound infections resulting from, related to, or identified during the provision of home health services.
2. Evidence-based practices that address reduction of preventable, unplanned patient or client admission or readmission to an acute care hospital resulting from, related to, or identified during the provision of home health services.
3. Evidence-based practices that address patient improvement in the activities of daily living resulting from, related to, or identified during the provision of home health services.
4. Evidence-based practices that address reduction of preventable medication errors resulting from, related to, or identified during the provision of home health services.
5. Evidence of a survey process to assess patient or client willingness to recommend the home health agency to family and friends.
6. Evidence of a survey process to assess patient or client satisfaction with communication and interaction between the home health agency and the patient or client and/or their representative(s).
7. Development of Quantitative metric tools to capture and calculate data, and assess risk for 1. through 6. above.
(b) Quantitative metric tools required by subsection (a)7. must include, at a minimum, quality measures to calculate the required data for the most recent 12 month period ending on the last business day of the most recent calendar quarter prior to application for the award. Data must demonstrate the applicant ranks within the following ranges compared to the current state-wide average:
1. Average quality score which is at or above the top 95th percentile state-wide for prevention of, unplanned patient or client emergency care for wound infections resulting from, related to, or identified during the provision of home health services.
2. Average quality score which is at or above the top 95th percentile state-wide for prevention of, unplanned patient or client admission or readmission to an acute care hospital resulting from, related to, or identified during the provision of home health services.
3. Average quality score which is at or above the top 95th percentile state-wide for patient improvement in the activities of daily living resulting from, related to, or identified during the provision of home health services.
4. Average quality score which is at or above the top 98th percentile state-wide for prevention of medication errors resulting from, related to, or identified during the provision of home health services.
5. Average quality score which is at or above the top 90th percentile state-wide survey of patient or client willingness to recommend the home health agency to family and friends.
6. Average quality score which is at or above the top 95th percentile state-wide for survey of patient or client satisfaction with the communication and interaction between the home health agency and the patient or client and/or their representative(s).
(c) Evidence of targeted employee in-service training by the home health agency.
(d) Evidence of the employee satisfaction process which demonstrates that information is obtained from employees concerning satisfaction with the home health agency.
(e) Stable Workforce. For the purposes of this rule, the term “”direct care worker”” means a certified nursing assistant, a home health aide, a personal care assistant, a companion services or homemaker services provider, or another individual who provides personal care as defined in Florida Statutes § 400.462, to individuals who are elderly, developmentally disabled, or chronically ill. An applicant for the Excellence in Home Health Award must demonstrate a stable workforce according to the following:
1. Have a turnover rate no greater than 50 percent for the most recent 12 month period ending on the last workday of the most recent calendar quarter prior to submission of an application. The turnover rate is the total number of terminations or resignations of direct care workers and licensed nurses during the quarter divided by the number of direct care workers and licensed nurses employed at the end of the quarter; or
2. Have a stability rate indicating that at least 50 percent of its staff have been employed at the home health agency for at least one year. The stability rate is the total number of direct care workers and licensed nurses that have been employed for more than 12 months, divided by the total number of direct care workers and licensed nurses employed at the end of the quarter.
3. An applicant must submit evidence of an effective recruitment and retention program.
(4) An accredited home health agency applying for the award must submit with the application the most recent accreditation survey report, including any plan of correction and follow up survey reports as evidence of compliance history.
(5) Termination.
(a) Termination of the Excellence in Home Health Designation. An awarded licensee that fails to maintain eligibility pursuant to Florida Statutes § 400.52(3), will be terminated from participation in the Excellence in Home Health Program and their award designation will be revoked.
(b) A licensee that has been terminated from the Excellence in Home Health program may reapply within the timeframes specified in section (2) of this rule and must meet all conditions necessary to be reconsidered for an Excellence in Home Health award.
(c) Denial of Excellence in Home Health Applicants. Prior to issuance of the award, any occurrence of the following will disqualify the licensee from continuing as an Excellence in Home Health applicant from the award process and the application will be denied:
1. The applicant fails to maintain eligibility pursuant to Florida Statutes § 400.52(3);
2. The applicant fails to maintain the minimum award criteria according to section (3) of this rule; and/or
3. The applicant fails to apply within the timeframes specified in section (2) of this rule.
(d) If the applicant meets criteria for denial at any time during the review process outlined in section (2) of this rule, AHCA will offer the opportunity for the applicant to withdraw the application.
Rulemaking Authority 400.52 FS. Law Implemented Florida Statutes § 400.52. History-New 7-25-23.