Florida Statutes 400.476 – Staffing requirements; notifications; limitations on staffing services
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(1) ADMINISTRATOR.–
(a) An administrator may manage only one home health agency, except that an administrator may manage up to five home health agencies if all five home health agencies have identical controlling interests as defined in s. 408.803 and are located within one agency geographic service area or within an immediately contiguous county. 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 429 which all have identical controlling interests as defined in s. 408.803. An administrator shall designate, in writing, for each licensed entity, a qualified alternate administrator to serve during the administrator’s absence.
Terms Used In Florida Statutes 400.476
- Administrator: means a direct employee, as defined in subsection (10), who is a licensed physician, physician assistant, or registered nurse licensed to practice in this state or an individual having at least 1 year of supervisory or administrative experience in home health care or in a facility licensed under chapter 395, under part II of this chapter, or under part I of chapter 429. See Florida Statutes 400.462
- Agency: means the Agency for Health Care Administration. See Florida Statutes 400.462
- Certified nursing assistant: means any person who has been issued a certificate under part II of chapter 464. See Florida Statutes 400.462
- Contract: A legal written agreement that becomes binding when signed.
- Department: means the Department of Children and Families. See Florida Statutes 400.462
- Director of nursing: means a registered nurse who is a direct employee, as defined in subsection (10), of the agency and who is a graduate of an approved school of nursing and is licensed in this state; who has at least 1 year of supervisory experience as a registered nurse; and who is responsible for overseeing the delivery of professional nursing and home health aide services of the agency. See Florida Statutes 400.462
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Home health agency: means a person that provides one or more home health services. See Florida Statutes 400.462
- Home health aide: means a person who is trained or qualified, as provided by rule, and who provides hands-on personal care, performs simple procedures as an extension of therapy or nursing services, assists in ambulation or exercises, assists in administering medications as permitted in rule and for which the person has received training established by the agency under this part, or performs tasks delegated to him or her under chapter 464. See Florida Statutes 400.462
- Home health aide for medically fragile children: means a family caregiver who meets the qualifications specified in this part and who performs tasks delegated to him or her under chapter 464 while caring for an eligible relative, and provides care relating to activities of daily living, including those associated with personal care; maintaining mobility; nutrition and hydration; toileting and elimination; assistive devices; safety and cleanliness; data gathering; reporting abnormal signs and symptoms; postmortem care; patient socialization and reality orientation; end-of-life care; cardiopulmonary resuscitation and emergency care; residents' or patients' rights; documentation of services performed; infection control; safety and emergency procedures; hygiene, grooming, skin care, and pressure sore prevention; wound care; portable oxygen use and safety and other respiratory procedures; tracheostomy care; enteral care and therapy; peripheral intravenous assistive activities and alternative feeding methods; and any other tasks delegated to the family caregiver under chapter 464. See Florida Statutes 400.462
- Physician: means a person licensed under chapter 458, chapter 459, chapter 460, or chapter 461. See Florida Statutes 400.462
- Physician assistant: means a person who is a graduate of an approved program or its equivalent, or meets standards approved by the boards, and is licensed to perform medical services delegated by the supervising physician, as defined in…. See Florida Statutes 400.462
- writing: includes handwriting, printing, typewriting, and all other methods and means of forming letters and characters upon paper, stone, wood, or other materials. See Florida Statutes 1.01
(b) An administrator of a home health agency who is a licensed physician, physician assistant, or registered nurse licensed to practice in this state may also be the director of nursing for a home health agency. 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.
(2) DIRECTOR OF NURSING.–
(a) A director of nursing may be the director of nursing for:
1. Up to two licensed home health agencies if the agencies have identical controlling interests as defined in s. 408.803 and are located within one agency geographic service area or within an immediately contiguous county; or
2. Up to five licensed home health agencies if:
a. All of the home health agencies have identical controlling interests as defined in s. 408.803;
b. All of the home health agencies are located within one agency geographic service area or within an immediately contiguous county; and
c. 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.
If a home health agency licensed under this chapter is part of a retirement community that provides multiple levels of care, an employee of the retirement community may serve as the director of nursing of the home health agency and up to a maximum of four entities, other than home health agencies, licensed under this chapter or chapter 429 which all have identical controlling interests as defined in s. 408.803.
(b) A home health agency that provides skilled nursing care may not operate for more than 30 calendar days without a director of nursing. 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. 408.814 or revoke the license. The agency shall fine a home health agency that fails to notify the agency as required in this paragraph $1,000 for the first violation and $2,000 for a repeat violation. 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.
(c) A home health agency that provides skilled nursing care must have a director of nursing.
(3) TRAINING.–A home health agency shall ensure that each certified nursing assistant employed by or under contract with the home health agency and each home health aide or home health aide for medically fragile children employed by or under contract with the home health agency is adequately trained to perform the tasks of a home health aide or home health aide for medically fragile children in the home setting. A parent, guardian, or family member who is seeking training required under s. 400.4765 to become a home health aide for medically fragile children is not required to repay or reimburse the home health agency for the costs associated with the home health aide for medically fragile children training program.
(4) STAFFING.–Staffing services may be provided anywhere within the state.