Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-37 - ADULT FAMILY CARE HOMES › Section 59A-37.008 - Records

Current through Reg. 50, No. 138; July 16, 2024
(1) RESIDENT RECORDS. The AFCH provider shall
				maintain a separate record for each resident on the premises and available for
				inspection by the agency.
(a) The record shall
				contain:
1. AHCA Form 3110-1023 (AFCH-1110)
				01/08, Resident Health Assessment for Adult Family-Care Homes (AFCH), required
				by Rule 59A-37.004, F.A.C. A completed
				and signed form faxed by the health care provider shall be acceptable. The
				resident's health care provider's certification whether he or she may be left
				without supervision in the AFCH for up to 2 hours in a 24-hour period (Section
				H of the form) must be completed and included pursuant to paragraphs (a) and
				(b), of subsection 59A-37.006(2),
				F.A.C.
2. A copy of the residency
				agreement which meets the requirements of Rule
				59A-37.005, F.A.C., including a
				copy of any notices of rate increases sent to the resident or the residents
				representative and any addendums.
3. For residents who are OSS recipients, a
				copy of the Alternate Care Certification for Optional State Supplementation
				(OSS) Form, CF-ES 1006, February 2005, provided by the Department of Children
				and Family Services.
4. Resident
				information which includes:
a. The name,
				address and telephone number of the resident's guardian, attorney-in-fact,
				health care surrogate, next-of-kin, and any other responsible party with
				authority to make decisions on behalf of the resident.
b. The name, address and telephone number of
				the resident's health care provider, health maintenance organization, dentist
				and case manager as applicable.
5. A complete accounting of any resident
				funds being received or distributed by the provider as required by Section
				429.85, F.S.
6. For residents who self-administer, with or
				without supervision or assistance, a list of the resident's current
				medications; or for resident's receiving administration, the record of
				medications administered, as required under Rule
				59A-37.006, F.A.C.
7. For residents receiving nursing services
				provided or arranged for by the provider, the nursing progress notes required
				under Rule 59A-37.006, F.A.C., and the
				health care provider's order authorizing the nursing service.
8. A copy of any special diet order
				prescribed by the resident's health care provider as required under Rule
				59A-37.006, F.A.C.
9. A record of any major incidents or
				significant health changes and action taken in response to such incidents or
				changes as required under Rule
				59A-37.006, F.A.C.
10. The resident's monthly weight record as
				required by Rule 59A-37.006, F.A.C.
11. Documentation that the resident's bill of
				rights and the procedure for lodging complaints has been discussed with the
				resident or the resident's representative, as required by Rule
				59A-37.004, F.A.C.
12. Documentation that the house rules have
				been discussed with the resident or the resident's representative as required
				by Rule 59A-37.004, F.A.C.
13. A copy of any notice of discharge sent to
				the resident or the resident's representative pursuant to Rule
				59A-37.004,
				F.A.C.