reglab/statecodes huggingface dataset:
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.0073 - HMO and PHC Penalty Categories

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Purpose. The purpose of this rule is to establish penalty categories that
				specify varying ranges of monetary fines for willful and nonwillful violations
				of applicable provisions of Chapter 641, Parts II and III, F.S., or rules
				promulgated thereunder.
(2) Scope.
				This rule developed by the Agency for Health Care Administration governs the
				issuance of penalties against health maintenance organizations and prepaid
				health clinics pursuant to the authority set forth in Chapter 641, F.S. It
				applies to all violations of the provisions of Chapter 641, Parts II and III,
				F.S., or rules promulgated thereunder.
(3) Definitions. All terms defined in the
				Health Maintenance Organization Act, Chapter 641, F.S., which are used in this
				rule shall have the same meaning as in the act:
(a) "Action" means an event or events leading
				to the commission of a violation.
(b) "Harm" means any physical or economic
				damages to a subscriber, member, covered person, or provider.
(c) "HMO" means a health maintenance
				organization as defined in Section
				641.19(13),
				F.S., and licensed pursuant to the provisions of Chapter 641, F.S.
(d) "Investigation", "examination",
				"inspection" means any official Agency review, analysis, inquiry, or research
				into referrals, complaints, or inquiries to determine the existence of a
				violation pursuant to Section
				641.515, F.S.
(e) "Knowing and Willful" means any act or
				omission, which is committed intentionally as opposed to accidentally and which
				is committed with knowledge of the act's unlawfulness or with reckless
				disregard as to the unlawfulness of the act.
(f) "Mitigating Factors" means a condition
				that moderates, lessens, or alleviates a determination of penalties for
				violations not listed in this rule.
(g) "PHC" means a prepaid health clinic as
				defined in Section 641.02(5),
				F.S., and licensed pursuant to the provisions of Chapter 641, F.S.
(h) "Provider" means any physician, hospital,
				or other institution, organization, or person that furnishes health care
				services and is licensed or otherwise authorized to practice in the
				state.
(i) "Repeat Violations"
				means a second or subsequent offense of any given violation under this rule
				within the preceding four years.
(j) "Subscriber" means an individual who has
				contracted, or on whose behalf a contract has been entered into, with a HMO or
				PHC for health care services.
(k)
				"Violation" means any finding by the Agency of noncompliance by a HMO or PHC
				with any applicable provisions of Chapter 641, Parts II and III, rules or
				orders of the Agency governing HMOs or PHCs.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.008 - Referral Procedures

Current through Reg. 50, No. 138; July 16, 2024
Each HMO or PHC must have in place:
(1) A system to facilitate referral of
				subscribers to contracted or non-contracted physician and hospital providers;
				and, in the case of non-contracted providers, include a procedure for prior
				authorization and written notification regarding such referral to the
				subscriber.
(2) A means for
				notifying the subscribers of the referral system, including the procedures for
				the subscribers to obtain a second medical opinion. Such notification shall be
				clearly stated in either the subscriber contract, member handbook or other
				written communication.
Rulemaking Authority 641.56 FS. Law Implemented 641.51(4),
					 641.495(3) FS.
New 1-28-88, Amended 3-11-92, Formerly
					 10D-100.008.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.009 - Examination by the Agency for Health Care Administration

Current through Reg. 50, No. 138; July 16, 2024
The AHCA shall conduct examinations and investigate
				  complaints regarding the quality of health care services being provided by the
				  HMO or PHC as frequently as necessary to carry out the provisions of Chapter
				  641, Part III, F.S. and Rule 59A-12, F.A.C.
Rulemaking Authority 641.56 FS. Law Implemented 641.515
					 FS.
New 1-28-88, Amended 3-11-92, Formerly
					 10D-100.009.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.010 - Subscriber Grievance Procedure

Current through Reg. 50, No. 138; July 16, 2024
Each HMO or PHC shall establish a subscriber grievance
				  procedure as specified under Section
				  641.511, F.S.
Rulemaking Authority 641.56 FS. Law Implemented 641.311,
					 641.511 FS.
New 1-28-88, Formerly 10D-100.010, Amended
					 4-10-03.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.011 - Hospital and Physician Information Disclosure

Current through Reg. 50, No. 138; July 16, 2024
The current list required by Section
				  641.54, F.S., must include the
				  date on which it was prepared or updated.
Rulemaking Authority 641.56 FS. Law Implemented 641.54
					 FS.
New 1-28-88, Formerly
					 10D-100.011.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.012 - Internal Risk Management Program

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Every health maintenance organization certified under Part III of Chapter 641,
				F.S., shall, as a part of its administrative function, establish an internal
				risk management program as defined in Section
				641.55, F.S:
(2) The risk management program shall be the
				ultimate responsibility of the governing body of the HMO.
(3) Every Staff Model and Mixed Model HMO
				certified under this part which has an annual premium volume of $10 million or
				more shall employ or contract with a risk manager who shall be responsible for
				implementation and oversight of the organization's internal risk management
				program. A part-time risk manager shall not be responsible for risk management
				programs in more than four organizations or facilities. Every IPA Model and
				every HMO with an annual premium volume of less than $10 million shall
				designate an officer or employee of the HMO to serve as risk manager.
(4) As part of the internal risk management
				program an incident reporting system shall be established for each HMO.
				Procedures shall be detailed in writing and disseminated to all employees of
				the HMO. Within 30 days of employment all new employees shall be instructed in
				the operation and responsibilities of the incident reporting system. All
				non-physician personnel who provide direct patient care in clinical areas of a
				Staff or Mixed Model HMO shall receive 1 hour annually of risk management and
				risk prevention education and training including the importance of accurate and
				timely incident reporting. The incident reporting system shall include the
				prompt, within 3 business days, reporting of incidents to the risk manager.
				Incident reports shall be on a form developed by the HMO for the purpose and
				shall contain at least the following information:
(a) The patient's name, date of birth, sex,
				physical findings or diagnosis and, if hospitalized; locating information,
				admission time and date, and the facility's name;
(b) A clear and concise description of the
				incident including time, date, exact location, and coding elements as needed
				for the annual report based on ICD-10-CM;
(c) Whether or not a physician was called
				and, if so, a brief statement of said physician's recommendations as to medical
				treatment, if any;
(d) A listing of
				all persons known to be involved directly in the incident, including witnesses,
				along with locating information for each; and,
(e) The name, signature and position of the
				person completing the report, along with date and time that the report was
				completed.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.013 - Advance Directives

Current through Reg. 50, No. 138; July 16, 2024
(1) Each health
				maintenance organization shall have written policies and procedures, which
				delineate the health care facility's position with respect to the state law and
				rules relative to advance directives. The policies shall not condition
				treatment or admission upon whether or not the individual has executed or
				waived an advance directive. In the event of conflict between the facility's
				policies and procedures and the individual's advance directive, provision
				should be made in accordance with Section
				765.308, F.S.
(2) The facility's policy shall include:
(a) Providing each adult individual, at the
				time of enrollment of the individual with the organization, with a copy of
				"Health Care Advance Directives - The Patients' Right to Decide, " as prepared
				by the Agency for Health Care Administration, 2727 Mahan Drive, Tallahassee, FL
				32308, effective 1-11-93, which is hereby incorporated by reference, or with a
				copy of some other substantially similar document which is a written
				description of Florida's state law regarding advance directives;
(b) Providing each adult individual, at the
				time of enrollment of the individual with the organization, with written
				information concerning the health care facility's policies respecting advance
				directives; and,
(c) The
				requirement that documentation of the existence of an advance directive be
				contained in the medical record. A health care facility which is provided with
				the individual's advance directive shall make the advance directive or a copy
				thereof a part of the individual's medical
				record.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.016 - Definitions for the Managed Care Ombudsman Committees (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 641.70 FS. Law Implemented 641.70
					 FS.
New 12-13-98, Repealed
					 9-6-18.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.017 - The Agency for Health Care Administration's Responsibilities (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 641.70 FS. Law Implemented 641.70
					 FS.
New 12-13-98, Repealed
					 9-6-18.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.018 - The District Managed Care Ombudsman Committees Responsibilities (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 641.70 FS. Law Implemented 641.70
					 FS.
New 12-13-98, Repealed
					 9-6-18.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.019 - The Statewide Managed Care Ombudsman Committee Responsibilities (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 641.70 FS. Law Implemented 641.70
					 FS.
New 12-13-98, Repealed
					 9-6-18.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.020 - Statewide Provider and Subscriber Assistance Program Forms (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 408.15 FS. Law Implemented 408.7056
					 FS.
New 9-17-00, Repealed
					 9-6-18.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-12 - HEALTH MAINTENANCE ORGANIZATIONS AND PREPAID HEALTH CLINICS › Section 59A-12.030 - Statewide Provider and Health Plan Claim Dispute Resolution Program

Current through Reg. 50, No. 138; July 16, 2024
(1) Definitions.
(a) "Contracted provider" means a provider
				who is under a contractual agreement with a health plan.
(b) "Disputed Claim" means a claim that has
				been submitted by a provider to the health plan or by a health plan to a
				provider for payment and has been denied in full or in part, or is presumed to
				have been underpaid or overpaid.
(c) "Disputed Claim Amount" means the
				difference between the expected reimbursement amount and the reimbursement
				received.
(d) "Health Plan" as
				defined in Section 408.7057(1)(b),
				F.S., or a managed care or long term care plan procured pursuant to Section
				409.966, F.S.
(e) "Non-contracted provider" means a
				provider that does not have a contractual agreement with a health
				plan.
(f) "Provider" as defined in
				Section 641.19(15),
				F.S., means any physician, hospital, institution, organization, or person that
				furnishes health care services and is licensed or otherwise authorized to
				practice in the state. Includes both contracted and non-contracted
				providers.
(g) "Professional
				services" means occupations that require special training or holding a
				professional license not classified as hospital inpatient or outpatient
				services.
(h) "Resolution
				organization" means a qualified independent third-party claim-dispute
				resolution entity selected by and contracted with the Agency for Health Care
				Administration.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.004 - License Procedure

Current through Reg. 50, No. 138; July 16, 2024
(1) Except as
				provided in Sections 400.903 and
				400.905, F.S., no person, firm,
				association, partnership, or corporation shall either directly or indirectly
				operate a PPEC center in this state without first applying for and receiving a
				license from the Agency.
(2)
				Application for a license to operate a PPEC center must be made on the Health
				Care Licensing Application, Prescribed Pediatric Extended Care Centers, AHCA
				Form 3110-8002, July 2014, hereby incorporated by reference, which must be
				submitted by the owner or administrator to the Agency. This form is available
				at
http://www.flrules.org/Gateway/reference.asp?No=Ref-04592
,
				and available from the Agency for Health Care Administration, 2727 Mahan Drive,
				MS #33, Tallahassee, Florida 32308, or at the web address at:
				http://ahca.myflorida.com/HQAlicensureforms. In addition to a completed
				application, applicants for initial, renewal and change of ownership must
				submit the following:
(a) Biennial licensure
				fees in the amount of $1, 512.35 payable to the Agency for Health Care
				Administration. A license for an initial or change of ownership application
				will not be issued until the application fee has been received by the Agency
				and all associated checks have cleared. If a check for the renewal licensure
				fee is dishonored and returned to the Agency, the license holder will have ten
				(10) calendar days to pay the full amount plus any applicable fees as provided
				by law. Such payment must be made by cashier's check or money order. Failure to
				pay the licensure and processing fee may result in suspension of the license
				until all fees are paid in full.
(b) Documentation of compliance with
				subsection 59A-13.022(1),
				F.A.C., regarding fire safety conducted within the previous three
				months.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.007 - Admission, Transfer, and Discharge Policies

Current through Reg. 50, No. 138; July 16, 2024
(1) Each PPEC center must have written
				policies and procedures governing the admission, transfer, and discharge of
				children.
(2) The admission of each
				child to a PPEC center must be under the supervision of the center
				administrator or designee, and must be in accordance with the center's child
				care policies and procedures.
(3)
				Each child admitted to a PPEC center must be admitted upon prescription by a
				licensed physician and must remain under the care of the licensed physician for
				the duration of the child's stay in the center.
(4) Each child admitted for service to a PPEC
				center must meet at least the following criteria:
(a) Infants and children considered for
				admission to the PPEC center will be those who are medically or technologically
				dependent.
(b) The infants and
				children must not, prior to admission, present significant risk of infection to
				other children or personnel. The medical and nursing directors must review, on
				a case-by-case basis, any child with a suspected infectious disease to
				determine appropriateness of admission.
(c) The child must be medically stabilized,
				require skilled nursing care, or other interventions, and be appropriate for
				outpatient care.
(d) If the child
				meets the preceding criteria, the medical or nursing director of the PPEC
				center must implement a preadmission plan which delineates services to be
				provided and appropriate sources for such services.
1. If the child is hospitalized at the time
				of referral, pre-admission planning will include the parents or guardians,
				relevant hospital medical, nursing, social services and developmental staff to
				assure that the hospital discharge plans will be implemented upon admission to
				the PPEC center.
2. A consent form
				outlining the purpose of a PPEC center, family responsibilities, authorized
				treatment and appropriate liability release, and emergency disposition plans
				must be signed by the parents or guardians and witnessed prior to admission to
				the PPEC center. The parents or guardians must be provided a copy of the
				consent form. A copy of the signed consent form must be maintained in the
				child's medical record. Confidentiality of the PPEC records must be maintained
				in accordance with applicable state and federal
				laws.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.008 - Child Care Policies

Current through Reg. 50, No. 138; July 16, 2024
(1) Each PPEC center
				must develop, implement, and maintain written policies and procedures governing
				all child care and related medical or other services provided.
(2) Child care policies and procedures must
				be developed, maintained and implemented by a group of professional PPEC center
				staff personnel comprised of at least the medical director or medical
				consultant, the center's administrator, and the director of nursing services.
				All child care policies and procedures must be reviewed at least annually and
				revised as needed.
(3) The child
				care policies and procedures developed must, at a minimum, ensure compliance
				with the provisions of Section
				400.914, F.S., and the standards
				contained in these rules.
Rulemaking Authority 400.914(1) FS. Law Implemented
					 400.914(1)(a) FS.
New 3-8-89, Formerly 10D-102.008, Amended
					 6-22-06.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.009 - Medical Director

Current through Reg. 50, No. 138; July 16, 2024
A board certified pediatrician must serve as the medical
				  director for the PPEC center. Responsibilities of the medical director
				  include:
(1) Periodic review of
				services to assure acceptable levels of quality of care and services.
(2) Maintenance of a liaison role with the
				medical community.
(3) Advisement
				on the development of new programs and modifications of existing
				programs.
(4) Assurance that
				medical consultation will be available in the event of the medical director's
				absence.
(5) Serving on committees
				as defined and required by these rules and by the center's policies.
(6) Consulting with the center's
				administrator on the health status of the center's personnel.
(7) Reviewing reports of all accidents or
				unusual incidents occurring on the premises and identifying to the center's
				administrator hazards to health and safety.
(8) Development and implementation of a
				policy and procedure for the delivery of emergency services and the delivery of
				regular physician's services when the child's attending physician or designated
				alternative is not available.
Rulemaking Authority 400.914(1) FS. Law Implemented
					 400.914(1)(f) FS.
New 3-8-89, Formerly 10D-102.009, Amended
					 6-22-06.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.010 - Nursing Services

Current through Reg. 50, No. 138; July 16, 2024
(1) A registered
				nurse (RN) will serve full-time as the Director of Nursing. The Director of
				Nursing must have at least the following qualifications:
(a) Hold a current Florida registered nurse
				license.
(b) Hold a current
				certification in Cardiopulmonary Resuscitation (CPR).
(c) Have a minimum of two (2) years general
				pediatric nursing experience of which at least six (6) months must have been
				spent caring for medically fragile infants or children in a pediatric intensive
				care, neonatal intensive care, PPEC or similar care setting during the previous
				five (5) years.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.013 - In-service Training for Staff and Parents and Guardians

Current through Reg. 50, No. 138; July 16, 2024
Each PPEC center must develop staff, parent and guardian
				  training programs.
(1) Staff training
				must include:
(a) Quarterly staff development
				programs appropriate to the category of personnel.
(b) Documentation of all staff development
				programs, and required participation.
(c) Current CPR certification for all
				staff.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.014 - Medical Record

Current through Reg. 50, No. 138; July 16, 2024
(1) A medical
				record must be developed at the time of admission, must be maintained for each
				child, signed by authorized personnel and contain at least the following:
(a) A medical plan of treatment and a nursing
				protocol of care.
(b) All details
				of the referral, admission, correspondence and papers concerning the
				child.
(c) Physician
				orders.
(d) Flow chart of
				medications and treatments administered.
(e) Concise, accurate information and
				initialed case notes reflecting progress toward achievement of care goals or
				reasons for lack of progress.
(f)
				Documentation of nutritional management and special diets, as
				appropriate.
(g) Documentation of
				physical, occupational, speech and other special therapies.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.015 - Quality Assurance Committee

Current through Reg. 50, No. 138; July 16, 2024
All PPEC centers must have a quality assurance program and
				  must conduct quarterly reviews of the PPEC center's medical records for at
				  least half of the children served by the PPEC center at the time of the quality
				  assurance review. The quarterly review sample must be randomly selected so each
				  child served at the center has an equal opportunity to be included in the
				  review.
(1) The quality assurance
				committee must include the following: the medical director, administrator,
				director of nursing, and three (3) other committee members as determined by
				each PPEC center.
(2) The quality
				assurance review will be conducted by two (2) members of the quality assurance
				committee. Within 15 calendar days of its review, the quality assurance
				committee must furnish copies of its report to the PPEC center medical and
				nursing directors.
(3) Each
				quarterly quality assurance review must include:
(a) A review of the goals in each child's
				nursing protocol.
(b) A review of
				the steps, process, and success in achieving the goals.
(c) Identification of goals not being
				achieved as expected, reasons for lack of achievement and plans to promote goal
				achievement.
(d) Evidence that the
				protocol has been revised to accommodate the findings of the quality assurance
				report will be forwarded to the quality assurance committee within then (10)
				calendar days of receipt of the quality assurance committee report.
(e) Implementation of revisions to the
				protocol must be documented in the child's record.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.020 - Infection Control

Current through Reg. 50, No. 138; July 16, 2024
Infection control requirements must include at least the
				  following:
(1) The PPEC center must
				have an isolation room with one (1) large glass area for observation of the
				child.
(2) Isolation procedures
				must be used to prevent cross-infections.
(3) All cribs and beds must be labeled with
				the individual child's name. Linens must be removed from the crib for
				laundering purposes only.
(4) Bed
				linens must be changed when soiled and as necessary, but not less than twice
				weekly.
(5) Antimicrobial soap and
				disposable paper towels must be at each sink.
(6) Staff must wash their hands after direct
				contact with each child, using appropriate hand washing techniques to prevent
				the spread of infection from one child to another.
(7) Children suspected of having a
				communicable disease, which may be transmitted through casual contact, as
				determined by the center's medical director, must be isolated; the parents or
				guardians must be notified of the condition; and the child must be removed from
				the PPEC center as soon as possible. When the communicable disease is no longer
				present, as evidenced by a written physician's statement, the child may return
				to the PPEC center.
(8) PPEC center
				staff members suspected of having a communicable disease must not return to the
				PPEC center until the signs and symptoms related to the communicable disease
				are no longer present, as evidenced by a written physician's
				statement.
Rulemaking Authority 400.914(1) FS. Law Implemented
					 400.914(1)(e) FS.
New 3-8-89, Formerly 10D-102.020, Amended
					 6-22-06.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-13 - PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS (PPEC) › Section 59A-13.022 - Emergency Procedures

Current through Reg. 50, No. 138; July 16, 2024
(1) All PPEC centers
				must conform to state standards prepared by the State Fire Marshal: Chapter
				69A-36, F.A.C., Uniform Fire Safety Standards for Child Care Facilities, and
				must be inspected annually. A copy of the current annual fire inspection
				report, conducted by the local authority having jurisdiction over fire safety
				or the State Fire Marshal, must be on file at the PPEC center. Documentation of
				a satisfactory fire safety inspection shall be provided at the time of the
				licensee's annual survey.
(2) There
				must be a working telephone, which is neither locked nor a pay station, in the
				PPEC center.
(3) Emergency
				telephone numbers must be posted on or in the immediate vicinity of all
				telephones.
(4) An emergency
				generator must exist, with sufficient generating power to continue function of
				medical equipment in the event of a power failure. The emergency generator must
				be tested every 30 days and satisfactory mechanical operation must be
				documented on a log designed for that purpose and signed by the person
				conducting the test.
(5) Emergency
				transportation must be performed by a licensed E.M.S. provider, with a PPEC
				center staff member accompanying each child.
(6) The PPEC center must have an emergency
				kit available to provide basic first aid and cardiopulmonary
				resuscitation.
Rulemaking Authority 400.914(1) FS. Law Implemented
					 400.914(1)(f) FS.
New 3-8-89, Formerly 10D-102.022, Amended
					 6-22-06.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-15 - PRIVATE UTILIZATION REVIEW › Section 59A-15.002 - Definitions (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 395.037 FS. Law Implemented 395.0172
					 FS.
New 2-18-92, Formerly 10D-111.002, Repealed
					 3-29-11.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-15 - PRIVATE UTILIZATION REVIEW › Section 59A-15.004 - Registration Requirements (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 395.1055 FS. Law Implemented 395.0199
					 FS.
New 2-18-92, Formerly 10D-111.004, Amended 3-18-96,
					 Repealed 3-29-11.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-15 - PRIVATE UTILIZATION REVIEW › Section 59A-15.009 - Confidentiality (Repealed)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 395.037 FS. Law Implemented 395.0172
					 FS.
New 2-18-92, Formerly 10D-111.009, Repealed
					 3-29-11.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.001 - Purpose (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.55
					 FS.
New 7-8-81, Formerly 10A-6.01, 10A-6.001, Transferred to
					 58A-6.001.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.002 - Definitions (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.55,
					 400.562 FS.
New 7-8-81, Amended 2-27-84, Formerly 10A-6.02, 10A-6.002,
					 Transferred to 58A-6.002.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.003 - Licensure (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.555,
					 400.556, 400.5565, 400.557, 400.558, 400.562
					 FS.
New 7-8-81, Amended 2-27-84, Formerly 10A-6.03, 10A-6.003,
					 Transferred to 58A-6.003.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.004 - Unlicensed Centers (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.558,
					 400.559 FS.
New 7-8-81, Amended 2-27-84, Formerly 10A-6.04, 10A-6.004,
					 Transferred to 58A-6.004.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.005 - Closing of a Center (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.558,
					 400.559, 400.562 FS.
New 7-8-81, Amended 2-27-84, Formerly 10A-6.05, 10A-6.005,
					 Transferred to 58A-6.005.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.006 - Governing Authority, Administration and Staffing (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 381.031, 400.562 FS. Law Implemented
					 381.031(1)(g)1., 400.562 FS.
New 7-8-81, Amended 2-27-84, Formerly 10A-6.06, 10A-6.006,
					 Transferred to 58A-6.006.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.007 - Standards for Participant Care (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.562
					 FS.
New 7-8-81, Amended 2-27-84, Formerly 10A-6.07, 10A-6.007,
					 Transferred to 58A-6.007.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.008 - Program Requirements (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.562
					 FS.
New 7-8-81, Formerly 10A-6.08, 10A-6.008, Transferred to
					 58A-6.008.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.009 - Basic Services (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.55,
					 400.562 FS.
New 7-8-81, Amended 2-27-84, Formerly 10A-6.09, 10A-6.009,
					 Transferred to 58A-6.009.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.010 - Supportive and Optional Services (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.55,
					 400.562 FS.
New 7-8-81, Formerly 10A-6.10, 10A-6.010, Transferred to
					 58A-6.010.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.011 - Participant and Program Data, Emergency Procedures (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.562
					 FS.
New 7-8-81, Amended 2-27-84, Formerly 10A-6.11, 10A-6.011,
					 Transferred to 58A-6.011.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.012 - Fiscal Standards (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.562
					 FS.
New 7-8-81, Formerly 10A-6.12, 10A-6.012, Transferred to
					 58A-6.012.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.013 - Physical Plant, Sanitary Conditions, Housekeeping Standards and Maintenance (Transferred)

Current through Reg. 50, No. 138; July 16, 2024
Rulemaking Authority 400.562 FS. Law Implemented 400.562
					 FS.
New 7-8-81, Amended 2-27-84, Formerly 10A-6.13, 10A-6.013,
					 Transferred to 58A-6.013.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.102 - Governing Authority, Administration and Staffing

Current through Reg. 50, No. 138; July 16, 2024
(1) The Center shall have a Governing
				Authority which shall establish policies in compliance with this rule chapter.
				Governing Authority, as defined in this rule chapter, may consist of one or
				more people, and designation of its membership or composition shall be
				determined by the Owner or Operator. The Governing Authority shall be
				responsible for ensuring compliance with standards requiring that:
(a) Admission criteria shall be determined by
				the Owner, Operator or Governing Authority and it may limit Participant
				eligibility to adults with Functional Impairments, in need of a protective
				environment or a program of therapeutic social and health activities and
				services as defined in this rule chapter. The Operator will assure that the
				admission of each Participant shall be reviewed within the confines of specific
				requirements set forth below:
1. Within
				forty-five days prior to admission to the Center, each person applying to be a
				Participant shall provide a statement signed by a physician licensed under
				chapters 458 and 459, F.S., a Florida licensed health care provider under the
				direct supervision of a physician, or a county public health unit. The
				statement must be signed within forty-five days prior to admission to the
				Center, and must state that the applicant is free from tuberculosis in the
				communicable form and free from signs and symptoms of any other communicable
				disease. Any Participant who is diagnosed as having a communicable disease
				shall be excluded from participation until deemed non-infectious. However,
				Participants who have Human Immunodeficiency Virus (HIV) infection may be
				admitted to the Center, provided that they would otherwise be eligible
				according to this rule.
2. No
				Participant shall be admitted or retained in a Center if he or she requires
				services from the Center that are beyond those that the Center is licensed to
				provide.
3. No Participant who
				requires medication during the time spent at the Center and who is incapable of
				self-administration of medication shall be admitted or retained unless there is
				a Staff member licensed according to Florida law to administer medications who
				will provide this service. A person licensed according to Florida law includes:
				a physician licensed under chapters 458 and 459, F.S.; an advanced registered
				nurse practitioner certified under chapter 464, F.S.; a dentist licensed under
				chapter 466, F.S.; a registered nurse or licensed practical nurse licensed
				under chapter 464, F.S.; or a physician's assistant, licensed under chapter
				458, F.S.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.104 - Program Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1) Each Center
				shall offer a planned program of varied activities and services promoting and
				maintaining the health of Participants and encouraging leisure activities.
				Opportunities for interaction and communication among Participants shall be
				available on a daily basis at each Center in order to enhance the Participant's
				well-being and to maximize individual functioning. Such activities and services
				shall be available during at least 60 percent of the time the Center is open to
				Participants and shall be documented in accordance with subsection
				(5).
(2) The Center shall make
				available Basic Services as defined in section
				429.901(3),
				F.S., and rule 59A-16.105, F.A.C., and may make
				available other Supportive and Optional Services.
(3) The Center shall provide for family
				consultation or referral service to community agencies, clinics, or physicians
				when the Participant or family is observed to be in need of intensive
				counseling, health, or mental health services.
(4) There shall be a written description of
				the range of services to be provided to Participants.
(5) A monthly schedule of daily activities
				shall be maintained on a current basis and displayed in a conspicuous
				place.
(6) The Center shall provide
				programs and information to increase the Participant's awareness of the
				following factors related to emergency preparedness and emergency management:
(a) The registration process for persons who
				need assistance during evacuations or when in shelter;
(b) The Center's activities and Staff
				available to assist in Participant's registration efforts; and,
(c) The implications of having a Functional
				Impairment in a disaster.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.105 - Basic Services

Current through Reg. 50, No. 138; July 16, 2024
(1) To be licensed
				as an Adult Day Care Center, the following minimum Basic Services shall be
				provided:
(a) A protective environment that
				promotes a non-institutional atmosphere where supervision for the health,
				safety and well-being of adults who have Functional Impairments is
				provided;
(b) A variety of
				therapeutic, social and health activities and services which help to restore,
				remediate, or maintain optimal functioning of the Participants and to increase
				interaction with others. Examples of such programs include exercise, health
				screening, health education, interpersonal communication, and behavior
				modification;
(c) Leisure-time
				activities or spectator or Participant programs designed to assist
				Participants' self-expression, enhance self-esteem and provide mental
				stimulation or social participation. Examples of such programs include
				opportunities for arts and crafts; daily exercise as can be tolerated by the
				Participant or as prescribed by the Participant's physician; development of
				hobbies; excursions or outings to points of interest to the Participants; and
				other outside activities which may include picnics and cookouts;
(d) Self-care training activities designed to
				assist Adults with Functional Impairments to restore or maintain the ability to
				perform Activities of Daily Living;
(e) Rest or period of relaxation or
				inactivity during the day, that meets the needs of the individual
				Participants;
(f) Nutritional
				services or food provided or prepared in a central location in a Center or by
				formal agreement with a third party; the activities performed and the resources
				utilized in the planning, processing, preparing, and serving of meals or
				snacks; nutritional education; and nutritional counseling.
(g) In-facility Respite Care for Adults with
				Functional Impairments for the purpose of relieving the primary
				caregiver.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.107 - Participant and Program Data, Comprehensive Emergency Management Plan

Current through Reg. 50, No. 138; July 16, 2024
(1) The Owner or Operator shall establish,
				maintain and make available and ready for immediate use to the Agency, complete
				and accurate social, medical and fiscal records which fully disclose the extent
				of services to be maintained by the Center for a period of two years.
(2) The Participant File shall include a
				Participant Data Sheet which shall be completed for each Participant within
				forty-five days prior to or twenty-four hours after admission to the Center and
				which shall include:
(a) Full name, birthday,
				address;
(b) Date admitted as a
				Participant and services to be provided;
(c) Next of kin, and address and phone number
				of such person;
(d) Guardian or
				Responsible Person and address and phone number of that person;
(e) Medicaid and Medicare identification and
				other health insurance numbers;
(f)
				Emergency contact person, home or office address and phone numbers of such
				person;
(g) Name and telephone
				number of attending physician to be contacted when there appears to be
				significant deviation from normal appearance or state of well-being of a
				Participant; physician's or hospital discharge statement no older than
				forty-five days indicating prescribed medications and dosage which is updated
				as changes are made by physicians or, until a statement is received, a dated
				and signed statement by the Participant, guardian or responsible person,
				stating that specific medication may be given as ordered by the attending
				physician; notation of physical and emotional conditions requiring care and
				medications administered; diet and mobility restrictions; and a statement that
				the Participant is free from tuberculosis in a communicable form;
(h) The Participant File shall be updated
				when there is a Significant Change in the Participant, or at least
				quarterly;
(i) The Owner or
				Operator or Staff designated by the Owner or Operator shall review and approve
				each Participant care plan.
Florida Administrative Code › 59 - AGENCY FOR HEALTH CARE ADMINISTRATION › 59A - Health Facility and Agency Licensing › Chapter 59A-16 - ADULT DAY CARE › Section 59A-16.108 - Fiscal Standards

Current through Reg. 50, No. 138; July 16, 2024
(1) The center shall
				establish and maintain a record of all funds held in trust, if any, and the
				participant funds shall be kept separate from the center funds. Such funds
				shall be used or expended only at the request of the participant, the
				participant's representative, designee, surrogate, guardian, or
				attorney-in-fact, if applicable.
(2) The center shall furnish at least
				annually, a complete verified statement of such funds or property to the
				participant or to the guardian or responsible person, detailing the amount and
				items received with sources and disposition. Such a report also shall be made
				at termination or transfer from the center.
(3) Any agency, governmental or private,
				contributing funds or property to the account of a participant, shall, upon
				request, be entitled to receive such a statement annually and upon termination
				or transfer.
(4) Centers shall
				maintain liability insurance coverage in force at all times. On the renewal
				date of the center's policy or whenever a center changes policies, the center
				shall file documentation with the AHCA, ADC Program, 2727 Mahan Drive,
				Tallahassee, FL 32308. Such documentation shall be issued by the insurance
				company, shall include the name of the center, dates of coverage and shall meet
				the criteria of this chapter.
Rulemaking Authority 429.929 FS. Law Implemented 429.929
					 FS.
New 7-8-81, Formerly 10A-6.12, 10A-6.012,
					 59A-16.012, Amended 11-9-95,
					 3-29-98, Formerly 58A-6.012,
					 7-1-19.