Florida Home Health Policy and Procedure Manual
For Florida home health agencies licensed by the Agency for Health Care Administration (AHCA) to provide skilled care, whether or not they are Medicare-certified. The manual has 57 policies and 63 forms, written to Chapter 400, Florida Statutes, Rule 59A-8 of the Florida Administrative Code and, for certified agencies, the home health Conditions of Participation (42 CFR Part 484). Each policy opens with a plain-English summary and names the rule it follows, and every one is filled in with your agency's details. You get Word and PDF files to keep, and your staff sign off on their phones.
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Florida · Home health
57 policies written to the Florida rules, with 63 forms. Every one is filled in with your agency's details.
- A plain-English summary first
- The rule each policy follows
- Word and PDF downloads, yours to keep
- Policies
- 57
- Forms
- 63
- Categories
- 13
- Policy Pack · required
- $950one-timeIncludes 90 days in the portal with Premium. To keep it open after that, Premium is $99 a month or $990 a year.
Read before you buy
3 free sample policies, shown in full for a sample agency.
FL-HH-CMP-01Free sample
Client rights
Complaints and Grievances
Tells patients, on or before the first day of service, how to complain to AHCA, using the statutory words (s. 408.810(5)(a)1., F.S.), and sets out how the Agency receives, logs, acknowledges, investigates, resolves, and answers every complaint, within the Agency's own time frames (5 to acknowledge and 30 to resolve, since Florida sets none for home health agencies), how complaints that involve abuse are reported to the Florida Abuse Hotline at once, how retaliation is prevented, and how the Agency cooperates with AHCA complaint investigations under s. 408.811, F.S. Adds the federal complaint duties for a Medicare-certified agency (42 CFR §484.50(e)(1)).
Read the full policy FL-HH-SG-01Free sample SafeguardingAbuse, Neglect, and Exploitation of Vulnerable Adults: Recognition and Reporting
Every employee and contractor who knows, or has reasonable cause to suspect, that a vulnerable adult has been or is being abused, neglected, or exploited must report it immediately to the Florida Abuse Hotline (s. 415.1034(1)(a), F.S.). This policy defines the terms as chapter 415, F.S., does, lists warning signs, sets out exactly how and to whom to report, what the report should contain, how the Agency protects the patient, handles an allegation against its own staff, and cooperates with protective investigators, and explains the protections for reporters and the penalties for failing to report. Never wait 24 hours or for anyone's permission: the law says immediately.
Read the full policy FL-HH-IC-01Free sample Infection controlInfection Prevention and Control Program
Sets the Agency's infection prevention and control program: policies consistent with CDC and OSHA guidelines, standard precautions, hand hygiene, personal protective equipment, bag technique, cleaning of equipment, transmission-based precautions, staff who are ill, surveillance of infections with a log, outbreak response, education of staff, patients, and caregivers, links to quality assurance, and the federal infection control condition for a Medicare-certified agency.
Read the full policy
Florida rules
What Florida's rules ask your policies to cover
- Patient rights. For a home health agency they come from s. 400.487(4), F.S., Rule 59A-8.0215 and, for certified agencies, 42 CFR §484.50. Florida's general Patient's Bill of Rights (s. 381.026, F.S.) does not apply to home health agencies. s. 400.487(4), F.S.
- First-day notices. On the first day of service each patient is told how to complain to AHCA, how to report abuse and how to report Medicaid fraud. s. 408.810(5), F.S.
- Abuse reporting. Suspected abuse, neglect or exploitation is reported immediately to the Florida Abuse Hotline. s. 415.1034, F.S.; s. 39.201, F.S. for children
- Emergency management. A comprehensive emergency management plan reviewed by the county health department, and a current list of patients prioritized for care in an emergency. s. 400.492, F.S.; Rule 59A-8.027, F.A.C.
- Records. Skilled care records are kept 6 years after care ends, and Medicaid records 5 years. s. 400.491(1), F.S.; s. 409.913, F.S.
Questions a surveyor may ask
Every policy lists questions a surveyor may ask about it, so your staff can practice the answers. A few from this manual:
How does a patient learn how to complain to you and to AHCA? Show me the notice and when this patient received it.FL-HH-CMP-01Complaints and Grievances
Show me when this patient was referred, when services started, and when the 48-hour assessment was done.FL-HH-ADM-02Start of Care, Admission Visit, and the 48-Hour Assessment
How often does a registered nurse supervise this aide, and where is the supervisory visit documented?FL-HH-AID-02Aide Assignments, Permitted and Prohibited Tasks, and Registered Nurse Supervisory Visits
How do you track verbal orders until the practitioner signs them? Show me any that are unsigned.FL-HH-ORD-01Treatment Orders and Verbal Orders
Show me your current prioritized patient list. Does it include residents of assisted living facilities and adult family-care homes who need nursing services?FL-HH-EP-02Special Needs Registry, Patient Emergency Plans, Prioritized Patient List, and Care During Emergencies
The full pack
Browse all 57 policies
Search by title, policy number or rule. Open any policy to see its summary, the rules it follows and what is inside.
All 57 policies
Client rights5
FL-HH-CMP-01Free sample
Complaints and Grievances
Tells patients, on or before the first day of service, how to complain to AHCA, using the statutory words (s. 408.810(5)(a)1., F.S.), and sets out how the Agency receives, logs, acknowledges, investigates, resolves, and answers every complaint, within the Agency's own time frames (5 to acknowledge and 30 to resolve, since Florida sets none for home health agencies), how complaints that involve abuse are reported to the Florida Abuse Hotline at once, how retaliation is prevented, and how the Agency cooperates with AHCA complaint investigations under s. 408.811, F.S. Adds the federal complaint duties for a Medicare-certified agency (42 CFR §484.50(e)(1)).
s. 408.810(5), F.S.
FL-HH-PR-01
Patient Rights and Responsibilities and the First-Day Notice
Sets out the rights every patient of the Agency has under Florida law, gives the extra federal rights a Medicare-certified agency must honor, and requires the first-day notice under s. 408.810(5), F.S. (how to report a complaint, abuse, neglect or exploitation, and Medicaid fraud, with the statutory wording and toll-free numbers) on or before the first day services are provided. It also covers the written notice of rights, the patient's signature, notice to a representative, and patient responsibilities.
s. 408.810(5), F.S.
FL-HH-PR-02
Advance Directives and Do Not Resuscitate Orders
States the Agency's position on Florida advance directive law, requires each adult patient to receive the AHCA advance directive brochure (or an equivalent description of Florida law) and the Agency's written advance directive policy in advance of services, requires the record to show whether the patient has an advance directive and to hold a copy or a documented request for one, forbids conditioning care on an advance directive, and sets how staff honor a valid Florida Do Not Resuscitate Order (DNRO).
Rule 59A-8.0245, F.A.C.
FL-HH-PR-03
Home Health Service Agreement, Consents, and Disclosure of Charges
Requires a signed home health service agreement at the start of services that specifies the services, the rates or charges for services paid with private funds, and the sources of payment; sets how consent to care is obtained and how a patient may refuse; requires the patient's written consent before a registered nurse makes supervisory visits of an aide; and sets how the Agency tells patients, orally and in writing, what payers will cover and what the patient may owe, including advance notice of non-covered care and of reduced or ended services.
s. 400.487(1), F.S.
FL-HH-PR-04
Language Access, Effective Communication, Accessibility, and Nondiscrimination
Requires the Agency to be able to communicate with every patient it accepts, directly, through a qualified interpreter, or through translation technology (Rule 59A-8.020(1), F.A.C.); to give information in plain language and accessible formats with free interpreters, translations, and auxiliary aids (42 CFR §484.50(f) for a Medicare-certified agency); to follow the Section 1557 language access, effective communication, reasonable modification, notice, and grievance requirements in 45 CFR Part 92 where it is a covered entity; and never to discriminate or retaliate.
Rule 59A-8.020(1), F.A.C.
Service delivery10
FL-HH-ADM-01
Referral Intake, Acceptance to Service, and Patients in Assisted Living Facilities
Sets how the Agency receives and records referrals and decides whether to accept a patient: only where there is a reasonable expectation that services can be provided safely in the patient's place of residence, including being able to communicate with the patient, where the county is on the license, and where the Agency has the staff and skills to provide every assigned visit. It sets the director of nursing's admission criteria, what happens when a referral is declined, how the Agency works with assisted living facilities and adult family-care homes (coordination, no duplication of care the facility must provide, fair market value, and the 72-hour report of an unlicensed facility), and, if the Agency is Medicare-certified, the acceptance-to-service policy and public information on services and limitations reviewed at least annually.
Rule 59A-8.020(1), F.A.C.
FL-HH-ADM-02
Start of Care, Admission Visit, and the 48-Hour Assessment
Sets how the Agency starts care once a referral is accepted: confirming orders, scheduling within the Agency's start-of-care time frame, who makes the admission visit (a direct employee or contractor, a registered nurse when nursing is ordered), the Florida assessment of the patient's needs within 48 hours after the start of services, and, if the Agency is Medicare-certified, the initial assessment visit within 48 hours of referral or return home or on the ordered start of care date. It lists what happens at the admission visit and what the clinical record must hold at the start of care, including the special needs registry information required on admission.
s. 400.487(1), F.S.
FL-HH-ADM-03
Medicare and Medicaid Eligibility, Certification, Face-to-Face Encounter, and Authorization
Sets how the Agency verifies coverage before care and makes sure every Medicare and Florida Medicaid patient meets the conditions for payment: the Medicare eligibility requirements (confined to the home, under the care of a physician or allowed practitioner, need for intermittent skilled nursing or therapy, under a plan of care), the certification and recertification by the physician or allowed practitioner, the face-to-face encounter within the 90 days before or the 30 days after the start of care (Medicare and Medicaid), documentation that supports eligibility, practitioner financial relationships, Florida Medicaid and managed care authorization, and signed orders before a claim is submitted.
42 CFR §424.22
FL-HH-ASM-01
Comprehensive Assessment, Reassessment, Drug Regimen Review, and OASIS
Sets how the Agency assesses every patient: the Florida assessment of the patient's needs within 48 hours after the start of services, the registered nurse's review and reconciliation of all medicines before an aide assists with self-administration or is delegated medication administration, and, if the Agency is Medicare-certified, the comprehensive assessment no later than 5 calendar days after the start of care with its required content (including a drug regimen review and OASIS), updates in the last 5 days of every 60 days, within 48 hours of return home from a hospital admission of 24 hours or more, and at discharge, and OASIS encoding and transmission within 30 days.
42 CFR §484.55
FL-HH-CC-01
Case Management, Coordination of Services, Case Conferences, and Reports to the Practitioner
Names the case manager for each type of case (a registered nurse for nursing cases, a licensed therapist for therapy-only or therapy-and-aide cases, a licensed dietitian or nutritionist for dietetics-only cases, each a direct employee or contractor), sets the case manager's duties under the Florida definition of case management, and sets how the Agency coordinates all disciplines and contracted staff, holds and records case conferences, and reports to the physician, physician assistant, or advanced practice registered nurse when the patient's condition changes or care deviates from the plan of care. If the Agency is Medicare-certified, it adds the federal coordination of care standard.
Rule 59A-8.008, F.A.C.
FL-HH-CC-02
Business Hours, 24-Hour Nursing Availability, and On-Call
Sets the Agency's business hours, when the Administrator and the director of nursing (or their alternates) must be available to the public, who answers the telephone and the door, and what happens when an AHCA surveyor arrives. It sets the on-call system required by Rule 59A-8.003(9)(d), F.A.C., so that active patients receiving skilled care can reach licensed professional nursing staff 24 hours a day and designated nursing staff can communicate directly with the patient, and it sets how on-call contacts are handled, recorded, and handed back to the case manager.
Rule 59A-8.003(9), F.A.C.
FL-HH-CP-01
Plan of Care, Treatment Order Review, and Patient Participation
Requires an individualized plan of care for every patient, prepared by the case manager with each discipline and in consultation with the physician, physician assistant, or advanced practice registered nurse, with specific goals for each skilled discipline and implementation plans covering the level of staff, the frequency of visits, and case management. Staff follow the treatment orders in the plan; changes need the practitioner's approval and verbal changes are put in writing, signed, and dated. The patient is told of the right to be informed of the plan, to participate in it, and to have a copy, and receives every assigned visit. The plan is reviewed as often as the patient's illness requires and, if the Agency is Medicare-certified, at least every 60 days, with the content and written patient information 42 CFR §484.60 requires.
Rule 59A-8.0215, F.A.C.
FL-HH-CS-01
Scope of Services, Skilled Care, Services Listed on the License, and Home Infusion Therapy
Defines the home health services the Agency may provide, limits them to the services listed on the Agency's AHCA license, requires at least one service to be provided directly by Agency employees, sets who manages each type of case, sets the conditions for home infusion therapy, and covers laboratory testing under CLIA and the federal services requirement for a Medicare-certified agency.
s. 400.464(1), F.S.
FL-HH-DC-01
Discharge Planning, Transfer and Discharge Summaries, and Written Termination Notice
Sets how the Agency plans for discharge from admission, the reasons it may transfer or discharge a patient, and the Florida rule that when it ends services for a patient who still needs care (as the practitioner determines), it develops a plan and makes a referral to another agency or provider before termination and notifies the patient in writing of the date of and reason for termination and the plan for continued services. It covers the discharge visit, Medicare termination notices, transfer to a facility or another agency (including sending a copy of the record on request), the Florida termination summary, and, if the Agency is Medicare-certified, the transfer summary within 2 business days and the discharge summary within 5 business days.
Rule 59A-8.020(4), F.A.C.
FL-HH-DC-02
Discharge for Cause, Nonpayment, Refusal of Services, and Patient-Initiated Discharge
Sets how the Agency handles a patient's refusal of services, a patient's decision to leave the Agency, nonpayment, and discharge for cause. A patient may refuse any service and may choose to be discharged or transferred at any time. Florida's written termination notice and referral rule does not apply to private-pay or privately insured patients who default through nonpayment, but the Agency still gives written notice and offers social work assistance when private funds run out. If the Agency is Medicare-certified, it may discharge for cause only under this policy, after advising the patient, representative, and practitioners that discharge for cause is being considered, trying to resolve the problem, giving contact information for other providers, and documenting the problem and the efforts in the clinical record. Refusals and missed visits are always documented so that a pattern of services not provided can be explained.
42 CFR §484.50(d)
Clinical tasks10
FL-HH-AID-01
Home Health Aide and Certified Nursing Assistant Qualifications, Training, and Competency
Sets who may work as a home health aide or certified nursing assistant for the Agency: the documents the Agency must hold before the first visit, the 40-hour Florida training and its 16 subject areas, the AHCA Home Health Aide Competency Test, the rules for an aide course the Agency teaches itself, validation of training received elsewhere, the annual in-service and CPR duties, and the 75-hour training and competency evaluation required if the Agency is Medicare-certified.
Rule 59A-8.0095(5), F.A.C.
FL-HH-AID-02
Aide Assignments, Permitted and Prohibited Tasks, and Registered Nurse Supervisory Visits
Sets how aides and CNAs are assigned to patients with written instructions, the personal care and other tasks they may and may not perform under Florida rule, how they report changes, and how registered nurses (or therapists in therapy-only cases) supervise them, including the patient's consent to supervisory visits, the Agency's supervisory visit intervals, and the federal 14-day and 60-day supervision standards for a Medicare-certified agency.
s. 400.487(3), F.S.
FL-HH-AID-03
Home Health Aides for Medically Fragile Children
Applies only if the Agency runs the Florida program for home health aides for medically fragile children (AMFC). Sets who may be an AMFC, the 76-hour approved training, validation and revalidation, retraining after a 24-month gap, the 12 hours of yearly in-service, registered nurse supervision at least every 60 days, medication training for additional routes, the limits on services, and the 48-hour adverse incident report to AHCA and the managed care plan.
s. 400.4765, F.S.
FL-HH-CS-02
Skilled Nursing Services: Registered Nurse and Licensed Practical Nurse Duties
Sets the duties of registered nurses and licensed practical nurses in the Agency: the registered nurse as case manager and owner of the clinical record, progress reports to the practitioner, assignment of personal care tasks, supervision of licensed practical nurses with their annual evaluation, licensed practical nurse duties, clinical notes, and the federal skilled professional services standard for a Medicare-certified agency.
Rule 59A-8.0095(3), F.A.C.
FL-HH-CS-03
Therapy, Dietetic and Nutrition, and Social Work Services
Sets the duties of physical therapists and assistants, speech pathologists, occupational therapists and assistants, respiratory therapists, social workers, and dietitians/nutritionists under Rule 59A-8.0095, F.A.C., the supervision of therapy assistants, therapist and dietitian case management, therapist supervision of aides in therapy-only cases, the limit on clinical counseling by social workers, and the federal standards for a Medicare-certified agency.
Rule 59A-8.0095, F.A.C.
FL-HH-CS-04
Death of a Patient at Home and Pronouncement of Death
Tells staff what to do when a patient dies at home or is found dead: CPR and 911 unless a valid Florida Do Not Resuscitate Order is present, reporting any death that falls under s. 406.11, F.S. to the medical examiner or law enforcement forthwith and leaving the scene undisturbed, the registered nurse's determination of death in an expected death, notifying the practitioner, family and funeral home, the death certificate duties Florida gives to others, care of the body, medications and equipment, documentation, discharge, and support for the family.
s. 406.12, F.S.
FL-HH-DEL-01
Registered Nurse Delegation of Tasks to Home Health Aides and CNAs
Sets when and how a registered nurse of the Agency may delegate nursing tasks, including medication administration, to a home health aide or CNA: the four conditions in Florida rule, the statutory criteria for a delegable task, the delegation process of the Board of Nursing, what the nurse documents, the patient's written consent, supervision, rescinding a delegation, and the tasks that may never be delegated.
Rule 59A-8.0216, F.A.C.
FL-HH-MED-01
Assistance With Self-Administered Medication
Sets when and how a home health aide or CNA of the Agency may help a medically stable patient take his or her own routine medications: the documented request and written informed consent, the registered nurse review and medication reconciliation, the 2 hours of training and label-reading check, what assistance includes and does not include under s. 400.488, F.S., help with glucometers, oxygen cannulas, and other tasks, and how assistance is recorded.
s. 400.488, F.S.
FL-HH-MED-02
Medication Administration by Aides and CNAs: Training, Validation, Medication Administration Record, and Errors
Sets the conditions under which a home health aide or CNA of the Agency may administer medication delegated by a registered nurse: the 6-hour course and annual 2-hour in-service, trainer qualifications, route-by-route validation at 100 percent within 90 days, yearly revalidation, the registered nurse medication assessment, the medication administration record and its 60-day review, the administration procedure, "as needed" medications, prohibited acts, storage and disposal, what happens after a violation, and how medication errors are reported and used in quality assurance.
Rule 59A-8.0219, F.A.C.
FL-HH-ORD-01
Treatment Orders and Verbal Orders
Sets how the Agency obtains, takes, records, carries out, and gets signed the treatment orders of physicians, physician assistants, and advanced practice registered nurses, including verbal and telephone orders, orders given before the start of care, changes when an order cannot be followed, fax and electronic signatures, the Agency's time frame for practitioner signature, the rule that signed orders come before billing, written medication orders for aides, and the federal verbal order standards for a Medicare-certified agency.
s. 400.487(2), F.S.
Safeguarding2
FL-HH-SG-01Free sample
Abuse, Neglect, and Exploitation of Vulnerable Adults: Recognition and Reporting
Every employee and contractor who knows, or has reasonable cause to suspect, that a vulnerable adult has been or is being abused, neglected, or exploited must report it immediately to the Florida Abuse Hotline (s. 415.1034(1)(a), F.S.). This policy defines the terms as chapter 415, F.S., does, lists warning signs, sets out exactly how and to whom to report, what the report should contain, how the Agency protects the patient, handles an allegation against its own staff, and cooperates with protective investigators, and explains the protections for reporters and the penalties for failing to report. Never wait 24 hours or for anyone's permission: the law says immediately.
s. 415.1034, F.S.
FL-HH-SG-02
Child Abuse, Abandonment, and Neglect: Mandatory Reporting
Every employee and contractor who knows, or has reasonable cause to suspect, child abuse, abandonment, or neglect must report immediately to the Florida Abuse Hotline (s. 39.201(1)(a), F.S.). Nurses and other health care professionals must give their names when they report (s. 39.201(1)(b)2., F.S.), and telling a supervisor does not relieve a person of the duty (s. 39.205(11), F.S.). Applies to pediatric patients, including children cared for by home health aides for medically fragile children, and to any child staff see in a patient's home.
s. 39.201, F.S.
Infection control3
FL-HH-IC-01Free sample
Infection Prevention and Control Program
Sets the Agency's infection prevention and control program: policies consistent with CDC and OSHA guidelines, standard precautions, hand hygiene, personal protective equipment, bag technique, cleaning of equipment, transmission-based precautions, staff who are ill, surveillance of infections with a log, outbreak response, education of staff, patients, and caregivers, links to quality assurance, and the federal infection control condition for a Medicare-certified agency.
Rule 59A-8.0095(2)(c), F.A.C.
FL-HH-IC-02
Bloodborne Pathogens Exposure Control, Sharps, and Biomedical Waste
Sets the Agency's exposure control plan under the OSHA bloodborne pathogens standard (exposure determination, safer sharps, PPE, hepatitis B vaccination within 10 working days with the mandatory declination, confidential post-exposure evaluation, training, and records, including the sharps injury log) and its biomedical waste plan under Florida Department of Health rules (telling patients how to handle home-generated waste, removing waste staff generate, red bags and sharps containers, labeling, the 30-day storage limit, transport, and training).
29 CFR §1910.1030
FL-HH-IC-03
Facial Coverings
Sets the only circumstances in which the Agency may require a patient, visitor, or employee to wear a facial covering under Florida law, the opt-out each person must be offered, the cases in which an employee may not opt out, where this policy must be posted, and how the OSHA respiratory protection standard still applies when a respirator is needed to protect staff.
s. 408.824, F.S.
Emergency preparedness2
FL-HH-EP-01
Comprehensive Emergency Management Plan and Emergency Preparedness Program
Requires the Agency to prepare, keep, and follow a comprehensive emergency management plan (CEMP) in the format of AHCA Form 3110-1022 (Rule 59A-8.027(1), F.A.C.; s. 400.492, F.S.), sets out who leads it (the safety liaison required by s. 408.821(1), F.S.), what the plan must cover, when it is reviewed, submitted, and reported to AHCA (the 30-day steps in s. 408.821(1), F.S.), how phone number changes are reported to county emergency management and county health departments, how the plan is activated, and how staff are trained. If the Agency is Medicare-certified, adds the federal emergency preparedness program, communication plan, and training and testing rules in 42 CFR §484.102.
s. 400.492, F.S.
FL-HH-EP-02
Special Needs Registry, Patient Emergency Plans, Prioritized Patient List, and Care During Emergencies
Sets out what staff do for each patient before, during, and after an emergency: telling every patient and caregiver on admission about the special needs registry and recording the patient's plan to evacuate or stay home (Rule 59A-8.027(8), F.A.C.), providing registration information each year and collecting and submitting registration information (s. 252.355(2)(b), F.S.; Rule 59A-8.027(13)), keeping a medication, supply, and equipment list in the home of each special needs patient (Rule 59A-8.027(17)), keeping a current prioritized patient list (s. 400.492(2), F.S.), contacting patients and facilities when an emergency threatens, continuing care at home and in special needs shelters, and documenting good-faith efforts when care cannot continue (s. 400.492(3), F.S.).
Rule 59A-8.027(8), F.A.C.
Records1
Privacy3
FL-HH-PRV-01
Patient Confidentiality and HIPAA Privacy
Keeps patient information confidential as s. 400.494, F.S., and Rule 59A-8.022(2), F.A.C., require; allows disclosure only as the HIPAA Privacy Rule permits and, beyond treatment, payment, operations, and disclosures the law requires, with the patient's written consent or authorization; names the privacy official; sets how the notice of privacy practices is given and acknowledged; and sets the time frames for the patient's rights to see, copy, amend, restrict, and receive an accounting of disclosures. Adds the OASIS confidentiality rule for a Medicare-certified agency.
s. 400.494, F.S.
FL-HH-PRV-02
HIPAA Security and Location of Electronic Health Records
Sets the administrative, physical, and technical safeguards the HIPAA Security Rule requires for electronic patient information, including the risk analysis, security official, access control, audit, device and media rules, contingency plan, and security incident response; meets Florida's rule that electronic records be authenticated, protected from unauthorized access, and able to be reconstructed after a system breakdown; and keeps all offsite and cloud storage of patient information in the continental United States, its territories, or Canada, as the licensee attests to AHCA.
45 CFR Part 164, Subpart C
FL-HH-PRV-03
Breach Notification Under HIPAA and the Florida Information Protection Act
Sets how the Agency investigates a possible breach of patient information, carries out the HIPAA four-factor risk assessment, and gives every notice required by the HIPAA Breach Notification Rule and the Florida Information Protection Act (s. 501.171, F.S.): to each affected person no later than 30 days after the breach is determined, which meets both laws; to the Florida Department of Legal Affairs when 500 or more Floridians are affected; to the media and HHS as HIPAA requires; and to the consumer reporting agencies when more than 1,000 people are notified at once.
s. 501.171, F.S.
Human resources5
FL-HH-HR-01
Personnel Policies, Job Descriptions, Qualifications, and Performance Evaluation
Requires written personnel policies and job descriptions, sets the Florida qualifications for every clinical discipline under Rule 59A-8.0095, F.A.C., requires those qualifications to be verified before the first patient visit, requires an annual performance evaluation for every employee and the annual registered nurse evaluation of each licensed practical nurse, and covers employment eligibility verification and workers' compensation.
Rule 59A-8.0095, F.A.C.
FL-HH-HR-02
Orientation, Required Training, and Annual In-Service Education
Sets the orientation every new staff member receives and the training Florida requires by deadline: the one-time HIV/AIDS course within 30 days, the dementia training under s. 430.5025, F.S., the annual in-service and current CPR for aides and CNAs, and the 2-hour annual medication in-service for aides who administer medication, plus the federal training for a Medicare-certified agency.
Rule 59A-8.0095(5), F.A.C.
FL-HH-HR-03
Level 2 Background Screening, the Clearinghouse, and Exemptions
Requires Level 2 background screening through AHCA and the Care Provider Background Screening Clearinghouse for every owner, administrator, financial officer, and staff member or contractor whose role requires it, bars contact with patients until screening is complete, sets rescreening, arrest reporting, the 5-business-day status reporting, the 90-day break-in-service rule, disqualification notices, and exemptions.
s. 408.809, F.S.
FL-HH-HR-04
Personnel Records and License and Certification Verification
Lists what every personnel file must hold, including the screening result and attestation, licenses and certifications, aide training or competency test documentation, CPR, HIV/AIDS and dementia training, and medication training and validation, and sets how personnel and employee medical records are kept, protected, made available to AHCA, and retained.
Rule 59A-35.090(3)(c), F.A.C.
FL-HH-HR-05
Employee Health Screening, Staff Safety in the Home, and Workplace Violence Prevention
Sets the Agency's own employee health screening standard (Florida home health rules require no tuberculosis test or health statement, but any health statement used must be truthful), immunization offers, fitness for duty, and the safety program for staff who work alone in patients' homes: visit risk assessment, check-in and check-out, safe travel, safe patient handling, animals and weapons, threats and violence, incident reporting, OSHA injury recording and reporting, and workers' compensation.
29 U.S.C. §654(a)(1)
Governance8
FL-HH-GOV-01
Governing Body, Ownership and Controlling Interests, Organization, and Lines of Authority
Names the licensee as legally responsible for every part of the Agency's operation, sets out how the governing body exercises that responsibility, keeps ownership and controlling interests lawful and screened, requires a written organizational chart with lines of authority down to the patient's home, and requires at least one home health service to be provided directly at all times.
s. 408.803(9), F.S.
FL-HH-GOV-02
Administrator and Alternate Administrator
Sets the Florida qualifications for the Administrator, limits how many agencies one Administrator may run, requires a written designation of a qualified alternate administrator, keeps the Administrator or alternate available to the public and to surveyors, and requires AHCA to be told of any change.
Rule 59A-8.0095(1), F.A.C.
FL-HH-GOV-03
Director of Nursing, Alternate Director of Nursing, and Clinical Manager
Requires a qualified director of nursing at all times, sets the limits on serving more than one agency and on the Administrator also serving as director of nursing, sets the 30-day and 10-day duties when the director of nursing leaves, lists the director of nursing's duties under Rule 59A-8.0095(2), F.A.C., and names the clinical manager if the Agency is Medicare-certified.
s. 400.476(2), F.S.
FL-HH-GOV-04
Licensure, Accreditation, Licensed Services, Insurance, and Changes Reported to AHCA
Keeps the Agency's license, the services listed on it, its accreditation for skilled care, and its required insurance current, sets the renewal and change deadlines in chapter 408, F.S., and chapter 59A-35, F.A.C., and lists every report the Agency owes AHCA with its time frame.
s. 400.471, F.S.
FL-HH-GOV-05
Geographic Service Area, Main Office, Satellite Offices, and Drop-Off Sites
Limits the Agency to the counties listed on its license, sets the rules for the main office, satellite offices, and drop-off sites, and requires a license amendment before the Agency moves, adds or drops a county, or opens or closes an office or drop-off site.
Rule 59A-8.007, F.A.C.
FL-HH-GOV-06
Licensure Surveys, Inspections, Certified Reports, and Plans of Correction
Prepares the Agency for unannounced licensure, accreditation, and complaint surveys, sets the one-hour and two-hour arrival duties, sets how the director of nursing produces a certified report of services within two or three hours, and sets the time frames for correcting deficiencies, filing plans of correction, and keeping inspection reports.
Rule 59A-8.003(2), F.A.C.
FL-HH-GOV-07
Contracted Personnel, Services Under Arrangement, and Staffing Services
Sets how the Agency uses contracted nurses, therapists, and other individuals or organizations, including the admission, evaluation, and discharge visits the Agency may now have contractors make, requires a written agreement and the same screening and qualifications as employees, keeps the Agency fully responsible for contracted care, and sets the rules for staffing services to facilities.
s. 400.487(5), F.S.
FL-HH-GOV-08
Change of Ownership, Inactive License, Closure, and Disposition of Records
Sets the 60-day notice and application rules for a change of ownership, keeps the transferor responsible until the new owner is licensed, sends all patient records to the new owner, covers an inactive license after a declared emergency, and sets the 30-day notice, patient notice, license surrender, and record disposition steps if the Agency closes.
s. 408.810(4), F.S.
Quality3
FL-HH-QA-01
Quality Assurance Program and Quarterly Clinical Record Review
Sets up the quality assurance program that Rule 59A-8.0095(2)(e), F.A.C., requires the director of nursing to establish and conduct: a documented review, at least quarterly, of a sample of both active and closed clinical records against the seven assurances the rule lists, the indicators the Agency tracks, how findings become corrective action plans, how medication errors and incidents feed the program, and how results reach the Administrator and the governing body. If the Agency is Medicare-certified, this program is run as one program with the QAPI program in Policy FL-HH-QA-02.
Rule 59A-8.0095(2)(e), F.A.C.
FL-HH-QA-02
Quality Assessment and Performance Improvement for Medicare-Certified Agencies
Sets out the quality assessment and performance improvement (QAPI) program that 42 CFR §484.65 requires of a Medicare-certified home health agency: an agency-wide, data-driven program using OASIS-derived and other quality data, focused on high-risk, high-volume, and problem-prone areas and on adverse patient events, with documented performance improvement projects and governing body oversight. Also covers participation in the Home Health Quality Reporting Program (42 CFR §484.245) and the expanded Home Health Value-Based Purchasing Model (42 CFR §484.350). If the Agency is not Medicare-certified, the Agency follows the program design in this policy as its own standard, alongside Policy FL-HH-QA-01.
42 CFR §484.65
FL-HH-QA-03
Incident Reporting, Investigation, and Adverse Incident Reports to AHCA
Explains what staff must report as an incident, how to report it, who is told, how incidents are investigated and fed into the quality assurance program, and where reports go outside the Agency. In Florida a home health agency must send an adverse incident report to AHCA only for incidents under the care of a home health aide for medically fragile children: electronically within 48 hours after the occurrence on AHCA Form 3110-0011 OL through the AHCA Single Sign On Portal, and to the managed care plan within 48 hours (Rule 59A-8.0099(7), F.A.C.; s. 400.54(2), F.S.). Abuse, neglect, and exploitation go to the Florida Abuse Hotline immediately.
Rule 59A-8.0099(7), F.A.C.
Business3
FL-HH-BUS-01
Financial Ability to Operate, Budget, Insurance, and Business Records
Keeps the Agency able to show AHCA its financial ability to operate, requires an annual budget approved by the governing body, requires notice to AHCA within 10 days of any court action to start bankruptcy, foreclosure, or eviction proceedings, keeps the required insurance in force, and sets how long business records are kept, with the federal institutional planning duties for a Medicare-certified agency.
s. 408.810(8), F.S.
FL-HH-BUS-02
Billing, Claims, Signed Treatment Orders Before Billing, and Overpayments
Requires every claim to be for services actually provided, ordered, documented, and covered, requires treatment orders to be signed before a claim for skilled services is submitted, keeps charges to patients to those disclosed in the service agreement, and sets the 60-day rule for reporting and returning overpayments.
s. 400.487(2), F.S.
FL-HH-BUS-03
Electronic Visit Verification for Florida Medicaid Home Health Services
Requires every Florida Medicaid home health service covered by electronic visit verification to be verified at the beginning and end of the visit in the EVV system designated by AHCA or by the member's managed care plan, and sets how missed verifications are corrected and documented.
Rule 59G-4.132, F.A.C.
Ethics2
FL-HH-ETH-01
Compliance Program, Exclusion Screening, and Fraud Prevention
Sets up the Agency's compliance program: a compliance officer, a code of conduct, training, a way to report concerns without retaliation, monthly screening of staff and contractors against exclusion lists, auditing, investigation, and correction, together with the Florida and federal false claims and Medicaid fraud laws staff must know.
s. 409.913, F.S.
FL-HH-ETH-02
Referrals, Remuneration, Medical Director Contracts, Patient Inducements, and Advertising
Prohibits paying or receiving anything of value for patient referrals, sets the strict Florida rules for medical director contracts and for dealings with physicians, discharge planners, and assisted living facilities, bans cash or equivalents to Medicare and Medicaid beneficiaries, and sets the advertising rules on license numbers, dementia care claims, the Excellence in Home Health designation, and aide training.
s. 400.474(6), F.S.
Questions
Questions about this manual
We provide only non-skilled care. Is this the right manual?
No. This one is for skilled home health. Agencies licensed for non-skilled services only, and homemaker and companion registrants, need the Florida home care manual.
Does it suit both Medicare-certified and non-certified agencies?
Yes. The policies follow Florida's rules for every licensed home health agency and add the federal Conditions of Participation where an agency is Medicare-certified.
Where Florida sets no number, what does the manual say?
Florida sets no fixed interval for some things, such as how often a registered nurse supervises an aide. There the policy states an agency standard and labels it as your agency's own choice, so you can change it.
What do the 57 policies cover?
Client rights (5), service delivery (10), clinical tasks (10), safeguarding (2), infection control (3), emergency preparedness (2), records (1), privacy (3), human resources (5), governance (8), quality (3), business (3) and ethics (2).
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