Florida Administrative Code

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 su…

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 Chapter 59A-12, F.A.C. Rulemaking Authority 641…

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. History-New 1-28-88, Formerly 10D-100.010, Amended 4-10-03.

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. History-New 1-28-88, Formerly 10D-100.011.

(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 respons…

(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…

Rulemaking Authority 641.70 FS. Law Implemented 641.70 FS. History-New 12-13-98, Repealed 9-6-18.

Rulemaking Authority 641.70 FS. Law Implemented 641.70 FS. History-New 12-13-98, Repealed 9-6-18.

Rulemaking Authority 641.70 FS. Law Implemented 641.70 FS. History-New 12-13-98, Repealed 9-6-18.

Rulemaking Authority 641.70 FS. Law Implemented 641.70 FS. History-New 12-13-98, Repealed 9-6-18.

Rulemaking Authority 408.15 FS. Law Implemented 408.7056 FS. History-New 9-17-00, Repealed 9-6-18.

(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 fu…

(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 …

(1) The licensee of each PPEC center shall have full legal authority and responsibility for the operation of the center. (2) Each PPEC center must be organized in accordance with a written table of organization, which describes the lines of authority and communication down to the…

(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 …

(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…

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…

(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) …

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) Cur…

(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, corre…

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 sel…

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 labele…

(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 au…

Rulemaking Authority 395.037 FS. Law Implemented 395.0172 FS. History-New 2-18-92, Formerly 10D-111.002, Repealed 3-29-11.

Rulemaking Authority 395.1055 FS. Law Implemented 395.0199 FS. History-New 2-18-92, Formerly 10D-111.004, Amended 3-18-96, Repealed 3-29-11.

Rulemaking Authority 395.037 FS. Law Implemented 395.0172 FS. History-New 2-18-92, Formerly 10D-111.009, Repealed 3-29-11.

(1) The following terms are defined in Sections 429.901 and 429.918, F.S., and are applicable to this rule chapter: "ADRD Participant," "Adult Day Care Center," or "Center," "Agency," "Basic Services," "Department," "Multiple or Repeated Violations," "Operator," "Owner," "Partici…

(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 th…

(1) The Center shall make a statement or summary statement of policies and procedures for Participant care available to Participants, to the responsible person, to the public, and to each member of the Center Staff. The statement or summary statement shall be displayed in a consp…

(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 …

(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 p…

In addition to the minimum Basic Services, the Center may choose to provide Supportive and Optional Services. If provided, such services must be administered by Staff qualified to provide such services and within the criteria established by relevant Florida Statutes. The followin…

(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…

(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…

(1) The Center shall provide adequate, safe and sanitary facilities appropriate for the services provided by the Center and for the needs of the Participants. All Centers receiving federal funds shall meet regulations for access to the handicapped in compliance with the Americans…

Rulemaking Authority 429.917(1) FS. Law Implemented 429.917(1) FS. History-New 1-1-04, Amended 8-3-15, Formerly 58A-6.015, Amended 7-1-19, Repealed 3-5-24.

Rulemaking Authority 429.918(6)(b), 429.929(1) FS. Law Implemented 429.918(6)(a) FS. History-New 8-3-15, Formerly 58A-6.0151, Amended 7-1-19, Repealed 3-5-24.

(1) Definitions. (a) Facility. A free-standing building, a complex of adjoined buildings, pods, or wings, or a complex of separate or adjoined buildings located within one campus. (b) Client. A person with a spinal-cord or head injury, as specified in section 400.9973(3), Florida…

Rulemaking Authority 400.805, 408.819 FS. Law Implemented 400.805, 408.805, 408.819 FS. History-New 9-28-92, Amended 10-19-94, 5-24-98, 8-28-14, Repealed 9-6-18.

(1) The licensee must ensure proper nutritional care for its clients, whether provided by the licensee or a third party, and shall provide education and training in proper nutrition and planning and preparation of meals consistent with the individualized client rehabilitation pla…

Each transitional living facility licensee must establish and implement written policies designed to maintain the physical plant and overall transitional living facility environment to assure the safety and well-being of clients. Rulemaking Authority 400.9982 FS. Law Implemented …

(1) It is the responsibility of the licensee to ensure that individual unlicensed direct care service staff (UDC) who will be administering medication to clients meet all requirements of this rule. (2) UDC may administer only prescribed, prepackaged, premeasured oral, topical nas…

(1) Required medication administration training must include criteria to ensure that competency is demonstrated through validation of the qualification of the unlicensed direct care services staff (UDC) and all requirements of UDC specified in this rule chapter. (2) Medication ad…

Rulemaking Authority 400.497, 400.506 FS. Law Implemented 400.497, 400.506 FS. History-New 2-9-93, Amended 12-24-00, Repealed 5-14-12.

When used in this rule chapter, unless the context otherwise requires, the term: (1) "AHCA" means Agency for Health Care Administration. (2) "Assistance with activities of daily living" means a certified nursing assistant or a home health aide providing an individual assistance w…

(1) In order to operate a nurse registry as defined under Section 400.462, F.S., the owner shall make application for a license as required by Rule 59A-35.060, F.A.C. The application shall be accompanied by a $2,000 licensure fee. The receipt of a license from AHCA shall be based…

(1) Each nurse registry shall disseminate the following rules and statutes to each applicable independent contractor at the time of registration. The rules and statutes may be provided by paper copy, by email or other means of electronic communication. (a) Registered nurses and l…