Section 400.476 - Staffing requirements; notifications; limitations on staffing services(1) ADMINISTRATOR.- (a) An administrator may manage only one home health agency, except that an administrator may manage up to five home health agencies if all five home health agencies have identical controlling interests as defined in s. 408.803 and are located within one agency geographic service area or within an immediately contiguous county. If the home health agency is licensed under this chapter and is part of a retirement community that provides multiple levels of care, an employee of the retirement community may administer the home health agency and up to a maximum of four entities licensed under this chapter or chapter 429 which all have identical controlling interests as defined in s. 408.803. An administrator shall designate, in writing, for each licensed entity, a qualified alternate administrator to serve during the administrator's absence.(b) An administrator of a home health agency who is a licensed physician, physician assistant, or registered nurse licensed to practice in this state may also be the director of nursing for a home health agency. An administrator may serve as a director of nursing for up to the number of entities authorized in subsection (2) only if there are 10 or fewer full-time equivalent employees and contracted personnel in each home health agency.(2) DIRECTOR OF NURSING.- (a) A director of nursing may be the director of nursing for:1. Up to two licensed home health agencies if the agencies have identical controlling interests as defined in s. 408.803 and are located within one agency geographic service area or within an immediately contiguous county; or2. Up to five licensed home health agencies if:a. All of the home health agencies have identical controlling interests as defined in s. 408.803;b. All of the home health agencies are located within one agency geographic service area or within an immediately contiguous county; andc. Each home health agency has a registered nurse who meets the qualifications of a director of nursing and who has a written delegation from the director of nursing to serve as the director of nursing for that home health agency when the director of nursing is not present. If a home health agency licensed under this chapter is part of a retirement community that provides multiple levels of care, an employee of the retirement community may serve as the director of nursing of the home health agency and up to a maximum of four entities, other than home health agencies, licensed under this chapter or chapter 429 which all have identical controlling interests as defined in s. 408.803.
(b) A home health agency that provides skilled nursing care may not operate for more than 30 calendar days without a director of nursing. A home health agency that provides skilled nursing care and the director of nursing of a home health agency must notify the agency within 10 business days after termination of the services of the director of nursing for the home health agency. A home health agency that provides skilled nursing care must notify the agency of the identity and qualifications of the new director of nursing within 10 days after the new director is hired. If a home health agency that provides skilled nursing care operates for more than 30 calendar days without a director of nursing, the home health agency commits a class II deficiency. In addition to the fine for a class II deficiency, the agency may issue a moratorium in accordance with s. 408.814 or revoke the license. The agency shall fine a home health agency that fails to notify the agency as required in this paragraph $1,000 for the first violation and $2,000 for a repeat violation. The agency may not take administrative action against a home health agency if the director of nursing fails to notify the department upon termination of services as the director of nursing for the home health agency.(c) A home health agency that provides skilled nursing care must have a director of nursing.(3) TRAINING.-A home health agency shall ensure that each certified nursing assistant employed by or under contract with the home health agency and each home health aide or home health aide for medically fragile children employed by or under contract with the home health agency is adequately trained to perform the tasks of a home health aide or home health aide for medically fragile children in the home setting. A parent, guardian, or family member who is seeking training required under s. 400.4765 to become a home health aide for medically fragile children is not required to repay or reimburse the home health agency for the costs associated with the home health aide for medically fragile children training program.(4) STAFFING.-Staffing services may be provided anywhere within the state. s.5, ch. 2008-246; s.49, ch. 2018-24; s.3, ch. 2023-183.Amended by 2023 Fla. Laws, ch. 183,s 3, eff. 6/2/2023.Amended by 2018 Fla. Laws, ch. 24, s 49, eff. 7/1/2018.