Fla. Admin. Code Ann. R. 59A-3.278 - Rehabilitation, Psychiatric and Substance Abuse Programs
(1) All rehabilitation, psychiatric, and
substance abuse programs provided by hospitals shall provide to the patient:
(a) An evaluation upon referral;
(b) Establishment of goals;
(c) Development of a plan of treatment,
including discharge planning, in coordination with the referring individual and
rehabilitation staff, and after discussion with the patient and
family;
(d) Regular and frequent
assessment, performed on an interdisciplinary basis, of the patient's condition
and progress, and of the results of treatment;
(e) Maintenance of treatment and progress
records; and,
(f) At least a
quarterly assessment of the quality and appropriateness of the care
provided.
(2) When any
rehabilitation activity, psychiatric or substance abuse treatment is provided
from outside the hospital, the source shall be available whenever needed for
patient care, meet all safety requirements, abide by all pertinent rules and
regulations of the hospital and medical staff, and document the quality
assurance measures to be implemented.
(3) The scope of services offered, and the
relationship of the rehabilitation, psychiatric or substance abuse program to
other hospital units, as well as all supervisory relationships within the
program, shall be defined in writing. Responsibility for the performance of
clinical services also shall be clearly defined. Delegation of authority within
the program shall be specified in job descriptions and in organizational plans.
Written policies and procedures to guide the operation of the rehabilitation
program shall be developed and reviewed at least annually, revised as
necessary, dated to indicate the time of last revision, and enforced.
(4) There shall be a current written plan of
care for each patient receiving rehabilitative, psychiatric or substance abuse
services. The plan shall state the diagnosis, and problem list when
appropriate, pertinent to the rehabilitation or treatment process; precautions
necessitated by the patient's general medical condition or other factors; the
short-term and long-term goals of the treatment program; and require monthly or
more frequent review of the patient's progress. The medical record and the
written plan shall evidence a team approach, with participation of the
professional and administrative staffs, the patient, and, as appropriate, the
patient's family. The medical record shall document the written instructions
given to the patient and the family concerning appropriate care after discharge
from the hospital.
(5) The
rehabilitation, psychiatric or substance abuse program must have notes and log
records that are separately identified from the other admission and discharge
records in the hospital in which it is located, and are separately
retrievable.
(6) The beds assigned
to the program must be physically separate from and not commingled with beds
not included in the unit. Rehabilitation, psychiatric or substance abuse
programs and beds may be located on the same floor as other programs or
beds.
(7) In addition to meeting the
requirements of subsections (1) through (6) of this section, rehabilitation
programs provided by hospitals must place responsibility for the medical
direction of the rehabilitation program on a physician member of the organized
medical staff who, on the basis of training, experience and interest, is
knowledgeable in the rehabilitation services offered. Unless otherwise
permitted by law, rehabilitation services shall be initiated by a physician.
The written request for services shall include reference to the diagnosis or
problems for which treatment is planned.
(8) In addition to meeting the requirements
of subsections (1)-(6) of this section, psychiatric, or substance abuse
rehabilitation programs provided by hospitals shall meet at least the following
additional standards:
(a) The program, unit,
service or similarly titled part shall treat only those patients whose primary
reason for admission was a diagnosis contained in the third edition of the
American Psychiatric Association Diagnostic and Statistical Manual.
(b) The program, unit, service or similarly
titled part shall have medical direction by an appropriately qualified
practitioner, including a physician who is certified by the American Board of
Psychiatry and Neurology or is eligible for examination by the Board or similar
specialty board recognized by the American Osteopathic Association, a clinical
psychologist, or a licensed physician with postgraduate training and experience
in the diagnosis and treatment of nervous and mental disorders.
(c) The program, unit, service or similarly
titled part shall furnish, through qualified personnel, psychological services,
social work services, psychiatric nursing, occupational therapy, and
recreational therapy, as appropriate to the needs of the patient.
(d) The program, unit, service or similarly
titled part shall have a charge nurse who is a registered professional nurse
qualified in psychiatric or mental health nursing.
(9) In addition to the medical direction
required in subsection (7), overall supervision and administration of the
following specialty rehabilitation programs may be provided by staff with the
following credentials:
(a) Physical Therapy -
A qualified physical therapist who shall be a graduate of a physical therapy
program approved by a nationally recognized accrediting body or have documented
equivalent training or experience, shall meet any current requirements for
licensure or registration, and shall be currently competent in the
field.
(b) Occupational Therapy - A
qualified occupational therapist who shall be a graduate of an occupational
therapy program approved by a nationally recognized accrediting body; or shall
currently hold certification by the American Occupational Therapy Association
as an Occupational Therapist, Registered; or shall have documented equivalent
training or experience; and shall meet all current requirements for licensure
under chapter 468, part IV, F.S.
(c) Speech Pathology and Audiology - A
qualified speech-language pathologist or audiologist who shall hold the
Certificate of Clinical Competence or a Statement of Equivalence in either
speech pathology or audiology issued by the American Speech-Language-Hearing
Association, or have documented equivalent training or experience; and shall
meet all current requirements for licensure under chapter 468, part II,
F.S.
(d) Rehabilitation Nursing - A
professionally qualified licensed registered nurse who shall have documented
training in rehabilitation nursing and at least one year of rehabilitation
nursing experience.
(e) Vocational
or Educational Rehabilitation - A qualified individual who shall be a graduate
of vocational rehabilitation program at the graduate level, or have documented
equivalent training or experience.
(f) Comprehensive Medical Rehabilitation - A
qualified physician who shall be a member of the organized professional staff
and who is certified, or eligible for examination, either by the American Board
of Physical Medicine and Rehabilitation or by a specialty related to
rehabilitation.
(10)
Nothing in this section shall be construed to prevent a hospital from providing
rehabilitation, psychiatric or substance abuse programs to its patients.
However, no hospital shall have rehabilitation, psychiatric, intensive
residential treatment program, or substance abuse beds unless it has obtained a
valid certificate of need as required by section
408.031 through
408.045, F.S., and meets the
requirements of this section.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.