Fla. Admin. Code Ann. R. 59A-4.103 - Licensure, Administration and Fiscal Management
(1) The licensee or applicant shall make
application for an initial, renewal or change of ownership license to operate a
nursing home facility and shall provide:
(a)
All of the information required by this rule, Chapter 400, Part II, F.S., and
Chapter 408, Part II, on the Health Care Licensing Application Nursing Homes,
AHCA Form 3110-6001, July 2014, which is incorporated by reference. These forms
may be obtained at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06014
and are available from the Agency for Health Care Administration, Long-Term
Care Unit, 2727 Mahan Drive, Mail Stop #33, Tallahassee, FL 32308 or at the web
address: http://ahca.myflorida.com/HQAlicensureforms; and,
(b) Proof of Financial Ability to Operate,
AHCA Form 3100-0009, July 2009, which is incorporated by reference in
subsection 59A-35.062(1),
F.A.C., available from the Agency for Health Care Administration, Long Term
Care Unit, 2727 Mahan Drive, Mail Stop #33, Tallahassee, Florida 32308 or
online at http://ahca.myflorida.com/HQAlicensureforms.
(2) The licensure fees must be included with
the application. The licensure fees are: a biennial fee of $100.00 per bed and
a resident protection fee of $.50 per bed as required by Section
400.062(3),
F.S., and the Data Collection and Analysis Assessment of $12.00 per bed as
required by Section 408.20(1)(b),
F.S. The assessment required by Section
408.20(1)(b),
F.S. is waived for facilities having a certificate of authority under Chapter
651, F.S.
(3) A nursing home
licensee may request an inactive license for part of a facility to use an
occupied contiguous portion of the facility for an alternative use as
authorized by Section
400.0712, F.S. Prior to
providing alternative services, the facility must submit a written request to
the Agency. A request may be submitted at any time during the licensure period
and must provide: the intended use of the inactive portion, a floor plan of the
building identifying the inactive area, the total number of inactive beds and
the prospective date the beds will become inactive.
(a) Upon receipt of written approval by the
Agency, as required in Section
408.808, F.S., to continue with
the plan for the partial inactive license, the licensee must submit a completed
Health Care Licensing Application, Nursing Homes, AHCA Form 3110-6001, July
2014, to the Agency within 60 days of the approval and a bed change request
form for beds certified through the Centers for Medicare and Medicaid Services.
The appropriate facility licensure application for the alternative use must
accompany this application, unless the space will be utilized for services
authorized under the existing nursing home licensure.
(b) If the alternative service license is
approved, a partial inactive license will be issued concurrently with the
issuance of the license for the alternative use. The expiration date of the
partial inactive license will be the same date that the licensee's nursing home
must file for renewal of their nursing home license. The licensee must indicate
the intent to continue the partial inactive license at each nursing home
licensure renewal. Licensure fees will remain at the standard rate for nursing
home beds, whether active or inactive, at the time of renewal and will not be
assessed for another Agency license for the alternative use of the inactive
beds.
(c) Notification to
reactivate the inactive portion of the building and the appropriate change
request form for beds certified through the Centers for Medicare and Medicaid
Services, must be submitted to the Agency at least 30 days prior to the planned
date to admit residents to the previously inactive beds. The inactive portion
of the license will be reactivated upon Agency approval.
(4) Administration.
(a) The licensee of each nursing home must
have full legal authority and responsibility for the operation of the
facility.
(b) The licensee of each
facility must designate one person, who is licensed by the Florida Department
of Health, Board of Nursing Home Administrators under Chapter 468, Part II,
F.S., as the Administrator who oversees the day to day administration and
operation of the facility.
(c) Each
nursing home must be organized according to a written table of
organization.
(5) Fiscal
Management.
(a) The licensee, for each
nursing home it operates, must maintain fiscal records in accordance with the
requirements of Chapter 400, Part II, F.S., and this rule.
(b) An accrual or cash system of accounting
must be used to reflect transactions of the business. Records and accounts of
transactions, such as, general ledgers and disbursement journals, must be
brought current no less than quarterly and shall be available for review by
authorized representatives of appropriate state and federal agencies.
(c) A licensee must obtain a surety bond as
required by Section 400.162, F.S.; it must be based
on twice the average monthly balance in the resident trust fund during the
prior fiscal year or $5, 000, whichever is greater. A licensee who owns more
than one nursing home may purchase a single surety bond to cover the residents'
funds held in nursing homes located within the state. A surety bond must
contain substantially the same language as is found in the Nursing Home Patient
Trust Surety Bond, AHCA Form 3110-6002, May 2008, which is incorporated by
reference, and may be obtained at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06016
and from the Agency online at http://ahca.myflorida.com. The surety bond must
be filed with the Agency for Health Care Administration, 2727 Mahan Drive, Mail
Stop #33, Tallahassee, Florida 32308.
(d) A self-insurance pool, which may be an
interest bearing account, may be established for non-certified facilities only
to provide compensation to any resident suffering financial loss in accordance
with the provisions of Section
400.162(5)(c),
F.S., as the result of one or more of the member licensees violating any of the
provisions of Section
400.162, F.S.
1. Such self-insurance pool must be
administered under the direction of an elected board of trustees. The
membership of the board of trustees must be composed of one representative from
each participating licensee.
2. An
application for establishing a self-insurance pool must be made by the trustees
to the Agency. Such application shall contain the following information: the
names, complete addresses, and affiliation of the trustees; the name and
complete address of each licensee participating in the pool; the total dollar
amount of the pool; and the name and complete address of the bank in which the
account is maintained and the account number. The application must be
accompanied by:
a. An individual application
from each licensee applying for membership in the self-insurance pool. Such
application must contain the following information: the name, telephone number,
and complete address of the facility and the licensee, the name of the
facility's administrator, manager or supervisor, his or her license and renewal
number; the names of all employees involved in the administration of the
resident trust fund account; the average monthly balance in the resident trust
fund account during the prior year; the total dollar amount the licensee has
deposited in the self-insurance pool; and the name and complete address of the
bank in which the account is maintained and the account number.
b. Prima facie evidence showing that each
individual member of the pool has deposited an amount equal to twice the
average monthly balance of the trust fund account or $5, 000.00 dollars,
whichever is greater, in a separate account maintained by the board of trustees
in the name of the self-insurance pool in a bank authorized under Chapter 658,
F.S., in the State of Florida that is a member of the Federal Reserve System to
secure performance of payment of all lawful awards made against any member or
members of the self-insurance pool as required by Section
400.162(5),
F.S., and this rule.
3.
After the inception date of the pool, prospective new members of the pool must
submit an application for membership to the board of trustees. Such application
must contain the information specified in subparagraph (5)(d)2. of this rule.
The trustees may approve the application for membership in accordance with
these rules. If so approved, the application for membership in accordance with
these rules must be filed with the Agency at the Agency for Health Care
Administration, Long-Term Care Unit, 2727 Mahan Drive, Mail Stop #33,
Tallahassee, FL 32308.
4. The
amount deposited in such an account must be maintained at all
times.
(e) If, at any
time during the period for which a license is issued, a licensee who has not
purchased a surety bond or entered into a self-insurance agreement is requested
to hold funds in trust as provided in Section
400.162(5),
F.S., the licensee must notify the Agency, in writing, of the request at the
Agency for Health Care Administration, Long-Term Care Unit, 2727 Mahan Drive,
Mail Stop #33, Tallahassee, FL 32308, and make application for a surety bond or
for participation in a self-insurance agreement within seven business days of
the request. Copies of the application, along with written documentation of
related correspondence with an insurance agency or group, must be maintained
and must be available for review. All notices required by this rule provision
must be sent to the Agency for Health Care Administration, 2727 Mahan Drive,
Mail Stop #33, Tallahassee, Florida 32308.
Notes
Rulemaking Authority 400.062, 400.071 2(3), 400.162(5)(c), 400.23, 408.034, 408.810(8), 408.819 FS. Law Implemented 400.062, 400.071, 400.0712, 400.102, 400.111, 400.141, 400.162, 400.20, 408.805, 408.806, 408.808, 408.810 FS.
New 4-1-82, Amended 4-1-84, 8-1-85, 1-1-86, 11-12-89, 12-25-90, 10-6-91, Formerly 10D-29.103, Amended 4-18-94, 2-6-97, 5-5-02, 12-21-15.
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