Fla. Admin. Code Ann. R. 59A-8.0095 - Personnel
(1) Administrator.
(a) The administrator of the agency shall:
1. Meet the criteria as defined in Sections
400.462(1) and
400.476(1),
F.S.
2. Designate, in writing a
direct employee or an individual covered under a management company contract to
manage the home health agency or an employee leasing contract that provides the
agency with full control over all operational duties and responsibilities to
serve as an on-site alternate administrator during absences of the
administrator. This person will be available during designated business hours,
when the administrator is not available. Available during designated business
hours means being readily available on the premises or by telecommunications.
During the absence of the administrator, the alternate administrator will have
the responsibility and authority for the daily operation of the agency. The
alternate administrator must meet the criteria as defined in Sections
400.462(1) and
400.476(1),
F.S.
(b) If an agency
changes administrator or alternate administrator, the agency shall notify AHCA
as required in subsection
59A-35.110(1),
F.A.C., by submitting the application forms referenced in subsection
59A-8.003(1),
F.A.C. Level 2 background screening compliance is required pursuant to Section
408.809, F.S., and Rule
59A-35.090,
F.A.C.
(2) Director of
Nursing.
(a) The director of nursing of the
agency shall:
1. Meet the criteria as defined
in Sections 400.462(10) and
400.476(2),
F.S.;
2. Supervise or manage,
directly or through qualified subordinates, all personnel who provide direct
patient care;
3. Ensure that the
professional standards of community nursing practice are maintained by all
nurses providing care; and,
4.
Maintain and adhere to agency procedure and patient care policy
manuals.
(b) The director
of nursing, the administrator, or alternate administrator shall establish
policies and procedures on biomedical waste for home health agencies providing
nursing and physical therapy services. The Department of Health website has
information on biomedical waste handling and the requirements at
www.doh.state.fl.us/Environment/Community/biomedical.
(c) The director of nursing shall:
1. Establish policies and procedures that are
consistent with recommended Centers for Disease Control (CDC) and Occupational
Safety and Health Agency (OSHA) guidelines for safety, universal precautions
and infection control procedures;
2. Employ and evaluate nursing
personnel;
3. Coordinate patient
care services;
4. Set or adopt
policies for, and keep records of criteria for admission to service, case
assignments and case management; and
5. Establish and adopt policies and
procedures for the delegation process of nursing tasks and activities as
specified in Chapter 64B9-14, F.A.C.
(d) Pursuant to Section
400.497(5)(a),
F.S., the director of nursing shall establish a process to verify that skilled
nursing and personal care services were provided. When requested by an AHCA
employee, the director of nursing shall provide a certified report that lists
the home health services provided by a specified direct service staff person or
contracted staff person for a specified time period as permitted in Section
400.497(5)(b),
F.S. A certified report shall be in the form of a written or typed document or
computer printout and signed by the director of nursing. The report must be
provided to the surveyor within two hours of the request, unless the time
period requested is longer than one year, then the report must be provided
within three hours of the request.
(e) The director of nursing shall establish
and conduct an ongoing quality assurance program. The program shall include at
least quarterly, documentation of the review of the care and services of a
sample of both active and closed clinical records by the director of nursing or
his or her delegate. The director of nursing assumes overall responsibility for
the quality assurance program. The quality assurance program is to assure that:
1. The home health agency accepts patients
whose home health service needs can be met by the home health agency;
2. Case assignment and management is
appropriate, adequate, and consistent with the plan of care, medical regimen
and patient needs. Plans of care are individualized based on the patient's
needs, strengths, limitations and goals;
3. Nursing and other services provided to the
patient are coordinated, appropriate, adequate, and consistent with plans of
care;
4. All services and outcomes
are completely and legibly documented, dated and signed in the clinical service
record;
5. The home health agency's
policies and procedures are followed;
6. Confidentiality of patient data is
maintained; and,
7. Findings of the
quality assurance program are used to improve services.
(f) In an agency with less than a total of 10
full time equivalent employees and contracted personnel, the director of
nursing may also be the administrator.
(g) If the director of nursing serves as the
director of nursing for more than two licensed home health agencies, then the
director of nursing shall designate, in writing, an alternate director of
nursing to serve during the director of nursing's absence. This person will be
available during designated business hours, when the director of nursing is not
available. Available during designated business hours means being readily
available on the premises or by telecommunications. The alternate director of
nursing must meet the criteria as defined in Sections
400.462(10) and
400.476(2),
F.S.
(h) If an agency changes the
director of nursing or alternate director of nursing, the agency shall notify
AHCA as required in Section
400.476(2)(b),
F.S., by submitting the application forms referenced in subsection
59A-8.003(1),
F.A.C. Level 2 background screening compliance is required pursuant to Section
408.809, F.S., and Rule
59A-35.090, F.A.C.
(i) An agency
that does not provide skilled care is not required to have a director of
nursing.
(3) Registered
Nurse.
(a) A registered nurse shall be
currently licensed in the state, pursuant to Chapter 464, F.S., and:
1. Be the case manager in all cases involving
nursing or both nursing and therapy care;
2. Be responsible for the clinical record for
each patient receiving nursing care;
3. Assure that progress reports are made to
the physician, physicians assistant or advanced practice registered nurse for
patients receiving nursing services when the patient's condition changes or
there are deviations from the plan of care; and
4. Provide nursing services within the scope
of practice authorized by the license issued by the State of Florida for a
registered nurse.
(b)
Each home health agency that provides skilled care or non-skilled care may have
an RN assign personal care tasks to licensed practical nurses, certified
nursing assistants and home health aides. The registered nurse maintains full
responsibility for personal care tasks assigned to home health aides or CNAs
and must ensure the home health aide or CNA is qualified to carry out those
assignments based on their training and experience.
(c) Each home health agency that provides
skilled care or non-skilled care must have an RN provide supervisory visits of
unlicensed assistive personnel, as defined in subsection
64B9-14.001(1),
F.A.C., who are employed by or under contract with the home health agency, in
accordance with Section
400.487(3),
F.S. The agency must obtain written consent from the patient, or the patient's
guardian or legal representative, to send an RN into the home to conduct
supervisory visits.
(d) The RN must
provide on-site supervision as needed, based upon the severity of patient's
medical condition and the home health aide's or CNA's training and experience.
Supervisory visits must be documented in patient files.
(e) Delegation of tasks for which additional
training and validation is required. If the home health agency provides skilled
care, an RN may delegate tasks in addition to assigned personal care tasks,
including medication administration, to a home health aide or CNA qualified to
perform the task pursuant to Rules
59A-8.0097,
59A-8.0219 and
59A-8.0216,
F.A.C.
(4) Licensed
Practical Nurse.
(a) A licensed practical
nurse shall be currently licensed in the state, pursuant to Chapter 464, F.S.,
and provide nursing care assigned by and under the direction of a registered
nurse who provides on-site supervision as needed, based upon the severity of
patients medical condition and the nurse's training and experience. Supervisory
visits will be documented in patient files. Provision shall be made in agency
policies and procedures for annual evaluation of the LPN's performance of
duties by the registered nurse.
(b)
A licensed practical nurse shall:
1. Prepare
and record clinical notes for the clinical record;
2. Report any changes in the patient's
condition to the registered nurse with the reports documented in the clinical
record;
3. Provide care to the
patient including the administration of treatments and medications within the
scope of practice authorized by the license issued by the State of Florida for
a licensed practical nurse; and,
4.
Perform other duties assigned by the registered
nurse.
(5) Home
Health Aide and Certified Nursing Assistant.
(a) A home health aide or a certified nursing
assistant (CNA) shall provide personal care services assigned by and under the
supervision of a registered nurse. When only physical, speech, or occupational
therapy is furnished, in addition to home health aide or CNA services,
supervision can be supplied by a licensed therapist directly employed by the
home health agency or by an independently contracted employee.
(b) Prior to a CNA providing services, the
home health agency shall have documentation of the CNA's current State of
Florida certification. A CNA that is currently certified in another state may
work as a home health aide in a home health agency in Florida if they present a
copy of their current certificate as a nursing assistant from that
state.
(c) Prior to a home health
aide providing services, a home health agency shall have on file documentation
of the home health aide's successful completion of at least forty hours of
training in the following subject areas or successful passage of the competency
test as stated in section (i), pursuant to Section
400.497(1),
F.S. An individual may complete home health aide training through a home health
agency licensed under Chapter 400, Part III, F.S., for the purpose of
employment with the agency. Home health aides who are licensed, certified or
trained in another state must provide documentation of course completion, such
as transcripts or a certificate that includes the course curriculum, to the
employing home health agency as evidence of required training.
1. Communication skills;
2. Observation, reporting and documentation
of patient or client status and the care or services provided;
3. Reading and recording temperature, pulse
and respiration;
4. Basic infection
control procedures;
5. Basic
elements of body functions that must be reported to the registered nurse
supervisor;
6. Maintenance of a
clean and safe environment;
7.
Recognition of emergencies and applicable follow-up within the home health aide
scope of performance;
8. Physical,
emotional, and developmental characteristics of the populations served by the
agency, including the need for respect for the patient or client, his privacy,
and his property;
9. Appropriate
and safe techniques in personal hygiene and grooming, including bed bath,
sponge, tub, or shower bath; shampoo, sink, tub, or bed; nail and skin care;
oral hygiene; care of dentures;
10.
Safe transfer techniques, including use of appropriate equipment, and
ambulation;
11. Normal range of
motion and positioning;
12.
Nutrition and fluid intake;
13.
Cultural differences in families;
14. Food preparation and household
chores;
15. Assistance with
self-administered medication. Home health aides and CNAs assisting with
self-administered medication, pursuant to Section
400.488, F.S., must receive a
minimum of 2 hours of training (which can be part of the 40 hour home health
training) prior to assuming this responsibility. Training must cover state law
and rule requirements with respect to the assistance with self-administration
of medications in the home, procedures for assisting the patient with
self-administration of medication, common medications, recognition of side
effects and adverse reactions and procedures to follow when patients appear to
be experiencing side effects and adverse reactions. Training must include
verification that each CNA and home health aide can read the prescription label
and any instructions. Individuals who cannot read must not be permitted to
assist with prescription medications. Other courses taken in fulfillment of
this requirement must be documented and maintained in the home health aide's
and the CNA's personnel file.
16.
Other topics pertinent to home health aide services.
(d) A home health aide seeking employment
with a Medicare or Medicaid certified home health agency may be required to
provide evidence of additional training incorporated within the Medicare
Conditions for Participation, 42 C.F.R., Part 484, and available at
https://ecfr.io/Title-42/Part-484.
(e) If a home health aide successfully
completes training through a vocational school or a nonpublic post-secondary
career school approved by Florida Department of Education, the individual must
present to a home health agency a diploma or certificate issued by that
institution. If the home health aide completes the training through a home
health agency, and wishes to be employed at another agency, the individual must
present to the other home health agency documentation of successful completion
of training as listed in paragraph (5)(c).
(f) A home health agency that teaches the
home health aide course to their employees pursuant to Section
400.497(1),
F.S., but is classified as a nonpublic post-secondary career school by the
Florida Department of Education, must issue the following documentation to
individuals at the time of successful completion of the training course. The
documentation must include the following: the title "Home Health Aide
Documentation;" the name, address, phone number, and license number of the home
health agency; the student's name, address, phone number, and social security
number; total number of clock hours completed in the training; the number of
clock hours for each unit or topic of training; signature of the person who
directed the training; and the date the training was completed. It must be
stated on the documentation that Section
400.497(1),
F.S., permits the home health agency conducting this training to provide such
documentation.
(g) A home health
agency that teaches the home health aide course, but is not an approved
nonpublic post-secondary career school, cannot charge a fee for the training
and cannot issue a document of completion with the words "diploma, "
"certificate, " "certification of completion, " or "transcript." The home
health agency cannot advertise that they are offering "training for home health
aides." The agency can indicate they are hiring home health aides with the
intention of providing training.
(h) Home health aide training must be
performed by or under the general supervision of a registered nurse who
possesses a minimum of two years nursing experience one of which must have been
in the provision of home health care.
(i) A licensed home health agency may choose
to administer the Home Health Aide Competency Test, form number AHCA 3110-1007,
February, 2001, incorporated by reference, in lieu of the forty hours of
training required in paragraph
59A-8.0095(5)(d),
F.A.C. This test is designed for home health agencies to determine competency
of potential employees. Home health agencies may obtain the form by sending a
request to HQAHOMEHEALTH@ahca.myflorida.com.
1. Home health agencies that choose to
administer the test, must maintain documentation of the aide's successful
passage of the competency test. However, if the home health aide does not pass
the test, it is the decision of the home health agency giving the test as to
whether the aide may take the test again. The home health agency may also
provide training or arrange for training in the areas that were not passed on
the test prior to the aide re-taking the test.
a. The Home Health Aide Competency Test, form
number AHCA 3110-1007, February 2001, has two parts: a practical part in which
competency is determined through observation of the performance of tasks and a
written part with questions to answer. Successful passage of the test means the
accurate performance of all 14 tasks on the practical part plus correctly
answering 90 of the 104 questions on the written part.
b. Successful passage of the competency test
alone does not permit a home health aide to assist with self-administration of
medication as described in Section
400.488, F.S. Any home health
aide that will assist patients with self-administration of medications must
have completed two hours of training on assistance with self-administered
medication as required in subparagraph
59A-8.0095(5)(d)
15., F.A.C.
2. Any staff
person of a home health agency may administer the written portion of the test,
but the practical competency test must be administered and evaluated by a
registered nurse or a licensed practical nurse under the supervision of a
registered nurse. The staff person, registered nurse, or licensed practical
nurse may also be responsible for grading the written test.
3. When a home health aide completes the
competency test through the employing agency and wishes to be employed at
another agency, the home health agency shall furnish documentation of
successful passage of the test to the requesting agency pursuant to Section
400.497(1),
F.S. Documentation of successful passage may be provided in a format
established by the home health agency, except as prohibited in paragraphs
(5)(f)-(g), that specifies limitations on the manner in which a home health
agency may describe home health aide training. The documentation, at minimum,
should include the home health aide's name, address and social security number;
the home health agency's name and address; date the test was passed; the
signature of the person providing the documentation; and any other information
necessary to document the aide's passage of the test.
(k) Home health aides and CNA's must receive
in-service training each calendar year. Medicare and Medicaid agencies should
check federal regulations for additional in-service training requirements. Home
health aides and CNAs must also maintain current cardiopulmonary resuscitation
(CPR) certification from an instructor or training provider approved to provide
CPR by the American Red Cross, the American Heart Association, the National
Safety Council, or an organization whose training is accredited by the
Commission on Accreditation for Pre-Hospital Continuing Education.
(l) Responsibilities of the home health aide
and CNA shall include:
1. The performance of
all personal care activities contained in a written assignment by a licensed
health professional employee or contractor of the home health agency and which
include assisting the patient or client with personal hygiene, ambulation,
eating, dressing, shaving, physical transfer, and other duties as
assigned.
2. Maintenance of a
clean, safe and healthy environment, which may include light cleaning and
straightening of the bathroom, straightening the sleeping and living areas,
washing the patient's or client's dishes or laundry, and such tasks to maintain
cleanliness and safety for the patient or client.
3. Other activities as taught by a licensed
health professional employee or contractor of the home health agency for a
specific patient or client and are restricted to the following:
a. Assisting with reinforcement of
dressing;
b. Applying and removing
anti-embolism stockings and hosiery prescribed for therapeutic treatment of the
legs.
c. Assisting with tasks
associated with elimination:
(I)
Toileting.
(II) Assisting with the
use of the bedpan and urinal.
(III)
Providing catheter care including changing the urinary catheter bag.
(IV) Collecting specimens.
(V) Emptying ostomy bags, or changing bags
that do not adhere to the skin.
(VI) Assisting with the placement and removal
of colostomy bags, excluding the removal of the flange or manipulation of the
stoma's site.
d.
Assisting with the use of devices for aid to daily living, such as a wheelchair
or walker;
e. Assisting with
prescribed range of motion exercises;
f. Assisting with prescribed ice cap or
collar;
g. Performing simple urine
tests for sugar, acetone or albumin;
h. Assisting with the use of a glucometer to
perform blood glucose testing;
i.
Measuring and preparing special diets;
j. Measuring intake and output of fluids,
and,
k. Measuring vital signs
including temperature, pulse, respiration or blood pressure.
l. Assisting with oxygen nasal cannulas and
continuous positive airway pressure (CPAP) devices, excluding the titration of
the prescribed oxygen levels.
4. Keeping records of personal health care
activities.
5. Observing appearance
and gross behavioral changes in the patient or client, reporting to the
registered nurse.
6. Supervision of
self-administered medication in the home is limited to the following:
a. Obtaining the medication container from
the storage area for the patient or client;
b. Ensuring that the medication is prescribed
for the patient or client;
c.
Reminding the patient or client that it is time to take the medication as
prescribed; and,
d. Observing the
patient or client self-administering the
medication.
(m)
In cases where a home health aide or a CNA will provide assistance with
self-administered medications in accordance with section
400.488, F.S., a review must be
conducted by a registered nurse to ensure the patient is medically stable with
the self-administration of routine, regularly scheduled medications. The
Registered Nurse must review and reconcile all currently prescribed and
over-the-counter medications to ensure the home health aide or CNA can provide
assistance in accordance with their training.
(n) A licensed health care professional shall
inform the patient, or the patient's caregiver, that the patient may receive
assistance with self-administered medication by an unlicensed person. The
patient, or the patient's caregiver, must give written consent for this
arrangement, pursuant to Section
400.488(2),
F.S.
(o) In providing assistance
with self-administered medication, in addition to the requirements outlined in
Section 400.488, F.S., a home health
aide or CNA may:
1. Prepare necessary items
such as juice, water, cups, or spoons to assist the patient in the
self-administration of medication;
2. Open and close the medication container or
tear the foil of prepackaged medications;
3. Assist the patient in the
self-administration process. Examples of such assistance include the steadying
of the arm, hand, or other parts of the patient's body so as to allow the
self-administration of medication;
4. Assist the patient by placing unused doses
of solid medication back into the medication container.
(p) Responsibilities of the home health aide
and CNA shall not include:
1. The performance
of any therapeutic service that requires licensure as a health care
professional;
2. Changing sterile
dressings;
3. Irrigating body
cavities such as giving an enema;
4. Performing irrigation of any wounds (such
as vascular ulcers, diabetic ulcers, pressure ulcers, surgical wounds) or apply
agents used in the debridement of necrotic tissues in wounds of any
type;
5. Performing a gastric
irrigation or enteral feeding;
6.
Catheterizing a patient;
7.
Administering any controlled substance listed in Schedule II, Schedule III, or
Schedule IV of s. 893.03 or
21 U.S.C. s.
812.;
8. Applying heat by any method;
9. Caring for a tracheotomy tube;
10. Providing any personal health service
which has not been included in the plan of care; or
11. Filling and removing medications from a
pill organizer or electronic medication dispenser.
(q) Individuals who have graduated from an
accredited school of nursing, and are waiting to take their boards for
licensure in Florida, may work as a home health aide. RNs or LPNs who can show
proof they are licensed in another state or in Florida, may work as a home
health aide in Florida.
(r)
Pursuant to Section 381.0035, F.S., all home health
agency employees, with the exception of employees subject to the requirements
of Section 456.033, F.S., must complete a
one-time education course on HIV and AIDS, within 30 days of
employment.
(6) Physical
Therapist and Physical Therapist Assistant.
(a) The physical therapist shall be currently
licensed in the state, pursuant to Chapter 486, F.S. The physical therapist
assistant shall be currently licensed in the state, pursuant to Chapter 486,
F.S.
1. Services provided by the physical
therapist shall be performed within the scope of practice authorized by the
license issued by the State of Florida for the practice of physical
therapist.
2. Services provided by
the physical therapist assistant will be provided under the general supervision
of a licensed physical therapist and shall not exceed any of the duties
authorized by the license issued by the State of Florida for the practice of
physical therapist assistant. General supervision means the supervision of a
physical therapist assistant shall not require on-site supervision by the
physical therapist. The physical therapists shall be accessible at all times by
two way communication, which enable the physical therapist to be readily
available for consultation during the delivery of care.
(b) The responsibilities of the physical
therapist are:
1. To provide physical therapy
services as prescribed by a physician, physician assistant, or advanced
practice registered nurse, acting within their scope of practice, which can be
safely provided in the home and assisting the physician, physician assistant,
or advanced practice registered nurse in evaluating patients by applying
diagnostic and prognostic muscle, nerve, joint and functional abilities
test;
2. To observe and record
activities and findings in the clinical record and report to the physician,
physician assistant, or advanced practice registered nurse the patient's
reaction to treatment and any changes in patient's condition, or when there are
deviations from the plan of care;
3. To instruct the patient and caregiver in
care and use of physical therapy devices;
4. To instruct other health team personnel
including, when appropriate, home health aides and caregivers in certain phases
of physical therapy with which they may work with the patient; and,
5. To instruct the caregiver on the patient's
total physical therapy program.
(7) Speech Pathologist. The speech
pathologist shall be currently licensed in the state, pursuant to chapter 468,
F.S., and shall:
(a) Assist the physician,
physician assistant, or advanced practice registered nurse in evaluating the
patient to determine the type of speech or language disorder and the
appropriate corrective therapy;
(b)
Provide rehabilitative services for speech and language disorders;
(c) Record activities and findings in the
clinical record and to report to the physician, physician assistant, or
advanced practice registered nurse the patient's reaction to treatment and any
changes in the patient's condition, or when there are deviations from the plan
of care; and,
(d) Instruct other
health team personnel and caregivers in methods of assisting the patient to
improve and correct speech disabilities.
(8) Occupational Therapist and Occupational
Therapist Assistant.
(a) The occupational
therapist shall be currently licensed in the state, pursuant to Chapter 468,
F.S., and the occupational therapist assistant shall be currently licensed in
the state, pursuant to Chapter 468, F.S. Duties of the occupational therapist
assistant shall be directed by the licensed occupational therapist and shall be
within the scope of practice authorizedby the license issued by the State of
Florida for the practice of occupational therapist assistant.
(b) The duties of the occupational therapist
are:
1. To provide occupational therapy
services as prescribed by a physician, physician assistant, or advanced
practice registered nurse, acting within their scope of practice, which can be
safely provided in the home and to assist the physician, physician assistant,
or advanced practice registered nurse in evaluating the patient's level of
function by applying diagnostic and therapeutic procedures;
2. To guide the patient in the use of
therapeutic, creative and self-care activities for the purpose of improving
function;
3. To observe and record
activities and findings in the clinical record and to report to the physician,
physician assistant, or advanced practice registered nurse the patient's
reaction to treatment and any changes in the patient's condition, or when there
are deviations from the plan of care; and,
4. To instruct the patient, caregivers and
other health team personnel, when appropriate, in therapeutic procedures of
occupational therapy.
(9) Respiratory Therapist.
(a) The respiratory therapist shall be
currently licensed by the state pursuant to Chapter 468, F.S., and have at
least one year of experience in respiratory therapy.
(b) The responsibilities of the respiratory
therapist are:
1. To provide respiratory
therapy services, prescribed by a physician, physician assistant, or advanced
practice registered nurse, acting within their scope of practice, which can be
safely provided in the home and to assist the physician, physician assistant,
or advanced practice registered nurse in evaluating patients through the use of
diagnostic testing related to the cardiopulmonary system;
2. To observe and record activities and
findings in the clinical record and report to the physician, physician
assistant, or advanced practice registered nurse the patient's reaction to
treatment and any changes in the patient's condition, or when there are
deviations from the plan of care;
3. To instruct the patient and caregiver in
care and use of respiratory therapy devices;
4. To instruct other health team personnel
including, when appropriate, home health aides and caregivers in certain phases
of respiratory therapy in which they may assist the patient; and,
5. To instruct the patient and caregiver on
the patient's total respiratory therapy program.
(10) Social Worker.
(a) The social worker shall be a graduate of
an accredited school of social work with one year of experience in social
services and shall:
1. Assist the physician,
physician assistant, or advanced practice registered nurse and other members of
the health team in understanding significant social and emotional factors
related to the patient's health problems;
2. Assess the social and emotional factors in
order to estimate the patient's capacity and potential to cope with problems of
daily living;
3. Help the patient
and caregiver to understand, accept and follow medical recommendations and
provide services planned to restore the patient to optimum social and health
adjustment;
4. Assist patients and
caregivers with personal and environmental difficulties which predispose toward
illness or interfere with obtaining maximum benefits from medical care;
and,
5. Identify resources, such as
caregivers and community agencies, to assist the patient to resume life in the
community, including discharge planning, or to learn to live within his
disability.
(b) The
social worker shall not provide clinical counseling to patients or caregivers
unless licensed pursuant to Chapter 491, F.S.
(11) Dietitian/Nutritionist.
(a) The dietitian/nutritionist shall be
currently licensed in this state, pursuant to Chapter 468, F.S., with at least
1 year of experience in dietetics and nutrition practice.
(b) The responsibilities of the
dietitian/nutritionist are:
1. To evaluate the
nutrition needs of individuals in the home, using appropriate data to determine
nutrient needs or status, and to make nutrition recommendations to the patient
to maximize the patient's health and well-being;
2. To provide dietetics and nutrition
counseling in the home, as prescribed by a physician, physician assistant, or
advanced practice registered nurse, acting within their scope of
practice;
3. To observe and record
activities and findings in the clinical record and report to the physician,
physician assistant, or advanced practice registered nurse, the patient's
reaction to treatment and any changes in a patient's condition;
4. To instruct the patient, caregiver(s), and
other health team personnel in various phases of dietetic and nutrition
treatment.
(12)
Homemakers and Companions.
(a) The homemaker
shall:
1. Maintain the home in an optimum
state of cleanliness and safety depending upon the client's and the caregiver's
resources;
2. Perform the functions
generally undertaken by the customary homemaker, including such duties as
preparation of meals, laundry, shopping, household chores, and care of
children;
3. Perform casual,
cosmetic assistance, such as brushing the client's hair and assisting with
make-up, filing and polishing nails but not clipping nails;
4. Stablize the client when walking, as
needed, by holding the client's arm or hand;
5. Report to the appropriate supervisor any
incidents or problems related to his work or to the caregiver;
6. Report any unusual incidents or changes in
the client's behavior to the case manager; and,
7. Maintain appropriate work
records.
8. If requested by the
client or his responsible party, the homemaker may verbally remind the client
that it is time to for the client to take his or her
medicine.
(b) The
companion shall:
1. Provide companionship for
the client;
2. Accompanying the
client to doctors appointments, recreational outings, or shopping;
3. Provide light housekeeping tasks such as
preparation of a meal or laundering the client's personal garments;
4. Perform casual, cosmetic assistance, such
as brushing the client's hair and assisting with make-up, filing and polishing
nails but not clipping nails;
5.
Stabilize the client when walking, as needed, by holding the client's arm or
hand;
6. Maintain a chronological
written record of services; and,
7.
Report any unusual incidents or changes in the patient's behavior to the case
manager.
8. If requested by the
client or his responsible party, the companion may verbally remind the client
that it is time for the client to take his or her
medicine.
Notes
Rulemaking Authority 400.488, 400.497 FS. Law Implemented 400.476, 400.487, 400.488, 400.497 FS.
New 1-20-97, Amended 1-17-00, 7-18-01, 9-22-05, 8-15-06, 7-11-13, 4-16-23.
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