The Florida Senate

400.506  Licensure of nurse registries; requirements; penalties.--

(1)  A nurse registry is exempt from the licensing requirements of a home health agency, but must be licensed as a nurse registry.

(2)  Application for license must be made to the Agency for Health Care Administration on forms furnished by it and must be accompanied by the appropriate licensure fee, as established by rule and not to exceed the cost of regulation under this part. The licensure fee for nurse registries may not exceed $1,000 and must be deposited in the Health Care Trust Fund.

(3)  The Agency for Health Care Administration may deny, revoke, or suspend a license or impose an administrative fine in the manner provided in chapter 120 against a nurse registry that:

(a)  Fails to comply with this section or applicable rules.

(b)  Commits an intentional, reckless, or negligent act that materially affects the health or safety of a person receiving services.

(4)  A license issued for the operation of a nurse registry, unless sooner suspended or revoked, expires 1 year after its date of issuance. Sixty days before the expiration date, an application for renewal must be submitted to the Agency for Health Care Administration on forms furnished by it. The Agency for Health Care Administration shall renew the license if the applicant has met the requirements of this section and applicable rules. A nurse registry against which a revocation or suspension proceeding is pending at the time of license renewal may be issued a conditional license effective until final disposition by the Agency for Health Care Administration of such proceedings. If judicial relief is sought from the final disposition, the court having jurisdiction may issue a conditional license for the duration of the judicial proceeding.

(5)  The Agency for Health Care Administration may institute injunctive proceedings under s. 400.515.

(6)  A person that offers or advertises to the public that it provides any service for which licensure is required under this section must include in such advertisement the license number issued to it by the Agency for Health Care Administration.

(7)  It is unlawful for a person to offer or advertise to the public services as defined by rule without obtaining a valid license from the Agency for Health Care Administration. It is unlawful for any holder of a license to advertise or hold out to the public that he or she holds a license for other than that for which he or she actually holds a license. A person who violates this subsection is subject to injunctive proceedings under s. 400.515.

(8)  Any duly authorized officer or employee of the Agency for Health Care Administration may make such inspections and investigations as are necessary to respond to complaints or to determine the state of compliance with this section and applicable rules.

(a)  If, in responding to a complaint, an agent or employee of the Agency for Health Care Administration has reason to believe that a crime has been committed, he or she shall notify the appropriate law enforcement agency.

(b)  If, in responding to a complaint, an agent or employee of the Agency for Health Care Administration has reason to believe that abuse, neglect, or exploitation has occurred, according to the definitions in chapter 415, he or she shall file a report under chapter 415.

(9)

(a)  A nurse registry may refer for contract in private residences registered nurses and licensed practical nurses registered and licensed under chapter 464, certified nursing assistants certified under s. 400.211, and sitters, companions, or homemakers for the purposes of providing those services authorized under s. 400.509(1).

(b)  A certified nursing assistant may be referred for a contract to provide care to a patient in his or her home only if that patient is under a physician's care. A certified nursing assistant referred for contract in a private residence shall be limited to assisting a patient with bathing, dressing, toileting, grooming, eating, physical transfer, and those normal daily routines the patient could perform for himself or herself were he or she physically capable. A certified nursing assistant may not provide medical or other health care services that require specialized training and that may be performed only by licensed health care professionals. The nurse registry shall obtain the name and address of the attending physician and send written notification to the physician within 48 hours after a contract is concluded that a certified nursing assistant will be providing care for that patient.

(c)  A registered nurse shall make monthly visits to the patient's home to assess the patient's condition and quality of care being provided by the certified nursing assistant. Any condition which in the professional judgment of the nurse requires further medical attention shall be reported to the attending physician and the nurse registry. The assessment shall become a part of the patient's file with the nurse registry and may be reviewed by the Agency for Health Care Administration during their survey procedure.

(d)  In order to refer for contract in private residences a certified nursing assistant or any person specified in s. 400.509(1), the nurse registry and such person registered with the nurse registry must also be registered under s. 400.509. Any person registered as an independent contractor with a nurse registry for the purpose of providing services authorized under s. 400.509(1) on or before October 1, 1990, is exempt from registration under s. 400.509 so long as such person remains continuously registered with that nurse registry.

(10)  A person who is referred by a nurse registry for contract in private residences and who is not a nurse licensed under chapter 464 may perform only those services or care to clients that the person has been certified to perform or trained to perform as required by law or rules of the Agency for Health Care Administration or the Department of Business and Professional Regulation. Providing services beyond the scope authorized under this subsection constitutes the unauthorized practice of medicine or a violation of the Nurse Practice Act and is punishable as provided under chapter 458, chapter 459, or chapter 464.

(11)  Each nurse registry must require every applicant for contract to complete an application form providing the following information:

(a)  The name, address, date of birth, and social security number of the applicant.

(b)  The educational background and employment history of the applicant.

(c)  The number and date of the applicable license or certification.

(d)  When appropriate, information concerning the renewal of the applicable license, registration, or certification.

(12)  Each nurse registry must comply with the procedures set forth in s. 400.497(3) for maintaining records of the employment history of all persons referred for contract and is subject to the standards and conditions set forth in s. 400.512. However, an initial screening may not be required for persons who have been continuously registered with the nurse registry since September 30, 1990.

(13)  The nurse registry must maintain the application on file, and that file must be open to the inspection of the Agency for Health Care Administration. The nurse registry must maintain on file the name and address of the client to whom the nurse or other nurse registry personnel is sent for contract and the amount of the fee received by the nurse registry. A nurse registry must maintain the file that includes the application and other applicable documentation for 3 years after the date of the last file entry of client-related information.

(14)  All persons referred for contract in private residences by a nurse registry must comply with the following requirements for a plan of treatment:

(a)  When, in accordance with the privileges and restrictions imposed upon a nurse under chapter 464, the delivery of care to a patient is under the direction or supervision of a physician or when a physician is responsible for the medical care of the patient, a medical plan of treatment must be established for each patient receiving care or treatment provided by a licensed nurse in the home. The original medical plan of treatment must be timely signed by the physician and reviewed by him or her in consultation with the licensed nurse at least every 2 months. Any additional order or change in orders must be obtained from the physician and reduced to writing and timely signed by the physician. The delivery of care under a medical plan of treatment must be substantiated by the appropriate nursing notes or documentation made by the nurse in compliance with nursing practices established under chapter 464.

(b)  Whenever a medical plan of treatment is established for a patient, the initial medical plan of treatment, any amendment to the plan, additional order or change in orders, and copy of nursing notes must be filed in the office of the nurse registry.

(15)  The nurse registry must comply with the notice requirements of s. 400.495, relating to abuse reporting.

(16)  The Agency for Health Care Administration shall adopt rules to implement this section.

History.--ss. 2, 4, ch. 90-101; s. 27, ch. 91-57; ss. 13, 23, ch. 93-214; s. 51, ch. 94-218; s. 1056, ch. 95-148.