Florida Administrative Code
59 - AGENCY FOR HEALTH CARE ADMINISTRATION
59A - Health Facility and Agency Licensing
Chapter 59A-36 - ASSISTED LIVING FACILITY
Section 59A-36.010 - Staffing Standards
Universal Citation: FL Admin Code R 59A-36.010
Current through Reg. 50, No. 187; September 24, 2024
(1) ADMINISTRATORS. Every facility must be under the supervision of an administrator who is responsible for the operation and maintenance of the facility including the management of all staff and the provision of appropriate care to all residents as required by chapters 408, part II, 429, part I, F.S., and rule chapter 59A-35, F.A.C., and this rule chapter.
(a) An administrator must:
1. Be at least 21 years of age;
2. If employed on or after October 30, 1995,
have, at a minimum, a high school diploma or G.E.D.;
3. Be in compliance with Level 2 background
screening requirements pursuant to sections
408.809 and
429.174, F.S.;
4. Complete the core training and core
competency test requirements pursuant to rule
59A-36.011, F.A.C., no later
than 90 days after becoming employed as a facility administrator.
Administrators who attended core training prior to July 1, 1997, are not
required to take the competency test unless specified elsewhere in this rule;
and,
5. Satisfy the continuing
education requirements pursuant to rule
59A-36.011, F.A.C.
Administrators who are not in compliance with these requirements must retake
the core training and core competency test requirements in effect on the date
the non-compliance is discovered by the agency or the
department.
(b) In the
event of extenuating circumstances, such as the death of a facility
administrator, the agency may permit an individual who otherwise has not
satisfied the training requirements of subparagraph (1)(a)4. of this rule, to
temporarily serve as the facility administrator for a period not to exceed 90
days. During the 90 day period, the individual temporarily serving as facility
administrator must:
1. Complete the core
training and core competency test requirements pursuant to rule
59A-36.011, F.A.C.; and,
2. Complete all additional
training requirements if the facility maintains licensure as an extended
congregate care or limited mental health facility.
(c) Administrators may supervise a maximum of
either three assisted living facilities or a group of facilities on a single
campus providing housing and health care Administrators who supervise more than
one facility must appoint in writing a separate manager for each facility.
However, an administrator supervising a maximum of three assisted living
facilities, each licensed for 16 or fewer beds and all within a 15 mile radius
of each other, is only required to appoint two managers to assist in the
operation and maintenance of those facilities.
(d) An individual serving as a manager must
satisfy the same qualifications, background screening, core training and
competency test requirements, and continuing education requirements as an
administrator pursuant to paragraph (1)(a) of this rule. Managers who attended
the core training program prior to April 20, 1998, are not required to take the
competency test unless specified elsewhere in this rule. In addition, a manager
may not serve as a manager of more than a single facility, except as provided
in paragraph (1)(c) of this rule, and may not simultaneously serve as an
administrator of any other facility.
(e) Pursuant to section
429.176, F.S., facility owners
must notify the Agency Central Office within 10 days of a change in facility
administrator on the Notification of Change of Administrator form, AHCA Form
3180-1006, June 2016, which is incorporated by reference and available online
at: http://www.flrules.org/Gateway/reference.asp?No=Ref-09393.
(2) STAFF.
(a) Within 30 days after beginning
employment, newly hired staff must submit a written statement from a health
care provider documenting that the individual does not have any signs or
symptoms of communicable disease. The examination performed by the health care
provider must have been conducted no earlier than 6 months before submission of
the statement. Newly hired staff does not include an employee transferring
without a break in service from one facility to another when the facility is
under the same management or ownership.
1.
Evidence of a negative tuberculosis examination must be documented on an annual
basis. Documentation provided by the Florida Department of Health or a licensed
health care provider certifying that there is a shortage of tuberculosis
testing materials satisfies the annual tuberculosis examination requirement. An
individual with a positive tuberculosis test must submit a health care
provider's statement that the individual does not constitute a risk of
communicating tuberculosis.
2. If
any staff member has, or is suspected of having, a communicable disease, such
individual must be immediately removed from duties until a written statement is
submitted from a health care provider indicating that the individual does not
constitute a risk of transmitting a communicable disease.
(b) Staff must be qualified to perform their
assigned duties consistent with their level of education, training,
preparation, and experience. Staff providing services requiring licensing or
certification must be appropriately licensed or certified. All staff must
exercise their responsibilities, consistent with their qualifications, to
observe residents, to document observations on the appropriate resident's
record, and to report the observations to the resident's health care provider
in accordance with this rule chapter.
(c) All staff must comply with the training
requirements of rule 59A-36.011, F.A.C.
(d) An assisted living facility contracting
to provide services to residents must ensure that individuals providing
services are qualified to perform their assigned duties in accordance with this
rule chapter. The contract between the facility and the staffing agency or
contractor must specifically describe the services the staffing agency or
contractor will provide to residents.
(e) For facilities with a licensed capacity
of 17 or more residents, the facility must:
1.
Develop a written job description for each staff position and provide a copy of
the job description to each staff member; and,
2. Maintain time sheets for all
staff.
(f) Level 2
background screening must be conducted for staff, including staff contracted by
the facility to provide services to residents, pursuant to sections
408.809 and
429.174,
F.S.
(3) STAFFING STANDARDS.
(a) Minimum staffing:
1. Facilities must maintain the following
minimum staff hours per week:
|
Number of Residents, Day Care Participants, and Respite Care Residents |
Staff Hours/Week |
|
0-5 |
168 |
|
6-15 |
212 |
|
16- 25 |
253 |
|
26-35 |
294 |
|
36-45 |
335 |
|
46-55 |
375 |
|
56- 65 |
416 |
|
66-75 |
457 |
|
76-85 |
498 |
|
86-95 |
539 |
For every 20 total combined residents, day care participants, and respite care residents over 95 add 42 staff hours per week.
2. Independent living
residents, as referenced in subsection
59A-36.015(3),
F.A.C., who occupy beds included within the licensed capacity of an assisted
living facility but do not receive personal, limited nursing, or extended
congregate care services, are not counted as residents for purposes of
computing minimum staff hours.
3.
At least one staff member who has access to facility and resident records in
case of an emergency must be in the facility at all times when residents are in
the facility. Residents serving as paid or volunteer staff may not be left
solely in charge of other residents while the facility administrator, manager
or other staff are absent from the facility.
4. In facilities with 17 or more residents,
there must be at least one staff member awake at all hours of the day and
night.
5. A staff member who has
completed courses in First Aid and Cardiopulmonary Resuscitation (CPR) and
holds a currently valid card documenting completion of such courses must be in
the facility at all times.
a. Documentation
of attendance at First Aid or CPR courses pursuant to subsection
59A-36.011(5),
F.A.C., satisfies this requirement.
b. A nurse is considered as having met the
course requirements for First Aid. An emergency medical technician or paramedic
currently certified under chapter 401, part III, F.S., is considered as having
met the course requirements for both First Aid and CPR.
6. During periods of temporary absence of the
administrator or manager of more than 48 hours when residents are on the
premises, a staff member who is at least 21 years of age must be physically
present and designated in writing to be in charge of the facility. No staff
member shall be in charge of a facility for a consecutive period of 21 days or
more, or for a total of 60 days within a calendar year, without being an
administrator or manager.
7. Staff
whose duties are exclusively building or grounds maintenance, clerical, or food
preparation do not count towards meeting the minimum staffing hours
requirement.
8. The administrator
or manager's time may be counted for the purpose of meeting the required
staffing hours, provided the administrator or manager is actively involved in
the day-to-day operation of the facility, including making decisions and
providing supervision for all aspects of resident care, and is listed on the
facility's staffing schedule.
9.
Only on-the-job staff may be counted in meeting the minimum staffing hours.
Vacant positions or absent staff may not be counted.
(b) Notwithstanding the minimum staffing
requirements specified in paragraph (a), all facilities, including those
composed of apartments, must have enough qualified staff to provide resident
supervision, and to provide or arrange for resident services in accordance with
the residents' scheduled and unscheduled service needs, resident contracts, and
resident care standards as described in rule
59A-36.007, F.A.C.
(c) The facility must maintain a written work
schedule that reflects its 24-hour staffing pattern for a given time period.
Upon request, the facility must make the daily work schedules of direct care
staff available to residents or their representatives.
(d) The facility must provide staff
immediately when the agency determines that the requirements of paragraph (a)
are not met. The facility must immediately increase staff above the minimum
levels established in paragraph (a), if the agency determines that adequate
supervision and care are not being provided to residents, resident care
standards described in rule
59A-36.007, F.A.C., are not
being met, or that the facility is failing to meet the terms of residents'
contracts. The agency will consult with the facility administrator and
residents regarding any determination that additional staff is required. Based
on the recommendations of the local fire safety authority, the agency may
require additional staff when the facility fails to meet the fire safety
standards described in rule chapter 69A-40, F.A.C., until such time as the
local fire safety authority informs the agency that fire safety requirements
are being met.
1. When additional staff is
required above the minimum, the agency will require the submission of a
corrective action plan within the time specified in the notification indicating
how the increased staffing is to be achieved to meet resident service needs.
The plan will be reviewed by the agency to determine if it sufficiently
increases the staffing levels to meet resident needs.
2. When the facility can demonstrate to the
agency that resident needs are being met, or that resident needs can be met
without increased staffing, the agency may modify staffing requirements for the
facility and the facility will no longer be required to maintain a plan with
the agency.
(e)
Facilities that are co-located with a nursing home may use shared staffing
provided that staff hours are only counted once for the purpose of meeting
either assisted living facility or nursing home minimum staffing
ratios.
(f) Facilities holding a
limited mental health, extended congregate care, or limited nursing services
license must also comply with the staffing requirements of rules
59A-36.020,
59A-36.021 or
59A-36.022, F.A.C.,
respectively.
Rulemaking Authority 429.41, 429.52, 429.929 FS. Law Implemented 429.174, 429.176, 429.41, 429.52, 429.905 FS.
New 5-14-81, Amended 1-6-82, 9-17-84, Formerly 10A-5.19, Amended 10-20-86, 6-21-88, 8-15-90, 9-30-92, Formerly 10A-5.019, Amended 10-30-95, 4-20-98, 11-2-98, 10-17-99, 7-30-06, 4-15-10, 4-17-14, 5-10-18, Formerly 58A-5.019, 7-1-19.
Disclaimer: These regulations may not be the most recent version. Florida may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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