Fla. Admin. Code R. 59A-8.0095

Current through Reg. 50, No. 235-239, December 10, 2024

Section 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.

Fla. Admin. Code Ann. R. 59A-8.0095

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, Amended by Florida Register Volume 49, Number 065, April 4, 2023 effective 4/16/2023.

New 1-20-97, Amended 1-17-00, 7-18-01, 9-22-05, 8-15-06, 7-11-13, 4-16-23.