Fla. Admin. Code R. 59A-35.115
(3) Administering the survey.
(a) Each facility must administer the anonymous surveys to all the facility’s staff members. For the purposes of this rule, all persons who work in the facility are considered staff members.
1. For hospitals, staff respondents will complete the Hospital Patient Safety Culture Survey, AHCA Form 3130-8015, October, 2022, incorporated by reference and available at: HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-15002" https://www.flrules.org/Gateway/reference.asp?No=Ref-15002 and at: https://ahca.myflorida.com/schs/commiteescouncils/indexpscs.shtml.
2. For ASCs, staff respondents will complete the Ambulatory Surgical Centers Patient Safety Culture Survey, AHCA Form 3130-8017, October, 2022, incorporated by reference and available at: HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-14999" https://www.flrules.org/Gateway/reference.asp?No=Ref-14999 and at: https://ahca.myflorida.com/schs/commiteescouncils/indexpscs.shtml.
3. For nursing homes, staff respondents will complete the Nursing Home Patient Safety Culture Survey, AHCA Form 3130-8021, October 2025, incorporated by reference and available at: HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18906%20"https://www.flrules.org/Gateway/reference.asp?No=Ref-18906 and at: https://ahca.myflorida.com/schs/commiteescouncils/indexpscs.shtml.
(b) Guidance and requirements for administering the PSCS can be found in the PSCS data entry guide and data file specifications:
1. For hospitals, the Hospital Patient Safety Culture Survey Data Entry Guide and Data File Specifications, AHCA Form 3130-8014, October 2025, is incorporated by reference and available at: HYPERLINK "https://flrules.org/Gateway/reference.asp?No=Ref-18904"https://flrules.org/Gateway/reference.asp?No=Ref-18904 and at: https://ahca.myflorida.com/schs/commiteescouncils/indexpscs.shtml.
2. For ASCs, the PSCS Data Entry Guide and Data File Specifications, AHCA Form 3130-8016, October 2022, is incorporated by reference and available at: HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-15001" https://www.flrules.org/Gateway/reference.asp?No=Ref-15001 and at: https://ahca.myflorida.com/schs/commiteescouncils/indexpscs.shtml.
3. For nursing homes, the Nursing Home Patient Safety Culture Survey Data Entry Guide and Data File Specifications, AHCA Form 3130-8022, October 2025, is incorporated by reference and available at: HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18905"https://www.flrules.org/Gateway/reference.asp?No=Ref-18905 and at: https://ahca.myflorida.com/schs/commiteescouncils/indexpscs.shtml.
(4) Data Submission.
(a) Upon the respondent’s completion of the survey, the contracted vendor or the facility personnel designated by the Chief Executive Officer (CEO), or the Nursing Home / ASC Administrator, as applicable, will collect, compile and submit the survey data using the facility specific data file specifications referenced in paragraph (3)(b) and the applicable data entry tool:
1. For hospitals, the PSCS Data Entry Tool, AHCA Form 3130-8015A October 2022, is incorporated by reference and available at: HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-15003" https://www.flrules.org/Gateway/reference.asp?No=Ref-15003 and at: https://ahca.myflorida.com/schs/commiteescouncils/indexpscs.shtml.
2. For ASCs, the PSCS Data Entry Tool, AHCA Form 3130-8017A, October 2022, is incorporated by reference and available at: HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-15000" https://www.flrules.org/Gateway/reference.asp?No=Ref-15000 and at: https://ahca.myflorida.com/schs/commiteescouncils/indexpscs.shtml.
3. For nursing homes, the Nursing Home Patient Safety Culture Survey Data Entry Tool, AHCA Form 3130-8021A, October 2025, is incorporated by reference and available at: HYPERLINK "https://www.flrules.org/Gateway/reference.asp?No=Ref-18907"https://www.flrules.org/Gateway/reference.asp?No=Ref-18907 and at: https://ahca.myflorida.com/schs/commiteescouncils/indexpscs.shtml.
Rulemaking Authority 400.141, 408.05, 395.1012 FS. Law Implemented 400.141, 408.05, 395.1012 FS. History–New 1-26-23, Amended 5-31-26.