Fla. Admin. Code R. 59A-8.0095
(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 Section 400.462(1), F.S.
3. An alternate administrator may be the alternate administrator for up to five home health agencies if all five home health agencies have identical controlling interests as defined in s. 408.803 and are located within one agency geographic service area or within an immediately contiguous county.
(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.
(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.
(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.
(3) Registered Nurse.
(a) A registered nurse shall be currently licensed to practice in the state, pursuant to Chapter 464, F.S. or hold an active multistate license under s. 464.0095 to practice professional nursing, 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 or an active multistate license under s. 464.0095 to practice professional nursing.
(4) Licensed Practical 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.
(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. 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. The training may be conducted in person, online, or through a hybrid program but must require the aide to demonstrate, in person, that he or she is able to perform the necessary skills associated with the subject areas listed below.
1. Communication skills;
2. Observation, reporting and documentation of patient or client status and the care or services provided;
3. Reading and recording vital signs to include temperature, pulse and respiration, and blood pressure;
4. Basic infection control procedures such as hand hygiene, personal protective equipment (PPE), bag technique, and equipment disinfection;
5. Basic elements of body functions that must be reported to the registered nurse supervisor including observation of new conditions or change in condition;
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; basic nail care to include filing and polishing the nails, but not clipping nails; basic skin care including washing, moisturizing, and applying lotion with positioning to prevent skin breakdown; oral hygiene; care of dentures; toileting including use of bedpan or urinal;
10. Safe transfer techniques, including use of appropriate equipment, and ambulation;
11. Assistance with basic range of motion exercises and positioning to prevent complications of immobility;
12. Basic nutrition and fluid intake, including following the prescribed diet, assistance with eating and drink, observing for signs of dehydration or inadequate intake and promoting regular eating and drink schedule;
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.
(i) A licensed home health agency may choose to administer the Home Health Aide Competency Test, AHCA 3110-1007, September 2025 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 HYPERLINK "mailto:HQAHOMEHEALTH@ahca.myflorida.com" HQAHOMEHEALTH@ahca.myflorida.com and including the name, address, and license number of the home health agency requesting the test.
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 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.
(l) Responsibilities of the home health aide and CNA shall include:
(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 mechanical lift, 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 prescribed or 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.
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 and toileting:
(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.
(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:
(8) Occupational Therapist and 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.
(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.
(11) Dietitian/Nutritionist.
(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.
Rulemaking Authority 400.488, 400.497 FS. Law Implemented 400.476, 400.487, 400.488, 400.497 FS. History–New 1-20-97, Amended 1-17-00, 7-18-01, 9-22-05, 8-15-06, 7-11-13, 4-16-23, 5-31-26.