Effective date: 5/4/2015

    (1) When the delivery of skilled care to a patient in the home is under the direction or supervision of a physician or when a physician, physician’s assistant or advanced practice registered nurse 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 the licensed nurse in the home or residence.

Terms Used In Florida Regulations 59A-18.011

  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Caregiver: means a registered nurse, licensed practical nurse, certified nursing assistant, home health aide, homemaker or companion that is referred by a nurse registry to provide services to patients. See Florida Regulations 59A-18.002
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Independent Contractor: means a person who contracts through a referral from a nurse registry. See Florida Regulations 59A-18.002
  • Plan of treatment: means written plan of care and treatment, including a medical plan of treatment, signed within 30 days by the physician, advanced practice registered nurse, or physician assistant to assure the delivery of safe and adequate care provided by a licensed nurse to a patient in the home. See Florida Regulations 59A-18.002
    (2) The licensed nurse providing care to the patient is responsible for having the medical plan of treatment signed by the physician, physician assistant, or advanced practice registered nurse, acting within his or her respective scope of practice, within 30 days from the initiation of services and reviewed by the physician, physician assistant, or advanced practice registered nurse in consultation with the licensed nurse at least every 2 months.
    (3) The licensed nurse responsible for delivering care to the patient is responsible for the medical plan of treatment which shall include, at a minimum, the following:
    (a) Diagnoses;
    (b) Activities permitted when indicated;
    (c) Diet when indicated;
    (d) Medication, treatments, and equipment required; and,
    (e) Dated signature of physician, physician assistant, or advanced practice registered nurse.
    (4) The delivery of care pursuant to a medical plan of treatment must be substantiated by the nursing notes or documentation made by the nurse in compliance with nursing practices established under chapter 464, F.S.
    (5) The initial medical plan of treatment, any amendment to the plan, additional orders or change in orders, and copy of clinical notes must be filed in the office of the nurse registry, pursuant to section 400.506(13)(b), F.S., within 30 days, pursuant to Florida Statutes § 400.497(8)
    (6) The nurse registry shall inform nurse registrants that the shift nurse that communicates with the physician’s office, the physician assistant or the advanced practice registered nurse about any changes in the orders should update the plan of treatment.
    (7) The patient, caregiver or guardian must be informed by independent contractors of the nurse registry that:
    (a) They have the right to be informed of the medical plan of treatment;
    (b) They have the right to participate in the development of the medical plan of treatment;
    (c) They may have a copy of the medical plan of treatment if requested; and,
    (d) The caregiver being referred is an independent contractor of the registry.
Rulemaking Authority 400.497, 400.506 FS. Implements Florida Statutes § 400.497, 400.506. History—New 2-9-93, Amended 1-27-94, 12-24-00, 8-10-06, 5-4-15.