Florida Regulations 59A-35.110: Reporting Requirements; Electronic Submission
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(1) During the two year licensure period, any change or expiration of any information that is required to be reported under Florida Statutes Chapter 408, Part II, or authorizing statutes for the provider type as specified in Florida Statutes § 408.803(3), during the license application process must be reported to the Agency within 21 days of occurrence of the change, including:
(a) Insurance coverage renewal;
(b) Bond renewal;
(c) Change of administrator or the similarly titled person who is responsible for the day-to-day operation of the provider;
(d) Annual sanitation inspections;
(e) Fire inspections.
(2) Electronic submission of information.
(a) The following required information must be submitted electronically through the Agency’s Single Sign On Portal located at https://apps.ahca.myflorida.com/SingleSignOnPortal:
1. Nursing homes:
Adverse incident reports must be submitted electronically to the Agency within 15 calendar days after the occurrence of the incident as required in Florida Statutes § 400.147 on Nursing Home Adverse Incident, AHCA Form 3110-0010 OL, April 2017, which is hereby incorporated by reference and available at: https://www.flrules.org/Gateway/reference.asp?No=Ref-08777, and through the Agency’s adverse incident reporting system which can only be accessed through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
2. Assisted living facilities:
Adverse incident reports must be submitted electronically to the Agency within 1 business day after the occurrence of the incident, and within 15 calendar days after the occurrence of the incident as required in Florida Statutes § 429.23, on Assisted Living Facility Adverse Incident, AHCA Form 3180-1025 OL, April 2017, which is hereby incorporated by reference and available at: https://www.flrules.org/Gateway/reference.asp?No=Ref-08778, and through the Agency’s adverse incident reporting system which can only be accessed through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
3. Hospitals:
Adverse incident reports must be submitted electronically to the Agency within 15 calendar days after the occurrence of the incident as required in Florida Statutes § 395.0197, on Hospital Adverse Incident, AHCA Form 3140-5001 OL, April 2017, which is hereby incorporated by reference and available at: https://www.flrules.org/Gateway/reference.asp?No=Ref-08779, and through the Agency’s adverse incident reporting system which can only be accessed through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
4. Ambulatory Surgical Centers:
Adverse incident reports must be submitted electronically to the Agency within 15 calendar days after the occurrence of the incident as required in Florida Statutes § 395.0197, on Ambulatory Surgical Center Adverse Incident, AHCA Form 3140-5004 OL, April 2017, which is hereby incorporated by reference and available at: https://www.flrules.org/Gateway/reference.asp?No=Ref-08780, and through the Agency’s adverse incident reporting system which can only be accessed through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
5. Hospitals and ambulatory surgical centers must submit annual reports pursuant to Section 395.0197 F.S., electronically to the Agency on Annual Report, AHCA Form 3140-5005 OL, May 2018, which is hereby incorporated by reference and available at: http://www.flrules.org/Gateway/reference.asp?No=Ref-12123, and through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
6. For the purposes of this rule, the following applies for submitting adverse incident reports:
a. A business day means any day other than a Saturday, Sunday, or legal holiday as designated in Florida Statutes § 110.117
b. A preliminary (1-Day) report is deemed late when submitted more than 1 business day after the day of the incident.
c. Nursing Homes, Hospitals, and Ambulatory Surgical Centers: A full report (15- Day) is deemed late when submitted more than 15 calendar days after the day of the incident.
d. Assisted Living Facilities: A full report (15-Day) is deemed late when submitted more than 15 calendar days after the day of the incident or more than 3 business days after the Agency issues the reminder pursuant to Florida Statutes § 429.23(5), whichever is later.
e. Assisted Living Facilities and Nursing Homes that submit reports deemed late may be fined up to $50 per day late not to exceed $500.
(b) The licensee must retain a copy of all documentation generated at time of reporting as confirmation of successful electronic submission.
(c) If the Agency’s Single Sign On Portal or the online adverse incident reporting system is temporarily out of service the licensee may contact the Agency directly at 1(888)419-3456 for assistance. Reporting will resume as soon as online access is restored.
(3) This rule is in effect for five years from its effective date.
Rulemaking Authority 395.0197, 408.806, 408.813, 408.819, 429.23 FS. Law Implemented 408.806, 408.813, 408.810, 429.23, 395.0197 FS. History-New 7-14-10, Amended 11-13-17, 2-2-21, 10-4-21.
(a) Insurance coverage renewal;
(b) Bond renewal;
(c) Change of administrator or the similarly titled person who is responsible for the day-to-day operation of the provider;
(d) Annual sanitation inspections;
(e) Fire inspections.
(2) Electronic submission of information.
(a) The following required information must be submitted electronically through the Agency’s Single Sign On Portal located at https://apps.ahca.myflorida.com/SingleSignOnPortal:
1. Nursing homes:
Adverse incident reports must be submitted electronically to the Agency within 15 calendar days after the occurrence of the incident as required in Florida Statutes § 400.147 on Nursing Home Adverse Incident, AHCA Form 3110-0010 OL, April 2017, which is hereby incorporated by reference and available at: https://www.flrules.org/Gateway/reference.asp?No=Ref-08777, and through the Agency’s adverse incident reporting system which can only be accessed through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
2. Assisted living facilities:
Adverse incident reports must be submitted electronically to the Agency within 1 business day after the occurrence of the incident, and within 15 calendar days after the occurrence of the incident as required in Florida Statutes § 429.23, on Assisted Living Facility Adverse Incident, AHCA Form 3180-1025 OL, April 2017, which is hereby incorporated by reference and available at: https://www.flrules.org/Gateway/reference.asp?No=Ref-08778, and through the Agency’s adverse incident reporting system which can only be accessed through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
3. Hospitals:
Adverse incident reports must be submitted electronically to the Agency within 15 calendar days after the occurrence of the incident as required in Florida Statutes § 395.0197, on Hospital Adverse Incident, AHCA Form 3140-5001 OL, April 2017, which is hereby incorporated by reference and available at: https://www.flrules.org/Gateway/reference.asp?No=Ref-08779, and through the Agency’s adverse incident reporting system which can only be accessed through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
4. Ambulatory Surgical Centers:
Adverse incident reports must be submitted electronically to the Agency within 15 calendar days after the occurrence of the incident as required in Florida Statutes § 395.0197, on Ambulatory Surgical Center Adverse Incident, AHCA Form 3140-5004 OL, April 2017, which is hereby incorporated by reference and available at: https://www.flrules.org/Gateway/reference.asp?No=Ref-08780, and through the Agency’s adverse incident reporting system which can only be accessed through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
5. Hospitals and ambulatory surgical centers must submit annual reports pursuant to Section 395.0197 F.S., electronically to the Agency on Annual Report, AHCA Form 3140-5005 OL, May 2018, which is hereby incorporated by reference and available at: http://www.flrules.org/Gateway/reference.asp?No=Ref-12123, and through the Agency’s Single Sign On Portal located at: https://apps.ahca.myflorida.com/SingleSignOnPortal.
6. For the purposes of this rule, the following applies for submitting adverse incident reports:
a. A business day means any day other than a Saturday, Sunday, or legal holiday as designated in Florida Statutes § 110.117
b. A preliminary (1-Day) report is deemed late when submitted more than 1 business day after the day of the incident.
c. Nursing Homes, Hospitals, and Ambulatory Surgical Centers: A full report (15- Day) is deemed late when submitted more than 15 calendar days after the day of the incident.
d. Assisted Living Facilities: A full report (15-Day) is deemed late when submitted more than 15 calendar days after the day of the incident or more than 3 business days after the Agency issues the reminder pursuant to Florida Statutes § 429.23(5), whichever is later.
e. Assisted Living Facilities and Nursing Homes that submit reports deemed late may be fined up to $50 per day late not to exceed $500.
(b) The licensee must retain a copy of all documentation generated at time of reporting as confirmation of successful electronic submission.
(c) If the Agency’s Single Sign On Portal or the online adverse incident reporting system is temporarily out of service the licensee may contact the Agency directly at 1(888)419-3456 for assistance. Reporting will resume as soon as online access is restored.
(3) This rule is in effect for five years from its effective date.
Rulemaking Authority 395.0197, 408.806, 408.813, 408.819, 429.23 FS. Law Implemented 408.806, 408.813, 408.810, 429.23, 395.0197 FS. History-New 7-14-10, Amended 11-13-17, 2-2-21, 10-4-21.