(1) A plan of care shall be established in consultation with the physician, physician assistant, or advanced practice registered nurse, pursuant to Florida Statutes § 400.487, and the home health agency staff who are involved in providing the care and services required to carry out the physician, physician assistant, or advanced practice registered nurse’s treatment orders. The plan must be included in the clinical record and available for review by all staff involved in providing care to the patient. The plan of care shall contain a list of individualized specific goals for each skilled discipline that provides patient care, with implementation plans addressing the level of staff who will provide care, the frequency of home visits to provide direct care and case management.
    (2) Home health agency staff must follow the physician, physician assistant, or advanced practice registered nurse’s treatment orders that are contained in the plan of care. If the orders cannot be followed and must be altered in some way, the patient’s physician, physician assistant, or advanced practice registered nurse must be notified and must approve of the change. Any verbal changes are put in writing and signed and dated with the date of receipt by the nurse or therapist who talked with the physician, physician assistant, or advanced practice registered nurse’s office.
    (3) The patient, caregiver or guardian must be informed by the home health agency personnel that:
    (a) He has the right to be informed of the plan of care;
    (b) He has the right to participate in the development of the plan of care; and,
    (c) He may have a copy of the plan if requested.
Rulemaking Authority 400.497 FS. Law Implemented Florida Statutes § 400.487. History-New 10-27-94, Amended 1-17-00, 7-18-01, 8-15-06.