Changes to Rule 58A-5.0131
Assistance with Transfer
Provides clarity to the previous definition for assistance with transfer. Total physical assistance with transfer would
require relocation of the resident.
Day Care Participant
Day care participants are persons that receive services at the facility for less than a 24 hour period. Please note that
day care participants now affect staffing (discussed below).
Nursing Assessments
The assessments must have the signature of the credentials of the assessor, e.g. RN. Keep in mind that AHCA’s
position is that a LPN is not allowed to approve and sign nursing assessments. Keep in mind that the rule
differentiates between a nursing assessment and other assessments.
Changes to Rule 58A-5.0181
Stage II Pressure Sore
Although not currently a change from current law, the rule makes it abundantly clear that a resident with a stage
II may remain in an assisted living facility as long as one of the following occurs:
a. The resident in a standard licensed ALF receives services from a third party.
b. The resident in a limited nursing service licensed ALF is receiving services from the facility.
Residents not Appropriate for Admission in a Standard, LNS, or LMH ALF
* Residents that require artificial airway management, except for those that use a CPAP or Bipap.
* Residents that require management of post-surgical drainage tubes and wound vacuum devices is prohibited.
* Residents that require the administration of blood products.
* An ALF must have the plan of care for residents that are receiving care for a surgical incision or wound that has
been stabilized. The plan of care must be in the resident record.
Additional Changes to Admissions in a Standard and LMH ALF
Residents in a standard or LMH licensed ALF are prohibited from allowing hemodialysis, peritoneal dialysis, or
Intravenous therapy within the facility.
Continued Residency
The resident’s legal representative is added as a person other than the resident that can authorize continued
residency for residents returning on hospice.
Stoma Site Flange Placement
A resident that needs care of stoma site flange placement that otherwise meets residency may be admitted to an
assisted living facility.
Resident Health Assessment
The resident health assessment March 2017 must be performed on the new AHCA Form 1823 for all residents
admitted on May 10, 2018 or thereafter.
Changes to Rule 58A-5.0182
Exception from Work Requiring Compensation
Residents may be required to clean their own rooms or apartments.
Elopement Standards
* The facility must be aware of the general location of residents assessed as a high risk for elopement.
* Residents must have photo identification upon admission for residents that are at risk for elopement.
Changes to Rule 58A-5.0185
Pill Organizers
* Clarifies that a resident that self administers may maintain a pill organizer.
* Unlicensed staff may not assist with a pill organizer.
Assistance with Self-Administration of Medication
Unlicensed staff must read the label “aloud” when providing medication to residents.
Stock Supply of Over the Counter Medication
* A facility may keep a stock supply of OTC products for multiple resident use. When providing any OTC product
that is kept by the facility as a stock supply to a resident, the staff member providing the medication must record
the name and amount of the OTC product provided in the resident’s medication observation record.
* All OTC products kept as a stock supply must be stored in a locked container or secure room in a central
location within the facility and must be labeled with the medication’s name, the date of purchase, and with a
notice that the medication is part of the facility’s stock supply.
Changes to Rule 58A-5.019
Day Care and Respite Residents
Staffing standards must include day care and respite residents. Practice Tip: Staffing is based on the week and in
all cases where you will go into the next staffing category, you will have to provide an additional 40 hour FTE for the
week.
Changes to Rule 58A-5.0191
Staff Preservice Orientation (see article)
* Facilities must provide a preservice orientation of at least 2 hours to all new assisted living facility employees who
have not previously completed core training.
* New staff must complete the preservice orientation prior to interacting with residents.
* Once complete, the employee and the facility administrator must sign a statement that the employee completed
the preservice orientation which must be kept in the employee’s personnel record.
* In addition to topics that may be chosen by the facility administrator, the preservice orientation must cover:
a. Resident rights
b. The facility’s license type and services offered by the facility .
Staff In-Service
The facility must use its infection control policies and procedures when offering staff in-service.
CPR Certification
*The rule clarifies that CPR certification must be done in person and that it requires return demonstration.
* The CPR Instructor has to be approved.
Assistance with Self Administration/Medication Management
Training shall include demonstrations of proper techniques. Including techniques for infection control and
ensure unlicensed staff have adequately demonstrated that they have acquired the skills necessary to provide such
assistance.
Additional Task Allowed Under Assistance with Medication (A focused 2hr training on topics required)
* Assist residents with insulin syringes that are pre-filled with the proper dosage by a pharmacist and insulin pens
that are pre-filled by the manufacturer by taking the medication, in its previously dispensed, properly labeled
container, from where it is stored, and bringing it to the resident for self-injection;.
* Assist with nebulizers.
* Use a glucometer to perform blood glucose testing;
* Assist residents with oxygen nasal cannulas and continuous positive airway pressure (CPAP} devices. Titration
of oxygen levels are prohibited.
* Application and removal of anti-embolism stockings and hosiery.
* Placement and removal of colostomy bags. It does not include the removal of the flange or manipilation of the
stoma site.
* Measurement of blood pressure, heart rate, temperature, and respiratory rate.
Nutrition and Food Service
A Certified food manager, certified dietary manager, registered or licensed dietitian, dietetic registered technician,
or health department sanitarian is exempted from the requirement to have the 2hr update annually.
Alzheimer’s Disease and Related Disorders
Clarifies that staff that interact with residents must have the initial 4 hours of training.
Changes to Rule 58A-5.024
Currently being litigated and these changes have not taken affect
Changes to Rule 58A-5.029
Community Living Support Plan
The plans must be updated annually or when there is a significant change in the resident’s behavioral health.
Request for Missing Information
A documented request for missing information pertaining to the community living support plan must be made in
72 hours of the residents admission.
Changes to Rule 58A-5.030
ECC Physical Plant Requirements Removed
ALFs are required to comply with the Florida Building Code for ALF requirements.
ECC Admissions and Continued Residency
* A person may not be admitted that need an artificial airway. CPAPs and Bipaps are permitted.
* A person may not be admitted to an ECC facility that needs the management of post-surgical drainage tubes or
a wound vacuum.
Changes to Rule 58A-5.031
Nursing Services in an LNS Facility
A nurse in a LNS facility may provide nursing care to residents that do not require 24-hour nursing supervision.
They may also provide 24-hour nursing care to residents on hospice.
Coordination of Care in LNS
A facility employed or contracted nurse must coordinate with third party nursing services to ensure that resident
care is provided in a safe and consistent manner. Practice Tip: If a facility only has a contracted nurse, they must
have that nurse scheduled to ensure the coordination required under the Rule.