Pascal Bergeron
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This article is to help ALF’s understand better what are considered Nursing services and require a Nurse to provide. Not all nursing services are allowed to be performed in the ALF setting.

Firstly, when something requires skilled nursing services, that means the services must be administered by a licensed practical nurse or registered nurse. If something requires rehabilitative services but not nursing services, that is a different pool of professionals.

Patient services must meet all of these criteria to be considered nursing services. It must:

Be ordered by and supervised by a physician

Medically complex enough to require the planning and implementation of a registered nurse

To be considered safe and effective, it must be required to be under the purview of a registered nurse or healthcare professional

Required to be done every day

Related to a documented injury or illness

Consistent with the state of the client’s age, state, and condition

There are several examples of nursing services for patients set forth in Florida law. Nursing services described in Florida law include

Intravenous medication

Subcutaneous injection required at least 5 times weekly (not including insulin) Management of medication regime on a daily basis for drugs with variable doses or with severe side effects

Levin tube and gastrostomy feedings

Administration of medical gases

Naso-pharyngeal and tracheotomy aspiration (excluding self-care residents)

Insertion, replacement, or sterilization of qualifying catheters

Qualifying colostomy and ileostomy care;

Treatment of qualifying decubitus ulcers

Treatment of widespread or infected skin disorders

Daily qualifying dressings when medication application is required

Prescribed daily heat treatments

Daily rehabilitation nursing procedures

Each of these skilled services that are considered nursing services are described in more significant detail in the Florida Administrative Code. You can read Florida Administrative Code 59G-4.290 Skilled Services here.

You may also want to review what is considered skilled rehabilitative services. Skilled rehabilitative services are also described in Florida Administrative code 59G-4.290.

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