From:Anne Menard, Supervisor, Home Care Unit, Bureau of Health Facility Regulation

Date:July 16, 2009

To:Nurse Registry Administrators

From:Anne Menard, Supervisor, Home Care Unit, Bureau of Health Facility Regulation

Subject:Legislative changes effective July 1, 2009 affecting nurse registries

The 2009 Florida Legislature passed Senate bill 1986 that made changes to state laws for nurse registries.

Following are the changes to the nurse registry law:

400.506(15), Florida Statutes:

(a) The agency may deny, suspend, or revoke the license of a nurse registry and shall impose a fine of $5,000 against a nurse registry that:

4. Gives remuneration to a case manager, discharge planner, facility-based staff member, or third-party vendor who is involved in the discharge planning process of a facility licensed under chapter 395 or this chapter and from whom the nurse registry receives referrals. A nurse registry is exempt from this subparagraph if it does not bill the Florida Medicaid program or the Medicare program or share a controlling interest with any entity licensed, registered, or certified under part II of chapter 408 that bills the Florida Medicaid program or the Medicare program.

5. Gives remuneration to a physician, a member of the physician's office staff, or an immediate family member of the physician, and the nurse registry received a patient referral in the last 12 months from that physician or the physician's office staff. A nurse registry is exempt from this subparagraph if it does not bill the Florida Medicaid program or the Medicare program or share a controlling interest with any entity licensed, registered, or certified under part II of chapter 408 that bills the Florida Medicaid program or the Medicare program.

The “Florida Medicaid program” includes all programs in Medicaid, including, but not limited to, all Medicaid Waivers and Medicaid HMO. This applies to nurse registries that bill the Florida Medicaid program or bill another agency that receives funding from the Medicaid program for services your nurse registry is sending independent contractors to provide. Please see the “Frequently Asked Questions”, Section 11, at the AHCA web site for questions and answers about the above law changes: click on “Nurse Registry.”

Additionalchanges were made to Chapter 408, Part II, Florida Statutes. This part isnamed “Health Care Licensing: General Provisions”andcovers the licensing of all provider types regulated by the Agency, including nurse registries. These changes are:

• The definition of “change of ownership” now reads “An event in which the licensee sells or otherwise transfers its ownership to a different individual or entity as evidenced by a change in federal employer identification number or taxpayer identification number; or an event in which 51 percent or more of the ownership, shares, membership, or controlling interest of a licensee is in any manner transferred or otherwise assigned.” This does not apply to a licensee that is publicly traded on a recognized stock exchange.The definition of “licensee” now includes all legal entities.

• Every patient and his or her immediate family or representative, must be given a description of Medicaid fraud written by the Agency and the statewide toll-free telephone number for the central Medicaid fraud hotline. The written description must be clearly legible and include the words: “To report suspected Medicaid fraud, please call toll-free 1-888-419-3456.” The Agency’s description is as follows:

Medicaid Fraud means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to him or herself or some other person. It includes any act that constitutes fraud under applicable federal or state law as it relates to Medicaid. The office of the Inspector General at the Agency for Health Care Administration accepts complaints regarding suspected fraud and abuse in the Florida Medicaid system by phone at 1-888-419-3456 or on the Agency web site at

Perhaps you can add this to the same sheet that has the AHCA complaint line and Abuse Hotline numbers that you already have to give out to new patients and their representatives

• Applications will be returned if submitted more than 120 days beforethe expiration of the current license or the requested effective date (such as with a change of ownership).

• Additional grounds are authorized for denial of applications if the applicant or a controlling interest has been convicted, plead guilty or no contest for a felony under chapters 209, 817 or 893, Florida Statutes; or 21 U.S.C. ss. 801-970 or 42 U.S.C. ss. 1395-1396; or been terminated for cause from the federal Medicare or any state Medicaid programs. Certain timeframes apply.

• Any information required to be reported to the Agency must be submitted within 21 calendar days after the report period or effective date of the information, whichever is earlier. This includes, but is not limited to, any change of information contained in the most recent application for licensure, such as changes in ownership that are less than 51%, changes of addresses, and changes of administrator and alternate administrator.

• Additional disqualifying offenses have been added for persons who are required to undergo background screening. These will apply to persons hired after October 1, 2009. A person who serves as a controlling interest or is an employee on September 30, 2009 will not have to be re-screened, if they have previously met the background screening requirements. If a person has one of the new disqualifying offenses, he or she may request an exemption from the Agency or the Department of Health Board of Nursing (if a nurse or certified nursing assistant), prior to September 30, 2009. For licensure purposes, the administrator and financial officer must still undergo level 2 screening every five years. A listing of the additional disqualifying offenses is in Senate Bill 1986, section 50.

• All nurse registries must designate a safety liaison as the primary contact for emergency operations. You already have a coordinator named in your emergency management plan that could be this liaison.

• The requirement for not-for-profit corporate licensees to routinely submit affidavits of voluntary board members is eliminated. The Agency may still require supplementary documentation as needed. The recommended application form posted on the Agency’s website has been revised to reflect this change.

• The Affidavit of Compliance with Screening Requirements is only required to be submitted at the time of licensure renewal, not annually.

The wording of these new laws is posted at the AHCA web site: click on “Nurse Registry.”

If you have questions about the law changes after checking the “Frequently Asked Questions”, section 11, at the AHCA web site, please send an email to or call the Home Care Unit at (850) 414-6010.

1