Florida Exam Quick Reference Chart 2024 PDF

FLORIDA EXAM QUICK REFERENCE CHART 2024 SECTION 1 - CHAPTER 400 1) Level 2 background screen for all new hires 2) Level 2 background must be repeated every 5 years 3) Resident receives the bill of rights prior to or upon admission 4) For involuntary discharge from fa...

FLORIDA EXAM QUICK REFERENCE CHART 2024 SECTION 1 - CHAPTER 400 1) Level 2 background screen for all new hires 2) Level 2 background must be repeated every 5 years 3) Resident receives the bill of rights prior to or upon admission 4) For involuntary discharge from facility, must give 30 days’ advance notice 5) Resident contact is kept for 5 years 6) Any changes in the facility contract, must give resident 14 days advanced notice in both in writing and orally 7) Must account for all refunds and provide final accounting within 30 days of death 8) Residents with communicable diseases cannot be admitted or retained unless the medical director or attending physician certifies adequate isolation measures are taken. 9) All staff must have 1 hour HIV training biennially and 2 hours within 6 months before providing care to an HIV resident. 10) Final resident bill must be given within 7 days after discharge or death. 11) Must refund any monies held within 30 days of death or discharge 12) Informed consent means to adequately inform the resident of the treatment to be provided, the side affects or consequences of such treatment, alternatives to the treatment and failure to do so is a tort or criminal battery. Remember, residents have a right to refuse treatment. 13) A resident has the eight to obtain their medications from a community pharmacy of their choice, however, the pharmacy must provide medications in a form maintained by the facility – for example if the nursing home uses bubble sheets to administer meds, the pharmacy must be able to dispense meds in bubble sheets. 14) A facility must provide a resident access to a cordless phone or a phone in a private area but not at the nursing station. 15) They do not have to be provided a phone bedside, but must have access to a phone and a location where they can speak in privacy and not be overheard. 16) A private pay resident has the right to reserve a bedhold for 30 days. They have to pay for it in advance. 17) A Medicaid resident is entitled to a bed hold of 15 days each year 18) Must file a notice of intent to sue a nursing home and wait 75 days before filing the actual lawsuit, to give the nursing home time to assess the claims and whether to settle the claim or go to trial. 19) Statutory waiting period is 75 days. 20) Within 75 days the facility must either reject the claim or make a settlement offer 21) A Settlement offer must be accepted within 15 days of receipt by the party suing the nursing home or the offer is considered rejected. 22) Statute of limitations is 2-6 years 23) Punitive damages is for gross negligence or intentional misconduct. 24) An award of punitive damages for negligence in caring for a resident is 3 times the amount of the compensatory damages or $1 million. 25) License fees are $100 per bed 26) The per bed resident protection fund fee is. $.50 per bed 27) A License will only be given to a facility that has a certificate of need. Florida State Exam Quick Reference Chart 2005 - 2023 Page 1 of 12  28) Inactive facility license is issued for up to 12 months, renewable for 6 months upon demonstration of progress toward reopening 29) If a licensee has a license revocation, suspension, or judicial proceedings pending at the time of renewal, a temporary license may be issued until final disposition of those proceedings. 30) AHCA must inspect a facility with a conditional license every 3 months 31) AHCA can enter a facility at any reasonable time to determine compliance with the laws and regulations – they can enter 24 hours a day – 7 days a week and can start a survey 3 AM if they want. 32) Each facility must keep copies of their inspection reports, complaint reports and plans of correction for the prior 5 years 33) The state will post the survey results for each facility for the prior 45 months 34) Survey and complaint survey reports must be kept in the main lobby or in a public place. Usually kept in a binder in the lobby attached to a chain so it doesn’t walk away. 35) Keep a copy of those survey reports in your own file in case it is lost. 36) The risk management/Quality assurance meeting must meet monthly and minutes of those meetings documented 37) The risk manager, NHA, DON, Medical Director and 3 other staff must attend the RM/QA meeting. 38) By state law, the NHA cannot be the risk manager 39) Non physician staff must receive a min of 1 hour of risk management training each year 40) Adverse incidents must be reported to the risk manager by staff within 3 days and the risk manager must report adverse incidents to the state within 1 working day. The 1 day report. 41) The risk manager must also initiate an investigation immediately and report the results of that investigation within 5 working days to the state The 5 day report. 42) Current residents must be provided copies of their records within 14 days of receipt of written request to spouse, guardian, surrogate, proxy, or attorney. 43) Former residents may be provided copies of their records within 30 days of requesting them in writing 44) Note that state law is silent as to the time frame in which you must provide access to inspect or just read their chart or records. 45) Resident records include medical, psychiatric and financial records and they all must be maintained for a minimum of 5 years 46) The Nursing home Watch list is published quarterly and lists all nursing homes in the state in bankruptcy or has substandard care violations 47) A Facility with more than 121 beds must have a ADON 48) A facility must use a licensed clinical laboratory to perform blood and urine tests 49) After the doctor visits every month for the first 90 days, the doctor must then visit residents every 2 months or every other month, and there is a 10 day grace period 50) The physician does not have perform a physical exam at each visit – just document a face to face visit 51) Must assess residents within 5 days of admission for the pneumococcal vaccine 52) A resident must have a physical exam every 3 months which is the purpose of the MDS. 53) A resident must have a comprehensive assessment within 14 days of admission. 54) Must do a comprehensive assessment every 12 months or since the last significant change 55) A comprehensive assessment and the comprehensive care plan must be reviewed every 3 months 56) Must have 12 fire drills each year. Florida State Exam Quick Reference Chart 2005 - 2023 Page 2 of 12  57) Must document a fire drill on each shift every 3 months. 58) A resident’s spouse, guardian, surrogate, proxy, or attorney may inspect their records 59) The medical director must attend the quality assessment and assurance committee quarterly 60) The medical director must visit the facility at least once each month 61) Resident Assessment Protocols or ( RAPS) have 18 triggers which highlight care issues requiring special attention 62) Dietary manager must document 45 hours of CEUS every 3 years 63) A resident has the right to use a pharmacy of their choice at the residents own expense or through Medicaid. The pharmacy must deliver meds to the facility and in the form used by the facility to administer drugs such as bubble sheets 64) Flu shots are to be given Between Nov 30 and March 31 of each year 65) Flu shots must be administered within 5 days after admission 66) Must notify a licensed physician within 30 days if a resident exhibits signs of dementia 67) Notice of discharge must be given to residents 30 days in advance 68) The facility must notify next of kin or the ombudsman within 5 days of the discharge. 69) Generator fuel supply 100 percent power for 64 hours or 72 hours for actual resident demand load 70) Quality care monitors visit facilities quarterly 71) Gold seal facilities are inspected every 2 years 72) Gold seal facilities can have an in-house Nursing Assistant training program if they choose to 73) The Gold seal commission has 12 members 74) A facility for Gold Seal award must have been licensed and in operation for the prior 30 months to filing the application 75) A facility for Gold Seal award must have no class 1 or 2 deficiencies in the last 30 months, and no serious complaint surveys for the prior 30 months 76) Gold seal facility must have financial stability, have a stable work force with low turnover rate within the 30 months preceding application and must be in the top 25% quality of care facility. 77) A facility for Gold Seal award must not have staff turnover greater that 50% in the recent 12 months 78) A facility for Gold Seal award must have stability rate with a 50% of staff employed for at least 1 year. 79) Alzheimer’s training for direct contact staff is 1 hour within 3 months of hire 80) An additional 3 hours Alzheimer’s training is required within 9 months for those who provide direct care. 81) A facility must provide residents an accounting of their trust fund or a statement of their account every 3 months or quarterly 82) The governing body has ultimate legal responsibility for the care provided by the facility 83) The governing body is responsible to develop and implement facility policies, 84) The governing body is responsible to make critical decisions and adopt or approve the facility budget 85) The administrator is responsible for day to day management of the facility 86) The facility license expires on the date printed on the face of the license 87) A geriatric clinic can treat patients 60 years and older 88) The patient load in the geriatric clinic must be at least 15 before the nursing staff in the clinic can be counted on the nurse staffing hours for the nursing home. 89) Staff can only work 16 hours shifts – 3 days in a row 90) A nursing aide has 4 months to pass their certification exam Florida State Exam Quick Reference Chart 2005 - 2023 Page 3 of 12  91) Must staff at least 2.5 hours of nursing aide time and 1 hour of licensed nursing time for each resident on any one day. 92) The facility must achieve an average of 3.6 hours by Saturday of each week of both nursing aide and licensed nursing hours Staffing hours were recently Changed as Follows and my be on the exam as January 1, 2023 93) Minimum of 2.0 hours of certified nursing hours per resident per day. 94) One hour of licensed nursing per resident per day. 95) Unlicensed nursing staff may fill the remaining.6 hours to total 3.6 hours per day. 96) Unlicensed staffing include: a. Paid feeding assistant (who completed a qualifying feeding assistant training program) b. Nursing c. Pharmacy d. Dietary e. Therapeutic activities f. Dental g. Podiatry h. Mental Health providers SECTION 2 - FOOD HYGIENE CHAPT. 64E-11 97) An air curtain blocks flying insects from entering the facility 98) Storage of raw food must be stored below ready to eat foods (raw meets must separated from prepared foods and stored below raw or prepared food to avoid contamination 99) Bulk food in separate containers must be relabeled identifying the food by common name 100) During food preparation and service, must store serving utensils in the food on the steam table which is heated to 140 degrees F or above 101) Only individual packages of sugar and condiments are to be used 102) Sanitizers and other toxic materials need to separate from food storage 103) If temps of potentially hazardous foods which are out of the safe range of 41 or below and 140 and above due to fire, flood, power outage, must notify the Department of Health you cannot safely store foods 104) Hazardous foods to be served without further cooking like egg salad, chicken salad and tuna salad must be prepared from chilled products 105) Pasteurized milk or egg products or boiled eggs can be left out at room temperature and will not spoil 106) Cannot leave food at room temperature for more than 4 hours 107) Must reheat potentially hazardous foods to a minimum 165 degrees F for 15 seconds 108) Ready to eat food must be reheated to 140 degrees F. 109) Must mark food held more than 24 hours with date of preparation 110) Cured meat and aged cheeses are exempt from date marking 111) Must discard food within 7 days of preparation or by sell by or use by date 112) Must notify the health department if management suspects an employee has a communicable disease. Florida State Exam Quick Reference Chart 2005 - 2023 Page 4 of 12  113) Headbands and caps are allowed if they restrain the hair 114) A 2 compartment sink, kitchenware and equipment and 3 compartment sink used for pots and utensils needing sanitization. 115) Dishes and forks and spoons and glasses are washed in the dishwasher 116) A low temp dishwasher must use water at a temp not less than 120 degrees (It sanitizes by chemical sanitizer) 117) Food manager certification is valid for 5 years 118) The food establishment permit must be renewed every year on Sept 30th 119) roast beef must be cooked to 130 degrees for 121 minutes 120) roast beef must be cooked to 145 degrees for 3 minutes 121) Must cook hamburger and hot dogs to 155 degrees for 15 seconds 122) Raw meats must be cooked for 145 degrees for 15 seconds 123) Poultry is cooked to 165 degrees for 15 seconds 124) Must attach a backflow preventer to any water supply attached to a sink to prevent dirty water from backing up into the clean water supply line 125) A chlorine sanitizer must be at 50 PPM 126) Cannot use enamel as food preparation material 127) Cannot use wood for cutting boards except Maple wood 128) Can only use wood in single service items SECTION 3 - CH 765 ADVANCED DIRECTIVES 129) A Proxy is assigned to make healthcare decisions by someone other than the resident (can be arranged by the facility) 130) A Surrogate is a competent adult designated by the principal (resident) to make care decisions upon the principal’s incapacity and can apply for public benefits 131) A Guardian is appointed by a court when an individual is found to lack capacity to make decisions for themselves 132) A POA or power of attorney can make only financial decisions 133) A durable POA can make both financial and healthcare decisions 134) Amending or revoking an advance directive can be done by signing a new one or destruction by the principal in the presence of third person, or by an oral expression in front of witnesses to amend or revoke it 135) Falsifying or destroying advanced directives is a third degree felony 136) Euthanasia is not murder or a crime 137) An advanced directive must be witnessed by 2 adults. Only one can be related by blood 138) Must inform residents they have a right to make an advanced directive but cannot require them to make one SECTION 4 - BIOMEDICAL WASTE 5% 139) Only a licensed transporter can transport biomedical waste 140) A licensed transporter must give the facility a receipt each time they pickup medical waste indicating the date and weight of the material collected 141) The facility must have a biomedical waste generator permit from the Fla Dept of Health 142) The permit must be renewed each year on Sept 30th 143) All bodily fluids that cannot be identified are treated as biomedical waste 144) Biomedical waste mixed with hazardous waste is managed as hazardous waste 145) Refresher training on biomedical waste must be provided to staff annually Florida State Exam Quick Reference Chart 2005 - 2023 Page 5 of 12  146) Each red plastic bag must have impact resistance of 165 grams and tear resistance of 480 grams 147) Waste bags and containers are labeled with the generators name and address 148) For an accidental spill, a waste transporter must notify the department within 1 day by phone and in writing with 10 days 149) A generator can transport 25 pounds of biomedical waste each month without a permit 150) Cannot store biomedical waste for more than 30 days in a facility SECTION 5 - NURSING HOME ADMINISTRATOR RULES 151) For initial licensure and renewal must have a , 3 hour HIV course and 2 hour prevention of medical errors 152) Provisional license is valid for 6 months or 180 days 153) Notification of change of address or job ,must notify the board within 48 hours in writing 154) NHA license fee is $255 biennial and a $5 fee for unauthorized practice fee 155) Inactive license must be renewed every 2 years, department will send 90 days in advance 156) Inactive license for 4 years and not practiced 2 of the 4 need to go before the board 157) Notice of noncompliance, false deceptive or misleading advertising 158) Statute of limitations is 4 years from the time of the incident 159) No more than 15 CEU hours for any one topic 160) License renewal must have a statement declaring the licensee completed all required courses (CEUS are randomly audited by the board) 161) A Preceptor must have been licensed and working as an administrator for 3 years prior to their application to be a preceptor 162) A preceptor must complete a 6 hour training program 163) A preceptor certificate is valid for 3 years 164) An NHA must complete 40 hours of CEUs every 2 years 165) Must complete a 2 hour medical hours course to renew your license 166) An NHA license is renewed every 2 years on Sept 30th 167) The Board for Nursing Home Administrators issues NHA licenses 168) If an NHA license has been inactive for more than 5 years, the licensee must pay a fee, complete at least 40 hours of CEUs for each year inactive and pass a special exam administered by the board. 169) AIT must complete a minimum of 40 hours between ___ and ____ AM SECTION 6 - STATE ADULT PROTECTIVE SERVICES 170) Administrative fines for making a false report of abuse is a maximum of $10,000 for each violation 171) Knowingly and willfully failing to report abuse is a second degree misdemeanor 172) If protective services personnel determine an individual needs protective services but lacks capacity to consent to such services, then the department must get a court order to provide such services. 173) If the individual is determined to be abuse but does have capacity, the department cannot force them accept such services. 174) Abuse investigators can close a case by one of the following designations – a.1. Proposed confirmed a.2. Unfounded a.3. Closed without classification An abuse case CANNOT be closed by a finding of guilty. 175) An alleged perpetrator has a right to counsel when being questioned or has the right to have someone with them. Florida State Exam Quick Reference Chart 2005 - 2023 Page 6 of 12 176) Must report suspected abuse within 24 hours 177) The risk management and QA committee meet monthly 178) Must post a surety bond for the resident trust fund equal to 2x the monthly average of balance of the account or $5000, whichever is greater 179) Safe food temperature – 41F or below for cold food and 140 or above for hot food 180) Nursing assessments must be completed upon admission as opposed to the comprehensive assessment that must be completed within 14 days of admission 181) Withholding life support would be considered which of the following: 1. Mercy killing 2. Euthanasia 3. Murder 4. Abuse 184. A hose connected to a sink must have a backflow prevention device 185. Required hot surface temperature of food utensils is 160 F which is the temperature of sanitizing items 186. Final rinse temperature is 180 F for a hot water dishwasher 187. Need an ADON with a facility of 121 beds or more or more than 120 beds 188. A facility has 30 days to pay a fine 189. The NHA needs 20 ceus for an NHA license EACH YEAR or 40 hours every 2 YEARS for renewal 190. A nursing home is inspected every 15 months (between 9-15 months) 191. The following must signoff on facility policies and procedures – Administrator, DON and medical director) 192. What is and is not biomedical waste or bodily fluids The following are bodily fluids a.i. Blood a.ii. Blood products a.iii. Cerebral spinal fluid a.iv. Semen a.v. Vaginal fluids Saliva is not a bodily fluid considered to transmit blood borne pathogens such as HIV 193. Must provide residents an accounting of their trust account quarterly 194. State officials can enter a facility at any hour 195. must use either the accrual or cash accounting system 196. The administrator is responsible to do the abuse investigation 197. Pots and pans must be at least 6 inches off the floor 198. Must use a 3 compartment sink to clean utensils in kitchen 199. In a four story building with 4 nursing stations on each floor needs how many nursing personnel? Need 16 Staff members (4 x 4 =16 or 1 person at each nursing station 200. There are 6 domains of practice that the AIT must cover in their 1.23.1. Personnel. - Recruitment, interviewing, employee selection, training, 1.23.2. Finance. - Accounting, budgeting, financial planning and asset management. 1.23.3. Marketing - Public relations activities and marketing programs. 1.23.4. Physical Resource Management. – Safety, fire, disaster plans and maintenance Florida State Exam Quick Reference Chart 2005 - 2023 Page 7 of 12  1.23.5. Laws, Regulatory Codes And Governing Boards. - Federal, state and local laws 1.23.6. Resident Care - Nursing, food, social, recreational, pharmacy, rehab physician services 201. Licensure by Endorsement - A license by endorsement is issued to NHA from another state seeking licensure in this state and: a.i.1. Holds a valid active license from another state a.i.2. Successfully completed the national examination a.i.3. Has passed the Florida laws and rules exam a.i.4. Has worked as a fully licensed administrator for 2 years within the 5- years immediately preceding the application by endorsement. a.i.4.23. A facility with a conditional or provisional license would be subject unannounced onsite inspections every 3 months of each facility with a conditional license until the facility achieves a standard license status and resolves any outstanding deficiencies. 202. AHCA or DCF does an abuse investigation within 24 hours of receiving a complaint 203. Must call the Central abuse hotline within 24 hours of knowledge of suspected abuse 1. The central abuse hotline must: a) Accept reports for investigation when there is a reasonable cause to suspect abuse, b) Determine if abuse allegations require immediate, 24-hour, or next-working- day response c) Refer calls not alleging abuse to other organizations d) Immediately identify and locate prior reports of abuse through the central abuse hotline. e) Evaluate, manage, and prevent and remediate abuse 2. Receive oral or written reports of known or suspected abuse 3. Determine if immediate onsite protective investigation is required 4. An immediate response requires an investigation be initiated immediately without delay 5. Where an Immediate response is required an investigation must be initiated within 24 hours of report 204. If a facility fails to honor or carry out an advanced directive, the resident or their legal representative can sue the facility in any court of competent jurisdiction to enforce such action and to recover actual and punitive damages for any deprivation of or infringement on the rights of a vulnerable adult. 205. Reactivation of Inactive License. a) An inactive license may remain on inactive status indefinitely b) An inactive license can be reactivated upon application, renewal fee and proof of completion of (20) classroom hours per year of continuing education Florida State Exam Quick Reference Chart 2005 - 2023 Page 8 of 12  c) A licensee with a license inactive for more than 2 consecutive biennial licensure cycles and who has not practiced for 2 out of the previous 4 years in another jurisdiction must appear before the Board and establish the ability to practice 206. If a staff member has a communicable disease, the local health department can close a facility, require lab examination of the employee, inspect the staff member for bodily leakage but MAY NOT Immediately revoke the facility license (you have the right to appeal the intending revocation of your license) 207. MERCY KILLING OR EUTHANASIA NOT AUTHORIZED; SUICIDE DISTINGUISHED (1) Nothing should be construed to condone, authorize, or approve mercy killing or euthanasia, or to permit any affirmative or deliberate act or omission to end life other than to permit the natural process of dying. (2) The withholding or withdrawal of life-prolonging procedures from a patient in accord with an advanced directive does not, for any purpose, constitute a suicide. 208. APPOINTMENT OF PROXY - ORDER OF DESIGNATION If an incapacitated patient has not executed an advance directive, or designated a surrogate to execute an advance directive, or the designated or alternate surrogate is no longer available to make health care decisions, health care decisions may be made for the patient by any of the following individuals, in the following order of priority, if no individual in a prior class is reasonably available, willing, or competent to act: (a) A judicially appointed guardian authorized to consent to medical treatment, (b) The patient's spouse; (c) An adult child of the patient, or if the patient has more than one adult child, a majority of the adult children who are reasonably available for consultation; (d) A parent of the patient; (e) The adult sibling of the patient or, if the patient has more than one sibling, a majority of the adult siblings who are reasonably available for consultation; (f) An adult relative of the patient who has exhibited special care and concern for the patient and who has maintained regular contact with the patient and who is familiar with the patient's activities, health, and religious or moral beliefs; or (g) A close friend of the patient. (h) A licensed clinical social worker or a graduate of a court-approved guardianship program. selected by the provider's bioethics committee and must not be employed by the provider. (i) If the provider has no bioethics committee, a proxy may be chosen by arrangement with the bioethics committee of another provider. (j) The proxy will be notified that, upon request, the provider must make available a second physician, not involved in the patient's care to assist the proxy in evaluating treatment. (k) Decisions to withhold or withdraw life-prolonging procedures will be reviewed by the facility's bioethics committee. (l) Documentation of efforts to locate proxies from prior classes must be recorded in the patient record. 209. IMMUNITY FROM LIABILITY Florida State Exam Quick Reference Chart 2005 - 2023 Page 9 of 12  1. A health care facility, provider, or other person who acts under the direction of a health care facility or provider is not subject to criminal prosecution or civil liability, and will not be deemed to have engaged in unprofessional conduct, as a result of carrying out a health care decision made in accordance with the provisions of this chapter. The surrogate or proxy who makes a health care decision on a patient's behalf is not subject to criminal prosecution or civil liability if acting in good faith 210. A 2- compartment sink is used to wash kitchenware and equipment not requiring sanitization; 211. A 3-compartment sink is needed to sanitize pots and utensils hand-washed 212. Potentially hazardous food” – Any perishable food which consists in whole or in part of milk or milk products, eggs, meat, poultry, fish, shellfish, edible crustacea: a) Capable of supporting rapid growth of infectious or toxigenic microorganisms; or b) Capable of supporting the slower growth of Clostridium botulinum 213. An NHA who practiced 2 of the last 5 years as an administrator in another state, can apply by endorsement to be licensed in this state and just needs to take the Florida exam. APPOINTMENT OF RECEIVER 214. The licensing agency can petition for the appointment of a receiver under the following conditions: a. The facility is operated without a license or the owner refuses to apply for one b. The facility is closing and arrangements have not been made to relocate all residents within 7 days of closing c. The facility cannot pay its bills and meet its financial obligations d. The facility has conditions that are an imminent safety threat AHCA and the Department of Elderly Affairs are required to assess all residents residing in facility to determine if they need to be transferred to another facility The receiver is appointed by a judge and has the power to make all decisions regarding the operation of the facility. The receiver is paid for by the facility. APPROVAL OF CONSTRUCTION PLANS 215. All construction and specification plans for initial construction, alteractions, additions and modifications to a facility must be approved by AHCA 216. The fee for AHCA to review the construction plans is $2000 plus 1% of the estimated total construction cost or actual construction cost, whichever is lower. 217. FLA Building and Fire Code and Fire Prevention Codes govern all facilities 218. The are 3 stages to the submission of construction plans: A. Stage 1 – Schematic Plans – A single line drawing of the floor plans, mechanical systems and life safety features Florida State Exam Quick Reference Chart 2005 - 2023 Page 10 of 12  B. Stage 2 – More detailed drawings of placement of rooms and functions, mechanical systems, water and electrical lines, life safety systems, site map and property dimensions and relationship to major roads C. Stage 3 – Actual blue prints and architectural and civil engineering plans prepared by licensed architects 219. Upon receipt of the final plans and specifications, AHCA has 60 days to approve or disapprove the plans, or require revisions. AHCA has 60 days to review and approve any subsequent plan revisions. 220. The owner must start actual construction with 365 days of receipt of approved final construction plans from AHCA SALE OF A FACILITY 221. The seller or tranferor of a Medicaid facility to a buyer is responsible for Medicaid overpayments paid to the facility during the period of time the seller operated the building (they must pay them back). The buyer is responsible for any over payments from the date they acquired the building 222. RESIDENT RIGHT TO APPEAL INVOLUNTARY DISCHARGE 223. Must provide residents 30 days advance of intent to discharge a resident involuntarily 224. There are 5 legal reasons to discharge against the resident’s will: a) Did not pay their bill (signed by NHA b) Cannot meet their needs (signed by doctor) c) Does need SNF care (signed by doctor) d) Is a danger to themselves (signed by doctor) e) Is a danger to others (signed by doctor) f) The facility is closing (signed by doctor) 225. A resident has the right to appeal a discharge within 90 days after receipt of the facility notice of discharge or transfer 226. If the resident files an appeal within 10 days of receipt of the notice of discharge, the resident can stay in the facility until the appeal is heard 227. If the resident loses the appeal, they can be discharged 228. Must advise the resident they have the right to appeal the discharge and also to have the ombudsman review it as well. 229. The NHA has 24 hours to forward to the ombudsman the resident’s request to have the ombudsman review the discharge 230. The ombudsman has 7 days to review the discharge notice and notify the facility and resident of their objections if any. 231. If the resident files the appeal 11 days after receipt of the notice of discharge, they can be discharged on day 30, but must be readmitted if they win their appeal. 232. The facility must notify AHCA of any proposed discharge or transfer of a resident because of unsafe conditions in the physical plant of the facility Florida State Exam Quick Reference Chart 2005 - 2023 Page 11 of 12  REQUIREMENTS FOR DENTAL, HEARING and FOOTCARE 233. Generally, a facility is only required to make sure that residents have access to dentist, podiatrist, hearing specialist or other services 234. The facility should have a contract with a dentist, podiatrist and other medical providers to see the resident in the facility. 235. The facility is not required to pay for the actual services. It is required to arrange for the services in the facility or to make appointments for office visits in the providers office. 236. The facility is responsible to make necessary arrangements to an outside providers office. IT IS NOT REQUIRED TO PAY FOR IT 237. However, it you have a Medicaid patient who needs emergency dental care for an abscess or condition that threatens their health issue, then the facility may have to pay for the dental care if the Medicaid resident cannot afford it. They could die from infection. Florida State Exam Quick Reference Chart 2005 - 2023 Page 12 of 12