Nursing Homes
Consumer Guides
- Nursing Home Guide
- Nursing Home Watchlist
- Nursing Home Guide/Watch List Posting Instructions
- Guía de Hogares de Ancianos (Spanish Nursing Home Guide)
Quality of Long-Term Care Facility
Improvement Trust Fund (Nursing Homes only)
An effort to use federal Civil Money Penalty funds (fines) to support innovative
ideas that directly impact quality of care or quality of life of nursing home
residents beyond minimum standards.
Nursing Home Gold Seal Award / Governor's Panel on Excellence in Long-Term Care
- Gold Seal Facility Listing
- Gold Seal Facility Best Practices
- Gold Seal Panel Members
- Gold Seal Panel Meetings
- May 7, 2008 Meeting
- May 27, 2008 Meeting
- June 13, 2008 Meeting
- August 18, 2008 Meeting
- September 16, 2008 Meeting
- October 21, 2008 Meeting
- December 8, 2008 Meeting
- May 14, 2009 Meeting
- Gold Seal Applications must be submitted by September 15, 2009 per Florida Administrative Code 59A-4.2015
Applications and Forms (Documents to download as PDF files)
- Consumer Info
- Controlling_Interest_Affidavit_for_Nursing_Homes_Coversheet
- Controlling_Interest_Affidavit_for_Nursing_Homes_A
- Controlling_Interest_Affidavit_for_Nursing_Homes_B
- Controlling_Interest_Affidavit_for_Nursing_Homes_C
- Controlling_Interest_Affidavit_for_Nursing_Homes_D - Voluntary Board Members
- Gold Seal Application
- Nursing Home Application
- Nursing_Home_Application_Instruction
- Proof of Financial Ability
- Surety_Bond
- Surety_Bond_Leased_Nursing Home
- Unconditional_Guarantee_of_Payment_Form
- Health Care Licensing Application
- Health Care Licensing Addendum
- Affidavit of Compliance --Level 2 Background Screening for Covered Employees (AHCA 3100-0007)
- Affidavit of Compliance with Background Screening Requirement (AHCA 3100-0008)
Transfer & Discharge Forms
- Transfer_Discharge_Notice
- Transfer_Discharge_Fair_Hearing_Request
- Transfer_Discharge_LTC_Ombudsman_Request
Miscellaneous Forms
- Adverse_Incident_Report_1_day
- Adverse_Incident_Report_15_days
- Attestation of Residency
- Bed Change Request Form
- Bed_Change_Request_Instructions
- Bed_Change_Room_List_Form
- Emergency Management Planning
- Facility Internet Acess Form
- Fire Incident Reporting and System Failure
- Fire Incident Reporting Form
- Hotline Poster (English
version)
- Hotline Poster (Creole
version)
- Hotline Poster (Spanish
version)
- Monthly_Liability_Claim_Information
- Nursing Home Staffing Report Form
- Staffing Formula Insert
Provider Emergency Contact Information and Resources
Resources
- Best Practices for Compliance to Food Sanitary Conditions, January, 2004
- Best Practices for Compliance to Resident Dignity, February, 2005
- Culture Change Information, December 4, 2008
- Determination of Nurse Staffing Adequacy in Nursing Homes, June, 2003
- Emergency Water Issues and
One Week Non-Perishable Food Supply document, March 2003
- Federal 5-Day Incident Reporting, March 4, 2008
- Reporting Requirements for Abuse and Neglect, March 6, 2003
- FMQA Health Care Quality Improvement Training Info, June, 2003
- Hurricane Preparedness Notice and Form for NHs and ICFs, July, 2005
- Nursing Home Round Table Presentation-Orlando, November, 2007
- Poster Questions & Answers document
May 11, 2000
- Quality Indicator Survey (QIS) Training Resource Manual, March, 2009
- Quality of Care Monitor Program: Guidelines for Falls, July, 2002
- Quality of Care Monitor Program: Guidelines for Pain, July, 2002
- Quality of Care
Monitor Program: Guidelines for Pressure Ulcers, July, 2002
- SB 1202 Questions & Answers,
February 15, 2002
- Statewide Provider Training, September, 2001
- Statewide Provider Training 1, September, 2002
- Statewide Provider Training 2, September, 2002
- Statewide Provider Training, November, 2003
- Statewide Provider
Training, January, 2005
- Surveyor Guidance for Hot Water Temperatures, January, 2002
- Surveyor Guidance for Taking Food Temperatures, March, 2003
Regulations
- Nursing Home Statutes -- Florida Statutes (F.S.), Chapter 400, Part II
- Nursing Home Rules -- Florida Administrative Code (F.A.C.), Chapter 59A-4
- Nursing Home Federal Code -- Code of Federal Regulations (CFR), Title 42, Part 483
