How Does a Health Care Services Pool Differ From a Home Health Agency, a Nurse Registry and a Homemaker and Companion Services Provider in Florida

There are important distinctions in the licensure requirements, the insurance requirements and the types of services that can be provided by home health agencies, nurse registries and homemaker and companion organizations in Florida. The owners and operators of such businesses must should be aware of these. Diligence must be taken to ensure that employees of one type of provider do not deliver services to clients/patients that are not authorized by the company’s license.

When applying for a license for any of these types of organizations, care must be taken to list all of the services that the organization will actually be delivering.

Home Health Agencies

Home Health Agencies (HHAs) are generally able to provide hands-on services to clients/patients. Among the services they may provide are:

Homemaker
Companion
Home Health Aide
Certified Nursing Assistant (CNA)
(Note: Some home health agencies only provide the above services.)
Nursing (LPN, RN)
Therapy: Physical (PT), Speech (ST), Occupational (OT)
Home Medical Equipment
Social Work
Dietetics & Nutrition
(Therapy, social work, dietetics & nutrition are generally not provided by licensed only HHAs, except for those that are in the process of getting certified for Medicare or Medicaid.)

Home Health Agencies are licensed and authorized pursuant to Chapter 400, Part III (Section 400.461), Florida Statutes, and Chapter 408, Part II, Florida Statutes, and are regulated pursuant to Chapter 59A-8, Florida Administrative Code (F.A.C.). The new licensing rules for them are located at Chapter 59A-35, Florida Administrative Code (F.A.C.).

Nurse Registries

Nurse Registries generally act as the intermediaries in locating and obtaining contracts between clients/patients and health providers such as nurses. Nurse Registries only have independent contractors.

Among the services that may be provided by the independent contractors of a Nurse Registry are:

Homemaker
Companion
Home Health Aide
Certified Nursing Assistant (CNA)
Nursing (LPN, RN)
(Note: Some Nurse Registries do not provide nurses)

Nurse Registries are licensed and authorized pursuant to Chapter 400, Part III (Section 400.461), Florida Statutes, and Chapter 408, Part II, Florida Statutes, and are regulated pursuant to Chapter 59A-18, Florida Administrative Code (F.A.C.). The new licensing rules for them are located at Chapter 59A-35, Florida Administrative Code (F.A.C.).

Homemaker and Companion Services Organizations

A Homemaker and Companion Services Organization may not provide any hands-on personal care or treatment of a client. For example, its employees may not bathe the client, changes bandages, or provide any hands on medical or nursing treatments.

Among the services they are authorized to provide are:

Homemaker Services
Companion Services

Homemaker and Companion Services Organization are licensed and authorized pursuant to Chapter 400, Part III (Section 400.461), Florida Statutes, and Chapter 408, Part II, Florida Statutes, and are regulated pursuant to Chapter 59A-8, Florida Administrative Code (F.A.C.). (specifically 59A-8.025), F.A.C. The new licensing rules for them are located at Chapter 59A-35, Florida Administrative Code (F.A.C.).

All of the foregoing are licensed and regulated by the Home Care Unit of the Agency for Health Care Administration (AHCA) in Tallahassee. It can be located at:

  Agency for Health Care Administration
  Bureau of Long Term Care Services
  Home Care Unit
  2727 Mahan Drive – Mail Stop #34
  Tallahassee, FL 32308
  Phone: (850) 412-4403 Phone
  Fax: (850) 922-5374 Fax

For a chart that shows a comparison of the organizations above: click here.

Health Care Services Pool

A health care services pool may hire or contract with individuals and assign them to health care facilities to support or supplement the facilities’ work force in temporary work situations such as employee absences, temporary skill shortages, seasonal workloads, and special assignments and projects but cannot provide private duty staffing or enter into direct contracts with individuals to provide services.

According to Section 400.980(1)(b), Florida Statutes:

“Health care services pool” means any person, firm, corporation, partnership, or association engaged for hire in the business of providing temporary employment in health care facilities, residential facilities, and agencies for licensed, certified, or trained health care personnel including, without limitation, nursing assistants, nurses’ aides, and orderlies. However, the term does not include nursing registries, a facility licensed under this chapter or chapter 429, a health care services pool established within a health care facility to provide services only within the confines of such facility, or any individual contractor directly providing temporary services to a health care facility without use or benefit of a contracting agent.

Comparisons and Contrasts

A nurse registry and a home health agency may provide services that are privately paid for by insurance or other means to patients in their home or place of residence and provide staff to health care facilities, schools, or other business entities on a temporary or school year basis.

A nurse registry and a health care services pool do not qualify for Medicare reimbursements; a home health agency does.

A nurse registry cannot have any employees except for the administrator, alternate administrator and office staff – all individuals who enter the home of patients to provide direct care must be independent contractors.

A home health agency and a health care services pool may hire employees or contract with independent contractors to provide staffing. However, a home health agency must provide at least one service directly.

A nurse registry is limited to contracting with only registered nurses, licensed practical nurses, certified nursing assistants, home health aides, homemakers, and companions.

Types of Health Businesses not Needing a License from AHCA

There are quite a few businesses, entities and individuals who provide health services to hospitals, nursing facilities, and even individual patients, which do not require any licensure by AHCA. These include, for example, those that consist of nurses that provide peripherally inserted central catheter (PICC) line insertion, placement or services. It includes perfusionists who run heart-lung machines during open heart surgery. It also includes Autologous Blood Recovery (ABR) services, which recover blood lost during surgery.

These are examples of just a few companies performing services in hospitals with no licensing requirements.

Disclaimer: This article is for information and educational purposes only and does not constitute legal advice. Always check for changes and updates in the laws and regulations.

© Copyright 2012 George F. Indest III, Board Certified by The Florida Bar in Health Law, The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, Florida 32714. Phone: (407) 331-6620. All rights reserved.