The types of services offered by home health agencies, nurse registries, and homemaker and companion organizations in Florida differ significantly in terms of licensure requirements, insurance requirements, and other factors. All of the essential rules and regulations must be understood by the proprietors and managers of such businesses. The delivery of services to clients or patients not permitted by the business’s license must be carefully monitored by employees of any service provider.

Additionally, a lot of care must be taken to accurately detail all the services each of these types of organizations will provide when submitting a licensing application.
Home Health Agencies
Home health agencies (HHAs) are typically able to offer clients and patients hands-on assistance. Some of the services they might offer include:

• Companion
• Homemaker
• Certified Nursing Assistant (CNA)
• Home Health Aide
• (Note:  Selective agencies are known to provide the above services.)
• Therapy:  Physical (PT), Speech (ST), Occupational (OT)
• Home Medical Equipment
• Nursing (LPN, RN)
• Dietetics & Nutrition
• Social Work
• (Except for those applying for Medicare or Medicaid certification, licensed-only HHAs typically do not offer therapy, social work, dietetics, or nutrition services.)
• Home Health Agencies are licensed and authorized under Chapter 400, Part III (Section 400.461), Florida Statutes, and Chapter 408, Part II, Florida Statutes, and are regulated according to Chapter 59A-8, Florida Administrative Code (F.A.C.). The new licensing rules are in Chapter 59A-35, Florida Administrative Code (F.A.C.).

Nurse Registries
In most cases, nurse registries serve as the middlemen for discovering and securing contracts between clients/patients and healthcare professionals like nurses. There are no employees at nurse registries, only independent contractors.
The following are some of the services that a nurse registry’s independent contractors may offer:

• Companion
• Homemaker
• Home Health Aide
• Nursing (LPN, RN)
• Certified Nursing Assistant (CNA)
• (Note:  Some nurse registries may not provide Nurses)
• Nurse Registries are licensed and authorized under Chapter 400, Part III (Section 400.461), Florida Statutes, and Chapter 408, Part II, Florida Statutes, and are regulated according to Chapter 59A-18, Florida Administrative Code (F.A.C.). The new licensing rules are in Chapter 59A-35, Florida Administrative Code (F.A.C.).

Homemaker and Companion Services Organizations
An organization that offers homemaker and companion services cannot give a client any direct care or treatment. For instance, its staff members are not permitted to bathe clients, change sutures, or provide direct nursing or medical care.
The following are some of the services they are permitted to offer:

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

All of the foregoing is 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

Phone: 850-412-4403
Fax: 850-922-5374
Health Care Services Pool
During temporary work situations like employee absences, temporary skill shortages, seasonal workloads, and special assignments and projects, a healthcare services pool may hire or contract individuals and assign them to healthcare facilities to support or supplement the facilities’ workforce. However, the pool cannot provide private practice staffing or register into contractual agreements with persons to provide assistance.
According to Section 400.980(1)(b), Florida Statutes:

Any individual, company, partnership, or association engaged in the business of placing licensed, certified, or trained healthcare professionals, including without limitation nursing assistants, nurses’ aides, and orderlies, temporarily in residential facilities, agencies, and healthcare facilities are referred to as a “health care services pool.” The term does not, however, apply to nursing registries, establishments covered by this chapter or chapter 429 licenses, healthcare services pools created inside of healthcare facilities to provide services only there, or to any individual contractor immediately delivering momentary services to a health institution without any of the aid of a contractual advisor.
Comparisons and Contrasts
In addition to providing staff to healthcare facilities, schools, or other commercial entities on a temporary or school-year basis, nurse registries and home health agencies may offer patients services privately funded by insurance or other means in the comfort of their homes or place of residence.

Home health agencies, not nurse registries or health services pools, are the only entities eligible for Medicare reimbursements.

All personnel who enter patients’ homes to offer direct care must be independent contractors. A nurse registry may only have one employee in addition to the administrator, backup administrator, and office staff.

For staffing, a home health organization or a pool of healthcare providers may hire employees or enter into agreements with independent contractors. But at least one service must be delivered directly by a home health organization.

Contracting with registered nurses, licensed practical nurses, nursing assistants, home health aides, homemakers, and companions is available to nurse registries.

Types of Health Businesses not Needing a License from AHCA.
Numerous organizations, groups, and people work in the healthcare industry and offer services to hospitals, nursing homes, and even individual patients without being licensed by the AHCA. One example is nurses who provide, administer, or offer services for peripherally inserted central catheter (PICC) lines. It also encompasses the percussionists who operate the heart-lung equipment used in open-heart surgery. Additionally, it covers services for Autologous Blood Recovery (ABR), which replaces blood loss after surgery.

These are only a few instances of businesses that operate in hospitals without needing a license.

Disclaimer: This material does not provide legal advice and is solely for informational and educational reasons. The rules and regulations here are always subject to revision.