APD > Group Homes
APD Group Home Monitoring Policies and Procedures
Monthly Monitoring Visits
- All Agency-licensed homes shall be monitored on at least a monthly basis by APD employees (either career service, select exempt, or OPS) or contracted vendors to ensure compliance with established licensure standards.
- Monthly surveys of each facility, either unannounced or announced, are conducted in order to ensure the facility is in full compliance with the applicable requirements of Chapter 393, F.S. as well as any of the administrative rules adopted pursuant to Chapter 393, F.S.
- Field office staff may survey facilities on more often than a monthly basis in situations where it is known or suspected that the facility is not in full compliance with Chapter 393, F.S. or any administrative rules adopted pursuant to Chapter 393, F.S. or in situations where the Agency has reason to believe that the health, safety, or welfare of residents may be at risk.
- No licensee or employee of a facility shall refuse to permit any Field Office staff or designated agent of the State of Florida to enter and inspect any facility building at any time or to inspect records relating to the operation of the facility or the provision of client care.
- The Agency may audit the financial records of any facility that it has reason to believe may not be in full compliance with the provisions of s. 393.067, F.S., provided that any financial audit of such facility shall be limited to records of clients funded by the Agency.
- Field office staff shall utilize the approved survey form in accordance with established survey procedures.
- Field office staff shall complete every item of the monthly survey form and ensure that all notations are legible. If a review item is not applicable during a particular visit, the appropriate N/A box on the form should be checked.
- Monthly monitoring visits should occur at varied times of the day and week and be unannounced at least quarterly. Visits should occur more frequently if there are complaints or issues of concern.
- For each home with residents, at least one monitoring visit each year must take place on a weekend.
- If monitoring staff observe or suspect abuse or neglect of any resident of the home has occurred, such staff members shall contact the Florida Abuse Hotline immediately.
- Issues revealed by the monitoring should be immediately brought to the attention of an Field medical case management nurse, field behavior analyst, or other supervisory staff as appropriate.
- Client financial records are to be reviewed by field staff as part of the monitoring visit. This shall consist of at least one or two residents’ files being reviewed each month. If there are concerns or discrepancies, additional staff may get involved to assist in a more thorough review.
- For homes with residents, at least six monthly monitoring surveys per year shall be done at times when at least one of the residents is present.
- If the equipment is available, all residential monitors should take cameras with them during their monitoring visits and take photographs of violations. Photographic evidence serves as important supporting documentation should the Agency take subsequent disciplinary action in response to observed violations. Taking photos of documents (such as Medication Administration Records or client funding ledgers) also ensures that evidence is maintained and preserved in situations where licensees modify or falsify such documents after the monitor leaves the facility.
- Field office staff must track all documented checklist deficiencies. When a deficiency is noted during a facility survey, field staff who conduct the subsequent monthly monitoring of that same facility shall ensure that either (1) all the previous months’ deficiencies have been corrected or (2) acceptable progress has been made in correcting those deficiencies. Such information should be included within the notes section of the survey form.
Quality Assurance for Monthly Residential Monitoring
- Monthly monitoring staff should be periodically rotated among facilities so that the same individuals do not monitor the same set of homes every month for an indefinite period of time.
- New monitors should have another field staff member or licensing supervisor accompany them on their first few site visits for training purposes.
- At least once per year, a field office supervisor must accompany each monthly monitor on at least one facility’s site visit and perform a simultaneous but independent monitoring. Following the visit, findings should then be discussed and reconciled.
- Issues revealed by the monitoring should be immediately brought to the attention of a field medical case management nurse, field behavior analyst, or other field office staff as appropriate. Such issues include a high frequency of Baker Acts, non-compliance with behavior plans (or lack of behavior plans for individuals with behavioral issues of concern), cases of suspected medical neglect, client injuries, and significant medication errors involving the omission of medications or unfilled prescriptions.
- Monthly surveys must be completed with sufficient supervisory oversight. Therefore, survey checklists require at least two signatures, including the person who completed the checklist and a supervisor from the field office (indicating his or her review and verification that the document was completed properly).
- On a regular basis, the Monitoring/Licensing Supervisor, Residential Planning Coordinator, Medical Case Manager, Field Behavior Analyst and others as appropriate should meet to discuss facilities in which there are health and safety concerns and/or that could benefit from the technical assistance.
- A field office supervisor should conduct regularly-scheduled meetings with monthly monitoring staff for the purposes of discussing specific homes and other issues of concern they may be encountering.
- Each month, a licensing supervisor should contact at least five facilities to verify that monitoring took place and that the monitoring staff was punctual, courteous, thorough, helpful, etc.
State Office Review and Oversight of Field Office Licensure Activities
Each month, the State Office staff will request the following information from field offices for the purposes of conducting ongoing desk reviews:
- A spreadsheet containing the names and addresses of APD-licensed homes which served at least one resident during a selected month.
- Copies of all monthly monitoring checklists for APD-licensed homes which received monthly inspections during a selected month.
- Copies of all Notices of Noncompliance issued in response to violations which were observed during a selected month.
- Copies of all corrective action plans received by the field office in response to the NNCs that were issued (as described in Bullet 3)