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Notice of Proposed Rulemaking- AHCA's Direct Care Workforce Survey

On Monday, November 20, 2023, AHCA published a Notice of Proposed Rulemaking for rule 59A-35.060, F.A.C., License Application Process. Via this NPR, AHCA intends to:

  • Move all licensure application forms into Rule Chapter 59A-35, as well as revise all licensure application attestation pages pursuant to 2023-33, LOF(an act relating to interests of foreign countries).

  • Revise licensure application forms for nursing homes, assisted living facilities, home health agencies, and homemaker/companion service providers are revised to include a direct care workforce survey in accordance with 408.822, F.S.

AHCA is holding a hearing on the proposed rule on December 19, 2023, from 10-11AM. FSLA will be monitoring the hearing and providing public comment as needed.

By way of background of these two laws AHCA is implementing via rulemaking:

During Florida's 2023 legislative session, SB 264 was passed and signed into law. The bill restricts a Florida governmental entity’s ability to contract with or provide economic incentives to a foreign country of concern. The bill also places specific limitations on the type and location of land and real property that may be owned or acquired by a foreign country of concern and certain persons and entities affiliated with such countries. 

You can read the final bill analysis here. FSLA previously reported on the Florida Department of Commerce's rulemaking efforts to implement this rulemakinghere.

Also, during Florida's 2020 legislative session, HB 607 was passed and signed into law. The bill created s. 408.822, F.S., which requires ALFs, nursing homes, home health agencies (or companion services or homemaker service providers) to furnish a direct care workforce survey to AHCA as part of the entity's licensure renewal process.

The statute requires the following information to be provided:

  • The number of registered nurses and the number of direct care workers by category employed by the licensee.

  • The turnover and vacancy rates of registered nurses and direct care workers and the contributing factors to these rates.

  • The average employee wage for registered nurses and each category of direct care worker.

  • Employment benefits for registered nurses and direct care workers and the average cost of such benefits to the employer and the employee.

  • Type and availability of training for registered nurses and direct care workers.

The term "direct care worker" is defined in s. 408.822, F.S., to mean: a certified nursing assistant, a home health aide, a personal care assistant, a companion services or homemaker services provider, a paid feeding assistant trained under s. 400.141(1)(v), or another individual who provides personal care as defined in s. 400.462 to individuals who are elderly, developmentally disabled, or chronically ill.


  • The facility administrator (or designee) is required to attest that the information provided is true and accurate to the best of his or knowledge.

  • AHCA is required to continually analyze the results of the surveys, publish the results on its website, and update the information published monthly.

Although the statute required these entities to provide this information beginning January 1, 2021, implementation was on hold - until this past June when AHCA stated requiring ALFs to mandatorily use the survey through AHCA's online licensing system as part of the renewal application process.

Please review the proposed survey and provide comments to Jason Hand, FSLA's Vice President of Public Policy and Legal Affairs by Friday, December 15, 2023. FSLA will assimilate the comments and will provide public comment during the AHCA workshop.

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