Florida Home Health Aide Requirements: Training, Competency and In-Service (2026)
Florida does not license home health aides, but its rules decide who may work as one. This guide covers the home health aide requirements in Florida from the aide's side: the routes to qualify under Fla. Admin. Code R. 59A-8.0095 as amended effective May 31, 2026, the 16 training subjects, what must happen before the first visit and every year after, and what a Medicare-certified agency adds on top.
Reviewed October 13, 2026 · 23 min read · Published October 13, 2026
The short version
- Florida does not license or certify home health aides: AHCA says aides 'are not licensed or certified by the Agency for Health Care Administration or any other Florida state agency or federal agency' (AHCA, Home Health Aides), and the statute defines an aide as 'a person who is trained or qualified, as provided by rule' (s. 400.462(17), F.S.).
- Before an aide provides services, the agency must have on file documentation of 'at least forty hours of training in the following subject areas or successful passage of the competency test' (Fla. Admin. Code R. 59A-8.0095(5)(c)).
- Since May 31, 2026, aide training may be online or hybrid but 'must require the aide to demonstrate, in person' the listed skills (Fla. Admin. Code R. 59A-8.0095(5)(c)).
- A CNA qualifies through certification instead, and the agency must have 'documentation of the CNA's current State of Florida certification' before the CNA provides services (Fla. Admin. Code R. 59A-8.0095(5)(b)).
- Passing the AHCA competency test means 'the accurate performance of all 14 tasks on the practical part plus correctly answering 90 of the 104 questions on the written part' (Fla. Admin. Code R. 59A-8.0095(5)(i)1.a.).
- When another institution, school or agency trained the aide, 'it is the responsibility of the employing home health agency to validate the aide's competency of training' (Fla. Admin. Code R. 59A-8.0095(5)(j), new May 31, 2026).
- Aides and CNAs 'must receive in-service training each calendar year', with no hour minimum in the rule, and must keep current CPR certification (Fla. Admin. Code R. 59A-8.0095(5)(k)).
- Every aide or CNA the agency employs must complete 'a one-time education course on HIV and AIDS, within 30 days of employment' (Fla. Admin. Code R. 59A-8.0095(5)(r)).
- At a Medicare-certified agency, the training route requires at least 75 hours (42 CFR 484.80(a)(1)(i), (b)(1)), an individual may furnish services 'only after that individual has successfully completed a competency evaluation program' (42 CFR 484.80(c)), and aides need 'at least 12 hours of in-service training during each 12-month period' (42 CFR 484.80(d)).
- At a certified agency, an aide with 24 consecutive months of no compensated services 'must complete another program' before providing services (42 CFR 484.80(a)(2)); Rule 59A-8.0095 has no equivalent for ordinary aides.
Start here: who counts as a home health aide in Florida
The definition. A home health aide is 'a person who is trained or qualified, as provided by rule, and who provides hands-on personal care' and related tasks (s. 400.462(17), F.S.). In this statute 'agency' means AHCA (s. 400.462(4), F.S.), so AHCA, not the employer, creates the aide competency test and sets the training curriculum (s. 400.497(1), F.S.). AHCA's Home Health Aides page says aides 'are not licensed or certified by the Agency for Health Care Administration or any other Florida state agency or federal agency', and its dated March 2018 fact sheet says there is no central state registry for aides.
Aide, CNA, companion or homemaker.
| Role | Legal footing | Hands-on personal care? |
|---|---|---|
| Home health aide | Trained or qualified under Rule 59A-8.0095(5) (s. 400.462(17), F.S.) | Yes, assigned and supervised by an RN (Fla. Admin. Code R. 59A-8.0095(5)(a)) |
| Certified nursing assistant | A certificate 'under part II of chapter 464' (s. 400.462(6), F.S.), on a public registry (s. 464.202, F.S.) | Yes, under the same RN assignment and supervision |
| Companion or sitter | s. 400.462(8), F.S. | No: 'A companion may not provide hands-on personal care to a client' |
| Homemaker | s. 400.462(22), F.S. | No: 'A homemaker may not provide hands-on personal care to a client' |
Licensed-only or Medicare-certified. Every agency licensed under Chapter 400, Part III follows the state rule. A Medicare-certified agency also follows 42 CFR 484.80: 'All home health aide services must be provided by individuals who meet the personnel requirements specified in paragraph (a) of this section.' The state rule only points to that layer, saying an aide seeking work with a 'Medicare or Medicaid certified home health agency may be required to provide evidence of additional training' (Fla. Admin. Code R. 59A-8.0095(5)(d)). Aides for medically fragile children (s. 400.4765, F.S.) are outside this guide, and the agency-wide file is in our Florida home health personnel file guide.
Three ways to qualify: training, the competency test, or CNA certification
Route 1: 40 hours of training. Before an aide provides services, the agency 'shall have on file documentation of the home health aide's successful completion of at least forty hours of training in the following subject areas or successful passage of the competency test' (Fla. Admin. Code R. 59A-8.0095(5)(c)). That is the floor for Florida home health aide training hours, unchanged in 2026, and no hours are set per subject. Training must be given by or under the general supervision of an RN with at least two years of nursing experience, one of them in home health care (same paragraph). AHCA's surveyor guidance (its ASPEN State Regulation Set H 8.07) adds that 'A CNA prep course is not a substitute for the 40 hour home health aide training.'
Online is allowed; skills are shown in person. Since May 31, 2026, 'The training may be conducted in person, online, or through a hybrid program but must require the aide to demonstrate, in person, that he or she is able to perform the necessary skills associated with the subject areas listed below' (Fla. Admin. Code R. 59A-8.0095(5)(c)). The rule names no evaluator, form or minimum in-person hours for the demonstration, and the demonstration applies to classroom courses too.
Training done elsewhere. Training through a licensed agency is 'for the purpose of employment with the agency' (Fla. Admin. Code R. 59A-8.0095(5)(e)). Aides trained in another state or at a vocational or career school must bring itemized documentation, including hours per topic, and 'The course must include validation of the aide's competency in person' (Fla. Admin. Code R. 59A-8.0095(5)(f)-(g)). At an agency that teaches its own course and is not a DOE-classified career school, the training must include in-person validation and the documentation must carry the title 'Home Health Aide Training Documentation'; the agency may not charge a fee, put words such as 'diploma' or 'certificate' on it, or advertise the training (Fla. Admin. Code R. 59A-8.0095(5)(h)). New in 2026, 'it is the responsibility of the employing home health agency to validate the aide's competency of training' whenever someone else trained the aide (Fla. Admin. Code R. 59A-8.0095(5)(j)).
Route 2: the AHCA competency test. The home health aide competency test Florida's rule names is AHCA 3110-1007, September 2025, which a licensed agency 'may choose to administer' in place of the 40 hours after requesting it from AHCA by email (Fla. Admin. Code R. 59A-8.0095(5)(i)). The agency, not the state, gives it. Passing means all 14 practical tasks and 90 of 104 written questions ((5)(i)1.a.). An RN, or an LPN under RN supervision, must give and grade the practical part ((5)(i)2.), and retakes are the testing agency's decision ((5)(i)1.). Passing 'alone does not permit a home health aide to assist with self-administration of medication' ((5)(i)1.b.).
Route 3: CNA certification. 'Prior to a CNA providing services, the home health agency shall have documentation of the CNA's current State of Florida certification,' and a CNA certified in another state 'may work as a home health aide' with a copy of the current certificate (Fla. Admin. Code R. 59A-8.0095(5)(b)). Rule 59A-8.0095 sets no minimum age for aides. The CNA registry is open to 'employers' (s. 464.202, F.S.); checking status before the first visit is our recommendation. AHCA's surveyor guidance goes further than the rule: 'The home health agency should have documentation of the CNA completion of the home health training.'
Other paths. Nursing graduates awaiting Florida boards, and RNs or LPNs licensed in Florida or another state, 'may work as a home health aide' (Fla. Admin. Code R. 59A-8.0095(5)(q)). The rule is silent on whether they also need (5)(c) documentation; we recommend confirming with AHCA.
What the training must cover
Rule 59A-8.0095(5)(c) lists 16 subject areas. Items 3, 4, 5, 9, 11 and 12 were expanded on May 31, 2026.
| # | Subject area, quoted from Fla. Admin. Code R. 59A-8.0095(5)(c) |
|---|---|
| 1 | 'Communication skills' |
| 2 | 'Observation, reporting and documentation of patient or client status and the care or services provided' |
| 3 | 'Reading and recording vital signs to include temperature, pulse and respiration, and blood pressure' |
| 4 | 'Basic infection control procedures such as hand hygiene, personal protective equipment (PPE), bag technique, and equipment disinfection' |
| 5 | 'Basic elements of body functions that must be reported to the registered nurse supervisor including observation of new conditions or change in condition' |
| 6 | 'Maintenance of a clean and safe environment' |
| 7 | 'Recognition of emergencies and applicable follow-up within the home health aide scope of performance' |
| 8 | 'Physical, emotional, and developmental characteristics of the populations served by the agency, including the need for respect for the patient or client, his privacy, and his property' |
| 9 | 'Appropriate and safe techniques in personal hygiene and grooming, including bed bath, sponge, tub, or shower bath; shampoo, sink, tub, or bed; basic nail care to include filing and polishing the nails, but not clipping nails; basic skin care including washing, moisturizing, and applying lotion with positioning to prevent skin breakdown; oral hygiene; care of dentures; toileting including use of bedpan or urinal' |
| 10 | 'Safe transfer techniques, including use of appropriate equipment, and ambulation' |
| 11 | 'Assistance with basic range of motion exercises and positioning to prevent complications of immobility' |
| 12 | 'Basic nutrition and fluid intake, including following the prescribed diet, assistance with eating and drink, observing for signs of dehydration or inadequate intake and promoting regular eating and drink schedule' |
| 13 | 'Cultural differences in families' |
| 14 | 'Food preparation and household chores' |
| 15 | 'Assistance with self-administered medication' |
| 16 | 'Other topics pertinent to home health aide services' |
Item 15. Aides and CNAs who assist with self-administered medication 'must receive a minimum of 2 hours of training (which can be part of the 40 hour home health training) prior to assuming this responsibility', and the training 'must include verification that each CNA and home health aide can read the prescription label and any instructions' (Fla. Admin. Code R. 59A-8.0095(5)(c)15.).
Training should match the assignment. Patient-specific extras, such as changing a urinary catheter bag, must be taught by a licensed health professional for that patient (Fla. Admin. Code R. 59A-8.0095(5)(l)3.), and AHCA's surveyor guidance says the agency 'should have documentation of this additional training prior to the aide assignment and performance of the tasks.' (5)(p) bars aides and CNAs from tasks including 'Filling and removing medications from a pill organizer or electronic medication dispenser' ((5)(p)11.).
At hire and the first months
| Item | Deadline | Source |
|---|---|---|
| Training or AHCA test documentation, or current CNA certification | Before the aide provides services | Fla. Admin. Code R. 59A-8.0095(5)(b)-(c) |
| In-person skills demonstration | Part of the training | Fla. Admin. Code R. 59A-8.0095(5)(c) |
| Your validation of an aide trained elsewhere | No deadline in the rule; before the first visit (our recommendation) | Fla. Admin. Code R. 59A-8.0095(5)(j) |
| Level 2 background screening | A condition of employment | s. 400.512, F.S.; s. 435.04(1)(a), F.S. |
| Current CPR certification | The rule says 'obtain and maintain'; before the first visit (our recommendation) | Fla. Admin. Code R. 59A-8.0095(5)(k) |
| Medication-assistance training | Before assisting | Fla. Admin. Code R. 59A-8.0095(5)(c)15. |
| HIV and AIDS course | Within 30 days of employment | Fla. Admin. Code R. 59A-8.0095(5)(r) |
| Dementia training | Written information at hire; 1 hour within 30 days; 2 more hours within 7 months | s. 430.5025(4)(a)-(c), F.S. |
Level 2 screening. Agencies 'shall require level 2 background screening for employees or contractors as required in s. 408.809(1)(e)' (s. 400.512, F.S.), which covers anyone expected to 'provide personal care or services directly to clients' (s. 408.809(1)(e), F.S.). The checks include FDLE and FBI fingerprints and a sex offender registry search (s. 435.04(1)(a), F.S.). The attestation and Clearinghouse steps come from AHCA's screening rule, which this guide does not quote; see our Level 2 rescreening guide. For exclusion checks, see our OIG exclusion screening guide.
HIV and AIDS. The course reaches employed aides and CNAs because the s. 456.033 exception covers licensees such as RNs and LPNs under 'part I of chapter 464' (s. 456.033, F.S.), not part II certificate holders or unlicensed aides. A course taken at another covered facility need not be repeated (s. 381.0035(1), F.S.).
Dementia training. Home health employees must complete it under s. 400.4785, F.S. Subsection (1) exempts an agency whose census was at least 90 percent aged 21 or younger 'from the training requirements in this section', but s. 430.5025 itself has no such exemption, so confirm with AHCA before relying on it.
Job description and TB. Rule 59A-8.0095 mentions neither, and no Florida source quoted here requires either for aides. A signed job description matching the (5)(l) duties is our recommendation; a TB test, if you require one, rests on agency policy or an accreditation standard you have adopted.
Every year: in-service training and CPR
The state rule. 'Home health aides and CNA's must receive in-service training each calendar year' (Fla. Admin. Code R. 59A-8.0095(5)(k)). It sets no hours, topics or deadline within the year. The 12 hours often quoted are federal. AHCA's surveyor guidance says 'The home health agency should determine the type and amount of in-service training to provide each year based on their assessment of the learning needs for their staff.' In practice, the home health aide in-service requirements in Florida mean in-service in every calendar year and a dated record to prove it; a written policy that fixes hours and topics is our recommendation.
CPR. Aides and CNAs 'must also obtain and maintain current cardiopulmonary resuscitation (CPR) certification' (Fla. Admin. Code R. 59A-8.0095(5)(k)). Since May 31, 2026, a card from a provider approved by the American Red Cross, the American Heart Association, the National Safety Council or an organization accredited by the Commission on Accreditation for Pre-Hospital Continuing Education satisfies the rule when the student had 'to demonstrate, in person, that he or she is able to perform cardiopulmonary resuscitation' (same paragraph). The rule sets no renewal interval beyond the card's own, and 42 CFR 484.80 has no CPR requirement. Online-only cards are not expressly banned, but we recommend replacing them with an in-person card.
| Recurring item | Cycle | Applies to | Source |
|---|---|---|---|
| In-service | Each calendar year | All aides and CNAs | Fla. Admin. Code R. 59A-8.0095(5)(k) |
| Level 2 rescreening | Every 5 years | Screened aides and CNAs | s. 408.809(2), F.S. |
| Federal in-service | At least 12 hours per 12-month period | Aides at Medicare-certified agencies | 42 CFR 484.80(d) |
| Medication administration in-service | 2 hours annually | Aides administering medication under RN delegation (skilled agencies only) | s. 400.489(2), F.S. |
| Medication administration validation | Expires after 1 year | Same aides | Fla. Admin. Code R. 59A-8.0097(5) |
| CNA in-service | 24 hours each biennium | The CNA personally | s. 464.203(7), F.S. |
Assistance is not administration. The 2 hours for medication assistance are taken once. Administration under delegation exists only 'If the home health agency provides skilled care' (Fla. Admin. Code R. 59A-8.0095(3)(e)). Dementia training has no recurring hours for home health staff (s. 430.5025(4), F.S.), and a CNA's biennial hours are the CNA's own duty, not the agency's (s. 464.203(7), F.S.).
Medicare-certified agencies: four routes, the 75-hour training route and 12 hours a year
Four routes. A qualified aide has completed (i) a training and competency evaluation program meeting paragraphs (b) and (c); (ii) 'A competency evaluation program that meets the requirements of paragraph (c) of this section'; (iii) a state-approved nurse aide program and 'is currently listed in good standing on the state nurse aide registry'; or (iv) a state licensure program meeting (b) and (c) (42 CFR 484.80(a)(1)(i)-(iv)). AHCA says Florida does not license aides, so no Florida program fits route (iv).
75 hours, 16 before 16. 'Classroom and supervised practical training must total at least 75 hours' (42 CFR 484.80(b)(1)), and 'A minimum of 16 hours of classroom training must precede a minimum of 16 hours of supervised practical training as part of the 75 hours' ((b)(2)). An RN, or an LPN under RN supervision, directly supervises practical training ((b)(1)); instructors are RNs with at least 2 years of nursing experience, at least 1 in home health care, or people under their general supervision ((e)); and the agency must document it all ((b)(4)).
An evaluation before any services. 'An individual may furnish home health services on behalf of an HHA only after that individual has successfully completed a competency evaluation program as described in this section' (42 CFR 484.80(c)). Communication, temperature, pulse and respiration, hygiene and grooming, transfers, and range of motion 'must be evaluated by observing an aide's performance of the task with a patient or pseudo-patient' ((c)(1)). 'The competency evaluation must be performed by a registered nurse in consultation with other skilled professionals, as appropriate' ((c)(3)). Florida lets an LPN under RN supervision give the practical part of the AHCA test, but the federal evaluation needs an RN. More than one 'unsatisfactory' required area fails the evaluation, and a failed task may not be done without direct RN supervision until retrained and re-evaluated ((c)(4)).
The AHCA test does not count. AHCA's Home Health Aides page says 'The AHCA test does not meet this federal regulation', citing 42 CFR 484.36, the pre-2018 section number. The page's table lists 75 hours of training 'OR' an evaluation; under (a)(1) and (c), training hours alone never qualify an aide.
CNAs. Whether a route (iii) CNA also needs a separate (c) evaluation is unsettled in the text; we recommend registry verification plus an RN-signed evaluation.
The 24-month lapse rule. 'If there has been a 24-month lapse in furnishing services for compensation, the individual must complete another program, as specified in paragraph (a)(1) of this section, before providing services' (42 CFR 484.80(a)(2)). It covers 'A home health aide or nurse aide', counts from the latest program completion, and any of the four routes cures it. Rule 59A-8.0095 has no equivalent for aides; Florida CNAs have their own 24-month rule (s. 464.203(5), F.S.).
12 hours of in-service. 'A home health aide must receive at least 12 hours of in-service training during each 12-month period' (42 CFR 484.80(d)). It may occur while the aide furnishes care, and an RN must supervise it ((d), (d)(1)). Those are the 12 hours of in-service a home health aide needs at a certified agency, but the rule does not say when the period starts. AHCA's 2018 fact sheet says it 'can be a calendar year or based on the date of hire'; treat that as dated guidance. We recommend one written definition, tracked separately from Florida's calendar year.
The rest of the federal personnel file at a Medicare-certified agency, from licensed staff qualifications to emergency preparedness training, is in the home health and hospice personnel file audit checklist.
Supervision of aides
Florida, every licensed agency. 'A home health aide or a certified nursing assistant (CNA) shall provide personal care services assigned by and under the supervision of a registered nurse' (Fla. Admin. Code R. 59A-8.0095(5)(a)), and the RN 'maintains full responsibility for personal care tasks assigned' ((3)(b)). When only physical, speech or occupational therapy is furnished along with aide services, an employed or contracted licensed therapist may supervise instead ((5)(a)); that turns on the case, not the agency type.
Every agency, skilled or non-skilled, must have an RN make supervisory visits of 'unlicensed assistive personnel, as defined in subsection 64B9-14.001(1), F.A.C.', employed or contracted, with the patient's written consent ((3)(c)). Aides fit that definition. CNAs do not, because 'Unlicensed assistive personnel do not include certified nursing assistants' (Fla. Admin. Code R. 64B9-14.001(1)), though they remain under RN supervision. Visits follow 'the patient's direction, approval, and agreement to pay the charge for the visits' (s. 400.487(3), F.S.). 'The RN must provide on-site supervision as needed', and 'Supervisory visits must be documented in patient files' ((3)(d)). No interval is set for ordinary aides; the 60-day figures for aides for medically fragile children (Fla. Admin. Code R. 59A-8.0099(2)(c)) and for MAR review under delegation (Fla. Admin. Code R. 59A-8.0219(1)(c)4.) are not general rules. The 2026 amendment did not change supervision.
AHCA's surveyor guidance, not rule text, lets a non-skilled agency 'conduct RN supervisory reviews through virtual visits, record reviews, or phone calls when the patient does not wish to pay for an RN visit in the home', and says 'The aide may only perform tasks that are part of the written care assignment.' We recommend a written supervision cadence.
Medicare-certified agencies. Aides work from 'written patient care instructions' (42 CFR 484.80(g)(1)), under fixed intervals:
| Patient receives | Supervisory check | Observation of each aide | Citation |
|---|---|---|---|
| Skilled nursing, PT, OT or speech-language pathology | RN or other skilled professional at least every 14 days; aide need not be present; on site, or rarely by real-time audio-video, at most once per patient per 60-day episode | Annual, on site, while the aide performs care; plus a visit whenever a concern is noted | 42 CFR 484.80(h)(1)(i)-(iv) |
| No skilled services | RN 'onsite, in person visit every 60 days'; aide need not be present | Semi-annual, on site, by an RN | 42 CFR 484.80(h)(2)(i)-(ii) |
A deficiency 'verified by the registered nurse or other appropriate skilled professional during an on-site visit' requires 'retraining and a competency evaluation for the deficient and all related skills' (42 CFR 484.80(h)(3)), not necessarily a full re-evaluation.
What to keep in the aide's file
The phrase 'personnel file' appears once in Rule 59A-8.0095, for medication-assistance training records (Fla. Admin. Code R. 59A-8.0095(5)(c)15.). The rest of the aide's file is evidence of qualifications stated elsewhere:
- Training, AHCA test or CNA certification documentation ((5)(b), (5)(c), (5)(i)1.)
- The in-person skills demonstration and any (5)(j) validation; the rule prescribes no form, so a dated, RN-signed record is our recommendation
- Medication-assistance training and the reading check ((5)(c)15.)
- Calendar-year in-service records and a current CPR card ((5)(k))
- HIV and AIDS and dementia training records (s. 381.0035(2), F.S.; s. 430.5025(4)(b)2., F.S.)
- At a certified agency, training, evaluation and in-service records (42 CFR 484.80(b)(4), (c)(5), (d)(2))
Supervisory notes and patient consents live in patient records; index them per aide. For the full file, including screening records and retention, see our Florida home health personnel file requirements guide, and for tracking each item per aide, our caregiver credential tracking software page.
If you also operate in North Carolina
North Carolina's home care rule, 10A NCAC 13J, sets no age, education or training-hour minimum for in-home aides; instead, an aide who is not on the nurse aide registry and was hired after April 1, 2009 needs a registered nurse's verification of six core personal care skills (10A NCAC 13J .1003(g)). Nurse Aide Registry listing is required when the plan of care calls for extensive assistance (10A NCAC 13J .1107(b)). 13J sets no in-service hour minimum either, only a written policy (10A NCAC 13J .1003(d)), which DHSR says 'should specify the number of in-service hours employees are required to complete' (DHSR Home Care FAQ, Q54). North Carolina also requires that 'Hands-on care employees must have a baseline skin test for TB' (10A NCAC 13J .1003(b)); see our North Carolina home care personnel file guide.
Where aide compliance breaks down
These are risks, not predictions of any survey result.
- Using the AHCA test at a certified agency. AHCA says it 'does not meet this federal regulation'.
- Online training with no in-person record. The rule has no transition clause for aides hired before May 31, 2026. We recommend completing a demonstration record and any (5)(j) validation now, with today's date; never backdate.
- Accepting outside paperwork as the whole answer. (5)(j) puts validation on the employer.
- Assuming CNA status. Certification must be current before services, and after 24 consecutive months without paid nursing-related services a CNA must retrain or retest (s. 464.203(5), F.S.).
- One clock for two in-service rules. The state calendar year and the federal 12-month count need separate tracking.
- Hiring an aide after a 24-month lapse in compensated services, at a certified agency, without a new (a)(1) program (42 CFR 484.80(a)(2)).
- Supervision with no written cadence, or, at a certified agency, virtual assessments beyond the federal cap.
- Backdated records. Under s. 400.474(3), F.S., as reproduced in AHCA's surveyor regulation set, AHCA 'shall impose a fine of $1,000 against a home health agency that demonstrates a pattern of falsifying' aide or CNA training documents.
What changed
Online and hybrid training allowed, with an in-person skills demonstration
Paragraph (5)(c) gained the sentence 'The training may be conducted in person, online, or through a hybrid program but must require the aide to demonstrate, in person, that he or she is able to perform the necessary skills associated with the subject areas listed below.' The 4/16/2023 text had no 'in person' wording anywhere. The sentence first appeared in the January 20, 2026 proposed rule and was reprinted unchanged in the April 7, 2026 notice of change, and the rule history now ends 'Amended ... 4-16-23, 5-31-26.' The 40-hour minimum and the competency test alternative did not change.
Fla. Admin. Code R. 59A-8.0095(5)(c) and history note
Six training subject areas expanded, and the trainer rule moved into (5)(c)
Item 3 now reads 'Reading and recording vital signs to include temperature, pulse and respiration, and blood pressure' (previously 'Reading and recording temperature, pulse and respiration'). Item 4 adds 'hand hygiene, personal protective equipment (PPE), bag technique, and equipment disinfection'. Item 5 adds 'observation of new conditions or change in condition'. Item 9 adds 'basic nail care to include filing and polishing the nails, but not clipping nails', basic skin care and 'toileting including use of bedpan or urinal'. Item 11 is now 'Assistance with basic range of motion exercises and positioning to prevent complications of immobility' (previously 'Normal range of motion and positioning'), and item 12 adds the prescribed diet, help with eating and drinking, and 'observing for signs of dehydration or inadequate intake'. The RN trainer qualification, formerly paragraph (5)(h), now sits in (5)(c) with the same substance.
Fla. Admin. Code R. 59A-8.0095(5)(c), (5)(c)3., 4., 5., 9., 11., 12.
Itemized documentation and in-person competency validation for aides trained elsewhere
Aides trained in another state or at a vocational or Department of Education approved career school must now produce documentation listing the institution name and address, school license number, student name, curriculum, total hours, hours per topic, the trainer's signature and qualifications and the completion date, and each course 'must include validation of the aide's competency in person.' The 2023 text asked out-of-state aides only for 'transcripts or a certificate that includes the course curriculum' and school graduates for 'a diploma or certificate issued by that institution.' An agency that trains its own employees now issues 'Home Health Aide Training Documentation' (previously 'Home Health Aide Documentation') carrying the 'signature and qualifications of the person who directed the training', and that training must also include in-person competency validation. The 2023 version of that paragraph applied to an agency that 'is classified' as a nonpublic post-secondary career school; the current text says 'is not classified'. An aide trained by another licensed agency still presents documentation of successful completion.
Fla. Admin. Code R. 59A-8.0095(5)(e)-(h)
New duty to validate the competency of aides trained elsewhere
New paragraph (5)(j): 'When the home health aide training is provided by another institution, school, or home health agency it is the responsibility of the employing home health agency to validate the aide's competency of training.' The 2023 text had no counterpart. The paragraph names no evaluator, form or deadline, and neither the amended rule nor the April 7, 2026 notice of change contains a transition clause for aides hired before May 31, 2026.
Fla. Admin. Code R. 59A-8.0095(5)(j)
Competency test updated to the September 2025 form
The rule now names 'the Home Health Aide Competency Test, AHCA 3110-1007, September 2025' in place of 'form number AHCA 3110-1007, February, 2001, incorporated by reference', and a request to AHCA must now include 'the name, address, and license number of the home health agency requesting the test.' The passing standard of all 14 practical tasks and 90 of 104 written questions did not change, and neither did the rule that an RN, or an LPN under RN supervision, gives the practical part.
Fla. Admin. Code R. 59A-8.0095(5)(i), (5)(i)1.a., (5)(i)2.
CPR must be obtained as well as maintained, with an in-person demonstration
Aides and CNAs 'must also obtain and maintain current cardiopulmonary resuscitation (CPR) certification'; the 2023 text said only 'maintain'. A new sentence says documentation from one of the four named provider categories, from a course 'in which the student is required to demonstrate, in person, that he or she is able to perform cardiopulmonary resuscitation satisfies this requirement.' The provider categories did not change, and the calendar-year in-service sentence in the same paragraph was not amended.
Fla. Admin. Code R. 59A-8.0095(5)(k)
The checklist
Every item below cites the rule it comes from. Take the PDF into the file room, or print this page.
Qualifying as an aide
Documentation of successful completion of at least 40 hours of training in the 16 listed subject areas, or of passing the AHCA competency test, on file
Home health aides, employed or under contract · Before the aide provides services
Fla. Admin. Code R. 59A-8.0095(5)(c); s. 400.497(1), F.S.; s. 400.476(3), F.S. · FL licensed HHA (all)
Evidence that the aide demonstrated, in person, the skills for the listed subject areas, whether the course was taught in person, online or as a hybrid
Home health aides qualifying by training · At training completion, before the aide provides services
Fla. Admin. Code R. 59A-8.0095(5)(c) (new 5/31/2026) · FL licensed HHA (all)
Training performed by or under the general supervision of an RN with at least two years of nursing experience, one of them in home health care; the trainer's signature and qualifications appear on the out-of-state, school and agency-issued documentation
RN trainer; aides trained by the agency or elsewhere · At training
Fla. Admin. Code R. 59A-8.0095(5)(c), (5)(f)-(h) · FL licensed HHA (all)
Documentation of successful completion of the 40-hour training from the Florida licensed agency that trained the aide; the paragraph lists no further elements, such as hours per topic
Aides trained by another Florida licensed home health agency · At hire, before the aide provides services
Fla. Admin. Code R. 59A-8.0095(5)(e); s. 400.497(1), F.S. · FL licensed HHA (all)
Course completion documentation showing the institution name and address, the state school license number, student name, curriculum, total hours, hours per topic, the trainer's signature and qualifications and the completion date, from a course that included in-person competency validation
Aides licensed, certified or trained in another state · At hire, before the aide provides services
Fla. Admin. Code R. 59A-8.0095(5)(f) (new 5/31/2026) · FL licensed HHA (all)
The same itemized course documentation, with the school license number issued by the Florida Department of Education, from a course that included in-person competency validation
Aides trained at a vocational school or a Department of Education approved nonpublic post-secondary career school · At hire, before the aide provides services
Fla. Admin. Code R. 59A-8.0095(5)(g) (new 5/31/2026) · FL licensed HHA (all)
Agency-issued document titled 'Home Health Aide Training Documentation' with the agency's name, address, phone and license number, the student's name, address, phone and Social Security number, total and per-topic clock hours, the trainer's signature and qualifications, the completion date and the s. 400.497(1) statement, from training that included in-person competency validation; no fee charged, no 'diploma' or 'certificate' wording, and no advertising of aide training
Agencies that train their own employees and are not classified as career schools · At successful completion of the training
Fla. Admin. Code R. 59A-8.0095(5)(h) · FL licensed HHA (all)
The employing agency's own validation of the aide's competency of training whenever another institution, school or agency provided the training; the paragraph names no evaluator, form or deadline
Aides trained elsewhere · Before the aide provides services is the conservative reading; paragraph (5)(j) itself states no deadline
Fla. Admin. Code R. 59A-8.0095(5)(j) (new 5/31/2026); s. 400.476(3), F.S. · FL licensed HHA (all)
Record of passing the Home Health Aide Competency Test, AHCA 3110-1007, September 2025: all 14 practical tasks and 90 of the 104 written questions, with the practical part given and evaluated by an RN, or an LPN under RN supervision; whether a failed aide may retake it is the agency's decision
Aides qualified by the test instead of the 40 hours · Before the aide provides services
Fla. Admin. Code R. 59A-8.0095(5)(i), (5)(i)1., (5)(i)1.a., (5)(i)2. · FL licensed HHA (all)
Documentation of test passage furnished to a new employing agency on request; the rule says it 'should include' the aide's name, address and Social Security number, the agency's name and address, the date the test was passed and the signature of the person providing it
Agency that administered the test · On request from the new employing agency
Fla. Admin. Code R. 59A-8.0095(5)(i)3.; s. 400.497(1), F.S. · FL licensed HHA (all)
Proof of graduation from an accredited school of nursing for a graduate awaiting Florida boards, or proof of Florida or out-of-state RN or LPN licensure; the rule does not say whether these individuals also need the (5)(c) documentation, so confirm the approach with AHCA's Home Health Unit
Nursing graduates, RNs and LPNs working as aides · At hire
Fla. Admin. Code R. 59A-8.0095(5)(q) · FL licensed HHA (all)
CNAs working as aides
Documentation of the CNA's current State of Florida certification
Florida CNAs · Before the CNA provides services
Fla. Admin. Code R. 59A-8.0095(5)(b); s. 400.462(6), F.S. · FL licensed HHA (all)
Copy of the CNA's current nursing assistant certificate from the other state
CNAs certified in another state who work as home health aides · Before working as an aide
Fla. Admin. Code R. 59A-8.0095(5)(b) · FL licensed HHA (all)
24 hours of in-service training each biennium, with documentation kept by the CNA; this is the CNA's own renewal duty, separate from the agency's calendar-year in-service
CNAs personally · During each biennium
s. 464.203(7)-(8), F.S. · FL CNA certification
A new training and competency evaluation program, or a new competency evaluation program, after 24 consecutive months without nursing-related services for pay
CNAs · After any 24 consecutive months without paid nursing-related services
s. 464.203(5), F.S. · FL CNA certification
At hire and the first months
One-time HIV and AIDS course certificate or roster entry; aides and CNAs are outside the s. 456.033 exception, and the agency keeps a record of employees and dates of attendance
All employees except those subject to s. 456.033, F.S. (such as RNs and LPNs); aides and CNAs are included · Within 30 days of employment; not repeated after moving from another covered facility
Fla. Admin. Code R. 59A-8.0095(5)(r); s. 381.0035(1)-(2), (4), F.S.; s. 456.033, F.S. · FL licensed HHA (all)
Current CPR card from an instructor or provider approved by the American Red Cross, the American Heart Association or the National Safety Council, or from an organization whose training is accredited by the Commission on Accreditation for Pre-Hospital Continuing Education, from a course in which the student demonstrated CPR in person
Home health aides and CNAs · Obtain, then keep current; the rule sets no separate deadline, and having the card before the first visit is our recommendation
Fla. Admin. Code R. 59A-8.0095(5)(k) (in-person clause new 5/31/2026) · FL licensed HHA (all)
Level 2 background screening conducted through AHCA, including fingerprint-based state and national criminal history checks and a search of the sexual predator and sexual offender registries; file contents and timing are covered in the Florida personnel file and Level 2 rescreening guides
Aides and CNAs, employed or under contract, who provide personal care directly to clients · At employment or contract
s. 400.512, F.S.; s. 408.809(1)(e), F.S.; s. 435.04(1)(a), F.S. · FL licensed HHA (all)
Basic written information about interacting with persons who have Alzheimer's disease or related forms of dementia, and the Department of Elderly Affairs 1-hour course, with the agency's record of completion
Employees, including contracted staff subject to Level 2 screening; the 1-hour course covers those who provide personal care or have regular patient contact. Confirm with AHCA before relying on the pediatric-census exemption in s. 400.4785(1), F.S. · Written information upon beginning employment; the course within 30 days
s. 400.4785, F.S.; s. 430.5025(2)(d), (4)(a), (4)(b), (4)(b)2., F.S. · FL licensed HHA (all)
Two additional hours of dementia training that include behavior management, promoting independence in activities of daily living, and skills in working with families and caregivers
Employees who provide personal care, including aides and CNAs; staff working before July 1, 2023 had to finish before July 1, 2026 · Within 7 months after beginning employment
s. 430.5025(4)(c), (9), F.S. · FL licensed HHA (all)
At least 2 hours of training in assisting with self-administered medication, which may be part of the 40 hours, including verification that the aide can read the prescription label and any instructions; a course taken outside the 40-hour training is documented in the personnel file, and passing the AHCA test alone does not qualify an aide to assist
Aides and CNAs who will assist with self-administered medication · Before assuming the responsibility
Fla. Admin. Code R. 59A-8.0095(5)(c)15., (5)(i)1.b.; s. 400.488(1)(b), F.S. · FL licensed HHA (all)
Every year and ongoing
In-service training records dated within each calendar year; the state rule sets no hour minimum, and AHCA surveyor guidance says the agency 'should determine the type and amount of in-service training to provide each year'
Home health aides and CNAs · Each calendar year
Fla. Admin. Code R. 59A-8.0095(5)(k); Fla. Admin. Code R. 59A-8.0097(1) · FL licensed HHA (all)
CPR card renewed so it stays current; the rule sets no renewal interval of its own, so the card's expiration date governs
Home health aides and CNAs · Before each card's expiration date
Fla. Admin. Code R. 59A-8.0095(5)(k) · FL licensed HHA (all)
Level 2 rescreening
Aides and CNAs in screened positions, employed or under contract · Every 5 years following employment or entry into a contract
s. 408.809(2), F.S. · FL licensed HHA (all)
Initial 6-hour medication administration course, a 2-hour medication in-service every year, and an RN validation that expires 1 year from its effective date, with revalidation within 60 days before expiration; training and validation records kept on file
Aides and CNAs who administer medication under RN delegation, at agencies that provide skilled care only · 6 hours before assuming the task; 2 hours annually; revalidation each year
Fla. Admin. Code R. 59A-8.0095(3)(e); Fla. Admin. Code R. 59A-8.0097(3)(a), (5)-(6); s. 400.489(2), F.S. · FL licensed HHA (skilled care only)
Supervision
Personal care assigned by and provided under the supervision of an RN; when only physical, speech or occupational therapy is furnished along with aide or CNA services, a licensed therapist, employed or contracted, may supervise instead
Home health aides and CNAs, case by case · Every assignment
Fla. Admin. Code R. 59A-8.0095(5)(a); Fla. Admin. Code R. 59A-8.008(2) · FL licensed HHA (all)
The assigning RN keeps full responsibility for the personal care tasks assigned and must ensure the aide or CNA is qualified for them based on training and experience
Assigning RN · At each assignment
Fla. Admin. Code R. 59A-8.0095(3)(b); s. 400.476(3), F.S. · FL licensed HHA (all)
Written assignment by a licensed health professional employee or contractor listing the personal care activities; aides and CNAs may not provide a personal health service that is not in the plan of care
Home health aides and CNAs (patient-record item) · Before the aide performs the tasks
Fla. Admin. Code R. 59A-8.0095(5)(l)1., (5)(p)10. · FL licensed HHA (all)
RN supervisory visits, with on-site supervision as needed based on the severity of the patient's condition and the aide's or CNA's training and experience, documented in the patient file; neither the rule nor s. 400.487(3), F.S. sets an interval for ordinary aides
Home health aides, employed or contracted, as unlicensed assistive personnel; CNAs are not unlicensed assistive personnel but remain under on-site supervision as needed · As needed; the agency's written policy sets the cadence
Fla. Admin. Code R. 59A-8.0095(3)(c)-(d); Fla. Admin. Code R. 64B9-14.001(1); s. 400.487(3), F.S. · FL licensed HHA (all)
Written consent from the patient, guardian or legal representative to send an RN into the home for supervisory visits
Patients served by home health aides (patient-record item) · Before the first supervisory visit
Fla. Admin. Code R. 59A-8.0095(3)(c) · FL licensed HHA (all)
Written policies and procedures that address the availability of a registered nurse supervisor during hours of patient service
Agencies that do not provide skilled services · In place while aides serve patients
Fla. Admin. Code R. 59A-8.003(9)(d) · FL licensed HHA (all)
Medicare-certified overlay
Evidence the aide completed one of four routes: training and competency evaluation under (b) and (c); a competency evaluation program under (c); a state-approved nurse aide training and competency evaluation program with current good standing on the state nurse aide registry; or a state licensure program meeting (b) and (c), which no Florida program fits because Florida does not license or certify aides
Home health aides and CNAs working as aides · Before furnishing services
42 CFR 484.80(a)(1)(i)-(iv); 42 CFR 484.115(d) · Medicare-certified HHA (42 CFR 484)
Training documentation showing at least 75 hours of classroom and supervised practical training, at least 16 classroom hours before at least 16 supervised practical hours, practical training under the direct supervision of an RN or an LPN supervised by an RN, and every (b)(3) subject area covered
Aides qualifying through training · Before furnishing services
42 CFR 484.80(b)(1)-(4); 42 CFR 484.2 · Medicare-certified HHA (42 CFR 484)
Competency evaluation performed by an RN that addresses every (b)(3) subject, with communication skills, reading and recording temperature, pulse and respiration, personal hygiene and grooming, safe transfer and ambulation, and range of motion and positioning observed with a patient or pseudo-patient; an 'unsatisfactory' rating in more than one required area means the aide has not passed, and a task rated unsatisfactory is done only under direct RN supervision until the aide is retrained and re-evaluated
Individuals furnishing aide services; for CNAs on the nurse aide route see the recommended-practice row, and Medicaid personal care aide-only services follow 42 CFR 484.80(i) · Before furnishing services
42 CFR 484.80(c), (c)(1), (c)(3)-(5) · Medicare-certified HHA (42 CFR 484)
Check that there has been no continuous 24-month period without compensated services since the aide's most recent qualifying program; if there has, the aide completes another (a)(1) program before providing services
Home health aides and nurse aides · At hire and on return after a long gap; the regulation states the test, not when to check
42 CFR 484.80(a)(2) · Medicare-certified HHA (42 CFR 484)
In-service log of at least 12 hours in each 12-month period, supervised by an RN; training may occur while the aide furnishes care, and any organization may offer it
Home health aides · Each 12-month period
42 CFR 484.80(d), (d)(1)-(2) · Medicare-certified HHA (42 CFR 484)
Supervisory assessment of the aide services at least every 14 days by an RN or other appropriate skilled professional, with the aide not required to be present, on site or, on the rare occasion, by real-time two-way audio-video, capped at 1 virtual assessment per patient in a 60-day episode; an annual on-site observation of each aide performing care; and an on-site visit whenever an area of concern is noted
Aides serving patients who also receive skilled nursing, physical or occupational therapy, or speech-language pathology · Every 14 days; annually; whenever a concern is noted
42 CFR 484.80(h)(1)(i)-(iv) · Medicare-certified HHA (42 CFR 484)
RN on-site, in-person visit every 60 days to assess the aide's care, with the aide not required to be present, and a semi-annual on-site observation of each aide performing non-skilled care
Aides serving patients who receive no skilled services · Every 60 days; semi-annually
42 CFR 484.80(h)(2)(i)-(ii) · Medicare-certified HHA (42 CFR 484)
Retraining and a competency evaluation in the deficient and all related skills after a deficiency in aide services is verified during an on-site visit
Home health aides · After a deficiency verified on site
42 CFR 484.80(h)(3) · Medicare-certified HHA (42 CFR 484)
Evidence that aides furnished under arrangement meet the training or competency evaluation requirements, with the agency supervising them as it supervises its own aides
Agencies that furnish aide services under arrangement · Before services under arrangement begin
42 CFR 484.80(h)(5)(ii)-(iii) · Medicare-certified HHA (42 CFR 484)
Recommended practice
Dated in-person skills demonstration sheet listing the (5)(c) subject areas, the evaluator and the setting, and an RN-signed competency validation for every aide trained elsewhere; for aides on staff before 5/31/2026, complete both now with the current date and never backdate
Every home health aide · At hire; now for existing staff
Fla. Admin. Code R. 59A-8.0095(5)(c), (5)(j) (basis for the recommendation) · Recommended (not required by rule)
Replace online-only CPR cards with a card from one of the four named provider categories, from a course with an in-person demonstration
Aides and CNAs holding online-only cards · At the next renewal or sooner
Fla. Admin. Code R. 59A-8.0095(5)(k) (basis for the recommendation) · Recommended (not required by rule)
Track the state calendar-year in-service and the federal 12-month count as two separate items, and write one definition of the federal 12-month period, hire anniversary or calendar year, into policy
Medicare-certified agencies · Ongoing
Fla. Admin. Code R. 59A-8.0095(5)(k); 42 CFR 484.80(d) · Recommended (not required by rule)
Per-aide index of supervisory visit records, which the rule files by patient, and a written supervision cadence at licensed-only agencies
Every agency that uses aides · Ongoing
Fla. Admin. Code R. 59A-8.0095(3)(d) (basis for the recommendation) · Recommended (not required by rule)
Dated printout of the CNA's status from the Board of Nursing's public CNA registry
CNAs working as aides · At hire, at each biennial renewal and before rehiring after a long gap
s. 464.202, F.S.; Fla. Admin. Code R. 59A-8.0095(5)(b) · Recommended (not required by rule)
Documentation of the CNA's completion of home health aide training; AHCA surveyor guidance says the agency 'should have documentation of the CNA completion of the home health training', while the rule itself requires only the certificate
CNAs working as aides · At hire
Fla. Admin. Code R. 59A-8.0095(5)(b)-(c) (AHCA ASPEN State Regulation Set H 8.07 guideline) · Recommended (not required by rule)
Signed job description that mirrors the (5)(l) duties and the (5)(p) list of tasks aides and CNAs may not perform; Rule 59A-8.0095 does not require a job description for aides
Home health aides and CNAs · At hire and at each revision
Fla. Admin. Code R. 59A-8.0095(5)(l), (5)(p) (basis for the recommendation) · Recommended (not required by rule)
TB screening only where agency policy or an accreditor requires it; Chapter 59A-8, F.A.C. contains no TB screening requirement for aides
Home health aides and CNAs · As agency or accreditor policy sets
Fla. Admin. Code R. 59A-8.0095 (no TB requirement) · Recommended (not required by rule)
Current registry good standing plus an RN-signed competency evaluation for a CNA working as an aide; the regulation does not settle whether the nurse aide route alone is enough without a separate competency evaluation
CNAs working as aides at certified agencies · Before furnishing services
42 CFR 484.80(a)(1)(iii), (c) (basis for the recommendation) · Recommended (not required by rule)
Questions administrators ask
Can a CNA work as a home health aide in Florida without more training?
Under the state rule, yes. 'Prior to a CNA providing services, the home health agency shall have documentation of the CNA's current State of Florida certification' (Fla. Admin. Code R. 59A-8.0095(5)(b)), and a CNA certified in another state may work as an aide with a copy of the current certificate (same paragraph). AHCA's surveyor guidance, which is not rule text, adds: 'The home health agency should have documentation of the CNA completion of the home health training.' At a Medicare-certified agency, a CNA can qualify through a state-approved nurse aide program and current good standing on the state registry (42 CFR 484.80(a)(1)(iii)); filing an RN-signed competency evaluation as well is our recommendation, not a rule.
How many training hours does a Florida home health aide need?
At a licensed-only agency, at least 40 hours in 16 subject areas, or passage of the AHCA competency test instead (Fla. Admin. Code R. 59A-8.0095(5)(c); s. 400.497(1), F.S.). No hours are set per subject, except that an aide who assists with self-administered medication needs 'a minimum of 2 hours of training (which can be part of the 40 hour home health training)' (Fla. Admin. Code R. 59A-8.0095(5)(c)15.). At a Medicare-certified agency, an aide who qualifies through training needs a program where 'Classroom and supervised practical training must total at least 75 hours' (42 CFR 484.80(b)(1)), plus an RN competency evaluation (42 CFR 484.80(c), (c)(3)); a competency evaluation program alone and the nurse aide route are others (42 CFR 484.80(a)(1)(ii)-(iii)).
Is the AHCA competency test enough without training?
At a licensed-only agency, yes: 'Successful passage of the competency test by home health aides may be substituted for the training required under this section' (s. 400.497(1), F.S.). AHCA provides the test 'upon request to licensed home health agencies' (AHCA, Home Health Aides), and passing means all 14 practical tasks and 90 of 104 written questions (Fla. Admin. Code R. 59A-8.0095(5)(i)1.a.). Two limits apply. Passing 'alone does not permit a home health aide to assist with self-administration of medication' (Fla. Admin. Code R. 59A-8.0095(5)(i)1.b.), and for Medicare and Medicaid agencies AHCA says 'The AHCA test does not meet this federal regulation' (AHCA, Home Health Aides).
Can home health aide training be online in Florida?
Partly. Since May 31, 2026, training 'may be conducted in person, online, or through a hybrid program but must require the aide to demonstrate, in person' the skills for the listed subject areas (Fla. Admin. Code R. 59A-8.0095(5)(c)). Classroom content can be online; the skills demonstration cannot. The rule names no form for proving the demonstration, so our recommendation is a dated skills sheet signed by the RN who watched it. The federal regulation for Medicare-certified agencies does not address online delivery of the classroom hours.
Does Florida require 12 hours of in-service a year?
Not under the state rule. 'Home health aides and CNA's must receive in-service training each calendar year' (Fla. Admin. Code R. 59A-8.0095(5)(k)), with no hour figure, and AHCA's surveyor guidance leaves the type and amount to the agency. The 12 hours are federal and bind Medicare-certified agencies: 'A home health aide must receive at least 12 hours of in-service training during each 12-month period' (42 CFR 484.80(d)).
Does a home health aide need CPR?
Yes. 'Home health aides and CNAs must also obtain and maintain current cardiopulmonary resuscitation (CPR) certification' (Fla. Admin. Code R. 59A-8.0095(5)(k)). Since May 31, 2026, the rule says a card from one of four named provider categories satisfies it when the course required the student 'to demonstrate, in person, that he or she is able to perform cardiopulmonary resuscitation' (same paragraph). Online-only cards are not expressly banned, but replacing them is our recommendation. The rule sets no renewal interval beyond the card's own, and 42 CFR 484.80 contains no CPR requirement.
How often must an aide be supervised?
At a licensed-only agency, no fixed interval applies to ordinary aides: 'The RN must provide on-site supervision as needed, based upon the severity of patient's medical condition and the home health aide's or CNA's training and experience' (Fla. Admin. Code R. 59A-8.0095(3)(d)). A written cadence is our recommendation. At a Medicare-certified agency the intervals are fixed: a supervisory assessment at least every 14 days and an annual on-site observation of each aide for patients receiving skilled services (42 CFR 484.80(h)(1)), and an RN on-site visit every 60 days plus a semi-annual on-site observation for patients who are not (42 CFR 484.80(h)(2)).
What happens when an aide goes 24 months without paid aide work?
At a Medicare-certified agency, after 'a 24-month lapse in furnishing services for compensation, the individual must complete another program, as specified in paragraph (a)(1) of this section, before providing services' (42 CFR 484.80(a)(2)); any of the four (a)(1) routes will do. Rule 59A-8.0095 has no equivalent for aides. Florida CNAs have their own 24-month rule (s. 464.203(5), F.S.), as do aides for medically fragile children (s. 400.4765(3)(c), F.S.).
Sources
- Fla. Admin. Code R. 59A-8.0095, Personnel (official text, effective 5/31/2026)
- Fla. Admin. Code R. 59A-8.0095 as in force 4/16/2023 to 5/30/2026 (superseded final rule text, for comparison)
- Notice of Development of Rulemaking, 59A-8.0095, Florida Administrative Register Vol. 51, No. 148 (July 31, 2025)
- Notice of Proposed Rule, 59A-8.002, 59A-8.008 and 59A-8.0095, Florida Administrative Register Vol. 52, No. 12 (January 20, 2026)
- Notice of Change, 59A-8.0095, Florida Administrative Register Vol. 52, No. 67 (April 7, 2026)
- Fla. Admin. Code R. 59A-8.002, definitions, including assistance with activities of daily living
- Fla. Admin. Code R. 59A-8.003, licensure requirements, including RN supervisor availability at non-skilled agencies
- Fla. Admin. Code R. 59A-8.008, scope of services, including case management in therapy and aide cases (effective 5/5/2026)
- Fla. Admin. Code R. 59A-8.0097, medication training and validation
- Fla. Admin. Code R. 59A-8.0099, minimum training requirements for home health aides for medically fragile children
- Fla. Admin. Code R. 59A-8.0216, RN delegation of tasks to aides and CNAs
- Fla. Admin. Code R. 59A-8.0219, medication administration by aides and CNAs
- Fla. Admin. Code R. 59A-8.022, clinical records, including supervisory home visits
- Fla. Admin. Code R. 64B9-14.001, Board of Nursing definitions, including unlicensed assistive personnel
- s. 400.462, F.S., definitions (home health aide, certified nursing assistant, companion, personal care, skilled care)
- s. 400.476, F.S., staffing requirements, including the duty to ensure aides and CNAs are adequately trained
- s. 400.4765, F.S., home health aide for medically fragile children program
- s. 400.4785, F.S., Alzheimer's and dementia training for home health agency employees
- s. 400.487, F.S., RN supervisory visits of patients receiving aide services
- s. 400.488, F.S., assistance with self-administered medication
- s. 400.489, F.S., medication administration by aides, including the annual 2-hour in-service
- s. 400.497, F.S., home health aide competency test and training
- s. 400.512, F.S., Level 2 screening of home health agency personnel
- s. 408.809, F.S., background screening and rescreening every 5 years
- s. 435.04, F.S., level 2 screening standards
- s. 430.5025, F.S., Alzheimer's disease and related forms of dementia training
- s. 381.0035, F.S., HIV and AIDS educational course for facility employees
- s. 456.033, F.S., HIV and AIDS requirements for listed licensees (the exception in s. 381.0035(4))
- s. 464.201, F.S., definitions for certified nursing assistants
- s. 464.202, F.S., Board of Nursing duties, including the public CNA registry
- s. 464.203, F.S., CNA certification, the 24-month lapse rule and biennial in-service
- 42 CFR 484.80, home health aide services (Medicare Conditions of Participation)
- 42 CFR 484.2, definitions, including pseudo-patient, simulation and supervised practical training
- 42 CFR 484.115, personnel qualifications (Medicare Conditions of Participation)
- 42 CFR 483.151 through 483.154, state approval of nurse aide training and competency evaluation programs (483.151 linked)
- 42 CFR 409.40, basis, purpose and scope of Medicare home health services (referenced by the 24-month lapse rule)
- AHCA, Home Health Aides (aides not licensed or certified; training or testing table; competency test request; statement that the AHCA test does not meet the federal regulation)
- AHCA, Fact Sheet on Home Health Aides (March 2018; predates the 2023 and 2026 amendments)
- AHCA ASPEN State Regulation Set H 8.07, Home Health Agencies (surveyor interpretive guidelines, effective 8/17/2026)
- Florida Board of Nursing, Certified Nursing Assistant (CNA) certification
- Florida Board of Nursing, Certified Nursing Assistant (CNA) renewal
- 10A NCAC 13J .1003, Personnel (North Carolina home care agencies; OAH per-rule text)
- 10A NCAC 13J .1107, In-Home Aide Services (North Carolina; OAH per-rule text)
- DHSR, Home Care Licensure Frequently Asked Questions (Revised 5/30/25), North Carolina, including Q54 on in-service hours
This guide is general information for Florida licensed home health agencies and the aides they employ, not legal advice. Rules and statutes change, and AHCA guidance can lag the current rule text, so verify every citation against the official source before acting on it, starting with Fla. Admin. Code R. 59A-8.0095 at flrules.org and 42 CFR 484.80 at ecfr.gov. AHCA's Home Health Aides page still cites the former federal section number, 42 CFR 484.36, and its aide fact sheet is dated March 2018. The AHCA surveyor regulation set quoted here, version H 8.07, effective August 17, 2026, is guidance, not rule text. Nothing here predicts or guarantees a survey outcome.