Florida Home Health Agency Personnel File Requirements: the 59A-8.0095 Checklist (2026)

This guide is written for a home health agency licensed under Chapter 400, Part III, Florida Statutes, and surveyed by AHCA against Fla. Admin. Code R. 59A-8.0095. It applies whether or not your agency is Medicare certified, and whether or not it is accredited.

Nurse registries under s. 400.506, F.S., are out of scope. So are homemaker and companion services registered separately from an agency. Every checklist row on this page carries one of seven scope labels, used exactly as written here: FL licensed HHA (all), FL licensed HHA (skilled care only), Medicare-certified only, all US employers, all Florida employers, accreditation only, and recommended practice, not law. Getting those labels right matters because the review systems measure against different yardsticks: AHCA cites deficiencies against the rule and the statutes, not against ACHC, CHAP or Joint Commission standards, while an accreditor reviews against its own standards, several of which the state rule never mentions.

One scope note inside the rule itself: an agency that does not provide skilled care is not required to have a director of nursing (Fla. Admin. Code R. 59A-8.0095(2)(i)), so the director of nursing section below applies only if you furnish skilled nursing.

Contracted staff, pool staff, volunteers and students. Florida has no single personnel-file rule that keys off employee versus contractor, and Rule 59A-8.0095 never mentions volunteers or students by name. Duties attach role by role.

Reaching contractors expressly: RN supervisory visits of unlicensed assistive personnel 'employed by or under contract with the home health agency' (Fla. Admin. Code R. 59A-8.0095(3)(c)); the director of nursing's certified report on any 'contracted staff person' (59A-8.0095(2)(d)); the headcount for a combined administrator and director of nursing, which counts 'employees and contracted personnel' (59A-8.0095(2)(f)); and Level 2 screening of contractors under s. 408.809(1)(e), F.S.

Triggered by function rather than payroll, so reaching contracted, pool and staffing-agency aides too: documentation of CNA certification before the CNA provides services (59A-8.0095(5)(b)), the 40 hours or the test before the aide provides services ((5)(c)), your own competency validation of anyone trained elsewhere ((5)(j)), and RN supervisory visits ((3)(c)-(d)).

Written for employees only: the HIV and AIDS course, which the rule limits to 'all home health agency employees' (59A-8.0095(5)(r)) and which says nothing about contractors or volunteers. Level 2 screening turns on the access criteria in s. 408.809(1)(e), F.S., not on payroll status, so a volunteer or student with hands-on patient contact can fall inside it. Because the rule does not resolve the employee-only items, an agency that uses volunteers or student placements should confirm its position with AHCA's Home Health Unit before a survey rather than assume either answer.

The rule history now reads 'Amended ... 7-11-13, 4-16-23, 5-31-26' (Fla. Admin. Code R. 59A-8.0095). The amendment was proposed 1/20/2026 and revised by a notice of change on 4/7/2026. If you are reading 59A-8.0095 on a mirror site, check the history line first; several widely indexed copies still show the 4-16-23 text and the superseded 'diploma or certificate' language.

In short, what changed: written designation and multi-agency rules for the alternate administrator, a new form reference for director of nursing changes, multistate license recognition for RNs, delivery-method and in-person demonstration rules for aide training, expanded training topics, itemized documentation standards for out-of-state and school training, a retitled agency-issued training document, a September 2025 competency test form, a new duty to validate the competency of externally trained aides, an in-person CPR safe harbor, and an expanded list of aide tasks. The full item-by-item change list, with citations, is at the end of this guide under 2026 changes.

If you only fix three things, fix these: a dated in-person skills demonstration record for every aide, your own competency validation for every aide trained somewhere else, and confirmation that the test you administer is the September 2025 version of AHCA 3110-1007.

If you are inside 30 days of a survey, clear these first: the Level 2 eligibility result and signed attestation for every person on the roster; aide 40-hour or test documentation plus the in-person skills demonstration record; your own validation for aides trained elsewhere; current CPR cards; current-calendar-year in-service records; HIV and AIDS course records; and the written alternate administrator designation.

What did not change: the 40-hour minimum, the competency test passing standard of all 14 practical tasks and 90 of 104 written questions, and the LPN paragraph, which was left untouched and so still refers only to Chapter 464 licensure without the multistate option.

Two drafting quirks to work around when you cite the rule. Paragraph (5)(i) refers to 'the forty hours of training required in paragraph 59A-8.0095(5)(d)', but the 40 hours and the subject list are in (5)(c); the same stale pointer appears in (5)(i)1.b. And (5)(i)3. refers to wording limits 'in paragraphs (5)(f)-(g)' that now live in (5)(h) after renumbering. Cite (5)(c) for training, (5)(i) for the test and (5)(h) for the wording limits.

Florida's rule is the floor for every licensed agency, and the Medicare Conditions of Participation stack on top of it at a certified agency. The two get blurred inside a single aide file more than anywhere else, so here is the aide file in one view. Items that apply identically to both, Level 2 screening, the HIV and AIDS course, the dementia training and the I-9, are covered in the sections that follow and are not repeated here.

Two notes on the AHCA statement. First, it settles for practical purposes the question the rule text alone cannot: a certified agency should treat the state test as a state document only. Second, the page still cites 42 CFR 484.36, the section number used before the current Conditions of Participation; the aide provisions now sit at 42 CFR 484.80. The full federal overlay, including administrator and clinical manager qualifications and the contractor exclusion bar, is in the Medicare-certified section below.

Rule 59A-8.0095 is not written as a personnel file checklist. It is written as a list of qualifications, trainings and duties by role. The phrase *personnel file* appears exactly once in Rule 59A-8.0095, in the medication-assistance training item, which says 'Other courses taken in fulfillment of this requirement must be documented and maintained in the home health aide's and the CNA's personnel file' (Fla. Admin. Code R. 59A-8.0095(5)(c)15.). The other explicit personnel-file mandate sits in the background screening rule that 59A-8.0095 cross-references, which says the eligibility results and signed attestation 'must be in the employee's personnel file, maintained by the provider' (Fla. Admin. Code R. 59A-35.090(3)(c)).

Everything else in the file is evidence. The rule says an aide's 40-hour training documentation must be 'on file' before the aide provides services (Fla. Admin. Code R. 59A-8.0095(5)(c)) and that a CNA's current Florida certification must be documented before the CNA provides services (Fla. Admin. Code R. 59A-8.0095(5)(b)). For most other items, the rule states a qualification, such as 'The respiratory therapist shall be currently licensed by the state pursuant to Chapter 468, F.S., and have at least one year of experience in respiratory therapy' (Fla. Admin. Code R. 59A-8.0095(9)(a)), and the personnel file is simply where the surveyor looks to see whether that is true.

Two honest gaps worth knowing before you build a file:

• AHCA's rule states no retention period for personnel records. There is no personnel-record retention clause anywhere in 59A-8.0095. Retention periods in this guide come from other sources, such as OSHA and the federal I-9 rule, or are labeled as practice.
• The rule does not require a job description, a resume, an employment application, references, a TB test or an auto insurance card. One qualification: AHCA's surveyor guidance does expect a job description and a resume or employment application in the director of nursing's file, which is guidance rather than rule text. See the director of nursing section. Accreditors require several of these documents for every employee, and most agencies keep them anyway. They are labeled as accreditation or practice below, not as Florida law.

These items apply to essentially everyone on payroll, regardless of discipline.

HIV and AIDS education. The rule requires that 'all home health agency employees, with the exception of employees subject to the requirements of Section 456.033, F.S., 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)). The 30-day clock appears only in the rule; the course content comes from s. 381.0035(1), F.S. The agency 'shall maintain a record of employees and dates of attendance' (s. 381.0035(2), F.S.). An employee who already took the course at another covered facility 'is not required to repeat the course upon changing employment to a different facility' (s. 381.0035(1), F.S.), so a dated prior certificate is acceptable evidence. Licensed practitioners covered by s. 456.033, F.S., including RNs, LPNs, PTs, PTAs, OTs, OTAs, respiratory therapists, dietitians, physicians and physician assistants, are exempt from the facility course (s. 381.0035(4), F.S.); for them the file needs current license verification, not an HIV certificate. Note that CNAs (Chapter 464, Part II) and speech-language pathologists (Chapter 468, Part I) are not on the s. 456.033 list, so they still need the facility course.

Alzheimer's and dementia training. Home health agency employees must complete the training required under s. 430.5025, F.S. (s. 400.4785, F.S.). The tiers are: basic written information about interacting with persons who have dementia 'Upon beginning employment' (s. 430.5025(4)(a), F.S.); a 1-hour Department of Elderly Affairs course 'Within 30 days after beginning employment' for each employee who provides personal care or has regular contact with patients (s. 430.5025(4)(b), F.S.); and 2 more hours 'Within 7 months after beginning employment' for employees who provide personal care (s. 430.5025(4)(c), F.S.). The agency 'must maintain a record of the employee's completion of the training program' for the 1-hour course and provide a copy on the employee's written request (s. 430.5025(4)(b)2., F.S.). 'Employee' here means a person, contracted staff member or independent contractor who is subject to Level 2 screening (s. 430.5025(2)(d), F.S.). The transition period for people hired before July 1, 2023 ran out on July 1, 2026 (s. 430.5025(9), F.S.), so every current person in scope should have records now. Section 400.4785(1), F.S. exempts an agency whose unduplicated census in the most recent calendar year was at least 90 percent aged 21 or younger at admission 'from the training requirements in this section', but s. 430.5025 has no such exemption, so confirm with AHCA before relying on it.

Form I-9 and E-Verify. Section 1 is completed at the time of hire (8 CFR 274a.2(b)(1)(i)(A)) and Section 2 'within three business days of the hire' (8 CFR 274a.2(b)(1)(ii)(B)). Florida restates the same window (s. 448.095(2)(a), F.S.) and requires private employers with 25 or more employees to use E-Verify (s. 448.095(2)(b)2., F.S.); the 3-business-day deadline for the E-Verify case is in (2)(a), not in (2)(b)2. The federal retention clock is three years after hire or one year after termination, whichever is later (8 CFR 274a.2(b)(2)(i)(A)). Copying the employee's identity and work-authorization documents is optional under federal law, which says an employer 'may, but is not required to, copy or make an electronic image of a document' (8 CFR 274a.2(b)(3)); Florida is stricter and requires the employer to keep a copy of the documentation provided and any official verification 'for at least 3 years' (s. 448.095(2)(d), F.S.). If E-Verify is unavailable for the full three business days, Florida requires the employer to document that unavailability (s. 448.095(2)(c), F.S.); a dated screenshot of the outage notice for each affected day is the usual evidence.

If you use a commercial background-check vendor. The Clearinghouse Level 2 result does not trigger the federal Fair Credit Reporting Act. If you separately buy a criminal, driving or employment-history report from a commercial screening vendor, FCRA does apply. It requires a stand-alone written disclosure and a signed authorization before the report is ordered (15 U.S.C. 1681b(b)(2)(A)), and a pre-adverse-action copy of the report before you act on it (15 U.S.C. 1681b(b)(3)(A)). Most agencies that screen only through the Clearinghouse never reach this.

Bloodborne pathogens and hepatitis B. For staff with occupational exposure, hepatitis B vaccination must be made available 'within 10 working days of initial assignment' (29 CFR 1910.1030(f)(2)(i)), and an employee who declines must sign the mandatory Appendix A statement (29 CFR 1910.1030(f)(2)(iv)). Bloodborne pathogens training is required at initial assignment and 'At least annually thereafter' (29 CFR 1910.1030(g)(2)(ii)), with training records kept 'for 3 years from the date on which the training occurred' (29 CFR 1910.1030(h)(2)(ii)). These are federal OSHA duties for private employers, not AHCA items, but a surveyor who opens a file will see them.

Screening is a process, but the personnel file is where it is proved.

Who must be screened. Level 2 screening reaches 'The licensee, if an individual' (s. 408.809(1)(a), F.S.), 'The administrator or a similarly titled person who is responsible for the day-to-day operation of the provider' and 'The financial officer or similarly titled individual' (s. 408.809(1)(b)-(c), F.S.), every controlling interest, and 'Any person, as required by authorizing statutes, seeking employment with a licensee or provider who is expected to, or whose responsibilities may require him or her to, provide personal care or services directly to clients' or have access to client funds, personal property or living areas (s. 408.809(1)(e), F.S.). For home health agencies the authorizing statute is s. 400.512, F.S.: 'The agency, registry, or service shall require level 2 background screening for employees or contractors as required in s. 408.809(1)(e) pursuant to chapter 435 and s. 408.809.' A level 2 investigation 'also includes a search of the sexual predator and sexual offender registries of any state in which the current or prospective employee resided during the immediate preceding 5 years' (s. 435.04(1)(a), F.S.).

What goes in the file. Two documents. 'The eligibility results of employee screening and the signed Attestation referenced in subsection 59A-35.090(2), F.A.C., must be in the employee's personnel file, maintained by the provider' (Fla. Admin. Code R. 59A-35.090(3)(c)). The attestation is AHCA Form 3100-0008, July 2024, which 'must be completed by the individual and retained by the provider upon hire' (Fla. Admin. Code R. 59A-35.090(2)(d)), and the statute requires every employee to 'attest, subject to penalty of perjury, to meeting the requirements for qualifying for employment pursuant to this chapter and agreeing to inform the employer immediately if arrested for any of the disqualifying offenses' (s. 435.05(2), F.S.). AHCA guidance adds a third: 'The Privacy Policy only needs to be signed the first time an employee receives a Clearinghouse screening and stored in the employee's personnel file' (AHCA Clearinghouse Renewals FAQ). That acknowledgment is generated during the person's first screening and printed from the Clearinghouse Results Website.

Timing. An employer 'may not hire, select, or otherwise allow an employee to have contact with any vulnerable person that would place the employee in a role that requires background screening until the screening process is completed' (s. 435.06(2)(a), F.S.). Hiring before results is allowed 'for training and orientation purposes' only, and 'the employee may not have direct contact with vulnerable persons' until screening is complete (s. 435.06(2)(d), F.S.). The administrator and chief financial officer are the exception: they must be screened and qualified before appointment (Fla. Admin. Code R. 59A-35.090(2)(e)).

Keeping it current. 'Every 5 years following his or her licensure, employment, or entry into a contract in a capacity that under subsection (1) would require level 2 background screening under chapter 435, each such person must submit to level 2 background rescreening' (s. 408.809(2), F.S.). Operationally AHCA measures the cycle by the Retained Prints Expiration Date on the Clearinghouse Person Profile: 'Providers may initiate a Clearinghouse Renewal 60 days before the Retained Prints Expiration Date is reached. If the Clearinghouse Renewal is not initiated before the retained prints expiration date a new screening will need to be initiated' (AHCA, Clearinghouse Renewals). Track the retained-prints date, not the eligibility date, and note that once the retained prints expire a full new screening, not a renewal, is required. The retained-prints date is one of several dates the five years can run from, and the s. 408.809(2) anniversary can come first after a late new screening; our Florida Level 2 rescreening guide names every date, works two dated examples and sets out the recovery path when the date has already passed.

Roster and gaps. Register with the Clearinghouse and 'maintain the employment or affiliation status of all persons included in the clearinghouse' (s. 435.12(2)(c), F.S.), reporting initial status and any change 'within 5 business days' (s. 435.12(2)(c)2., F.S.). Some AHCA Clearinghouse instruction materials still print the pre-2024 10-business-day figure; the statute's 5 business days controls (s. 435.12(2)(c)1.-2., F.S.). Initiate every check through the Clearinghouse before sending anyone to Livescan (s. 435.12(2)(d), F.S.). 'A person with a break in service of more than 90 days from a position that requires screening by a specified agency must submit to a national screening' (s. 435.12(2)(b)1., F.S.).

When something turns up. Notify the employee in writing, 'stating the specific record that indicates noncompliance with the standards in this chapter' (s. 435.06(1), F.S.). On learning of an arrest for a disqualifying offense, remove the employee from contact with vulnerable persons (s. 435.06(2)(b), F.S.). On confirmed noncompliance, terminate or 'place the employee in a position for which background screening is not required' (s. 435.06(2)(c), F.S.) unless an exemption is granted.

One narrow route exists after a rescreen. Where a person who is currently employed or contracted, and who was previously screened and qualified under s. 435.04, F.S., has a rescreen surface an offense committed before the last screening, the person may continue working while an exemption request is pending if the request reaches the appropriate licensing agency within 30 days after the person receives the results (s. 408.809(4), F.S., unnumbered paragraph following (4)(w)). Two traps: the 30 days run from the person's receipt, not yours, so ask for the date; and for a Department of Health licensed professional practicing within their scope the exemption is granted by the DOH board, not AHCA (s. 408.809(6)(b), F.S.).

For contractors, 'Evidence of contractor screening may be retained by the contractor's employer or the licensee' (s. 408.809(1)(e), F.S.). Note the tension between that statute and the rule: Fla. Admin. Code R. 59A-35.090(3)(c) says the eligibility results and the attestation must be in the personnel file maintained by the provider, with no contractor exception. The conservative course is to obtain and keep the Clearinghouse eligibility printout yourself; if you do rely on the vendor's file, note in your own file where the evidence lives, and keep the contractor on your roster either way.

At the agency level, not the employee level, you must submit to AHCA 'annually or at the time of license renewal, under penalty of perjury, a signed attestation attesting to compliance with the provisions of this chapter' (s. 435.05(3), F.S.).

If you also operate in North Carolina. North Carolina's criminal history check statute, G.S. 131E-265, has no provision recognizing another state's screening, so a Florida-screened aide is checked again under North Carolina's own process, alongside a Health Care Personnel Registry search before hire. Our North Carolina home care personnel file guide covers both.

This is where the May 2026 amendment did the most work.

For the aide's side of these rules in one place, the three ways to qualify, what the training must cover, the yearly in-service and CPR duties, and the Medicare routes, see our Florida home health aide requirements guide.

Who supervises. '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)). One alternative path: 'When only physical, speech, or occupational therapy is furnished, in addition to home health aide or CNA services, supervision can be supplied by a licensed therapist directly employed by the home health agency or by an independently contracted employee' (same paragraph). In those cases, the supervising therapist's license and the supervision records belong in the file in place of the RN's.

CNAs. '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)). Florida CNA certificates renew biennially (s. 464.203(8), F.S.), so re-verify at renewal. Renewal is conditioned on 24 hours of in-service per biennium, but that duty and the four-year record-retention duty run to the CNA personally, not to your agency (s. 464.203(7), F.S.; Fla. Admin. Code R. 64B9-15.011(6)). Collecting the certificates is good practice and doubles as proof of your own calendar-year in-service, but a surveyor will hold the agency to (5)(k), not to the board's biennium. A CNA certified elsewhere may work as a home health aide in Florida 'if they present a copy of their current certificate as a nursing assistant from that state' (Fla. Admin. Code R. 59A-8.0095(5)(b)).

The 40 hours, or the test. Before an aide provides services the agency must have on file documentation of '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); s. 400.497(1), F.S.). The 16 subject areas are listed in the rule and several were expanded in 2026, for example topic 4, now 'Basic infection control procedures such as hand hygiene, personal protective equipment (PPE), bag technique, and equipment disinfection' (Fla. Admin. Code R. 59A-8.0095(5)(c)4.). Hours per topic are required as part of the documentation formats in paragraphs (5)(f), (5)(g) and (5)(h), and not in (5)(e).

Who trains, and how. 'Home health aide training must be performed by or under the general supervision of a registered nurse who possesses a minimum of two years nursing experience, one of which must have been in the provision of home health care' (Fla. Admin. Code R. 59A-8.0095(5)(c)). New in 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' (same paragraph). That in-person demonstration applies to all training, not only online courses, so make sure the completion documentation reflects it; a dated skills-demonstration sheet is the cleanest way to show it.

Where the training came from. Four paths, four different documents. An aide trained by another licensed agency 'must present the documentation of successful completion of the training to the employing home health agency' (Fla. Admin. Code R. 59A-8.0095(5)(e)); that paragraph asks for nothing more, so you cannot reject the file for lacking an hours-per-topic breakdown. An aide trained in another state must produce documentation that includes 'the issuing agency or institution name and address, school license number issued by the state, student name, course curriculum, total number of hours of training' plus hours per topic, trainer signature and qualifications, and completion date, and the course 'must include validation of the aide's competency in person' (Fla. Admin. Code R. 59A-8.0095(5)(f)). A vocational or Florida DOE-approved career school graduate must produce the same itemized documentation (Fla. Admin. Code R. 59A-8.0095(5)(g)). An agency that trains its own aides and is not a career school must issue a document carrying 'the title "Home Health Aide Training Documentation;" the name, address, phone number, and license number of the home health agency; the student's name, address, phone number, and social security number' and the remaining elements (Fla. Admin. Code R. 59A-8.0095(5)(h)). That same paragraph bars the agency from charging a fee, from using the words 'diploma,' 'certificate,' 'certification of completion,' or 'transcript' on the documentation, and from advertising that it offers aide training. Because the agency-issued document contains a Social Security number, store it with access controls.

Validate competency yourself. New in 2026: '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' (Fla. Admin. Code R. 59A-8.0095(5)(j)). The duty is mandatory. The paragraph names no evaluator, no document and no deadline, so an RN-signed skills checklist in your own file is the usual evidence rather than a stated rule requirement.

What about aides already on staff. Neither the amended rule nor the 4/7/2026 notice of change contains a transition clause for aides hired before 5/31/2026, and AHCA has not published guidance on the point. The rule text is written in the present tense and applies to the employing agency, not to the training event. The conservative reading, and the one to take before a survey, is that every aide currently providing services should have a dated in-person skills demonstration record and, if trained elsewhere, an RN-signed competency validation on file now. Both can be completed prospectively with today's date. Do not backdate them to the original training.

The competency test route. An agency may administer 'the Home Health Aide Competency Test, AHCA 3110-1007, September 2025 in lieu of the forty hours of training' (Fla. Admin. Code R. 59A-8.0095(5)(i)); the form is requested from AHCA by email with the agency's name, address and license number. Agencies that use it 'must maintain documentation of the aide's successful passage of the competency test' (Fla. Admin. Code R. 59A-8.0095(5)(i)1.), and passing 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.). Any staff person may give the written part, but 'the practical competency test must be administered and evaluated by a registered nurse or a licensed practical nurse under the supervision of a registered nurse' (Fla. Admin. Code R. 59A-8.0095(5)(i)2.). Passing the test '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.). When an aide who tested with you moves on, you 'shall furnish documentation of successful passage of the test to the requesting agency'; the rule says that documentation 'should include' the aide's name, address and Social Security number, the agency's name and address, the date passed and the signature of the person providing it (Fla. Admin. Code R. 59A-8.0095(5)(i)3.).

Medication assistance. An aide or CNA who will 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' (Fla. Admin. Code R. 59A-8.0095(5)(c)15.). The same subparagraph requires 'verification that each CNA and home health aide can read the prescription label and any instructions. Individuals who cannot read must not be permitted to assist with prescription medications.'

Two patient-level preconditions sit alongside the training record, and the training certificate alone does not satisfy them. Before an aide or CNA assists, 'a review must be conducted by a registered nurse to ensure the patient is medically stable with the self-administration of routine, regularly scheduled medications,' and the RN 'must review and reconcile all currently prescribed and over-the-counter medications' (Fla. Admin. Code R. 59A-8.0095(5)(m)). And a licensed health care professional must inform the patient or caregiver that an unlicensed person may provide the assistance, and 'The patient, or the patient's caregiver, must give written consent for this arrangement' (Fla. Admin. Code R. 59A-8.0095(5)(n); s. 400.488(2), F.S.). Both are patient-record documents; index them so you can produce them per aide.

What aides and CNAs may not do. The rule sets an express floor the training file cannot cross. Responsibilities 'shall not include' any therapeutic service requiring licensure as a health care professional, changing sterile dressings, irrigating body cavities such as giving an enema, performing irrigation of any wounds, performing a gastric irrigation or enteral feeding, catheterizing a patient, administering any controlled substance listed in Schedule II, Schedule III or Schedule IV, applying heat by any method, caring for a tracheotomy tube, providing any personal health service not included in the plan of care, or 'Filling and removing medications from a pill organizer or electronic medication dispenser' (Fla. Admin. Code R. 59A-8.0095(5)(p)). The pill organizer item and the enteral feeding item are the two most commonly assumed to be permitted. How (5)(p) interacts with delegated medication administration under (3)(e) and Rule 59A-8.0097 is not addressed in the rule text; confirm with AHCA before delegating any task on this list.

Annual in-service and CPR. 'Home health aides and CNA's must receive in-service training each calendar year' (Fla. Admin. Code R. 59A-8.0095(5)(k)). The state rule sets no hour minimum; the same paragraph tells Medicare and Medicaid agencies to check federal rules. Aides and CNAs 'must also obtain and maintain current cardiopulmonary resuscitation (CPR) certification' (same paragraph). The rule then identifies one form of documentation that satisfies the requirement: a card from an approved provider (the American Red Cross, the American Heart Association, the National Safety Council, or an organization whose training is accredited by the Commission on Accreditation for Pre-Hospital Continuing Education, or CAPCE) 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 rule names what satisfies the requirement and does not expressly forbid anything else, so an online-only card is not flatly prohibited. It is also not covered by the sentence a surveyor will read. The practical answer: replace online-only cards with a skills-check card from one of the four named provider categories, and if a survey is imminent, schedule the replacement rather than arguing the point at the exit conference.

RN supervisory visits. 'Each home health agency that provides skilled care or non-skilled care must have an RN provide supervisory visits of unlicensed assistive personnel ... who are employed by or under contract with the home health agency, in accordance with Section 400.487(3), F.S. The agency must obtain written consent from the patient, or the patient's guardian or legal representative, to send an RN into the home to conduct supervisory visits' (Fla. Admin. Code R. 59A-8.0095(3)(c)). The visits themselves are on demand rather than on a calendar: '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. Supervisory visits must be documented in patient files' (Fla. Admin. Code R. 59A-8.0095(3)(d)). Neither the rule nor s. 400.487(3), F.S. sets an interval, so your own policy defines the cadence. Keep the written consent on file for every patient served by unlicensed assistive personnel, and index the visit records so you can produce them per aide.

Two special cases. Nursing graduates awaiting Florida boards, and RNs or LPNs licensed in Florida or another state, may work as home health aides (Fla. Admin. Code R. 59A-8.0095(5)(q)); keep the diploma or the license verification in the file. The rule does not say whether these individuals also need the 40-hour training documentation required by (5)(c), so confirm your approach with AHCA before treating the diploma or license as a substitute. And at an agency that provides skilled care, where an RN delegates tasks beyond personal care, including medication administration, the aide or CNA must be 'qualified to perform the task pursuant to Rules 59A-8.0097, 59A-8.0219 and 59A-8.0216, F.A.C.' (Fla. Admin. Code R. 59A-8.0095(3)(e)). The specific training, validation and documentation for each delegable task live in those three rules, which this guide does not summarize. Read them, or ask AHCA, before an RN delegates medication administration or any other task beyond assigned personal care.

The rule states one core qualification for each discipline. Your file needs dated, primary-source verification of each, refreshed at renewal. The rule prescribes no verification method or interval, so the printout-at-hire-and-at-renewal habit is sound practice rather than a stated mandate.

• Registered nurse. 'A registered nurse shall be currently licensed to practice in the state, pursuant to Chapter 464, F.S. or hold an active multistate license under s. 464.0095 to practice professional nursing' (Fla. Admin. Code R. 59A-8.0095(3)(a)). The multistate compact language is new as of 5/31/2026, so a Nursys verification for a compact nurse is now acceptable evidence. The same paragraph makes the RN 'the case manager in all cases involving nursing or both nursing and therapy care,' responsible for each nursing patient's clinical record, and responsible for assuring progress reports reach the physician, physician assistant or advanced practice registered nurse on any change in condition or deviation from the plan of care (Fla. Admin. Code R. 59A-8.0095(3)(a)1.-3.), language worth mirroring in the RN job description even though the rule does not require one.
• Licensed practical nurse. The LPN must be currently licensed under Chapter 464, F.S., and must 'provide nursing care assigned by and under the direction of a registered nurse who provides on-site supervision as needed, based upon the severity of patients medical condition and the nurse's training and experience,' with those 'Supervisory visits ... documented in patient files' (Fla. Admin. Code R. 59A-8.0095(4)(a)). Like the aide supervisory visit, that is a patient-record document; index it so you can produce it per nurse. The same paragraph adds that 'Provision shall be made in agency policies and procedures for annual evaluation of the LPN's performance of duties by the registered nurse.' What the rule mandates in terms is the policy provision; the completed annual evaluation is the evidence a surveyor will look for. This is the only evaluation the rule puts on an annual cycle. It is not the only evaluation Florida requires: in an agency that provides skilled care the director of nursing must 'Employ and evaluate nursing personnel' (Fla. Admin. Code R. 59A-8.0095(2)(c)2.), a duty with no stated interval.
• LPN multistate licenses. The 2026 amendment did not add compact-license language for LPNs, so the LPN paragraph still reads Chapter 464 only. The Nurse Licensure Compact covers LPNs and VNs, so the omission may be drafting rather than policy, but the rule text is what a surveyor reads. If you staff LPNs on a multistate license, confirm in writing with AHCA's Home Health Unit that (4)(a) is read to include s. 464.0095 licensees before you rely on it, and until then keep a Nursys multistate privilege verification in the file alongside the license.
• Physical therapist and assistant. Both 'shall be currently licensed in the state, pursuant to Chapter 486, F.S.' (Fla. Admin. Code R. 59A-8.0095(6)(a)). PTA services are provided 'under the general supervision of a licensed physical therapist,' which the rule defines as not requiring on-site supervision so long as 'The physical therapists shall be accessible at all times by two way communication' and readily available for consultation during the delivery of care (Fla. Admin. Code R. 59A-8.0095(6)(a)2.), so the PTA's file or assignment record should name the supervising PT and the contact method.
• Speech pathologist. 'The speech pathologist shall be currently licensed in the state, pursuant to Chapter 468, F.S.' (Fla. Admin. Code R. 59A-8.0095(7)).
• Occupational therapist and assistant. Both currently licensed under Chapter 468, F.S., and 'Duties of the occupational therapist assistant shall be directed by the licensed occupational therapist and shall be within the scope of practice authorized by the license' (Fla. Admin. Code R. 59A-8.0095(8)(a)), so name the directing OT in the assistant's assignment record.
• Respiratory therapist. Currently licensed under Chapter 468, F.S., 'and have at least one year of experience in respiratory therapy' (Fla. Admin. Code R. 59A-8.0095(9)(a)), so the file needs experience verification as well as the license.
• Social worker. 'The social worker shall be a graduate of an accredited school of social work with one year of experience in social services' (Fla. Admin. Code R. 59A-8.0095(10)(a)), and may not provide clinical counseling unless licensed under Chapter 491, F.S. (Fla. Admin. Code R. 59A-8.0095(10)(b)).
• Dietitian or nutritionist. Currently licensed under Chapter 468, F.S., 'with at least 1 year of experience in dietetics and nutrition practice' (Fla. Admin. Code R. 59A-8.0095(11)(a)).

For homemakers and companions the rule sets duties only. Both must keep records: a homemaker must 'Maintain appropriate work records' (Fla. Admin. Code R. 59A-8.0095(12)(a)7.) and a companion must 'Maintain a chronological written record of services' (Fla. Admin. Code R. 59A-8.0095(12)(b)6.). Both must report unusual incidents or changes in the client's behavior to the case manager (59A-8.0095(12)(a)6., (12)(b)7.). Both are limited to verbally reminding a client that it is time to take medicine, and only if the client or responsible party asks (59A-8.0095(12)(a)8., (12)(b)8.); neither may do what an aide may do under (5)(l)6. The rule imposes no training, licensure or personnel-file document on either role. Their background screening obligation comes from s. 408.809, F.S., not from this rule.

These are the files a surveyor can ask for by name, and the rule attaches the most specific qualification and notification duties to them.

Administrator. The administrator must 'Meet the criteria as defined in Sections 400.462(1) and 400.476(1), F.S.' (Fla. Admin. Code R. 59A-8.0095(1)(a)1.). Under the statute that means a direct employee 'who is a licensed physician, physician assistant, or registered nurse licensed to practice in this state or an individual having at least 1 year of supervisory or administrative experience in home health care' or in a Chapter 395, Chapter 400 Part II or Chapter 429 Part I facility (s. 400.462(1), F.S.). Direct employee has a specific meaning: withholding taxes are paid by the agency, by a management company under a day-to-day management contract, or by an employee leasing company handling payroll (s. 400.462(10), F.S.), so payroll evidence from any of the three works. An administrator may manage only one agency, 'except that an administrator may manage up to five home health agencies if all five home health agencies have identical controlling interests as defined in s. 408.803' (s. 400.476(1)(a), F.S.).

Alternate administrator. The administrator must 'Designate, in writing a direct employee or an individual covered under a management company contract to manage the home health agency or an employee leasing contract that provides the agency with full control over all operational duties and responsibilities' as the on-site alternate (Fla. Admin. Code R. 59A-8.0095(1)(a)2.). The rule also defines what the designation has to deliver: the alternate 'will be available during designated business hours, when the administrator is not available,' meaning 'readily available on the premises or by telecommunications,' and during the administrator's absence 'will have the responsibility and authority for the daily operation of the agency' (same subparagraph). Put both sentences in the written designation itself; the same availability standard applies to an alternate director of nursing under (2)(g). The statute makes the same point for each licensed entity: 'An administrator shall designate, in writing, for each licensed entity, a qualified alternate administrator to serve during the administrator's absence' (s. 400.476(1)(a), F.S.). As of 5/31/2026 the alternate must meet only s. 400.462(1) criteria, and one alternate 'may be the alternate administrator for up to five home health agencies if all five home health agencies have identical controlling interests as defined in s. 408.803' and sit in one geographic service area or an immediately contiguous county (Fla. Admin. Code R. 59A-8.0095(1)(a)3.).

Changes of administrator. 'If an agency changes administrator or alternate administrator, the agency shall notify AHCA as required in subsection 59A-35.110(1), F.A.C., by submitting the application forms referenced in subsection 59A-8.003(1), F.A.C.' (Fla. Admin. Code R. 59A-8.0095(1)(b)), and 'Level 2 background screening compliance is required pursuant to Section 408.809, F.S., and Rule 59A-35.090, F.A.C.' (same paragraph). Keeping proof of the submission is practice, not a stated rule duty, but AHCA's surveyor guidance for this paragraph instructs the surveyor to 'ask for documentation that Laboratory and In-home Unit was notified of the change' (AHCA ASPEN State Regulation Set H 8.07, guidance on Fla. Admin. Code R. 59A-8.0095(1)(b)), so keep the dated copy.

One caveat on that source, which this guide quotes again below. The version quoted here, H 8.07, effective August 17, 2026, prints the amended aide training paragraph, the September 2025 competency test and the multistate RN license language, but its reprint of paragraph (2)(h) still gives the pre-amendment form reference, 'subsection 59A-8.003(1), F.A.C.', where the 5/31/2026 rule says 'paragraph 59A-35.060(3)(k), F.A.C.' Use it for what a surveyor expects to see in a file, not for the text of the rule, and confirm with the Home Health Unit if its requirement text conflicts with the 5/31/2026 rule.

Administrator serving as director of nursing. An administrator who is a licensed physician, physician assistant or RN may also serve as director of nursing 'only if there are 10 or fewer full-time equivalent employees and contracted personnel in each home health agency' (s. 400.476(1)(b), F.S.); note the rule's own wording is stricter, 'less than a total of 10' (Fla. Admin. Code R. 59A-8.0095(2)(f)), so use the rule's threshold. There is also a tension the statutes do not resolve: s. 400.476(1)(b) says an administrator who is 'a licensed physician, physician assistant, or registered nurse' may also be the director of nursing, while the definition of director of nursing in s. 400.462(11), F.S. reaches only a registered nurse. Confirm with AHCA before relying on a non-RN administrator as director of nursing.

This section applies only if your agency provides skilled care (Fla. Admin. Code R. 59A-8.0095(2)(i)).

Qualifications. The director of nursing must meet the statutory definition: an RN who is a direct employee, 'who is a graduate of an approved school of nursing and is licensed in this state; who has at least 1 year of supervisory experience as a registered nurse' (s. 400.462(11), F.S.). Be aware the rule's cross-reference is stale: Fla. Admin. Code R. 59A-8.0095(2)(a)1. cites 'Sections 400.462(10) and 400.476(2), F.S.', and in the current statute subsection (10) is the direct employee definition while (11) is the director of nursing definition. The same stale reference appears in (2)(g) for the alternate director of nursing. Cite the statute, not the rule's number. AHCA's surveyor guidance says documentation for this position 'should consist of current state registered nursing license, job description, resume and/or employment application that includes evidence of one year of supervision as an RN, and a W-4 or Florida W-2 form' (AHCA ASPEN State Regulation Set H 8.07, guidance on the director of nursing qualifications, s. 400.462 and s. 400.476(2), F.S.); that is guidance, subject to the caveat above, and it is the clearest available statement of what a surveyor expects to find.

Changes and coverage. 'If an agency changes the director of nursing or alternate director of nursing, the agency shall notify AHCA as required in Section 400.476(2)(b), F.S., by submitting the application forms referenced in paragraph 59A-35.060(3)(k), F.A.C.' (Fla. Admin. Code R. 59A-8.0095(2)(h)); the form reference changed on 5/31/2026. The statutory deadlines are notice within 10 business days after termination of the director's services and notice of the new director's identity and qualifications 'within 10 days after the new director is hired' (s. 400.476(2)(b), F.S.), with no more than 30 calendar days of operation without a director of nursing. Where one director covers three to five commonly owned agencies, each agency must have 'a registered nurse who meets the qualifications of a director of nursing and who has a written delegation from the director of nursing to serve as the director of nursing' (s. 400.476(2)(a)2.c., F.S.). Where the director serves more than two licensed agencies, the rule requires a written designation of an alternate director of nursing with the same availability and authority terms as the alternate administrator (Fla. Admin. Code R. 59A-8.0095(2)(g)).

Evaluating nursing personnel. The director of nursing must 'Employ and evaluate nursing personnel' (Fla. Admin. Code R. 59A-8.0095(2)(c)2.). The rule sets no interval, so keep a dated evaluation for each nurse and let agency policy set the cycle. This duty is broader than the annual LPN evaluation under (4)(a) and is easy to miss because the rule states it in three words.

Agency-level duties the director of nursing owns. These are agency policies and records rather than personnel-file documents, but a surveyor will ask for them and they are the densest set of duties in the rule:

• Biomedical waste policies and procedures, established by the director of nursing, the administrator or the alternate administrator, for agencies providing nursing and physical therapy services (Fla. Admin. Code R. 59A-8.0095(2)(b)).
• Policies and procedures 'consistent with recommended Centers for Disease Control (CDC) and Occupational Safety and Health Agency (OSHA) guidelines for safety, universal precautions and infection control procedures' (59A-8.0095(2)(c)1.).
• Policies for, and records of, 'criteria for admission to service, case assignments and case management' (59A-8.0095(2)(c)4.).
• Policies and procedures for the delegation of nursing tasks and activities as specified in Chapter 64B9-14, F.A.C. (59A-8.0095(2)(c)5.).
• Supervision or management, directly or through qualified subordinates, of all personnel who provide direct patient care; assurance that professional standards of community nursing practice are maintained by all nurses providing care; and maintenance of and adherence to the agency procedure and patient care policy manuals (59A-8.0095(2)(a)2.-4.).
• An ongoing quality assurance program that includes 'at least quarterly, documentation of the review of the care and services of a sample of both active and closed clinical records by the director of nursing or his or her delegate' (59A-8.0095(2)(e)).

The certified report. On request from an AHCA employee the director of nursing must produce a certified report of services by a named staff person, and 'The report must be provided to the surveyor within two hours of the request, unless the time period requested is longer than one year, then the report must be provided within three hours of the request' (Fla. Admin. Code R. 59A-8.0095(2)(d)). AHCA may ask about any period up to two years back (s. 400.497(5)(b), F.S.). That deadline is why visit records need to be indexed by staff member, not only by patient.

If your agency is Medicare certified, the state file is the floor and the Conditions of Participation stack on top. The state rule acknowledges this only in passing: an aide seeking employment with a Medicare or Medicaid certified agency 'may be required to provide evidence of additional training incorporated within the Medicare Conditions for Participation, 42 C.F.R., Part 484' (Fla. Admin. Code R. 59A-8.0095(5)(d)). The binding federal text is 42 CFR 484.80.

• Qualification route. 'A qualified home health aide is a person who has successfully completed: (i) A training and competency evaluation program as specified in paragraphs (b) and (c) respectively of this section; or (ii) A competency evaluation program that meets the requirements of paragraph (c) of this section' (42 CFR 484.80(a)(1)), a state-approved nurse aide program with current good standing on the registry ((a)(1)(iii)), or a state licensure program meeting (b) and (c) ((a)(1)(iv)).
• Hours. On the training routes (42 CFR 484.80(a)(1)(i), (iv)), 'Classroom and supervised practical training must total at least 75 hours. (2) 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' (42 CFR 484.80(b)(1)-(2)), documented under (b)(4).
• Competency evaluation. '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)); it must be performed by a registered nurse. Florida allows an LPN under RN supervision to give the practical part of the AHCA test (Fla. Admin. Code R. 59A-8.0095(5)(i)2.), so for a certified agency have the RN sign.
• Do not rely on the AHCA test federally. AHCA's own Home Health Aides page states that 'The AHCA test does not meet this federal regulation' (AHCA, Home Health Aides); the page cites 42 CFR 484.36, the section number used before the current Conditions of Participation, and the aide provisions now sit at 42 CFR 484.80. A certified agency should not rely on the state test alone; hold evidence of one of the 42 CFR 484.80(a)(1) routes, such as a training and competency evaluation program, a competency evaluation program that meets paragraph (c), or a state-approved nurse aide program with current registry good standing (42 CFR 484.80(a)(1)). For a CNA on the registry route, filing an RN-signed competency evaluation as well is our recommendation, not a rule (42 CFR 484.80(a)(1)(iii), (c)).
• 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)). Rule 59A-8.0095 has no equivalent for aides; Florida CNAs have their own 24-month rule (s. 464.203(5), F.S.).
• 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)), supervised by an RN. Track both this and Florida's calendar-year requirement; the cycles are different.
• Leadership and clinicians. Administrators hired on or after January 13, 2018 must be 'a licensed physician, a registered nurse, or hold an undergraduate degree' with 'at least 1 year of supervisory or administrative experience in home health care or a related health care program' (42 CFR 484.115(a)(2)). The clinical manager must be 'a licensed physician, physical therapist, speech-language pathologist, occupational therapist, audiologist, social worker, or a registered nurse' (42 CFR 484.115(c)). Discipline standards for RNs, LPNs, therapists and social workers sit at 42 CFR 484.115(k), (e), (h)-(i), (f)-(g), (n) and (m), and 'all persons furnishing services to patients must be licensed, certified, or registered, as applicable, in accordance with the state licensing authority' (42 CFR 484.100(b)).
• Contractors and infection control. A party furnishing services under arrangement 'may not have been: (i) Denied Medicare or Medicaid enrollment; (ii) Been excluded or terminated from any federal health care program or Medicaid' (42 CFR 484.105(e)(2)), and the HHA must ensure contracted aides meet the training or competency requirements (42 CFR 484.80(h)(5)(iii)). 'The HHA must provide infection control education to staff, patients, and caregiver(s)' (42 CFR 484.70(c)). When the administrator is unavailable, 'a qualified, pre-designated person, who is authorized in writing by the administrator and the governing body, assumes the same responsibilities and obligations as the administrator' (42 CFR 484.105(b)(2)).
• Exclusion screening is not only an accreditation item. Federal law bars payment for services furnished by an excluded person: 'no payment will be made by Medicare ... Medicaid, or any other Federal health care program for any item or service furnished ... By an excluded individual or entity' (42 CFR 1001.1901(b)(1)), and civil money penalties reach a person who 'Arranges or contracts (by employment or otherwise) with an individual or entity that the person knows, or should know, is excluded' (42 CFR 1003.200(b)(4)). Rule 59A-8.0095 contains no exclusion-check requirement, but a certified agency should screen employees and contractors against the OIG List of Excluded Individuals and Entities and keep the dated result. Monthly rechecking is OIG guidance, not a regulation. Florida Medicaid's December 2023 provider agreement forms add a contract term: paragraph 5(r) of the MPA Non-Institutional and MPA Institutional forms requires a monthly search of the LEIE, SAM and AHCA's final order database for every employee and contractor, where that paragraph is in the agreement you signed, and the Provider General Handbook (July 2012) contains no exclusion screening duty. For what is required, what is only recommended, and how to set a frequency you can defend, see our guide on how often you have to check the OIG exclusion list.

If you hold ACHC, CHAP or Joint Commission accreditation, the file grows. None of these are Florida law, and AHCA cites against the rule and statutes, not against accreditation standards.

ACHC publishes a personnel file survey checklist. Some of its items appear nowhere in Rule 59A-8.0095 and have no counterpart anywhere else in Florida law: 'Evidence of initial and annual TB screening' (ACHC HH4-2C.01), 'Current driver's license and MVR check, if applicable' (ACHC HH4-2F.01), the OIG exclusion list check in ACHC HH4-2H.01, and 'Evidence of access to personnel policies' (ACHC HH4-2I.01). Note that the exclusion check is separately consequential for a Medicare or Medicaid agency, as set out in the section above.

Four further items appear nowhere in the rule text but do have Florida counterparts outside it, so do not strip them out of a file on the strength of this page. A 'Position application (N/A for contract staff)' and 'Dated and signed withholding statements' (ACHC HH4-1A.02), and a 'Signed job description or contract' (ACHC HH4-2E.01), map onto AHCA's own surveyor guidance for the director of nursing, which expects 'current state registered nursing license, job description, resume and/or employment application that includes evidence of one year of supervision as an RN, and a W-4 or Florida W-2 form' (AHCA ASPEN State Regulation Set H 8.07, guidance on the director of nursing qualifications, s. 400.462 and s. 400.476(2), F.S.); the withholding record is also how direct-employee status under s. 400.462(10), F.S. is proved for the administrator and the director of nursing. And the 'national sex offender registry check' in ACHC HH4-2H.01 is already inside the Level 2 investigation, which 'also includes a search of the sexual predator and sexual offender registries of any state in which the current or prospective employee resided during the immediate preceding 5 years' (s. 435.04(1)(a), F.S.). What ACHC adds on these four is the documented check for every employee, not the check itself, and Florida reaches only two positions and only through guidance and the incorporated statutory definitions.

ACHC also goes further than Florida on several items the state rule does touch. It requires that credentialing be 'conducted at the time of hire and prior to expiration of the credentials' with 'Evidence that licensed staff credentials have been verified and are current' (ACHC HH4-2B.01), where Florida requires only that each discipline be currently licensed (Fla. Admin. Code R. 59A-8.0095(3)(a), (4)(a), (6)-(11)) and that CNA certification be documented before services (59A-8.0095(5)(b)), without prescribing a verification method or interval. It requires 'Initial and annual competency assessment' (ACHC HH4-6A.01), where Florida's competency duties attach at hire: validation of an externally trained aide's competency (59A-8.0095(5)(j)) and an in-person skills demonstration (59A-8.0095(5)(c)), with no annual cycle. It requires an 'Initial and annual on-site observation visit' (ACHC HH4-7C.01), where Florida requires RN supervisory visits of unlicensed assistive personnel as needed, documented in the patient record (59A-8.0095(3)(c)-(d)). It requires a 'Most recent annual performance evaluation' for every employee (ACHC HH4-2J.01), where the only Florida evaluation duties are the director of nursing's duty to 'employ and evaluate nursing personnel,' which sets no interval (59A-8.0095(2)(c)2.), and the requirement that agency policy provide for annual RN evaluation of each LPN (59A-8.0095(4)(a)). And it requires annual education of 12 hours for direct-care personnel and 8 hours for non-direct-care personnel (ACHC HH4-8A.01), where Florida requires only that home health aides and CNAs 'receive in-service training each calendar year' (59A-8.0095(5)(k)), with no hour minimum and no requirement at all for non-direct-care staff. ACHC also recommends, rather than requires, that you 'Ensure personnel records have been audited and contain all required elements' each year (ACHC Annual Compliance Checklist [514]).

CHAP offers its standards free through a download form, so we do not quote them here; the current home health edition is Home Health Standards of Excellence v.5.2.0, effective March 23, 2026 (CHAP Standards Monitor). What CHAP publishes without a form is its home health policy list, dated July 2025, which ties personnel policies and hiring criteria to HRM.1, aide training and competency to HRM.10 and HRM.11, supervision of personnel to HRM.18, evaluation of personnel performance to HRM.22, the aide annual observation visit to HRM.23, and TB testing and screening to IPC.14. Confirm those numbers against the March 2026 edition before citing them.

The Joint Commission keeps its home care standards in a manual that is not public. Its 2021 sample staff competency policy for home health and hospice cites, as HR.01.06.01, EP 6, the requirement that 'Staff competence is assessed and documented once every three years, or more frequently as required by organization policy or in accordance with law and regulation', with competence first assessed during orientation (Joint Commission, PolicySource Home Care sample pages, first published April 2021). We could not confirm that the element of performance keeps that number in the 2026 manual; the Joint Commission's 2026 Standards FAQs file home care questions on competency and verification under the Human Resources (HR) chapter (for example FAQ 000001472, updated April 22, 2026). Confirm the number against your own current manual before citing it. That three-year interval is a maximum, and the EP itself defers to organization policy and to law and regulation. Florida imposes its competency duties at hire rather than on a cycle: validation of an externally trained aide's competency under Fla. Admin. Code R. 59A-8.0095(5)(j) and an in-person skills demonstration under (5)(c). It separately requires aide and CNA in-service every calendar year under (5)(k), which is training, not competency assessment. Medicare-certified agencies add 12 in-service hours per 12-month period under 42 CFR 484.80(d).

The federal Conditions of Participation these accreditors survey against for deemed status are set out file by file, for home health agencies and hospices, in the home health and hospice personnel file audit checklist.

Inspections are unannounced except as specified in s. 408.806 (s. 408.811(1)(a), F.S.). The generic relicensure interval in s. 408.811(1)(b), F.S. is biennial 'unless otherwise specified by authorizing statutes or applicable rules,' and for home health agencies the rule does specify otherwise: agencies 'will be surveyed prior to initial licensure, and at least every 36.9 months on an unannounced basis thereafter' (Fla. Admin. Code R. 59A-8.003(2)(a)). Follow-up surveys to verify correction may be conducted at any time, unannounced. During a survey, 'The agency shall have access to and the licensee shall provide, or if requested send, copies of all provider records required during an inspection or other review at no cost to the agency' (s. 408.811(3), F.S.). If the administrator, the director of nursing or the person authorized to give access to patient records is not on site when the surveyor arrives, that person or the designated alternate must be on the premises within an hour (Fla. Admin. Code R. 59A-8.003(9)(c)), and failure to be available 'will be grounds for denial or revocation of the agency license' (Fla. Admin. Code R. 59A-8.003(9)(e)).

Deficiencies must be corrected 'within 30 calendar days after the provider is notified of inspection results unless an alternative timeframe is required or approved by the agency' (s. 408.811(4), F.S.), and a required plan of correction is due within 10 calendar days (s. 408.811(5), F.S.).

Three things worth knowing about how personnel items surface:

• Administrator and alternate administrator. AHCA's surveyor guidance tells the surveyor, 'If a new administrator has been appointed since the last survey, ask for documentation that Laboratory and In-home Unit was notified of the change' (AHCA ASPEN State Regulation Set H 8.07, guidance on Fla. Admin. Code R. 59A-8.0095(1)(b)).
• Background screening documentation. The controlling requirement is Fla. Admin. Code R. 59A-35.090(3), which places the eligibility result and signed attestation in the personnel file. Requirement text printed on older AHCA inspection records reflects the pre-2024 10-business-day roster rule; the current statute is 5 business days (s. 435.12(2)(c)2., F.S.).
• Falsification is treated seriously. AHCA's surveyor guidance states that 'In addition to fines, falsification of training records could result in a finding of immediate jeopardy for a home health agency' (AHCA ASPEN State Regulation Set H 8.07, guidance on s. 400.474(3), F.S.), and s. 400.474(3), F.S. imposes a fine on an agency that demonstrates a pattern of falsifying aide or CNA training documents or staff health statements, with a pattern shown by at least three fraudulent entries or documents. Note the tension there: s. 400.474(3) penalizes falsified 'health statements for staff providing direct care to patients,' but no provision of Rule 59A-8.0095 or ch. 400, Part III requires such a statement in the first place. Where the duty exists it comes from Medicare's infection control condition, accreditation standards or your own policy. If your agency collects health statements, the falsification penalty reaches them. Whether AHCA expects one in a licensed-only agency's file is unresolved, so confirm it with the Home Health Unit. Never backdate a training record. If a record is missing, document the gap and remediate forward.

Tag numbers on AHCA's public inspection pages use a legacy numbering scheme that differs from the numbering in AHCA's surveyor regulation set, so identify requirements by rule citation rather than by tag number.

Florida's personnel rule sets no retention period for personnel records. Where retention exists, it comes from elsewhere:

• Bloodborne pathogens training records: 3 years from the training date (29 CFR 1910.1030(h)(2)(ii)).
• I-9 and supporting documents: 3 years after hire or 1 year after termination, whichever is later (8 CFR 274a.2(b)(2)(i)(A)); Florida separately requires the eligibility documentation the employee provided and any official E-Verify verification to be kept 'for at least 3 years' (s. 448.095(2)(d), F.S.), even though copying those documents is optional under federal law (8 CFR 274a.2(b)(3)).
• Inspection reports: at least 3 years, regardless of a change of ownership (s. 408.811(6)(a), F.S.).
• CNA in-service records: 4 years, but that duty runs to the certified nursing assistant personally, not to the agency (Fla. Admin. Code R. 64B9-15.011(6)).
• Per-staff service data: no stated retention, but AHCA may request a certified report covering 'a period not to exceed 2 years prior to the date of the request' (s. 400.497(5)(b), F.S.), which is a practical floor for visit records tied to each staff member.

A few organizing habits that pay off at survey. Keep the file retrievable and printable as one document, because a surveyor asks for a named person's file and reads it in order. Segregate documents containing Social Security numbers, including the agency-issued 'Home Health Aide Training Documentation' required by Fla. Admin. Code R. 59A-8.0095(5)(h) and the test-passage documentation described in Fla. Admin. Code R. 59A-8.0095(5)(i)3., behind access controls. Index the patient-record documents that prove personnel duties, including RN supervisory visits, LPN supervisory visits and medication-assistance consents, so you can produce them per staff member rather than per patient. Store I-9s separately from the rest of the file so an immigration inspection does not expose everything else; that is common practice, not a rule. Finally, track dated items by expiration, not by hire date: licenses, CPR cards, the retained-prints date and the calendar-year in-service each run on their own clock.