The Florida Agency for Health Care Administration (AHCA) has published proposed revisions to Rule 59A-8.0248, Florida Administrative Code, governing the state’s Excellence in Home Health Award program.

The proposed rule represents the first major overhaul of the program since its creation and implements changes required by House Bill 1353 (Chapter 2025-127, Laws of Florida), landmark legislation championed by HCAF and signed into law by Governor Ron DeSantis in 2025.

The Excellence in Home Health Award was originally intended to recognize high-performing home health agencies demonstrating strong quality outcomes, workforce stability, patient satisfaction, and compliance histories. However, in the nearly three years since the program was established, not a single Florida home health agency has successfully obtained the designation.

Providers across the industry consistently raised concerns that the program’s criteria and scoring methodology were overly burdensome, operationally impractical, and heavily weighted toward skilled providers, leaving many non-skilled (non-medical) agencies effectively excluded from meaningful participation.

Those concerns ultimately led HCAF to pursue legislative changes during the 2025 Session requiring AHCA to modernize the program and establish standards better aligned with the realities of Florida’s diverse home care industry, including varying payer mixes, service models, patient populations, and operational structures.

According to AHCA, the proposed amendments are intended “to update standards and criteria adaptable to all types of home health agencies.”

HCAF has formally requested a rule workshop to ensure providers and stakeholders have an opportunity to review the proposed criteria, ask questions, and provide feedback before the rule is finalized.

What the Proposed Rule Would Change

The revisions would significantly restructure the program by creating separate quality standards for skilled and non-skilled home health agencies while placing greater emphasis on workforce development, innovation, operational quality, and patient or client satisfaction.

Agencies would continue applying through AHCA Form 3110-9002 and would need to demonstrate compliance with standards related to:

• Continuous Quality Improvement (CQI)
• Workforce stability
• Employee development and retention
• Patient and client satisfaction
• Innovation in care delivery
• Inspection history
• Data-driven quality monitoring

Skilled Home Health Agency Criteria

For agencies providing skilled care services, the proposed rule establishes a “Service Excellence” framework focused on clinical quality outcomes and adverse event reduction.

These agencies would be required to maintain evidence-based quality assurance programs focused on reducing preventable emergency care, hospital admissions and readmissions, and adverse events.

The rule defines adverse events broadly to include incidents such as death, brain or spinal damage, permanent disfigurement, fractures, neurological impairment, or events reported to law enforcement.

Applicants would also need to submit a written summary of adverse events from the prior 12 months, including unplanned emergency department visits and hospitalizations, along with documentation demonstrating proactive monitoring and corrective action efforts.

Non-Skilled Home Health Agency Criteria

One of the most significant changes is the creation of distinct award standards for agencies providing only non-skilled services.

Rather than relying primarily on hospital-based or clinical outcome measures, the proposed criteria for non-skilled agencies focus on improvement in activities of daily living (ADLs), quality of personal care services, emotional wellness and caregiver engagement, and overall client well-being.

The criteria specifically reference caregiver support for emotional wellness through active listening, stress management, and social engagement.

Non-skilled agencies would also need to demonstrate data-driven quality monitoring through internal audits, caregiver performance evaluations, quality improvement goals, and staff training initiatives.

Workforce Stability & Employee Development

The proposed rule continues to place substantial emphasis on workforce stability and retention.

Applicants would need to demonstrate either a turnover rate no greater than 50% or at least 50% of staff employed for more than one year.

Agencies must also provide evidence of recruitment and retention efforts, employee in-service training programs, and employee satisfaction processes.

Patient & Client Satisfaction Standards

The proposed rule would formally establish satisfaction thresholds for participating agencies.

Applicants must demonstrate processes measuring willingness to recommend the agency and satisfaction with communication and interaction. To qualify, agencies must achieve an average satisfaction rate of at least 80% for both communication and recommendation metrics.

Innovation in Care Delivery

Another notable addition is a new “Innovation in Care Delivery” component designed to recognize agencies implementing modernized care strategies and technologies.

Examples identified in the proposed rule include:

• Telehealth
• Artificial intelligence (AI)
• Remote patient monitoring
• Robotics
• Personalized preventative care models
• Specialized caregiver training programs

According to AHCA, these innovations should improve outcomes, reduce preventable hospitalizations and emergency care, improve convenience, and better tailor services to individual needs.

New Inspection Score Methodology

The proposed rule would establish a new inspection-based scoring methodology for the Excellence in Home Health Award program.

Under the proposal, agencies would be required to achieve a “Service Excellence” inspection score of 50 points or less to qualify for the designation. The score would be calculated by dividing the agency’s total inspection score by the number of inspections conducted during a 40-month review period.

The proposed rule also establishes updated disqualification standards for agencies receiving certain deficiencies or failing to maintain award criteria.

According to AHCA, additional scoring methodology details are available through the agency’s Excellence in Home Health methodology webpage.

Rule Workshop & Stakeholder Participation

AHCA has scheduled a rule hearing for Tuesday, June 16, 2026, from 2:00 PM to 3:00 PM ET.

HCAF strongly encourages both skilled and non-skilled providers to carefully review the proposed rule and participate in the rulemaking process to help ensure the final program is operationally realistic, appropriately tailored across provider types, and reflective of Florida’s full home care continuum.

In-Person:

Agency for Health Care Administration
2727 Mahan Drive
Building 2, Conference Room F
Tallahassee, FL 32308

Virtual Participation:

• Conference Line: (850) 792-4898
• Conference Code: 499 504 446#

Advocacy in Action — and What Comes Next

This achievement underscores the impact of a unified home care voice in Tallahassee. HCAF’s ability to secure and implement meaningful policy reforms is driven by the engagement of its members and the support of the Home Care Political Action Committee (PAC).

With the 2026 elections approaching and the 2027 Legislative Session on the horizon, HCAF will continue advocating for reforms that reduce administrative burdens, strengthen the workforce pipeline, and support sustainable, high-quality care in the home.

This victory demonstrates what coordinated advocacy can accomplish — but continued progress depends on maintaining a strong presence at the Capitol.

To help support future legislative and regulatory victories, providers are encouraged to contribute to the Home Care PAC.

Click here to contribute today!