Florida’s revised Excellence in Home Health Award program (Rule 59G-8.0248) will take effect October 12, 2026, establishing updated recognition criteria for skilled and non-skilled home health agencies. The final rule addresses service quality, workforce stability, patient and client satisfaction, innovation, and inspection history. View the final rule and official rulemaking record.

The changes follow advocacy by HCAF to make the program more practical and inclusive of Florida’s diverse home health providers. They implement reforms enacted through House Bill 1353 in 2025 and reflect several recommendations HCAF submitted during rulemaking.

From Legislative Reform to Final Adoption

HCAF championed House Bill 1353 to modernize the award program alongside broader home health operational reforms. Signed into law in June 2025, the legislation directed the Agency for Health Care Administration (AHCA) to develop standards adaptable to agencies regardless of payer type, patient population, or service designation.

As HCAF reported during the legislative and rulemaking process, the original framework had not produced an award recipient and relied heavily on clinical measures that did not fit many providers, particularly agencies offering only non-skilled services.

HCAF’s June 2026 formal comments, informed by member feedback, recommended clearer standards, less duplicative documentation, broader recognition of innovation, and greater transparency in inspection scoring.

The final rule incorporates several provisions consistent with those recommendations:

• Broader Evidence-Based Practice Documentation: Agencies may demonstrate their practices through policies and procedures, quality assurance and performance improvement activities, nationally recognized best practices, staff training, and other documented improvement initiatives.
• Innovation Beyond Advanced Technology: Caregiver training programs and operational improvements are expressly included alongside tools such as telehealth, artificial intelligence, and remote monitoring.
• Service-Specific Quality Criteria: Skilled and non-skilled agencies have distinct standards appropriate to the services they provide.

Some recommendations were not fully adopted. Skilled agencies must still submit written adverse event summaries; employee satisfaction processes must include a survey; and emotional wellness remains part of the non-skilled quality criteria. The final rule also references an online inspection scoring methodology, which agencies should review when preparing an application.

Who is Eligible?

Under Section 400.52, Florida Statutes, applicants must have been actively licensed and operating for at least 24 months. During the preceding 24 months, they must have had no licensure denials, revocations, Class I or Class II deficiencies, or uncorrected Class III deficiencies.

Eligible agencies must also document compliance with the rule’s award criteria. Meeting basic licensure requirements alone does not establish eligibility for the designation.

What Agencies Must Demonstrate

Service Excellence

Skilled agencies must maintain a quality assurance program that evaluates at least three quality indicators addressing care delivery, services, and operations, with a focus on improving outcomes and reducing unplanned emergency visits and hospitalizations.

Applicants must demonstrate evidence-based practices addressing preventable adverse events and submit a written summary covering the previous 12 months, including unplanned emergency department visits and hospitalizations. Documentation must show a proactive monitoring, investigation, and action process.

Agencies providing only non-skilled services must also evaluate at least three quality indicators, focused on personal care delivery, services, and operations. Their documentation must address daily living support, personal care quality, emotional wellness, and overall client well-being.

Non-skilled applicants must provide evidence from the previous 12 months, including data-driven monitoring and goals, internal audits of documentation and caregiver performance, and staff training on best practices.

Workforce Stability and Development

Agencies must document targeted employee inservice training, an employee satisfaction process that includes a survey, and an effective recruitment and retention program.

Applicants must meet one of two workforce benchmarks:

• A turnover rate no greater than 50% under the rule’s calculation requirements; or
• A stability rate of at least 50%, demonstrating the required level of staff tenure.

The rule’s turnover provision references a 12-month measurement period while describing a quarterly calculation. Agencies using this pathway should obtain AHCA clarification on the calculation before submitting an application.

Patient or Client Satisfaction

Agencies must use surveys to measure communication and interaction with patients, clients, or their representatives, as well as willingness to recommend the agency to family and friends.

Applicants must demonstrate an average satisfaction rate of at least 80% for communication and willingness to recommend.

Innovation in Care Delivery

Applicants must document innovative strategies developed and implemented within the previous 12 months. Examples include technology, personalized care models, caregiver education, and operational improvements.

These strategies must address improved patient or client experiences and outcomes, reduced preventable emergency care or hospitalizations, and training tailored to individual care needs.

Inspection History

Applicants must achieve a Service Excellence Inspection Score of 50 points or less, calculated using the total score divided by the number of inspections within a 40-month window.

Accredited agencies must submit accreditation survey reports from the previous 40 months, including applicable licensure and complaint inspections, plans of correction, and follow-up reports.

The rule directs providers to AHCA’s Excellence in Home Health Methodology. Questions about scoring may be sent to HQAHomeHealth@ahca.myflorida.com.

Application Deadlines and Renewal

Agencies must use the updated Application for Excellence in Home Health Award, AHCA Form 3110-9002, April 2026. Access the application.

The rule establishes two annual initial application cycles:

• March 15 Deadline: Reviews conclude by May 15, with decisions issued no later than June 15.
• September 15 Deadline: Reviews conclude by November 15, with decisions issued no later than December 15.

Because the revised rule takes effect after this year’s September deadline, the next regularly scheduled initial application deadline is March 15, 2027. Agencies should confirm any transition instructions with AHCA.

If AHCA requests missing information, applicants have 21 days to respond before the application is deemed incomplete and withdrawn from consideration.

The award expires with the agency’s license. Renewal applications must accompany the agency’s license renewal application, and all relicensure requirements must be satisfied before the designation is issued.

Maintaining and Using the Designation

Award recipients may use the designation in advertising and marketing for the awarded licensee, with the award’s effective and expiration dates displayed. The rule requires removal from marketing materials within 90 days after termination or expiration, subject to statutory restrictions on use.

Agencies must maintain eligibility. Class I or Class II deficiencies, or reissued citations for uncorrected Class III, Class IV, or unclassified deficiencies, can result in revocation. Correcting a disqualifying event does not automatically reinstate the award.

Preparing to Apply

The revised program creates a more relevant pathway for recognizing excellence across skilled and non-skilled home health agencies — a central goal of HCAF’s legislative advocacy.

Agencies interested in applying should begin reviewing their quality indicators, workforce records, satisfaction results, innovation initiatives, and inspection history. Many criteria require a documented track record, making early preparation important.

For questions about the final rule or implementation concerns, contact Kyle Simon, Senior Director of Policy, Advocacy & Communications, at ksimon@homecarefla.org.