Limited Nursing Services License

A Limited Nursing Services (LNS) License is a specialty license that enables a facility to provide a select number of nursing services.

Residents of facilities licensed to provide LNS services are required to meet the standard ALF admission criteria. However, in addition to the nursing services permitted in standard license, facilities holding a LNS license may provide, directly or through contract, the following limited nursing services:

• Conducting passive range of motion exercises
• Applying ice caps or collars
• Applying heat, including dry heat, hot water bottle, heating pad, aquathermia, moist heat, hot compresses, sitz bath and hot soaks
• Cutting the toenails of diabetic residents or residents with a documented circulatory problem if the written approval of the resident's health care provider has been obtained
• Performing ear and eye irrigations
• Conducting a urine dipstick test
• Replacement of an established self-maintained indwelling urinary catheter, or performance of an intermittent urinary catheterizations
• Performing digital stool removal therapies
• Applying and changing routine dressings that do not require packing or irrigation, but are for abrasions, skin tears and closed surgical wounds
• Care for stage 2 pressure sores. Care for stage 3 or 4 pressure sores are not permitted under this rule
• Caring for casts, braces and splints. Care for head braces, such as a halo is not permitted under this rule
• Conduct nursing assessments if conducted by a registered nurse or under the direct supervision of a registered nurse
• For hospice patients, providing any nursing service permitted within the scope of the nurse's license including 24-hour nursing supervision.

In order for limited nursing services to be provided in an ALF, the AHCA Assisted Living Unit must first determine that all requirements established in law and rule are met and must specifically designate, on the facility's license, that such services may be provided. New facilities may make apply for an LNS license at the time of initial application.

Existing facilities qualifying to provide limited nursing services shall have maintained a standard license and may not have been subject to administrative sanctions that affect the health, safety, and welfare of residents for the previous 2 years or since initial licensure if the facility has been licensed for less than 2 years.

LNS Licensing Fees

In addition to the total fee assessed under paragraph (a), AHCA shall require facilities that are licensed to provide limited nursing services under this part to pay an additional fee per licensed facility. The amount of the LNS biennial fee shall be $250 per license, with an additional fee of $10 per resident based on the total licensed resident capacity of the facility. No part of this fee shall be returned to the facility. The agency may adjust the per bed license fee and the biennial license fee once each year by not more than the average rate of inflation for the 12 months immediately preceding the increase

NOTE: The agency may adjust the per bed and the total licensure fee annually based on the change in the consumer price index.