Provider Name: SUNSHINE STATE MEDICAL INC
Provider Type: Health Care Clinic
Inspection Data from January 1, 2008 to present
Export Results


Survey DateInspection TypeTrack IDDeficiencyRequirement DescriptionCorrection Date
12/09/2019StandardCIXJNoneNoneNoneNone
08/24/2017StandardH4NHNoneNoneNoneNone
12/29/2015StandardZ4ZRU0175LEVEL 2 BACKGROUND SCREENING REQUIRED400.991(5), F.S. (a) As used in this subsection, the term "applicant" means individuals owning or controlling, directly or indirectly, 5 percent or more of an interest in a clinic; the medical or clinic director, or a similarly titled person who is responsible for the day-to-day operation of the licensed clinic; the financial officer or similarly titled individual who is responsible for the financial operation of the clinic; and licensed health care practitioners at the clinic. (b) The agency shall require level 2 background screening for applicants and personnel as required in s. 408.809(1)(e) pursuant to chapter 435 and s. 408.809. 01/27/2016
12/29/2015StandardZ4ZRU0304MEDICAL DIRECTOR; ON SITE FOR SURVEY59A-33.012(2), F.A.C. (2) The medical or clinic director must attend the survey entrance conference and be available when the survey is conducted for the surveyor to determine compliance with minimum standards and requirements for licensure. Other key personnel required include the financial director, a representative of management or ownership and persons responsible for patient records and billing. 01/27/2016
12/29/2015StandardZ4ZRU0307CLINIC RESPONSIBILITIES-ORGANIZATIONAL CHART59A-33.012, F.A.C. (3) To facilitate a licensure survey, the health care clinic shall have the following materials readily available for review at the time of the survey: (p) An organizational flow chart with lines of authority and names of key individuals and positions; 01/27/2016
12/29/2015StandardZ4ZRU0308CLINIC RESPONSIBLITIES-LOG OF LEVEL 2 BKGD CK59A-33.012, F.A.C. (3) To facilitate a licensure survey, the health care clinic shall have the following materials readily available for review at the time of the survey: (r) Log of all natural persons required and who have been screened under Level 2 criteria of Chapter 435 and Section 400.991, F.S.; 01/27/2016
12/29/2015StandardZ4ZRU0311CLINIC RESPONSIBILITIES-STAFF OPERATIONS59A-33.012, F.A.C. (3) To facilitate a licensure survey, the health care clinic shall have the following materials readily available for review at the time of the survey: (c) Written policies, protocols, guidelines and procedures used or to be used by the facility staff in day-to-day operations. This includes protocols for physician assistants and advanced registered nurse practitioners plus a copy of the supervision form submitted to the Department of Health by the physician supervisor 01/27/2016
12/29/2015StandardZ4ZRU0319CLINIC RESPONSIBILITIES - PERSONNEL FILE59A-33.012(3) To facilitate a licensure survey, the health care clinic shall have the following materials readily available for review at the time of the survey: (h) Personnel files; 01/27/2016
12/29/2015StandardZ4ZRU0326CLINIC RESPONSIBILITIES-CLINIC RECORDS SYSTEM59A-33.012, F.A.C. (3) To facilitate a licensure survey, the health care clinic shall have the following materials readily available for review at the time of the survey: (d) Any policies, procedures, guidelines, checklists and/or means that are used in the systematic creation and maintenance of the health care clinic's medical record system; 01/27/2016
12/29/2015StandardZ4ZRU0330CLINIC RESP-RECORDS, SURGERY, ADV INCIDENTS400.9935, F.S. (1) The medical director or the clinic director shall: (f) Ensure compliance with the recordkeeping, office surgery, and adverse incident reporting requirements of chapter 456, the respective practice acts, and rules adopted under this part and part II of chapter 408. 59A-33.012, F.A.C. (3) To facilitate a licensure survey, the health care clinic shall have the following materials readily available for review at the time of the survey: (e) Any policies, procedures, guidelines, checklists that demonstrate compliance with the medical records retention, disposition, reproduction, and disclosure requirements of the medical or clinic director's practice act; (f) Any policies, procedures, guidelines, checklists that demonstrate compliance with the office surgery requirements of the practice acts for services performed at the facility; (g) Any policies, procedures, guidelines, checklists that demonstrate compliance with adverse incident reporting requirements and injury disclosure; 01/27/2016
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