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Laws and Rules: Florida Respiratory Care Board

2 Contact Hours
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This peer reviewed course is applicable for the following professions:
Respiratory Care Practitioner, Respiratory Therapist (RT)
This course will be updated or discontinued on or before Friday, April 30, 2027

Nationally Accredited

CEUFast, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. ANCC Provider number #P0274.


Outcomes

≥ 92% of participants will know the current rules and laws for respiratory therapists in Florida.

Objectives

After completing this course, the learner will be able to:

  1. Recognize appropriate information sources for Florida's respiratory therapist rules and laws.
  2. Define the respiratory therapist’s scope of practice in Florida.
  3. Apply current licensing and renewal requirements for respiratory therapists in Florida.
  4. Outline the services provided by respiratory therapists in Florida.
  5. Apply principles of ethics as they relate to a respiratory therapist’s care of patients in Florida.
  6. Summarize possible violations that may be grounds for disciplinary action in Florida.
CEUFast Inc. and the course planners for this educational activity do not have any relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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Laws and Rules: Florida Respiratory Care Board
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To earn a certificate of completion you have one of two options:
  1. Take test and pass with a score of at least 80%
  2. Attest that you have read and learned all the course materials.
    (NOTE: Some approval agencies and organizations require you to take a test and "No Test" is NOT an option.)
Author:    Brittane Strahan (MSN, RN, CCRP)

Introduction

Respiratory therapy is one of the more recent additions to the allied health fields. The first recorded respiratory therapy program was initiated in 1943 by Edwin Levine at the Michael Reese Hospital in Chicago. A far cry from today’s highly regulated respiratory programs, devices, and professionals, Levine’s team paved the way for establishing the discipline. As the 20th and 21st centuries have rolled on, training has become more specialized and regulated, devices have become smaller, more specific, and more capable of delivering required respiratory treatments, and professionals are more highly skilled and competent (AARC, n.d.a).

The regulatory bodies have evolved with the profession. In the 1950s, standards for educational programs were outlined. Two years later, the American Medical Association authorized the creation of respiratory therapy programs based on those criteria. In 1960, the first exam was instituted to formally credential respiratory therapists (RTs). Several years later, the Board of Schools of Inhalation Therapy Technicians was formed, and shortly after, a technician certification examination was established for those who were ineligible to take the registration exam. In 1974, the two credentialing programs were combined into a single National Board of Respiratory Therapy. Twelve years later, the American Association for Respiratory Care (AARC) was renamed from the previously existing American Association for Respiratory Therapy. The same year, the National Board of Respiratory Therapy was renamed to the National Board for Respiratory Care (NRBC) (AARC, n.d.a).

The first clinical practice guidelines in respiratory therapy were developed in 1990. Sixteen years later, in 2006, the AARC established a benchmarking program to support evidence-based care in respiratory therapy. In 2009, the AARC initiated the asthma self-management education certification program, and several years later (2013), the adult critical care course was established to train therapists who wanted to receive the newly created adult critical care specialist credential. Finally, in 2016, a goal was instituted that 80% of licensed respiratory professionals should have completed at least a bachelor’s degree by 2020, and all new programs must offer a minimum of a bachelor’s degree. In 2017, the AARC celebrated 70 years since its creation (AARC, n.d.a).

In Florida, specifically, the AARC authorized the Florida Society of Respiratory Care in 1975 (Florida Society for Respiratory Care, n.d.a). At this point, respiratory therapy was a recognized and licensed discipline in the state of Florida. Since then, the profession has continued to grow and evolve with the advancement of the field.

Respiratory Practice Act

The Respiratory Practice Act in Florida, most recently updated in March of 2023, is a comprehensive guidebook for legal and practice expectations of certified, registered, and/or licensed therapists. The Respiratory Practice Act, or “rules and laws,” can be found at the Florida Board of Respiratory Care website (Link) (Florida BORC, 2023). This comprehensive guidance provides a thorough overview of the statutes passed by the Florida State Legislature and the rules and regulations passed by the Florida Board of Respiratory Care (BORC). Rules and regulations, which are administrative laws, clarify the statutes in the practice of respiratory care (Florida BORC, 2023).

The Laws and Rules grant the authority to regulate respiratory care applicants and licensure, provide broad statements of duties, and specify how board members are appointed. A respiratory therapist’s practice is directly affected by the ability to make informed decisions within the parameters of laws and rules. Rules need to be well-known, understood, and applied consistently in practice.

photo of florida respiratory care board website

While the numerical layout of the statutes, rules, and regulations may seem complicated, it is not important to know the specific number of the statute or rule. The document is easily searchable online and has clear section headings. The rules are listed under codes beginning with 468, and the Florida statutes are listed under Title XXXII and Chapter 456. The statutes in chapter 456 cover all healthcare providers in Florida (Florida BORC, 2023; Hardt, 2020).

Check the website regularly to keep up with any changes or additions that will affect your practice. Also, ensure your contact information is up-to-date; otherwise, the license renewal notice will go to the wrong address.

According to the landing page for the BORC, they were formed to ensure that RTs in Florida are licensed and meet the minimum standards for safe practice. Licensure is a requirement to protect the people of Florida and ensure safe respiratory care. You cannot call yourself an RT or practice in the state of Florida without a license (Florida BORC, n.d.a). The BORC also disciplines and rehabilitates respiratory practitioners in Florida if warranted (Florida BORC, n.d.a).

Additional information and insight into the Laws and Rules for Florida’s RTs can be obtained on the Florida Society for Respiratory Care (Link) (Florida Society for Respiratory Care, n.d.b).

Purpose

The purpose of the laws and statutes documentation is to ensure that RTs are appropriately trained, credentialed, and safe practitioners. To qualify as an RT, an individual must receive the appropriate educational training (preferably a bachelor’s degree in an approved and accredited program), become certified and/or registered (via mandatory testing), and finally licensed. The statutes and guidelines are set forth to eliminate any burden on the patient to determine if their RT is appropriately skilled and competent to perform their duties. Under no circumstances is the licensed RT authorized to practice medicine (Florida BORC, 2023).

A third purpose of the rules and laws legislation is to regulate the collection and analysis of blood gas laboratories. Those collecting and analyzing the results, leading to potential changes in the patient care plan, must be appropriately supervised by a physician (Florida BORC, 2023).

According to the U.S. Bureau of Labor Statistics, respiratory therapists can care for patients with respiratory problems at any stage of the lifespan. However, they may take care of a more targeted population depending on their employment. Likewise, not only may they care for patients of different ages, but care may be given in different environments, including intensive care units (adult and pediatric), emergency rooms, clinics, or skilled nursing facilities (U.S. Bureau of Labor Statistics, 2024).

Definitions and Services

As defined in the Laws and Rules document, the following definitions apply: (Florida BORC, 2023)

  • “Board” - Board of Respiratory Care (BORC)
  • “Certified respiratory therapist” - a licensed RT who has been certified by the National Board of Respiratory Care and is employed to provide respiratory care under physician orders; functions in unsupervised patient care situations where individual clinical judgement is required
  • “Critical care” - provides care in life-threatening emergencies
  • “Department” - Department of Health
  • “Direct supervision” - delivers care under a licensed, registered, or certified respiratory therapist who is present and available in the patient-care location
  • “Physician supervision” - care is supervised and authorized by a licensed physician who is readily accessible to the RT
  • “Practice of respiratory care” or “respiratory therapy” - allied health specialty of the cardiopulmonary system practiced under the supervision of a licensed physician according to the specific institution’s policies, procedures, and protocols (including: assessment, diagnostic evaluations, treatments, management, control, rehabilitation, education, and care for patients requiring respiratory therapy services)
  • “Registered respiratory therapist” - a licensed RT who has been registered by the National Board of Respiratory Care and is employed to provide respiratory care under physician orders; functions in unsupervised patient care situations where individual clinical judgement is required
  • “Respiratory care practitioner” - a licensed practitioner employed to deliver respiratory care services under physician supervision
  • “Respiratory care services” include:
    • Evaluation of disease and delivery of care to manage an individual’s respiratory disease
    • Diagnostic and therapeutic use of respiratory interventions, including equipment, devices, or medical gas
    • Medication administration and/or procedures as ordered and authorized by a licensed and supervising physician and in accordance with institutional procedures and policies
      • Recent research has indicated that RTs are aptly placed to evaluate institutional policies and procedures that may not correlate with AARC clinical practice guidelines. In some cases, the “de-implementation” process of removing unnecessary procedures and medications can decrease healthcare burden related to short staffing or resource utilization (Miller et al., 2023)
      • RTs should never administer medications without a physician's order (AARC, n.d.b)
      • Medications may include oxygen, aerosol therapy (with or without pharmacologic agents including: corticosteroids, bronchodilators, antibiotics, theophylline, and other respiratory stimulants, mucolytics, and saline nebulizers), humidified air (AARC, n.d.b; Kerstens et al., 2019)
    • Initiation and continued management of ventilators and other respiratory support devices
    • Diagnostic procedures, research, and therapeutic treatments and procedures, including: management of ventilatory device settings (volume, pressure, and flow), blood gas collection and analysis, pulmonary function testing, and other specified monitoring of cardiopulmonary function
    • Cardiopulmonary rehabilitation
    • Cardiopulmonary resuscitation, advanced cardiac life support (adult and pediatric), and neonatal resuscitation
    • Insertion and maintenance of artificial airways and intravascular catheters
    • Education of patients, families, healthcare providers, and community members regarding disease management and smoking cessation or preventionf patients, families, healthcare providers, and community members regarding disease management and smoking cessation or prevention
      • Recent research suggests that RT-driven education and protocols for the management of patients in a primary care setting can be beneficial to the patient and caregiver as well as the healthcare system (Baker, 2023)
    • Initiation and management of hyperbaric oxygen therapies (Florida BORC, 2023, pp. 2-3)

All procedures, treatments, and other professional services must be carried out under the oversight of a physician (AARC, n.d.b).

Board of Respiratory Care

The BORC is in charge of establishing the minimum parameters for professionals certified, registered, and/or licensed to deliver respiratory care services. The BORC also has the power to take disciplinary action. In disciplinary cases, the BORC can call witnesses and take testimony. Finally, the Board oversees the review of academic programs accredited for training RTs (Florida BORC, 2023, p.3).

The Governor appoints, and the Senate approves, the seven BORC members. Membership includes (Florida BORC, 2023, pp. 3-4):

  1. A registered respiratory therapist
  2. A certified respiratory therapist
  3. A respiratory care professional from each of the following areas:
    1. Respiratory care education
    2. Respiratory care management and supervision
    3. Homecare/subacute
  4. Two consumer members, who are residents of this state and have never been licensed as health care practitioners

Each respiratory care professional on the Board must have been actively engaged in delivering respiratory care services in Florida for at least four consecutive years before appointment. The term is limited to four years, and there is a two-term (consecutive) limit. To prevent too many vacancies at one time, the terms will be staggered over two, three, and four-year terms. The BORC will meet at least twice a year and can schedule additional meetings as needed. Ethical guidelines for the profession are at the discretion of the BORC (Florida BORC, 2023, pp. 3-4).

Licensure

As with other healthcare fields, clinical practice requires a license. There are different parameters to obtain an initial license, maintain a current license, or reinstate a lapsed or expired license. To be licensed, the RT must be actively “certified” or “registered.” Licensure by endorsement occurs for a credentialed or registered RT after evidence of credentialing has been verified, under oath, by the BORC.

Only licensed persons have the right to use the following title (Florida BORC, 2023, pp. 4-5):

  • "Respiratory Care Practitioner" and the abbreviation "RCP"
  • "Registered Respiratory Therapist" and the abbreviation "RRT"
  • "Certified Respiratory Therapist" and the abbreviation "CRT"

No individual shall use these titles or provide respiratory care services without a license.

Therapists licensed or credentialed in another state or country may petition the BORC to consider their licensure and other criteria to be acceptable per Florida’s standards and thereby obtain their Florida license by endorsement (Florida BORC, 2023, p. 4). Just as important to know when considering becoming licensed in Florida after holding a license from another state or country is that the scope of practice laws vary between states. Therefore, it is critical to know and operate within your current scope (AARC, n.d.b).

In certain situations, the RT may be able to practice beyond the normal scope. This is possible when the licensed RT obtains further credentialing offered by the AARC. This specific credential is the “advanced practice respiratory therapist” or APRT. Similar to other advanced practice providers, the RT is able to function at a higher level while still working under physician supervision (Varekojis et al., 2021). Without this additional credentialing, an RT should not exceed the state scope of practice act.

Reactivating a lapsed or retired license requires additional steps. Specific instructions and licensure requirements are available here(Florida BORC, n.d.a).

For those who have not practiced in the preceding two years, a BORC-approved comprehensive review course must be completed before applying for a license or recredentialing. This step ensures that the practitioner is capable of performing the necessary skills to care for patients safely. This BORC-approved comprehensive course must include the following:

  • 3 hours- patient assessment
  • 2 hours- hemodynamics
  • 1 hour- pulmonary function
  • 1 hour- arterial blood gases
  • 2 hours- respiratory equipment
  • 1 hour- airway care
  • 2 hours- mechanical ventilation
  • 1 hour- emergency care/ special procedures
  • 1 hour- general respiratory care (including medications) (Florida BORC, n.d.a)

Initial

Initial licensure can be obtained after passing both of the NBRC exams. These include the multiple-choice examination, which grants certification, and the clinical simulation exam, which leads to registration. Florida law stipulates that the initial application must be reviewed within 30 days, but the turnaround time is usually much shorter (Florida BORC, n.d.a).

According to the Florida BORC website, the following list summarizes the complete process for obtaining a license to practice as an RT in Florida (Florida BORC, n.d.a).

  • Request that an official letter of verification from the NBRC be sent directly to the BORC.
  • Request license verification(s) from all states in which you have ever held a license, if applicable. The verification must be sent directly to the BORC. There may be a fee to send the license from one licensing board to another.
  • Complete your Florida application online here.
  • If applicants have any affirmative answers in the Criminal, Personal, or Disciplinary sections of the application, submission of the personal statement and supporting documentation can be emailed or faxed to the board office. This documentation is reviewed to determine if a personal appearance at a board meeting is required.

Renewal

License renewal is required every two years to ensure that RTs are competent and proficient in delivering up-to-date and evidence-based care. To maintain licensure, RT professionals must keep a current address on file with the BORC, keep up to date on their continuing education, and submit the required application and fee (Florida BORC, 2023, p. 5).

The applicant's current address must be on file with the BORC to ensure that the renewal notice is received. If an applicant does not renew their active or inactive license by the deadline, it will be marked as delinquent. In the case of a delinquent license, failure to renew by the deadline renders the license null and void. In the case of a null, void, or voluntarily relinquished license, the applicant must reapply for licensure and meet the current requirements regardless of the requirements at the time of their initial licensure (Florida BORC, n.d.b).

Continuing Education (CE) Requirements

Continuing education is required as a condition for the renewal of licensure of all licensed RTs. Each licensee must earn at least 24 hours of continuing education credit during each two-year renewal period, including two required courses (medical error and laws and rules) (Florida BORC, 2023, p.5; Florida BORC, n.d.b). None of these hours can be obtained by taking Basic Life Support (BLS) training. No more than five hours shall be awarded to complete courses focusing on risk management (Florida BORC, 2023, p. 32).

If initial licensing occurs in the second half of the biennium, the licensee is exempt from the 24-hour continuing education credit requirement. However, they are required to take the following courses, totaling seven credits:

  • 2 hours - prevention of medical errors
  • 2 hours - Florida respiratory laws and rules
  • 3 hours - HIV/ AIDS training (this requirement only applies to the first license renewal) (Florida BORC, 2023, p.32; Florida BORC, n.d.b)

Licensees who currently hold a CRT and who are transitioning to an RRT credential are not exempt from the continuing education requirement at license renewal (Florida BORC, 2023, p.32).

For subsequent license renewals, the following CE requirements must be met (Florida BORC, n.d.b):

REQUIRED SUBJECT AREAREQUIRED NUMBER OF HOURSIMPORTANT INFORMATION
General Hours20 
Medical Error2Mandatory: 2 hours in a board-approved continuing education course pursuant to Rule 64B32-6.006, FAC.
Laws and Rules2

Mandatory: 2 credit hours pursuant to subsection 64B32-6.001(5), FAC 

Licensees may earn up to 8 continuing education hours per biennium by attending meetings of the BORC, but no more than 2 of those hours will be credited to satisfy the Florida laws and rules requirement.

Each licensee must submit satisfactory proof to the Board of participation in appropriate continuing education using the electronic reporting system CE Broker. Education providers approved by the BORC are required to report contact hours to CE Broker. For example, CEUFast.com is a BORC provider and reports your contact hours automatically. The participant must enter continuing education contact hours by non-BORC providers into CE Broker at www.CEBroker.com(Florida BORC, 2023, p.32-33).

Fees

The Laws and Rules documentation provides many fee structures. There are licensing fees and fees for disciplinary action. Licensing fees can range between $50 (application) and $200 (license renewal). Disciplinary fees vary based on the infraction. Fines vary between $250 and $1,500,000 (Florida BORC, 2023, pp. 14-29).

Disciplinary Grounds and Actions

Numerous behaviors can lead to disciplinary action. Ranging from bribery to practicing without a license, the severity of the punishment is based on the infraction. After committing a behavior resulting in disciplinary action, licensure could be revoked or denied, fines incurred, and further disciplinary measures taken.

Disciplinary Grounds

The following acts constitute grounds for denial of a license or disciplinary action as specified in section 456.072(2) (Florida BORC, 2023, pp. 5-6; 13-31):

  1. Procuring, attempting to procure, or renewing a license by bribery, fraudulent misrepresentation, or a department or BORC
  2. Having licensure, certification, or registration to deliver respiratory care services revoked, suspended, or otherwise acted against, including the denial of licensure, certification, or registration by the licensing authority of another state, territory, or country
  3. Being convicted or found guilty of or entering a plea of nolo contendere to a crime that directly relates to respiratory care services
  4. Willfully making or filing a false report or record, willfully failing to file a report or record required by state or federal law, or willfully impeding or obstructing such filing or inducing another person to do so. Such reports or records include only those reports or records that require the signature of an RCP or licensed RT
  5. Circulating false, misleading, or deceptive advertising
  6. Unprofessional conduct:
    1. Violating the confidentiality of a patient
    2. Falsely misrepresenting the facts on an RT employment application
    3. Leaving an assignment before properly advising appropriate supervisory personnel
    4. Providing false or incorrect information to an employer regarding the certification, registration, or licensure status
    5. Failing to report another licensee in violation of the laws or rules of the profession
    6. Using foul or abusive language in patient care or public areas
  7. Engaging or attempting to engage in the possession, sale, or distribution of controlled substances
  8. Willfully failing to report any violation of this part
  9. Violating a lawful order of the Board or department previously entered in a disciplinary hearing
  10. Engaging in the delivery of respiratory care services with a revoked, suspended, or inactive license
  11. Permitting, aiding, assisting, procuring, or advising any unlicensed person
  12. Failing to perform any statutory or legal obligation placed upon a licensed RCP or RT
  13. Accepting and performing professional responsibilities that the licensee knows they are not competent to perform
  14. Delegating professional responsibilities to a person when the licensee delegating such responsibilities knows that such person is not qualified to perform them
  15. Gross or repeated malpractice or the failure to deliver respiratory care services with that level of care, skill, and treatment recognized as appropriate for the situation by another RCP or RT
  16. Paying or receiving any commission, bonus, kickback, or rebate to or from, or engaging in any split-fee arrangement in any form whatsoever with, a person, organization, or agency, either directly or indirectly, for goods or services rendered to referred patients
  17. Exercising influence within a respiratory care relationship for engaging a patient in sexual activity; a patient is presumed to be incapable of giving free, full, and informed consent to sexual activity with the patient's RCP or RT
  18. Making deceptive, untrue, or fraudulent representations in the delivery of respiratory care services or employing a trick or scheme in the delivery of respiratory care services
  19. Soliciting patients using fraud, deception, or otherwise misleading statements, or through intimidation or undue influence
  20. Failing to keep written respiratory care records justifying the licensee’s actions
  21. Exercising influence on the patient in such a manner as to exploit them for the financial gain of the licensee or a third party
  22. Performing professional services that have not been duly ordered by a licensed physician and not according to protocols established by the hospital, other health care provider, or the Board, except as provided in sections 743.064, 766.103, and 768.13
  23. Being unable to deliver respiratory care services with reasonable skill and safety to patients because of illness or use of alcohol, drugs, narcotics, chemicals, or any mental or physical condition
    1. In enforcing this paragraph, the department shall, upon probable cause, have the authority to compel an RCP or RT to submit to a mental or physical examination by physicians designated by the department
    2. The cost of the examination shall be borne by the licensee
    3. The failure of an RCP or RT to submit to such an examination constitutes an admission of the allegations against them, upon which a default and a final order may be entered without the taking of testimony or presentation of evidence unless the failure was due to circumstances beyond their control
    4. A RCP or RT affected under this paragraph shall, at reasonable intervals, be allowed to demonstrate that she or he can resume the competent delivery of respiratory care services with reasonable skill and safety to her or his patients
    5. In any proceeding under this paragraph, neither the record of proceedings nor the orders entered by the Board shall be used against an RCP or RT in any other proceeding

Disciplinary Actions(Florida BORC, 2023, pp. 6-8)

  1. The Board may enter an order denying licensure or imposing any of the penalties in section 456.072(2) against any applicant for licensure or licensee who is found guilty of violating any provision of subsection (1) of this section or who is found guilty of violating any provision of section 456.072(1).
  2. The Board shall not reinstate licensure or issue a license to a person it has deemed unqualified until it is satisfied that such person has complied with all the terms and conditions outlined in the final order and that the RCP or RT is capable of safely delivering respiratory care services.
  3. The Board may, by rule, establish guidelines for the disposition of disciplinary cases involving specific types of violations. Such guidelines may include minimum and maximum fines, periods of supervision on probation, or conditions upon probation or re-issuance of a license.

A probable cause hearing is conducted as the final step in the disciplinary process against RTs in FL. This occurs when a complaint is issued against the therapist by the Board of Respiratory Care, a panel of at least three board members is convened to investigate, and a majority vote is obtained (Hardt, 2020). Disciplinary action is then determined and applied.

Reporting Violations and Patient Care Concerns

The RT has a responsibility to report breaches in practice (Florida BORC, 2023, p. 17). The Department of Health investigates complaints and reports involving healthcare practitioners and enforces appropriate Florida Statutes (Florida Health, 2023). The action that may be taken against health care practitioners is administrative. That website is here.

Violations

Disciplinary guidelines in section 64B32-5.001 are imposed by the Board when a licensee is in violation of chapter 468 or 456 or has committed an act of unprofessional conduct. The penalties correspond to the severity and repetition of the violations. Mitigating or aggravating circumstances used to justify any deviation from the specified guidelines must be called out in the final order (Florida BORC, 2023, pp. 13-29).

In determining the appropriate disciplinary action to be imposed in each case, the Board shall take into consideration the following factors (Florida BORC, 2023, p.13):

  1. Danger to the public
  2. Length of time since the date of the violation
  3. Number of previous disciplinary cases filed against the applicant or licensee
  4. Length of time the applicant or licensee has practiced
  5. Actual damage, physical or otherwise, to the patient
  6. Deterrent effect of the penalty imposed
  7. Effect of the penalty upon the applicant’s or licensee’s livelihood
  8. Actions taken by the licensee to correct the violation or to remedy the complaint
  9. Pecuniary benefits or self-gain inuring to the applicant, licensee, or registrant
  10. Vulnerability of the patient due to age or disability

The verbal identification of offenses is descriptive only; the full language of each cited statutory provision must be consulted to determine the aberrant conduct. For applicants, any offenses listed herein are sufficient for refusal to certify an application for licensure. In addition to the penalty imposed, the Board shall recover the investigation costs and prosecution of the case. Additionally, if the Board makes a finding of pecuniary benefit or self-gain related to the violation, it shall require a refund of fees billed and collected from the patient or a third party on behalf of the patient. If the violation is not made in error but intentionally through fraud, fines are increased to $10,000 per offense or count (Florida BORC, 2023, p.13).

VIOLATIONRECOMMENDED RANGE OF PENALTY
(a) Attempting to obtain a license by bribery, fraud, or through an error of the Department or the Board. (Sections 468.365(1)(a), 456.072(1)(h), F.S.)First OffenseMinimum: Reprimand and $250.00 fine

Maximum: Reprimand, $500.00 fine, and one year probation with conditions, or denial
Second OffenseMinimum: Reprimand, $500.00 fine, and one year suspension followed by one year probation with conditions

Maximum: Reprimand, $1,000.00 fine, one year suspension followed by two years probation, or denial
Third OffenseRevocation or denial
Telehealth RegistrantsRevocation or denial
*However, if the violation is not through an error but is for fraud or making a false or fraudulent representation, the fine is increased to $10,000 per count or offense. Conditional probation and a reprimand will also be imposed for the first and subsequent offenses.
If the error in licensing is due to an error on the part of the Board then a letter of concern is issued. However, licensure could still be revoked or denied.
(b) Actions taken against the license by another jurisdiction. (Sections 468.365(1)(b), 456.072(l)(f), F.S.)First Offense
  • Minimum: Reprimand, imposition of discipline comparable to the discipline which would have been imposed if the substantive violation occurred in Florida, and a fine of $300.00
  • Maximum: Reprimand, suspension of the license until the license is unencumbered in the jurisdiction in which disciplinary action was originally taken, and a fine of $1,000.00. Practitioners licensed in this state may be ordered to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with an evaluation from PRN that the practitioner is safe to practice.
Second Offense
  • Minimum: Same as for a first offense and a fine of $1,000.00
  • Maximum: Same as for first offense and fine of $2,000.00.
Third Offense
  • Minimum: Same as for a first offense and a fine of $2,000.00
  • Maximum: Same as for first offense and fine of $5,000.00.
Telehealth Registrants
  • Letter of concern up to reprimand, one year suspension, and corrective action plan completion (first offense)
  • Letter of concern up to reprimand, two year suspension, and corrective action plan completion up to denial or revocation of license (second and subsequent offense)
(c) Guilt of crime directly relating to practice or ability to practice. (Sections 468.365(1)(c), 456.072(1)(c), F.S.)First Offense
  • Minimum: Reprimand, fine of $500.00, and six months probation with conditions
  • Maximum: Revocation of the license and a fine of $1,000.00
Second Offense
  • Minimum: Reprimand, one year suspension followed by one year probation with conditions, and $1,000.00 fine
  • Maximum: Revocation and fine of $2,500.00
Telehealth Registrants  
  • Reprimand, six month suspension, and corrective action plan completion up to revocation (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(d) Willfully failing to file a report as required. (Sections 468.365(1)(d), 456.072(1)(l), F.S.)First Offense
  • Minimum: Reprimand, fine of $300.00, and six months probation with conditions
  • Maximum: Reprimand, and one year probation with conditions, and a fine of $1,000.00
Second Offense
  • Minimum: Reprimand, fine of $1,500.00, and one year probation with conditions
  • Maximum: Reprimand, six month suspension followed by a one year probation with conditions, and a fine of $3,000.00
Third Offense
  • Minimum: Reprimand, one year suspension followed by a one year probation with conditions, and a fine of $3,000.00
  • Maximum: Revocation and a fine of $5,000.00
Telehealth Registrants
  • Reprimand, suspension (six month - one year), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(e) False, deceptive, or misleading advertising. (Section 468.365(1)(e), F.S.)First Offense
  • Minimum: Reprimand and $250.00 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions, and a fine of $500.00
Second Offense
  • Minimum: Reprimand, $500.00 fine, and one year probation with conditions
  • Maximum: Reprimand, one year suspension followed by one year probation with conditions, and a fine of $1,500.00
Third Offense
  • Minimum: Reprimand, one year suspension followed by one year probation with conditions, and $1,500.00 fine
  • Maximum: Revocation and a fine of $5,000.00
Telehealth Registrants
  • Reprimand, suspension (six month - one year), and potentially a corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(f) Unprofessional conduct. (Section 468.365(1)(f), F.S.)First Offense
  • Minimum: Reprimand, one year probation with conditions, and a $300.00 fine
  • Maximum: Reprimand, six months suspension, followed by one year probation with conditions, and a fine of $1,000.00
Second Offense
  • Minimum: Reprimand, six months suspension followed by one year probation with conditions, and a $1,500.00 fine
  • Maximum: Reprimand, one year suspension, followed by two years probation with conditions, and a fine of $3,000.00
Third Offense
  • Minimum: Reprimand, one year suspension, followed by two years probation with conditions, and a fine of $3,000.00
  • Maximum: Revocation and a $5,000, 00 fine
Telehealth Registrants
  • Reprimand, suspension (one - two year) and corrective action plan completion (first offense)
  • Reprimand, minimum two year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(g) Controlled substances. (Section 468.365(1)(g), F.S.)First Offense
  • Minimum: Reprimand, six month probation with conditions, and a $1,00.00 fine
  • Maximum: Reprimand, one year suspension followed by one year probation with conditions, and $3,000.00 fine, or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice
Second Offense
  • Minimum: Reprimand, one year suspension followed by one year probation with conditions, and $3,000.00 fine
  • Maximum: Reprimand, one year suspension followed by two years probation with conditions, and $5,000.00 fine, or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice
Third Offense
  • Revocation
Telehealth Registrants
  • Reprimand, minimum six months suspension and corrective action plan completion up to revocation (first offense)
  • Reprimand, minimum one year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(h) Failure to report another licensee in violation.(Sections 468.365(1)(h), 456.072(1)(i), F.S.)First Offense
  • Minimum: Letter of concern and $250.00 fine
  • Maximum: Reprimand, six months probation with conditions, and fine of $500.00
Second Offense
  • Minimum: Reprimand, six months probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, one year suspension, and a fine of $1,500.00
Third Offense
  • Minimum: Reprimand, six months probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, one year suspension, and a fine of $1,500.00
Telehealth Registrants
  • Letter of concern up to reprimand, six months suspension and corrective action plan completion (first offense)
  • Reprimand, suspension (six months - one year), and corrective action plan completion up to revocation (second and subsequent offense)
(i) Violation of order of the Board or Department or failure to comply with subpoena. (Sections 468.365(1)(i), 456.072(1)(q), F.S.)First Offense
  • Minimum: Reprimand, $300 fine, compliance with the order or subpoena
  • Maximum: Reprimand, $1,000.00 fine, six months suspension, and compliance with order or subpoena
Second Offense
  • Minimum: Reprimand, $1,000.00 fine, one year suspension, and compliance with the order or subpoena
  • Maximum: Revocation and a fine of $3,000.00
Telehealth Registrants
  • Reprimand, suspension (six months - one year), corrective action plan completion, and compliance with subpoena (first offense)
  • Reprimand, two year suspension, corrective action plan completion, and and compliance with subpoena up to revocation (second and subsequent offense)
(j) Unlicensed practice. (Section 468.365(1)(j), F.S.)First Offense
  • Minimum: Reprimand and $500.00 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions, and a fine of $1,500.00
Second Offense
  • Minimum: Reprimand, six months suspension followed by one year probation with conditions, and $1,500,00 fine
  • Maximum: Revocation and a fine of $5,000.00
Telehealth Registrants
  • Reprimand, suspension (six month - one year), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(k) Aiding unlicensed practice. (Sections 468.365(1)(k), 456.072(1)(j), F.S.)First Offense
  • Minimum: Reprimand, one year probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, six months suspension followed by one year of probation with conditions, and a fine of $1,500.00
Second Offense
  • Minimum: Reprimand, six month suspension followed by one year of probation with conditions, and a $1,500.00 fine
  • Maximum: Revocation and a fine of $5,000.00
Third Offense
  • Minimum: Reprimand, one year suspension followed by two years probation with conditions, and $5,000.00 fine
  • Maximum: Revocation and a fine of $10,000.00
Telehealth Registrants
  • Reprimand, suspension (one - two year), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second offense)
  • Revocation (third offense)
(l) Failure to perform legal obligation. (Sections 468.365(1)(l), 456.072(1)(k), F.S.)First Offense
  • Minimum: Reprimand and a $300.00 fine
  • Maximum: Reprimand, one year probation with conditions, and a fine of $1,000.00
Second Offense
  • Minimum: Reprimand, one year probation with conditions, and $1,000.00 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions, and a fine of $2,500.00
Third Offense
  • Minimum: Reprimand, one year suspension followed by one year probation with conditions, and a $2,500.00 fine
  • Maximum: Revocation and a fine of $5,000.00
Telehealth Registrants
  • Reprimand, suspension (six month to one year), and corrective action plan completion (first offense)
  • Reprimand, suspension (one - two year), and corrective action plan completion (second offense)
  • Revocation (third offense)
(m) Practicing beyond competence level. (Sections 468.365(1)(m), 456.072(1)(o), F.S.)First Offense
  • Minimum: Reprimand, six months probation with conditions, and a $300.00 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions, and a fine of $1,000.00
Second Offense
  • Minimum: Reprimand, six months suspension followed by one year probation with conditions, and a $1,500.00 fine
  • Maximum: Reprimand, one year suspension followed by one year probation with conditions, and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, one year suspension followed by two years probation with conditions, and a $2,500.00 fine
  • Maximum: Revocation and a fine of $5,000.00
Telehealth Registrants
  • Reprimand, suspension (six month - one year), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second offense)
  • Revocation (third offense)
(n) Delegation of professional responsibilities to unqualified persons. (Sections 468.365(1)(n), 456.072(1)(p), F.S.)First Offense
  • Minimum: Reprimand, one year probation with conditions, and a $300.00 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions, and a $1,000.00 fine
Second Offense
  • Minimum: Reprimand, six months suspension followed by one year of probation with conditions, and $1,000.00 fine
  • Maximum: Reprimand, one year suspension followed by one year probation with conditions, and $3,000.00 fine
Third Offense
  • Minimum: Reprimand, one year suspension followed by two years probation with conditions, and a $3,000.00 fine
  • Maximum: Revocation and $5,000.00 fine
Telehealth Registrants
  • Reprimand, suspension (one - two year), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second offense)
  • Revocation (third offense)
(o) Malpractice. (Section 468.365(1)(o), F.S.)First Offense
  • Minimum: Reprimand, one year probation with conditions, and $500.00 fine
  • Maximum: Reprimand, six months suspension followed by one year of probation with conditions, and a $1,500.00 fine
Second Offense
  • Minimum: Reprimand, two years probation with conditions, and a $1,500.00 fine
  • Maximum: Reprimand, one year suspension followed by two years of probation with conditions, and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, one year suspension followed by two years of probation with conditions, and a 2,500.00 fine
  • Maximum: Revocation and a $5,000.00 fine
Telehealth Registrants
  • Reprimand, suspension (one - two year), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second offense)
  • Revocation (third offense)
(p) Kickbacks or split fee arrangements. (Section 468.365(1)(p), F.S.)First Offense
  • Minimum: Reprimand, refund of fees billed, six months suspension followed by a one year probation with conditions, and a $300.00 fine
  • Maximum: Reprimand, refund of fees billed, one year suspension followed by a one year probation with conditions, and a $1,000.00 fine
Second Offense
  • Minimum: Reprimand, refund of fees billed, one year suspension followed by a two years probation with conditions, and a $1,500.00 fine
  • Maximum: Reprimand, refund of fees billed, two years suspension followed by two years probation with conditions, and a $5,000.00 fine
Third Offense
  • Revocation
Telehealth Registrants
  • Reprimand, suspension (18 month - three year), and corrective action plan completion (first offense)
  • Reprimand, three year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(q) Exercising influence or engage patient in sex. (Sections 468.365(1)(q), 456.072(1)(v), F.S.)First Offense
  • Minimum: Reprimand, six month suspension followed by one year probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, one year suspension followed by one year probation with conditions, and a $1,500.00 fine, or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice
Second Offense
  • Minimum: Reprimand and one year suspension followed by two year probation with conditions, and a $1,500.00 fine
  • Maximum: Reprimand, two year suspension followed by two year probation with conditions, and a $5,000.00 fine, or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice, or revocation
Telehealth Registrants
  • Reprimand, three year suspension, and corrective action plan completion up to revocation (first offense)
  • Revocation (second offense)
(r) Deceptive, untrue, or fraudulent representations in the practice of respiratory care. (Sections 468.365(1)(r), 456.072(1)(a), (m), F.S.)First Offense
  • Minimum: Reprimand and one year probation with conditions, and a fine of $10,000.00 per count or offense
  • Maximum: Revocation, and a fine of $10,000.00 per count or offense
Second Offense
  • Minimum: Reprimand and one year suspension followed by one year of probation with conditions a fine of $10,000.00 per count or offense
  • Maximum: Revocation and a fine of $10,000.00 per count or offense
Telehealth Registrants
  • Reprimand, one year suspension, and corrective action plan completion up to revocation (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second offense)
(s) Improper solicitation of patients. (Section 468.365(1)(s), F.S.)First Offense
  • Minimum: Reprimand, one year probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, six months suspension with followed by one year probation Page 22 of 78 with condition, and a $1,500.00 fine
Second Offense
  • Minimum: Reprimand, six months suspension followed by one year probation with conditions and $1,500.00 fine
  • Maximum: Reprimand, one year suspension followed by two years probation with conditions, and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, two years suspension followed by two years probation with conditions, and a $2,500.00 fine
  • Maximum: Revocation and a $5,000.00 fine
Telehealth Registrants
  • Reprimand, suspension (one - two year), and corrective action plan completion up to revocation (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second offense)
  • Reprimand, three year suspension, and corrective action plan completion up to revocation (third offense)
(t) Failure to keep written medical records. (Section 468.365(1)(t), F.S.)First Offense
  • Minimum: Letter of concern
  • Maximum: Reprimand, one year probation with conditions and a $300.00 fine
Second Offense
  • Minimum: Reprimand, one year probation with conditions and a $500.00 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions, and a $1,500.00 fine
Third Offense
  • Minimum: Reprimand, one year suspension followed by one year probation, and a $1,500.00 fine
  • Maximum: Revocation and a $5,000.00 fine
Telehealth Registrants
  • Letter of concern up to reprimand, one year suspension, and corrective action plan completion (first offense)
  • Reprimand up to two year suspension and corrective action plan completion (second offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (third offense)
(u) Exercising influence on patient for financial gain. (Sections 468.365(1)(u), 456.072(1)(n), F.S.)First Offense
  • Minimum: Reprimand, refund of fees billed, a minimum of one year probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, refund of fees billed, one year suspension followed by one year probation with conditions, and a $1,500.00 fine
Second Offense
  • Minimum: Reprimand, refund of fees billed, one year suspension followed by one year probation with conditions, and a $1,500.00 fine
  • Maximum: Reprimand, refund of fees billed, two years suspension followed by one year probation with conditions, and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, refund of fees billed, two year suspension followed by one year probation with conditions, and a $2,500.00 fine
  • Maximum: Revocation, refund of bills paid, and a $5,000.00 fine
Telehealth Registrants
  • Reprimand, suspension (one - two year), and corrective action plan completion (first offense)
  • Reprimand up to two year suspension and corrective action plan completion up to revocation (second offense)
  • Revocation (third offense)
(v) Performing professional services not authorized by a physician. (Section 468.365(1)(v), F.S.)First Offense
  • Minimum: Reprimand and a $300 fine
  • Maximum: Reprimand, six month suspension followed by one year probation with conditions, and a $1,000.00 fine
Second Offense
  • Minimum: Reprimand, one year probation with conditions, and a $1,000.00 fine
  • Maximum: Reprimand, one year suspension followed by one year probation, and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, one year suspension followed by one year probation, and a $2,500.00 fine
  • Maximum: Revocation and a $5,000.00 fine
Telehealth Registrants
  • Reprimand up to one year suspension and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second offense)
  • Revocation (third offense)
(w) Inability to practice respiratory care with skill and safety. (Sections 468.365(1)(w), 456.072(1)(z), F.S.)First Offense
  • Minimum: Reprimand, six months probation with conditions, and $300.00 fine
  • Maximum: Reprimand, six month suspension followed by one year probation with conditions and a $1,000.00 fine, or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice
Second Offense
  • Minimum: Reprimand, six month suspension followed by one year of probation with conditions, and $1,000.00 fine
  • Maximum: Reprimand, six month suspension followed by one year probation with conditions and a $1,000.00 fine, or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice
Third Offense
  • Minimum: Reprimand, one year suspension followed by two years of probation with conditions, and $3,000.00 fine, or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice
  • Maximum: Revocation and a $5,000.00 fine
Telehealth Registrants
  • Reprimand, suspension (six month - two years), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(x) Violation of this chapter, Chapter 456, F.S., or any rules adopted pursuant thereto. (Sections 468.365(1)(x), 456.072(1)(b), (dd), F.S.)First Offense
  • Minimum: Reprimand and $300.00 fine
  • Maximum: Reprimand, one year probation with conditions, and a $1,000.00 fine
Second Offense
  • Minimum: Reprimand, six months suspension followed by one year probation with conditions, and a $1,000.00 fine
  • Maximum: Reprimand, one year suspension followed by one year probation with conditions, and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, one year suspension followed by one year probation with conditions, and a $3,000.00 fine
  • Maximum: Revocation and a $5,000.00 fine
Telehealth Registrants
  • Reprimand, suspension (six month - one year), and corrective action plan completion (first offense)
  • Reprimand, suspension (18 month - two years), and corrective action plan completion up to revocation (second offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (third and subsequent offense)
(y) Improper interference with investigation, inspection or discipline. (Section 456.072(1)(r), F.S.)First Offense
  • Minimum: Reprimand, six months of probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions a $1,500.00 fine
Second Offense
  • Minimum: Reprimand, six months suspension followed by one year probation with conditions, and a $1,500.00 fine
  • Maximum: Reprimand, one year suspension followed by one year probation, and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, one year suspension followed by one year probation, and a $3,000.00 fine
  • Maximum: Revocation and a $5,000.00 fine
Telehealth Registrants
  • Reprimand, suspension (six month - two years), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second offense)
  • Revocation (third offense)
(z) Failure to report conviction or plea. (Section 456.072(1)(x), F.S.)First Offense
  • Minimum: Reprimand and a $300 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions, and a $1,000.00 fine
Second Offense
  • Minimum: Reprimand, one year probation with conditions, and a $1,000.00 fine
  • Maximum: Reprimand, one year suspension followed by one year probation with conditions, and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, one year suspension followed by two years probation with conditions, and a $5,000.00 fine
  • Maximum: Revocation
Telehealth Registrants
  • Reprimand, suspension (six - 18 months), and corrective action plan completion (first offense)
  • Reprimand, two year suspension up to revocation (second offense)
  • Revocation (third offense)
(aa) Wrong patient, wrong site, or wrong or unauthorized procedure. (Section 456.072(1)(bb), F.S.)First Offense
  • Minimum: Reprimand, one year probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, one year suspension followed by one year probation with conditions and a fine $1,500.00 fine
Second Offense
  • Minimum: Reprimand, two years probation with conditions, and a $1,000.00 fine
  • Maximum: Reprimand, two years suspension followed by two years probation and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, two years suspension followed by two years probation, and a $2,500.00 fine
  • Maximum: Revocation and $5,000.00 fine
Telehealth Registrants
  • Reprimand, suspension (one - two years), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion  up to revocation (second offense)
  • Revocation (third offense)
(bb) Leaving a foreign body in a patient. (Section 456.072(1)(bb), (cc), F.S.)First Offense
  • Minimum: Reprimand, one year probation with conditions, and $500.00 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions and a $1,500.00 fine
Second Offense
  • Minimum: Reprimand, two year probation with conditions, and a $1,000.00 fine
  • Maximum: Reprimand, one year suspension followed by one year of probation with conditions, and a $3,000.00 fine
Third Offense
  • Minimum: Reprimand, one year suspension followed by two years probation, and a $2,500.00 fine
  • Maximum: Revocation and $5,000.00 fine
Telehealth Registrants
  • N/A
(cc) Testing positive in a pre-employer ordered drug screen. (Section 456.072(1)(aa), F.S.)First Offense
  • Minimum: Reprimand, six months probation with conditions, and $500.00 fine
  • Maximum: Reprimand, one year probation with conditions, and $1,000.00 fine, or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice
Second Offense
  • Minimum: Reprimand, one year probation with conditions, and $1,000.00 fine, or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice
  • Maximum: Reprimand, two years probation with conditions, and $3,000.00 fine, or or referral to PRN for evaluation, compliance with PRN recommendations or appearance before the Board with PRN evaluation stating the practitioner is safe to practice
Telehealth Registrants
  • Reprimand, one year suspension, and corrective action plan completion up to denial and revocation (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to denial and revocation (second offense)
(dd) Being terminated from an impaired practitioner treatment program for failure to comply with the terms of contract or for not successfully completing any drug treatment or alcohol treatment program. (Section 456.072(1) (hh), F.S.)Any Offense
  • Reprimand, suspension until compliant with the terms of the impaired practitioner treatment program contract, and a $250 fine up to revocation and a $1,000.00 fine
Telehealth Registrants
  • Revocation
(ee) Practicing with a delinquent, retired, or inactive status license. (Section 456.072(1)(o), F.S.)Any Offense
  • Minimum: Reprimand and a $2,500.00 fine
  • Maximum: Revocation and a $10,000.00 fine
Telehealth Registrants
  • Revocation
(ff) Failure to notify a patient through written or oral notice of the type of license the practitioner holds. (Section 456.072(1)(t), F.S.)First Offense
  • Minimum: Letter of Concern and submission of an affidavit attesting that the licensee has read the Florida laws and rules
  • Maximum: Reprimand and submission of an affidavit attesting that the licensee has read the Florida laws and rules
Second Offense
  • Minimum: Reprimand, $100.00 fine, and submission of an affidavit attesting that the licensee has read the Florida laws and rules
  • Maximum: Reprimand, $500.00 fine, and submission of an affidavit attesting that the licensee has read the Florida laws and rules
Telehealth Registrants
  • Letter of concern up to reprimand, six month suspension, and corrective action plan completion (first offense)
  • Reprimand, one year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(gg) Any felony offense classified under Chapter 409, 817, 893, F.S., or 21 U.S.C ss. 801-970, or 42 U.S.C. ss. 1395-1396. (Section 456.0635, F.S.)Any Offense
  • Minimum: Admission for examination, licensing, and renewal of a license shall be refused for the time periods set forth in Section 456.0635, F.S.
  • Maximum: Revocation
Telehealth Registrants
  • Registration shall be refused for the time periods set forth in Section 456.0635, F.S. up to revocation (any offense)
(hh) Terminated for cause from the Florida Medicaid program pursuant to Section 409.913, F.S. (Section 456.0635, F.S.)Any Offense
  • Minimum: Admission for examination, licensing, and renewal of a license shall be refused for the time periods set forth in Section 456.0635, F.S.
  • Maximum: Revocation
Telehealth Registrants
  • Registration shall be refused for the time periods set forth in Section 456.0635, F.S. up to revocation (any offense)
(ii) Terminated for cause, pursuant to the appeals procedures established by the state or Federal Government, from any other state Medicaid program. (Section 456.0635, F.S.)Any Offense
  • Minimum: Admission for examination, licensing, and renewal of a license shall be refused for the time periods outlined in Section 456.0635, F.S.
  • Maximum: Revocation
Telehealth Registrants
  • Registration shall be refused for the time periods set forth in Section 456.0635, F.S. up to revocation (any offense)
(jj) Willfully failing to comply with Section 627.64194 or 641.513, F.S., with such frequency as to indicate a general business practice. (Section 456.072(1)(oo), F.S.)First Offense
  • Minimum: Reprimand, refund of fees billed, one year probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, two years suspension followed by one year probation with conditions, and a $2,000.00 fine
Second Offense
  • Minimum: Reprimand, refund of fees billed, and two years probation with conditions, and a $2,500.00 fine
  • Maximum: Reprimand, refund of fees billed, two year suspension followed by two years probation with conditions, and a $10.000.00 fine
Third Offense
  • Revocation
Telehealth Registrants
  • Reprimand, suspension (one - two years), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second offense)
  • Revocation (third offense)
(kk) Providing information, including written documentation, indicating that a person’s need for an emotional support animal under Section 760.27, F.S., without personal knowledge of the person’s disability or disability-related need for the specific emotional support animal. (Section 456.072(1)(pp), F.S.First Offense
  • Minimum: Reprimand, one year probation with conditions, and a $500.00 fine
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions, and a $1,000.00 fine
Second Offense
  • Minimum: Reprimand, one year suspension followed by one year probation with conditions, and a $2,000.00 fine
  • Maximum: Reprimand, two years suspension followed by a two years probation, and a $5,000.00 fine
Telehealth Registrants
  • Reprimand, suspension (one - two year), and corrective action plan completion (first offense)
  • Reprimand, two year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(ll)  Failure to comply with the parental consent requirements of Section 1014.06, F.S. (Section 456.072(1)(rr), F.S.)First Offense
  • Minimum: Reprimand and a $250 fine
  • Maximum: Reprimand, $500 fine, and one year of probation with conditions
Second Offense
  • Minimum: Reprimand, $500 fine, and one year probation with conditions
  • Maximum: Reprimand, six months suspension followed by one year probation with conditions, and $1,000.00 fine
Telehealth Registrants
  • Reprimand and up to six month suspension, and corrective action plan completion (first offense)
  • Reprimand, one year suspension, and corrective action plan completion up to revocation (second and subsequent offense)
(mm) Being convicted or found guilty of, entering a plea of guilty or nolo contendere to, or committing or attempting, soliciting, or conspiring to commit an act that would constitute a violation of any of the offenses listed in Section 456.074(5), F.S.First Offense
  • Minimum: $10,000 fine and revocation
  • Maximum: Revocation
Telehealth Registrants
  • Revocation
(nn) Failure to display hyperlink on telehealth registrant’s website
→Telehealth Registrants ONLY
First Offense
  • Minimum: Letter of Concern
  • Maximum: Reprimand, suspension until compliant, and completion of a corrective action plan
Second and subsequent offense
  • Reprimand, suspension until complaint, corrective action plan completion up to revocation
(oo) Failing to notify the board of restrictions placed on his or her license to practice, or any disciplinary action taken or pending against him or her, in any state or jurisdiction within 5 business days after the restriction is placed or disciplinary action is initiated or taken (Section 456.47(4)(d), F.S.)
→Telehealth Registrants ONLY
First Offense
  • Minimum: Reprimand, suspension until license is active and unencumbered in all jurisdictions where restricted or action was taken, and completion of a corrective action plan
  • Maximum: Revocation
Second and subsequent offense
  • Minimum: Reprimand, suspension until license is active and unencumbered in all jurisdictions where restricted or action was taken, and completion of a corrective action plan
  • Maximum: Revocation
(pp)  Opening an office in Florida or providing in-person healthcare services to patients in Florida (Section 456.74(4)(f), F.S.)
  →Telehealth Registrants ONLY
First Offense
  • Revocation

The Board is not limited in its ability to recommend that the Department of Health pursue civil or criminal charges, if warranted (Florida BORC, 2023, p. 29).

Penalties for Violations

The Rules and Laws (Florida BORC, 2023, p.8) contain a short list of violations. These violations are considered third-degree felonies and are punishable as per sections 775.082, 775.083, or 775.084.

  1. It is a violation of law for any person, including any firm, association, or corporation, to:
    1. Sell or fraudulently obtain, attempt to obtain, or furnish to any person a diploma, license, or record
    2. Deliver respiratory care services under any diploma, license, or record that was illegally or fraudulently obtained, signed, or issued unlawfully or under fraudulent representation
    3. Deliver respiratory care services unless such person is duly licensed to do so or unless such person is exempted according to section 468.368
    4. Use, in connection with their name, any designation that they are an RCP or RT, duly licensed, unless they are so licensed
    5. Advertise an educational program as meeting the requirements to prepare RCPs or RTs unless the program is Board-approved
    6. Knowingly employ unlicensed persons in the delivery of respiratory care services unless exempted
    7. Knowingly conceals information relative to any violation of this part

Citations

Pursuant to section 456.077, the following violations may be disposed of by citation with the specified penalty. These violations are not a substantial risk to public health, safety, or welfare, or have been mitigated before the citation could be issued.

All citations require the practitioner to correct the violation within a specified time period (not to exceed 90 days) and submit documentation that the behavior has been corrected. If the violation is not corrected or is disputed, the licensee will be subject to section 456.073 (disciplinary action). The licensee will be required to pay any fines and investigative costs (Florida BORC, 2023, p.31).

In the case of two violations, one of which is not eligible for a citation, the procedures of section 456.073 apply. Fines must be paid within 90 days of issuance. Payment should be made to the Department of Health in Tallahassee. A copy of the citation must accompany the payment. Periodically, the Department of Health will submit a review to the Board for a licensee to include the number and nature of citations, the penalties imposed, and the licensee’s level of compliance (Florida BORC, 2023, p.31).

A notice of noncompliance will be sent as a first response to a minor rule violation. Failure of the licensee to correct the violation within 15 days will result in a citation, if appropriate, or disciplinary proceedings. Two minor violations can result in a notice of noncompliance. These include failure to notify the Board of an address change within 60 days or the non-intentional issuance of a bad check to the Department (Florida BORC, 2023, p.31).

The following violations are citation eligible (Florida BORC, 2023, p.31):

  1. Violations of continuing education requirements must be completed within 90 days of the filing of the final order. The licensee must submit certified documentation of completion of all the CE requirements for the period of the issued citation; before renewing the license for the next biennium, the licensee must document compliance with the CE requirements for the relevant period.
  2. Failure to document the HIV/AIDS continuing education requirement. The fine shall be $100.
  3. Documentation of some, but not all, of the 24 hours of continuing education for license renewal. The fine shall be $50 for each hour that is not documented.
  4. Violation of any portion of Rule 64B32-5.003, FAC, for unprofessional conduct. The fine shall be $300.
  5. Failure to notify the Board of the licensee’s current address as required by Rule 64B32-1.006, FAC. The fine shall be $50.
  6. Failure to keep written respiratory care records justifying the action taken on only one patient under Section 468.365(1)(t), FS. The fine shall be $100.
  7. Circulating misleading advertising in violation of Section 468.365(1)(e), FS. The fine shall be $500.
  8. Exercising influence on a patient to exploit the patient for financial gain by promoting or selling services, goods, appliances, or drugs under Section 468.365(1)(u), FS. The fine shall be $1,000.
  9. Failure to submit compliance documentation after receiving the continuing education audit notification under Section 468.365(1)(x), FS. The fine shall be $150.
  10. Failure to provide satisfaction, including the costs incurred following receipt of the Department's notification of a check dishonored for insufficient funds under Section 468.365(1)(l), FS. The fine shall be $150.
  11. Failure to pay required fees or fines on time under Section 468.365(1)(i), FS. The fine shall be $150.

Exemptions

The Laws and Rules set forth by the BORC should not be used to restrict the practice of the following (Florida BORC, 2023, p.8):

  1. An individual licensed in Florida practicing within the scope of their license
  2. A U.S. government employee carrying out their official duties
  3. A friend or family member providing respiratory care services to an ill person, not claiming to be an RCP or RT
  4. An individual providing emergency respiratory care services, not claiming to be an RCP or RT
  5. Any individual who delivers, assembles, sets up, or tests equipment for home use under the order of a licensed physician
    1. This does not authorize the individual to practice as an RCP or RT
  6. A credentialed pulmonary function technologist performing cardiopulmonary diagnostic studies
  7. Any student enrolled in a board-approved, accredited respiratory care program performing respiratory care as part of a required course
  8. Surrogate family members who deliver incidental respiratory care to non-institutionalized persons but do not claim to be RCPs or RTs
  9. Any individual credentialed by the Undersea Hyperbaric Society in hyperbaric medicine while performing related duties
    1. This does not authorize the individual to practice as an RCP or RT

Payment for Care

Hospitals, institutions, or other employers are not required to reimburse respiratory care providers in any way to remain compliant with the Laws and Rules (Florida BORC, 2023, p.9).

Ethics

Working as a respiratory therapist requires adherence to a code of ethics. According to the AARC (2021), the RCP or RT shall:

  1. Behave professionally with integrity, objectivity, and in a way that builds trust
  2. Practice evidence-based medicine
  3. Maintain and improve education, skills, and competency through continuing education options; document completed education appropriately
  4. Always act within the scope of practice and perform only skills that you are competent in performing
  5. Respect and protect the patient legally and personally (right to privacy, only performing care under informed consent, and the right to refuse treatment)
  6. Do not release protected information unless directed by the patient/ family or required by law
  7. Provide care without regard to culture, language, nationality, religion, etc.
  8. Promote wellness and disease prevention
  9. Abstain from illegal or unethical behaviors
  10. Report known illegal, fraudulent, unethical, or incompetent acts by other professionals
  11. Follow research procedures in a scientific and ethical manner
  12. Comply with all federal and state laws for the RT profession
  13. Abstain from fraudulent behaviors or any conduct generating a conflict of interest
  14. Improve access, efficacy, and cost in patient care
  15. Utilize resources appropriately
  16. Build an atmosphere of respect, trust, and communication with other health care professionals to provide excellent patient care

Case Study

Case Study: Unlicensed Respiratory Therapy Practice in the NICU

Paul, a certified respiratory therapist (RT), is working independently in the neonatal intensive care unit (NICU) while his preceptor is off the floor due to a personal issue. Although Paul has not yet obtained his license, the nursing and physician staff believe him to be appropriately licensed and capable of independent practice.

A premature infant, born at 24 weeks of gestation, is admitted to the NICU. She was delivered 12 hours ago, with poor Apgar scores and no spontaneous respiratory effort. Immediately after birth, the infant was intubated and placed on a traditional ventilator. Her condition remained stable until about 20 minutes ago, when the nurse noticed her oxygen saturation levels in the high 70s, a rapid respiratory rate, and signs of distress. The nurse performed suctioning, auscultated breath sounds, and verified the position of the endotracheal tube (ET tube) before calling Paul for assistance.

Paul confirmed the nurse's assessment, checked the ventilator settings, and ensured the equipment was functioning properly. He reviewed the infant's medication records and saw that surfactant had been administered immediately after delivery. The nurse then called for the physician's assistance, and the infant was repositioned to optimize her airway.

Upon arrival, the physician ordered a stat chest x-ray and a second dose of surfactant. The X-ray revealed a large pneumothorax, and the physician proceeded with a needle thoracentesis to relieve the pressure. He also adjusted the infant’s ventilator settings and administered another dose of surfactant.

Meanwhile, Paul prepared an oscillating ventilator as per the physician's orders. He and the infant's nurse transitioned the infant to the new ventilator and repositioned her in the incubator. The infant showed signs of improvement shortly after the changes were made.

Upon the preceptor's return to the unit, Paul briefed him on the care provided to the premature infant, including the interventions he had carried out. The preceptor was immediately upset, as Paul had performed these critical tasks without being licensed, and without any formal communication that Paul was not yet licensed to practice independently. This lack of transparency led to a stern discussion about Paul’s actions, which were deemed inappropriate given his unlicensed status.

Several months later, the hospital faced a lawsuit alleging that the infant did not receive appropriate, licensed respiratory care. Paul and his preceptor were both charged under the Florida Respiratory Practice Act for the following violations:

  1. Guilty of a crime related to practice or the ability to practice (Paul and Licensed Preceptor)
  2. Unlicensed practice (Paul)
  3. Aiding unlicensed practice (Licensed Preceptor)
  4. Practicing beyond competence (Paul)
  5. Delegating professional responsibilities to an unqualified person (Licensed Preceptor)
  6. Malpractice (Paul and Licensed Preceptor)
  7. Deceptive, untrue, or fraudulent representation in the practice of respiratory care (Paul)
  8. Inability to practice respiratory care with skill and safety (Paul)

The preceptor was not charged for failing to report Paul’s unlicensed status because, at the time, Paul was not licensed. Furthermore, litigation was pending against some of the nursing and physician staff for allowing Paul to provide care independently without being informed of his unlicensed status.

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Implicit Bias Statement

CEUFast, Inc. is committed to furthering diversity, equity, and inclusion (DEI). While reflecting on this course content, CEUFast, Inc. would like you to consider your individual perspective and question your own biases. Remember, implicit bias is a form of bias that impacts our practice as healthcare professionals. Implicit bias occurs when we have automatic prejudices, judgments, and/or a general attitude towards a person or a group of people based on associated stereotypes we have formed over time. These automatic thoughts occur without our conscious knowledge and without our intentional desire to discriminate. The concern with implicit bias is that this can impact our actions and decisions with our workplace leadership, colleagues, and even our patients. While it is our universal goal to treat everyone equally, our implicit biases can influence our interactions, assessments, communication, prioritization, and decision-making concerning patients, which can ultimately adversely impact health outcomes. It is important to keep this in mind in order to intentionally work to self-identify our own risk areas where our implicit biases might influence our behaviors. Together, we can cease perpetuating stereotypes and remind each other to remain mindful to help avoid reacting according to biases that are contrary to our conscious beliefs and values.

References

  • American Association for Respiratory Care (AARC). (n.d.a.). Respiratory care: A journey through time. American Association for Respiratory Care. Visit Source.
  • American Association for Respiratory Care (AARC). (n.d.b.). Respiratory care practice law by state. American Association for Respiratory Care. Visit Source.
  • American Association for Respiratory Care (AARC). (2021). AARC statement of ethics and professional conduct. American Association for Respiratory Care. Visit Source.
  • Baker, J. A. (2023). Respiratory therapist–driven protocol in primary care: Is the profession ready and able to expand into primary care? Respiratory Care, 68(9), 1320–1321. Visit Source.
  • Florida Board of Respiratory Care (Florida BORC). (n.d.a.). Licensing and Registration. Florida Board of Respiratory Care. Visit Source.
  • Florida Board of Respiratory Care (Florida BORC).  (n.d.b.). Renewal information. Florida Board of Respiratory Care. Visit Source.
  • Florida Board of Respiratory Care (Florida BORC). (2023). Board of Respiratory Care laws and rules. Florida Board of Respiratory Care. Visit Source.
  • Florida Health. (2023). Florida health care complaint portal. Florida Department of Health. Visit Source.
  • Florida Society for Respiratory Care. (n.d.a.) AARC charter. Florida Society for Respiratory Care. Retrieved March 4, 2025. Visit Source.
  • Florida Society for Respiratory Care. (n.d.b.) Home. Florida Society for Respiratory Care. Retrieved March 6, 2025. Visit Source.
  • Hardt, S. (2020). Board laws and rules. American Lung Association. Visit Source.
  • Kerstjens, H. A. M., Upham, J. W., & Yang, I. A. (2019). Airway pharmacology: Treatment options and algorithms to treat patients with chronic obstructive pulmonary disease. Journal of Thoracic Disease, 11(Suppl 17), S2200–S2209. Visit Source.
  • Miller AG, Burr KL, Juby J, Hinkson CR, Hoerr CA, Roberts KJ, et al. (2023). With Great Clinical Practice Guidelines Comes Great (or at Least Better) Resource Allocation. Respiratory Care, 68(5), 706–707. Visit Source.
  • U. S. Bureau of Labor Statistics. (2024). Respiratory therapists. United States Department of Labor. Visit Source.
  • Varekojis, S. M., Schweller, J., & Sergakis, G. (2021). Introducing the advanced practice respiratory therapist. Chest, 160(2), e157–e159. Visit Source.