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State Coordinator

Linda L. Savage 


Regional Coordinator

Lady Sue H. Bell BSN, MBA/MHA, RN 

(336) 288-8549

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» RN Circulator Laws and Language


HB483 as passed: Section 1. Paragraph (d) is added to subsection (2) of section 395.0191, Florida Statutes, to read: 395.0191 Staff membership and clinical privileges.-- (2)(d) Each hospital shall meet the requirements of the Medicare and Medicaid Conditions of Participation for Hospitals under 42 C.F.R. s. 482.51(a)(3) as they apply to registered nurses performing circulating duties in the operating room and as provided in the interpretive guidelines provided by the United States Department of Health and Human Services. A circulating nurse shall be present in the operating room for the duration of a surgical procedure. Section 2. This act shall take effect July 1, 2006.


FLORIDA ADMINISTRATIVE CODE TITLE 59 AGENCY FOR HEALTH CARE ADMINISTRATION 59A HEALTH FACILITY AND AGENCY LICENSING CHAPTER 59A-5 AMBULATORY SURGICAL CENTER LICENSURE 59A-5.0085 Departments and Services (d) A registered nurse shall serve as O.R. Circulating Nurse. (3) NURSING SERVICE. This service shall be organized under written policies and procedures relating to patient care, establishment of standards for nursing care and mechanisms for evaluating such care, and nursing services. (c) A registered professional nurse shall be the operating room circulating nurse.

» Registered Nurse First Assistants (RNFAs)

Reimbursement: Florida Statutes, Title XXXII, Chapter 464, Part 1, 464.027 (1) Legislative Intent – The purposes of this section are to: a. Encourage the use of registered nurse first assistants B. Provide for reimbursement for the registered nurse first assistant from managed health care agencies, state agencies, workers’ compensation carriers, and private insurance companies. AND: Florida Statutes, Title XXXVII, Chapter 627, Part II, § 627.419 (6) Notwithstanding any other provision of law, when any health insurance policy, health care services plan, or other contract provides for payment for surgical first assisting benefits or services, the policy, plan, or contract is to be construed as providing for payment to a registered nurse first assistant or employers of a physician assistant or nurse first assistant who performs such services that are within the scope of a physician assistant's or a registered nurse first assistant’s professional license. The provisions of this subsection apply only if reimbursement for an assisting physician, licensed under chapter 458 or chapter 459, would be covered and a physician assistant or a registered nurse first assistant who performs such services is used as a substitute.

Definition: Florida Annotated Statutes -TITLE 32. REGULATION OF PROFESSIONS AND OCCUPATIONS. CHAPTER 464. NURSING. PART I. NURSE PRACTICE ACT. 464.027. Registered nurse first assistant (2) DEFINITIONS. --As used in this section, the term: (c) "Registered nurse first assistant" means a person who meets the qualifications listed in this section. (3) QUALIFICATIONS. --A registered nurse first assistant is any person who: (a) Is licensed as a registered nurse under this part; (b) Is certified in perioperative nursing; and (c) Holds a certificate from, and has successfully completed a recognized program

Scope: The Florida 2005 Statutes, Regulation of Professions and Occupations, Chapter 464, 464.027, Registered Nurse First Assistants. (4) INSTITUTIONAL POWERS.--Each health care institution must establish specific procedures for the appointment and reappointment of registered nurse first assistant staff members and for granting, renewing, and revising their clinical privileges.

Guidelines for Perioperative Practice


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