A DEM, or Designated Establishment Manager, is a specific role in the Massage Therapy Industry in the State of Florida, USA. According to 2024 Regulation of Professions and Occupations, regarding Florida Statute 480.033 (7), a “Designated Establishment Manager” is a Massage Therapist who holds a clear and active license without restriction; a Health Care Practitioner licensed under Chapter 457; or a Physician licensed under Chapters 458, 459, or 460, who is responsible for the operation of a Massage Establishment in accordance with the provisions of that chapter, and who is designated "The Manager" by the rules or practices at the Establishment.

Every Licensed Massage Establishment in the State of Florida must comply with this new law.

As it pertains to a Designated Establishment Manager in Florida, "floating" typically means:

The practice of serving as the designated manager for multiple massage establishments within a certain area, rotating between these locations to fulfill legal and operational responsibilities. This Manager is not permanently stationed at any single establishment but instead moves between them as needed to ensure compliance with state regulations, oversee operations, and address any issues that arise.

Example:

Sarah is a Licensed Massage Therapist who serves as a floating Designated Establishment Manager for three Massage Establishments in Miami. On Mondays and Tuesdays, she's at "Relaxation Haven" on Ocean Drive; she ensures all Therapists have up-to-date licenses and the establishment adheres to Florida's sanitation standards. Wednesdays and Thursdays find her at "Sunshine Spa" in Coral Gables, where she conducts staff training and handles client concerns. She rounds out her week on Fridays and Saturdays at "Beachside Bliss" in South Beach, overseeing operations and ensuring all required documentation is in order. By floating between these establishments, Sarah fulfills the legal requirement for each to have a DEM while efficiently managing her time and responsibilities across multiple locations.

This arrangement is perfectly legal as there are no rules in the Statute against one DEM servicing multiple Establishments. It may even be ideal if you're a Spa Owner who has high turnover or you don't want to rely on one of your regular providers who are there to service your patrons on a daily basis. You may consider contracting with a Non Disclosure Agreement to protect any sensative proprietary business information.

It can happen to anyone and it's not the end of the world, but it will be the end of massages being performed at your Establishment until you acquire a DEM and report the correction to the Florida Board of Massage Therapy.

Here's an example of a high-end Luxury Spa in Miami who had their Massage Establishment License suspended after 23 years in business: According to the Miami Herald article, The Massage Establishment License of the renowned Mandarin Oriental in Miami, Florida was suspended immediately on August 4, 2024 due to the failure to have a Designated Establishment Manager (DEM) practicing at the location between May 22 and August 1, 2024. Should this happen to you, you can continue other non-massage related services, but not Massage Therapy until your Licensed is cleared again by the State Inspector.

In summary, a Designated Establishment Manager (DEM) is responsible for ensuring the Massage Establishment operates in compliance with the laws and rules governing Massage Therapy in the State of Florida. This includes: Verifying all practicing Licensed Massage Therapists are properly licensed and maintain current, active licenses. Ensuring the Establishment adheres to legal requirements for documentation and identification of workers. Reporting potential violations related to sexual misconduct or human trafficking. Implementing and maintaining procedures for reporting suspected human trafficking. Overseeing general compliance with state laws and regulations pertaining to Massage Therapy practice and Establishment operations. Notifying the Florida Massage Board within 3 days if they cease to serve as the DEM for an Establishment. The DEM plays a crucial role in maintaining professional standards, legal compliance, and ethical practices within the Massage Establishment.

Here are the important technicalities according to Florida's Rulemaking Authority for 64B7-26.0035 Designated Establishment Managers' Responsibilities:

1. The Massage Therapist who serves as the Designated Establishment Manager (DEM) for a Massage Establishment or Establishments must practice in the Massage Establishment or Establishments where they are serving as DEM.

2. The Massage Therapist who serves as the DEM of a Massage Establishment must ensure that the Massage Establishment operate in compliance with the law, Chapters 456 and 480, F.S., and Division 64B7, F.A.C.

3. For each Massage Establishment, the Massage Therapist who serves as the DEM must:

(a) Ensure that every Massage Therapist, practicing in the Massage Establishment is duly licensed, and that the licenses

of all Massage Therapist practicing in the Massage Establishment are current and active;

(b) Ensure that every Massage Therapist practicing in the Massage Establishment has displayed their license as required by Rule 64B7-23.003, F.A.C.;

(c) Ensure that the Massage Establishment remains in compliance with Section 480.0535(2), F.S., concerning

documentation required while working in an Establishment;

(d) Ensure that each Licensed Massage Therapist and any person working in the Massage Establishment has

unrestricted access to their own personal valid Government Identification to comply with Section 480.0535(1), F.S.;

(e) Upon a report of any potential violations of Section 480.0485, F.S., Rules 64B7-23.005 and/or 64B7-26.010, F.A.C.,

related to sexual misconduct, or sexual activity report the potential violation to The Department for investigation

pursuant to Section 456.073(1), F.S., within three days; and

(f) Ensure compliance with the provisions of Sections 456.0341, and 480.043, F.S., regarding human trafficking signage

and procedures by:

1. Ensuring the Establishment has a reporting procedure for human trafficking pursuant to Section 480.043(13), F.S.;

2. Ensuring that all Massage Therapists and employees working in the Establishment are aware of the

establishment’s procedure for reporting suspected human trafficking; and

3. No DEM shall engage in or permit any person or person to engage in sexual activity in the Massage Establishment

or to use the Massage Establishment to make arrangements to engage in sexual activity in any other place.

4. A Massage Therapist who no longer serves as DEM for an Establishment must notify the Board, within 3 days, that the Massage Therapist is no longer serving. Notification must include the license number of the Establishment and the date on which the Massage Therapist ceased serving as DEM for the Establishment.

According to the final Rule: 64B7-26.0035 "Designated Establishment Managers", if you are no longer a DEM at a Florida Licensed Massage Establishment, you have only 3 days to report this information to the Florida Board of Massage Therapy. You must also include the Massage Establishment License number and the date you ceased serving as their DEM.

Since the rule does not state the Board's prefered method of reporting the removal status, there are 3 ways to do it:

Call: 850-245-4161

Fax: 850-412-2681

Email: Florida's Massage Board and / or Medical Quality Assurance's Licensure Support Services

If you are an Establishment Owner who is not the DEM or are Designating another DEM for your Establishment and you need to report a change, please see the Q/A on this below.

If you are an Establishment Owner and need to report that your DEM changed, you must fill out and submit Florida's Massage Establishment Change of Corporate Officer / InterestedParty / Designated Establishment Manager form within 10 days of your former DEM reporting their change of status with your Establishment.

No, there can only be one DEM per Establishment. You may retain the same DEM to serve in that role for more than one Establishment location but you cannot have two DEM's at the same Establishment's address.

Yes, the newly ammended rule to Florida Statute 480.033(7) has been updated to include an expansion of the rule for who can be a Designated Establishment Manager to include: a health care practitioner licensed under chapter 457; or a physician licensed under chapter 458, 459, or chapter 460, who is responsible for the operation of a Massage Establishment in accordance with the provisions of this chapter, and who is designated the manager by the rules or practices at the establishment.

This means Accupuncturists, Dermatologists, Physical Therapists, Chiropractors, and Osteopathic Physicians who employ Massage Therapists to work on their patients are excluded from needing a Massage Establishment License or they may serve as a Designated Establishment Manager.

To be a DEM, a Licensed Massage Therapist must hold a clear and active license without restriction. They must be responsible for the operation of a Licensed Massage Establishment in accordance with Chapter 456, Florida Statutes, 480, Florida Statutes, and 64B7, Florida Administrative Code and be designated by the rules or practices at the establishment.

They may also be a health care practitioner licensed under chapter 457; or a physician licensed under chapters 458, 459, or chapter 460, who is responsible for the operation of a Massage Establishment in accordance with the provisions of the chapter, and who is designated the manager by the rules or practices at the establishment.

In short, this means Accupuncturists, Dermatologists, Physical Therapists, Chiropractors, and Osteopathic Physicians who employ Massage Therapists to work on their patients are excluded from needing a Massage Establishment License or they may serve as a Designated Establishment Manager.

A Massage Therapist cannot serve as a DEM if:

1. They obtained a Massage Establishment license by fraud or misrepresentation.

2. Are found guilty of fraud or deceit or of gross negligence, incompetency, or misconduct in the operation of a Massage Establishment.

3. Have had a final order entered against them or other disciplinary action taken against their license for sexual misconduct involving prostitution.

4. Have had a final order entered against them, or other disciplinary action taken for crimes related to the practice of Massage Therapy involving prostitution.

5. Have been convicted of or entered a plea of guilty or nolo contendere to any misdemeanor or felony crime, regardless of adjudication, related to prostitution or related acts as described in s. 796.07, Florida Statutes.

Yes, as long as you meet all the qualifications.

No, the DEM is not required to be present during the inspection. Inspection results can be requested at any time and the Eestablishment is provided with a copy after the inspection.

If you receive a report of an accusation of sexual misconduct at or affiliated with a Florida Licensed Massage Establishment, you are required to report the accusation within three days. Your report should be made in the form of a complaint @ www.flhealthcomplaint.gov.

As a DEM, you should address the issue with the Massage Establishment.  If the Establishment Owner refuses to resolve the violation, you may report the issue by submitting a complaint to www.flhealthcomplaint.gov . If you no longer wish to serve as the DEM of the Establishment, you can also remove your designation by reporting your resignation to the Florida Board of Massage Therapy.

No, the form to formally designate an Establishment Manager must be submitted by the Establishment Owner(s).

You are required to report your resignation to the Florida Massage Board within 3 days of termination. Since the rule does not state the Board's prefered method of reporting the removal status, there are 3 ways to do it:

1. Call: 850-245-4161

2. Fax: 850-412-2681

3. Email: Florida's Massage Board and / or Medical Quality Assurance's Licensure Support Services

No, not unless the DEM is also the Establishment Owner. However, the DEM should ensure that the Establishment is operating in compliance with the laws and rules which govern the license and should take care to remind the Establishment Owner when License renewals are due as part of managerial duties. However, please refer to your contract, job description or verbal agreements concerning whether this is part of the standard operating procedures of the Establishment.

The DEM can be either one as long as they meet the qualifications and the Establishment Owner submits the designation.

Yes, The Florida Board of Massage Therapy will send each party a verification email to the email addresses on record.

Yes, the State Board will notify the Establishment Owner when their DEM resigns. The Establishment Owner has 10 days to submit a new form designating a new Establishment Manager.

We're so glad you asked! White Linen Spa Group will gladly serve as a salary negotiator and Virtual Assistant in creating contract templates you can run by your legal advisor to speed up the process of securing a mutually beneficial arrangement. Click below to apply as a DEM Provider, book a free consult or Join Us in our Member's area if you're an Employer.

It's understandable and recommended to seek help in navigating Florida's Legal System regarding the Healthcare Industry. Although many Florida LMT's work in Spa Establishments and not Medical Establishments, they are still governed by Florida's Department of Health. It's important to seek legal help if you want peace of mind around the subject of Designating an Establishment Manager or your duties and responsibilities as a DEM. Florida Healthcare Lawfim specializes in such legal matters and have summarized the current legalities around this subject on their site. Here are the highlights in a July 2024 article by Rachel E. Broughton, Attorney @FloridaHealthcareLawfirm discussing Florida's new law, House Bill 197, that affects Massage Therapists and their workplaces. This law, which came into effect on July 1, 2024, changes some important definitions and introduces new record-keeping requirements. Let's break down what this means for Massage Therapists and the places they work.

Key Changes:

1. Broader definitions of who's in charge and who's an employee

2. New rules about keeping records for employees and patients

3. Potential impacts on office-sharing arrangements

What's Changed?

The law now defines a "Designated Establishment Manager" as a Licensed Massage Therapist or Healthcare Practitioner who runs a Massage Establishment. It also broadens the definition of an "Employee" to include Independent Contractors and even people who do tasks like cleaning or preparing meals, whether they're paid or not.

New Record-Keeping Rules:

- For employees: Businesses must keep detailed records including full name, birth date, address, phone number, position, and ID copy.

- For patients: Records must include date, time, service type, Therapist's name, and Patient's full name, address, and phone number.

- These records must be kept for at least one year.

Impact on Office Sharing:

If you're a non-Massage Therapist sharing an office with a Massage Therapist, you might be considered their "employee" under this new law. This could mean you have to follow these new record-keeping rules.

What Should You Do?

- If you're sharing an office, make sure you have a clear sublease agreement.

- Keep your business operations separate from the Massage Therapist's.

- Consider consulting with a healthcare attorney to ensure you're following the new rules correctly.

Summary:

Florida's new law expands definitions of who's considered a Manager and Employee in Massage Establishments. It also introduces strict record-keeping requirements. This could affect how Massage Therapists work, especially those sharing offices with other professionals. It's important to understand these changes and take steps to ensure compliance.