Senate Bill sb1472

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    Florida Senate - 2005                                  SB 1472

    By Senator Peaden





    2-1051A-05

  1                      A bill to be entitled

  2         An act relating to hospitals; amending s.

  3         395.002, F.S.; redefining the term "hospital"

  4         to exclude designated critical access hospitals

  5         from certain requirements; amending ss. 395.003

  6         and 408.061, F.S.; conforming cross-references;

  7         amending s. 408.07, F.S.; defining the term

  8         "critical access hospital"; redefining the term

  9         "rural hospital" to delete certain requirements

10         applicable to the designation of a critical

11         access hospital; amending ss. 458.345 and

12         459.021, F.S.; conforming cross-references;

13         providing an effective date.

14  

15  Be It Enacted by the Legislature of the State of Florida:

16  

17         Section 1.  Subsections (13) and (24) of section

18  395.002, Florida Statutes, are amended to read:

19         395.002  Definitions.--As used in this chapter:

20         (13)  "Hospital" means any establishment that:

21         (a)  Offers services more intensive than those required

22  for room, board, personal services, and general nursing care,

23  and offers facilities and beds for use beyond 24 hours by

24  individuals requiring diagnosis, treatment, or care for

25  illness, injury, deformity, infirmity, abnormality, disease,

26  or pregnancy; and

27         (b)  Regularly makes available at least clinical

28  laboratory services, diagnostic X-ray services, and treatment

29  facilities for surgery or obstetrical care, or other

30  definitive medical treatment of similar extent, except that a

31  critical access hospital, as defined in s. 408.07, is not

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 1  required to make available treatment facilities for surgery,

 2  obstetrical care, or similar services as long as it maintains

 3  its designation as a critical access hospital, but must make

 4  such facilities available if it ceases to be designated as a

 5  critical access hospital.

 6  

 7  However, the provisions of this chapter do not apply to any

 8  institution conducted by or for the adherents of any

 9  well-recognized church or religious denomination that depends

10  exclusively upon prayer or spiritual means to heal, care for,

11  or treat any person.  For purposes of local zoning matters,

12  the term "hospital" includes a medical office building located

13  on the same premises as a hospital facility, provided the land

14  on which the medical office building is constructed is zoned

15  for use as a hospital; provided the premises were zoned for

16  hospital purposes on January 1, 1992.

17         (24)  "Premises" means those buildings, beds, and

18  equipment located at the address of the licensed facility and

19  all other buildings, beds, and equipment for the provision of

20  hospital, ambulatory surgical, or mobile surgical care located

21  in such reasonable proximity to the address of the licensed

22  facility as to appear to the public to be under the dominion

23  and control of the licensee. For any licensee that is a

24  teaching hospital as defined in s. 408.07(45) s. 408.07(44),

25  reasonable proximity includes any buildings, beds, services,

26  programs, and equipment under the dominion and control of the

27  licensee that are located at a site with a main address that

28  is within 1 mile of the main address of the licensed facility;

29  and all such buildings, beds, and equipment may, at the

30  request of a licensee or applicant, be included on the

31  facility license as a single premises.

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 1         Section 2.  Paragraph (e) of subsection (2) of section

 2  395.003, Florida Statutes, is amended to read:

 3         395.003  Licensure; issuance, renewal, denial,

 4  modification, suspension, and revocation.--

 5         (2)

 6         (e)  The agency shall, at the request of a licensee

 7  that is a teaching hospital as defined in s. 408.07(45) s.

 8  408.07(44), issue a single license to a licensee for

 9  facilities that have been previously licensed as separate

10  premises, provided such separately licensed facilities, taken

11  together, constitute the same premises as defined in s.

12  395.002(24). Such license for the single premises shall

13  include all of the beds, services, and programs that were

14  previously included on the licenses for the separate premises.

15  The granting of a single license under this paragraph shall

16  not in any manner reduce the number of beds, services, or

17  programs operated by the licensee.

18         Section 3.  Subsection (4) of section 408.061, Florida

19  Statutes, is amended to read:

20         408.061  Data collection; uniform systems of financial

21  reporting; information relating to physician charges;

22  confidential information; immunity.--

23         (4)  Within 120 days after the end of its fiscal year,

24  each health care facility, excluding continuing care

25  facilities and nursing homes as defined in s. 408.07(14) and

26  (37) (36), shall file with the agency, on forms adopted by the

27  agency and based on the uniform system of financial reporting,

28  its actual financial experience for that fiscal year,

29  including expenditures, revenues, and statistical measures.

30  Such data may be based on internal financial reports which are

31  certified to be complete and accurate by the provider.

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 1  However, hospitals' actual financial experience shall be their

 2  audited actual experience. Every nursing home shall submit to

 3  the agency, in a format designated by the agency, a

 4  statistical profile of the nursing home residents. The agency,

 5  in conjunction with the Department of Elderly Affairs and the

 6  Department of Health, shall review these statistical profiles

 7  and develop recommendations for the types of residents who

 8  might more appropriately be placed in their homes or other

 9  noninstitutional settings.

10         Section 4.  Section 408.07, Florida Statutes, is

11  amended to read:

12         408.07  Definitions.--As used in this chapter, with the

13  exception of ss. 408.031-408.045, the term:

14         (1)  "Accepted" means that the agency has found that a

15  report or data submitted by a health care facility or a health

16  care provider contains all schedules and data required by the

17  agency and has been prepared in the format specified by the

18  agency, and otherwise conforms to applicable rule or Florida

19  Hospital Uniform Reporting System manual requirements

20  regarding reports in effect at the time such report was

21  submitted, and the data are mathematically reasonable and

22  accurate.

23         (2)  "Adjusted admission" means the sum of acute and

24  intensive care admissions divided by the ratio of inpatient

25  revenues generated from acute, intensive, ambulatory, and

26  ancillary patient services to gross revenues.  If a hospital

27  reports only subacute admissions, then "adjusted admission"

28  means the sum of subacute admissions divided by the ratio of

29  total inpatient revenues to gross revenues.

30         (3)  "Agency" means the Agency for Health Care

31  Administration.

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 1         (4)  "Alcohol or chemical dependency treatment center"

 2  means an organization licensed under chapter 397.

 3         (5)  "Ambulatory care center" means an organization

 4  which employs or contracts with licensed health care

 5  professionals to provide diagnosis or treatment services

 6  predominantly on a walk-in basis and the organization holds

 7  itself out as providing care on a walk-in basis.  Such an

 8  organization is not an ambulatory care center if it is wholly

 9  owned and operated by five or fewer health care providers.

10         (6)  "Ambulatory surgical center" means a facility

11  licensed as an ambulatory surgical center under chapter 395.

12         (7)  "Audited actual data" means information contained

13  within financial statements examined by an independent,

14  Florida-licensed, certified public accountant in accordance

15  with generally accepted auditing standards, but does not

16  include data within a financial statement about which the

17  certified public accountant does not express an opinion or

18  issues a disclaimer.

19         (8)  "Birth center" means an organization licensed

20  under s. 383.305.

21         (9)  "Cardiac catheterization laboratory" means a

22  freestanding facility that employs or contracts with licensed

23  health care professionals to provide diagnostic or therapeutic

24  services for cardiac conditions such as cardiac

25  catheterization or balloon angioplasty.

26         (10)  "Case mix" means a calculated index for each

27  health care facility or health care provider, based on patient

28  data, reflecting the relative costliness of the mix of cases

29  to that facility or provider compared to a state or national

30  mix of cases.

31  

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 1         (11)  "Clinical laboratory" means a facility licensed

 2  under s. 483.091, excluding:  any hospital laboratory defined

 3  under s. 483.041(6); any clinical laboratory operated by the

 4  state or a political subdivision of the state; any blood or

 5  tissue bank where the majority of revenues are received from

 6  the sale of blood or tissue and where blood, plasma, or tissue

 7  is procured from volunteer donors and donated, processed,

 8  stored, or distributed on a nonprofit basis; and any clinical

 9  laboratory which is wholly owned and operated by physicians

10  who are licensed pursuant to chapter 458 or chapter 459 and

11  who practice in the same group practice, and at which no

12  clinical laboratory work is performed for patients referred by

13  any health care provider who is not a member of that same

14  group practice.

15         (12)  "Comprehensive rehabilitative hospital" or

16  "rehabilitative hospital" means a hospital licensed by the

17  agency as a specialty hospital as defined in s. 395.002;

18  provided that the hospital provides a program of comprehensive

19  medical rehabilitative services and is designed, equipped,

20  organized, and operated solely to deliver comprehensive

21  medical rehabilitative services, and further provided that all

22  licensed beds in the hospital are classified as "comprehensive

23  rehabilitative beds" pursuant to s. 395.003(4), and are not

24  classified as "general beds."

25         (13)  "Consumer" means any person other than a person

26  who administers health activities, is a member of the

27  governing body of a health care facility, provides health

28  services, has a fiduciary interest in a health facility or

29  other health agency or its affiliated entities, or has a

30  material financial interest in the rendering of health

31  services.

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 1         (14)  "Continuing care facility" means a facility

 2  licensed under chapter 651.

 3         (15)  "Critical access hospital" means a hospital that

 4  meets the definition of the term "critical access hospital" in

 5  42 U.S.C. s. 1395i-4(e) under the Social Security Act and is

 6  certified by the Secretary of the United States Department of

 7  Health and Human Services as a critical access hospital.

 8         (16)(15)  "Cross-subsidization" means that the revenues

 9  from one type of hospital service are sufficiently higher than

10  the costs of providing such service as to offset some of the

11  costs of providing another type of service in the hospital.

12  Cross-subsidization results from the lack of a direct

13  relationship between charges and the costs of providing a

14  particular hospital service or type of service.

15         (17)(16)  "Deductions from gross revenue" or

16  "deductions from revenue" means reductions from gross revenue

17  resulting from inability to collect payment of charges.  For

18  hospitals, such reductions include contractual adjustments;

19  uncompensated care; administrative, courtesy, and policy

20  discounts and adjustments; and other such revenue deductions,

21  but also includes the offset of restricted donations and

22  grants for indigent care.

23         (18)(17)  "Diagnostic-imaging center" means a

24  freestanding outpatient facility that provides specialized

25  services for the diagnosis of a disease by examination and

26  also provides radiological services. Such a facility is not a

27  diagnostic-imaging center if it is wholly owned and operated

28  by physicians who are licensed pursuant to chapter 458 or

29  chapter 459 and who practice in the same group practice and no

30  diagnostic-imaging work is performed at such facility for

31  

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 1  patients referred by any health care provider who is not a

 2  member of that same group practice.

 3         (19)(18)  "FHURS" means the Florida Hospital Uniform

 4  Reporting System developed by the agency.

 5         (20)(19)  "Freestanding" means that a health facility

 6  bills and receives revenue which is not directly subject to

 7  the hospital assessment for the Public Medical Assistance

 8  Trust Fund as described in s. 395.701.

 9         (21)(20)  "Freestanding radiation therapy center" means

10  a facility where treatment is provided through the use of

11  radiation therapy machines that are registered under s. 404.22

12  and the provisions of the Florida Administrative Code

13  implementing s. 404.22.  Such a facility is not a freestanding

14  radiation therapy center if it is wholly owned and operated by

15  physicians licensed pursuant to chapter 458 or chapter 459 who

16  practice within the specialty of diagnostic or therapeutic

17  radiology.

18         (22)(21)  "GRAA" means gross revenue per adjusted

19  admission.

20         (23)(22)  "Gross revenue" means the sum of daily

21  hospital service charges, ambulatory service charges,

22  ancillary service charges, and other operating revenue.  Gross

23  revenues do not include contributions, donations, legacies, or

24  bequests made to a hospital without restriction by the donors.

25         (24)(23)  "Health care facility" means an ambulatory

26  surgical center, a hospice, a nursing home, a hospital, a

27  diagnostic-imaging center, a freestanding or hospital-based

28  therapy center, a clinical laboratory, a home health agency, a

29  cardiac catheterization laboratory, a medical equipment

30  supplier, an alcohol or chemical dependency treatment center,

31  a physical rehabilitation center, a lithotripsy center, an

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 1  ambulatory care center, a birth center, or a nursing home

 2  component licensed under chapter 400 within a continuing care

 3  facility licensed under chapter 651.

 4         (25)(24)  "Health care provider" means a health care

 5  professional licensed under chapter 458, chapter 459, chapter

 6  460, chapter 461, chapter 463, chapter 464, chapter 465,

 7  chapter 466, part I, part III, part IV, part V, or part X of

 8  chapter 468, chapter 483, chapter 484, chapter 486, chapter

 9  490, or chapter 491.

10         (26)(25)  "Health care purchaser" means an employer in

11  the state, other than a health care facility, health insurer,

12  or health care provider, who provides health care coverage for

13  her or his employees.

14         (27)(26)  "Health insurer" means any insurance company

15  authorized to transact health insurance in the state, any

16  insurance company authorized to transact health insurance or

17  casualty insurance in the state that is offering a minimum

18  premium plan or stop-loss coverage for any person or entity

19  providing health care benefits, any self-insurance plan as

20  defined in s. 624.031, any health maintenance organization

21  authorized to transact business in the state pursuant to part

22  I of chapter 641, any prepaid health clinic authorized to

23  transact business in the state pursuant to part II of chapter

24  641, any multiple-employer welfare arrangement authorized to

25  transact business in the state pursuant to ss. 624.436-624.45,

26  or any fraternal benefit society providing health benefits to

27  its members as authorized pursuant to chapter 632.

28         (28)(27)  "Home health agency" means an organization

29  licensed under part IV of chapter 400.

30         (29)(28)  "Hospice" means an organization licensed

31  under part VI of chapter 400.

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 1         (30)(29)  "Hospital" means a health care institution

 2  licensed by the Agency for Health Care Administration as a

 3  hospital under chapter 395.

 4         (31)(30)  "Lithotripsy center" means a freestanding

 5  facility that employs or contracts with licensed health care

 6  professionals to provide diagnosis or treatment services using

 7  electro-hydraulic shock waves.

 8         (32)(31)  "Local health council" means the agency

 9  defined in s. 408.033.

10         (33)(32)  "Market basket index" means the Florida

11  hospital input price index (FHIPI), which is a statewide

12  market basket index used to measure inflation in hospital

13  input prices weighted for the Florida-specific experience

14  which uses multistate regional and state-specific price

15  measures, when available.  The index shall be constructed in

16  the same manner as the index employed by the Secretary of the

17  United States Department of Health and Human Services for

18  determining the inflation in hospital input prices for

19  purposes of Medicare reimbursement.

20         (34)(33)  "Medical equipment supplier" means an

21  organization that provides medical equipment and supplies used

22  by health care providers and health care facilities in the

23  diagnosis or treatment of disease.

24         (35)(34)  "Net revenue" means gross revenue minus

25  deductions from revenue.

26         (36)(35)  "New hospital" means a hospital in its

27  initial year of operation as a licensed hospital and does not

28  include any facility which has been in existence as a licensed

29  hospital, regardless of changes in ownership, for over 1

30  calendar year.

31  

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 1         (37)(36)  "Nursing home" means a facility licensed

 2  under s. 400.062 or, for resident level and financial data

 3  collection purposes only, any institution licensed under

 4  chapter 395 and which has a Medicare or Medicaid certified

 5  distinct part used for skilled nursing home care, but does not

 6  include a facility licensed under chapter 651.

 7         (38)(37)  "Operating expenses" means total expenses

 8  excluding income taxes.

 9         (39)(38)  "Other operating revenue" means all revenue

10  generated from hospital operations other than revenue directly

11  associated with patient care.

12         (40)(39)  "Physical rehabilitation center" means an

13  organization that employs or contracts with health care

14  professionals licensed under part I or part III of chapter 468

15  or chapter 486 to provide speech, occupational, or physical

16  therapy services on an outpatient or ambulatory basis.

17         (41)(40)  "Prospective payment arrangement" means a

18  financial agreement negotiated between a hospital and an

19  insurer, health maintenance organization, preferred provider

20  organization, or other third-party payor which contains, at a

21  minimum, the elements provided for in s. 408.50.

22         (42)(41)  "Rate of return" means the financial

23  indicators used to determine or demonstrate reasonableness of

24  the financial requirements of a hospital.  Such indicators

25  shall include, but not be limited to:  return on assets,

26  return on equity, total margin, and debt service coverage.

27         (43)(42)  "Rural hospital" means an acute care hospital

28  licensed under chapter 395, having 100 or fewer licensed beds

29  and an emergency room, and which is:

30  

31  

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 1         (a)  The sole provider within a county with a

 2  population density of no greater than 100 persons per square

 3  mile;

 4         (b)  An acute care hospital, in a county with a

 5  population density of no greater than 100 persons per square

 6  mile, which is at least 30 minutes of travel time, on normally

 7  traveled roads under normal traffic conditions, from another

 8  acute care hospital within the same county;

 9         (c)  A hospital supported by a tax district or

10  subdistrict whose boundaries encompass a population of 100

11  persons or fewer per square mile;

12         (d)  A hospital with a service area that has a

13  population of 100 persons or fewer per square mile.  As used

14  in this paragraph, the term "service area" means the fewest

15  number of zip codes that account for 75 percent of the

16  hospital's discharges for the most recent 5-year period, based

17  on information available from the hospital inpatient discharge

18  database in the State Center for Health Statistics at the

19  Agency for Health Care Administration; or

20         (e)  A hospital designated as A critical access

21  hospital by the Department of Health in accordance with

22  federal regulations and state requirements.

23  

24  Population densities used in this subsection must be based

25  upon the most recently completed United States census. A

26  hospital that received funds under s. 409.9116 for a quarter

27  beginning no later than July 1, 2002, is deemed to have been

28  and shall continue to be a rural hospital from that date

29  through June 30, 2012, if the hospital continues to have 100

30  or fewer licensed beds and an emergency room, or meets the

31  criteria of s. 395.602(2)(e)4. An acute care hospital that has

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 1  not previously been designated as a rural hospital and that

 2  meets the criteria of this subsection shall be granted such

 3  designation upon application, including supporting

 4  documentation, to the Agency for Health Care Administration.

 5         (44)(43)  "Special study" means a nonrecurring

 6  data-gathering and analysis effort designed to aid the agency

 7  in meeting its responsibilities pursuant to this chapter.

 8         (45)(44)  "Teaching hospital" means any Florida

 9  hospital officially affiliated with an accredited Florida

10  medical school which exhibits activity in the area of graduate

11  medical education as reflected by at least seven different

12  graduate medical education programs accredited by the

13  Accreditation Council for Graduate Medical Education or the

14  Council on Postdoctoral Training of the American Osteopathic

15  Association and the presence of 100 or more full-time

16  equivalent resident physicians. The Director of the Agency for

17  Health Care Administration shall be responsible for

18  determining which hospitals meet this definition.

19         Section 5.  Subsection (1) of section 458.345, Florida

20  Statutes, is amended to read:

21         458.345  Registration of resident physicians, interns,

22  and fellows; list of hospital employees; prescribing of

23  medicinal drugs; penalty.--

24         (1)  Any person desiring to practice as a resident

25  physician, assistant resident physician, house physician,

26  intern, or fellow in fellowship training which leads to

27  subspecialty board certification in this state, or any person

28  desiring to practice as a resident physician, assistant

29  resident physician, house physician, intern, or fellow in

30  fellowship training in a teaching hospital in this state as

31  defined in s. 408.07(45) s. 408.07(44) or s. 395.805(2), who

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 1  does not hold a valid, active license issued under this

 2  chapter shall apply to the department to be registered and

 3  shall remit a fee not to exceed $300 as set by the board.  The

 4  department shall register any applicant the board certifies

 5  has met the following requirements:

 6         (a)  Is at least 21 years of age.

 7         (b)  Has not committed any act or offense within or

 8  without the state which would constitute the basis for refusal

 9  to certify an application for licensure pursuant to s.

10  458.331.

11         (c)  Is a graduate of a medical school or college as

12  specified in s. 458.311(1)(f).

13         Section 6.  Subsection (1) of section 459.021, Florida

14  Statutes, is amended to read:

15         459.021  Registration of resident physicians, interns,

16  and fellows; list of hospital employees; penalty.--

17         (1)  Any person who holds a degree of Doctor of

18  Osteopathic Medicine from a college of osteopathic medicine

19  recognized and approved by the American Osteopathic

20  Association who desires to practice as a resident physician,

21  assistant resident physician, house physician, intern, or

22  fellow in fellowship training which leads to subspecialty

23  board certification in this state, or any person desiring to

24  practice as a resident physician, assistant resident

25  physician, house physician, intern, or fellow in fellowship

26  training in a teaching hospital in this state as defined in s.

27  408.07(45) s. 408.07(44) or s. 395.805(2), who does not hold

28  an active license issued under this chapter shall apply to the

29  department to be registered, on an application provided by the

30  department, within 30 days of commencing such a training

31  

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 1  program and shall remit a fee not to exceed $300 as set by the

 2  board.

 3         Section 7.  This act shall take effect upon becoming a

 4  law.

 5  

 6            *****************************************

 7                          SENATE SUMMARY

 8    Redefines the term "hospital" to exclude designated
      critical access hospitals from certain requirements.
 9    Defines the term "critical access hospital."

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