Florida Senate - 2013                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 966
       
       
       
       
       
       
                                Barcode 481238                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                 Floor: WD/2R          .                                
             04/30/2013 03:06 PM       .                                
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       Senator Soto moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete lines 2561 - 3073
    4  and insert:
    5  complaints that resulted in a citation for licensure. The agency
    6  must first consult with the state long-term care ombudsman
    7  program council for the area in which the facility is located to
    8  determine whether if any complaints have been made and
    9  substantiated about the quality of services or care. The agency
   10  may not waive one of the required yearly monitoring visits if
   11  complaints have been made and substantiated.
   12         4.3. A facility that is licensed to provide extended
   13  congregate care services must:
   14         a. Demonstrate the capability to meet unanticipated
   15  resident service needs.
   16         b. Offer a physical environment that promotes a homelike
   17  setting, provides for resident privacy, promotes resident
   18  independence, and allows sufficient congregate space as defined
   19  by rule.
   20         c. Have sufficient staff available, taking into account the
   21  physical plant and firesafety features of the building, to
   22  assist with the evacuation of residents in an emergency.
   23         d. Adopt and follow policies and procedures that maximize
   24  resident independence, dignity, choice, and decisionmaking to
   25  permit residents to age in place, so that moves due to changes
   26  in functional status are minimized or avoided.
   27         e. Allow residents or, if applicable, a resident’s
   28  representative, designee, surrogate, guardian, or attorney in
   29  fact to make a variety of personal choices, participate in
   30  developing service plans, and share responsibility in
   31  decisionmaking.
   32         f. Implement the concept of managed risk.
   33         g. Provide, directly or through contract, the services of a
   34  person licensed under part I of chapter 464.
   35         h. In addition to the training mandated in s. 429.52,
   36  provide specialized training as defined by rule for facility
   37  staff.
   38         5.4. A facility that is licensed to provide extended
   39  congregate care services is exempt from the criteria for
   40  continued residency set forth in rules adopted under s. 429.41.
   41  A licensed facility must adopt its own requirements within
   42  guidelines for continued residency set forth by rule. However,
   43  the facility may not serve residents who require 24-hour nursing
   44  supervision. A licensed facility that provides extended
   45  congregate care services must also provide each resident with a
   46  written copy of facility policies governing admission and
   47  retention.
   48         5. The primary purpose of extended congregate care services
   49  is to allow residents, as they become more impaired, the option
   50  of remaining in a familiar setting from which they would
   51  otherwise be disqualified for continued residency. A facility
   52  licensed to provide extended congregate care services may also
   53  admit an individual who exceeds the admission criteria for a
   54  facility with a standard license, if the individual is
   55  determined appropriate for admission to the extended congregate
   56  care facility.
   57         6. Before the admission of an individual to a facility
   58  licensed to provide extended congregate care services, the
   59  individual must undergo a medical examination as provided in s.
   60  429.26(4) and the facility must develop a preliminary service
   61  plan for the individual.
   62         7. If When a facility can no longer provide or arrange for
   63  services in accordance with the resident’s service plan and
   64  needs and the facility’s policy, the facility must shall make
   65  arrangements for relocating the person in accordance with s.
   66  429.28(1)(k).
   67         8. Failure to provide extended congregate care services may
   68  result in denial of extended congregate care license renewal.
   69  
   70  The agency may deny or revoke a facility’s extended congregate
   71  care license for not meeting the standards of an extended
   72  congregate care license or for any of the grounds listed in this
   73  subsection.
   74         (c) A limited nursing services license shall be issued to a
   75  facility that provides services beyond those authorized in
   76  paragraph (a) and as specified in this paragraph.
   77         1. In order for limited nursing services to be provided in
   78  a facility licensed under this part, the agency must first
   79  determine that all requirements established in law and rule are
   80  met and must specifically designate, on the facility’s license,
   81  that such services may be provided. Such designation may be made
   82  at the time of initial licensure or licensure renewal
   83  relicensure, or upon request in writing by a licensee under this
   84  part and part II of chapter 408. Notification of approval or
   85  denial of such request shall be made in accordance with part II
   86  of chapter 408. An existing facility that qualifies facilities
   87  qualifying to provide limited nursing services must shall have
   88  maintained a standard license and may not have been subject to
   89  administrative sanctions that affect the health, safety, and
   90  welfare of residents for the previous 2 years or since initial
   91  licensure if the facility has been licensed for less than 2
   92  years.
   93         2. A facility Facilities that is are licensed to provide
   94  limited nursing services shall maintain a written progress
   95  report on each person who receives such nursing services. The,
   96  which report must describe describes the type, amount, duration,
   97  scope, and outcome of services that are rendered and the general
   98  status of the resident’s health. A registered nurse representing
   99  the agency shall visit the facility such facilities at least
  100  annually twice a year to monitor residents who are receiving
  101  limited nursing services and to determine if the facility is in
  102  compliance with applicable provisions of this part, part II of
  103  chapter 408, and related rules. The monitoring visits may be
  104  provided through contractual arrangements with appropriate
  105  community agencies. A registered nurse shall also serve as part
  106  of the team that inspects such facility. Visits may be in
  107  conjunction with other agency inspections. The agency may waive
  108  one of the required yearly monitoring visits for a facility that
  109  has:
  110         a. A limited nursing services license for at least 24
  111  months;
  112         b. No class I or class II violations and no uncorrected
  113  class III violations; and
  114         c. No confirmed ombudsman program complaints that resulted
  115  in a citation for licensure.
  116         3. A person who receives limited nursing services under
  117  this part must meet the admission criteria established by the
  118  agency for assisted living facilities. When a resident no longer
  119  meets the admission criteria for a facility licensed under this
  120  part, arrangements for relocating the person shall be made in
  121  accordance with s. 429.28(1)(k), unless the facility is licensed
  122  to provide extended congregate care services.
  123         Section 59. Section 429.075, Florida Statutes, is amended
  124  to read:
  125         429.075 Limited mental health license.—An assisted living
  126  facility that serves one three or more mental health residents
  127  must obtain a limited mental health license.
  128         (1) To obtain a limited mental health license, a facility
  129  must hold a standard license as an assisted living facility,
  130  must not have any current uncorrected deficiencies or
  131  violations, and must ensure that, within 6 months after
  132  receiving a limited mental health license, the facility
  133  administrator and the staff of the facility who are in direct
  134  contact with mental health residents must complete training of
  135  no less than 6 hours related to their duties. Such designation
  136  may be made at the time of initial licensure or relicensure or
  137  upon request in writing by a licensee under this part and part
  138  II of chapter 408. Notification of approval or denial of such
  139  request shall be made in accordance with this part, part II of
  140  chapter 408, and applicable rules. This training must will be
  141  provided by or approved by the Department of Children and
  142  Families Family Services.
  143         (2) A facility that is Facilities licensed to provide
  144  services to mental health residents must shall provide
  145  appropriate supervision and staffing to provide for the health,
  146  safety, and welfare of such residents.
  147         (3) A facility that has a limited mental health license
  148  must:
  149         (a) Have a copy of each mental health resident’s community
  150  living support plan and the cooperative agreement with the
  151  mental health care services provider. The support plan and the
  152  agreement may be combined.
  153         (b) Have documentation that is provided by the Department
  154  of Children and Families Family Services that each mental health
  155  resident has been assessed and determined to be able to live in
  156  the community in an assisted living facility that has with a
  157  limited mental health license.
  158         (c) Make the community living support plan available for
  159  inspection by the resident, the resident’s legal guardian, the
  160  resident’s health care surrogate, and other individuals who have
  161  a lawful basis for reviewing this document.
  162         (d) Assist the mental health resident in carrying out the
  163  activities identified in the individual’s community living
  164  support plan.
  165         (4) A facility that has with a limited mental health
  166  license may enter into a cooperative agreement with a private
  167  mental health provider. For purposes of the limited mental
  168  health license, the private mental health provider may act as
  169  the case manager.
  170         Section 60. Section 429.14, Florida Statutes, is amended to
  171  read:
  172         429.14 Administrative penalties.—
  173         (1) In addition to the requirements of part II of chapter
  174  408, the agency may deny, revoke, and suspend any license issued
  175  under this part and impose an administrative fine in the manner
  176  provided in chapter 120 against a licensee for a violation of
  177  any provision of this part, part II of chapter 408, or
  178  applicable rules, or for any of the following actions by a
  179  licensee, for the actions of any person subject to level 2
  180  background screening under s. 408.809, or for the actions of any
  181  facility staff employee:
  182         (a) An intentional or negligent act seriously affecting the
  183  health, safety, or welfare of a resident of the facility.
  184         (b) A The determination by the agency that the owner lacks
  185  the financial ability to provide continuing adequate care to
  186  residents.
  187         (c) Misappropriation or conversion of the property of a
  188  resident of the facility.
  189         (d) Failure to follow the criteria and procedures provided
  190  under part I of chapter 394 relating to the transportation,
  191  voluntary admission, and involuntary examination of a facility
  192  resident.
  193         (e) A citation of any of the following violations
  194  deficiencies as specified in s. 429.19:
  195         1. One or more cited class I violations deficiencies.
  196         2. Three or more cited class II violations deficiencies.
  197         3. Five or more cited class III violations deficiencies
  198  that have been cited on a single survey and have not been
  199  corrected within the times specified.
  200         (f) Failure to comply with the background screening
  201  standards of this part, s. 408.809(1), or chapter 435.
  202         (g) Violation of a moratorium.
  203         (h) Failure of the license applicant, the licensee during
  204  relicensure, or a licensee that holds a provisional license to
  205  meet the minimum license requirements of this part, or related
  206  rules, at the time of license application or renewal.
  207         (i) An intentional or negligent life-threatening act in
  208  violation of the uniform firesafety standards for assisted
  209  living facilities or other firesafety standards which that
  210  threatens the health, safety, or welfare of a resident of a
  211  facility, as communicated to the agency by the local authority
  212  having jurisdiction or the State Fire Marshal.
  213         (j) Knowingly operating any unlicensed facility or
  214  providing without a license any service that must be licensed
  215  under this chapter or chapter 400.
  216         (k) Any act constituting a ground upon which application
  217  for a license may be denied.
  218         (2) Upon notification by the local authority having
  219  jurisdiction or by the State Fire Marshal, the agency may deny
  220  or revoke the license of an assisted living facility that fails
  221  to correct cited fire code violations that affect or threaten
  222  the health, safety, or welfare of a resident of a facility.
  223         (3) The agency may deny or revoke a license of an to any
  224  applicant or controlling interest as defined in part II of
  225  chapter 408 which has or had a 25-percent or greater financial
  226  or ownership interest in any other facility that is licensed
  227  under this part, or in any entity licensed by this state or
  228  another state to provide health or residential care, if that
  229  which facility or entity during the 5 years prior to the
  230  application for a license closed due to financial inability to
  231  operate; had a receiver appointed or a license denied,
  232  suspended, or revoked; was subject to a moratorium; or had an
  233  injunctive proceeding initiated against it.
  234         (4) The agency shall deny or revoke the license of an
  235  assisted living facility if:
  236         (a)There are two moratoria, issued pursuant to this part
  237  or part II of chapter 408, within a 2-year period which are
  238  imposed by final order;
  239         (b)The facility is cited for two or more class I
  240  violations arising from unrelated circumstances during the same
  241  survey or investigation; or
  242         (c)The facility is cited for two or more class I
  243  violations arising from separate surveys or investigations
  244  within a 2-year period that has two or more class I violations
  245  that are similar or identical to violations identified by the
  246  agency during a survey, inspection, monitoring visit, or
  247  complaint investigation occurring within the previous 2 years.
  248         (5) An action taken by the agency to suspend, deny, or
  249  revoke a facility’s license under this part or part II of
  250  chapter 408, in which the agency claims that the facility owner
  251  or an employee of the facility has threatened the health,
  252  safety, or welfare of a resident of the facility must be heard
  253  by the Division of Administrative Hearings of the Department of
  254  Management Services within 120 days after receipt of the
  255  facility’s request for a hearing, unless that time limitation is
  256  waived by both parties. The administrative law judge shall must
  257  render a decision within 30 days after receipt of a proposed
  258  recommended order.
  259         (6) The agency shall impose an immediate moratorium, as
  260  provided under s. 408.814, on an assisted living facility that
  261  fails to provide the agency access to the facility or prohibits
  262  the agency from conducting a regulatory inspection. The licensee
  263  may not restrict agency staff in accessing and copying records
  264  or in conducting confidential interviews with facility staff or
  265  any individual who receives services from the facility provide
  266  to the Division of Hotels and Restaurants of the Department of
  267  Business and Professional Regulation, on a monthly basis, a list
  268  of those assisted living facilities that have had their licenses
  269  denied, suspended, or revoked or that are involved in an
  270  appellate proceeding pursuant to s. 120.60 related to the
  271  denial, suspension, or revocation of a license.
  272         (7) Agency notification of a license suspension or
  273  revocation, or denial of a license renewal, shall be posted and
  274  visible to the public at the facility.
  275         (8) If a facility is required to relocate some or all of
  276  its residents due to agency action, that facility is exempt from
  277  the 45 days’ notice requirement in s. 429.28(1)(k). This
  278  provision does not exempt the facility from any deadlines for
  279  corrective action set by the agency.
  280         Section 61. Paragraphs (a) and (b) of subsection (2) of
  281  section 429.178, Florida Statutes, are amended to read:
  282         429.178 Special care for persons with Alzheimer’s disease
  283  or other related disorders.—
  284         (2)(a) An individual who is employed by a facility that
  285  provides special care for residents with Alzheimer’s disease or
  286  other related disorders, and who has regular contact with such
  287  residents, must complete up to 4 hours of initial dementia
  288  specific training developed or approved by the department. The
  289  training must shall be completed within 3 months after beginning
  290  employment and satisfy shall satisfy the core training
  291  requirements of s. 429.52(3)(g) s. 429.52(2)(g).
  292         (b) A direct caregiver who is employed by a facility that
  293  provides special care for residents with Alzheimer’s disease or
  294  other related disorders, and who provides direct care to such
  295  residents, must complete the required initial training and 4
  296  additional hours of training developed or approved by the
  297  department. The training must shall be completed within 9 months
  298  after beginning employment and satisfy shall satisfy the core
  299  training requirements of s. 429.52(3)(g) s. 429.52(2)(g).
  300         Section 62. Section 429.19, Florida Statutes, is amended to
  301  read:
  302         429.19 Violations; imposition of administrative fines;
  303  grounds.—
  304         (1) In addition to the requirements of part II of chapter
  305  408, the agency shall impose an administrative fine in the
  306  manner provided in chapter 120 for the violation of any
  307  provision of this part, part II of chapter 408, and applicable
  308  rules by an assisted living facility, for the actions of any
  309  person subject to level 2 background screening under s. 408.809,
  310  for the actions of any facility employee, or for an intentional
  311  or negligent act seriously affecting the health, safety, or
  312  welfare of a resident of the facility.
  313         (2) Each violation of this part and adopted rules must
  314  shall be classified according to the nature of the violation and
  315  the gravity of its probable effect on facility residents. The
  316  agency shall indicate the classification on the written notice
  317  of the violation as follows:
  318         (a) Class “I” violations are defined in s. 408.813. The
  319  agency shall impose an administrative fine of $7,500 for each a
  320  cited class I violation in a facility that is licensed for fewer
  321  than 100 beds at the time of the violation in an amount not less
  322  than $5,000 and not exceeding $10,000 for each violation. The
  323  agency shall impose an administrative fine of $11,250 for each
  324  cited class I violation in a facility that is licensed for 100
  325  or more beds at the time of the violation. If the noncompliance
  326  occurs within the prior 12 months, the fine must be levied for
  327  violations that are corrected before an inspection.
  328         (b) Class “II” violations are defined in s. 408.813. The
  329  agency shall impose an administrative fine of $3,000 for each a
  330  cited class II violation in a facility that is licensed for
  331  fewer than 100 beds at the time of the violation in an amount
  332  not less than $1,000 and not exceeding $5,000 for each
  333  violation. The agency shall impose an administrative fine of
  334  $4,500 for each cited class II violation in a facility that is
  335  licensed for 100 or more beds at the time of the violation.
  336         (c) Class “III” violations are defined in s. 408.813. The
  337  agency shall impose an administrative fine of $750 for each a
  338  cited class III violation in a facility that is licensed for
  339  fewer than 100 beds at the time of the violation in an amount
  340  not less than $500 and not exceeding $1,000 for each violation.
  341  The agency shall impose an administrative fine of $1,125 for
  342  each cited class III violation in a facility that is licensed
  343  for 100 or more beds at the time of the violation.
  344         (d) Class “IV” violations are defined in s. 408.813. The
  345  agency shall impose an administrative fine of $150 for each a
  346  cited class IV violation in a facility that is licensed for
  347  fewer than 100 beds at the time of the violation in an amount
  348  not less than $100 and not exceeding $200 for each violation.
  349  The agency shall impose an administrative fine of $225 for each
  350  cited class IV violation in a facility that is licensed for 100
  351  or more beds at the time of the violation.
  352         (e) Any fine imposed for class I and class II violations
  353  must be doubled if a facility was previously cited for one or
  354  more class I or class II violations during the agency’s last
  355  licensure inspection or any inspection or complaint
  356  investigation since the last licensure inspection.
  357         (f) Notwithstanding s. 408.813(2)(c) and (d) and s.
  358  408.832, a fine must be imposed for each class III and class IV
  359  violation, regardless of correction, if a facility was
  360  previously cited for one or more class III or class IV
  361  violations during the agency’s last licensure inspection or any
  362  inspection or complaint investigation since the last licensure
  363  inspection, for the same regulatory violation. A fine imposed
  364  for class III or class IV violations must be doubled if a
  365  facility was previously cited for one or more class III or class
  366  IV violations during the agency’s last two licensure inspections
  367  for the same regulatory violation.
  368         (g) Regardless of the class of violation cited, instead of
  369  the fine amounts listed in paragraphs (a)-(d), the agency shall
  370  impose an administrative fine of $500 if a facility is found not
  371  to be in compliance with the background screening requirements
  372  as provided in s. 408.809.
  373         (3) For purposes of this section, in determining if a
  374  penalty is to be imposed and in fixing the amount of the fine,
  375  the agency shall consider the following factors:
  376         (a) The gravity of the violation, including the probability
  377  that death or serious physical or emotional harm to a resident
  378  will result or has resulted, the severity of the action or
  379  potential harm, and the extent to which the provisions of the
  380  applicable laws or rules were violated.
  381         (b) Actions taken by the owner or administrator to correct
  382  violations.
  383         (c) Any previous violations.
  384         (d) The financial benefit to the facility of committing or
  385  continuing the violation.
  386         (e) The licensed capacity of the facility.
  387         (3)(4) Each day of continuing violation after the date
  388  established by the agency fixed for correction termination of
  389  the violation, as ordered by the agency, constitutes an
  390  additional, separate, and distinct violation.
  391         (4)(5)An Any action taken to correct a violation shall be
  392  documented in writing by the owner or administrator of the
  393  facility and verified through followup visits by agency
  394  personnel. The agency may impose a fine and, in the case of an
  395  owner-operated facility, revoke or deny a facility’s license
  396  when a facility administrator fraudulently misrepresents action
  397  taken to correct a violation.
  398         (5)(6)A Any facility whose owner fails to apply for a
  399  change-of-ownership license in accordance with part II of
  400  chapter 408 and operates the facility under the new ownership is
  401  subject to a fine of $5,000.
  402         (6)(7) In addition to any administrative fines imposed, the
  403  agency may assess a survey fee, equal to the lesser of one half
  404  of the facility’s biennial license and bed fee or $500, to cover
  405  the cost of conducting initial complaint investigations that
  406  result in the finding of a violation that was the subject of the
  407  complaint or monitoring visits conducted under s. 429.28(3)(c)
  408  to verify the correction of the violations.
  409         (7)(8) During an inspection, the agency shall make a
  410  reasonable attempt to discuss each violation with the owner or
  411  administrator of the facility, prior to written notification.
  412         (8)(9) The agency shall develop and disseminate an annual
  413  list of all facilities sanctioned or fined for violations of
  414  state standards, the number and class of violations involved,
  415  the penalties imposed, and the current status of cases. The list
  416  shall be disseminated, at no charge, to the Department of
  417  Elderly Affairs, the Department of Health, the Department of
  418  Children and Families Family Services, the Agency for Persons
  419  with Disabilities, the area agencies on aging, the Florida
  420  Statewide Advocacy Council, and the state and local ombudsman
  421  program councils. The Department of Children and Families Family
  422  Services shall disseminate the list to service providers under
  423  contract to the department who are responsible for referring
  424  persons to a facility for residency. The agency may charge a fee
  425  commensurate with the cost of printing and postage to other
  426  interested parties requesting a copy of this list. This
  427  information may be provided electronically or through the
  428  agency’s Internet site.
  429         Section 63. Subsections (1) and (8) of section 429.26,
  430  Florida Statutes, are amended to read:
  431         429.26 Appropriateness of placements; examinations of
  432  residents.—
  433         (1) The owner or administrator of a facility is responsible
  434  for determining the appropriateness of admission of an
  435  individual to the facility and for determining the continued
  436  appropriateness of residence of an individual in the facility. A
  437  determination shall be based upon an assessment of the
  438  strengths, needs, and preferences of the resident, the care and
  439  services offered or arranged for by the facility in accordance
  440  with facility policy, and any limitations in law or rule related
  441  to admission criteria or continued residency for the type of
  442  license held by the facility under this part. A resident who
  443  requires assistance with portable oxygen, colostomy care, and
  444  anti-embolism stockings or hosiery, and who otherwise meets the
  445  admission criteria, may be admitted to a standard licensed
  446  assisted living facility if the facility has a licensed nurse on
  447  staff or under contract to perform the services. A resident may
  448  not be moved from one facility to another without consultation
  449  with and agreement from the resident or, if applicable, the
  450  resident’s representative or designee or the resident’s family,
  451  guardian, surrogate, or attorney in fact. In the case of a
  452  resident who has been placed by the department or the Department
  453  of Children and Families Family Services, the administrator must
  454  notify the appropriate contact person in the applicable
  455  department.
  456         (8) The Department of Children and Families Family Services
  457  may require an examination for supplemental security income and
  458  optional state supplementation recipients residing in facilities
  459  at any time and shall provide the examination whenever a
  460  resident’s condition requires it. Any facility administrator;
  461  personnel of the agency, the department, or the Department of
  462  Children and Families Family Services; or representative of the
  463  state long-term care ombudsman program council member who
  464  believes a resident needs to be evaluated shall notify the
  465  resident’s case manager, who shall take appropriate action. A
  466  report of the examination findings shall be provided to the
  467  resident’s case manager and the facility administrator to help
  468  the administrator meet his or her responsibilities under
  469  subsection (1).
  470         Section 64. Subsection (2), paragraph (b) of subsection
  471  (3), and subsection(6) of section 429.28, Florida Statutes, are
  472  amended to read:
  473         429.28 Resident bill of rights.—
  474         (2) The administrator of a facility shall ensure that a
  475  written notice of the rights, obligations, and prohibitions set
  476  forth in this part is posted in a prominent place in each
  477  facility and read or explained to residents who cannot read. The
  478  This notice must shall include the statewide toll-free telephone
  479  number and the e-mail address name, address, and telephone
  480  numbers of the state local ombudsman program council and central
  481  abuse hotline and, if when applicable, Disability Rights Florida
  482  the Advocacy Center for Persons with Disabilities, Inc., and the
  483  Florida local advocacy council, where complaints may be lodged.
  484  The notice must state that a complaint made to the state
  485  ombudsman program, the names and identities of the residents
  486  involved in the complaint, and the identity of complainants are
  487  kept confidential pursuant to s. 400.0077 and that retaliatory
  488  action cannot be taken against a resident for presenting
  489  grievances or for exercising any other resident right. The
  490  facility must ensure a resident’s access to a telephone to call
  491  the state local ombudsman program council, central abuse
  492  hotline, and Disability Rights Florida Advocacy Center for
  493  Persons with Disabilities, Inc., and the Florida local advocacy
  494  council.
  495         (3)
  496         (b) In order to determine whether the facility is
  497  adequately protecting residents’ rights, the biennial survey
  498  shall include private informal conversations with a sample of
  499  residents and consultation with the state ombudsman program
  500  council in the planning and service area in which the facility
  501  is located to discuss residents’ experiences within the
  502  facility.
  503         (6) A Any facility that which terminates the residency of
  504  an individual who participated in activities specified in
  505  subsection (5) must shall show good cause in a court of
  506  competent jurisdiction. If good cause is not shown, the agency
  507  shall impose a fine of $2,500 in addition to any other penalty
  508  assessed against the facility.
  509         Section 65. Section 429.34, Florida Statutes, is amended to
  510  read:
  511         429.34 Right of entry and inspection.—
  512         (1) In addition to the requirements of s. 408.811, any duly
  513  designated officer or employee of the department, the Department
  514  of Children and Families Family Services, the Medicaid Fraud
  515  Control Unit of the Office of the Attorney General, the state or
  516  local fire marshal, or a representative member of the state or
  517  local long-term care ombudsman program has council shall have
  518  the right to enter unannounced upon and into the premises of any
  519  facility licensed pursuant to this part in order to determine
  520  the state of compliance with the provisions of this part, part
  521  II of chapter 408, and applicable rules. Data collected by the
  522  state or local long-term care ombudsman program councils or the
  523  state or local advocacy councils may be used by the agency in
  524  investigations involving violations of regulatory standards. A
  525  person specified in this section who knows or has reasonable
  526  cause to suspect that a vulnerable adult has been or is being
  527  abused, neglected, or exploited shall immediately report such
  528  knowledge or suspicion to the central abuse hotline pursuant to
  529  chapter 415.
  530         (2) Each licensed assisted living facility must be
  531  inspected by the agency at least once every 24 months to
  532  determine compliance with this chapter and related rules. If an
  533  assisted living facility is cited for one or more class I
  534  violations or two or more class II violations arising from
  535  separate surveys within a 60-day period or due to unrelated
  536  circumstances during the same survey, the agency must conduct an
  537  additional licensure inspection within 6 months. In addition to
  538  any fines imposed on the facility under s. 429.19, the licensee
  539  must pay a fee for the cost of the additional inspection
  540  equivalent to the standard assisted living facility license and
  541  per-bed fees, without exception for beds designated for
  542  recipients of optional state supplementation. The agency shall
  543  adjust the fee in accordance with s. 408.805.
  544  
  545  ================= T I T L E  A M E N D M E N T ================
  546         And the title is amended as follows:
  547         Delete lines 217 - 285
  548  and insert:
  549         by the act; amending s. 429.07, F.S.; providing that
  550         an extended congregate care license is issued to
  551         certain facilities that have been licensed as assisted
  552         living facilities under certain circumstances;
  553         providing the purpose of an extended congregate care
  554         license; providing that the initial extended
  555         congregate care license of an assisted living facility
  556         is provisional under certain circumstances; requiring
  557         the licensee to notify the Agency for Health Care
  558         Administration whenever it accepts a resident who
  559         qualifies for extended congregate care services;
  560         requiring the agency to inspect the facility for
  561         compliance with the requirements of an extended
  562         congregate care license; authorizing the agency to
  563         waive one of the required yearly monitoring visits
  564         under certain circumstances; authorizing the agency to
  565         deny or revoke a facility’s extended congregate care
  566         license for certain reasons or on certain grounds;
  567         requiring a registered nurse representing the agency
  568         to visit the facility at least annually, rather than
  569         twice a year, to monitor residents who are receiving
  570         limited nursing services; providing that the agency’s
  571         monitoring visits may be in conjunction with other
  572         agency inspections; authorizing the agency to waive
  573         one of the required yearly monitoring visits for
  574         certain facilities; conforming provisions to changes
  575         made by the act; amending s. 429.075, F.S.; requiring
  576         an assisted living facility that serves one or more
  577         mental health residents to obtain a limited mental
  578         health license; amending s. 429.14, F.S.; revising the
  579         actions in which the agency may deny, revoke, or
  580         suspend the license of an assisted living facility and
  581         impose an administrative fine; revising the criteria
  582         upon which the agency must deny or revoke the license
  583         of an assisted living facility; requiring the agency
  584         to impose an immediate moratorium on the license of an
  585         assisted living facility under certain circumstances;
  586         deleting a provision requiring the agency to provide a
  587         list of facilities with denied, suspended, or revoked
  588         licenses to the Department of Business and
  589         Professional Regulation; exempting a facility from the
  590         45-day notice requirement if it is required to
  591         relocate some or all of its residents; amending s.
  592         429.178, F.S.; conforming cross-references; amending
  593         s. 429.19, F.S.; revising the amounts and uses of
  594         administrative fines; requiring the agency to levy a
  595         fine for violations that are corrected before an
  596         inspection if noncompliance occurred within a
  597         specified period of time; deleting factors that the
  598         agency is required to consider to determine penalties
  599         and fines; conforming provisions to changes made by
  600         the act; amending s. 429.26, F.S.; providing that
  601         certain residents may be admitted to a standard
  602         licensed assisted living facility under certain
  603         circumstances; conforming provisions to changes made
  604         by the act; amending s. 429.28, F.S.; requiring that
  605         residents of facilities be informed that the identity
  606         of the resident and complainant in a complaint made to
  607         the State Long-Term Care Ombudsman Program is
  608         confidential and that retaliatory action cannot be
  609         taken against a resident for presenting grievances or
  610         for exercising any other resident right; providing
  611         that a facility that terminates an individual’s
  612         residency is fined if good cause is not shown in
  613         court; conforming provisions to changes made by the
  614         act; amending s. 429.34, F.S.; requiring certain
  615         persons to report elder abuse in assisted living
  616         facilities; requiring the agency to regularly inspect
  617         every licensed assisted living facility; requiring the
  618         agency to conduct more frequent inspections under
  619         certain circumstances; requiring the licensee to pay a
  620         fee for the cost of additional inspections; requiring
  621         the agency to adjust the fee; conforming provisions to
  622         changes made by the act;