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The Florida Senate

2018 Florida Statutes

Title XXXVII INSURANCE
Chapter 651 CONTINUING CARE CONTRACTS Entire Chapter
SECTION 057
Continuing care at-home contracts.
F.S. 651.057
651.057 Continuing care at-home contracts.—
(1) In addition to the requirements of s. 651.055, a provider offering contracts for continuing care at-home must:
(a) Disclose the following in the continuing care at-home contract:
1. Whether transportation will be provided to residents when traveling to and from the facility for services;
2. That the provider has no liability for residents residing outside the facility beyond the delivery of services specified in the contract and future access to nursing care or personal services at the facility or in another setting designated in the contract;
3. The mechanism for monitoring residents who live outside the facility;
4. The process that will be followed to establish priority if a resident wishes to exercise his or her right to move into the facility; and
5. The policy that will be followed if a resident living outside the facility relocates to a different residence and no longer avails himself or herself of services provided by the facility.
(b) Ensure that persons employed by or under contract with the provider who assist in the delivery of services to residents residing outside the facility are appropriately licensed or certified as required by law.
(c) Include operating expenses for continuing care at-home contracts in the calculation of the operating reserve required by s. 651.035(1)(c).
(d) Include the operating activities for continuing care at-home contracts in the total operation of the facility when submitting financial reports to the office as required by s. 651.026.
(2) A provider that holds a certificate of authority and wishes to offer continuing care at-home must also:
(a) Submit a business plan to the office with the following information:
1. A description of the continuing care at-home services that will be provided, the market to be served, and the fees to be charged;
2. A copy of the proposed continuing care at-home contract;
3. An actuarial study prepared by an independent actuary in accordance with the standards adopted by the American Academy of Actuaries which presents the impact of providing continuing care at-home on the overall operation of the facility; and
4. A market feasibility study that meets the requirements of s. 651.022(3) and documents that there is sufficient interest in continuing care at-home contracts to support such a program;
(b) Demonstrate to the office that the proposal to offer continuing care at-home contracts to individuals who do not immediately move into the facility will not place the provider in an unsound financial condition;
(c) Comply with the requirements of s. 651.021(2), except that an actuarial study may be substituted for the feasibility study; and
(d) Comply with the requirements of this chapter.
(3) Contracts to provide continuing care at-home, including contracts that are terminable by either party, may include agreements to provide care for any duration.
(4) A provider offering continuing care at-home contracts must, at a minimum, have a facility that is licensed under this chapter and has accommodations for independent living which are primarily intended for residents who do not require staff supervision. The facility need not offer assisted living units licensed under part I of chapter 429 or nursing home units licensed under part II of chapter 400 in order to be able to offer continuing care at-home contracts.
(a) The combined number of outstanding continuing care (CCRC) and continuing care at-home (CCAH) contracts allowed at the facility may be the greater of:
1. One and one-half times the combined number of independent living units (ILU), assisted living units (ALF) that are licensed under part I of chapter 429, and nursing home units licensed under part II of chapter 400 at the facility; or
2. Four times the combined number of assisted living units (ALF) that are licensed under part I of chapter 429 and nursing home units that are licensed under part II of chapter 400 at that facility.
(b) The number of independent living units at the facility must be equal to or greater than 10 percent of the initial 100 continuing care (CCRC) and continuing care at-home (CCAH) contracts and 5 percent of the combined number of outstanding continuing care (CCRC) and continuing care at-home (CCAH) contracts in excess of 100 issued by that facility.
History.—s. 10, ch. 2011-193.