Senate Bill 1770

CODING: Words stricken are deletions; words underlined are additions.



    Florida Senate - 1998                                  SB 1770

    By Senator Holzendorf





    2-1311-98                                               See HB

  1                      A bill to be entitled

  2         An act relating to nursing homes; providing a

  3         short title; amending s. 400.23, F.S.;

  4         requiring rules providing staffing requirements

  5         for nursing homes; providing minimum ratios of

  6         certified nursing assistants to residents;

  7         providing application of requirements;

  8         requiring certain information to be posted in

  9         each facility; amending s. 400.063, F.S.;

10         conforming a cross reference; providing an

11         effective date.

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

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15         Section 1.  Section 400.23(3), Florida Statutes, may be

16  cited as the "Florida Nursing Home Quality Care Act."

17         Section 2.  Subsections (3) through (13) of section

18  400.23, Florida Statutes, are renumbered as subsections (4)

19  through (14), respectively, and a new subsection (3) is added

20  to said section to read:

21         400.23  Rules; criteria; Nursing Home Advisory

22  Committee; evaluation and rating system; fee for review of

23  plans.--

24         (3)  The agency shall adopt rules providing staffing

25  requirements for nursing homes, including minimum staffing

26  requirements for certified nursing assistants. These rules

27  shall include the following requirements for each nursing home

28  facility:

29         (a)  The facility shall maintain a minimum ratio of

30  certified nursing assistants to residents of not less than:

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 1998                                  SB 1770
    2-1311-98                                               See HB




  1         1.  Day shift:  one certified nursing assistant for

  2  every eight residents.

  3         2.  Afternoon shift:  one certified nursing assistant

  4  for every 10 residents.

  5         3.  Midnight shift:  one certified nursing assistant

  6  for every 15 residents.

  7         (b)  An employee designated as a member of the nursing

  8  staff shall not provide services such as food preparation,

  9  housekeeping, laundry, or maintenance services. A person

10  employed to provide such services shall not provide nursing

11  care to residents and shall not be counted in determining the

12  ratios of residents to nursing staff.

13         (c)  The requirements provided in this subsection shall

14  apply to all nursing home residents, including respite care

15  residents, and must be adjusted upward to meet any special

16  care needs of residents. Staffing assignments must be based on

17  accurate acuity levels and the intensity and time needed to

18  provide safe, preventive, and restorative care. The

19  requirements provided in this subsection must be enforced for

20  all residents, regardless of payment source. No ongoing

21  waivers shall be allowed.

22         (d)  The facility shall post the current ratios of

23  residents to staff for each wing and floor of the facility and

24  for each shift. The posted ratios shall show separately the

25  number of residents to licensed nursing staff and the number

26  of residents to unlicensed nursing staff directly responsible

27  for resident care. In addition, such information shall be

28  posted for the most recently concluded cost-reporting period

29  in the form of average daily staffing ratios for that period.

30  This information must be posted in each facility in a manner

31  which is visible and accessible to all residents and their

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 1998                                  SB 1770
    2-1311-98                                               See HB




  1  families and caregivers, and to potential consumers of the

  2  facility's services.

  3         Section 3.  Subsection (1) of section 400.063, Florida

  4  Statutes, is mended to read:

  5         400.063  Resident Protection Trust Fund.--

  6         (1)  A Resident Protection Trust Fund shall be

  7  established for the purpose of collecting and disbursing funds

  8  generated from the license fees and administrative fines as

  9  provided for in ss. 393.0673(2), 400.062(3)(b), 400.111(1),

10  400.121(2), and 400.23(10)(9).  Such funds shall be for the

11  sole purpose of paying for the appropriate alternate

12  placement, care, and treatment of residents who are removed

13  from a facility licensed under this part or a facility

14  specified in s. 393.0678(1) in which the agency determines

15  that existing conditions or practices constitute an immediate

16  danger to the health, safety, or security of the residents.

17  If the agency determines that it is in the best interest of

18  the health, safety, or security of the residents to provide

19  for an orderly removal of the residents from the facility, the

20  agency may utilize such funds to maintain and care for the

21  residents in the facility pending removal and alternative

22  placement.  The maintenance and care of the residents shall be

23  under the direction and control of a receiver appointed

24  pursuant to s. 393.0678(1) or s. 400.126(1).  However, funds

25  may be expended in an emergency upon a filing of a petition

26  for a receiver, upon the declaration of a state of local

27  emergency pursuant to s. 252.38(3)(a)5., or upon a duly

28  authorized local order of evacuation of a facility by

29  emergency personnel to protect the health and safety of the

30  residents.

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 1998                                  SB 1770
    2-1311-98                                               See HB




  1         Section 4.  This act shall take effect October 1 of the

  2  year in which enacted.

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  5                          HOUSE SUMMARY

  6
      Creates the "Florida Nursing Home Quality Care Act."
  7    Directs the Agency for Health Care Administration to
      adopt rules providing staffing requirements for nursing
  8    homes, including minimum requirements for the ratio of
      certified nursing assistants to residents. Provides for
  9    determination of such ratios and application to all
      residents. Requires posting of information on such ratios
10    in each facility in specified places and in a visible and
      accessible manner.
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