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





                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)

                            CHAMBER ACTION
              Senate                               House
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 4                                                                

 5                                           ORIGINAL STAMP BELOW

 6

 7

 8

 9

10                                                                

11  The Committee on Health & Human Services Appropriations

12  offered the following:

13

14         Amendment (with title amendment) 

15  Remove from the bill:  Everything after the enacting clause

16

17  and insert in lieu thereof:

18         Section 1.  Section 400.402, Florida Statutes, is

19  amended to read:

20         400.402  Definitions.--When used in this part, unless

21  the context otherwise requires, the term:

22         (1)  "Activities of daily living" means functions and

23  tasks for self-care, including ambulation, bathing, dressing,

24  eating, grooming, and toileting, and other similar tasks.

25         (2)  "Administrator" means an individual at least 21

26  years of age who is responsible for the operation and

27  maintenance who has general administrative charge of an

28  assisted living facility.

29         (3)  "Assisted living facility," hereinafter referred

30  to as "facility," means any building or buildings, section of

31  a building, or distinct part of a building, residence, private

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  home, boarding home, home for the aged, or other place,

 2  whether operated for profit or not, which undertakes through

 3  its ownership or management to provide, for a period exceeding

 4  24 hours, housing, food service, and one or more personal

 5  services for four or more adults, not related to the owner or

 6  administrator by blood or marriage, who require such services;

 7  or to provide extended congregate care, limited nursing

 8  services, or limited mental health services, when specifically

 9  licensed to do so pursuant to s. 400.407, unless the facility

10  is licensed as an adult family-care home.  A facility offering

11  personal services, extended congregate care, limited nursing

12  services, or limited mental health services for fewer than

13  four adults is within the meaning of this definition if it

14  formally or informally advertises to or solicits the public

15  for residents or referrals and holds itself out to the public

16  to be an establishment which regularly provides such services,

17  unless the facility is licensed as an adult family-care home.

18         (3)(4)  "Agency" means the Agency for Health Care

19  Administration.

20         (4)(5)  "Aging in place" or "age in place" means the

21  process of providing increased or adjusted services to a

22  person to compensate for by which a person chooses to remain

23  in a residential environment despite the physical or mental

24  decline that may occur with the aging process, in order to

25  maximize.  For aging in place to occur, needed services are

26  added, increased, or adjusted to compensate for the physical

27  or mental decline of the individual, while maximizing the

28  person's dignity and independence and permit the person to

29  remain in a familiar, noninstitutional, residential

30  environment for as long as possible.  Such services may be

31  provided by facility staff, volunteers, family, or friends, or

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  through contractual arrangements with a third party.

 2         (5)(6)  "Applicant" means an individual owner,

 3  corporation, partnership, firm, association, or governmental

 4  entity that applies any facility owner, or if a business

 5  entity, a person appointed by such entity to make application

 6  for a license.

 7         (7)  "Assistance with activities of daily living" means

 8  direct physical assistance with activities of daily living as

 9  defined in subsection (1).

10         (6)  "Assisted living facility" means any building or

11  buildings, section or distinct part of a building, private

12  home, boarding home, home for the aged, or other residential

13  facility, whether operated for profit or not, which undertakes

14  through its ownership or management to provide housing, meals,

15  and one or more personal services for a period exceeding 24

16  hours to one or more adults who are not relatives of the owner

17  or administrator.

18         (7)(8)  "Chemical restraint" means a pharmacologic drug

19  that physically limits, restricts, or deprives an individual

20  of movement or mobility, and is used for discipline or

21  convenience and not required for the treatment of medical

22  symptoms.

23         (8)(9)  "Community living support plan" means a written

24  document prepared by a mental health resident and the

25  resident's mental health case manager of that resident in

26  consultation with the administrator of an assisted living the

27  facility with a limited mental health license or the

28  administrator's designee. A copy must be provided to the

29  administrator. The plan must include information about the

30  supports, services, and special needs of the resident which

31  enable the resident to live in the assisted living facility

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  and a method by which facility staff can recognize and respond

 2  to the signs and symptoms particular to that resident which

 3  indicate the need for professional services.

 4         (9)(10)  "Cooperative agreement" means a written

 5  statement of understanding between a mental health care

 6  services provider and the administrator of the assisted living

 7  facility with a limited mental health license in which a

 8  mental health resident is living. The agreement must specify

 9  specifies directions for accessing emergency and after-hours

10  care for the mental health resident. A single cooperative

11  agreement may cover all mental health residents of a single

12  facility who are clients of the same mental health care

13  provider. and a method by which the staff of the facility can

14  recognize and respond to the signs and symptoms particular to

15  that mental health resident that indicate the need for

16  professional services. The cooperative agreement may be a

17  component of the community living support plan.

18         (10)(11)  "Department" means the Department of Elderly

19  Affairs.

20         (11)(12)  "Emergency" means a situation, physical

21  condition, or method of operation which presents imminent

22  danger of death or serious physical or mental harm to facility

23  residents.

24         (12)(13)  "Extended congregate care" means acts beyond

25  those authorized in subsection (17) (16) that may be performed

26  pursuant to chapter 464 by persons licensed thereunder while

27  carrying out their professional duties, and other supportive

28  services which may be specified by rule.  The purpose of such

29  services is to enable residents to age in place in a

30  residential environment despite mental or physical limitations

31  that might otherwise disqualify them from residency in a

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  facility licensed under this part.

 2         (13)(14)  "Guardian" means a person to whom the law has

 3  entrusted the custody and control of the person or property,

 4  or both, of a person who has been legally adjudged

 5  incapacitated.

 6         (14)(15)  "Limited nursing services" means acts that

 7  may be performed pursuant to chapter 464 by persons licensed

 8  thereunder while carrying out their professional duties but

 9  limited to those acts which the department specifies by rule.

10  Acts which may be specified by rule as allowable limited

11  nursing services shall be for persons who meet the admission

12  criteria established by the department for assisted living

13  facilities and shall not be complex enough to require 24-hour

14  nursing supervision and may include such services as the

15  application and care of routine dressings, and care of casts,

16  braces, and splints.

17         (15)(16)  "Managed risk" means the process by which the

18  facility staff discuss the service plan and the needs of the

19  resident with the resident and, if applicable, the resident's

20  representative or designee or the resident's surrogate,

21  guardian, or attorney in fact, in such a way that the

22  consequences of a decision, including any inherent risk, are

23  explained to all parties and reviewed periodically in

24  conjunction with the service plan, taking into account changes

25  in the resident's status and the ability of the facility to

26  respond accordingly.

27         (16)(17)  "Mental health resident" means an individual

28  who receives social security disability income due to a mental

29  disorder as determined by the Social Security Administration

30  or receives supplemental security income due to a mental

31  disorder as determined by the Social Security Administration

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  and receives optional state supplementation.

 2         (17)(18)  "Personal services" means direct physical

 3  include, but are not limited to, such services as:  individual

 4  assistance with or supervision of the essential activities of

 5  daily living and the self-administration of medication as

 6  defined in subsection (1), and other similar services which

 7  the department may define by rule.  "Personal services" shall

 8  not be construed to mean the provision of medical, nursing,

 9  dental, or mental health services. by the staff of a facility,

10  except as provided in this part. In addition, an emergency

11  response device installed in the apartment or living area of a

12  resident shall not be classified as a personal service.

13         (18)(19)  "Physical restraint" means a device which

14  physically limits, restricts, or deprives an individual of

15  movement or mobility, including, but not limited to, a

16  half-bed rail, a full-bed rail, a geriatric chair, and a posey

17  restraint. The term "physical restraint" shall also include

18  any device which was not specifically manufactured as a

19  restraint but which has been altered, arranged, or otherwise

20  used for this purpose. The term shall not include bandage

21  material used for the purpose of binding a wound or injury.

22         (19)  "Relative" means an individual who is the father,

23  mother, stepfather, stepmother, son, daughter, brother,

24  sister, grandmother, grandfather, great-grandmother,

25  great-grandfather, grandson, granddaughter, uncle, aunt, first

26  cousin, nephew, niece, husband, wife, father-in-law,

27  mother-in-law, son-in-law, daughter-in-law, brother-in-law,

28  sister-in-law, stepson, stepdaughter, stepbrother, stepsister,

29  half-brother, or half-sister of an owner or administrator.

30         (20)  "Resident" means a person 18 years of age or

31  older, residing in and receiving care from a facility.

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1         (21)  "Resident's representative or designee" means a

 2  person other than the owner, or an agent or employee of the

 3  facility, designated in writing by the resident, if legally

 4  competent, to receive notice of changes in the contract

 5  executed pursuant to s. 400.424; to receive notice of and to

 6  participate in meetings between the resident and the facility

 7  owner, administrator, or staff concerning the rights of the

 8  resident; to assist the resident in contacting the ombudsman

 9  council if the resident has a complaint against the facility;

10  or to bring legal action on behalf of the resident pursuant to

11  s. 400.429.

12         (22)  "Service plan" means a written plan, developed

13  and agreed upon by the resident and, if applicable, the

14  resident's representative or designee or the resident's

15  surrogate, guardian, or attorney in fact, if any, and the

16  administrator or designee representing the facility, which

17  addresses the unique physical and psychosocial needs,

18  abilities, and personal preferences of each resident receiving

19  extended congregate care services. The plan shall include a

20  brief written description, in easily understood language, of

21  what services shall be provided, who shall provide the

22  services, when the services shall be rendered, and the

23  purposes and benefits of the services.

24         (23)  "Shared responsibility" means exploring the

25  options available to a resident within a facility and the

26  risks involved with each option when making decisions

27  pertaining to the resident's abilities, preferences, and

28  service needs, thereby enabling the resident and, if

29  applicable, the resident's representative or designee, or the

30  resident's surrogate, guardian, or attorney in fact, and the

31  facility to develop a service plan which best meets the

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  resident's needs and seeks to improve the resident's quality

 2  of life.

 3         (24)  "Supervision of activities of daily living" means

 4  reminding residents to engage in activities of daily living

 5  and the self-administration of medication, and, when

 6  necessary, observing or providing verbal cuing to residents

 7  while they perform these activities.

 8         (25)  "Supervision of self-administered medication"

 9  means reminding residents to take medication, opening bottle

10  caps for residents, opening prepackaged medication for

11  residents, reading the medication label to residents,

12  observing residents while they take medication, checking the

13  self-administered dosage against the label of the container,

14  reassuring residents that they have obtained and are taking

15  the dosage as prescribed, keeping daily records of when

16  residents receive supervision pursuant to this subsection, and

17  immediately reporting noticeable changes in the condition of a

18  resident to the resident's physician and the resident's case

19  manager, if one exists.  Residents who are capable of

20  administering their own medication shall be allowed to do so.

21         (25)(26)  "Supplemental security income," Title XVI of

22  the Social Security Act, means a program through which the

23  Federal Government guarantees a minimum monthly income to

24  every person who is age 65 or older, or disabled, or blind and

25  meets the income and asset requirements.

26         (26)(27)  "Supportive services" means services designed

27  to encourage and assist aged persons or adults with

28  disabilities to remain in the least restrictive living

29  environment and to maintain their independence as long as

30  possible.

31         (27)(28)  "Twenty-four-hour nursing supervision" means

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  services that are ordered by a physician for a resident whose

 2  condition requires the supervision of a physician and

 3  continued monitoring of vital signs and physical status.  Such

 4  services shall be:  medically complex enough to require

 5  constant supervision, assessment, planning, or intervention by

 6  a nurse; required to be performed by or under the direct

 7  supervision of licensed nursing personnel or other

 8  professional personnel for safe and effective performance;

 9  required on a daily basis; and consistent with the nature and

10  severity of the resident's condition or the disease state or

11  stage.

12         Section 2.  Subsection (2) of section 400.404, Florida

13  Statutes, is amended to read:

14         400.404  Facilities to be licensed; exemptions.--

15         (2)  The following are exempt from licensure under this

16  part:

17         (a)  Any facility, institution, or other place operated

18  by the Federal Government or any agency of the Federal

19  Government.

20         (b)  Any facility or part of a facility licensed under

21  chapter 393 or chapter 394.

22         (c)  Any facility licensed as an adult family-care home

23  under part VII.

24         (d)  Any person who provides housing, meals, and one or

25  more personal services on a 24-hour basis in the person's own

26  home to not more than two adults who do not receive optional

27  state supplementation. The person who provides the housing,

28  meals, and personal services must own or rent, and live in,

29  the home.

30         (e)(c)  Any home or facility approved by the United

31  States Department of Veterans Affairs as a residential care

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  home wherein care is provided exclusively to three or fewer

 2  veterans.

 3         (f)(d)  Any facility that has been incorporated in this

 4  state for 50 years or more on or before July 1, 1983, and the

 5  board of directors of which is nominated or elected by the

 6  residents, until the facility is sold or its ownership is

 7  transferred; or any facility, with improvements or additions

 8  thereto, which has existed and operated continuously in this

 9  state for 60 years or more on or before July 1, 1989, is

10  directly or indirectly owned and operated by a nationally

11  recognized fraternal organization, is not open to the public,

12  and accepts only its own members and their spouses as

13  residents.

14         (g)(e)  Any facility certified under chapter 651, or a

15  retirement community, may provide services authorized under

16  this part or part IV of this chapter to its residents who live

17  in single-family homes, duplexes, quadruplexes, or apartments

18  located on the campus without obtaining a license to operate

19  an assisted living facility if residential units within such

20  buildings are used by residents who do not require staff

21  supervision for that portion of the day when personal services

22  are not being delivered and the owner obtains a home health

23  license to provide such services.  However, any building or

24  distinct part of a building on the campus that is designated

25  for persons who receive personal services and require

26  supervision beyond that which is available while such services

27  are being rendered must be licensed in accordance with this

28  part. If a facility provides personal services to residents

29  who do not otherwise require supervision and the owner is not

30  licensed as a home health agency, the buildings or distinct

31  parts of buildings where such services are rendered must be

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  licensed under this part. A resident of a facility that

 2  obtains a home health license may contract with a home health

 3  agency of his or her choice, provided that the home health

 4  agency provides liability insurance and workers' compensation

 5  coverage for its employees. Facilities covered by this

 6  exemption may establish policies that give residents the

 7  option of contracting for services and care beyond that which

 8  is provided by the facility to enable them to age in place.

 9  For purposes of this section, a retirement community consists

10  of a facility licensed under this part or under part II, and

11  apartments designed for independent living located on the same

12  campus.

13         Section 3.  Subsection (1) of section 400.407, Florida

14  Statutes, is amended to read:

15         400.407  License required; fee, display.--

16         (1)(a)  A license issued by the agency is required for

17  an assisted living facility operating in this state. It is

18  unlawful to operate or maintain a facility without first

19  obtaining from the agency a license authorizing such

20  operation.

21         (b)1.  Any person found guilty of violating paragraph

22  (a) who, upon notification by the agency, fails, within 10

23  working days after receiving such notification, to apply for a

24  license commits a felony of the third degree, punishable as

25  provided in s. 775.082, s. 775.083, or s. 775.084.

26         2.  Any person found to be in violation of paragraph

27  (a) due to a change in s. 400.402(3), (18), (24), or (25) or a

28  modification in department policy pertaining to personal

29  services as provided for in s. 400.402 and who, upon

30  notification by the agency, fails, within 10 working days

31  after receiving such notification, to apply for a license

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  commits a felony of the third degree, punishable as provided

 2  in s. 775.082, s. 775.083, or s. 775.084.

 3         3.  Except as provided for in subparagraph 2., any

 4  person who violates paragraph (a) who previously operated a

 5  licensed facility or concurrently operates a licensed facility

 6  and an unlicensed facility commits a felony of the third

 7  degree, punishable as provided in s. 775.082, s. 775.083, or

 8  s. 775.084.

 9         4.  Any person who fails to obtain a license after

10  agency notification may be fined for each day of noncompliance

11  pursuant to s. 400.419(1)(b).

12         5.  When an owner has an interest in more than one

13  facility, and fails to license any one of these facilities,

14  the agency may revoke the license or impose a moratorium on

15  any or all of the licensed facilities until such time as the

16  delinquent facility is licensed.

17         6.  If the agency determines that an owner is operating

18  or maintaining a facility without obtaining a license

19  authorizing such operation and determines that a condition

20  exists in the facility that poses a threat to the health,

21  safety, or welfare of a resident of the facility, the owner

22  commits neglect as defined in s. 415.102 and is subject to the

23  same actions and penalties specified in ss. 400.414 and

24  400.419 for a negligent act seriously affecting the health,

25  safety, or welfare of a resident of the facility.

26         Section 4.  Effective January 1, 1999, subsection (1)

27  of section 400.4075, Florida Statutes, is amended to read:

28         400.4075  Limited mental health license.--An assisted

29  living facility that serves three or more mental health

30  residents must obtain a limited mental health license.

31         (1)  To obtain a limited mental health license, a

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  facility must hold a standard license as an assisted living

 2  facility, must not have any current uncorrected deficiencies

 3  or violations, and must ensure that, within 6 months after

 4  receiving a limited mental health license, the facility

 5  administrator and the staff of the facility who are in direct

 6  contact with mental health residents must complete training of

 7  no less than 6 hours related to their duties. This training

 8  will be provided by or approved by the Department of Children

 9  and Family Services.

10         Section 5.  Section 400.408, Florida Statutes, is

11  amended to read:

12         400.408  Unlicensed facilities; referral of person for

13  residency to unlicensed facility; penalties penalty;

14  verification of licensure status.--

15         (1)(a)  It is unlawful to own, operate, or maintain an

16  assisted living facility without obtaining a license under

17  this part.

18         (b)  Except as provided under paragraph (d), any person

19  who owns, operates, or maintains an unlicensed assisted living

20  facility commits a felony of the third degree, punishable as

21  provided in s. 775.082, s. 775.083, or s. 775.084. Application

22  for licensure within 10 working days after notification shall

23  be an affirmative defense to this felony violation.

24         (c)  Any person found guilty of violating paragraph (a)

25  a second or subsequent time commits a felony of the second

26  degree, punishable as provided under s. 775.082, s. 775.083,

27  or s. 775.084.

28         (d)  Any person who owns, operates, or maintains an

29  unlicensed assisted living facility due to a change in this

30  part or a modification in department rule within 6 months

31  after the effective date of such change and who, within 10

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  working days after receiving notification from the agency,

 2  fails to cease operation or apply for a license under this

 3  part commits a felony of the third degree, punishable as

 4  provided in s. 775.082, s. 775.083, or s. 775.084.

 5         (e)  Pursuant to this subsection, any facility that

 6  fails to apply for a license or cease operation after agency

 7  notification may be fined for each day of noncompliance

 8  pursuant to s. 400.419.

 9         (f)  When a licensee has an interest in more than one

10  assisted living facility, and fails to license any one of

11  these facilities, the agency may revoke the license or impose

12  a moratorium on any or all of the licensed facilities until

13  such time as the unlicensed facility applies for licensure or

14  ceases operation.

15         (g)  If the agency determines that an owner is

16  operating or maintaining an assisted living facility without

17  obtaining a license and determines that a condition exists in

18  the facility that poses a threat to the health, safety, or

19  welfare of a resident of the facility, the owner is subject to

20  the same actions and fines imposed against a licensed facility

21  as specified in ss. 400.414 and 400.419.

22         (h)  Any person aware of the operation of an unlicensed

23  assisted living facility must report that facility to the

24  agency. The agency shall provide to the department and to

25  elder information and referral providers a list, by county, of

26  licensed assisted living facilities, to assist persons who are

27  considering an assisted living facility placement in locating

28  a licensed facility.

29         (2)(1)  It is unlawful to knowingly refer a person for

30  residency to an unlicensed facility that provides services

31  that may only be provided by an assisted living facility; to

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  an assisted living facility the license of which is under

 2  denial or has been suspended or revoked; or to an assisted

 3  living a facility that has a moratorium on admissions.  Any

 4  person who violates this subsection commits is guilty of a

 5  noncriminal violation, punishable by a fine not exceeding $500

 6  as provided in s. 775.083.

 7         (a)  Any employee of the agency or department, or the

 8  Department of Children and Family Health and Rehabilitative

 9  Services, who knowingly refers a person for residency to an

10  unlicensed facility; to a facility the license of which is

11  under denial or has been suspended or revoked; or to a

12  facility that has a moratorium on admissions is subject to

13  disciplinary action by the agency or department, or the

14  Department of Children and Family Health and Rehabilitative

15  Services.

16         (b)  The employer of any person who is under contract

17  with the agency or department, or the Department of Children

18  and Family Health and Rehabilitative Services, and who

19  knowingly refers a person for residency to an unlicensed

20  facility; to a facility the license of which is under denial

21  or has been suspended or revoked; or to a facility that has a

22  moratorium on admissions shall be fined and required to

23  prepare a corrective action plan designed to prevent such

24  referrals.

25         (c)(2)  The agency shall provide the department and the

26  Department of Children and Family Health and Rehabilitative

27  Services with a list of licensed facilities within each county

28  and shall update the list at least quarterly monthly.

29         (d)(3)  At least annually, the agency shall notify, in

30  appropriate trade publications as defined by rule, physicians

31  licensed under chapter 458 or chapter 459 pursuant to chapter

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  458, osteopathic physicians licensed pursuant to chapter 459,

 2  hospitals licensed under pursuant to part I of chapter 395,

 3  and nursing home facilities licensed under pursuant to part II

 4  of this chapter, and employees of the agency or the

 5  department, or the Department of Children and Family Health

 6  and Rehabilitative Services, who are responsible having a

 7  responsibility for referring persons for residency, that it is

 8  unlawful to knowingly refer a person for residency to an

 9  unlicensed assisted living facility and shall notify them of

10  the penalty for violating such prohibition. The department and

11  the Department of Children and Family Services shall, in turn,

12  notify service providers under contract to the respective

13  departments who have responsibility for resident referrals to

14  facilities. Further, the notice must direct each noticed

15  facility and individual to contact the appropriate agency

16  office in order to verify the licensure status of any facility

17  prior to referring any person for residency. Each notice must

18  include the name, telephone number, and mailing address of the

19  appropriate office to contact.

20         Section 6.  Section 400.411, Florida Statutes, is

21  amended to read:

22         400.411  Initial application for license; provisional

23  license.--

24         (1)  Application for license shall be made to the

25  agency on forms furnished by it and shall be accompanied by

26  the appropriate license fee. The application shall contain

27  sufficient information, as required by rules of the

28  department, to establish that the applicant can provide

29  adequate care.

30         (2)  The applicant may be an individual owner,

31  corporation, partnership, firm, association, or governmental

                                  16

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  entity.

 2         (3)(2)  The application shall be signed by the

 3  applicant under oath and shall contain the following:

 4         (a)  The name, address, date of birth, and social

 5  security number of the applicant and the name by which the

 6  facility is to be known.  Pursuant thereto:

 7         1.  If the applicant is a firm, partnership, or

 8  association, the application shall contain the name, address,

 9  date of birth, and social security number of every member

10  thereof.

11         2.  If the applicant is a corporation, the application

12  shall contain the corporation's its name and address, the

13  name, address, date of birth, and social security number of

14  each of its directors and officers, and the name and address

15  of each person having at least a 5-percent ownership

16  10-percent interest in the corporation.

17         (b)  The name and address of any professional service,

18  firm, association, partnership, or corporation that is to

19  provide goods, leases, or services to the facility for which

20  the application is made, if a 5-percent 10-percent or greater

21  interest in the service, firm, association, partnership, or

22  corporation is owned by a person whose name must be listed on

23  the application under paragraph (a).

24         (c)  Information sufficient that provides a source to

25  establish the suitable character, financial stability, and

26  competency of the applicant and of each person specified in

27  the application under paragraph (a) subparagraph (a)1. or

28  subparagraph (a)2. who has at least a 10-percent interest in

29  the firm, partnership, association, or corporation and, if

30  different from the applicant, applicable, of the administrator

31  and financial officer., including

                                  17

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1         (d)  The name and address of any long-term care

 2  facility with which the applicant, or administrator, or

 3  financial officer has been affiliated through ownership or

 4  employment within 5 years of the date of this license the

 5  application for a license; and a signed affidavit disclosing

 6  any financial or ownership interest that the applicant, or any

 7  person listed in paragraph (a) principal, partner, or

 8  shareholder thereof, holds or has held within the last 5 years

 9  in any other facility licensed under this part, or in any

10  other entity licensed by this the state or another state to

11  provide health or residential care, which facility or entity

12  closed or ceased to operate as a result of financial problems,

13  or has had a receiver appointed or a license denied, suspended

14  or revoked, or was subject to a moratorium on admissions, or

15  has had an injunctive proceeding initiated against it.

16         (e)(d)  The names and addresses of other persons of

17  whom the agency may inquire as to the character, and

18  reputation, and financial responsibility of the owner and, if

19  different from the applicant, the administrator and financial

20  officer applicant and, if applicable, of the administrator.

21         (e)  The names and addresses of other persons of whom

22  the agency may inquire as to the financial responsibility of

23  the applicant.

24         (f)  Identification of all other homes or facilities,

25  including the addresses and the license or licenses under

26  which they operate, if applicable, which are currently

27  operated by the applicant or administrator and which provide

28  housing, meals, and personal services to residents adults.

29         (g)  Such other reasonable information as may be

30  required by the agency to evaluate the ability of the

31  applicant to meet the responsibilities entailed under this

                                  18

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  part.

 2         (g)(h)  The location of the facility for which a

 3  license is sought and documentation, signed by the appropriate

 4  local government official, which states that the applicant has

 5  met local zoning requirements.

 6         (h)(i)  The name, address, date of birth, social

 7  security number, education, and experience of the

 8  administrator if different from the applicant.

 9         (4)(3)  The applicant shall furnish satisfactory proof

10  of financial ability to operate and conduct the facility in

11  accordance with the requirements of this part. A certificate

12  of authority, pursuant to chapter 651, may be provided as

13  proof of financial ability. An applicant applying for an

14  initial license shall submit a balance sheet setting forth the

15  assets and liabilities of the owner and a statement projecting

16  revenues, expenses, taxes, extraordinary items, and other

17  credits or charges for the first 12 months of operation of the

18  facility.

19         (5)(4)  If the applicant is a continuing care facility

20  certified under chapter 651, a copy of the facility's

21  certificate of authority must be provided offers continuing

22  care agreements, as defined in chapter 651, proof shall be

23  furnished that the applicant has obtained a certificate of

24  authority as required for operation under that chapter.

25         (6)(5)  The applicant shall provide proof of liability

26  insurance as defined in s. 624.605.

27         (7)(6)  If the applicant is a community residential

28  home, the applicant must provide proof that it has met the

29  requirements specified in chapter 419 shall apply to community

30  residential homes zoned single-family or multifamily.

31         (8)(7)  The applicant must provide the agency with

                                  19

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  proof of legal right to occupy the property.  This proof may

 2  include, but is not limited to, copies of recorded warranty

 3  deeds, or copies of lease or rental agreements, contracts for

 4  deeds, quitclaim deeds, or other such documentation.

 5         (9)(8)  The applicant must furnish proof that the

 6  facility has received a satisfactory firesafety inspection.

 7  The local fire marshal or other authority having jurisdiction

 8  or the State Fire Marshal must conduct the inspection within

 9  30 days after the written request by the applicant. If an

10  authority having jurisdiction does not have a certified

11  firesafety inspector, the State Fire Marshal shall conduct the

12  inspection.

13         (10)  The applicant must furnish documentation of a

14  satisfactory sanitation inspection of the facility by the

15  county health department.

16         (11)(9)  A provisional license may be issued to an

17  applicant making initial application for licensure or making

18  application for a change of ownership.  A provisional license

19  shall be limited in duration to a specific period of time not

20  to exceed 6 months, as determined by the agency.

21         (12)(10)  No county or municipality shall issue an

22  occupational license which is being obtained for the purpose

23  of operating a facility regulated under this part without

24  first ascertaining that the applicant has been licensed to

25  operate such facility at the specified location or locations

26  by the agency.  The agency shall furnish to local agencies

27  responsible for issuing occupational licenses sufficient

28  instruction for making such the above-required determinations.

29         Section 7.  Section 400.414, Florida Statutes, is

30  amended to read:

31         400.414  Denial, revocation, or suspension of license;

                                  20

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  imposition of administrative fine; grounds.--

 2         (1)  The agency may deny, revoke, or suspend any a

 3  license issued under this part or impose an administrative

 4  fine in the manner provided in chapter 120. At the chapter 120

 5  hearing, the agency shall prove by a preponderance of the

 6  evidence that its actions are warranted.

 7         (2)  Any of the following actions by an assisted living

 8  facility or any facility employee a facility or its employee

 9  shall be grounds for action by the agency against a licensee:

10         (a)  An intentional or negligent act seriously

11  affecting the health, safety, or welfare of a resident of the

12  facility.

13         (b)  The determination by the agency that the facility

14  owner, or administrator, or financial officer is not of

15  suitable character or competency, or that the owner lacks the

16  financial ability, to provide continuing adequate care to

17  residents, pursuant to the information obtained through s.

18  400.411, s. 400.417, or s. 400.434.

19         (c)  Misappropriation or conversion of the property of

20  a resident of the facility.

21         (d)  Failure to follow the criteria and procedures

22  provided under part I of chapter 394 relating to the

23  transportation, voluntary admission, and involuntary

24  examination of a facility resident.

25         (e)  One or more class I, three or more class II, or

26  five or more repeated or recurring identical or similar class

27  III violations of this part which were identified by the

28  agency within the last 2 years during the last biennial

29  inspection, monitoring visit, or complaint investigation and

30  which, in the aggregate, affect the health, safety, or welfare

31  of the facility residents.

                                  21

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1         (f)  A confirmed report of adult abuse, neglect, or

 2  exploitation, as defined in s. 415.102, which has been upheld

 3  following a chapter 120 hearing or a waiver of such

 4  proceedings where the perpetrator is an employee, volunteer,

 5  administrator, or owner, or otherwise has access to the

 6  residents of a facility, and the owner or administrator has

 7  not taken action to remove the perpetrator. Exemptions from

 8  disqualification may be granted as set forth in s. 435.07. No

 9  administrative action may be taken against the facility if the

10  perpetrator is granted an exemption.

11         (g)  Violation of a moratorium.

12         (h)  Failure of the license applicant, the licensee

13  during relicensure, or failure of a licensee that holds a

14  provisional an initial or change of ownership license, to meet

15  the minimum license standards or the requirements of rules

16  adopted under this part, or related rules, at the time of

17  license application or renewal.

18         (i)  A fraudulent statement or omission of any material

19  fact on an application for a license or any other document

20  required by the agency that is signed and notarized.

21         (j)  An intentional or negligent life-threatening act

22  in violation of the uniform firesafety standards for assisted

23  living facilities or other firesafety standards established by

24  the State Fire Marshal, that threatens the health, safety, or

25  welfare of a resident of a facility, as communicated to the

26  agency by the local State Fire Marshal, a local fire marshal,

27  or other authority having jurisdiction or the State Fire

28  Marshal.

29         (k)  Knowingly operating any unlicensed facility or

30  providing without a license any service that must be licensed

31  under this chapter.

                                  22

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1

 2  Administrative proceedings challenging agency action under

 3  this subsection shall be reviewed on the basis of the facts

 4  and conditions that resulted in the agency action.

 5         (3)  Proceedings brought under paragraphs (2)(a), (c),

 6  (e), and (j) shall not be subject to de novo review.

 7         (2)(4)  Upon notification by the local State Fire

 8  Marshal, local fire marshal, or other authority having

 9  jurisdiction or the State Fire Marshal, the agency may deny or

10  revoke the license of an assisted living a facility that fails

11  to correct cited fire code violations issued by the State Fire

12  Marshal, a local fire marshal, or other authority having

13  jurisdiction, that affect or threaten the health, safety, or

14  welfare of a resident of a facility.

15         (3)  The agency may deny a license to any applicant or

16  to any officer or board member of an applicant who is a firm,

17  corporation, partnership, or association or who owns 5 percent

18  or more of the facility, if the applicant, officer, or board

19  member has or had a 25-percent or greater financial or

20  ownership interest in any other facility licensed under this

21  part, or in any entity licensed by this state or another state

22  to provide health or residential care, which facility or

23  entity during the 5 years prior to the application for a

24  license closed due to financial inability to operate; had a

25  receiver appointed or a license denied, suspended, or revoked;

26  was subject to a moratorium on admissions; had an injunctive

27  proceeding initiated against it; or has an outstanding fine

28  assessed under this chapter.

29         (4)  The agency shall deny or revoke the license of an

30  assisted living facility that has two or more class I

31  violations that are similar or identical to violations

                                  23

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  identified by the agency during a survey, inspection,

 2  monitoring visit, or complaint investigation occurring within

 3  the previous 2 years.

 4         (5)  The agency may deny a license to an applicant who

 5  owns 25 percent or more of, or operates, a facility which,

 6  during the 5 years prior to the application for a license, has

 7  had a license denied, suspended, or revoked pursuant to

 8  subsection (2), or, during the 2 years prior to the

 9  application for a license, has had a moratorium imposed on

10  admissions, has had an injunctive proceeding initiated against

11  it, has had a receiver appointed, was closed due to financial

12  inability to operate, or has an outstanding fine assessed

13  under this part.

14         (5)(6)  An action taken by the agency to suspend, deny,

15  or revoke a facility's license under this part, in which the

16  agency claims that the facility owner or an employee of the

17  facility has threatened the health, safety, or welfare of a

18  resident of the facility, shall, upon receipt of the

19  facility's request for a hearing, be heard by the Division of

20  Administrative Hearings of the Department of Management

21  Services within 120 days after receipt of the facility's the

22  request for a hearing, unless that time limitation period is

23  waived by both parties.  The administrative law judge must

24  render a decision within 30 days after receipt of a proposed

25  recommended order the hearing.

26         (6)(7)  The agency shall provide to the Division of

27  Hotels and Restaurants of the Department of Business and

28  Professional Regulation, on a monthly basis, a list of those

29  assisted living facilities which have had their licenses

30  denied, suspended, or revoked or which are involved in an

31  appellate proceeding pursuant to s. 120.60 related to the

                                  24

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  denial, suspension, or revocation of a license.

 2         (7)  Agency notification of a license suspension or

 3  revocation, or denial of a license renewal, shall be posted

 4  and visible to the public at the facility.

 5         Section 8.  Section 400.415, Florida Statutes, is

 6  amended to read:

 7         400.415  Moratorium on admissions; notice.--The agency

 8  may impose an immediate moratorium on admissions to any

 9  assisted living facility if when the agency determines that

10  any condition in the facility presents a threat to the health,

11  safety, or welfare of the residents in the facility.

12         (1)  A facility the license of which is denied,

13  revoked, or suspended pursuant to as a result of a violation

14  of s. 400.414 may be subject to immediate imposition of a

15  moratorium on admissions to run concurrently with licensure

16  denial, revocation, or suspension.

17         (2)  When a moratorium is placed on a facility, notice

18  of the moratorium shall be posted and visible to the public at

19  the facility until the moratorium is lifted.

20         (3)  The department may by rule establish conditions

21  that constitute grounds for imposing a moratorium on a

22  facility and procedures for imposing and lifting a moratorium,

23  as necessary to administer this section.

24         Section 9.  Section 400.417, Florida Statutes, is

25  amended to read:

26         400.417  Expiration of license; renewal; conditional

27  license.--

28         (1)  Biennial licenses issued for the operation of a

29  facility, unless sooner suspended or revoked, shall expire

30  automatically 2 years from the date of issuance. Limited

31  nursing, extended congregate care, and limited mental health

                                  25

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  licenses shall expire at the same time as the facility's

 2  standard license, regardless of when issued. The agency shall

 3  notify the facility by certified mail at least 120 days prior

 4  to the expiration of the license that a renewal license

 5  relicensure is necessary to continue operation.  Ninety days

 6  prior to the expiration date, an application for renewal shall

 7  be submitted to the agency. A license shall be renewed upon

 8  the filing of an application on forms furnished by the agency

 9  if the applicant has first met the requirements established

10  under this part and all rules promulgated under this part. The

11  failure to file a timely renewal application shall result in a

12  late fee charged to the facility in an amount equal to 50

13  percent of the current fee. in effect on the last preceding

14  regular renewal date.  Late fees shall be deposited into the

15  Health Care Trust Fund as provided in s. 400.418.  The

16  facility shall file with the application satisfactory proof of

17  ability to operate and conduct the facility in accordance with

18  the requirements of this part.

19         (2)  A license shall be renewed within 90 days upon the

20  timely filing of an application on forms furnished by the

21  agency and the provision of satisfactory proof of ability to

22  operate and conduct the facility in accordance with the

23  requirements of this part and adopted rules, including An

24  applicant for renewal of a license must furnish proof that the

25  facility has received a satisfactory firesafety inspection,

26  conducted by the local fire marshal or other authority having

27  jurisdiction or the State Fire Marshal, within the preceding

28  12 months.

29         (3)  An applicant for renewal of a license who has

30  complied on the initial license application with the

31  provisions of s. 400.411 with respect to proof of financial

                                  26

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  ability to operate shall not be required to provide further

 2  proof of financial ability on renewal applications unless the

 3  facility or any other facility owned or operated in whole or

 4  in part by the same person or business entity has demonstrated

 5  financial instability as provided under s. 400.447(2)

 6  evidenced by bad checks, delinquent accounts, or nonpayment of

 7  withholding taxes, utility expenses, or other essential

 8  services or unless the agency suspects that the facility is

 9  not financially stable as a result of the annual survey or

10  complaints from the public or a report from the State

11  Long-Term Care Ombudsman Council.  Each facility must shall

12  report to the agency any adverse court action concerning the

13  facility's financial viability, within 7 days after its

14  occurrence.  The agency shall have access to books, records,

15  and any other financial documents maintained by the facility

16  to the extent necessary to determine the facility's financial

17  stability carry out the purpose of this section.  A license

18  for the operation of a facility shall not be renewed if the

19  licensee has any outstanding fines assessed pursuant to this

20  part which are in final order status.

21         (4)(2)  A licensee against whom a revocation or

22  suspension proceeding is pending at the time of license

23  renewal may be issued a conditional license effective until

24  final disposition by the agency of such proceeding.  If

25  judicial relief is sought from the final disposition, the

26  court having jurisdiction may issue a conditional license for

27  the duration of the judicial proceeding.

28         (5)(3)  A conditional license may be issued to an

29  applicant for license renewal if when the applicant fails to

30  meet all standards and requirements for licensure.  A

31  conditional license issued under this subsection shall be

                                  27

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  limited in duration to a specific period of time not to exceed

 2  6 months, as determined by the agency, and shall be

 3  accompanied by an agency-approved approved plan of correction.

 4         (6)  When an extended care or limited nursing license

 5  is requested during a facility's biennial license period, the

 6  fee shall be prorated in order to permit the additional

 7  license to expire at the end of the biennial license period.

 8  The fee shall be calculated as of the date the additional

 9  license application is received by the agency.

10         (7)  The department may by rule establish renewal

11  procedures, identify forms, and specify documentation

12  necessary to administer this section.

13         Section 10.  Section 400.4174, Florida Statutes, is

14  amended to read:

15         400.4174  Reports of abuse in facilities.--When an

16  employee, volunteer, administrator, or owner of a facility is

17  the subject of has a confirmed report of adult abuse, neglect,

18  or exploitation, as defined in s. 415.102, or child abuse or

19  neglect, as defined in s. 415.503, and the protective

20  investigator knows that the individual is an employee,

21  volunteer, administrator, or owner of a facility, the agency

22  shall be notified of the confirmed report.

23         Section 11.  Section 400.4176, Florida Statutes, is

24  amended to read:

25         400.4176  Notice of change of administrator.--If,

26  during the period for which a license is issued, the owner

27  changes administrators, the owner must notify the agency of

28  the change within 10 45 days thereof and must provide

29  documentation within 90 days that the new administrator has

30  completed the applicable core educational requirements under

31  s. 400.452.  Background screening shall be completed on any

                                  28

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  new administrator to establish that the individual is of

 2  suitable character as specified in s. 400.411 ss.

 3  400.411(2)(c) and 400.456.

 4         Section 12.  Subsection (1) of section 400.418, Florida

 5  Statutes, is amended to read:

 6         400.418  Disposition of fees and administrative

 7  fines.--

 8         (1)  Income from license fees, inspection fees, late

 9  fees, and administrative fines generated pursuant to ss.

10  400.407, 400.408, 400.417, 400.419, and 400.431 shall be

11  deposited in the Health Care Trust Fund administered by the

12  agency.  Such funds shall be directed to and used by the

13  agency for the following purposes:

14         (a)  Up to 50 percent of the trust funds accrued each

15  fiscal year under this part may be used to offset the expenses

16  of receivership, pursuant to s. 400.422, if the court

17  determines that the income and assets of the facility are

18  insufficient to provide for adequate management and operation.

19         (b)  An amount of $5,000 of the trust funds accrued

20  each year under this part shall be allocated to pay for

21  inspection-related physical and mental health examinations

22  requested by the agency pursuant to s. 400.426 for residents

23  who are either recipients of supplemental security income or

24  have monthly incomes not in excess of the maximum combined

25  federal and state cash subsidies available to supplemental

26  security income recipients, as provided for in s. 409.212.

27  Such funds shall only be used where the resident is ineligible

28  for Medicaid.

29         (c)  Any trust funds accrued each year under this part

30  and not used for the purposes specified in paragraphs (a) and

31  (b) shall be used to offset the costs of the licensure

                                  29

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  program, including the costs of conducting background

 2  investigations, verifying information submitted, defraying the

 3  costs of processing the names of applicants, and conducting

 4  inspections and monitoring visits pursuant to this part.

 5         Section 13.  Section 400.419, Florida Statutes, is

 6  amended to read:

 7         400.419  Violations; administrative fines penalties.--

 8         (1)(a)  If the agency determines that a facility is not

 9  in compliance with standards promulgated pursuant to the

10  provisions of this part, including the failure to report

11  evidence of the facility's financial instability or the

12  operation of a facility without a license, the agency, as an

13  alternative to or in conjunction with an administrative action

14  against a facility, shall make a reasonable attempt to discuss

15  each violation and recommended corrective action with the

16  owner or administrator of the facility, prior to written

17  notification thereof.  The agency, instead of fixing a period

18  within which the facility shall enter into compliance with

19  standards, may request a plan of corrective action from the

20  facility which demonstrates a good faith effort to remedy each

21  violation by a specific date, subject to the approval of the

22  agency.

23         (b)  Any facility owner or administrator found in

24  violation of this part, including any individual operating a

25  facility without a license, shall be subject to a fine, set

26  and levied by the agency.

27         (c)  Each day during which any person violates any such

28  provision after the date fixed for termination of the

29  violation, as ordered by the agency, constitutes an

30  additional, separate, and distinct violation.

31         (d)  Any action taken to correct a violation shall be

                                  30

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  documented in writing by the administrator of the facility and

 2  verified through followup visits by licensing personnel of the

 3  agency.  The agency may impose a fine and, in the case of an

 4  owner-operated facility, revoke a facility's license when a

 5  facility administrator fraudulently misrepresents action taken

 6  to correct a violation.

 7         (e)  If a facility desires to appeal any agency action

 8  under this section, it shall send a written request for a

 9  hearing to the agency within 15 days of receipt by certified

10  mail of notice of the action of the agency. If the fine is

11  upheld, the violator shall pay the fine, plus interest at the

12  legal rate as specified in s. 687.01, for each day beyond the

13  date set by the agency for payment of the fine.

14         (2)  In determining if a penalty is to be imposed and

15  in fixing the amount of the penalty to be imposed, if any, for

16  a violation, the agency shall consider the following factors:

17         (a)  The gravity of the violation, including the

18  probability that death or serious physical or emotional harm

19  to a resident will result or has resulted, the severity of the

20  action or potential harm, and the extent to which the

21  provisions of the applicable statutes or rules were violated.

22         (b)  Actions taken by the owner or administrator to

23  correct violations.

24         (c)  Any previous violations.

25         (d)  The financial benefit to the facility of

26  committing or continuing the violation.

27         (e)  The licensed capacity of the facility.

28         (1)(3)  Each violation of this part and adopted rules

29  shall be classified according to the nature of the violation

30  and the gravity of its probable effect on facility residents.

31  The agency shall indicate the classification of each violation

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  on the written face of the notice of the violation as follows:

 2         (a)  Class "I" violations are those conditions or

 3  occurrences related to the operation and maintenance of a

 4  facility or to the personal care of residents which the agency

 5  determines present an imminent danger to the residents or

 6  guests of the facility or a substantial probability that death

 7  or serious physical or emotional harm would result therefrom.

 8  The condition or practice constituting a class I violation

 9  shall be abated or eliminated within 24 hours, unless a fixed

10  period, as determined by the agency, is required for

11  correction.  A class I violation is subject to an

12  administrative fine a civil penalty in an amount not less than

13  $1,000 and not exceeding $10,000 $5,000 for each violation.  A

14  fine may be levied notwithstanding the correction of the

15  violation.

16         (b)  Class "II" violations are those conditions or

17  occurrences related to the operation and maintenance of a

18  facility or to the personal care of residents which the agency

19  determines directly threaten the physical or emotional health,

20  safety, or security of the facility residents, other than

21  class I violations. A class II violation is subject to an

22  administrative fine a civil penalty in an amount not less than

23  $500 and not exceeding $5,000 $1,000 for each violation.  A

24  citation for a class II violation shall specify the time

25  within which the violation is required to be corrected.  If a

26  class II violation is corrected within the time specified, no

27  fine civil penalty may be imposed, unless it is a repeated

28  offense.

29         (c)  Class "III" violations are those conditions or

30  occurrences related to the operation and maintenance of a

31  facility or to the personal care of residents which the agency

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  determines indirectly or potentially threaten the physical or

 2  emotional health, safety, or security of facility residents,

 3  other than class I or class II violations.  A class III

 4  violation is subject to an administrative fine a civil penalty

 5  of not less than $100 and not exceeding $1,000 $500 for each

 6  violation.  A citation for a class III violation shall specify

 7  the time within which the violation is required to be

 8  corrected.  If a class III violation is corrected within the

 9  time specified, no fine civil penalty may be imposed, unless

10  it is a repeated offense.

11         (d)  Class "IV" violations are those conditions or

12  occurrences related to the operation and maintenance of a

13  building or to required reports, forms, or documents that do

14  not have the potential of negatively affecting residents.

15  These violations are of a type that the agency determines do

16  not threaten the health, safety, or security of residents of

17  the facility.  A facility that does not correct a class IV

18  violation within the time limit specified in the

19  agency-approved corrective action plan is subject to an

20  administrative fine a civil penalty of not less than $50 nor

21  more than $200 for each violation.  Any class IV violation

22  that is corrected during the time an agency survey is being

23  conducted will be identified as an agency finding and not as a

24  violation.

25         (2)(4)  The agency may set and levy a fine not to

26  exceed $1,000 $500 for each violation which cannot be

27  classified according to subsection (1) (3).  In no event may

28  Such fines fine in the aggregate may not exceed $10,000 per

29  survey $5,000.

30         (3)  In determining if a penalty is to be imposed and

31  in fixing the amount of the fine, the agency shall consider

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  the following factors:

 2         (a)  The gravity of the violation, including the

 3  probability that death or serious physical or emotional harm

 4  to a resident will result or has resulted, the severity of the

 5  action or potential harm, and the extent to which the

 6  provisions of the applicable laws or rules were violated.

 7         (b)  Actions taken by the owner or administrator to

 8  correct violations.

 9         (c)  Any previous violations.

10         (d)  The financial benefit to the facility of

11  committing or continuing the violation.

12         (e)  The licensed capacity of the facility.

13         (4)  Each day of continuing violation after the date

14  fixed for termination of the violation, as ordered by the

15  agency, constitutes an additional, separate, and distinct

16  violation.

17         (5)  Any action taken to correct a violation shall be

18  documented in writing by the owner or administrator of the

19  facility and verified through followup visits by agency

20  personnel. The agency may impose a fine and, in the case of an

21  owner-operated facility, revoke or deny a facility's license

22  when a facility administrator fraudulently misrepresents

23  action taken to correct a violation.

24         (6)  For fines that are upheld following administrative

25  or judicial review, the violator shall pay the fine, plus

26  interest at the rate as specified in s. 55.03, for each day

27  beyond the date set by the agency for payment of the fine.

28         (7)  Except as provided in subsection (8), any facility

29  that continues to operate without having applied for a license

30  10 days after agency notification is subject to a $1,000 fine.

31  Each day beyond 20 days after agency notification constitutes

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  a separate violation and the facility is subject to a fine of

 2  $500 per day.

 3         (8)  Unlicensed facilities whose owner or administrator

 4  concurrently operates a licensed facility, has previously

 5  operated a licensed facility, or has been employed in a

 6  licensed facility shall immediately be subject to an

 7  administrative fine of $5,000 upon agency notification. Each

 8  day that a facility continues to operate without having

 9  applied for a license within 10 working days after agency

10  notification constitutes a separate violation, and such

11  facility shall be subject to a fine of $500 per day

12  retroactive to the date of agency notification.

13         (9)  Any facility whose owner fails to apply for a

14  change-of-ownership license in accordance with s. 400.412 and

15  operates the facility under the new ownership is subject to a

16  fine not to exceed $5,000.

17         (10)  In addition to any administrative fines imposed,

18  the agency may assess a survey fee, equal to the lesser of one

19  half of the facility's biennial license and bed fee or $500,

20  to cover the cost of conducting initial complaint

21  investigations that result in the finding of a violation that

22  was the subject of the complaint or monitoring visits

23  conducted under s. 400.428(3)(c) to verify the correction of

24  the violations.

25         (11)  The agency, as an alternative to or in

26  conjunction with an administrative action against a facility

27  for violations of this part and adopted rules, shall make a

28  reasonable attempt to discuss each violation and recommended

29  corrective action with the owner or administrator of the

30  facility, prior to written notification. The agency, instead

31  of fixing a period within which the facility shall enter into

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  compliance with standards, may request a plan of corrective

 2  action from the facility which demonstrates a good-faith

 3  effort to remedy each violation by a specific date, subject to

 4  the approval of the agency.

 5         (12)(5)  Administrative fines Civil penalties paid by

 6  any facility under this section the provisions of subsection

 7  (3) shall be deposited into the Health Care Trust Fund and

 8  expended as provided in s. 400.418.

 9         (13)(6)  The agency shall develop and disseminate an

10  annual list of all facilities sanctioned or fined $5,000 or

11  more in excess of $500 for violations of state standards, the

12  number and class of violations involved, the penalties

13  imposed, and the current status of cases. The list shall be

14  disseminated, at no charge, to the Department of Elderly

15  Affairs, the Department of Health and Rehabilitative Services,

16  the Department of Children and Family Services, the area

17  agencies on aging, the Statewide Human Rights Advocacy

18  Committee, and the state and district nursing home and

19  long-term care facility ombudsman councils. The Department of

20  Children and Family Services shall disseminate the list to

21  service providers under contract to the department who are

22  responsible for referring persons to a facility for residency.

23  The agency may charge a fee commensurate with the cost of

24  printing and postage to other interested parties requesting a

25  copy of this list.

26         Section 14.  Section 400.4195, Florida Statutes, is

27  amended to read:

28         400.4195  Rebates prohibited; penalties.--

29         (1)  It is unlawful for any assisted living facility

30  licensed under this part to contract or promise to pay or

31  receive any commission, bonus, kickback, or rebate or engage

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  in any split-fee arrangement in any form whatsoever with any

 2  physician, surgeon, organization, agency, or person, either

 3  directly or indirectly, for residents referred to an assisted

 4  living facility licensed under this part.  A facility may

 5  employ or contract with persons to market the facility,

 6  provided the employee or contract provider clearly indicates

 7  that he or she represents the facility.  A person or agency

 8  independent of the facility may provide placement or referral

 9  services for a fee to individuals seeking assistance in

10  finding a suitable facility; however, any fee paid for

11  placement or referral services must be paid by the individual

12  looking for a facility, not by the facility.

13         (2)  A violation of this section shall be considered

14  patient brokering and is punishable as provided in s. 817.505.

15  The department, in consultation with the agency, shall adopt

16  rules which assess administrative penalties for acts

17  prohibited by subsection (1).

18         Section 15.  Paragraph (a) of subsection (1) of section

19  400.422, Florida Statutes, is amended to read:

20         400.422  Receivership proceedings.--

21         (1)  As an alternative to or in conjunction with an

22  injunctive proceeding, the agency may petition a court of

23  competent jurisdiction for the appointment of a receiver, if

24  suitable alternate placements are not available, when any of

25  the following conditions exist:

26         (a)  The facility is operating without a license and

27  refuses to make application for a license as required by ss.

28  s. 400.407 and 400.408.

29         Section 16.  Section 400.4256, Florida Statutes, is

30  created to read:

31         400.4256  Assistance with self-administration of

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  medication.--

 2         (1)  For the purposes of this section, the term:

 3         (a)  "Informed consent" means advising the resident, or

 4  the resident's surrogate, guardian, or attorney in fact, that

 5  an assisted living facility is not required to have a licensed

 6  nurse on staff, that the resident may be receiving assistance

 7  with self-administration of medication from an unlicensed

 8  person, and that such assistance, if provided by an unlicensed

 9  person, will or will not be overseen by a licensed nurse.

10         (b)  "Unlicensed person" means an individual not

11  currently licensed to practice nursing or medicine who is

12  employed by or under contract to an assisted living facility

13  and who has received training with respect to assisting with

14  the self-administration of medication in an assisted living

15  facility as provided under s. 400.452 prior to providing such

16  assistance as described in this section.

17         (2)  Residents who are capable of self-administering

18  their own medications without assistance shall be encouraged

19  and allowed to do so. However, an unlicensed person may,

20  consistent with a dispensed prescription's label or the

21  package directions of an over-the-counter medication, assist a

22  resident whose condition is medically stable with the

23  self-administration of routine, regularly scheduled

24  medications that are intended to be self-administered.

25  Assistance with self-administration of medication by an

26  unlicensed person may occur only upon a documented request by,

27  and the written informed consent of, a resident or the

28  resident's surrogate, guardian, or attorney in fact. For the

29  purposes of this section, self-administered medications

30  include both legend and over-the-counter oral dosage forms,

31  topical dosage forms, and topical opthalmic, otic, and nasal

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  dosage forms including solutions, suspensions, sprays, and

 2  inhalers.

 3         (3)  Assistance with self-administration of medication

 4  includes:

 5         (a)  Taking the medication, in its previously

 6  dispensed, properly labeled container, from where it is

 7  stored, and bringing it to the resident.

 8         (b)  In the presence of the resident, reading the

 9  label, opening the container, removing a prescribed amount of

10  medication from the container, and closing the container.

11         (c)  Placing an oral dosage in the resident's hand or

12  placing the dosage in another container and helping the

13  resident by lifting the container to his or her mouth.

14         (d)  Applying topical medications.

15         (e)  Returning the medication container to proper

16  storage.

17         (f)  Keeping a record of when a resident receives

18  assistance with self-administration of medication under this

19  section.

20         (4)  Assistance with self-administration of medication

21  does not include:

22         (a)  Mixing, compounding, converting, or calculating

23  medication doses, except for measuring a prescribed amount of

24  liquid medication or breaking a scored tabled or crushing a

25  tablet as prescribed.

26         (b)  The preparation of syringes for injection or the

27  administration of medications by any injectable route.

28         (c)  Administration of medications through intermittent

29  positive pressure breathing machines or a nebulizer.

30         (d)  Administration of medications by way of a tube

31  inserted in a cavity of the body.

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1         (e)  Administration of parenteral preparations.

 2         (f)  Irrigations or debriding agents used in the

 3  treatment of a skin condition.

 4         (g)  Rectal, urethral, or vaginal preparations.

 5         (h)  Medications ordered by the physician or health

 6  care professional with prescriptive authority to be given "as

 7  needed," and at the request of a competent resident, unless

 8  the order is written with specific parameters that preclude

 9  independent judgment on the part of the unlicensed person.

10         (i)  Medications for which the time of administration,

11  the amount, the strength of dosage, the method of

12  administration, or the reason for administration requires

13  judgment or discretion on the part of the unlicensed person.

14         (5)  Assistance with the self-administration of

15  medication by an unlicensed person as described in this

16  section shall not be considered administration as defined in

17  s. 465.003.

18         (6)  The department may by rule establish facility

19  procedures and interpret terms as necessary to implement this

20  section.

21         Section 17.  Subsection (3) of section 400.428, Florida

22  Statutes, is amended to read:

23         400.428  Resident bill of rights.--

24         (3)(a)  The agency shall conduct a survey an inspection

25  to determine general compliance with facility standards and

26  compliance with residents' rights as a prerequisite to initial

27  or renewal licensure or licensure renewal.

28         (b)  In order to determine whether the facility is

29  adequately protecting residents' rights, the biennial survey

30  inspection of the facility shall include private informal

31  conversations with a sample of residents and consultation with

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  the ombudsman council in the planning and service area, as

 2  defined in part II, in which the facility is located to

 3  discuss residents' experiences within the facility with

 4  respect to rights specified in this section and general

 5  compliance with standards.

 6         (c)  During any calendar year in which no survey

 7  inspection is conducted, the agency shall conduct at least one

 8  monitoring visit of each facility cited in the previous year

 9  for a class I or class II violation, or more than three

10  uncorrected class III violations, that led to a conditional

11  license or a moratorium on admissions.

12         (d)  The agency may conduct periodic followup

13  inspections as necessary to monitor the compliance of

14  facilities with a history of any class I, class II, or class

15  III violations that threaten the health, safety, or security

16  of residents.

17         (e)(d)  The agency may conduct complaint investigations

18  as warranted to investigate any allegations of noncompliance

19  with requirements required under this part or rules adopted

20  promulgated under this part.

21         Section 18.  Section 400.442, Florida Statutes, is

22  amended to read:

23         400.442  Pharmacy and dietary services.--

24         (1)  Notwithstanding s. 400.419, Any assisted living

25  facility in which the agency has documented a class I or class

26  II deficiency or uncorrected class III deficiencies regarding

27  medicinal drugs or over-the-counter preparations, including

28  their storage, use, delivery, or administration, or dietary

29  services, or both, during a biennial survey or a monitoring

30  visit or an investigation in response to a complaint, shall,

31  in addition to or as an alternative to any penalties imposed

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  under s. 400.419, be required to employ the consultant

 2  services of a licensed pharmacist, a licensed registered

 3  nurse, or a registered or licensed dietitian, or both, as

 4  applicable.  The consultant shall provide onsite consultation

 5  and shall continue with, at a minimum, provide onsite

 6  quarterly consultation until the inspection team from the

 7  agency determines that such consultation services are no

 8  longer required.

 9         (2)  A corrective action plan for deficiencies related

10  to assistance with the self-administration of medication or

11  the administration of medication must be developed and

12  implemented by the facility within 48 hours after notification

13  of such deficiency, or sooner if the deficiency is determined

14  by the agency to be life threatening.

15         (3)(2)  The agency shall employ at least two

16  pharmacists licensed pursuant to chapter 465 among its

17  personnel who biennially inspect assisted living facilities

18  licensed under this part, to participate in biennial

19  inspections or consult with the agency regarding deficiencies

20  relating to medicinal drugs or over-the-counter preparations,

21  including, but not limited to, their storage, use, delivery,

22  or administration.  A corrective action plan for deficiencies

23  related to the administration or supervision of medication

24  must be developed and implemented within 48 hours after

25  notification of the deficiency, or sooner if the deficiency is

26  determined by the agency to be life threatening.

27         Section 19.  Section 400.452, Florida Statutes, is

28  amended to read:

29         400.452  Staff training and educational programs; core

30  educational requirement.--

31         (1)  The department shall provide, or cause to be

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  provided, training and educational programs for the

 2  administrators and such other assisted living facility staff

 3  as are defined by the department to better enable them to

 4  appropriately respond to the needs of residents, to maintain

 5  resident care and facility standards, and to meet licensure

 6  requirements.

 7         (2)  The department shall also establish a core

 8  educational requirement to be used in these programs.

 9  Successful completion of the core educational requirement must

10  include successful completion of a competency test. Programs

11  must be provided by the department or by a provider approved

12  by the department at least quarterly.  The core educational

13  requirement must cover at least the following topics:

14         (a)  State law and rules relating to on assisted living

15  facilities, including lifesafety requirements and procedures.

16         (b)  Resident rights and identifying and reporting

17  abuse, neglect, and exploitation.

18         (c)  Special needs of elderly persons, persons with

19  mental illness, and persons with developmental disabilities

20  and how to meet those needs.

21         (d)  Nutrition and food service, including acceptable

22  sanitation practices for preparing, storing, and serving food.

23         (e)  Medication management and recordkeeping, and

24  proper techniques for assisting residents with

25  self-administered medication, including recordkeeping.

26         (f)  Firesafety requirements, including fire evacuation

27  drill procedures and other emergency procedures drills.

28         (g)  Care of persons with Alzheimer's disease and other

29  related disorders.

30         (3)  Such a program must be available at least

31  quarterly in each planning and service area district of the

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  department of Health and Rehabilitative Services.  The

 2  competency test must be developed by the department in

 3  conjunction with the agency and providers and must be

 4  available for use by January 1, 1997. Beginning July 1, 1997,

 5  A new facility administrator must complete the core

 6  educational requirement including the competency test within 3

 7  months after being employed as an administrator.  Failure to

 8  complete a core educational requirement specified in this

 9  subsection is a violation of this part and subjects the

10  violator to an administrative fine a penalty as prescribed in

11  s. 400.419. Administrators licensed in accordance with chapter

12  468, part II, are exempt from this requirement. Other licensed

13  professionals may be exempted, as determined by the department

14  by rule.

15         (4)  Administrators are required to participate in

16  continuing education for a minimum of 12 contact hours every 2

17  years as specified by rule of the department.

18         (5)  Staff involved with the management of medications

19  and assisting with the self-administration of medications

20  under s. 400.4256 must complete a minimum of 4 hours of

21  training pursuant to a curriculum developed by the department,

22  provided by a registered nurse, licensed pharmacist, or

23  department staff. Administrators and staff of facilities more

24  than 10 percent of whose residents are mental health residents

25  shall participate in training in the care and supervision of

26  such residents as specified by rule of the department.

27         (6)  Other facility staff shall participate in training

28  relevant to their job duties as specified by rule of the

29  department.

30         (7)  Any facility more than 90 percent of whose

31  residents receive monthly optional supplementation payments is

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  not required to pay for the training and education programs

 2  provided under this section. A facility that has one or more

 3  such residents shall pay a reduced fee that is proportional to

 4  the percentage of such residents in the facility. A facility

 5  that does not have any residents who receive monthly optional

 6  supplementation payments must pay a reasonable fee, as

 7  established by the department, for such training and education

 8  programs. A facility that has one or more such residents shall

 9  pay a reduced fee that is proportional to the percentage of

10  such residents in the facility. Any facility more than 90

11  percent of whose residents receive monthly optional state

12  supplementation payments is not required to pay for the

13  training and continuing education programs required under this

14  section.

15         (8)  If the department or the agency determines that

16  there are problems in a facility that could be reduced through

17  specific staff training or education beyond that already

18  required under this section, the department or the agency may

19  require, and provide, or cause to be provided, the training or

20  education of any personal care staff in the facility.

21         (9)  The department shall adopt rules pursuant to the

22  Administrative Procedure Act to establish training programs,

23  standards and curriculum for training, staff training

24  requirements, procedures for approving training programs, and

25  training fees.

26         Section 20.  Paragraph (c) is added to subsection (2)

27  of section 400.474, Florida Statutes, to read:

28         400.474  Denial, suspension, revocation of license;

29  injunction; grounds.--

30         (2)  Any of the following actions by a home health

31  agency or its employee is grounds for disciplinary action by

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1  the Agency for Health Care Administration:

 2         (c)  Knowingly providing home health services in an

 3  unlicensed assisted living facility or unlicensed adult

 4  family-care home, unless the home health agency or employee

 5  reports the unlicensed facility or home to the agency within

 6  72 hours after providing the services.

 7         Section 21.  Section 400.618, Florida Statutes, is

 8  amended to read:

 9         400.618  Definitions.--As used in this part ss.

10  400.616-400.629, the term:

11         (1)  "Activities of daily living" means functions and

12  tasks for self-care, including eating, bathing, grooming,

13  dressing, ambulating, and other similar tasks.

14         (2)  "Adult family-care home" means a full-time,

15  family-type living arrangement, in a private home, under which

16  a person who owns or rents, and lives in, the home provides or

17  persons provide, for profit or not for profit, room, board,

18  and one or more personal services, on a 24-hour basis as

19  appropriate for the level of functional impairment, for no

20  more than five aged persons or disabled adults who are not

21  relatives. The following family-type living arrangements

22  establishments are not required to be licensed as an adult

23  family-care home homes:

24         (a)  An arrangement whereby the person who owns or

25  rents the home provides room, board, and establishment that

26  provides personal services for not more than two three or

27  fewer adults who do not receive optional state supplementation

28  under s. 409.212, but that does not hold itself out to the

29  public to be an establishment that regularly provides such

30  services. The person who provides the housing, meals, and

31  personal services must own or rent, and live in, the home.

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 1         (b)  An arrangement whereby the person who owns or

 2  rents the home provides room, board, and establishment in

 3  which a person or persons provide personal services only to

 4  their relatives.

 5         (c)  An establishment that is licensed as an assisted

 6  living facility under part III.

 7         (3)  "Aged person" means any person age 60 or over who

 8  is currently a resident of the state and who, because of a

 9  functional impairment, requires one or more personal services

10  but does not require 24-hour skilled nursing home or

11  institutional care.

12         (4)  "Agency" means the Agency for Health Care

13  Administration.

14         (5)  "Aging in place" means remaining in a

15  noninstitutional living environment despite the physical or

16  mental changes that may occur in a person who is aging.  For

17  aging in place to occur, needed services are added, increased,

18  or adjusted to compensate for a person's physical or mental

19  changes.

20         (6)  "Chemical restraint" means a pharmacologic drug

21  that physically limits, restricts, or deprives an individual

22  of movement or mobility, and is used for discipline or

23  convenience and not required for the treatment of medical

24  symptoms.

25         (7)  "Department" means the Department of Elderly

26  Affairs.

27         (8)  "Disabled adult" means any person between 18 and

28  59 years of age, inclusive, who is a resident of the state and

29  who has one or more permanent physical or mental limitations

30  that restrict the person's ability to perform the normal

31  activities of daily living.

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 1         (9)  "Personal services" include, but are not limited

 2  to, individual assistance with or supervision of activities of

 3  daily living; supervision of self-administered medication; and

 4  other similar services that the department defines by rule.

 5         (10)  "Provider" means a person who is licensed to

 6  operate an adult family-care home.

 7         (11)  "Relative" means an individual who is the father,

 8  mother, son, daughter, brother, sister, uncle, aunt, first

 9  cousin, nephew, niece, husband, wife, father-in-law,

10  mother-in-law, son-in-law, daughter-in-law, brother-in-law,

11  sister-in-law, stepfather, stepmother, stepson, stepdaughter,

12  stepbrother, stepsister, half brother, or half sister of a

13  provider.

14         Section 22.  Paragraph (h) of subsection (3) of section

15  408.036, Florida Statutes, is amended to read:

16         408.036  Projects subject to review.--

17         (3)  EXEMPTIONS.--Upon request, supported by such

18  documentation as the agency requires, the agency shall grant

19  an exemption from the provisions of subsection (1):

20         (h)  For the establishment of a Medicare-certified home

21  health agency by a facility certified under chapter 651; a

22  retirement community, as defined in s. 400.404(2)(g) s.

23  400.404(2)(e); or a residential facility that serves only

24  retired military personnel, their dependents, and the

25  surviving dependents of deceased military personnel.

26  Medicare-reimbursed home health services provided through such

27  agency shall be offered exclusively to residents of the

28  facility or retirement community or to residents of facilities

29  or retirement communities owned, operated, or managed by the

30  same corporate entity. Each visit made to deliver

31  Medicare-reimbursable home health services to a home health

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 1  patient who, at the time of service, is not a resident of the

 2  facility or retirement community shall be a deceptive and

 3  unfair trade practice and constitutes a violation of ss.

 4  501.201-501.213.

 5

 6  A request for exemption under this subsection may be made at

 7  any time and is not subject to the batching requirements of

 8  this section.

 9         Section 23.  Subsection (3) is added to section

10  394.4574, Florida Statutes, to read:

11         394.4574  Department responsibilities for a mental

12  health resident who resides in an assisted living facility

13  that holds a limited mental health license.--

14         (3)  The secretary of the department, in consultation

15  with the Agency for Health Care Administration, shall annually

16  require each district administrator to develop, with community

17  input, detailed plans that demonstrate how the district will

18  ensure the provision of state-funded mental health and

19  substance abuse treatment services to residents of assisted

20  living facilities that hold a limited mental health license.

21  These plans must be consistent with the alcohol, drug abuse,

22  and mental health district plan developed pursuant to s.

23  394.75 and must address case management services; access to

24  consumer-operated drop-in centers; access to services during

25  evenings, weekends, and holidays; supervision of the clinical

26  needs of the residents; and access to emergency psychiatric

27  care.

28         Section 24.  Except as otherwise provided herein, this

29  act shall take effect October 1 of the year in which enacted.

30

31

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 1  ================ T I T L E   A M E N D M E N T ===============

 2  And the title is amended as follows:

 3  remove from the title of the bill:  the entire title

 4

 5  and insert in lieu thereof:

 6                      A bill to be entitled

 7         An act relating to assisted living facilities

 8         and adult family-care homes; amending s.

 9         400.402, F.S.; revising definitions; amending

10         s. 400.404, F.S.; providing additional

11         exemptions from licensure as an assisted living

12         facility; amending ss. 400.407 and 400.408,

13         F.S.; reorganizing and revising provisions

14         relating to unlawful facilities; providing

15         penalties; requiring report of unlicensed

16         facilities; providing for disciplinary actions;

17         revising provisions relating to referral to

18         unlicensed facilities; providing for certain

19         notice to service providers; amending s.

20         400.4075, F.S.; providing an additional

21         requirement for a limited mental health

22         license; amending s. 400.411, F.S.; revising

23         requirements for an initial application for

24         license; providing for a fee; amending s.

25         400.414, F.S.; revising authority and grounds

26         for denial, revocation, or suspension of

27         licenses or imposition of administrative fines;

28         specifying terms for review of proceedings

29         challenging administrative actions; amending s.

30         400.415, F.S.; requiring a facility to post

31         notice of a moratorium on admissions; providing

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 1         for rules establishing grounds for imposition

 2         of a moratorium; amending s. 400.417, F.S.;

 3         providing for coordinated expiration of a

 4         facility's licenses; providing for prorated

 5         fees; revising requirements for license

 6         renewal; providing for rules; amending s.

 7         400.4174, F.S.; amending an outdated reference

 8         to child abuse or neglect; amending s.

 9         400.4176, F.S.; revising time requirement for

10         notice of change of administrator; amending ss.

11         400.418, 400.422, and 408.036, F.S., relating

12         to the disposition of fees and fines,

13         receivership proceedings, and the review of

14         certain projects; conforming cross references

15         to changes made by the act; amending s.

16         400.419, F.S.; revising procedures relating to

17         violations and penalties; increasing

18         administrative fines for specified classes of

19         violations; providing fines for unlicensed

20         operation of a facility and for failure to

21         apply for a change of ownership license;

22         authorizing a survey fee to cover the cost of

23         certain complaint investigations; providing for

24         corrective action plans to correct violations;

25         expanding dissemination of information

26         regarding facilities sanctioned or fined;

27         amending s. 400.4195, F.S., relating to a

28         prohibition on rebates; providing a penalty;

29         creating s. 400.4256, F.S.; establishing

30         procedures for assistance with the

31         self-administration of medication; amending s.

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                                                   HOUSE AMENDMENT

                                               Bill No. CS/HB 3667

    Amendment No.     (for drafter's use only)





 1         400.428, F.S.; providing for surveys to

 2         determine compliance with facility standards

 3         and residents' rights; amending s. 400.442,

 4         F.S.; providing for professional assistance and

 5         corrective action plans for facilities with

 6         deficiencies related to the administration of

 7         medications; amending s. 400.452, F.S.;

 8         revising provisions relating to facility staff

 9         training and education programs; providing for

10         rules; amending s. 400.474, F.S.; providing for

11         disciplinary action against a home health

12         agency or employee who knowingly provides

13         services in an unlicensed assisted living

14         facility or adult family-care home; amending s.

15         400.618, F.S.; revising the definition of the

16         term "adult family-care home"; amending s.

17         394.4574, F.S.; requiring district

18         administrators of the Department of Children

19         and Family Services to develop plans to ensure

20         the provision of mental health and substance

21         abuse treatment services to residents of

22         assisted living facilities that hold a limited

23         mental health license; providing effective

24         dates.

25

26

27

28

29

30

31

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