SENATE AMENDMENT
    Bill No. CS for CS for CS for SB 1202
    Amendment No. ___   Barcode 420982
                            CHAMBER ACTION
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11  Senator Burt moved the following amendment:
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13         Senate Amendment (with title amendment) 
14         On page 43, line 10, through
15            page 46, line 2, delete those lines
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17  and insert:  
18         Section 20.  Section 400.121, Florida Statutes, is
19  amended to read:
20         400.121  Denial, suspension, revocation of license;
21  moratorium on admissions; administrative fines; procedure;
22  order to increase staffing.--
23         (1)  The agency may deny an application, revoke, or
24  suspend a license, or impose an administrative fine, not to
25  exceed $500 per violation per day, against any applicant or
26  licensee for the following violations by the applicant,
27  licensee, or other controlling interest: for
28         (a)  A violation of any provision of s. 400.102(1);.
29         (b)  A demonstrated pattern of deficient practice;
30         (c)  Failure to pay any outstanding fines assessed by
31  final order of the agency or final order of the Health Care
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    7:12 PM   04/23/01                              s1202c3c-16j01

SENATE AMENDMENT Bill No. CS for CS for CS for SB 1202 Amendment No. ___ Barcode 420982 1 Financing Administration pursuant to requirements for federal 2 certification. The agency may renew or approve the license of 3 an applicant following the assessment of a fine by final order 4 if such fine has been paid into an escrow account pending an 5 appeal of a final order; 6 (d) Exclusion from the Medicare or Medicaid program; 7 or 8 (e) An adverse action by a regulatory agency against 9 any other licensed facility that has a common controlling 10 interest with the licensee or applicant against whom the 11 action under this section is being brought. If the adverse 12 action involves solely the management company, the applicant 13 or licensee shall be given 30 days to remedy before final 14 action is taken. If the adverse action is based solely upon 15 actions by a controlling interest, the applicant or licensee 16 may present factors in mitigation of any proposed penalty 17 based upon a showing that such penalty is inappropriate under 18 the circumstances. 19 20 All hearings shall be held within the county in which the 21 licensee or applicant operates or applies for a license to 22 operate a facility as defined herein. 23 (2) Except as provided in s. 400.23(8), a $500 fine 24 shall be imposed The agency, as a part of any final order 25 issued by it under this part, may impose such fine as it deems 26 proper, except that such fine may not exceed $500 for each 27 violation. Each day a violation of this part occurs 28 constitutes a separate violation and is subject to a separate 29 fine, but in no event may any fine aggregate more than $5,000. 30 A fine may be levied pursuant to this section in lieu of and 31 notwithstanding the provisions of s. 400.23. Fines paid by any 2 7:12 PM 04/23/01 s1202c3c-16j01
SENATE AMENDMENT Bill No. CS for CS for CS for SB 1202 Amendment No. ___ Barcode 420982 1 nursing home facility licensee under this subsection shall be 2 deposited in the Resident Protection Trust Fund and expended 3 as provided in s. 400.063. 4 (3) The agency shall revoke or deny a nursing home 5 license if the licensee or controlling interest operates a 6 facility in this state that: 7 (a) Has had two moratoria imposed by final order for 8 substandard quality of care, as defined by Title 42, C.F.R. 9 part 483, within any 30-month period; 10 (b) Is conditionally licensed for 180 or more 11 continuous days; 12 (c) Is cited for two class I deficiencies arising from 13 unrelated circumstances during the same survey or 14 investigation; or 15 (d) Is cited for two class I deficiencies arising from 16 separate surveys or investigations within a 30-month period. 17 18 The licensee may present factors in mitigation of revocation, 19 and the agency may make a determination not to revoke a 20 license based upon a showing that revocation is inappropriate 21 under the circumstances. 22 (4)(3) The agency may issue an order immediately 23 suspending or revoking a license when it determines that any 24 condition in the facility presents a danger to the health, 25 safety, or welfare of the residents in the facility. 26 (5)(4)(a) The agency may impose an immediate 27 moratorium on admissions to any facility when the agency 28 determines that any condition in the facility presents a 29 threat to the health, safety, or welfare of the residents in 30 the facility. 31 (b) Where the agency has placed a moratorium on 3 7:12 PM 04/23/01 s1202c3c-16j01
SENATE AMENDMENT Bill No. CS for CS for CS for SB 1202 Amendment No. ___ Barcode 420982 1 admissions on any facility two times within a 7-year period, 2 the agency may suspend the license of the nursing home and the 3 facility's management company, if any. The licensee shall be 4 afforded an administrative hearing within 90 days after the 5 suspension to determine whether the license should be revoked. 6 During the suspension, the agency shall take the facility into 7 receivership and shall operate the facility. 8 (6)(5) An action taken by the agency to deny, suspend, 9 or revoke a facility's license under this part, in which the 10 agency claims that the facility owner or an employee of the 11 facility has threatened the health, safety, or welfare of a 12 resident of the facility, shall be heard by the Division of 13 Administrative Hearings of the Department of Management 14 Services within 60 120 days after the assignment of an 15 administrative law judge receipt of the facility's request for 16 a hearing, unless the time limitation is waived by both 17 parties. The administrative law judge must render a decision 18 within 30 days after receipt of a proposed recommended order. 19 This subsection does not modify the requirement that an 20 administrative hearing be held within 90 days after a license 21 is suspended under paragraph (4)(b). 22 (7)(6) The agency is authorized to require a facility 23 to increase staffing beyond the minimum required by law, if 24 the agency has taken administrative action against the 25 facility for care-related deficiencies directly attributable 26 to insufficient staff. Under such circumstances, the facility 27 may request an expedited interim rate increase. The agency 28 shall process the request within 10 days after receipt of all 29 required documentation from the facility. A facility that 30 fails to maintain the required increased staffing is subject 31 to a fine of $500 per day for each day the staffing is below 4 7:12 PM 04/23/01 s1202c3c-16j01
SENATE AMENDMENT Bill No. CS for CS for CS for SB 1202 Amendment No. ___ Barcode 420982 1 the level required by the agency. 2 (8) An administrative proceeding challenging an action 3 taken by the agency pursuant to this section shall be reviewed 4 on the basis of the facts and conditions that resulted in such 5 agency action. 6 (9) Notwithstanding any other provision of law to the 7 contrary, agency action in an administrative proceeding under 8 this section may be overcome by the licensee upon a showing by 9 a preponderance of the evidence to the contrary. 10 (10) In addition to any other sanction imposed under 11 this part, in any final order that imposes sanctions, the 12 agency may assess costs related to the investigation and 13 prosecution of the case. Payment of agency costs shall be 14 deposited into the Health Care Trust Fund. 15 16 17 ================ T I T L E A M E N D M E N T =============== 18 And the title is amended as follows: 19 On page 4, line 8, after the semicolon, 20 21 insert: 22 requiring that the agency revoke or deny a 23 nursing home license under specified 24 circumstances; providing standards for 25 administrative proceedings; providing for the 26 agency to assess the costs of an investigation 27 and prosecution; 28 29 30 31 5 7:12 PM 04/23/01 s1202c3c-16j01