Senate Bill sb2192
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Florida Senate - 2001 SB 2192
By Senator Holzendorf
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1 A bill to be entitled
2 An act relating to nursing homes; amending s.
3 400.23, F.S.; requiring rules providing
4 staffing requirements for nursing homes;
5 providing minimum ratios of certified nursing
6 assistants to residents; providing
7 applicability of requirements; requiring that
8 certain information be posted in each facility;
9 amending s. 400.063, F.S.; conforming a
10 cross-reference; providing an effective date.
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12 Be It Enacted by the Legislature of the State of Florida:
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14 Section 1. Subsection (3) of section 400.23, Florida
15 Statutes, is amended to read:
16 400.23 Rules; evaluation and deficiencies; licensure
17 status.--
18 (3)(a) The agency shall adopt rules providing for the
19 minimum staffing requirements for nursing homes. These
20 requirements shall include, for each nursing home facility, a
21 minimum certified nursing assistant staffing and a minimum
22 licensed nursing staffing per resident per day, including
23 evening and night shifts and weekends. The facility shall
24 maintain a minimum ratio of certified nursing assistants to
25 residents of not less than one certified nursing assistant for
26 every five residents, during the day shift; one certified
27 nursing assistant for every six residents, during the
28 afternoon shift; and one certified nursing assistant for every
29 eight residents, during the midnight shift.
30 (b) Agency rules shall specify requirements for
31 documentation of compliance with staffing standards, sanctions
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Florida Senate - 2001 SB 2192
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1 for violation of such standards, and requirements for daily
2 posting of the names of staff on duty for the benefit of
3 facility residents and the public. The agency shall recognize
4 the use of licensed nurses for compliance with minimum
5 staffing requirements for certified nursing assistants,
6 provided that the facility otherwise meets the minimum
7 staffing requirements for licensed nurses and that the
8 licensed nurses so recognized are performing the duties of a
9 certified nursing assistant. Unless otherwise approved by the
10 agency, licensed nurses counted towards the minimum staffing
11 requirements for certified nursing assistants must exclusively
12 perform the duties of a certified nursing assistant for the
13 entire shift and shall not also be counted towards the minimum
14 staffing requirements for licensed nurses. If the agency
15 approved a facility's request to use a licensed nurse to
16 perform both licensed nursing and certified nursing assistant
17 duties, the facility must allocate the amount of staff time
18 specifically spent on certified nursing assistant duties for
19 the purpose of documenting compliance with minimum staffing
20 requirements for certified and licensed nursing staff. In no
21 event may the hours of a licensed nurse with dual job
22 responsibilities be counted twice.
23 (c)(b) The agency shall adopt rules to allow properly
24 trained staff of a nursing facility, in addition to certified
25 nursing assistants and licensed nurses, to assist residents
26 with eating. The rules shall specify the minimum training
27 requirements and shall specify the physiological conditions or
28 disorders of residents which would necessitate that the eating
29 assistance be provided by nursing personnel of the facility.
30 Nonnursing staff providing eating assistance to residents
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Florida Senate - 2001 SB 2192
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1 under the provisions of this subsection shall not count
2 towards compliance with minimum staffing standards.
3 (d) An employee who is designated as a member of the
4 nursing staff may not provide services such as food
5 preparation, housekeeping, laundry, or maintenance services. A
6 person who is employed to provide such services as food
7 preparation, housekeeping, laundry, or maintenance services
8 may not provide nursing care to residents and may not be
9 counted in determining the ratios of residents to nursing
10 staff.
11 (e) The staffing requirements provided in paragraphs
12 (a)-(d) apply to all nursing home residents, including
13 respite-care residents, and must be adjusted upward to meet
14 any special care needs of residents. Staffing assignments must
15 be based on accurate acuity levels and the intensity and time
16 needed to provide safe, preventive, and restorative care. The
17 staffing requirements provided in paragraphs (a)-(d) must be
18 enforced for all residents, regardless of payment source. No
19 ongoing waivers are allowed.
20 (f) The facility shall post the current ratios of
21 residents to staff for each wing and floor of the facility and
22 for each shift. The posted ratios must show separately the
23 ratio of residents to licensed nursing staff and the ratio of
24 residents to unlicensed nursing staff directly responsible for
25 resident care. In addition, such information must be posted
26 for the most recently concluded cost-reporting period in the
27 form of average daily staffing ratios for that period. This
28 information must be posted in each facility in a manner that
29 is visible and accessible to all residents and their families
30 and caregivers and to potential consumers of the facility's
31 services.
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Florida Senate - 2001 SB 2192
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1 (g)(c) Licensed practical nurses licensed under
2 chapter 464 who are providing nursing services in nursing home
3 facilities under this part may supervise the activities of
4 other licensed practical nurses, certified nursing assistants,
5 and other unlicensed personnel providing services in such
6 facilities in accordance with rules adopted by the Board of
7 Nursing.
8 Section 2. Subsection (1) of section 400.063, Florida
9 Statutes, is amended to read:
10 400.063 Resident Protection Trust Fund.--
11 (1) A Resident Protection Trust Fund shall be
12 established for the purpose of collecting and disbursing funds
13 generated from the license fees and administrative fines as
14 provided for in ss. 393.0673(2), 400.062(3)(b), 400.111(1),
15 400.121(2), and 400.23(9) 400.23(8). Such funds shall be for
16 the sole purpose of paying for the appropriate alternate
17 placement, care, and treatment of residents who are removed
18 from a facility licensed under this part or a facility
19 specified in s. 393.0678(1) in which the agency determines
20 that existing conditions or practices constitute an immediate
21 danger to the health, safety, or security of the residents.
22 If the agency determines that it is in the best interest of
23 the health, safety, or security of the residents to provide
24 for an orderly removal of the residents from the facility, the
25 agency may utilize such funds to maintain and care for the
26 residents in the facility pending removal and alternative
27 placement. The maintenance and care of the residents shall be
28 under the direction and control of a receiver appointed
29 pursuant to s. 393.0678(1) or s. 400.126(1). However, funds
30 may be expended in an emergency upon a filing of a petition
31 for a receiver, upon the declaration of a state of local
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1 emergency pursuant to s. 252.38(3)(a)5., or upon a duly
2 authorized local order of evacuation of a facility by
3 emergency personnel to protect the health and safety of the
4 residents.
5 Section 3. This act shall take effect October 1, 2001.
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8 SENATE SUMMARY
9 Directs the Agency for Health Care Administration to
adopt rules that prescribe staffing requirements for
10 nursing homes, including minimum requirements for the
ratio of certified nursing assistants to residents.
11 Provides for the determination of such ratios and their
application to all residents. Requires the posting of
12 information on such ratios in each facility, in specified
places and in a visible and accessible manner.
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