Senate Bill sb1558

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    Florida Senate - 2004                                  SB 1558

    By Senator Atwater





    25-1093-04

  1                      A bill to be entitled

  2         An act relating to nursing homes; amending s.

  3         400.141, F.S.; providing that a nursing home

  4         that fails to comply with a specified

  5         percentage of the state minimum-staffing

  6         requirements may not accept new admissions

  7         until certain conditions are satisfied;

  8         amending s. 400.23, F.S.; providing that the

  9         standards for nursing supervision of nursing

10         home residents are altered for night shift

11         duties; providing an effective date.

12  

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

14  

15         Section 1.  Subsection (15) of section 400.141, Florida

16  Statutes, is amended to read:

17         400.141  Administration and management of nursing home

18  facilities.--Every licensed facility shall comply with all

19  applicable standards and rules of the agency and shall:

20         (15)  Submit semiannually to the agency, or more

21  frequently if requested by the agency, information regarding

22  facility staff-to-resident ratios, staff turnover, and staff

23  stability, including information regarding certified nursing

24  assistants, licensed nurses, the director of nursing, and the

25  facility administrator. For purposes of this reporting:

26         (a)  Staff-to-resident ratios must be reported in the

27  categories specified in s. 400.23(3)(a) and applicable rules.

28  The ratio must be reported as an average for the most recent

29  calendar quarter.

30         (b)  Staff turnover must be reported for the most

31  recent 12-month period ending on the last workday of the most

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    Florida Senate - 2004                                  SB 1558
    25-1093-04




 1  recent calendar quarter prior to the date the information is

 2  submitted. The turnover rate must be computed quarterly, with

 3  the annual rate being the cumulative sum of the quarterly

 4  rates. The turnover rate is the total number of terminations

 5  or separations experienced during the quarter, excluding any

 6  employee terminated during a probationary period of 3 months

 7  or less, divided by the total number of staff employed at the

 8  end of the period for which the rate is computed, and

 9  expressed as a percentage.

10         (c)  The formula for determining staff stability is the

11  total number of employees that have been employed for more

12  than 12 months, divided by the total number of employees

13  employed at the end of the most recent calendar quarter, and

14  expressed as a percentage.

15         (d)  A nursing facility that has failed to comply with

16  97 percent of the state minimum-staffing requirements for 2

17  consecutive days is prohibited from accepting new admissions

18  until the facility has achieved the minimum-staffing

19  requirements for a period of 6 consecutive days. For the

20  purposes of this paragraph, any person who was a resident of

21  the facility and was absent from the facility for the purpose

22  of receiving medical care at a separate location or was on a

23  leave of absence is not considered a new admission. Failure to

24  impose such an admissions moratorium constitutes a class II

25  deficiency.

26         (e)  A nursing facility that which does not have a

27  conditional license may be cited for failure to comply with

28  the standards in s. 400.23(3)(a) only if it has failed to meet

29  those standards on 2 consecutive days or if it has failed to

30  meet at least 97 percent of those standards on any one day.

31  

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    Florida Senate - 2004                                  SB 1558
    25-1093-04




 1         (f)  A facility that which has a conditional license

 2  must be in compliance with the standards in s. 400.23(3)(a) at

 3  all times.

 4  

 5  Nothing in this section shall limit the agency's ability to

 6  impose a deficiency or take other actions if a facility does

 7  not have enough staff to meet the residents' needs.

 8         Section 2.  Paragraph (a) of subsection (3) of section

 9  400.23, Florida Statutes, is amended to read:

10         400.23  Rules; evaluation and deficiencies; licensure

11  status.--

12         (3)(a)  The agency shall adopt rules providing for the

13  minimum staffing requirements for nursing homes. These

14  requirements shall include, for each nursing home facility, a

15  minimum certified nursing assistant staffing of 2.3 hours of

16  direct care per resident per day beginning January 1, 2002,

17  increasing to 2.6 hours of direct care per resident per day

18  beginning January 1, 2003, and increasing to 2.9 hours of

19  direct care per resident per day beginning May 1, 2004.

20  Beginning January 1, 2002, no facility shall staff below one

21  certified nursing assistant per 20 residents, and a minimum

22  licensed nursing staffing of 1.0 hour of direct resident care

23  per resident per day but never below one licensed nurse per 40

24  residents except during the night shift when one licensed

25  nurse per 60 residents shall apply. Nursing assistants

26  employed never below one licensed nurse per 40 residents.

27  Nursing assistants employed under s. 400.211(2) may be

28  included in computing the staffing ratio for certified nursing

29  assistants only if they provide nursing assistance services to

30  residents on a full-time basis. Each nursing home must

31  document compliance with staffing standards as required under

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    Florida Senate - 2004                                  SB 1558
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 1  this paragraph and post daily the names of staff on duty for

 2  the benefit of facility residents and the public. The agency

 3  shall recognize the use of licensed nurses for compliance with

 4  minimum staffing requirements for certified nursing

 5  assistants, provided that the facility otherwise meets the

 6  minimum staffing requirements for licensed nurses and that the

 7  licensed nurses so recognized are performing the duties of a

 8  certified nursing assistant. Unless otherwise approved by the

 9  agency, licensed nurses counted towards the minimum staffing

10  requirements for certified nursing assistants must exclusively

11  perform the duties of a certified nursing assistant for the

12  entire shift and shall not also be counted towards the minimum

13  staffing requirements for licensed nurses. If the agency

14  approved a facility's request to use a licensed nurse to

15  perform both licensed nursing and certified nursing assistant

16  duties, the facility must allocate the amount of staff time

17  specifically spent on certified nursing assistant duties for

18  the purpose of documenting compliance with minimum staffing

19  requirements for certified and licensed nursing staff. In no

20  event may the hours of a licensed nurse with dual job

21  responsibilities be counted twice.

22         Section 3.  This act shall take effect July 1, 2004.

23  

24            *****************************************

25                          SENATE SUMMARY

26    Provides that a nursing home that fails to comply with 97
      percent of the state minimum-staffing requirements may
27    not accept new admissions until certain conditions are
      met. Provides that standards for nursing supervision of
28    nursing home residents are altered for night shift
      duties.
29  

30  

31  

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