HB 1267

1
A bill to be entitled
2An act relating to nursing homes; amending s. 400.23,
3F.S.; providing for alternative bed locations in nursing
4home rooms and providing criteria for bed placement;
5requiring a signed statement from the resident or
6representative if the alternative bed placement is not in
7compliance with the Florida Building Code; requiring the
8facility to maintain a log of alternative bed placements
9and to retain the signed statements; requiring the nursing
10home to notify the Agency for Health Care Administration
11with respect to such practice; amending s. 633.022, F.S.;
12requiring nursing homes to be protected by certain
13automatic sprinkler systems; providing a schedule;
14authorizing the Division of State Fire Marshal to grant
15certain time extensions; authorizing the division to adopt
16certain rules; providing for administrative sanctions
17under certain circumstances; requiring adjustments to
18certain provider Medicaid rates for reimbursement for
19Medicaid's portion of costs to meet certain requirements;
20requiring funding for such adjustments to come from
21existing nursing home appropriations; creating s. 633.024,
22F.S.; providing legislative findings and intent; creating
23s. 633.0245, F.S.; authorizing the State Fire Marshal to
24enter into an investment agreement with public
25depositories to establish the State Fire Marshal Nursing
26Home Fire Protection Loan Guarantee Program as a limited
27loan guarantee program to retrofit nursing homes with fire
28protection systems; providing investment and agreement
29limitations; requiring the State Fire Marshal to solicit
30requests for proposals; providing for application
31requirements and procedures; providing for review and
32approval by the State Fire Marshal; providing application
33requirements and procedures for program loans by public
34depositories; providing deadlines and limitations;
35limiting certain claims for loss under certain
36circumstances; providing a definition; authorizing the
37State Fire Marshal to adopt rules; providing an effective
38date.
39
40Be It Enacted by the Legislature of the State of Florida:
41
42     Section 1.  Paragraph (a) of subsection (2) of section
43400.23, Florida Statutes, is amended to read:
44     400.23  Rules; evaluation and deficiencies; licensure
45status.--
46     (2)  Pursuant to the intention of the Legislature, the
47agency, in consultation with the Department of Health and the
48Department of Elderly Affairs, shall adopt and enforce rules to
49implement this part, which shall include reasonable and fair
50criteria in relation to:
51     (a)  The location of the facility and housing conditions
52that will ensure the health, safety, and comfort of residents,
53including an adequate call system. In making such rules, the
54agency shall be guided by criteria recommended by nationally
55recognized reputable professional groups and associations with
56knowledge of such subject matters. The agency shall update or
57revise such criteria as the need arises. The agency may require
58alterations to a building if it determines that an existing
59condition constitutes a distinct hazard to life, health, or
60safety. In performing any inspections of facilities authorized
61by this part, the agency may enforce the special-occupancy
62provisions of the Florida Building Code and the Florida Fire
63Prevention Code which apply to nursing homes. Residents or their
64representatives shall be able to request a change in the
65placement of the bed in their room, provided that at admission
66they are presented with a room that meets requirements of the
67Florida Building Code. The location of a bed may be changed if
68the requested placement does not infringe on the resident's
69roommate or interfere with the resident's care or safety as
70determined by the care planning team in accordance with facility
71policies and procedures. In addition, the bed placement may not
72be used as a restraint. Each facility shall maintain a log of
73resident rooms with beds that are not in strict compliance with
74the Florida Building Code in order for such log to be used by
75surveyors and nurse monitors during inspections and visits. Any
76resident or resident representative who requests that a bed be
77moved shall sign a statement indicating that they understand the
78room will not be in compliance with the Florida Building Code,
79but they would prefer to exercise their right to self-
80determination. The statement must be retained as part of the
81resident's care plan. Any facility that offers this option shall
82notify the agency of this practice by submitting a letter signed
83by the nursing home administrator of record and a copy of the
84facility's policies and procedures. The agency is directed to
85provide assistance to the Florida Building Commission in
86updating the construction standards of the code relative to
87nursing homes.
88     Section 2.  Subsection (4) is added to section 633.022,
89Florida Statutes, to read:
90     633.022  Uniform firesafety standards.--The Legislature
91hereby determines that to protect the public health, safety, and
92welfare it is necessary to provide for firesafety standards
93governing the construction and utilization of certain buildings
94and structures. The Legislature further determines that certain
95buildings or structures, due to their specialized use or to the
96special characteristics of the person utilizing or occupying
97these buildings or structures, should be subject to firesafety
98standards reflecting these special needs as may be appropriate.
99     (4)(a)  Notwithstanding any provision of law to the
100contrary, each nursing home licensed under part II of chapter
101400 shall be protected by an approved, supervised automatic
102sprinkler system in accordance with section 9 of National Fire
103Protection Association, Inc., Life Safety Code, in accordance
104with the following schedule:
105     1.  Each hazardous area of each nursing home shall be
106protected by an approved, supervised automatic sprinkler system
107by no later than December 31, 2008.
108     2.  Each entire nursing home shall be protected by an
109approved, supervised automatic sprinkler system by no later than
110December 31, 2010.
111     (b)  The division may grant up to two 1-year extensions of
112the time limits for compliance in subparagraph (a)2. if the
113division determines that the nursing home has been prevented
114from complying for reasons beyond its control.
115     (c)  The division is authorized to adopt any rule necessary
116for the implementation and enforcement of this subsection. The
117division shall enforce this subsection in accordance with the
118provisions of this chapter, and any nursing home licensed under
119part II of chapter 400 that is in violation of this subsection
120may be subject to administrative sanctions by the division
121pursuant to this chapter.
122     (d)  Adjustments shall be made to the provider Medicaid
123rate to allow reimbursement over a 5-year period for Medicaid's
124portion of the costs incurred to meet the requirements of this
125subsection. Funding for this adjustment shall come from existing
126nursing home appropriations.
127     Section 3.  Section 633.024, Florida Statutes, is created
128to read:
129     633.024  Legislative findings and intent; ensuring
130effective fire protection of vulnerable nursing home residents
131essential; retrofit of existing nursing homes expedited by
132limited state loan guarantee; funding through Insurance
133Regulatory Trust Fund.--
134     (1)  It is the intent of the Legislature to promote the
135essential public purpose of ensuring effective fire protection
136for the safety and welfare of nursing home residents of this
137state who, because of their inability to protect themselves, are
138most vulnerable to catastrophic injury or death in the event of
139a fire. The Legislature finds that this purpose is served by
140requiring the installation of appropriate fire protection
141systems in all nursing home facilities in this state that do not
142currently have fire protection systems in operation for the
143protection of their residents. The Legislature finds that the
144high capital cost of retrofitting appropriate fire protection
145systems at nursing home facilities not originally designed with
146fire protection systems has discouraged the owners and operators
147of such facilities from doing so. The Legislature therefore
148finds that state action to provide a limited state guarantee of
149loans covering these capital costs will expedite the immediate
150installation of fire protection systems at facilities that lack
151such systems and thereby ensure effective protection for those
152nursing home populations that are now most vulnerable to the
153catastrophic effects of fire.
154     (2)  Because the Insurance Regulatory Trust Fund is funded
155by the proceeds of fire insurance premiums written in this
156state, the Legislature finds that it is in the public interest
157for moneys held in the Insurance Regulatory Trust Fund to be
158used to fund the limited loan guarantee program that mobilizes
159private funding for the retrofitting of fire protection systems
160at unprotected nursing homes located in this state.
161     Section 4.  Section 633.0245, Florida Statutes, is created
162to read:
163     633.0245  State Fire Marshal Nursing Home Fire Protection
164Loan Guarantee Program.--
165     (1)  The State Fire Marshal, with the assistance of the
166Division of Treasury of the Department of Financial Services,
167may enter into an investment agreement concerning the investment
168of certain funds held in the Insurance Regulatory Trust Fund for
169the purpose of establishing a limited loan guarantee program to
170be known as the State Fire Marshal Nursing Home Fire Protection
171Loan Guarantee Program. The investment must be limited as
172follows:
173     (a)  Not more than $4 million of the balance in the
174Insurance Regulatory Trust Fund in any fiscal year may be at
175risk at any time for the purpose of limited loan guarantees.
176     (b)  Such funds at risk at any time may not be used to
177guarantee any limited loan guarantee agreement for a period
178longer than 10 years.
179     (c)  No limited loan guarantee agreement based on invested
180funds may be entered into after December 1, 2006.
181     (2)  The State Fire Marshal may enter into limited loan
182guarantee agreements with one or more financial institutions
183qualified as public depositories in this state. Such agreements
184shall provide a limited guarantee by the State of Florida
185covering no more than 50 percent of the principal sum loaned by
186such financial institution to an eligible nursing home, as
187defined in subsection (10), for the sole purpose of the initial
188installation at such nursing home of a fire protection system,
189as defined in s. 633.021(8), approved by the State Fire Marshal
190as being in compliance with the provisions of s. 633.022 and
191rules adopted thereunder.
192     (3)  The State Fire Marshal shall solicit requests for
193proposals from qualified financial institutions willing to fund
194loans to eligible nursing homes for the installation of fire
195protection systems approved by the State Fire Marshal under the
196State Fire Marshal Nursing Home Fire Protection Loan Guarantee
197Program. Each request for proposal shall specify the terms and
198conditions under which the responding institution is prepared to
199make loans under the program, including, but not limited to,
200applicable interest rates, repayment terms, credit policies,
201loan fees, and proposed security interests to be executed by the
202borrower. After evaluation of all requests for proposals, the
203State Fire Marshal shall select one or more responding
204institutions as designated lenders under the program.
205     (4)  The State Fire Marshal shall prescribe by rule an
206application form for participation in the State Fire Marshal
207Nursing Home Fire Protection Loan Guarantee Program to be
208submitted by each eligible nursing home that desires to install
209a fire protection system funded by a loan from a designated
210lender under the program. Nothing in this section shall be
211deemed to require an eligible nursing home to do business with a
212designated lender. At a minimum, the application shall require
213each applicant to provide the following information:
214     (a)  The name and address of the eligible nursing home.
215     (b)  The name and address of the owner of the nursing home
216or, if the owner is a partnership, the name and address of the
217general partner.
218     (c)  The lessee of the nursing home premises, if any.
219     (d)  A complete description of the structure or structures
220where the fire protection system is to be installed, including
221age, physical dimensions, overall square footage, a real extent
222of proposed coverage areas, and other relevant information
223concerning the premises.
224     (e)  Bed capacity of the nursing home, including beds
225eligible for Medicare or Medicaid reimbursement.
226     (f)  A statement regarding the availability to the
227applicant of third-party reimbursement for installation of the
228fire protection system.
229     (g)  The location of closest water mains and fire hydrants,
230if any.
231     (h)  Complete sealed drawings showing the fire protection
232system to be installed.
233     (i)  Cost documentation, with a separate breakdown of cost
234for labor and materials.
235     (j)  Verification of the application by the applicant.
236     (5)  The State Fire Marshal shall evaluate each application
237submitted under this section to determine whether the proposed
238fire protection system is feasible for installation as proposed
239and complies with all applicable firesafety code provisions. An
240application may not be approved without a positive determination
241by the State Fire Marshal under this subsection. If the State
242Fire Marshal is able to determine that the proposed fire
243protection system is feasible and complies with applicable
244firesafety codes, the application shall be approved for
245submission to one or more lenders for funding. If the
246application is insufficient, the State Fire Marshal shall notify
247the applicant in writing and identify areas of deficiency that
248must be corrected in order for the application to be approved.
249     (6)  As soon as practicable after approval, each approved
250application shall be submitted by the State Fire Marshal to one
251or more designated lenders for funding. Upon request of a
252designated lender, an approved applicant shall provide the
253lender with documentation of its credit history and financial
254status. If, after review of the applicant's documentation, a
255lender refuses to fund the application, the lender shall
256promptly notify the applicant and the State Fire Marshal in
257writing of any reasons for its action. If the lender agrees to
258fund the application, the lender shall notify the applicant and
259the State Fire Marshal and schedule a closing date for the loan.
260     (7)  At closing, the applicant shall execute appropriate
261documents necessary to provide the lender and the State Fire
262Marshal with a security interest in the property where the fire
263protection system is to be installed. The State Fire Marshal
264shall then execute a limited loan guarantee in favor of the
265lender guaranteeing no more than 50 percent of the face value of
266the loan.
267     (8)  A designated lender covered by a limited state
268guarantee for a loan under this section is not entitled to file
269a claim for loss pursuant to the guarantee unless all reasonable
270and normal remedies available and customary for lending
271institutions for resolving problems of loan repayments are
272exhausted. If the lender has received collateral security in
273connection with the loan, the lender must first exhaust all
274available remedies against the collateral security.
275     (9)  No application for participation in the State Fire
276Marshal Nursing Home Fire Protection Loan Guarantee Program may
277be accepted by the State Fire Marshal after June 30, 2006.
278     (10)  For purposes of this section, "eligible nursing home"
279means a nursing home facility that provides nursing services as
280defined in chapter 464, is licensed under part II of chapter
281400, and is certified by the Agency for Health Care
282Administration to lack an installed fire protection system as
283defined in s. 633.021(8).
284     (11)  The State Fire Marshal may adopt any rules necessary
285to implement the provisions of this section.
286     Section 5.  This act shall take effect July 1, 2005.


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