1 | The Health & Families Council recommends the following: |
2 |
|
3 | Council/Committee Substitute |
4 | Remove the entire bill and insert: |
5 | A bill to be entitled |
6 | An act relating to the licensure of health care providers; |
7 | creating pts. I, II, III, and IV of ch. 408, F.S.; |
8 | creating s. 408.801, F.S.; providing a popular name; |
9 | providing legislative findings and purpose; creating s. |
10 | 408.802, F.S.; providing applicability; creating s. |
11 | 408.803, F.S.; providing definitions; creating s. 408.804, |
12 | F.S.; requiring providers to have and display a license; |
13 | providing limitations; creating s. 408.805, F.S.; |
14 | establishing license fees; providing a method for |
15 | calculating annual adjustment of fees; creating s. |
16 | 408.806, F.S.; providing a license application process; |
17 | requiring specified information to be included on the |
18 | application; requiring payment of late fees under certain |
19 | circumstances; requiring inspections; providing an |
20 | exception; authorizing the Agency for Health Care |
21 | Administration to establish procedures and rules for |
22 | electronic transmission of required information; creating |
23 | s. 408.807, F.S.; providing procedures for change of |
24 | ownership; requiring the transferor to notify the agency |
25 | in writing within a specified time period; providing for |
26 | duties and liability of the transferor; providing for |
27 | maintenance of records; creating s. 408.808, F.S.; |
28 | providing license categories and requirements therefor; |
29 | creating s. 408.809, F.S.; requiring background screening |
30 | of specified employees; providing for submission of proof |
31 | of compliance, under certain circumstances; providing |
32 | conditions for granting provisional and standard licenses; |
33 | providing an exception to screening requirements; creating |
34 | s. 408.810, F.S.; providing minimum licensure |
35 | requirements; providing procedures for discontinuance of |
36 | operation and surrender of license; requiring forwarding |
37 | of client records; requiring publication of a notice of |
38 | discontinuance of operation of a provider; providing |
39 | penalties; providing for statewide toll-free telephone |
40 | numbers for reporting complaints and abusive, neglectful, |
41 | and exploitative practices; requiring proof of legal right |
42 | to occupy property, proof of insurance, and proof of |
43 | financial viability, under certain circumstances; |
44 | requiring disclosure of information relating to financial |
45 | instability; providing a penalty; prohibiting the agency |
46 | from licensing a health care provider that does not have a |
47 | certificate of need or an exemption; creating s. 408.811, |
48 | F.S.; providing for inspections and investigations to |
49 | determine compliance; providing that inspection reports |
50 | are public records; requiring retention of records for a |
51 | specified period of time; creating s. 408.812, F.S.; |
52 | prohibiting certain unlicensed activity by a provider; |
53 | requiring unlicensed providers to cease activity; |
54 | providing penalties; requiring reporting of unlicensed |
55 | providers; creating s. 408.813, F.S.; authorizing the |
56 | agency to impose administrative fines; creating s. |
57 | 408.814, F.S.; providing conditions for the agency to |
58 | impose a moratorium or emergency suspension on a provider; |
59 | requiring notice; creating s. 408.815, F.S.; providing |
60 | grounds for denial or revocation of a license or change- |
61 | of-ownership application; providing conditions to continue |
62 | operation; exempting renewal applications from provisions |
63 | requiring the agency to approve or deny an application |
64 | within a specified period of time, under certain |
65 | circumstances; creating s. 408.816, F.S.; authorizing the |
66 | agency to institute injunction proceedings, under certain |
67 | circumstances; creating s. 408.817, F.S.; providing basis |
68 | for review of administrative proceedings challenging |
69 | agency licensure enforcement action; creating s. 408.818, |
70 | F.S.; requiring fees and fines related to health care |
71 | licensing to be deposited into the Health Care Trust Fund; |
72 | creating s. 408.819, F.S.; authorizing the agency to adopt |
73 | rules; providing a timeframe for compliance; amending s. |
74 | 112.0455, F.S.; providing applicability of licensure |
75 | requirements under pt. II of ch. 408, F.S., to drug- |
76 | testing laboratories; establishing fees for license |
77 | applications; amending ss. 381.0303 and 381.78, F.S.; |
78 | conforming cross references; amending ss. 383.301, |
79 | 383.305, and 383.309, F.S.; providing applicability of |
80 | licensure requirements under pt. II of ch. 408, F.S., to |
81 | birth centers; repealing s. 383.304, F.S., relating to |
82 | licensure requirement for birth centers; amending s. |
83 | 383.315, F.S.; revising a provision relating to birth |
84 | center consultation agreements; repealing s. 383.332, |
85 | F.S., relating to establishing, managing, or operating a |
86 | birth center without a license and penalties therefor; |
87 | amending s. 383.324, F.S.; conforming provisions relating |
88 | to inspections and investigations of birth centers to |
89 | changes made by the act; repealing s. 383.325, F.S., |
90 | relating to inspection reports; amending s. 383.33, F.S., |
91 | relating to administrative fines, penalties, emergency |
92 | orders , and moratoriums on admissions; conforming |
93 | provisions to changes made by the act; repealing s. |
94 | 383.331, F.S., relating to injunctive relief; amending s. |
95 | 383.335, F.S., relating to partial exemptions; conforming |
96 | provisions to changes made by the act; amending s. 383.50, |
97 | F.S.; conforming a cross reference; amending s. 390.011, |
98 | F.S.; revising a definition; amending s. 390.012, F.S., |
99 | relating to rulemaking power of the agency; conforming |
100 | provisions to changes made by the act; repealing s. |
101 | 390.013, F.S., relating to effective date of rules |
102 | governing abortion clinics; amending s. 390.014, F.S.; |
103 | providing applicability of licensure requirements under |
104 | pt. II of ch. 408, F.S., to abortion clinics; increasing |
105 | fees for licensing of abortion clinics; repealing s. |
106 | 390.015, F.S., relating to application for license to |
107 | operate an abortion clinic; repealing s. 390.016, F.S., |
108 | relating to expiration and renewal of license; repealing |
109 | s. 390.017, F.S., relating to grounds for suspension or |
110 | revocation of license; amending s. 390.018, F.S.; |
111 | providing applicability of pt. II of ch. 408, F.S., to |
112 | administrative fines; repealing s. 390.019, F.S., relating |
113 | to inspections and investigations of abortion clinics; |
114 | repealing s. 390.021, F.S., relating to injunctive relief; |
115 | amending s. 393.501, F.S.; revising provisions relating to |
116 | rulemaking; amending s. 394.455, F.S.; revising a |
117 | definition; amending s. 394.4787, F.S.; conforming a cross |
118 | reference; amending s. 394.67, F.S.; deleting and revising |
119 | and providing definitions; conforming cross references; |
120 | amending ss. 394.74 and 394.82, F.S.; conforming cross |
121 | references; amending s. 394.875, F.S.; providing purpose |
122 | of short-term residential treatment facilities; providing |
123 | applicability of licensure requirements under pt. II of |
124 | ch. 408, F.S., to crisis stabilization units, short-term |
125 | residential treatment facilities, residential treatment |
126 | facilities, and residential treatment centers for children |
127 | and adolescents; providing an exemption from licensure |
128 | requirements for hospitals licensed under ch. 395, F.S., |
129 | and certain programs operated therein; repealing s. |
130 | 394.876, F.S., relating to license applications; amending |
131 | s. 394.877, F.S.; providing applicability of pt. II of ch. |
132 | 408, F.S., to license fees; amending s. 394.878, F.S., |
133 | relating to issuance and renewal of licenses; conforming |
134 | provisions to changes made by the act; amending s. |
135 | 394.879, F.S.; providing for rulemaking authority; |
136 | conforming provisions to changes made by the act; amending |
137 | s. 394.90, F.S.; conforming provisions relating to |
138 | inspections of crisis stabilization units and residential |
139 | treatment facilities to changes made by the act; repealing |
140 | s. 394.902, F.S., relating to denial, suspension, and |
141 | revocation of licenses of certain mental health |
142 | facilities; amending s. 394.907, F.S., relating to access |
143 | to records of community mental health centers; providing |
144 | for the department to determine licensee compliance with |
145 | quality assurance programs; amending s. 395.002, F.S.; |
146 | deleting a definition; conforming cross references; |
147 | amending ss. 395.003, 395.004, and 395.0161, F.S.; |
148 | providing applicability of licensure requirements under |
149 | pt. II of ch. 408, F.S., to hospitals, ambulatory surgical |
150 | centers, and mobile surgical facilities; repealing s. |
151 | 395.0055, F.S., relating to background screening; |
152 | repealing s. 395.0162, F.S., relating to inspection |
153 | reports; amending s. 395.0163, F.S.; revising provisions |
154 | relating to deposit of fees; conforming provisions to |
155 | changes made by the act; providing an exception to Florida |
156 | Building Code requirements for a licensed facility under |
157 | specified circumstances; amending s. 395.0191, F.S.; |
158 | requiring the presence of certain registered nurses in the |
159 | operating room of a facility licensed under ch. 395, F.S., |
160 | during specified procedures; amending s. 395.0193, F.S.; |
161 | requiring that reports concerning disciplinary actions be |
162 | reported to the Department of Health and that final |
163 | disciplinary actions be reported to the Division of Health |
164 | Quality Assurance; conforming a cross reference; amending |
165 | s. 395.0197, F.S.; conforming a cross reference; amending |
166 | ss. 395.0199 and 395.1046, F.S.; providing applicability |
167 | of licensure requirements under pt. II of ch. 408, F.S., |
168 | to health care utilization review and complaint |
169 | investigation procedures; amending s. 395.1055, F.S.; |
170 | providing applicability of licensure requirements under |
171 | pt. II of ch. 408, F.S., to adoption and enforcement of |
172 | rules; requiring the agency to enforce compliance with |
173 | provisions relating to specified immunizations; amending |
174 | ss. 395.1065, 395.10973, and 395.10974, F.S.; providing |
175 | applicability of licensure requirements under pt. II of |
176 | ch. 408, F.S., to administrative penalties and |
177 | injunctions, rulemaking, and health care risk managers; |
178 | amending ss. 395.602 and 395.701, F.S.; conforming cross |
179 | references; amending s. 400.021, F.S.; deleting |
180 | definitions; amending s. 400.022, F.S.; providing |
181 | applicability of licensure requirements under pt. II of |
182 | ch. 408, F.S., to grounds for action for a violation of |
183 | residents' rights; amending s. 400.051, F.S.; conforming a |
184 | cross reference; amending s. 400.062, F.S.; providing |
185 | applicability of licensure requirements under pt. II of |
186 | ch. 408, F.S., to nursing homes and related health care |
187 | facilities; revising provisions relating to license fees; |
188 | amending s. 400.063, F.S.; conforming a cross reference; |
189 | amending ss. 400.071 and 400.0712, F.S.; providing |
190 | applicability of licensure requirements under pt. II of |
191 | ch. 408, F.S., to license applications; amending s. |
192 | 400.102, F.S.; providing applicability of licensure |
193 | requirements under pt. II of ch. 408, F.S., to grounds for |
194 | action by the agency against a licensee; amending s. |
195 | 400.111, F.S.; providing applicability of licensure |
196 | requirements under pt. II of ch. 408, F.S.; requiring a |
197 | licensee to disclose certain holdings of a controlling |
198 | interest; amending s. 400.1183, F.S.; revising a provision |
199 | requiring facilities to report resident grievances to the |
200 | agency; amending s. 400.121, F.S., relating to denial, |
201 | suspension, and revocation of licenses and administrative |
202 | fines; conforming provisions to changes made by the act; |
203 | repealing s. 400.125, F.S., relating to injunction |
204 | proceedings; amending s. 400.141, F.S.; revising timeframe |
205 | for submission of information related to staffing |
206 | requirements and number of vacant beds in a facility; |
207 | conforming a cross reference; amending s. 400.162, F.S.; |
208 | providing for payment of a deceased resident's funeral |
209 | services under certain circumstances; amending s. 400.179, |
210 | F.S.; revising provisions relating to liability for |
211 | Medicaid underpayments and overpayments; conforming |
212 | provisions to changes made by the act; amending s. 400.18, |
213 | F.S.; revising provisions relating to the closing of a |
214 | nursing home facility; conforming provisions to changes |
215 | made by the act; amending s. 400.19, F.S.; providing |
216 | applicability of licensure requirements under pt. II of |
217 | ch. 408, F.S., to nursing home facility inspections; |
218 | revising a provision relating to a fine; amending s. |
219 | 400.191, F.S.; authorizing the agency to provide |
220 | electronic access to inspection reports; requiring the |
221 | agency to publish the Nursing Home Guide in printed and |
222 | electronic formats and providing information to be |
223 | included therein; revising information to be included on |
224 | the agency Internet site; revising provisions relating to |
225 | availability of nursing home facility records; amending s. |
226 | 400.20, F.S.; revising language relating to nursing home |
227 | administrators; amending s. 400.23, F.S.; providing |
228 | applicability of pt. II of ch. 408, F.S., to rulemaking |
229 | for nursing home facilities; providing an alternative to |
230 | nursing home room requirements under the Florida Building |
231 | Code, under certain circumstances; requiring nursing home |
232 | facilities to document rooms not in compliance with the |
233 | Florida Building Code and to notify the agency of the |
234 | practice; amending s. 400.241, F.S.; providing |
235 | applicability of licensure requirements under pt. II of |
236 | ch. 408, F.S., to prohibited acts relating to |
237 | establishment, operation, or advertisement of nursing home |
238 | facilities; amending s. 400.402, F.S.; revising and |
239 | deleting definitions; amending s. 400.407, F.S.; providing |
240 | applicability of licensure requirements under pt. II of |
241 | ch. 408, F.S., to assisted living facilities; conforming |
242 | provisions to changes made by the act; providing an |
243 | exemption; amending s. 400.4075, F.S.; providing |
244 | applicability of licensure requirements under pt. II of |
245 | ch. 408, F.S., to limited mental health licenses; amending |
246 | s. 400.408, F.S., relating to penalties imposed on |
247 | unlicensed assisted living facilities; conforming |
248 | provisions to changes made by the act; amending ss. |
249 | 400.411, 400.412, 400.414, 400.417, and 400.4174, F.S.; |
250 | providing applicability of licensure requirements under |
251 | pt. II of ch. 408, F.S., to assisted living facilities; |
252 | conforming provisions to changes made by the act; |
253 | repealing s. 400.415, F.S., relating to a moratorium on |
254 | admissions and notice thereof; amending s. 400.4176, F.S.; |
255 | conforming provisions to changes made by the act; amending |
256 | s. 400.4178, F.S.; deleting provisions exempting specified |
257 | nursing home facilities from fees for training and |
258 | education programs relating to special care for persons |
259 | with Alzheimer's disease or other related disorders; |
260 | amending ss. 400.418 and 400.419, F.S.; providing |
261 | applicability of pt. II of ch. 408, F.S., to provisions |
262 | relating to disposition and imposition of fees and fines |
263 | collected under pt. III of ch. 400, F.S.; conforming |
264 | provisions to changes made by the act; repealing s. |
265 | 400.421, F.S., relating to injunctive proceedings; |
266 | amending s. 400.422, F.S.; conforming a cross reference; |
267 | amending s. 400.423, F.S.; transferring rulemaking |
268 | authority from the Department of Elderly Affairs to the |
269 | agency; amending s. 400.424, F.S.; providing that fines on |
270 | assisted living facilities for failure to comply with |
271 | certain refund provisions are not subject to s. |
272 | 400.419(3), F.S.; amending ss. 400.4255, 400.4256, |
273 | 400.427, and 400.4275, F.S.; conforming provisions to |
274 | changes made by the act; amending s. 400.426, F.S.; |
275 | conforming a cross reference; amending ss. 400.431 and |
276 | 400.434, F.S.; providing applicability of licensure |
277 | requirements under pt. II of ch. 408, F.S., to the closing |
278 | of and right of entry and inspection of assisted living |
279 | facilities; amending s. 400.435, F.S.; revising provisions |
280 | relating to maintenance of records of inspection reports |
281 | for a specified period of time; amending s. 400.441, F.S.; |
282 | transferring rulemaking authority from the Department of |
283 | Elderly Affairs to the agency; deleting provisions |
284 | requiring submission of proposed rules and a report to the |
285 | Legislature; deleting a fee for copies of rules and |
286 | standards; conforming provisions to changes made by the |
287 | act; amending ss. 400.442 and 400.444, F.S.; conforming |
288 | provisions to changes made by the act; amending s. |
289 | 400.447, F.S.; providing applicability of licensure |
290 | requirements under pt. II of ch. 408, F.S., to prohibited |
291 | acts and penalties for violation of said requirements; |
292 | repealing s. 400.451, F.S., relating to compliance by |
293 | existing facilities with applicable rules and standards; |
294 | amending ss. 400.452 and 400.454, F.S.; conforming |
295 | provisions to changes made by the act; amending ss. |
296 | 400.464, 400.471, 400.474, and 400.484, F.S.; providing |
297 | applicability of licensure requirements under pt. II of |
298 | ch. 408, F.S., to home health agencies; amending s. |
299 | 400.487, F.S.; revising contents of home health service |
300 | agreements; authorizing physician assistants and advanced |
301 | registered nurse practitioners to establish treatment |
302 | orders; amending s. 400.494, F.S.; conforming provisions |
303 | to changes made by the act; amending ss. 400.495 and |
304 | 400.497, F.S.; providing applicability of licensure |
305 | requirements under pt. II of ch. 408, F.S., to the toll- |
306 | free central abuse hotline and rules establishing minimum |
307 | standards for home health aides; amending s. 400.506, |
308 | F.S.; providing applicability of licensure requirements |
309 | under pt. II of ch. 408, F.S., to nurse registries; |
310 | requiring a nurse registry to notify patients or their |
311 | families of the availability and costs of visits by |
312 | registered nurses; permitting physician assistants and |
313 | advanced registered nurse practitioners to sign a plan of |
314 | treatment; revising provisions relating to assessment of |
315 | costs related to certain investigations; amending s. |
316 | 400.509, F.S.; providing applicability of pt. II of ch. |
317 | 408, F.S., to the registration of companion or homemaker |
318 | service providers exempt from licensure; providing a fee |
319 | for registration; conforming provisions to changes made by |
320 | the act; amending s. 400.512, F.S.; conforming provisions |
321 | relating to the screening of home health agency, nurse |
322 | registry, companion, and homemaker personnel to changes |
323 | made by the act; repealing s. 400.515, F.S., relating to |
324 | injunction proceedings; amending s. 400.551, F.S.; |
325 | revising definitions; amending ss. 400.554, 400.555, |
326 | 400.5565, 400.557, and 400.5572, F.S.; providing |
327 | applicability of licensure requirements under pt. II of |
328 | ch. 408, F.S., to adult day care centers; amending s. |
329 | 400.556, F.S.; authorizing the agency to impose an |
330 | emergency action against an owner, operator, or employee |
331 | of an adult day care facility; revising grounds for action |
332 | by the agency against an owner, operator, or employee of |
333 | an adult day care facility; providing applicability of |
334 | licensure requirements under pt. II of ch. 408, F.S.; |
335 | repealing s. 400.5575, F.S., relating to disposition of |
336 | fees and fines; repealing s. 400.558, F.S., relating to |
337 | injunctive relief; amending ss. 400.559 and 400.56, F.S.; |
338 | providing applicability of licensure requirements under |
339 | pt. II of ch. 408, F.S., to the closing of and right of |
340 | entry and inspection of adult day care centers; amending |
341 | s. 400.562, F.S.; transferring rulemaking authority from |
342 | the Department of Elderly Affairs to the agency; deleting |
343 | a fee for copies of rules and standards; conforming |
344 | provisions to changes made by the act; repealing s. |
345 | 400.564, F.S., relating to prohibited acts and penalties |
346 | therefor; amending ss. 400.602, 400.605, 400.606, |
347 | 400.6065, and 400.607, F.S.; providing applicability of |
348 | licensure requirements under pt. II of ch. 408, F.S., to |
349 | hospices; conforming provisions to changes made by the |
350 | act; amending s. 400.6095, F.S.; conforming provisions |
351 | relating to rulemaking to changes made by the act; |
352 | amending ss. 400.617, 400.6211, and 400.625, F.S.; |
353 | conforming provisions relating to legislative intent and |
354 | purpose, rulemaking, training and education programs, and |
355 | residency agreements for adult family-care homes to |
356 | changes made by the act; amending ss. 400.619, 400.6194, |
357 | 400.6196, and 400.621, F.S.; providing applicability of |
358 | licensure requirements under pt. II of ch. 408, F.S., to |
359 | adult family-care homes; repealing s. 400.622, F.S., |
360 | relating to injunctive proceedings; amending s. 400.801, |
361 | F.S.; conforming provisions relating to homes for special |
362 | services to changes made by the act; providing a fee; |
363 | amending s. 400.805, F.S.; providing applicability of |
364 | licensure requirements under pt. II of ch. 408, F.S., to |
365 | transitional living facilities; providing a fee; amending |
366 | s. 400.902, F.S.; revising a definition; amending ss. |
367 | 400.903, 400.905, 400.907, and 400.908, F.S.; providing |
368 | applicability of licensure requirements under pt. II of |
369 | ch. 408, F.S., to prescribed pediatric extended care |
370 | centers; repealing s. 400.906, F.S., relating to initial |
371 | application for a license; repealing s. 400.910, F.S., |
372 | relating to expiration or renewal of a license and |
373 | conditional licenses; repealing s. 400.911, F.S., relating |
374 | to injunction proceedings; amending s. 400.912, F.S.; |
375 | conforming provisions relating to the closing of a |
376 | prescribed pediatric extended care center to changes made |
377 | by the act; repealing s. 400.913, F.S., relating to right |
378 | of entry and inspection; amending ss. 400.914 and 400.915, |
379 | F.S.; providing applicability of licensure requirements |
380 | under pt. II of ch. 408, F.S., to rules establishing |
381 | standards for and requirements for construction and |
382 | renovation of prescribed pediatric extended care centers; |
383 | repealing s. 400.916, F.S., relating to penalties for |
384 | prohibited acts; repealing s. 400.917, F.S., relating to |
385 | disposition of moneys from fines and fees; amending s. |
386 | 400.925, F.S.; deleting and revising definitions; amending |
387 | ss. 400.93, 400.931, 400.932, 400.933, and 400.935, F.S.; |
388 | providing applicability of licensure requirements under |
389 | pt. II of ch. 408, F.S., to home medical equipment |
390 | providers; repealing s. 400.95, F.S., relating to notice |
391 | of toll-free telephone number for the central abuse |
392 | hotline; amending ss. 400.953 and 400.955, F.S.; revising |
393 | provisions relating to background screening of home |
394 | medical equipment provider personnel; repealing s. |
395 | 400.956, F.S., relating to injunction proceedings; |
396 | amending s. 400.960, F.S.; deleting and revising |
397 | definitions; amending s. 400.962, F.S.; providing |
398 | applicability of licensure requirements under pt. II of |
399 | ch. 408, F.S., to intermediate care facilities for persons |
400 | with developmental disabilities; providing a fee; |
401 | repealing s. 400.963, F.S., relating to injunctive |
402 | proceedings; repealing s. 400.965, F.S., relating to |
403 | grounds for actions by the agency against the licensee; |
404 | amending s. 400.967, F.S.; providing applicability of |
405 | licensure requirements under pt. II of ch. 408, F.S., to |
406 | intermediate care facilities for persons with |
407 | developmental disabilities; requiring facilities to adhere |
408 | to the Bill of Rights of Persons Who are Developmentally |
409 | Disabled; amending s. 400.968, F.S.; conforming provisions |
410 | relating to injunctive proceedings and a moratorium on |
411 | admissions to changes made by the act; amending s. |
412 | 400.9685, F.S.; conforming language to changes made by the |
413 | act; amending s. 400.969, F.S.; providing applicability of |
414 | pt. II of ch. 408, F.S., to penalties relating to |
415 | intermediate care facilities for persons with |
416 | developmental disabilities; amending s. 400.980, F.S.; |
417 | providing applicability of licensure requirements under |
418 | pt. II of ch. 408, F.S., to health care services pools; |
419 | amending ss. 400.991, 400.9915, 400.9925, 400.993, and |
420 | 400.9935, F.S.; providing applicability of licensure |
421 | requirements under pt. II of ch. 408, F.S., to health care |
422 | clinics; providing a fee; repealing s. 400.992, F.S., |
423 | relating to license renewal, transfer of ownership, and |
424 | provisional licenses; repealing s. 400.994, F.S., relating |
425 | to injunctive proceedings; repealing s. 400.9945, F.S., |
426 | relating to agency actions; amending s. 400.995, F.S.; |
427 | conforming provisions relating to agency administrative |
428 | penalties to changes made by the act; amending s. 401.265, |
429 | F.S.; requiring license requirements for emergency medical |
430 | technicians and paramedics; amending s. 408.831, F.S.; |
431 | revising provisions relating to agency action to deny, |
432 | suspend, or revoke a license or application; amending s. |
433 | 440.102, F.S.; providing applicability of licensure |
434 | requirements under pt. II of ch. 408, F.S., to drug |
435 | testing standards for laboratories; amending s. 464.015, |
436 | F.S.; providing restrictions on the use of the title |
437 | "Certified Registered Nurse Anesthetist"; amending s. |
438 | 464.016, F.S.; providing a penalty for misuse of the title |
439 | "Certified Registered Nurse Anesthetist"; amending ss. |
440 | 483.035, 483.051, 483.061, 483.091, 483.101, 483.111, |
441 | 483.172, 483.201, 483.221, and 483.23, F.S.; providing |
442 | applicability of licensure requirements under pt. II of |
443 | ch. 408, F.S., to clinical laboratories; repealing s. |
444 | 483.131, F.S., relating to the display of a license; |
445 | repealing s. 483.25, F.S., relating to injunctive |
446 | proceedings; amending ss. 483.291, 483.294, 483.30, |
447 | 483.302, 483.317, 483.32, and 483.322, F.S.; providing |
448 | applicability of licensure requirements under pt. II of |
449 | ch. 408, F.S., to multiphasic health testing centers; |
450 | repealing s. 483.311, F.S., relating to the display of a |
451 | license; repealing s. 483.328, F.S., relating to |
452 | injunctive relief; amending s. 765.541, F.S.; conforming |
453 | provisions relating to cadaveric organ and tissue |
454 | procurement to changes made by the act; amending s. |
455 | 765.542, F.S.; providing applicability of licensure |
456 | requirements under pt. II of ch. 408, F.S., to organ |
457 | procurement organizations and tissue and eye banks; |
458 | amending s. 765.544, F.S.; conforming provisions relating |
459 | to application fees from organizations and tissue and eye |
460 | banks to changes made by the act; amending ss. 402.164, |
461 | 409.815, 409.905, 409.907, 468.505, 483.106, 766.118, |
462 | 766.316, and 812.014, F.S.; conforming cross references; |
463 | providing for priority of application in case of conflict; |
464 | transferring rules adopted by the Department of Elderly |
465 | Affairs under pts. III, V, VI, and VII of ch. 400, F.S., |
466 | to the agency; authorizing the agency to issue licenses |
467 | for less than a specified time period and providing |
468 | conditions therefor; providing an effective date. |
469 |
|
470 | Be It Enacted by the Legislature of the State of Florida: |
471 |
|
472 | Section 1. Part I of chapter 408, Florida Statutes, |
473 | consisting of sections 408.031, 408.032, 408.033, 408.034, |
474 | 408.035, 408.036, 408.0361, 408.037, 408.038, 408.039, 408.040, |
475 | 408.041, 408.042, 408.043, 408.044, 408.045, 408.0455, 408.05, |
476 | 408.061, 408.062, 408.063, 408.07, 408.08, 408.09, 408.10, |
477 | 408.15, 408.16, 408.18, 408.185, 408.20, 408.301, 408.302, |
478 | 408.40, 408.50, 408.70, 408.7056, 408.7057, and 408.7071, |
479 | Florida Statutes, is created and entitled "Health Facility and |
480 | Services Planning." |
481 | Section 2. Part II of chapter 408, Florida Statutes, |
482 | consisting of sections 408.801, 408.802, 408.803, 408.804, |
483 | 408.805, 408.806, 408.807, 408.808, 408.809, 408.810, 408.811, |
484 | 408.812, 408.813, 408.814, 408.815, 408.816, 408.817, 408.818, |
485 | 408.819, and 408.831, Florida Statutes, is created and entitled |
486 | "Health Care Licensing: General Provisions." |
487 | Section 3. Part III of chapter 408, Florida Statutes, |
488 | consisting of sections 408.90, 408.901, 408.902, 408.903, |
489 | 408.904, 408.905, 408.906, 408.907, 408.908, and 408.909, |
490 | Florida Statutes, is created and entitled "Health Insurance |
491 | Access." |
492 | Section 4. Part IV of chapter 408, Florida Statutes, |
493 | consisting of sections 408.911, 408.913, 408.914, 408.915, |
494 | 408.916, 408.917, and 408.918, Florida Statutes, is created and |
495 | entitled "Health and Human Services Eligibility Access System." |
496 | Section 5. Sections 408.801, 408.802, 408.803, 408.804, |
497 | 408.805, 408.806, 408.807, 408.808, 408.809, 408.810, 408.811, |
498 | 408.812, 408.813, 408.814, 408.815, 408.816, 408.817, 408.818, |
499 | and 408.819, Florida Statutes, are created to read: |
500 | 408.801 Popular name; purpose.-- |
501 | (1) This part may be cited as the "Health Care Licensing |
502 | Procedures Act." |
503 | (2) The Legislature finds that there is unnecessary |
504 | duplication and variation in the requirements for licensure by |
505 | the Agency for Health Care Administration brought about by the |
506 | historical pattern of legislative action focused exclusively on |
507 | a single type of regulated provider. It is the intent of the |
508 | Legislature to provide a streamlined and consistent set of basic |
509 | licensing requirements for all such providers in order to |
510 | minimize confusion, standardize terminology, and include issues |
511 | that are otherwise not adequately addressed in the Florida |
512 | Statutes pertaining to specific providers. |
513 | 408.802 Applicability.--The provisions of this part apply |
514 | to the provision of services that require licensure as defined |
515 | in this part and to the following entities licensed, registered, |
516 | or certified by the Agency for Health Care Administration, as |
517 | described in chapters 112, 383, 390, 394, 395, 400, 440, 483, |
518 | and 765: |
519 | (1) Laboratories authorized to perform testing under the |
520 | Drug-Free Workplace Act, as provided under ss. 112.0455 and |
521 | 440.102. |
522 | (2) Birth centers, as provided under chapter 383. |
523 | (3) Abortion clinics, as provided under chapter 390. |
524 | (4) Crisis stabilization units, as provided under parts I |
525 | and IV of chapter 394. |
526 | (5) Short-term residential treatment facilities, as |
527 | provided under parts I and IV of chapter 394. |
528 | (6) Residential treatment facilities, as provided under |
529 | part IV of chapter 394. |
530 | (7) Residential treatment centers for children and |
531 | adolescents, as provided under part IV of chapter 394. |
532 | (8) Hospitals, as provided under part I of chapter 395. |
533 | (9) Ambulatory surgical centers, as provided under part I |
534 | of chapter 395. |
535 | (10) Mobile surgical facilities, as provided under part I |
536 | of chapter 395. |
537 | (11) Private review agents, as provided under part I of |
538 | chapter 395. |
539 | (12) Health care risk managers, as provided under part I |
540 | of chapter 395. |
541 | (13) Nursing homes, as provided under part II of chapter |
542 | 400. |
543 | (14) Assisted living facilities, as provided under part |
544 | III of chapter 400. |
545 | (15) Home health agencies, as provided under part IV of |
546 | chapter 400. |
547 | (16) Nurse registries, as provided under part IV of |
548 | chapter 400. |
549 | (17) Companion services or homemaker services providers, |
550 | as provided under part IV of chapter 400. |
551 | (18) Adult day care centers, as provided under part V of |
552 | chapter 400. |
553 | (19) Hospices, as provided under part VI of chapter 400. |
554 | (20) Adult family-care homes, as provided under part VII |
555 | of chapter 400. |
556 | (21) Homes for special services, as provided under part |
557 | VIII of chapter 400. |
558 | (22) Transitional living facilities, as provided under |
559 | part VIII of chapter 400. |
560 | (23) Prescribed pediatric extended care centers, as |
561 | provided under part IX of chapter 400. |
562 | (24) Home medical equipment providers, as provided under |
563 | part X of chapter 400. |
564 | (25) Intermediate care facilities for persons with |
565 | developmental disabilities, as provided under part XI of chapter |
566 | 400. |
567 | (26) Health care services pools, as provided under part |
568 | XII of chapter 400. |
569 | (27) Health care clinics, as provided under part XIII of |
570 | chapter 400. |
571 | (28) Clinical laboratories, as provided under part I of |
572 | chapter 483. |
573 | (29) Multiphasic health testing centers, as provided under |
574 | part II of chapter 483. |
575 | (30) Organ and tissue procurement agencies, as provided |
576 | under chapter 765. |
577 | 408.803 Definitions.--As used in this part, the term: |
578 | (1) "Agency" means the Agency for Health Care |
579 | Administration, which is the licensing agency under this part. |
580 | (2) "Applicant" means an individual, corporation, |
581 | partnership, firm, association, or governmental entity that |
582 | submits an application to the agency for a license. |
583 | (3) "Authorizing statute" means the statute authorizing |
584 | the licensed operation of a provider listed in s. 408.802, |
585 | including chapters 112, 383, 390, 394, 395, 400, 440, 483, and |
586 | 765. |
587 | (4) "Certification" means certification as a Medicare or |
588 | Medicaid provider of the services that require licensure or |
589 | certification pursuant to the federal Clinical Laboratory |
590 | Improvement Amendment (CLIA). |
591 | (5) "Change in ownership" means an event in which the |
592 | licensee changes to a different legal entity or in which 45 |
593 | percent or more of the ownership, voting shares, or interest in |
594 | a corporation whose shares are not publicly traded on a |
595 | recognized stock exchange is transferred or assigned, including |
596 | the final transfer or assignment of multiple transfers or |
597 | assignments over a 2-year period that cumulatively total 45 |
598 | percent or greater. However, a change solely in the management |
599 | company is not a change of ownership. |
600 | (6) "Client" means any person receiving services from a |
601 | provider listed in s. 408.802. |
602 | (7) "Controlling interest" means: |
603 | (a) The applicant or licensee; |
604 | (b) A person or entity that serves as an officer of, is on |
605 | the board of directors of, or has a 5 percent or greater |
606 | ownership interest in the applicant or licensee; or |
607 | (c) A person or entity that serves as an officer of, is on |
608 | the board of directors of, or has a 5 percent or greater |
609 | ownership interest in the management company or other entity, |
610 | related or unrelated, with which the applicant or licensee |
611 | contracts to manage the provider. |
612 |
|
613 | The term does not include a voluntary board member. |
614 | (8) "License" means any permit, registration, certificate, |
615 | or license issued by the agency. |
616 | (9) "Licensee" means an individual, corporation, |
617 | partnership, firm, association, or governmental entity that is |
618 | issued a permit, registration, certificate, or license by the |
619 | agency. The licensee is legally responsible for all aspects of |
620 | the provider operation. |
621 | (10) "Moratorium" means a prohibition on the acceptance of |
622 | new clients. |
623 | (11) "Provider" means any activity, service, agency, or |
624 | facility regulated by the agency and listed in s. 408.802. |
625 | (12) "Services that require licensure" means those |
626 | services, including residential services, that require a valid |
627 | license before those services may be provided in accordance with |
628 | authorizing statutes and agency rules. |
629 | (13) "Voluntary board member" means a board member of a |
630 | not-for-profit corporation or organization who serves solely in |
631 | a voluntary capacity, does not receive any remuneration for his |
632 | or her services on the board of directors, and has no financial |
633 | interest in the corporation or organization. The agency shall |
634 | recognize a person as a voluntary board member following |
635 | submission of a statement to the agency by the board member and |
636 | the not-for-profit corporation or organization that affirms that |
637 | the board member conforms to this definition. The statement |
638 | affirming the status of the board member must be submitted to |
639 | the agency on a form provided by the agency. |
640 | 408.804 License required; display.-- |
641 | (1) It is unlawful to provide services that require |
642 | licensure, or operate or maintain a provider that offers or |
643 | provides services that require licensure, without first |
644 | obtaining from the agency a license authorizing the provision of |
645 | such services or the operation or maintenance of such provider. |
646 | (2) A license must be displayed in a conspicuous place |
647 | readily visible to clients who enter at the address that appears |
648 | on the license and is valid only in the hands of the licensee to |
649 | whom it is issued and may not be sold, assigned, or otherwise |
650 | transferred, voluntarily or involuntarily. The license is valid |
651 | only for the licensee, provider, and location for which the |
652 | license is issued. |
653 | 408.805 Fees required; adjustments.--Unless otherwise |
654 | limited by authorizing statutes, license fees must be reasonably |
655 | calculated by the agency to cover its costs in carrying out its |
656 | responsibilities under this part, authorizing statutes, and |
657 | applicable rules, including the cost of licensure, inspection, |
658 | and regulation of providers. |
659 | (1) Licensure fees shall be adjusted to provide for |
660 | biennial licensure in agency rules. |
661 | (2) The agency shall annually adjust licensure fees, |
662 | including fees paid per bed, by not more than the change in the |
663 | Consumer Price Index based on the 12 months immediately |
664 | preceding the increase. |
665 | (3) The agency may, by rule, adjust licensure fees to |
666 | cover the cost of administering this part, authorizing statutes, |
667 | and applicable rules. |
668 | (4) An inspection fee must be paid as required in |
669 | authorizing statutes. |
670 | (5) Fees are nonrefundable. |
671 | (6) When a change is reported that requires issuance of a |
672 | license, a fee may be assessed. The fee must be based on the |
673 | actual cost of processing and issuing the license. |
674 | (7) A fee may be charged to a licensee requesting a |
675 | duplicate license. The fee may not exceed the actual cost of |
676 | duplication and postage. |
677 | (8) Total fees collected may not exceed the cost of |
678 | administering this part, authorizing statutes, and applicable |
679 | rules. |
680 | 408.806 License application process.-- |
681 | (1) An application for licensure must be made to the |
682 | agency on forms furnished by the agency, submitted under oath, |
683 | and accompanied by the appropriate fee in order to be accepted |
684 | and considered timely. The application must contain information |
685 | required by authorizing statutes and applicable rules and must |
686 | include: |
687 | (a) The name, address, and social security number of the |
688 | applicant and each controlling interest if the applicant or |
689 | controlling interest is an individual. |
690 | (b) The name, address, and federal employer identification |
691 | number or taxpayer identification number of the applicant and |
692 | each controlling interest if the applicant or controlling |
693 | interest is not an individual. |
694 | (c) The name by which the provider is to be known. |
695 | (d) The total number of beds or capacity requested, as |
696 | applicable. |
697 | (e) The following information regarding the location of |
698 | the provider for which the application is made: |
699 | 1. A report or letter from the zoning authority indicating |
700 | that the location is zoned appropriately for its use. If the |
701 | provider is a community residential home under chapter 419, the |
702 | zoning requirement must be satisfied by proof of compliance with |
703 | chapter 419. The zoning report or letter is not required for a |
704 | renewal application if the provider location did not change |
705 | since the date on which the most recent license was issued. |
706 | 2. A satisfactory fire safety report from the local |
707 | authority having jurisdiction or the state fire marshal. |
708 | (f) The name of the person or persons under whose |
709 | management or supervision the provider will be operated and the |
710 | name of the administrator, if required. |
711 | (g) If the applicant offers continuing care agreements as |
712 | defined in chapter 651, proof shall be furnished that the |
713 | applicant has obtained a certificate of authority as required |
714 | for operation under chapter 651. |
715 | (h) Other information, including satisfactory inspection |
716 | results, that the agency finds necessary to determine the |
717 | ability of the applicant to carry out its responsibilities under |
718 | this part, authorizing statutes, and applicable rules. |
719 | (2)(a) The applicant for a renewal license must submit an |
720 | application that must be received by the agency at least 60 days |
721 | prior to the expiration of the current license. |
722 | (b) The applicant for initial licensure due to a change of |
723 | ownership must submit an application that must be received by |
724 | the agency at least 60 days prior to the date of change of |
725 | ownership. |
726 | (c) For any other application or request, the applicant |
727 | must submit an application or request that must be received by |
728 | the agency at least 60 days prior to the requested effective |
729 | date, unless otherwise specified in authorizing statutes or |
730 | rules. |
731 | (d) The agency shall notify the licensee by mail or |
732 | electronically at least 90 days prior to the expiration of a |
733 | license that a renewal license is necessary to continue |
734 | operation. The failure to timely file an application and submit |
735 | a license fee shall result in a late fee charged to the licensee |
736 | by the agency in an amount equal to 50 percent of the licensure |
737 | fee but in no event shall the aggregate amount of the fine |
738 | exceed $5,000. If an application is received after the required |
739 | filing date and exhibits a hand-canceled postmark obtained from |
740 | a United States Post Office dated on or before the required |
741 | filing date, no fine will be levied. |
742 | (3)(a) Upon receipt of an application for a license, the |
743 | agency shall examine the application and, within 30 days after |
744 | receipt, notify the applicant in writing of any apparent errors |
745 | or omissions and request any additional information required. |
746 | (b) Requested information omitted from an application for |
747 | licensure, license renewal, or change of ownership, other than |
748 | an inspection, must be filed with the agency within 21 days |
749 | after the agency's request for omitted information or the |
750 | application shall be deemed incomplete and shall be withdrawn |
751 | from further consideration and the fees shall be forfeited. |
752 | (c) Within 60 days after the receipt of a complete |
753 | application, the agency shall approve or deny the application. |
754 | (4)(a) Licensees subject to the provisions of this part |
755 | shall be issued biennial licenses unless conditions of the |
756 | license category specify a shorter license period. |
757 | (b) Each license issued shall indicate the name of the |
758 | licensee, the type of provider or service that the licensee is |
759 | required or authorized to operate or offer, the date the license |
760 | is effective, the expiration date of the license, the maximum |
761 | capacity of the licensed premises, if applicable, and any other |
762 | information required or deemed necessary by the agency. |
763 | (5) In accordance with authorizing statutes and applicable |
764 | rules, proof of compliance with s. 408.810 must be submitted |
765 | with an application for licensure. |
766 | (6) The agency may not issue an initial license to a |
767 | health care provider subject to the certificate-of-need |
768 | provisions in part I of this chapter if the licensee has not |
769 | been issued a certificate of need or certificate-of-need |
770 | exemption, when applicable. Failure to apply for the renewal of |
771 | a license prior to the expiration date renders the license null |
772 | and void. |
773 | (7)(a) An applicant must demonstrate compliance with the |
774 | requirements in this part, authorizing statutes, and applicable |
775 | rules during an inspection pursuant to s. 408.811, as required |
776 | by authorizing statutes. |
777 | (b) An initial inspection is not required for companion |
778 | services or homemaker services providers, as provided under part |
779 | IV of chapter 400, or for health care services pools, as |
780 | provided under part XII of chapter 400. |
781 | (c) If an inspection is required by the authorizing |
782 | statute for a license application other than an initial |
783 | application, the inspection must be unannounced. This paragraph |
784 | does not apply to inspections required pursuant to ss. 383.324, |
785 | 395.0161(4), and 483.061(2). |
786 | (d) If a provider is not available when an inspection is |
787 | attempted, the application shall be denied. |
788 | (8) The agency may establish procedures for the electronic |
789 | submission of required information, including, but not limited |
790 | to: |
791 | (a) Licensure applications. |
792 | (b) Required signatures. |
793 | (c) Payment of fees. |
794 | (d) Notarization of applications. |
795 |
|
796 | Requirements for electronic submission of any documents required |
797 | by this part or authorizing statutes may be established by rule. |
798 | 408.807 Change of ownership.--Whenever a change of |
799 | ownership occurs: |
800 | (1) The transferor shall notify the agency in writing at |
801 | least 60 days before the anticipated date of the change of |
802 | ownership. |
803 | (2) The transferee shall make application to the agency |
804 | for a license within the timeframes required in s. 408.806. |
805 | (3) The transferor shall be responsible and liable for: |
806 | (a) The lawful operation of the provider and the welfare |
807 | of the clients served until the date the transferee is licensed |
808 | by the agency. |
809 | (b) Any and all penalties imposed against the transferor |
810 | for violations occurring before the date of change of ownership. |
811 | (4) Any restriction on licensure, including a conditional |
812 | license existing at the time of a change of ownership, shall |
813 | remain in effect until removed by the agency. |
814 | (5) The transferee shall maintain records of the |
815 | transferor as required in this part, authorizing statutes, and |
816 | applicable rules, including: |
817 | (a) All client records. |
818 | (b) Inspection reports. |
819 | (c) All records required to be maintained pursuant to s. |
820 | 409.913, if applicable. |
821 | 408.808 License categories.-- |
822 | (1) STANDARD LICENSE.--A standard license may be issued to |
823 | an applicant at the time of initial licensure, license renewal, |
824 | or change of ownership. A standard license shall be issued when |
825 | the applicant is in compliance with all statutory requirements |
826 | and agency rules. Unless sooner revoked, a standard license |
827 | expires 2 years after the date of issue. |
828 | (2) PROVISIONAL LICENSE.--A provisional license may be |
829 | issued to an applicant pursuant to s. 408.809(3). An applicant |
830 | against whom a proceeding denying or revoking a license is |
831 | pending at the time of license renewal may be issued a |
832 | provisional license effective until final agency action not |
833 | subject to further appeal. |
834 | (3) INACTIVE LICENSE.--An inactive license may be issued |
835 | to a health care provider subject to the certificate-of-need |
836 | provisions in part I of this chapter when the provider is |
837 | currently licensed, does not have a provisional license, and |
838 | will be temporarily unable to provide services but is reasonably |
839 | expected to resume services within 12 months. Such designation |
840 | may be made for a period not to exceed 12 months but may be |
841 | renewed by the agency for up to 6 additional months upon |
842 | demonstration by the licensee of the provider's progress toward |
843 | reopening. A request by a licensee for an inactive license or to |
844 | extend the previously approved inactive period must be submitted |
845 | to the agency and include a written justification for the |
846 | inactive license with the beginning and ending dates of |
847 | inactivity specified, a plan for the transfer of any clients to |
848 | other providers, and the appropriate licensure fees. The agency |
849 | may not accept a request that is submitted after initiating |
850 | closure, after any suspension of service, or after notifying |
851 | clients of closure or suspension of service. Upon agency |
852 | approval, the provider shall notify clients of any necessary |
853 | discharge or transfer as required by authorizing statutes or |
854 | applicable rules. The beginning of the inactive license period |
855 | is the date the provider ceases operations. The end of the |
856 | inactive license period shall become the license expiration |
857 | date. All licensure fees must be current, must be paid in full, |
858 | and may be prorated. Reactivation of an inactive license |
859 | requires the approval of a renewal application, including |
860 | payment of licensure fees and agency inspections indicating |
861 | compliance with all requirements of this part, authorizing |
862 | statutes, and applicable rules. |
863 | (4) OTHER LICENSES.--Other types of license categories may |
864 | be issued pursuant to authorizing statutes or applicable rules. |
865 | 408.809 Background screening; prohibited offenses.-- |
866 | (1) Level 2 background screening pursuant to chapter 435 |
867 | must be conducted through the agency on each of the following |
868 | persons, who shall be considered an employee for the purposes of |
869 | conducting screening under chapter 435: |
870 | (a) The licensee, if an individual. |
871 | (b) The administrator or a similarly titled person who is |
872 | responsible for the day-to-day operation of the provider. |
873 | (c) The financial officer or similarly titled individual |
874 | who is responsible for the financial operation of the licensee |
875 | or provider. |
876 | (d) Any person who is a controlling interest if the agency |
877 | has reason to believe that such person has been convicted of any |
878 | offense prohibited by s. 435.04. For each controlling interest |
879 | who has been convicted of any such offense, the licensee shall |
880 | submit to the agency a description and explanation of the |
881 | conviction at the time of license application. |
882 | (2) Proof of compliance with level 2 screening standards |
883 | submitted within the previous 5 years to meet any provider or |
884 | professional licensure requirements of the agency, the |
885 | Department of Health, the Agency for Persons with Disabilities, |
886 | or the Department of Children and Family Services satisfies the |
887 | requirements of this section, provided that such proof is |
888 | accompanied, under penalty of perjury, by an affidavit of |
889 | compliance with the provisions of chapter 435 using forms |
890 | provided by the agency. Proof of compliance with the background |
891 | screening requirements of the Department of Financial Services |
892 | submitted within the previous 5 years for an applicant for a |
893 | certificate of authority to operate a continuing care retirement |
894 | community under chapter 651 satisfies the Department of Law |
895 | Enforcement and Federal Bureau of Investigation portions of a |
896 | level 2 background check. |
897 | (3) A provisional license may be granted to an applicant |
898 | when each individual required by this section to undergo |
899 | background screening has met the standards for the Department of |
900 | Law Enforcement background check but the agency has not yet |
901 | received background screening results from the Federal Bureau of |
902 | Investigation. A standard license may be granted to the licensee |
903 | upon the agency's receipt of a report of the results of the |
904 | Federal Bureau of Investigation background screening for each |
905 | individual required by this section to undergo background |
906 | screening that confirms that all standards have been met or upon |
907 | the granting of an exemption from disqualification by the agency |
908 | as set forth in chapter 435. |
909 | (4) When a change of any person required to be screened |
910 | under this section occurs, the licensee must notify the agency |
911 | of the change within the time period specified in the |
912 | authorizing statute or rules and must submit to the agency |
913 | information necessary to conduct level 2 screening or provide |
914 | evidence of compliance with background screening requirements of |
915 | this section. The person may serve in his or her capacity |
916 | pending the agency's receipt of the report from the Federal |
917 | Bureau of Investigation if he or she has met the standards for |
918 | the Department of Law Enforcement background check. However, the |
919 | person may not continue to serve if the report indicates any |
920 | violation of background screening standards unless an exemption |
921 | from disqualification has been granted by the agency as set |
922 | forth in chapter 435. |
923 | (5) Background screening is not required to obtain a |
924 | certificate of exemption issued under s. 483.106. |
925 | 408.810 Minimum licensure requirements.--In addition to |
926 | the licensure requirements specified in this part, authorizing |
927 | statutes, and applicable rules, each applicant and licensee must |
928 | comply with the requirements of this section in order to obtain |
929 | and maintain a license. |
930 | (1) An applicant for licensure must comply with the |
931 | background screening requirements of s. 408.809. |
932 | (2) An applicant for licensure must provide a description |
933 | and explanation of any exclusions, suspensions, or terminations |
934 | of the applicant from the Medicare, Medicaid, or federal |
935 | Clinical Laboratory Improvement Amendment (CLIA) programs. |
936 | (3) Unless otherwise specified in this part, authorizing |
937 | statutes, or applicable rules, any information required to be |
938 | reported to the agency must be submitted within 21 calendar days |
939 | after the report period or effective date of the information. |
940 | (4) Whenever a licensee discontinues operation of a |
941 | provider: |
942 | (a) The licensee must inform the agency not less than 30 |
943 | days prior to the discontinuance of operation and inform clients |
944 | of discharge as required by authorizing statutes. Immediately |
945 | upon discontinuance of operation of a provider, the licensee |
946 | shall surrender the license to the agency and the license shall |
947 | be canceled. |
948 | (b) Upon closure of a provider, the licensee shall remain |
949 | responsible for retaining and appropriately distributing all |
950 | records within the timeframes prescribed in authorizing statutes |
951 | and applicable rules. In addition, the licensee or, in the event |
952 | of death or dissolution of a licensee, the estate or agent of |
953 | the licensee shall: |
954 | 1. Make arrangements to forward records for each client to |
955 | one of the following, based upon the client's choice: the client |
956 | or the client's legal representative, the client's attending |
957 | physician, or the health care provider where the client |
958 | currently receives services; or |
959 | 2. Cause a notice to be published in the newspaper of |
960 | greatest general circulation in the county where the provider |
961 | was located that advises clients of the discontinuance of the |
962 | provider operation. The notice must inform clients that they may |
963 | obtain copies of their records and specify the name, address, |
964 | and telephone number of the person from whom the copies of |
965 | records may be obtained. The notice must appear at least once a |
966 | week for 4 consecutive weeks. Failure to comply with this |
967 | paragraph is a misdemeanor of the second degree, punishable as |
968 | provided in s. 775.082 or s. 775.083. |
969 | (5)(a) On or before the first day services are provided to |
970 | a client, a licensee must inform the client and his or her |
971 | immediate family or representative, if appropriate, of the right |
972 | to report: |
973 | 1. Complaints. The statewide toll-free telephone number |
974 | for reporting complaints to the agency must be provided to |
975 | clients in a manner that is clearly legible and must include the |
976 | words: "To report a complaint regarding the services you |
977 | receive, please call toll-free (phone number)." |
978 | 2. Abusive, neglectful, or exploitative practices. The |
979 | statewide toll-free telephone number for the central abuse |
980 | hotline must be provided to clients in a manner that is clearly |
981 | legible and must include the words: "To report abuse, neglect, |
982 | or exploitation, please call toll-free (phone number)." The |
983 | agency shall publish a minimum of a 90-day advance notice of a |
984 | change in the toll-free telephone numbers. |
985 | (b) Each licensee shall establish appropriate policies and |
986 | procedures for providing such notice to clients. |
987 | (6) An applicant must provide the agency with proof of the |
988 | applicant's legal right to occupy the property before a license |
989 | may be issued. Proof may include, but need not be limited to, |
990 | copies of warranty deeds, lease or rental agreements, contracts |
991 | for deeds, quitclaim deeds, or other such documentation. |
992 | (7) If proof of insurance is required by the authorizing |
993 | statute, that insurance must be in compliance with chapter 624, |
994 | chapter 626, chapter 627, or chapter 628 and with agency rules. |
995 | (8) Upon application for initial licensure or change-of- |
996 | ownership licensure, the applicant shall furnish satisfactory |
997 | proof of the applicant's financial ability to operate in |
998 | accordance with the requirements of this part, authorizing |
999 | statutes, and applicable rules. The agency shall establish |
1000 | standards for this purpose, including information concerning the |
1001 | applicant's controlling interests. The agency shall also |
1002 | establish documentation requirements, to be completed by each |
1003 | applicant, that show anticipated provider revenues and |
1004 | expenditures, the basis for financing the anticipated cash-flow |
1005 | requirements of the provider, and an applicant's access to |
1006 | contingency financing. A current certificate of authority, |
1007 | pursuant to chapter 651, may be provided as proof of financial |
1008 | ability to operate. The agency may require a licensee to provide |
1009 | proof of financial ability to operate at any time if there is |
1010 | evidence of financial instability, including, but not limited |
1011 | to, unpaid expenses necessary for the basic operations of the |
1012 | provider. |
1013 | (9) A controlling interest may not withhold from the |
1014 | agency any evidence of financial instability of a licensed |
1015 | provider, including, but not limited to, checks returned due to |
1016 | insufficient funds, delinquent accounts, nonpayment of |
1017 | withholding taxes, unpaid utility expenses, nonpayment for |
1018 | essential services, or adverse court action concerning the |
1019 | financial viability of the provider or any other provider |
1020 | licensed under this part that is under the control of the |
1021 | controlling interest. Any person who violates this subsection |
1022 | commits a misdemeanor of the second degree, punishable as |
1023 | provided in s. 775.082 or s. 775.083. Each day of continuing |
1024 | violation is a separate offense. |
1025 | (10) The agency may not issue a license to a health care |
1026 | provider subject to the certificate-of-need provisions in part I |
1027 | of this chapter if the health care provider has not been issued |
1028 | a certificate of need or an exemption. Upon initial licensure of |
1029 | any such provider, the authorization contained in the |
1030 | certificate of need shall be considered fully implemented and |
1031 | merged into the license and shall have no force and effect upon |
1032 | termination of the license for any reason. |
1033 | 408.811 Right of inspection; copies; inspection reports.-- |
1034 | (1) An authorized officer or employee of the agency may |
1035 | make or cause to be made any inspection or investigation deemed |
1036 | necessary by the agency to determine the state of compliance |
1037 | with this part, authorizing statutes, and applicable rules. The |
1038 | right of inspection extends to any business that the agency has |
1039 | reason to believe is being operated as a provider without a |
1040 | license, but inspection of any business suspected of being |
1041 | operated without the appropriate license may not be made without |
1042 | the permission of the owner or person in charge unless a warrant |
1043 | is first obtained from a circuit court. Any application for a |
1044 | license issued under this part, authorizing statutes, or |
1045 | applicable rules constitutes permission for an appropriate |
1046 | inspection to verify the information submitted on or in |
1047 | connection with the application. |
1048 | (a) All inspections shall be unannounced, except as |
1049 | specified in s. 408.806. |
1050 | (b) Inspections for relicensure shall be conducted |
1051 | biennially unless otherwise specified by authorizing statutes or |
1052 | applicable rules. |
1053 | (2) Inspections conducted in conjunction with |
1054 | certification may be accepted in lieu of a complete licensure |
1055 | inspection. However, a licensure inspection may also be |
1056 | conducted to review any licensure requirements that are not also |
1057 | requirements for certification. |
1058 | (3) The agency shall have access to and the licensee shall |
1059 | provide copies of all provider records required during an |
1060 | inspection at no cost to the agency. |
1061 | (4)(a) Each licensee shall maintain as public information, |
1062 | available upon request, records of all inspection reports |
1063 | pertaining to that provider that have been filed by the agency |
1064 | unless those reports are exempt from or contain information that |
1065 | is exempt from s. 119.07(1) or is otherwise made confidential by |
1066 | law. Effective October 1, 2005, copies of such reports shall be |
1067 | retained in the records of the provider for at least 3 years |
1068 | following the date the reports are filed and issued, regardless |
1069 | of a change of ownership. |
1070 | (b) A licensee shall, upon the request of any person who |
1071 | has completed a written application with intent to be admitted |
1072 | by such provider, any person who is a client of such provider, |
1073 | or any relative, spouse, or guardian of any such person, furnish |
1074 | to the requester a copy of the last inspection report pertaining |
1075 | to the licensed provider that was issued by the agency or by an |
1076 | accrediting organization if such report is used in lieu of a |
1077 | licensure inspection. |
1078 | 408.812 Unlicensed activity.-- |
1079 | (1) A person or entity may not offer or advertise services |
1080 | that require licensure as defined by this part, authorizing |
1081 | statutes, or applicable rules to the public without obtaining a |
1082 | valid license from the agency. A licenseholder may not advertise |
1083 | or hold out to the public that he or she holds a license for |
1084 | other than that for which he or she actually holds the license. |
1085 | (2) The operation or maintenance of an unlicensed provider |
1086 | or the performance of any services that require licensure |
1087 | without proper licensure is a violation of this part and |
1088 | authorizing statutes. Unlicensed activity constitutes harm that |
1089 | materially affects the health, safety, and welfare of clients. |
1090 | The agency or any state attorney may, in addition to other |
1091 | remedies provided in this part, bring an action for an |
1092 | injunction to restrain such violation or to enjoin the future |
1093 | operation or maintenance of any such provider or the provision |
1094 | of services that require licensure in violation of this part and |
1095 | authorizing statutes until compliance with this part, |
1096 | authorizing statutes, and agency rules has been demonstrated to |
1097 | the satisfaction of the agency. |
1098 | (3) Any person or entity that owns, operates, or maintains |
1099 | an unlicensed provider and that, after receiving notification |
1100 | from the agency, fails to cease operation and apply for a |
1101 | license under this part and authorizing statutes commits a |
1102 | felony of the third degree, punishable as provided in s. |
1103 | 775.082, s. 775.083, or s. 775.084. Each day of continued |
1104 | operation is a separate offense. |
1105 | (4) Any person or entity found who violates subsection (3) |
1106 | a second or subsequent time commits a felony of the second |
1107 | degree, punishable as provided in s. 775.082, s. 775.083, or s. |
1108 | 775.084. Each day of continued operation is a separate offense. |
1109 | (5) Any person or entity that fails to cease operation |
1110 | after agency notification may be fined $1,000 for each day of |
1111 | noncompliance. |
1112 | (6) When a controlling interest or licensee has an |
1113 | interest in more than one provider and fails to license a |
1114 | provider rendering services that require licensure, the agency |
1115 | may revoke all licenses, impose actions under s. 408.814, and |
1116 | impose a fine of $1,000 per day unless otherwise specified by |
1117 | authorizing statutes against each licensee until such time as |
1118 | the appropriate license is obtained for the unlicensed |
1119 | operation. |
1120 | (7) In addition to granting injunctive relief pursuant to |
1121 | subsection (2), if the agency determines that a person or entity |
1122 | is operating or maintaining a provider without obtaining a |
1123 | license and determines that a condition exists that poses a |
1124 | threat to the health, safety, or welfare of a client of the |
1125 | provider, the person or entity is subject to the same actions |
1126 | and fines imposed against a licensee as specified in this part, |
1127 | authorizing statutes, and agency rules. |
1128 | (8) Any person aware of the operation of an unlicensed |
1129 | provider must report that provider to the agency. |
1130 | 408.813 Administrative fines.--As a penalty for any |
1131 | violation of this part, authorizing statutes, or applicable |
1132 | rules, the agency may impose an administrative fine. Unless the |
1133 | amount or aggregate limitation of the fine is prescribed by |
1134 | authorizing statutes or applicable rules, the agency may |
1135 | establish criteria by rule for the amount of administrative |
1136 | fines applicable to this part, authorizing statutes, and |
1137 | applicable rules. Each day of violation constitutes a separate |
1138 | violation and is subject to a separate fine. For fines imposed |
1139 | by final order of the agency and not subject to further appeal, |
1140 | the violator shall pay the fine plus interest at the rate |
1141 | specified in s. 55.03 for each day beyond the date set by the |
1142 | agency for payment of the fine. |
1143 | 408.814 Moratoriums; emergency suspensions.-- |
1144 | (1) The agency may impose an immediate moratorium or |
1145 | emergency suspension as defined in s. 120.60 on any provider if |
1146 | the agency determines that any condition related to the provider |
1147 | or licensee presents a threat to the health, safety, or welfare |
1148 | of a client. |
1149 | (2) A provider or licensee, the license of which is denied |
1150 | or revoked, may be subject to immediate imposition of a |
1151 | moratorium or emergency suspension to run concurrently with |
1152 | licensure denial, revocation, or injunction. |
1153 | (3) A moratorium or emergency suspension remains in effect |
1154 | after a change of ownership, unless the agency has determined |
1155 | that the conditions that created the moratorium, emergency |
1156 | suspension, or denial of licensure have been corrected. |
1157 | (4) When a moratorium or emergency suspension is placed on |
1158 | a provider or licensee, notice of the action shall be posted and |
1159 | visible to the public at the location of the provider until the |
1160 | action is lifted. |
1161 | 408.815 License or application denial; revocation.-- |
1162 | (1) In addition to the grounds provided in authorizing |
1163 | statutes, grounds that may be used by the agency for denying and |
1164 | revoking a license or change-of-ownership application include |
1165 | any of the following actions by a controlling interest: |
1166 | (a) False representation of a material fact in the license |
1167 | application or omission of any material fact from the |
1168 | application. |
1169 | (b) An intentional or negligent act materially affecting |
1170 | the health or safety of a client of the provider. |
1171 | (c) A violation of this part, authorizing statutes, or |
1172 | applicable rules. |
1173 | (d) A demonstrated pattern of deficient performance. |
1174 | (e) The applicant, licensee, or controlling interest has |
1175 | been or is currently excluded, suspended, terminated from |
1176 | participation in the state Medicaid program, the Medicaid |
1177 | program of any other state, or the Medicare program. |
1178 | (2) If a licensee lawfully continues to operate while a |
1179 | denial or revocation is pending in litigation, the licensee must |
1180 | continue to meet all other requirements of this part, |
1181 | authorizing statutes, and applicable rules and must file |
1182 | subsequent renewal applications for licensure and pay all |
1183 | licensure fees. The provisions of ss. 120.60(1) and |
1184 | 408.806(3)(c) shall not apply to renewal applications filed |
1185 | during the time period in which the litigation of the denial or |
1186 | revocation is pending until that litigation is final. |
1187 | (3) An action under s. 408.814 or denial of the license of |
1188 | the transferor may be grounds for denial of a change-of- |
1189 | ownership application of the transferee. |
1190 | 408.816 Injunctions.-- |
1191 | (1) In addition to the other powers provided by this part |
1192 | and authorizing statutes, the agency may institute injunction |
1193 | proceedings in a court of competent jurisdiction to: |
1194 | (a) Restrain or prevent the establishment or operation of |
1195 | a provider that does not have a license or is in violation of |
1196 | any provision of this part, authorizing statutes, or applicable |
1197 | rules. The agency may also institute injunction proceedings in a |
1198 | court of competent jurisdiction when a violation of this part, |
1199 | authorizing statutes, or applicable rules constitutes an |
1200 | emergency affecting the immediate health and safety of a client. |
1201 | (b) Enforce the provisions of this part, authorizing |
1202 | statutes, or any minimum standard, rule, or order issued or |
1203 | entered into pursuant thereto when the attempt by the agency to |
1204 | correct a violation through administrative sanctions has failed |
1205 | or when the violation materially affects the health, safety, or |
1206 | welfare of clients or involves any operation of an unlicensed |
1207 | provider. |
1208 | (c) Terminate the operation of a provider when a violation |
1209 | of any provision of this part, authorizing statutes, or any |
1210 | standard or rule adopted pursuant thereto exists that materially |
1211 | affects the health, safety, or welfare of clients. |
1212 |
|
1213 | Such injunctive relief may be temporary or permanent. |
1214 | (2) If action is necessary to protect clients of providers |
1215 | from immediate, life-threatening situations, the court may allow |
1216 | a temporary injunction without bond upon proper proof being |
1217 | made. If it appears by competent evidence or a sworn, |
1218 | substantiated affidavit that a temporary injunction should be |
1219 | issued, the court, pending the determination on final hearing, |
1220 | shall enjoin the operation of the provider. |
1221 | 408.817 Administrative proceedings.--Administrative |
1222 | proceedings challenging agency licensure enforcement action |
1223 | shall be reviewed on the basis of the facts and conditions that |
1224 | resulted in the agency action. |
1225 | 408.818 Health Care Trust Fund.--Unless otherwise |
1226 | prescribed by authorizing statutes, all fees and fines collected |
1227 | under this part, authorizing statutes, and applicable rules |
1228 | shall be deposited into the Health Care Trust Fund, created in |
1229 | s. 408.16, and used to pay the costs of the agency in |
1230 | administering the provider program paying the fees or fines. |
1231 | 408.819 Rules.--The agency is authorized to adopt rules as |
1232 | necessary to administer this part. Any licensed provider that is |
1233 | in operation at the time of adoption of any applicable rule |
1234 | under this part or authorizing statutes shall be given a |
1235 | reasonable time under the particular circumstances, not to |
1236 | exceed 6 months after the date of such adoption, within which to |
1237 | comply with such rule, unless otherwise specified by rule. |
1238 | Section 6. Subsections (12) and (17) and paragraph (a) of |
1239 | subsection (13) of section 112.0455, Florida Statutes, are |
1240 | amended to read: |
1241 | 112.0455 Drug-Free Workplace Act.-- |
1242 | (12) DRUG-TESTING STANDARDS; LABORATORIES.-- |
1243 | (a) The requirements of part II of chapter 408 shall apply |
1244 | to the provision of services that require licensure pursuant to |
1245 | this section and part II of chapter 408 and to entities licensed |
1246 | by or applying for such licensure from the Agency for Health |
1247 | Care Administration pursuant to this section. |
1248 | (b)(a) A laboratory may analyze initial or confirmation |
1249 | drug specimens only if: |
1250 | 1. The laboratory is licensed and approved by the Agency |
1251 | for Health Care Administration using criteria established by the |
1252 | United States Department of Health and Human Services as general |
1253 | guidelines for modeling the state drug testing program and in |
1254 | accordance with part II of chapter 408. Each applicant for |
1255 | licensure and licensee must comply with all requirements of part |
1256 | II of chapter 408 except s. 408.810(5)-(10). the following |
1257 | requirements: |
1258 | a. Upon receipt of a completed, signed, and dated |
1259 | application, the agency shall require background screening, in |
1260 | accordance with the level 2 standards for screening set forth in |
1261 | chapter 435, of the managing employee, or other similarly titled |
1262 | individual responsible for the daily operation of the |
1263 | laboratory, and of the financial officer, or other similarly |
1264 | titled individual who is responsible for the financial operation |
1265 | of the laboratory, including billings for services. The |
1266 | applicant must comply with the procedures for level 2 background |
1267 | screening as set forth in chapter 435, as well as the |
1268 | requirements of s. 435.03(3). |
1269 | b. The agency may require background screening of any |
1270 | other individual who is an applicant if the agency has probable |
1271 | cause to believe that he or she has been convicted of an offense |
1272 | prohibited under the level 2 standards for screening set forth |
1273 | in chapter 435. |
1274 | c. Proof of compliance with the level 2 background |
1275 | screening requirements of chapter 435 which has been submitted |
1276 | within the previous 5 years in compliance with any other health |
1277 | care licensure requirements of this state is acceptable in |
1278 | fulfillment of screening requirements. |
1279 | d. A provisional license may be granted to an applicant |
1280 | when each individual required by this section to undergo |
1281 | background screening has met the standards for the Department of |
1282 | Law Enforcement background check, but the agency has not yet |
1283 | received background screening results from the Federal Bureau of |
1284 | Investigation, or a request for a disqualification exemption has |
1285 | been submitted to the agency as set forth in chapter 435, but a |
1286 | response has not yet been issued. A license may be granted to |
1287 | the applicant upon the agency's receipt of a report of the |
1288 | results of the Federal Bureau of Investigation background |
1289 | screening for each individual required by this section to |
1290 | undergo background screening which confirms that all standards |
1291 | have been met, or upon the granting of a disqualification |
1292 | exemption by the agency as set forth in chapter 435. Any other |
1293 | person who is required to undergo level 2 background screening |
1294 | may serve in his or her capacity pending the agency's receipt of |
1295 | the report from the Federal Bureau of Investigation. However, |
1296 | the person may not continue to serve if the report indicates any |
1297 | violation of background screening standards and a |
1298 | disqualification exemption has not been requested of and granted |
1299 | by the agency as set forth in chapter 435. |
1300 | e. Each applicant must submit to the agency, with its |
1301 | application, a description and explanation of any exclusions, |
1302 | permanent suspensions, or terminations of the applicant from the |
1303 | Medicare or Medicaid programs. Proof of compliance with the |
1304 | requirements for disclosure of ownership and control interests |
1305 | under the Medicaid or Medicare programs shall be accepted in |
1306 | lieu of this submission. |
1307 | f. Each applicant must submit to the agency a description |
1308 | and explanation of any conviction of an offense prohibited under |
1309 | the level 2 standards of chapter 435 by a member of the board of |
1310 | directors of the applicant, its officers, or any individual |
1311 | owning 5 percent or more of the applicant. This requirement does |
1312 | not apply to a director of a not-for-profit corporation or |
1313 | organization if the director serves solely in a voluntary |
1314 | capacity for the corporation or organization, does not regularly |
1315 | take part in the day-to-day operational decisions of the |
1316 | corporation or organization, receives no remuneration for his or |
1317 | her services on the corporation or organization's board of |
1318 | directors, and has no financial interest and has no family |
1319 | members with a financial interest in the corporation or |
1320 | organization, provided that the director and the not-for-profit |
1321 | corporation or organization include in the application a |
1322 | statement affirming that the director's relationship to the |
1323 | corporation satisfies the requirements of this sub-subparagraph. |
1324 | g. A license may not be granted to any applicant if the |
1325 | applicant or managing employee has been found guilty of, |
1326 | regardless of adjudication, or has entered a plea of nolo |
1327 | contendere or guilty to, any offense prohibited under the level |
1328 | 2 standards for screening set forth in chapter 435, unless an |
1329 | exemption from disqualification has been granted by the agency |
1330 | as set forth in chapter 435. |
1331 | h. The agency may deny or revoke licensure if the |
1332 | applicant: |
1333 | (I) Has falsely represented a material fact in the |
1334 | application required by sub-subparagraph e. or sub-subparagraph |
1335 | f., or has omitted any material fact from the application |
1336 | required by sub-subparagraph e. or sub-subparagraph f.; or |
1337 | (II) Has had prior action taken against the applicant |
1338 | under the Medicaid or Medicare program as set forth in sub- |
1339 | subparagraph e. |
1340 | i. An application for license renewal must contain the |
1341 | information required under sub-subparagraphs e. and f. |
1342 | 2. The laboratory has written procedures to ensure chain |
1343 | of custody. |
1344 | 3. The laboratory follows proper quality control |
1345 | procedures, including, but not limited to: |
1346 | a. The use of internal quality controls including the use |
1347 | of samples of known concentrations which are used to check the |
1348 | performance and calibration of testing equipment, and periodic |
1349 | use of blind samples for overall accuracy. |
1350 | b. An internal review and certification process for drug |
1351 | test results, conducted by a person qualified to perform that |
1352 | function in the testing laboratory. |
1353 | c. Security measures implemented by the testing laboratory |
1354 | to preclude adulteration of specimens and drug test results. |
1355 | d. Other necessary and proper actions taken to ensure |
1356 | reliable and accurate drug test results. |
1357 | (c)(b) A laboratory shall disclose to the employer a |
1358 | written test result report within 7 working days after receipt |
1359 | of the sample. All laboratory reports of a drug test result |
1360 | shall, at a minimum, state: |
1361 | 1. The name and address of the laboratory which performed |
1362 | the test and the positive identification of the person tested. |
1363 | 2. Positive results on confirmation tests only, or |
1364 | negative results, as applicable. |
1365 | 3. A list of the drugs for which the drug analyses were |
1366 | conducted. |
1367 | 4. The type of tests conducted for both initial and |
1368 | confirmation tests and the minimum cutoff levels of the tests. |
1369 | 5. Any correlation between medication reported by the |
1370 | employee or job applicant pursuant to subparagraph (8)(b)2. and |
1371 | a positive confirmed drug test result. |
1372 |
|
1373 | No report shall disclose the presence or absence of any drug |
1374 | other than a specific drug and its metabolites listed pursuant |
1375 | to this section. |
1376 | (d)(c) The laboratory shall submit to the Agency for |
1377 | Health Care Administration a monthly report with statistical |
1378 | information regarding the testing of employees and job |
1379 | applicants. The reports shall include information on the methods |
1380 | of analyses conducted, the drugs tested for, the number of |
1381 | positive and negative results for both initial and confirmation |
1382 | tests, and any other information deemed appropriate by the |
1383 | Agency for Health Care Administration. No monthly report shall |
1384 | identify specific employees or job applicants. |
1385 | (e)(d) Laboratories shall provide technical assistance to |
1386 | the employer, employee, or job applicant for the purpose of |
1387 | interpreting any positive confirmed test results which could |
1388 | have been caused by prescription or nonprescription medication |
1389 | taken by the employee or job applicant. |
1390 | (13) RULES.-- |
1391 | (a) The Agency for Health Care Administration may adopt |
1392 | additional rules to support this law and part II of chapter 408, |
1393 | using criteria established by the United States Department of |
1394 | Health and Human Services as general guidelines for modeling |
1395 | drug-free workplace laboratories the state drug-testing program, |
1396 | concerning, but not limited to: |
1397 | 1. Standards for drug-testing laboratory licensing and |
1398 | denial, suspension, and revocation of a license. |
1399 | 2. Urine, hair, blood, and other body specimens and |
1400 | minimum specimen amounts which are appropriate for drug testing, |
1401 | not inconsistent with other provisions established by law. |
1402 | 3. Methods of analysis and procedures to ensure reliable |
1403 | drug-testing results, including standards for initial tests and |
1404 | confirmation tests, not inconsistent with other provisions |
1405 | established by law. |
1406 | 4. Minimum cutoff detection levels for drugs or their |
1407 | metabolites for the purposes of determining a positive test |
1408 | result, not inconsistent with other provisions established by |
1409 | law. |
1410 | 5. Chain-of-custody procedures to ensure proper |
1411 | identification, labeling, and handling of specimens being |
1412 | tested, not inconsistent with other provisions established by |
1413 | law. |
1414 | 6. Retention, storage, and transportation procedures to |
1415 | ensure reliable results on confirmation tests and retests. |
1416 | 7. A list of the most common medications by brand name or |
1417 | common name, as applicable, as well as by chemical name, which |
1418 | may alter or affect a drug test. |
1419 |
|
1420 | This section shall not be construed to eliminate the bargainable |
1421 | rights as provided in the collective bargaining process where |
1422 | applicable. |
1423 | (17) LICENSE FEE.--Fees from licensure of drug-testing |
1424 | laboratories shall be sufficient to carry out the |
1425 | responsibilities of the Agency for Health Care Administration |
1426 | for the regulation of drug-testing laboratories. In accordance |
1427 | with s. 408.805, applicants and licensees shall pay a fee for |
1428 | each license application submitted under this part, part II of |
1429 | chapter 408, and applicable rules. The fee shall be not less |
1430 | than $16,000 or more than $20,000 per biennium and shall be |
1431 | established by rule. The Agency for Health Care Administration |
1432 | shall collect fees for all licenses issued under this part. Each |
1433 | nonrefundable fee shall be due at the time of application and |
1434 | shall be payable to the Agency for Health Care Administration to |
1435 | be deposited in a trust fund administered by the Agency for |
1436 | Health Care Administration and used only for the purposes of |
1437 | this section. The fee schedule is as follows: For licensure as a |
1438 | drug-testing laboratory, an annual fee of not less than $8,000 |
1439 | or more than $10,000 per fiscal year; for late filing of an |
1440 | application for renewal, an additional fee of $500 per day shall |
1441 | be charged. |
1442 | Section 7. Subsection (7) of section 381.0303, Florida |
1443 | Statutes, is amended to read: |
1444 | 381.0303 Health practitioner recruitment for special needs |
1445 | shelters.-- |
1446 | (7) REVIEW OF EMERGENCY MANAGEMENT PLANS.--The submission |
1447 | of emergency management plans to county health departments by |
1448 | home health agencies pursuant to s. 400.497(8)(c) and (d) and by |
1449 | nurse registries pursuant to s. 400.506(11)(16)(e) and by |
1450 | hospice programs pursuant to s. 400.610(1)(b) is conditional |
1451 | upon the receipt of an appropriation by the department to |
1452 | establish medical services disaster coordinator positions in |
1453 | county health departments unless the secretary of the department |
1454 | and a local county commission jointly determine to require such |
1455 | plans to be submitted based on a determination that there is a |
1456 | special need to protect public health in the local area during |
1457 | an emergency. |
1458 | Section 8. Paragraph (b) of subsection (4) of section |
1459 | 381.78, Florida Statutes, is amended to read: |
1460 | 381.78 Advisory council on brain and spinal cord |
1461 | injuries.-- |
1462 | (4) The council shall: |
1463 | (b) Annually appoint a five-member committee composed of |
1464 | one individual who has a brain injury or has a family member |
1465 | with a brain injury, one individual who has a spinal cord injury |
1466 | or has a family member with a spinal cord injury, and three |
1467 | members who shall be chosen from among these representative |
1468 | groups: physicians, other allied health professionals, |
1469 | administrators of brain and spinal cord injury programs, and |
1470 | representatives from support groups with expertise in areas |
1471 | related to the rehabilitation of individuals who have brain or |
1472 | spinal cord injuries, except that one and only one member of the |
1473 | committee shall be an administrator of a transitional living |
1474 | facility. Membership on the council is not a prerequisite for |
1475 | membership on this committee. |
1476 | 1. The committee shall perform onsite visits to those |
1477 | transitional living facilities identified by the Agency for |
1478 | Health Care Administration as being in possible violation of the |
1479 | statutes and rules regulating such facilities. The committee |
1480 | members have the same rights of entry and inspection granted |
1481 | under s. 400.805(4)(8) to designated representatives of the |
1482 | agency. |
1483 | 2. Factual findings of the committee resulting from an |
1484 | onsite investigation of a facility pursuant to subparagraph 1. |
1485 | shall be adopted by the agency in developing its administrative |
1486 | response regarding enforcement of statutes and rules regulating |
1487 | the operation of the facility. |
1488 | 3. Onsite investigations by the committee shall be funded |
1489 | by the Health Care Trust Fund. |
1490 | 4. Travel expenses for committee members shall be |
1491 | reimbursed in accordance with s. 112.061. |
1492 | 5. Members of the committee shall recuse themselves from |
1493 | participating in any investigation that would create a conflict |
1494 | of interest under state law, and the council shall replace the |
1495 | member, either temporarily or permanently. |
1496 | Section 9. Section 383.301, Florida Statutes, is amended |
1497 | to read: |
1498 | 383.301 Licensure and regulation of birth centers; |
1499 | legislative intent.--It is the intent of the Legislature to |
1500 | provide for the protection of public health and safety in the |
1501 | establishment, maintenance, and operation of birth centers by |
1502 | providing for licensure of birth centers and for the |
1503 | development, establishment, and enforcement of minimum standards |
1504 | with respect to birth centers. The requirements of part II of |
1505 | chapter 408 shall apply to the provision of services that |
1506 | require licensure pursuant to ss. 383.30-383.335 and part II of |
1507 | chapter 408 and to entities licensed by or applying for such |
1508 | licensure from the Agency for Health Care Administration |
1509 | pursuant to ss. 383.30-383.335. |
1510 | Section 10. Section 383.304, Florida Statutes, is |
1511 | repealed. |
1512 | Section 11. Section 383.305, Florida Statutes, is amended |
1513 | to read: |
1514 | 383.305 Licensure; issuance, renewal, denial, suspension, |
1515 | revocation; fees; background screening.-- |
1516 | (1)(a) In accordance with s. 408.805, an applicant or a |
1517 | licensee shall pay a fee for each license application submitted |
1518 | under ss. 383.30-383.335 and part II of chapter 408. The amount |
1519 | of the fee shall be established by rule. Upon receipt of an |
1520 | application for a license and the license fee, the agency shall |
1521 | issue a license if the applicant and facility have received all |
1522 | approvals required by law and meet the requirements established |
1523 | under ss. 383.30-383.335 and by rules promulgated hereunder. |
1524 | (b) A provisional license may be issued to any birth |
1525 | center that is in substantial compliance with ss. 383.30-383.335 |
1526 | and with the rules of the agency. A provisional license may be |
1527 | granted for a period of no more than 1 year from the effective |
1528 | date of rules adopted by the agency, shall expire automatically |
1529 | at the end of its term, and may not be renewed. |
1530 | (c) A license, unless sooner suspended or revoked, |
1531 | automatically expires 1 year from its date of issuance and is |
1532 | renewable upon application for renewal and payment of the fee |
1533 | prescribed, provided the applicant and the birth center meet the |
1534 | requirements established under ss. 383.30-383.335 and by rules |
1535 | promulgated hereunder. A complete application for renewal of a |
1536 | license shall be made 90 days prior to expiration of the license |
1537 | on forms provided by the agency. |
1538 | (2) An application for a license, or renewal thereof, |
1539 | shall be made to the agency upon forms provided by it and shall |
1540 | contain such information as the agency reasonably requires, |
1541 | which may include affirmative evidence of ability to comply with |
1542 | applicable laws and rules. |
1543 | (3)(a) Each application for a birth center license, or |
1544 | renewal thereof, shall be accompanied by a license fee. Fees |
1545 | shall be established by rule of the agency. Such fees are |
1546 | payable to the agency and shall be deposited in a trust fund |
1547 | administered by the agency, to be used for the sole purpose of |
1548 | carrying out the provisions of ss. 383.30-383.335. |
1549 | (b) The fees established pursuant to ss. 383.30-383.335 |
1550 | shall be based on actual costs incurred by the agency in the |
1551 | administration of its duties under such sections. |
1552 | (4) Each license is valid only for the person or |
1553 | governmental unit to whom or which it is issued; is not subject |
1554 | to sale, assignment, or other transfer, voluntary or |
1555 | involuntary; and is not valid for any premises other than those |
1556 | for which it was originally issued. |
1557 | (5) Each license shall be posted in a conspicuous place on |
1558 | the licensed premises. |
1559 | (6) Whenever the agency finds that there has been a |
1560 | substantial failure to comply with the requirements established |
1561 | under ss. 383.30-383.335 or in rules adopted under those |
1562 | sections, it is authorized to deny, suspend, or revoke a |
1563 | license. |
1564 | (2)(7) Each applicant for licensure and each licensee must |
1565 | comply with the following requirements of part II of chapter 408 |
1566 | except s. 408.810(7)-(10).: |
1567 | (a) Upon receipt of a completed, signed, and dated |
1568 | application, the agency shall require background screening, in |
1569 | accordance with the level 2 standards for screening set forth in |
1570 | chapter 435, of the managing employee, or other similarly titled |
1571 | individual who is responsible for the daily operation of the |
1572 | center, and of the financial officer, or other similarly titled |
1573 | individual who is responsible for the financial operation of the |
1574 | center, including billings for patient care and services. The |
1575 | applicant must comply with the procedures for level 2 background |
1576 | screening as set forth in chapter 435 as well as the |
1577 | requirements of s. 435.03(3). |
1578 | (b) The agency may require background screening of any |
1579 | other individual who is an applicant if the agency has probable |
1580 | cause to believe that he or she has been convicted of a crime or |
1581 | has committed any other offense prohibited under the level 2 |
1582 | standards for screening set forth in chapter 435. |
1583 | (c) Proof of compliance with the level 2 background |
1584 | screening requirements of chapter 435 which has been submitted |
1585 | within the previous 5 years in compliance with any other health |
1586 | care licensure requirements of this state is acceptable in |
1587 | fulfillment of the requirements of paragraph (a). |
1588 | (d) A provisional license may be granted to an applicant |
1589 | when each individual required by this section to undergo |
1590 | background screening has met the standards for the Department of |
1591 | Law Enforcement background check, but the agency has not yet |
1592 | received background screening results from the Federal Bureau of |
1593 | Investigation, or a request for a disqualification exemption has |
1594 | been submitted to the agency as set forth in chapter 435 but a |
1595 | response has not yet been issued. A standard license may be |
1596 | granted to the applicant upon the agency's receipt of a report |
1597 | of the results of the Federal Bureau of Investigation background |
1598 | screening for each individual required by this section to |
1599 | undergo background screening which confirms that all standards |
1600 | have been met, or upon the granting of a disqualification |
1601 | exemption by the agency as set forth in chapter 435. Any other |
1602 | person who is required to undergo level 2 background screening |
1603 | may serve in his or her capacity pending the agency's receipt of |
1604 | the report from the Federal Bureau of Investigation. However, |
1605 | the person may not continue to serve if the report indicates any |
1606 | violation of background screening standards and a |
1607 | disqualification exemption has not been requested of and granted |
1608 | by the agency as set forth in chapter 435. |
1609 | (e) Each applicant must submit to the agency, with its |
1610 | application, a description and explanation of any exclusions, |
1611 | permanent suspensions, or terminations of the applicant from the |
1612 | Medicare or Medicaid programs. Proof of compliance with the |
1613 | requirements for disclosure of ownership and control interests |
1614 | under the Medicaid or Medicare programs shall be accepted in |
1615 | lieu of this submission. |
1616 | (f) Each applicant must submit to the agency a description |
1617 | and explanation of any conviction of an offense prohibited under |
1618 | the level 2 standards of chapter 435 by a member of the board of |
1619 | directors of the applicant, its officers, or any individual |
1620 | owning 5 percent or more of the applicant. This requirement does |
1621 | not apply to a director of a not-for-profit corporation or |
1622 | organization if the director serves solely in a voluntary |
1623 | capacity for the corporation or organization, does not regularly |
1624 | take part in the day-to-day operational decisions of the |
1625 | corporation or organization, receives no remuneration for his or |
1626 | her services on the corporation or organization's board of |
1627 | directors, and has no financial interest and has no family |
1628 | members with a financial interest in the corporation or |
1629 | organization, provided that the director and the not-for-profit |
1630 | corporation or organization include in the application a |
1631 | statement affirming that the director's relationship to the |
1632 | corporation satisfies the requirements of this paragraph. |
1633 | (g) A license may not be granted to an applicant if the |
1634 | applicant or managing employee has been found guilty of, |
1635 | regardless of adjudication, or has entered a plea of nolo |
1636 | contendere or guilty to, any offense prohibited under the level |
1637 | 2 standards for screening set forth in chapter 435, unless an |
1638 | exemption from disqualification has been granted by the agency |
1639 | as set forth in chapter 435. |
1640 | (h) The agency may deny or revoke licensure if the |
1641 | applicant: |
1642 | 1. Has falsely represented a material fact in the |
1643 | application required by paragraph (e) or paragraph (f), or has |
1644 | omitted any material fact from the application required by |
1645 | paragraph (e) or paragraph (f); or |
1646 | 2. Has had prior action taken against the applicant under |
1647 | the Medicaid or Medicare program as set forth in paragraph (e). |
1648 | (i) An application for license renewal must contain the |
1649 | information required under paragraphs (e) and (f). |
1650 | Section 12. Section 383.309, Florida Statutes, is amended |
1651 | to read: |
1652 | 383.309 Minimum standards for birth centers; rules and |
1653 | enforcement.-- |
1654 | (1) The agency shall adopt and enforce rules to administer |
1655 | ss. 383.30-383.335 and part II of chapter 408, which rules shall |
1656 | include, but are not limited to, reasonable and fair minimum |
1657 | standards for ensuring that: |
1658 | (a) Sufficient numbers and qualified types of personnel |
1659 | and occupational disciplines are available at all times to |
1660 | provide necessary and adequate patient care and safety. |
1661 | (b) Infection control, housekeeping, sanitary conditions, |
1662 | disaster plan, and medical record procedures that will |
1663 | adequately protect patient care and provide safety are |
1664 | established and implemented. |
1665 | (c) Licensed facilities are established, organized, and |
1666 | operated consistent with established programmatic standards. |
1667 | (2) Any licensed facility that is in operation at the time |
1668 | of adoption of any applicable rule under ss. 383.30-383.335 |
1669 | shall be given a reasonable time under the particular |
1670 | circumstances, not to exceed 1 year after the date of such |
1671 | adoption, within which to comply with such rule. |
1672 | (2)(3) The agency may not establish any rule governing the |
1673 | design, construction, erection, alteration, modification, |
1674 | repair, or demolition of birth centers. It is the intent of the |
1675 | Legislature to preempt that function to the Florida Building |
1676 | Commission and the State Fire Marshal through adoption and |
1677 | maintenance of the Florida Building Code and the Florida Fire |
1678 | Prevention Code. However, the agency shall provide technical |
1679 | assistance to the commission and the State Fire Marshal in |
1680 | updating the construction standards of the Florida Building Code |
1681 | and the Florida Fire Prevention Code which govern birth centers. |
1682 | In addition, the agency may enforce the special-occupancy |
1683 | provisions of the Florida Building Code and the Florida Fire |
1684 | Prevention Code which apply to birth centers in conducting any |
1685 | inspection authorized under this chapter. |
1686 | Section 13. Subsection (1) of section 383.315, Florida |
1687 | Statutes, is amended to read: |
1688 | 383.315 Agreements with consultants for advice or |
1689 | services; maintenance.-- |
1690 | (1) A birth center shall maintain in writing a |
1691 | consultation agreement, signed within the current license period |
1692 | year, with each consultant who has agreed to provide advice and |
1693 | services to the birth center as requested. |
1694 | Section 14. Section 383.324, Florida Statutes, is amended |
1695 | to read: |
1696 | 383.324 Inspections and investigations; Inspection fees.-- |
1697 | (1) The agency shall make or cause to be made such |
1698 | inspections and investigations as it deems necessary. |
1699 | (2) Each facility licensed under s. 383.305 shall pay to |
1700 | the agency, at the time of inspection, an inspection fee |
1701 | established by rule of the agency. |
1702 | (3) The agency shall coordinate all periodic inspections |
1703 | for licensure made by the agency to ensure that the cost to the |
1704 | facility of such inspections and the disruption of services by |
1705 | such inspections is minimized. |
1706 | Section 15. Section 383.325, Florida Statutes, is |
1707 | repealed. |
1708 | Section 16. Section 383.33, Florida Statutes, is amended |
1709 | to read: |
1710 | 383.33 Administrative fines penalties; emergency orders; |
1711 | moratorium on admissions.-- |
1712 | (1)(a) In addition to the requirements of part II of |
1713 | chapter 408, the agency may deny, revoke, or suspend a license, |
1714 | or impose an administrative fine not to exceed $500 per |
1715 | violation per day, for the violation of any provision of ss. |
1716 | 383.30-383.335, part II of chapter 408, or applicable rules or |
1717 | any rule adopted under ss. 383.30-383.335. Each day of violation |
1718 | constitutes a separate violation and is subject to a separate |
1719 | fine. |
1720 | (2)(b) In determining the amount of the fine to be levied |
1721 | for a violation, as provided in subsection (1) paragraph (a), |
1722 | the following factors shall be considered: |
1723 | (a)1. The severity of the violation, including the |
1724 | probability that death or serious harm to the health or safety |
1725 | of any person will result or has resulted; the severity of the |
1726 | actual or potential harm; and the extent to which the provisions |
1727 | of ss. 383.30-383.335, part II of chapter 408, or applicable |
1728 | rules were violated. |
1729 | (b)2. Actions taken by the licensee to correct the |
1730 | violations or to remedy complaints. |
1731 | (c)3. Any previous violations by the licensee. |
1732 | (c) All amounts collected pursuant to this section shall |
1733 | be deposited into a trust fund administered by the agency to be |
1734 | used for the sole purpose of carrying out the provisions of ss. |
1735 | 383.30-383.335. |
1736 | (2) The agency may issue an emergency order immediately |
1737 | suspending or revoking a license when it determines that any |
1738 | condition in the licensed facility presents a clear and present |
1739 | danger to the public health and safety. |
1740 | (3) The agency may impose an immediate moratorium on |
1741 | elective admissions to any licensed facility, building or |
1742 | portion thereof, or service when the agency determines that any |
1743 | condition in the facility presents a threat to the public health |
1744 | or safety. |
1745 | Section 17. Section 383.331, Florida Statutes, is |
1746 | repealed. |
1747 | Section 18. Section 383.332, Florida Statutes, is |
1748 | repealed. |
1749 | Section 19. Subsection (1) of section 383.335, Florida |
1750 | Statutes, is amended to read: |
1751 | 383.335 Partial exemptions.-- |
1752 | (1) Any facility that which was providing obstetrical and |
1753 | gynecological surgical services and was owned and operated by a |
1754 | board-certified obstetrician on June 15, 1984, and that which is |
1755 | otherwise subject to licensure under ss. 383.30-383.335 as a |
1756 | birth center, is exempt from the provisions of ss. 383.30- |
1757 | 383.335 and part II of chapter 408 which restrict the provision |
1758 | of surgical services and outlet forceps delivery and the |
1759 | administration of anesthesia at birth centers. The agency shall |
1760 | adopt rules specifically related to the performance of such |
1761 | services and the administration of anesthesia at such |
1762 | facilities. |
1763 | Section 20. Subsection (4) of section 383.50, Florida |
1764 | Statutes, is amended to read: |
1765 | 383.50 Treatment of abandoned newborn infant.-- |
1766 | (4) Each hospital of this state subject to s. 395.1041 |
1767 | shall, and any other hospital may, admit and provide all |
1768 | necessary emergency services and care, as defined in s. |
1769 | 395.002(9)(10), to any newborn infant left with the hospital in |
1770 | accordance with this section. The hospital or any of its |
1771 | licensed health care professionals shall consider these actions |
1772 | as implied consent for treatment, and a hospital accepting |
1773 | physical custody of a newborn infant has implied consent to |
1774 | perform all necessary emergency services and care. The hospital |
1775 | or any of its licensed health care professionals is immune from |
1776 | criminal or civil liability for acting in good faith in |
1777 | accordance with this section. Nothing in this subsection limits |
1778 | liability for negligence. |
1779 | Section 21. Subsection (5) of section 390.011, Florida |
1780 | Statutes, is amended to read: |
1781 | 390.011 Definitions.--As used in this chapter, the term: |
1782 | (5) "Hospital" means a facility as defined in s. 395.002 |
1783 | and licensed under chapter 395. |
1784 | Section 22. Subsection (1) of section 390.012, Florida |
1785 | Statutes, is amended to read: |
1786 | 390.012 Powers of agency; rules; disposal of fetal |
1787 | remains.-- |
1788 | (1) The agency may shall have the authority to develop and |
1789 | enforce rules pursuant to ss. 390.001-390.018 and part II of |
1790 | chapter 408 for the health, care, and treatment of persons in |
1791 | abortion clinics and for the safe operation of such clinics. |
1792 | These rules shall be comparable to rules which apply to all |
1793 | surgical procedures requiring approximately the same degree of |
1794 | skill and care as the performance of first trimester abortions. |
1795 | The rules shall be reasonably related to the preservation of |
1796 | maternal health of the clients. The rules shall not impose a |
1797 | legally significant burden on a woman's freedom to decide |
1798 | whether to terminate her pregnancy. The rules shall provide for: |
1799 | (a) The performance of pregnancy termination procedures |
1800 | only by a licensed physician. |
1801 | (b) The making, protection, and preservation of patient |
1802 | records, which shall be treated as medical records under chapter |
1803 | 458. |
1804 | Section 23. Section 390.013, Florida Statutes, is |
1805 | repealed. |
1806 | Section 24. Section 390.014, Florida Statutes, is amended |
1807 | to read: |
1808 | 390.014 Licenses; fees, display, etc.-- |
1809 | (1) The requirements of part II of chapter 408 shall apply |
1810 | to the provision of services that require licensure pursuant to |
1811 | ss. 390.011-390.018 and part II of chapter 408 and to entities |
1812 | licensed by or applying for such licensure from the Agency for |
1813 | Health Care Administration pursuant to ss. 390.011-390.018. |
1814 | However, each applicant for licensure and each licensee is |
1815 | exempt from s. 408.810(7)-(10). No abortion clinic shall operate |
1816 | in this state without a currently effective license issued by |
1817 | the agency. |
1818 | (2) A separate license shall be required for each clinic |
1819 | maintained on separate premises, even though it is operated by |
1820 | the same management as another clinic; but a separate license |
1821 | shall not be required for separate buildings on the same |
1822 | premises. |
1823 | (3) In accordance with s. 408.805, an applicant or |
1824 | licensee shall pay a fee for each license application submitted |
1825 | under this part and part II of chapter 408. The amount of the |
1826 | fee shall be established by rule and The annual license fee |
1827 | required for a clinic shall be nonrefundable and shall be |
1828 | reasonably calculated to cover the cost of regulation under this |
1829 | chapter, but may not be less than $70 or $35 nor more than $500 |
1830 | per biennium $250. |
1831 | (4) Counties and municipalities applying for licenses |
1832 | under this act shall be exempt from the payment of the license |
1833 | fees. |
1834 | (5) The license shall be displayed in a conspicuous place |
1835 | inside the clinic. |
1836 | (6) A license shall be valid only for the clinic to which |
1837 | it is issued, and it shall not be subject to sale, assignment, |
1838 | or other transfer, voluntary or involuntary. No license shall be |
1839 | valid for any premises other than those for which it was |
1840 | originally issued. |
1841 | Section 25. Section 390.015, Florida Statutes, is |
1842 | repealed. |
1843 | Section 26. Section 390.016, Florida Statutes, is |
1844 | repealed. |
1845 | Section 27. Section 390.017, Florida Statutes, is |
1846 | repealed. |
1847 | Section 28. Section 390.018, Florida Statutes, is amended |
1848 | to read: |
1849 | 390.018 Administrative fine penalty in lieu of revocation |
1850 | or suspension.--In addition to the requirements of part II of |
1851 | chapter 408 If the agency finds that one or more grounds exist |
1852 | for the revocation or suspension of a license issued to an |
1853 | abortion clinic, the agency may, in lieu of such suspension or |
1854 | revocation, impose a fine upon the clinic in an amount not to |
1855 | exceed $1,000 for each violation of any provision this part, |
1856 | part II of chapter 408, or applicable rules. The fine shall be |
1857 | paid to the agency within 60 days from the date of entry of the |
1858 | administrative order. If the licensee fails to pay the fine in |
1859 | its entirety to the agency within the period allowed, the |
1860 | license of the licensee shall stand suspended, revoked, or |
1861 | renewal or continuation may be refused, as the case may be, upon |
1862 | expiration of such period and without any further administrative |
1863 | or judicial proceedings. |
1864 | Section 29. Section 390.019, Florida Statutes, is |
1865 | repealed. |
1866 | Section 30. Section 390.021, Florida Statutes, is |
1867 | repealed. |
1868 | Section 31. Subsection (13) of section 394.455, Florida |
1869 | Statutes, is amended to read: |
1870 | 394.455 Definitions.--As used in this part, unless the |
1871 | context clearly requires otherwise, the term: |
1872 | (13) "Hospital" means a facility as defined in s. 395.002 |
1873 | and licensed under chapter 395. |
1874 | Section 32. Subsection (7) of section 394.4787, Florida |
1875 | Statutes, is amended to read: |
1876 | 394.4787 Definitions; ss. 394.4786, 394.4787, 394.4788, |
1877 | and 394.4789.--As used in this section and ss. 394.4786, |
1878 | 394.4788, and 394.4789: |
1879 | (7) "Specialty psychiatric hospital" means a hospital |
1880 | licensed by the agency pursuant to s. 395.002(28)(29) as a |
1881 | specialty psychiatric hospital. |
1882 | Section 33. Subsections (3) through (23) of section |
1883 | 394.67, Florida Statutes, are renumbered as subsections (2) |
1884 | through (22), respectively, present subsections (2) and (4) are |
1885 | amended, and a new subsection (23) is added to said section, to |
1886 | read: |
1887 | 394.67 Definitions.--As used in this part, the term: |
1888 | (2) "Applicant" means an individual applicant, or any |
1889 | officer, director, agent, managing employee, or affiliated |
1890 | person, or any partner or shareholder having an ownership |
1891 | interest equal to a 5-percent or greater interest in the |
1892 | corporation, partnership, or other business entity. |
1893 | (3)(4) "Crisis services" means short-term evaluation, |
1894 | stabilization, and brief intervention services provided to a |
1895 | person who is experiencing an acute mental or emotional crisis, |
1896 | as defined in subsection (17) (18), or an acute substance abuse |
1897 | crisis, as defined in subsection (18) (19), to prevent further |
1898 | deterioration of the person's mental health. Crisis services are |
1899 | provided in settings such as a crisis stabilization unit, an |
1900 | inpatient unit, a short-term residential treatment program, a |
1901 | detoxification facility, or an addictions receiving facility; at |
1902 | the site of the crisis by a mobile crisis response team; or at a |
1903 | hospital on an outpatient basis. |
1904 | (23) "Short-term residential treatment facility" means a |
1905 | facility that provides an alternative to inpatient |
1906 | hospitalization and that provides brief, intensive services 24 |
1907 | hours a day, 7 days a week for mentally ill individuals who are |
1908 | temporarily in need of a 24-hour-a-day structured therapeutic |
1909 | setting as a less restrictive but longer-term alternative to |
1910 | hospitalization. |
1911 | Section 34. Paragraph (a) of subsection (3) of section |
1912 | 394.74, Florida Statutes, is amended to read: |
1913 | 394.74 Contracts for provision of local substance abuse |
1914 | and mental health programs.-- |
1915 | (3) Contracts shall include, but are not limited to: |
1916 | (a) A provision that, within the limits of available |
1917 | resources, substance abuse and mental health crisis services, as |
1918 | defined in s. 394.67(3)(4), shall be available to any individual |
1919 | residing or employed within the service area, regardless of |
1920 | ability to pay for such services, current or past health |
1921 | condition, or any other factor; |
1922 | Section 35. Subsections (1) and (5) of section 394.82, |
1923 | Florida Statutes, are amended to read: |
1924 | 394.82 Funding of expanded services.-- |
1925 | (1) Pursuant to the General Appropriations Acts for the |
1926 | 2001-2002 and 2002-2003 fiscal years, funds appropriated to the |
1927 | Department of Children and Family Services for the purpose of |
1928 | expanding community mental health services must be used to |
1929 | implement programs that emphasize crisis services as defined in |
1930 | s. 394.67(3)(4) and treatment services, rehabilitative services, |
1931 | support services, and case management services, as defined in s. |
1932 | 394.67(15)(16). Following the 2002-2003 fiscal year, the |
1933 | Department of Children and Family Services must continue to |
1934 | expand the provision of these community mental health services. |
1935 | (5) By January 1, 2004, the crisis services defined in s. |
1936 | 394.67(3)(4) shall be implemented, as appropriate, in the |
1937 | state's public community mental health system to serve children |
1938 | and adults who are experiencing an acute mental or emotional |
1939 | crisis, as defined in s. 394.67(17)(18). By January 1, 2006, the |
1940 | mental health services defined in s. 394.67(15)(16) shall be |
1941 | implemented, as appropriate, in the state's public community |
1942 | mental health system to serve adults and older adults who have a |
1943 | severe and persistent mental illness and to serve children who |
1944 | have a serious emotional disturbance or mental illness, as |
1945 | defined in s. 394.492(6). |
1946 | Section 36. Section 394.875, Florida Statutes, is amended |
1947 | to read: |
1948 | 394.875 Crisis stabilization units, short-term residential |
1949 | treatment facilities, residential treatment facilities, and |
1950 | residential treatment centers for children and adolescents; |
1951 | authorized services; license required; penalties.-- |
1952 | (1)(a) The purpose of a crisis stabilization unit is to |
1953 | stabilize and redirect a client to the most appropriate and |
1954 | least restrictive community setting available, consistent with |
1955 | the client's needs. Crisis stabilization units may screen, |
1956 | assess, and admit for stabilization persons who present |
1957 | themselves to the unit and persons who are brought to the unit |
1958 | under s. 394.463. Clients may be provided 24-hour observation, |
1959 | medication prescribed by a physician or psychiatrist, and other |
1960 | appropriate services. Crisis stabilization units shall provide |
1961 | services regardless of the client's ability to pay and shall be |
1962 | limited in size to a maximum of 30 beds. |
1963 | (b) The purpose of a short-term residential treatment |
1964 | facility is to provide intensive services in a 24-hour-a-day |
1965 | structured therapeutic setting as a less restrictive but longer- |
1966 | term alternative to hospitalization. |
1967 | (c)(b) The purpose of a residential treatment facility is |
1968 | to be a part of a comprehensive treatment program for mentally |
1969 | ill individuals in a community-based residential setting. |
1970 | (d)(c) The purpose of a residential treatment center for |
1971 | children and adolescents is to provide mental health assessment |
1972 | and treatment services pursuant to ss. 394.491, 394.495, and |
1973 | 394.496 to children and adolescents who meet the target |
1974 | population criteria specified in s. 394.493(1)(a), (b), or (c). |
1975 | (2) The requirements of part II of chapter 408 shall apply |
1976 | to the provision of services that require licensure under ss. |
1977 | 394.455-394.904 and part II of chapter 408 and to entities |
1978 | licensed by or applying for such licensure from the Agency for |
1979 | Health Care Administration pursuant to ss. 394.455-394.904. |
1980 | However, each applicant for licensure and each licensee is |
1981 | exempt from the provisions of s. 408.810(8)?(10). It is unlawful |
1982 | for any entity to hold itself out as a crisis stabilization |
1983 | unit, a residential treatment facility, or a residential |
1984 | treatment center for children and adolescents, or to act as a |
1985 | crisis stabilization unit, a residential treatment facility, or |
1986 | a residential treatment center for children and adolescents, |
1987 | unless it is licensed by the agency pursuant to this chapter. |
1988 | (3) Any person who violates subsection (2) is guilty of a |
1989 | misdemeanor of the first degree, punishable as provided in s. |
1990 | 775.082 or s. 775.083. |
1991 | (4) The agency may maintain an action in circuit court to |
1992 | enjoin the unlawful operation of a crisis stabilization unit, a |
1993 | residential treatment facility, or a residential treatment |
1994 | center for children and adolescents if the agency first gives |
1995 | the violator 14 days' notice of its intention to maintain such |
1996 | action and if the violator fails to apply for licensure within |
1997 | such 14-day period. |
1998 | (3)(5) The following are exempt from licensure as required |
1999 | in ss. 394.455-394.904 Subsection (2) does not apply to: |
2000 | (a) Hospitals licensed pursuant to chapter 395 or programs |
2001 | operated within such hospitals. Homes for special services |
2002 | licensed under chapter 400; or |
2003 | (b) Nursing homes licensed under chapter 400. |
2004 | (c) Comprehensive transitional education programs licensed |
2005 | under s. 393.067. |
2006 | (4)(6) The department, in consultation with the agency, |
2007 | may establish multiple license classifications for residential |
2008 | treatment facilities. |
2009 | (5)(7) The agency may not issue a license to a crisis |
2010 | stabilization unit unless the unit receives state mental health |
2011 | funds and is affiliated with a designated public receiving |
2012 | facility. |
2013 | (6)(8) The agency may issue a license for a crisis |
2014 | stabilization unit or short-term residential treatment facility, |
2015 | certifying the number of authorized beds for such facility as |
2016 | indicated by existing need and available appropriations. The |
2017 | agency may disapprove an application for such a license if it |
2018 | determines that a facility should not be licensed pursuant to |
2019 | the provisions of this chapter. Any facility operating beds in |
2020 | excess of those authorized by the agency shall, upon demand of |
2021 | the agency, reduce the number of beds to the authorized number, |
2022 | forfeit its license, or provide evidence of a license issued |
2023 | pursuant to chapter 395 for the excess beds. |
2024 | (7)(9) A children's crisis stabilization unit which does |
2025 | not exceed 20 licensed beds and which provides separate |
2026 | facilities or a distinct part of a facility, separate staffing, |
2027 | and treatment exclusively for minors may be located on the same |
2028 | premises as a crisis stabilization unit serving adults. The |
2029 | department, in consultation with the agency, shall adopt rules |
2030 | governing facility construction, staffing and licensure |
2031 | requirements, and the operation of such units for minors. |
2032 | (8)(10) The department, in consultation with the agency, |
2033 | must adopt rules governing a residential treatment center for |
2034 | children and adolescents which specify licensure standards for: |
2035 | admission; length of stay; program and staffing; discharge and |
2036 | discharge planning; treatment planning; seclusion, restraints, |
2037 | and time-out; rights of patients under s. 394.459; use of |
2038 | psychotropic medications; and standards for the operation of |
2039 | such centers. |
2040 | (9)(11) Notwithstanding the provisions of subsection (8), |
2041 | crisis stabilization units may not exceed their licensed |
2042 | capacity by more than 10 percent, nor may they exceed their |
2043 | licensed capacity for more than 3 consecutive working days or |
2044 | for more than 7 days in 1 month. |
2045 | (10)(12) Notwithstanding the other provisions of this |
2046 | section, any facility licensed under former chapter 396 and |
2047 | chapter 397 for detoxification, residential level I care, and |
2048 | outpatient treatment may elect to license concurrently all of |
2049 | the beds at such facility both for that purpose and as a long- |
2050 | term residential treatment facility pursuant to this section, if |
2051 | all of the following conditions are met: |
2052 | (a) The licensure application is received by the |
2053 | department prior to January 1, 1993. |
2054 | (b) On January 1, 1993, the facility was licensed under |
2055 | former chapter 396 and chapter 397 as a facility for |
2056 | detoxification, residential level I care, and outpatient |
2057 | treatment of substance abuse. |
2058 | (c) The facility restricted its practice to the treatment |
2059 | of law enforcement personnel for a period of at least 12 months |
2060 | beginning after January 1, 1992. |
2061 | (d) The number of beds to be licensed under this chapter |
2062 | is equal to or less than the number of beds licensed under |
2063 | former chapter 396 and chapter 397 as of January 1, 1993. |
2064 | (e) The licensee agrees in writing to a condition placed |
2065 | upon the license that the facility will limit its treatment |
2066 | exclusively to law enforcement personnel and their immediate |
2067 | families who are seeking admission on a voluntary basis and who |
2068 | are exhibiting symptoms of posttraumatic stress disorder or |
2069 | other mental health problems, including drug or alcohol abuse, |
2070 | which are directly related to law enforcement work and which are |
2071 | amenable to verbal treatment therapies; the licensee agrees to |
2072 | coordinate the provision of appropriate postresidential care for |
2073 | discharged individuals; and the licensee further agrees in |
2074 | writing that a failure to meet any condition specified in this |
2075 | paragraph shall constitute grounds for a revocation of the |
2076 | facility's license as a residential treatment facility. |
2077 | (f) The licensee agrees that the facility will meet all |
2078 | licensure requirements for a residential treatment facility, |
2079 | including minimum standards for compliance with lifesafety |
2080 | requirements, except those licensure requirements which are in |
2081 | express conflict with the conditions and other provisions |
2082 | specified in this subsection. |
2083 | (g) The licensee agrees that the conditions stated in this |
2084 | subsection must be agreed to in writing by any person acquiring |
2085 | the facility by any means. |
2086 |
|
2087 | Any facility licensed under this subsection is not required to |
2088 | provide any services to any persons except those included in the |
2089 | specified conditions of licensure, and is exempt from any |
2090 | requirements related to the 60-day or greater average length of |
2091 | stay imposed on community-based residential treatment facilities |
2092 | otherwise licensed under this chapter. |
2093 | (13) Each applicant for licensure must comply with the |
2094 | following requirements: |
2095 | (a) Upon receipt of a completed, signed, and dated |
2096 | application, the agency shall require background screening, in |
2097 | accordance with the level 2 standards for screening set forth in |
2098 | chapter 435, of the managing employee and financial officer, or |
2099 | other similarly titled individual who is responsible for the |
2100 | financial operation of the facility, including billings for |
2101 | client care and services. The applicant must comply with the |
2102 | procedures for level 2 background screening as set forth in |
2103 | chapter 435, as well as the requirements of s. 435.03(3). |
2104 | (b) The agency may require background screening of any |
2105 | other individual who is an applicant if the agency has probable |
2106 | cause to believe that he or she has been convicted of a crime or |
2107 | has committed any other offense prohibited under the level 2 |
2108 | standards for screening set forth in chapter 435. |
2109 | (c) Proof of compliance with the level 2 background |
2110 | screening requirements of chapter 435 which has been submitted |
2111 | within the previous 5 years in compliance with any other health |
2112 | care licensure requirements of this state is acceptable in |
2113 | fulfillment of the requirements of paragraph (a). |
2114 | (d) A provisional license may be granted to an applicant |
2115 | when each individual required by this section to undergo |
2116 | background screening has met the standards for the Department of |
2117 | Law Enforcement background check, but the agency has not yet |
2118 | received background screening results from the Federal Bureau of |
2119 | Investigation, or a request for a disqualification exemption has |
2120 | been submitted to the agency as set forth in chapter 435, but a |
2121 | response has not yet been issued. A standard license may be |
2122 | granted to the applicant upon the agency's receipt of a report |
2123 | of the results of the Federal Bureau of Investigation background |
2124 | screening for each individual required by this section to |
2125 | undergo background screening which confirms that all standards |
2126 | have been met, or upon the granting of a disqualification |
2127 | exemption by the agency as set forth in chapter 435. Any other |
2128 | person who is required to undergo level 2 background screening |
2129 | may serve in his or her capacity pending the agency's receipt of |
2130 | the report from the Federal Bureau of Investigation. However, |
2131 | the person may not continue to serve if the report indicates any |
2132 | violation of background screening standards and a |
2133 | disqualification exemption has not been requested of and granted |
2134 | by the agency as set forth in chapter 435. |
2135 | (e) Each applicant must submit to the agency, with its |
2136 | application, a description and explanation of any exclusions, |
2137 | permanent suspensions, or terminations of the applicant from the |
2138 | Medicare or Medicaid programs. Proof of compliance with the |
2139 | requirements for disclosure of ownership and control interests |
2140 | under the Medicaid or Medicare programs shall be accepted in |
2141 | lieu of this submission. |
2142 | (f) Each applicant must submit to the agency a description |
2143 | and explanation of any conviction of an offense prohibited under |
2144 | the level 2 standards of chapter 435 by a member of the board of |
2145 | directors of the applicant, its officers, or any individual |
2146 | owning 5 percent or more of the applicant. This requirement does |
2147 | not apply to a director of a not-for-profit corporation or |
2148 | organization if the director serves solely in a voluntary |
2149 | capacity for the corporation or organization, does not regularly |
2150 | take part in the day-to-day operational decisions of the |
2151 | corporation or organization, receives no remuneration for his or |
2152 | her services on the corporation or organization's board of |
2153 | directors, and has no financial interest and has no family |
2154 | members with a financial interest in the corporation or |
2155 | organization, provided that the director and the not-for-profit |
2156 | corporation or organization include in the application a |
2157 | statement affirming that the director's relationship to the |
2158 | corporation satisfies the requirements of this paragraph. |
2159 | (g) A license may not be granted to an applicant if the |
2160 | applicant or managing employee has been found guilty of, |
2161 | regardless of adjudication, or has entered a plea of nolo |
2162 | contendere or guilty to, any offense prohibited under the level |
2163 | 2 standards for screening set forth in chapter 435, unless an |
2164 | exemption from disqualification has been granted by the agency |
2165 | as set forth in chapter 435. |
2166 | (h) The agency may deny or revoke licensure if the |
2167 | applicant: |
2168 | 1. Has falsely represented a material fact in the |
2169 | application required by paragraph (e) or paragraph (f), or has |
2170 | omitted any material fact from the application required by |
2171 | paragraph (e) or paragraph (f); or |
2172 | 2. Has had prior action taken against the applicant under |
2173 | the Medicaid or Medicare program as set forth in paragraph (e). |
2174 | (i) An application for license renewal must contain the |
2175 | information required under paragraphs (e) and (f). |
2176 | Section 37. Section 394.876, Florida Statutes, is |
2177 | repealed. |
2178 | Section 38. Section 394.877, Florida Statutes, is amended |
2179 | to read: |
2180 | 394.877 Fees.-- |
2181 | (1) In accordance with s. 408.805, an applicant or |
2182 | licensee shall pay a fee for each license application submitted |
2183 | under this part, part II of chapter 408, and applicable rules. |
2184 | The amount of the fee shall be established by rule. Each |
2185 | application for licensure or renewal must be accompanied by a |
2186 | fee set by the department, in consultation with the agency, by |
2187 | rule. Such fees shall be reasonably calculated to cover only the |
2188 | cost of regulation under this chapter. |
2189 | (2) All fees collected under this section shall be |
2190 | deposited in the Health Care Trust Fund. |
2191 | Section 39. Section 394.878, Florida Statutes, is amended |
2192 | to read: |
2193 | 394.878 Issuance and renewal of licenses.-- |
2194 | (1) Upon review of the application for licensure and |
2195 | receipt of appropriate fees, the agency shall issue an original |
2196 | or renewal license to any applicant that meets the requirements |
2197 | of this chapter. |
2198 | (2) A license is valid for a period of 1 year. An |
2199 | applicant for renewal of a license shall apply to the agency no |
2200 | later than 90 days before expiration of the current license. |
2201 | (3) A license may not be transferred from one entity to |
2202 | another and is valid only for the premises for which it was |
2203 | originally issued. For the purposes of this subsection, |
2204 | "transfer" includes, but is not limited to, transfer of a |
2205 | majority of the ownership interests in a licensee or transfer of |
2206 | responsibilities under the license to another entity by |
2207 | contractual arrangement. |
2208 | (4) Each license shall state the services which the |
2209 | licensee is required or authorized to perform and the maximum |
2210 | residential capacity of the licensed premises. |
2211 | (1)(5) The agency may issue a probationary license to an |
2212 | applicant that has completed the application requirements of |
2213 | this chapter but has not, at the time of the application, |
2214 | developed an operational crisis stabilization unit or |
2215 | residential treatment facility. The probationary license shall |
2216 | expire 90 days after issuance and may once be renewed for an |
2217 | additional 90-day period. The agency may cancel a probationary |
2218 | license at any time. |
2219 | (2)(6) The agency may issue an interim license to an |
2220 | applicant that has substantially completed all application |
2221 | requirements and has initiated action to fully meet such |
2222 | requirements. The interim license shall expire 90 days after |
2223 | issuance and, in cases of extreme hardship, may once be renewed |
2224 | for an additional 90-day period. |
2225 | (7) Any applicant which fails to file an application for |
2226 | license renewal during the 90-day relicensure period shall be |
2227 | considered unlicensed and subject to penalties pursuant to s. |
2228 | 394.875. |
2229 | Section 40. Subsections (1), (3), and (4) of section |
2230 | 394.879, Florida Statutes, are amended to read: |
2231 | 394.879 Rules; enforcement.-- |
2232 | (1) The agency, in consultation with the department, may |
2233 | adopt rules to implement the requirements of part II of chapter |
2234 | 408. The department, in consultation with the agency, shall |
2235 | adopt rules pursuant to ss. 120.536(1) and 120.54 to implement |
2236 | the provisions of this chapter, including, at a minimum, rules |
2237 | providing standards to ensure that: |
2238 | (a) Sufficient numbers and types of qualified personnel |
2239 | are on duty and available at all times to provide necessary and |
2240 | adequate client safety and care. |
2241 | (b) Adequate space is provided each client of a licensed |
2242 | facility. |
2243 | (c) Licensed facilities are limited to an appropriate |
2244 | number of beds. |
2245 | (d) Each licensee establishes and implements adequate |
2246 | infection control, housekeeping, sanitation, disaster planning, |
2247 | and medical recordkeeping. |
2248 | (e) Licensed facilities are established, organized, and |
2249 | operated in accordance with programmatic standards of the |
2250 | department. |
2251 | (f) The operation and purposes of these facilities assure |
2252 | individuals' health, safety, and welfare. |
2253 | (3) The department, in consultation with the agency, shall |
2254 | allow any licensed facility in operation at the time of adoption |
2255 | of any rule a reasonable period, not to exceed 1 year, to bring |
2256 | itself into compliance with department rules such rule. |
2257 | (4) In accordance with part II of chapter 408, the agency |
2258 | may impose an administrative penalty of no more than $500 per |
2259 | day against any licensee that violates any rule adopted pursuant |
2260 | to this section and may suspend and or revoke the license and or |
2261 | deny the renewal application of such licensee. In imposing such |
2262 | penalty, the agency shall consider the severity of the |
2263 | violation, actions taken by the licensee to correct the |
2264 | violation, and previous violations by the licensee. Fines |
2265 | collected under this subsection shall be deposited in the Mental |
2266 | Health Facility Licensing Trust Fund. |
2267 | Section 41. Paragraph (a) of subsection (1) of section |
2268 | 394.90, Florida Statutes, is amended to read: |
2269 | 394.90 Inspection; right of entry; records.-- |
2270 | (1)(a) The department and the agency, in accordance with |
2271 | s. 408.811, may enter and inspect at any time a licensed |
2272 | facility to determine whether the facility is in compliance with |
2273 | this chapter and the applicable rules of the department. |
2274 | Section 42. Section 394.902, Florida Statutes, is |
2275 | repealed. |
2276 | Section 43. Subsection (7) of section 394.907, Florida |
2277 | Statutes, is amended to read: |
2278 | 394.907 Community mental health centers; quality assurance |
2279 | programs.-- |
2280 | (7) The department shall have access to all records |
2281 | necessary to determine licensee agency compliance with the |
2282 | provisions of this section. The records of quality assurance |
2283 | programs which relate solely to actions taken in carrying out |
2284 | the provisions of this section, and records obtained by the |
2285 | department to determine licensee agency compliance with this |
2286 | section, are confidential and exempt from s. 119.07(1). Such |
2287 | records are not admissible in any civil or administrative |
2288 | action, except in disciplinary proceedings by the Department of |
2289 | Business and Professional Regulation and the appropriate |
2290 | regulatory board, nor shall such records be available to the |
2291 | public as part of the record of investigation for, and |
2292 | prosecution in disciplinary proceedings made available to the |
2293 | public by the Department of Business and Professional Regulation |
2294 | or the appropriate regulatory board. Meetings or portions of |
2295 | meetings of quality assurance program committees that relate |
2296 | solely to actions taken pursuant to this section are exempt from |
2297 | s. 286.011. |
2298 | Section 44. Subsections (5) through (33) of section |
2299 | 395.002, Florida Statutes, are renumbered as subsections (4) |
2300 | through (32), respectively, and present subsections (4), (11), |
2301 | and (29) of said section are amended to read: |
2302 | 395.002 Definitions.--As used in this chapter: |
2303 | (4) "Applicant" means an individual applicant, or any |
2304 | officer, director, or agent, or any partner or shareholder |
2305 | having an ownership interest equal to a 5-percent or greater |
2306 | interest in the corporation, partnership, or other business |
2307 | entity. |
2308 | (10)(11) "General hospital" means any facility which meets |
2309 | the provisions of subsection (12) (13) and which regularly makes |
2310 | its facilities and services available to the general population. |
2311 | (28)(29) "Specialty hospital" means any facility which |
2312 | meets the provisions of subsection (12) (13), and which |
2313 | regularly makes available either: |
2314 | (a) The range of medical services offered by general |
2315 | hospitals, but restricted to a defined age or gender group of |
2316 | the population; |
2317 | (b) A restricted range of services appropriate to the |
2318 | diagnosis, care, and treatment of patients with specific |
2319 | categories of medical or psychiatric illnesses or disorders; or |
2320 | (c) Intensive residential treatment programs for children |
2321 | and adolescents as defined in subsection (15) (16). |
2322 | Section 45. Section 395.003, Florida Statutes, is amended |
2323 | to read: |
2324 | 395.003 Licensure; issuance, renewal, denial, |
2325 | modification, suspension, and revocation.-- |
2326 | (1)(a) The requirements of part II of chapter 408 shall |
2327 | apply to the provision of services that require licensure |
2328 | pursuant to ss. 395.001-395.1065 and part II of chapter 408 and |
2329 | to entities licensed by or applying for such licensure from the |
2330 | Agency for Health Care Administration pursuant to ss. 395.001- |
2331 | 395.1065. However, each applicant for licensure and each |
2332 | licensee is exempt from s. 408.810(7)-(9). Ambulatory surgical |
2333 | center and mobile surgical facility licensees and applicants for |
2334 | such licensure are also exempt from s. 408.810(10). A person may |
2335 | not establish, conduct, or maintain a hospital, ambulatory |
2336 | surgical center, or mobile surgical facility in this state |
2337 | without first obtaining a license under this part. |
2338 | (b)1. It is unlawful for a person to use or advertise to |
2339 | the public, in any way or by any medium whatsoever, any facility |
2340 | as a "hospital," "ambulatory surgical center," or "mobile |
2341 | surgical facility" unless such facility has first secured a |
2342 | license under the provisions of this part. |
2343 | 2. This part does not apply to veterinary hospitals or to |
2344 | commercial business establishments using the word "hospital," |
2345 | "ambulatory surgical center," or "mobile surgical facility" as a |
2346 | part of a trade name if no treatment of human beings is |
2347 | performed on the premises of such establishments. |
2348 | (c)3. By December 31, 2004, the agency shall submit a |
2349 | report to the President of the Senate and the Speaker of the |
2350 | House of Representatives recommending whether it is in the |
2351 | public interest to allow a hospital to license or operate an |
2352 | emergency department located off the premises of the hospital. |
2353 | If the agency finds it to be in the public interest, the report |
2354 | shall also recommend licensure criteria for such medical |
2355 | facilities, including criteria related to quality of care and, |
2356 | if deemed necessary, the elimination of the possibility of |
2357 | confusion related to the service capabilities of such facility |
2358 | in comparison to the service capabilities of an emergency |
2359 | department located on the premises of the hospital. Until July |
2360 | 1, 2005, additional emergency departments located off the |
2361 | premises of licensed hospitals may not be authorized by the |
2362 | agency. |
2363 | (2)(a) Upon the receipt of an application for a license |
2364 | and the license fee, the agency shall issue a license if the |
2365 | applicant and facility have received all approvals required by |
2366 | law and meet the requirements established under this part and in |
2367 | rules. Such license shall include all beds and services located |
2368 | on the premises of the facility. |
2369 | (b) A provisional license may be issued to a new facility |
2370 | or a facility that is in substantial compliance with this part |
2371 | and with the rules of the agency. A provisional license shall be |
2372 | granted for a period of no more than 1 year and shall expire |
2373 | automatically at the end of its term. A provisional license may |
2374 | not be renewed. |
2375 | (c) A license, unless sooner suspended or revoked, shall |
2376 | automatically expire 2 years from the date of issuance and shall |
2377 | be renewable biennially upon application for renewal and payment |
2378 | of the fee prescribed by s. 395.004(2), provided the applicant |
2379 | and licensed facility meet the requirements established under |
2380 | this part and in rules. An application for renewal of a license |
2381 | shall be made 90 days prior to expiration of the license, on |
2382 | forms provided by the agency. |
2383 | (a)(d) The agency shall, at the request of a licensee, |
2384 | issue a single license to a licensee for facilities located on |
2385 | separate premises. Such a license shall specifically state the |
2386 | location of the facilities, the services, and the licensed beds |
2387 | available on each separate premises. If a licensee requests a |
2388 | single license, the licensee shall designate which facility or |
2389 | office is responsible for receipt of information, payment of |
2390 | fees, service of process, and all other activities necessary for |
2391 | the agency to carry out the provisions of this part. |
2392 | (b)(e) The agency shall, at the request of a licensee that |
2393 | is a teaching hospital as defined in s. 408.07(44), issue a |
2394 | single license to a licensee for facilities that have been |
2395 | previously licensed as separate premises, provided such |
2396 | separately licensed facilities, taken together, constitute the |
2397 | same premises as defined in s. 395.002(23)(24). Such license for |
2398 | the single premises shall include all of the beds, services, and |
2399 | programs that were previously included on the licenses for the |
2400 | separate premises. The granting of a single license under this |
2401 | paragraph shall not in any manner reduce the number of beds, |
2402 | services, or programs operated by the licensee. |
2403 | (c)(f) Intensive residential treatment programs for |
2404 | children and adolescents which have received accreditation from |
2405 | the Joint Commission on Accreditation of Healthcare |
2406 | Organizations and which meet the minimum standards developed by |
2407 | rule of the agency for such programs shall be licensed by the |
2408 | agency under this part. |
2409 | (3)(a) Each license shall be valid only for the person to |
2410 | whom it is issued and shall not be sold, assigned, or otherwise |
2411 | transferred, voluntarily or involuntarily. A license is only |
2412 | valid for the premises for which it was originally issued. |
2413 | (b)1. An application for a new license is required if |
2414 | ownership, a majority of the ownership, or controlling interest |
2415 | of a licensed facility is transferred or assigned and when a |
2416 | lessee agrees to undertake or provide services to the extent |
2417 | that legal liability for operation of the facility rests with |
2418 | the lessee. The application for a new license showing such |
2419 | change shall be made at least 60 days prior to the date of the |
2420 | sale, transfer, assignment, or lease. |
2421 | (3)2. After a change of ownership has occurred, the |
2422 | transferee shall be liable for any liability to the state, |
2423 | regardless of when identified, resulting from changes to |
2424 | allowable costs affecting provider reimbursement for Medicaid |
2425 | participation or Public Medical Assistance Trust Fund |
2426 | Assessments, and related administrative fines. The transferee, |
2427 | simultaneously with the transfer of ownership, shall pay or make |
2428 | arrangements to pay to the agency or the department any amount |
2429 | owed to the agency or the department; payment assurances may be |
2430 | in the form of an irrevocable credit instrument or payment bond |
2431 | acceptable to the agency or the department provided by or on |
2432 | behalf of the transferor. The issuance of a license to the |
2433 | transferee shall be delayed pending payment or until arrangement |
2434 | for payment acceptable to the agency or the department is made. |
2435 | (4) The agency shall issue a license which specifies the |
2436 | service categories and the number of hospital beds in each bed |
2437 | category for which a license is received. Such information shall |
2438 | be listed on the face of the license. All beds which are not |
2439 | covered by any specialty-bed-need methodology shall be specified |
2440 | as general beds. A licensed facility shall not operate a number |
2441 | of hospital beds greater than the number indicated by the agency |
2442 | on the face of the license without approval from the agency |
2443 | under conditions established by rule. |
2444 | (5)(a) Adherence to patient rights, standards of care, and |
2445 | examination and placement procedures provided under part I of |
2446 | chapter 394 shall be a condition of licensure for hospitals |
2447 | providing voluntary or involuntary medical or psychiatric |
2448 | observation, evaluation, diagnosis, or treatment. |
2449 | (b) Any hospital that provides psychiatric treatment to |
2450 | persons under 18 years of age who have emotional disturbances |
2451 | shall comply with the procedures pertaining to the rights of |
2452 | patients prescribed in part I of chapter 394. |
2453 | (6) No specialty hospital shall provide any service or |
2454 | regularly serve any population group beyond those services or |
2455 | groups specified in its license. |
2456 | (7) Licenses shall be posted in a conspicuous place on |
2457 | each of the licensed premises. |
2458 | (7)(8) In addition to the requirements of part II of |
2459 | chapter 408, whenever the agency finds that there has been a |
2460 | substantial failure to comply with the requirements established |
2461 | under this part or in rules, the agency is authorized to deny, |
2462 | modify, suspend, and or revoke: |
2463 | (a) A license; |
2464 | (b) That part of a license which is limited to a separate |
2465 | premises, as designated on the license; or |
2466 | (c) Licensure approval limited to a facility, building, or |
2467 | portion thereof, or a service, within a given premises. |
2468 | (8)(9) A hospital may not be licensed or relicensed if: |
2469 | (a) The diagnosis-related groups for 65 percent or more of |
2470 | the discharges from the hospital, in the most recent year for |
2471 | which data is available to the Agency for Health Care |
2472 | Administration pursuant to s. 408.061, are for diagnosis, care, |
2473 | and treatment of patients who have: |
2474 | 1. Cardiac-related diseases and disorders classified as |
2475 | diagnosis-related groups 103-145, 478-479, 514-518, or 525-527; |
2476 | 2. Orthopedic-related diseases and disorders classified as |
2477 | diagnosis-related groups 209-256, 471, 491, 496-503, or 519-520; |
2478 | 3. Cancer-related diseases and disorders classified as |
2479 | diagnosis-related groups 64, 82, 172, 173, 199, 200, 203, 257- |
2480 | 260, 274, 275, 303, 306, 307, 318, 319, 338, 344, 346, 347, 363, |
2481 | 366, 367, 400-414, 473, or 492; or |
2482 | 4. Any combination of the above discharges. |
2483 | (b) The hospital restricts its medical and surgical |
2484 | services to primarily or exclusively cardiac, orthopedic, |
2485 | surgical, or oncology specialties. |
2486 | (9)(10) A hospital licensed as of June 1, 2004, shall be |
2487 | exempt from subsection (8) (9) as long as the hospital maintains |
2488 | the same ownership, facility street address, and range of |
2489 | services that were in existence on June 1, 2004. Any transfer of |
2490 | beds, or other agreements that result in the establishment of a |
2491 | hospital or hospital services within the intent of this section, |
2492 | shall be subject to subsection (8) (9). Unless the hospital is |
2493 | otherwise exempt under subsection (8) (9), the agency shall deny |
2494 | or revoke the license of a hospital that violates any of the |
2495 | criteria set forth in that subsection. |
2496 | (10)(11) The agency may adopt rules implementing the |
2497 | licensure requirements set forth in subsection (8) (9). Within |
2498 | 14 days after rendering its decision on a license application or |
2499 | revocation, the agency shall publish its proposed decision in |
2500 | the Florida Administrative Weekly. Within 21 days after |
2501 | publication of the agency's decision, any authorized person may |
2502 | file a request for an administrative hearing. In administrative |
2503 | proceedings challenging the approval, denial, or revocation of a |
2504 | license pursuant to subsection (8) (9), the hearing must be |
2505 | based on the facts and law existing at the time of the agency's |
2506 | proposed agency action. Existing hospitals may initiate or |
2507 | intervene in an administrative hearing to approve, deny, or |
2508 | revoke licensure under subsection (8) (9) based upon a showing |
2509 | that an established program will be substantially affected by |
2510 | the issuance or renewal of a license to a hospital within the |
2511 | same district or service area. |
2512 | Section 46. Section 395.004, Florida Statutes, is amended |
2513 | to read: |
2514 | 395.004 Application for license, fees; expenses.-- |
2515 | (1) In accordance with s. 408.805, an applicant or |
2516 | licensee shall pay a fee for each license application submitted |
2517 | under this part, part II of chapter 408, and applicable rules. |
2518 | The amount of the fee shall be established by rule. An |
2519 | application for a license or renewal thereof shall be made under |
2520 | oath to the agency, upon forms provided by it, and shall contain |
2521 | such information as the agency reasonably requires, which may |
2522 | include affirmative evidence of ability to comply with |
2523 | applicable laws and rules. |
2524 | (2) Each application for a general hospital license, |
2525 | specialty hospital license, ambulatory surgical center license, |
2526 | or mobile surgical facility license, or renewal thereof, shall |
2527 | be accompanied by a license fee, in accordance with the |
2528 | following schedule: |
2529 | (a) The biennial license, provisional license, and license |
2530 | renewal fee required of a facility licensed under this part |
2531 | shall be reasonably calculated to cover the cost of regulation |
2532 | under this part and shall be established by rule at the rate of |
2533 | not less than $9.50 per hospital bed, nor more than $30 per |
2534 | hospital bed, except that the minimum license fee shall be |
2535 | $1,500 and the total fees collected from all licensed facilities |
2536 | may not exceed the cost of properly carrying out the provisions |
2537 | of this part. |
2538 | (b) Such fees shall be paid to the agency and shall be |
2539 | deposited in the Planning and Regulation Trust Fund of the |
2540 | agency, which is hereby created, for the sole purpose of |
2541 | carrying out the provisions of this part. |
2542 | Section 47. Section 395.0055, Florida Statutes, is |
2543 | repealed. |
2544 | Section 48. Section 395.0161, Florida Statutes, is amended |
2545 | to read: |
2546 | 395.0161 Licensure inspection.-- |
2547 | (1) In accordance with s. 408.811, the agency shall make |
2548 | or cause to be made such inspections and investigations as it |
2549 | deems necessary, including: |
2550 | (a) Inspections directed by the Health Care Financing |
2551 | Administration. |
2552 | (b) Validation inspections. |
2553 | (c) Lifesafety inspections. |
2554 | (d) Licensure complaint investigations, including full |
2555 | licensure investigations with a review of all licensure |
2556 | standards as outlined in the administrative rules. Complaints |
2557 | received by the agency from individuals, organizations, or other |
2558 | sources are subject to review and investigation by the agency. |
2559 | (e) Emergency access complaint investigations. |
2560 | (f) inspections of mobile surgical facilities at each time |
2561 | a facility establishes a new location, prior to the admission of |
2562 | patients. However, such inspections shall not be required when a |
2563 | mobile surgical facility is moved temporarily to a location |
2564 | where medical treatment will not be provided. |
2565 | (2) The agency shall accept, in lieu of its own periodic |
2566 | inspections for licensure, the survey or inspection of an |
2567 | accrediting organization, provided the accreditation of the |
2568 | licensed facility is not provisional and provided the licensed |
2569 | facility authorizes release of, and the agency receives the |
2570 | report of, the accrediting organization. The agency shall |
2571 | develop, and adopt by rule, criteria for accepting survey |
2572 | reports of accrediting organizations in lieu of conducting a |
2573 | state licensure inspection. |
2574 | (3) In accordance with s. 408.805, an applicant or |
2575 | licensee shall pay a fee for each license application submitted |
2576 | under this part, part II of chapter 408, and applicable rules. |
2577 | With the exception of state-operated licensed facilities, each |
2578 | facility licensed under this part shall pay to the agency, at |
2579 | the time of inspection, the following fees: |
2580 | (a) Inspection for licensure.--A fee shall be paid which |
2581 | is not less than $8 per hospital bed, nor more than $12 per |
2582 | hospital bed, except that the minimum fee shall be $400 per |
2583 | facility. |
2584 | (b) Inspection for lifesafety only.--A fee shall be paid |
2585 | which is not less than 75 cents per hospital bed, nor more than |
2586 | $1.50 per hospital bed, except that the minimum fee shall be $40 |
2587 | per facility. |
2588 | (4) The agency shall coordinate all periodic inspections |
2589 | for licensure made by the agency to ensure that the cost to the |
2590 | facility of such inspections and the disruption of services by |
2591 | such inspections is minimized. |
2592 | Section 49. Section 395.0162, Florida Statutes, is |
2593 | repealed. |
2594 | Section 50. A licensee that failed to renew its ambulatory |
2595 | surgical center license may meet requirements of the Florida |
2596 | Building Code that were in effect at the time of original |
2597 | licensure for the purposes of an initial application if: |
2598 | (a) The license expired between July 1, 2004, and December |
2599 | 31, 2004. |
2600 | (b) The initial license application was filed within 30 |
2601 | days after the license expiration. |
2602 | (c) The ambulatory surgical center is in compliance with |
2603 | regulatory requirements based upon agency inspection. |
2604 |
|
2605 | This section only applies to the initial application for |
2606 | licensure and does not circumvent any requirement to meet |
2607 | current Florida Building Code requirements for renovations or |
2608 | other modifications. |
2609 | Section 51. Subsections (2) and (3) of section 395.0163, |
2610 | Florida Statutes, are amended to read: |
2611 | 395.0163 Construction inspections; plan submission and |
2612 | approval; fees.-- |
2613 | (2)(a) The agency is authorized to charge an initial fee |
2614 | of $2,000 for review of plans and construction on all projects, |
2615 | no part of which is refundable. The agency may also collect a |
2616 | fee, not to exceed 1 percent of the estimated construction cost |
2617 | or the actual cost of review, whichever is less, for the portion |
2618 | of the review which encompasses initial review through the |
2619 | initial revised construction document review. The agency is |
2620 | further authorized to collect its actual costs on all subsequent |
2621 | portions of the review and construction inspections. The initial |
2622 | fee payment shall accompany the initial submission of plans and |
2623 | specifications. Any subsequent payment that is due is payable |
2624 | upon receipt of the invoice from the agency. |
2625 | (b) Notwithstanding any other provisions of law to the |
2626 | contrary, all moneys received by the agency pursuant to the |
2627 | provisions of this section shall be deposited in the Planning |
2628 | and Regulation Trust Fund, as created by s. 395.004, to be held |
2629 | and applied solely for the operations required under this |
2630 | section. |
2631 | (3) In accordance with s. 408.811, the agency shall |
2632 | inspect a mobile surgical facility at initial licensure and at |
2633 | each time the facility establishes a new location, prior to |
2634 | admission of patients. However, such inspections shall not be |
2635 | required when a mobile surgical facility is moved temporarily to |
2636 | a location where medical treatment will not be provided. |
2637 | Section 52. Paragraph (c) of subsection (2) of section |
2638 | 395.0191, Florida Statutes, is redesignated as paragraph (d), |
2639 | and a new paragraph (c) is added to said subsection, to read: |
2640 | 395.0191 Staff membership and clinical privileges.-- |
2641 | (2) |
2642 | (c) A registered nurse licensed under part I of chapter |
2643 | 464 and qualified by training and experience in perioperative |
2644 | nursing as defined in s. 464.027(2)(a) shall be present in the |
2645 | operating room and function as the circulating nurse during all |
2646 | operative, surgical, or invasive procedures. |
2647 | Section 53. Subsections (4) and (6) of section 395.0193, |
2648 | Florida Statutes, are amended to read: |
2649 | 395.0193 Licensed facilities; peer review; disciplinary |
2650 | powers; agency or partnership with physicians.-- |
2651 | (4) Pursuant to ss. 458.337 and 459.016, any disciplinary |
2652 | actions taken under subsection (3) shall be reported in writing |
2653 | to the Department of Health Division of Health Quality Assurance |
2654 | of the agency within 30 working days after its initial |
2655 | occurrence, regardless of the pendency of appeals to the |
2656 | governing board of the hospital. The notification shall identify |
2657 | the disciplined practitioner, the action taken, and the reason |
2658 | for such action. All final disciplinary actions taken under |
2659 | subsection (3), if different from those which were reported to |
2660 | the department agency within 30 days after the initial |
2661 | occurrence, shall be reported within 10 working days to the |
2662 | Department of Health Division of Health Quality Assurance of the |
2663 | agency in writing and shall specify the disciplinary action |
2664 | taken and the specific grounds therefor. Final disciplinary |
2665 | actions shall be reported monthly to the Division of Health |
2666 | Quality Assurance of the agency. The division shall review each |
2667 | report and determine whether it potentially involved conduct by |
2668 | the licensee that is subject to disciplinary action, in which |
2669 | case s. 456.073 shall apply. The reports are not subject to |
2670 | inspection under s. 119.07(1) even if the division's |
2671 | investigation results in a finding of probable cause. |
2672 | (6) For a single incident or series of isolated incidents |
2673 | that are nonwillful violations of the reporting requirements of |
2674 | this section, the agency shall first seek to obtain corrective |
2675 | action by the facility. If correction is not demonstrated within |
2676 | the timeframe established by the agency or if there is a pattern |
2677 | of nonwillful violations of this section, the agency may impose |
2678 | an administrative fine, not to exceed $5,000 for any violation |
2679 | of the reporting requirements of this section. The |
2680 | administrative fine for repeated nonwillful violations shall not |
2681 | exceed $10,000 for any violation. The administrative fine for |
2682 | each intentional and willful violation may not exceed $25,000 |
2683 | per violation, per day. The fine for an intentional and willful |
2684 | violation of this section may not exceed $250,000. In |
2685 | determining the amount of fine to be levied, the agency shall be |
2686 | guided by s. 395.1065(1)(2)(b). |
2687 | Section 54. Subsection (12) of section 395.0197, Florida |
2688 | Statutes, is amended to read: |
2689 | 395.0197 Internal risk management program.-- |
2690 | (12) In addition to any penalty imposed pursuant to this |
2691 | section, the agency shall require a written plan of correction |
2692 | from the facility. For a single incident or series of isolated |
2693 | incidents that are nonwillful violations of the reporting |
2694 | requirements of this section, the agency shall first seek to |
2695 | obtain corrective action by the facility. If the correction is |
2696 | not demonstrated within the timeframe established by the agency |
2697 | or if there is a pattern of nonwillful violations of this |
2698 | section, the agency may impose an administrative fine, not to |
2699 | exceed $5,000 for any violation of the reporting requirements of |
2700 | this section. The administrative fine for repeated nonwillful |
2701 | violations shall not exceed $10,000 for any violation. The |
2702 | administrative fine for each intentional and willful violation |
2703 | may not exceed $25,000 per violation, per day. The fine for an |
2704 | intentional and willful violation of this section may not exceed |
2705 | $250,000. In determining the amount of fine to be levied, the |
2706 | agency shall be guided by s. 395.1065(1)(2)(b). |
2707 | Section 55. Section 395.0199, Florida Statutes, is amended |
2708 | to read: |
2709 | 395.0199 Private utilization review.-- |
2710 | (1) The purpose of this section is to: |
2711 | (a) Promote the delivery of quality health care in a cost- |
2712 | effective manner. |
2713 | (b) Foster greater coordination between providers and |
2714 | health insurers performing utilization review. |
2715 | (c) Protect patients and insurance providers by ensuring |
2716 | that private review agents are qualified to perform utilization |
2717 | review activities and to make informed decisions on the |
2718 | appropriateness of medical care. |
2719 | (d) This section does not regulate the activities of |
2720 | private review agents, health insurers, health maintenance |
2721 | organizations, or hospitals, except as expressly provided |
2722 | herein, or authorize regulation or intervention as to the |
2723 | correctness of utilization review decisions of insurers or |
2724 | private review agents. |
2725 | (2) The requirements of part II of chapter 408 shall apply |
2726 | to the provision of services that require registration or |
2727 | licensure pursuant to this section and part II of chapter 408 |
2728 | and to persons registered by or applying for such registration |
2729 | from the Agency for Health Care Administration pursuant to this |
2730 | section. However, each applicant for registration and registrant |
2731 | is exempt from the provisions of ss. 408.806(1)(e)2., |
2732 | 408.810(5)-(10), and 408.811. A private review agent conducting |
2733 | utilization review as to health care services performed or |
2734 | proposed to be performed in this state shall register with the |
2735 | agency in accordance with this section. |
2736 | (3) In accordance with s. 408.805, an applicant for |
2737 | registration or registrant shall pay a fee for each registration |
2738 | application submitted under this section, part II of chapter |
2739 | 408, and applicable rules. The amount of the fee shall be |
2740 | established by rule Registration shall be made annually with the |
2741 | agency on forms furnished by the agency and shall be accompanied |
2742 | by the appropriate registration fee as set by the agency. The |
2743 | fee and shall be sufficient to pay for the administrative costs |
2744 | of registering the agent, but shall not exceed $250. The agency |
2745 | may also charge reasonable fees, reflecting actual costs, to |
2746 | persons requesting copies of registration. |
2747 | (4) Each applicant for registration must comply with the |
2748 | following requirements: |
2749 | (a) Upon receipt of a completed, signed, and dated |
2750 | application, the agency shall require background screening, in |
2751 | accordance with the level 2 standards for screening set forth in |
2752 | chapter 435, of the managing employee or other similarly titled |
2753 | individual who is responsible for the operation of the entity. |
2754 | The applicant must comply with the procedures for level 2 |
2755 | background screening as set forth in chapter 435, as well as the |
2756 | requirements of s. 435.03(3). |
2757 | (b) The agency may require background screening of any |
2758 | other individual who is an applicant, if the agency has probable |
2759 | cause to believe that he or she has been convicted of a crime or |
2760 | has committed any other offense prohibited under the level 2 |
2761 | standards for screening set forth in chapter 435. |
2762 | (c) Proof of compliance with the level 2 background |
2763 | screening requirements of chapter 435 which has been submitted |
2764 | within the previous 5 years in compliance with any other health |
2765 | care licensure requirements of this state is acceptable in |
2766 | fulfillment of the requirements of paragraph (a). |
2767 | (d) A provisional registration may be granted to an |
2768 | applicant when each individual required by this section to |
2769 | undergo background screening has met the standards for the |
2770 | Department of Law Enforcement background check, but the agency |
2771 | has not yet received background screening results from the |
2772 | Federal Bureau of Investigation, or a request for a |
2773 | disqualification exemption has been submitted to the agency as |
2774 | set forth in chapter 435 but a response has not yet been issued. |
2775 | A standard registration may be granted to the applicant upon the |
2776 | agency's receipt of a report of the results of the Federal |
2777 | Bureau of Investigation background screening for each individual |
2778 | required by this section to undergo background screening which |
2779 | confirms that all standards have been met, or upon the granting |
2780 | of a disqualification exemption by the agency as set forth in |
2781 | chapter 435. Any other person who is required to undergo level 2 |
2782 | background screening may serve in his or her capacity pending |
2783 | the agency's receipt of the report from the Federal Bureau of |
2784 | Investigation. However, the person may not continue to serve if |
2785 | the report indicates any violation of background screening |
2786 | standards and a disqualification exemption has not been |
2787 | requested of and granted by the agency as set forth in chapter |
2788 | 435. |
2789 | (e) Each applicant must submit to the agency, with its |
2790 | application, a description and explanation of any exclusions, |
2791 | permanent suspensions, or terminations of the applicant from the |
2792 | Medicare or Medicaid programs. Proof of compliance with the |
2793 | requirements for disclosure of ownership and control interests |
2794 | under the Medicaid or Medicare programs shall be accepted in |
2795 | lieu of this submission. |
2796 | (f) Each applicant must submit to the agency a description |
2797 | and explanation of any conviction of an offense prohibited under |
2798 | the level 2 standards of chapter 435 by a member of the board of |
2799 | directors of the applicant, its officers, or any individual |
2800 | owning 5 percent or more of the applicant. This requirement does |
2801 | not apply to a director of a not-for-profit corporation or |
2802 | organization if the director serves solely in a voluntary |
2803 | capacity for the corporation or organization, does not regularly |
2804 | take part in the day-to-day operational decisions of the |
2805 | corporation or organization, receives no remuneration for his or |
2806 | her services on the corporation or organization's board of |
2807 | directors, and has no financial interest and has no family |
2808 | members with a financial interest in the corporation or |
2809 | organization, provided that the director and the not-for-profit |
2810 | corporation or organization include in the application a |
2811 | statement affirming that the director's relationship to the |
2812 | corporation satisfies the requirements of this paragraph. |
2813 | (g) A registration may not be granted to an applicant if |
2814 | the applicant or managing employee has been found guilty of, |
2815 | regardless of adjudication, or has entered a plea of nolo |
2816 | contendere or guilty to, any offense prohibited under the level |
2817 | 2 standards for screening set forth in chapter 435, unless an |
2818 | exemption from disqualification has been granted by the agency |
2819 | as set forth in chapter 435. |
2820 | (h) The agency may deny or revoke the registration if any |
2821 | applicant: |
2822 | 1. Has falsely represented a material fact in the |
2823 | application required by paragraph (e) or paragraph (f), or has |
2824 | omitted any material fact from the application required by |
2825 | paragraph (e) or paragraph (f); or |
2826 | 2. Has had prior action taken against the applicant under |
2827 | the Medicaid or Medicare program as set forth in paragraph (e). |
2828 | (i) An application for registration renewal must contain |
2829 | the information required under paragraphs (e) and (f). |
2830 | (4)(5) Registration shall include the following: |
2831 | (a) A description of the review policies and procedures to |
2832 | be used in evaluating proposed or delivered hospital care. |
2833 | (b) The name, address, and telephone number of the |
2834 | utilization review agent performing utilization review, who |
2835 | shall be at least: |
2836 | 1. A licensed practical nurse or licensed registered |
2837 | nurse, or other similarly qualified medical records or health |
2838 | care professionals, for performing initial review when |
2839 | information is necessary from the physician or hospital to |
2840 | determine the medical necessity or appropriateness of hospital |
2841 | services; or |
2842 | 2. A licensed physician, or a licensed physician |
2843 | practicing in the field of psychiatry for review of mental |
2844 | health services, for an initial denial determination prior to a |
2845 | final denial determination by the health insurer and which shall |
2846 | include the written evaluation and findings of the reviewing |
2847 | physician. |
2848 | (c) A description of an appeal procedure for patients or |
2849 | health care providers whose services are under review, who may |
2850 | appeal an initial denial determination prior to a final |
2851 | determination by the health insurer with whom the private review |
2852 | agent has contracted. The appeal procedure shall provide for |
2853 | review by a licensed physician, or by a licensed physician |
2854 | practicing in the field of psychiatry for review of mental |
2855 | health services, and shall include the written evaluation and |
2856 | findings of the reviewing physician. |
2857 | (d) A designation of the times when the staff of the |
2858 | utilization review agent will be available by toll-free |
2859 | telephone, which shall include at least 40 hours per week during |
2860 | the normal business hours of the agent. |
2861 | (e) An acknowledgment and agreement that any private |
2862 | review agent which, as a general business practice, fails to |
2863 | adhere to the policies, procedures, and representations made in |
2864 | its application for registration shall have its registration |
2865 | revoked. |
2866 | (f) Disclosure of any incentive payment provision or quota |
2867 | provision which is contained in the agent's contract with a |
2868 | health insurer and is based on reduction or denial of services, |
2869 | reduction of length of stay, or selection of treatment setting. |
2870 | (g) Updates of any material changes to review policies or |
2871 | procedures. |
2872 | (6) The agency may impose fines or suspend or revoke the |
2873 | registration of any private review agent in violation of this |
2874 | section. Any private review agent failing to register or update |
2875 | registration as required by this section shall be deemed to be |
2876 | within the jurisdiction of the agency and subject to an |
2877 | administrative penalty not to exceed $1,000. The agency may |
2878 | bring actions to enjoin activities of private review agents in |
2879 | violation of this section. |
2880 | (5)(7) No insurer shall knowingly contract with or utilize |
2881 | a private review agent which has failed to register as required |
2882 | by this section or which has had a registration revoked by the |
2883 | agency. |
2884 | (6)(8) A private review agent which operates under |
2885 | contract with the federal or state government for utilization |
2886 | review of patients eligible for hospital or other services under |
2887 | Title XVIII or Title XIX of the Social Security Act is exempt |
2888 | from the provisions of this section for services provided under |
2889 | such contract. A private review agent which provides utilization |
2890 | review services to the federal or state government and a private |
2891 | insurer shall not be exempt for services provided to |
2892 | nonfederally funded patients. This section shall not apply to |
2893 | persons who perform utilization review services for medically |
2894 | necessary hospital services provided to injured workers pursuant |
2895 | to chapter 440 and shall not apply to self-insurance funds or |
2896 | service companies authorized pursuant to chapter 440 or part VII |
2897 | of chapter 626. |
2898 | (7)(9) Facilities licensed under this chapter shall |
2899 | promptly comply with the requests of utilization review agents |
2900 | or insurers which are reasonably necessary to facilitate prompt |
2901 | accomplishment of utilization review activities. |
2902 | (8)(10) The agency shall adopt rules to implement the |
2903 | provisions of this section. |
2904 | Section 56. Section 395.1046, Florida Statutes, is amended |
2905 | to read: |
2906 | 395.1046 Complaint investigation procedures.-- |
2907 | (1) In accordance with s. 408.811, the agency shall |
2908 | investigate any complaint against a hospital for any violation |
2909 | of s. 395.1041 that the agency reasonably believes to be legally |
2910 | sufficient. A complaint is legally sufficient if it contains |
2911 | ultimate facts that which show that a violation of this section |
2912 | chapter, or any rule adopted under this chapter by the agency |
2913 | under this section, has occurred. The agency may investigate, or |
2914 | continue to investigate, and may take appropriate final action |
2915 | on a complaint, even though the original complainant withdraws |
2916 | his or her complaint or otherwise indicates his or her desire |
2917 | not to cause it to be investigated to completion. When an |
2918 | investigation of any person or facility is undertaken, the |
2919 | agency shall notify such person in writing of the investigation |
2920 | and inform the person or facility in writing of the substance, |
2921 | the facts which show that a violation has occurred, and the |
2922 | source of any complaint filed against him or her. The agency may |
2923 | conduct an investigation without notification to any person if |
2924 | the act under investigation is a criminal offense. The agency |
2925 | shall have access to all records necessary for the investigation |
2926 | of the complaint. |
2927 | (2) The agency or its agent shall expeditiously |
2928 | investigate each complaint against a hospital for a violation of |
2929 | s. 395.1041. When its investigation is complete, the agency |
2930 | shall prepare an investigative report. The report shall contain |
2931 | the investigative findings and the recommendations of the agency |
2932 | concerning the existence of probable cause. |
2933 | (3) The complaint and all information obtained by the |
2934 | agency during an investigation conducted pursuant to this |
2935 | section are exempt from the provisions of s. 119.07(1) and s. |
2936 | 24(a), Art. I of the State Constitution until 10 days after the |
2937 | facility has been determined by the agency to be out of |
2938 | compliance with regulatory requirements probable cause has been |
2939 | found to exist by the agency, or until the person who is the |
2940 | subject of the investigation waives his or her privilege of |
2941 | confidentiality, whichever occurs first. In cases where the |
2942 | agency finds that the complaint is either not legally sufficient |
2943 | or does not demonstrate the facility's noncompliance with |
2944 | regulatory requirements when the agency determines that no |
2945 | probable cause exists, all records pertaining thereto are |
2946 | confidential and exempt from the provisions of s. 119.07(1) and |
2947 | s. 24(a), Art. I of the State Constitution. However, the |
2948 | complaint and a summary of the agency's findings shall be |
2949 | available, although information therein identifying an |
2950 | individual shall not be disclosed. |
2951 | Section 57. Subsections (1) and (7) of section 395.1055, |
2952 | Florida Statutes, are amended to read: |
2953 | 395.1055 Rules and enforcement.-- |
2954 | (1) The agency shall adopt rules pursuant to ss. |
2955 | 120.536(1) and 120.54 to implement the provisions of this part |
2956 | and part II of chapter 408, which shall include reasonable and |
2957 | fair minimum standards for ensuring that: |
2958 | (a) Sufficient numbers and qualified types of personnel |
2959 | and occupational disciplines are on duty and available at all |
2960 | times to provide necessary and adequate patient care and safety. |
2961 | (b) Infection control, housekeeping, sanitary conditions, |
2962 | and medical record procedures that will adequately protect |
2963 | patient care and safety are established and implemented. |
2964 | (c) A comprehensive emergency management plan is prepared |
2965 | and updated annually. Such standards must be included in the |
2966 | rules adopted by the agency after consulting with the Department |
2967 | of Community Affairs. At a minimum, the rules must provide for |
2968 | plan components that address emergency evacuation |
2969 | transportation; adequate sheltering arrangements; postdisaster |
2970 | activities, including emergency power, food, and water; |
2971 | postdisaster transportation; supplies; staffing; emergency |
2972 | equipment; individual identification of residents and transfer |
2973 | of records, and responding to family inquiries. The |
2974 | comprehensive emergency management plan is subject to review and |
2975 | approval by the local emergency management agency. During its |
2976 | review, the local emergency management agency shall ensure that |
2977 | the following agencies, at a minimum, are given the opportunity |
2978 | to review the plan: the Department of Elderly Affairs, the |
2979 | Department of Health, the Agency for Health Care Administration, |
2980 | and the Department of Community Affairs. Also, appropriate |
2981 | volunteer organizations must be given the opportunity to review |
2982 | the plan. The local emergency management agency shall complete |
2983 | its review within 60 days and either approve the plan or advise |
2984 | the facility of necessary revisions. |
2985 | (d) Licensed facilities are established, organized, and |
2986 | operated consistent with established standards and rules. |
2987 | (e) Licensed facility beds conform to minimum space, |
2988 | equipment, and furnishings standards as specified by the |
2989 | department. |
2990 | (f) All hospitals submit such data as necessary to conduct |
2991 | certificate-of-need reviews required under part I of chapter 408 |
2992 | ss. 408.031-408.045. Such data shall include, but shall not be |
2993 | limited to, patient origin data, hospital utilization data, type |
2994 | of service reporting, and facility staffing data. The agency |
2995 | shall not collect data that identifies or could disclose the |
2996 | identity of individual patients. The agency shall utilize |
2997 | existing uniform statewide data sources when available and shall |
2998 | minimize reporting costs to hospitals. |
2999 | (g) Each hospital has a quality improvement program |
3000 | designed according to standards established by their current |
3001 | accrediting organization. This program will enhance quality of |
3002 | care and emphasize quality patient outcomes, corrective action |
3003 | for problems, governing board review, and reporting to the |
3004 | agency of standardized data elements necessary to analyze |
3005 | quality of care outcomes. The agency shall use existing data, |
3006 | when available, and shall not duplicate the efforts of other |
3007 | state agencies in order to obtain such data. |
3008 | (h) Licensed facilities make available on their Internet |
3009 | websites, no later than October 1, 2004, and in a hard copy |
3010 | format upon request, a description of and a link to the patient |
3011 | charge and performance outcome data collected from licensed |
3012 | facilities pursuant to s. 408.061. |
3013 | (7) The agency shall enforce compliance with the |
3014 | provisions of s. 381.005(2) and rules adopted thereunder with |
3015 | respect to immunizations against the influenza virus and |
3016 | pneumococcal bacteria. Any licensed facility which is in |
3017 | operation at the time of promulgation of any applicable rules |
3018 | under this part shall be given a reasonable time, under the |
3019 | particular circumstances, but not to exceed 1 year from the date |
3020 | of such promulgation, within which to comply with such rules. |
3021 | Section 58. Section 395.1065, Florida Statutes, is amended |
3022 | to read: |
3023 | 395.1065 Criminal and Administrative penalties; |
3024 | injunctions; emergency orders; moratorium.-- |
3025 | (1) Any person establishing, conducting, managing, or |
3026 | operating any facility without a license under this part is |
3027 | guilty of a misdemeanor and, upon conviction, shall be fined not |
3028 | more than $500 for the first offense and not more than $1,000 |
3029 | for each subsequent offense, and each day of continuing |
3030 | violation after conviction shall be considered a separate |
3031 | offense. |
3032 | (1)(2)(a) The agency may deny, revoke, or suspend a |
3033 | license or impose an administrative fine, not to exceed $1,000 |
3034 | per violation, per day, for the violation of any provision of |
3035 | this part, part II of chapter 408, or applicable rules adopted |
3036 | under this part. Each day of violation constitutes a separate |
3037 | violation and is subject to a separate fine. |
3038 | (b) In determining the amount of fine to be levied for a |
3039 | violation, as provided in paragraph (a), the following factors |
3040 | shall be considered: |
3041 | 1. The severity of the violation, including the |
3042 | probability that death or serious harm to the health or safety |
3043 | of any person will result or has resulted, the severity of the |
3044 | actual or potential harm, and the extent to which the provisions |
3045 | of this part were violated. |
3046 | 2. Actions taken by the licensee to correct the violations |
3047 | or to remedy complaints. |
3048 | 3. Any previous violations of the licensee. |
3049 | (c) All amounts collected pursuant to this section shall |
3050 | be deposited into the Planning and Regulation Trust Fund, as |
3051 | created by s. 395.004. |
3052 | (c)(d) The agency may impose an administrative fine for |
3053 | the violation of s. 641.3154 or, if sufficient claims due to a |
3054 | provider from a health maintenance organization do not exist to |
3055 | enable the take-back of an overpayment, as provided under s. |
3056 | 641.3155(5), for the violation of s. 641.3155(5). The |
3057 | administrative fine for a violation cited in this paragraph |
3058 | shall be in the amounts specified in s. 641.52(5), and the |
3059 | provisions of paragraph (a) do not apply. |
3060 | (2)(3) Notwithstanding the existence or pursuit of any |
3061 | other remedy, the agency may maintain an action in the name of |
3062 | the state for injunction or other process to enforce the |
3063 | provisions of this part, part II of chapter 408, and applicable |
3064 | rules promulgated hereunder. |
3065 | (4) The agency may issue an emergency order immediately |
3066 | suspending or revoking a license when it determines that any |
3067 | condition in the licensed facility presents a clear and present |
3068 | danger to public health and safety. |
3069 | (5) The agency may impose an immediate moratorium on |
3070 | elective admissions to any licensed facility, building, or |
3071 | portion thereof, or service, when the agency determines that any |
3072 | condition in the facility presents a threat to public health or |
3073 | safety. |
3074 | (3)(6) In seeking to impose penalties against a facility |
3075 | as defined in s. 394.455 for a violation of part I of chapter |
3076 | 394, the agency is authorized to rely on the investigation and |
3077 | findings by the Department of Health in lieu of conducting its |
3078 | own investigation. |
3079 | (4)(7) The agency shall impose a fine of $500 for each |
3080 | instance of the facility's failure to provide the information |
3081 | required by rules adopted pursuant to s. 395.1055(1)(h). |
3082 | Section 59. Subsection (1) of section 395.10973, Florida |
3083 | Statutes, is amended to read: |
3084 | 395.10973 Powers and duties of the agency.--It is the |
3085 | function of the agency to: |
3086 | (1) Adopt rules pursuant to ss. 120.536(1) and 120.54 to |
3087 | implement the provisions of this part and part II of chapter 408 |
3088 | conferring duties upon it. |
3089 | Section 60. Section 395.10974, Florida Statutes, is |
3090 | amended to read: |
3091 | 395.10974 Health care risk managers; qualifications, |
3092 | licensure, fees.-- |
3093 | (1) The requirements of part II of chapter 408 shall apply |
3094 | to the provision of services that require licensure pursuant to |
3095 | ss. 395.10971?395.10976 and part II of chapter 408 and to |
3096 | entities licensed by or applying for such licensure from the |
3097 | Agency for Health Care Administration pursuant to ss. 395.10971? |
3098 | 395.10976. Any person desiring to be licensed as a health care |
3099 | risk manager shall submit an application on a form provided by |
3100 | the agency. In order to qualify for licensure, the applicant |
3101 | shall submit evidence satisfactory to the agency that which |
3102 | demonstrates the applicant's competence, by education or |
3103 | experience, in the following areas: |
3104 | (a) Applicable standards of health care risk management. |
3105 | (b) Applicable federal, state, and local health and safety |
3106 | laws and rules. |
3107 | (c) General risk management administration. |
3108 | (d) Patient care. |
3109 | (e) Medical care. |
3110 | (f) Personal and social care. |
3111 | (g) Accident prevention. |
3112 | (h) Departmental organization and management. |
3113 | (i) Community interrelationships. |
3114 | (j) Medical terminology. |
3115 |
|
3116 | Each applicant for licensure and licensee must comply with all |
3117 | provisions of part II of chapter 408 except ss. 408.806(1)(e)2., |
3118 | 408.810, and 408.811. The agency may require such additional |
3119 | information, from the applicant or any other person, as may be |
3120 | reasonably required to verify the information contained in the |
3121 | application. |
3122 | (2) The agency shall not grant or issue a license as a |
3123 | health care risk manager to any individual unless from the |
3124 | application it affirmatively appears that the applicant: |
3125 | (a) Is 18 years of age or over; |
3126 | (b) Is a high school graduate or equivalent; and |
3127 | (c)1. Has fulfilled the requirements of a 1-year program |
3128 | or its equivalent in health care risk management training which |
3129 | may be developed or approved by the agency; |
3130 | 2. Has completed 2 years of college-level studies which |
3131 | would prepare the applicant for health care risk management, to |
3132 | be further defined by rule; or |
3133 | 3. Has obtained 1 year of practical experience in health |
3134 | care risk management. |
3135 | (3) The agency shall issue a license to practice health |
3136 | care risk management to any applicant who qualifies under this |
3137 | section. In accordance with s. 408.805, an applicant or licensee |
3138 | shall pay a fee for each license application submitted under |
3139 | this part, part II of chapter 408, and applicable rules. The |
3140 | amount of the fee shall be established by rule as follows: and |
3141 | submits an application fee of not more than $75, a background |
3142 | screening fingerprinting fee of not more than $75, and a license |
3143 | fee of not more than $100. The agency shall by rule establish |
3144 | fees and procedures for the issuance and cancellation of |
3145 | licenses. |
3146 | (4) The agency shall renew a health care risk manager |
3147 | license upon receipt of a biennial renewal application and fees. |
3148 | The agency shall by rule establish a procedure for the biennial |
3149 | renewal of licenses. |
3150 | Section 61. Subsections (6) through (19) of section |
3151 | 400.021, Florida Statutes, are renumbered as subsections (5) |
3152 | through (18), respectively, and present subsections (5) and (20) |
3153 | of said section are amended to read: |
3154 | 400.021 Definitions.--When used in this part, unless the |
3155 | context otherwise requires, the term: |
3156 | (5) "Controlling interest" means: |
3157 | (a) The applicant for licensure or a licensee; |
3158 | (b) A person or entity that serves as an officer of, is on |
3159 | the board of directors of, or has a 5 percent or greater |
3160 | ownership interest in the management company or other entity, |
3161 | related or unrelated, which the applicant or licensee may |
3162 | contract with to operate the facility; or |
3163 | (c) A person or entity that serves as an officer of, is on |
3164 | the board of directors of, or has a 5 percent or greater |
3165 | ownership interest in the applicant or licensee. |
3166 |
|
3167 | The term does not include a voluntary board member. |
3168 | (20) "Voluntary board member" means a director of a not- |
3169 | for-profit corporation or organization who serves solely in a |
3170 | voluntary capacity for the corporation or organization, does not |
3171 | receive any remuneration for his or her services on the board of |
3172 | directors, and has no financial interest in the corporation or |
3173 | organization. The agency shall recognize a person as a voluntary |
3174 | board member following submission of a statement to the agency |
3175 | by the director and the not-for-profit corporation or |
3176 | organization which affirms that the director conforms to this |
3177 | definition. The statement affirming the status of the director |
3178 | must be submitted to the agency on a form provided by the |
3179 | agency. |
3180 | Section 62. Paragraph (c) of subsection (2) of section |
3181 | 395.602, Florida Statutes, is amended to read: |
3182 | 395.602 Rural hospitals.-- |
3183 | (2) DEFINITIONS.--As used in this part: |
3184 | (c) "Inactive rural hospital bed" means a licensed acute |
3185 | care hospital bed, as defined in s. 395.002(13)(14), that is |
3186 | inactive in that it cannot be occupied by acute care inpatients. |
3187 | Section 63. Paragraph (c) of subsection (1) of section |
3188 | 395.701, Florida Statutes, is amended to read: |
3189 | 395.701 Annual assessments on net operating revenues for |
3190 | inpatient and outpatient services to fund public medical |
3191 | assistance; administrative fines for failure to pay assessments |
3192 | when due; exemption.-- |
3193 | (1) For the purposes of this section, the term: |
3194 | (c) "Hospital" means a health care institution as defined |
3195 | in s. 395.002(12)(13), but does not include any hospital |
3196 | operated by the agency or the Department of Corrections. |
3197 | Section 64. Subsection (3) of section 400.022, Florida |
3198 | Statutes, is amended to read: |
3199 | 400.022 Residents' rights.-- |
3200 | (3) Any violation of the resident's rights set forth in |
3201 | this section shall constitute grounds for action by the agency |
3202 | under the provisions of s. 400.102, s. 400.121, or part II of |
3203 | chapter 408. In order to determine whether the licensee is |
3204 | adequately protecting residents' rights, the licensure annual |
3205 | inspection of the facility shall include private informal |
3206 | conversations with a sample of residents to discuss residents' |
3207 | experiences within the facility with respect to rights specified |
3208 | in this section and general compliance with standards, and |
3209 | consultation with the ombudsman council in the local planning |
3210 | and service area of the Department of Elderly Affairs in which |
3211 | the nursing home is located. |
3212 | Section 65. Paragraph (b) of subsection (1) of section |
3213 | 400.051, Florida Statutes, is amended to read: |
3214 | 400.051 Homes or institutions exempt from the provisions |
3215 | of this part.-- |
3216 | (1) The following shall be exempt from the provisions of |
3217 | this part: |
3218 | (b) Any hospital, as defined in s. 395.002(11), that is |
3219 | licensed under chapter 395. |
3220 | Section 66. Section 400.062, Florida Statutes, is amended |
3221 | to read: |
3222 | 400.062 License required; fee; disposition; display; |
3223 | transfer.-- |
3224 | (1) The requirements of part II of chapter 408 shall apply |
3225 | to the provision of services that require licensure pursuant to |
3226 | this part and part II of chapter 408 and to entities licensed by |
3227 | or applying for such licensure from the Agency for Health Care |
3228 | Administration pursuant to this part. However, each applicant |
3229 | for licensure and each licensee is exempt from s. 408.810(7). It |
3230 | is unlawful to operate or maintain a facility without first |
3231 | obtaining from the agency a license authorizing such operation. |
3232 | (2) Separate licenses shall be required for facilities |
3233 | maintained in separate premises, even though operated under the |
3234 | same management. However, a separate license shall not be |
3235 | required for separate buildings on the same grounds. |
3236 | (3) In accordance with s. 408.805, an applicant or |
3237 | licensee shall pay a fee for each license application submitted |
3238 | under this part, part II of chapter 408, and applicable rules. |
3239 | The annual license fee required for each license issued under |
3240 | this part shall be comprised of two parts. Part I of the license |
3241 | fee shall be the basic license fee. The rate per bed for the |
3242 | basic license fee shall be established biennially annually and |
3243 | shall be $100 $50 per bed unless modified by rule. The agency |
3244 | may adjust the per bed licensure fees by the Consumer Price |
3245 | Index based on the 12 months immediately preceding the increase |
3246 | to cover the cost of regulation under this part. Part II of the |
3247 | license fee shall be the resident protection fee, which shall be |
3248 | at the rate of not less than 50 25 cents per bed. The rate per |
3249 | bed shall be the minimum rate per bed, and such rate shall |
3250 | remain in effect until the effective date of a rate per bed |
3251 | adopted by rule by the agency pursuant to this part. At such |
3252 | time as the amount on deposit in the Resident Protection Trust |
3253 | Fund is less than $1 million, the agency may adopt rules to |
3254 | establish a rate which may not exceed $20 $10 per bed. The rate |
3255 | per bed shall revert back to the minimum rate per bed when the |
3256 | amount on deposit in the Resident Protection Trust Fund reaches |
3257 | $1 million, except that any rate established by rule shall |
3258 | remain in effect until such time as the rate has been equally |
3259 | required for each license issued under this part. Any amount in |
3260 | the fund in excess of $2 million shall revert to the Health Care |
3261 | Trust Fund and may not be expended without prior approval of the |
3262 | Legislature. The agency may prorate the biennial annual license |
3263 | fee for those licenses which it issues under this part for less |
3264 | than 2 years 1 year. Funds generated by license fees collected |
3265 | in accordance with this section shall be deposited in the |
3266 | following manner: |
3267 | (a) The basic license fee collected shall be deposited in |
3268 | the Health Care Trust Fund, established for the sole purpose of |
3269 | carrying out this part. When the balance of the account |
3270 | established in the Health Care Trust Fund for the deposit of |
3271 | fees collected as authorized under this section exceeds one- |
3272 | third of the annual cost of regulation under this part, the |
3273 | excess shall be used to reduce the licensure fees in the next |
3274 | year. |
3275 | (b) The resident protection fee collected shall be |
3276 | deposited in the Resident Protection Trust Fund for the sole |
3277 | purpose of paying, in accordance with the provisions of s. |
3278 | 400.063, for the appropriate alternate placement, care, and |
3279 | treatment of a resident removed from a nursing home facility on |
3280 | a temporary, emergency basis or for the maintenance and care of |
3281 | residents in a nursing home facility pending removal and |
3282 | alternate placement. |
3283 | (4) Counties or municipalities applying for licenses under |
3284 | this part are exempt from license fees authorized under this |
3285 | section. |
3286 | (5) The license shall be displayed in a conspicuous place |
3287 | inside the facility. |
3288 | (6) A license shall be valid only in the hands of the |
3289 | individual, firm, partnership, association, or corporation to |
3290 | whom it is issued and shall not be subject to sale, assignment, |
3291 | or other transfer, voluntary or involuntary, nor shall a license |
3292 | be valid for any premises other than those for which originally |
3293 | issued. |
3294 | Section 67. Subsection (1) of section 400.063, Florida |
3295 | Statutes, is amended to read: |
3296 | 400.063 Resident Protection Trust Fund.-- |
3297 | (1) A Resident Protection Trust Fund shall be established |
3298 | for the purpose of collecting and disbursing funds generated |
3299 | from the license fees and administrative fines as provided for |
3300 | in ss. 393.0673(2), 400.062(3)(b), 400.111(1), 400.121(2), and |
3301 | 400.23(8). Such funds shall be for the sole purpose of paying |
3302 | for the appropriate alternate placement, care, and treatment of |
3303 | residents who are removed from a facility licensed under this |
3304 | part or a facility specified in s. 393.0678(1) in which the |
3305 | agency determines that existing conditions or practices |
3306 | constitute an immediate danger to the health, safety, or |
3307 | security of the residents. If the agency determines that it is |
3308 | in the best interest of the health, safety, or security of the |
3309 | residents to provide for an orderly removal of the residents |
3310 | from the facility, the agency may utilize such funds to maintain |
3311 | and care for the residents in the facility pending removal and |
3312 | alternative placement. The maintenance and care of the residents |
3313 | shall be under the direction and control of a receiver appointed |
3314 | pursuant to s. 393.0678(1) or s. 400.126(1). However, funds may |
3315 | be expended in an emergency upon a filing of a petition for a |
3316 | receiver, upon the declaration of a state of local emergency |
3317 | pursuant to s. 252.38(3)(a)5., or upon a duly authorized local |
3318 | order of evacuation of a facility by emergency personnel to |
3319 | protect the health and safety of the residents. |
3320 | Section 68. Section 400.071, Florida Statutes, is amended |
3321 | to read: |
3322 | 400.071 Application for license.-- |
3323 | (1) An application for a license as required by s. 400.062 |
3324 | shall be made to the agency on forms furnished by it and shall |
3325 | be accompanied by the appropriate license fee. |
3326 | (1)(2) The application for a license shall be under oath |
3327 | and shall contain the following: |
3328 | (a) The name, address, and social security number of the |
3329 | applicant if an individual; if the applicant is a firm, |
3330 | partnership, or association, its name, address, and employer |
3331 | identification number (EIN), and the name and address of any |
3332 | controlling interest; and the name by which the facility is to |
3333 | be known. |
3334 | (b) The name of any person whose name is required on the |
3335 | application under the provisions of paragraph (a) and who owns |
3336 | at least a 10-percent interest in any professional service, |
3337 | firm, association, partnership, or corporation providing goods, |
3338 | leases, or services to the facility for which the application is |
3339 | made, and the name and address of the professional service, |
3340 | firm, association, partnership, or corporation in which such |
3341 | interest is held. |
3342 | (c) The location of the facility for which a license is |
3343 | sought and an indication, as in the original application, that |
3344 | such location conforms to the local zoning ordinances. |
3345 | (d) The name of the person or persons under whose |
3346 | management or supervision the facility will be conducted and the |
3347 | name of the administrator. |
3348 | (a)(e) A signed affidavit disclosing any financial or |
3349 | ownership interest that a controlling interest as defined in |
3350 | part II of chapter 408 person or entity described in paragraph |
3351 | (a) or paragraph (d) has held in the last 5 years in any entity |
3352 | licensed by this state or any other state to provide health or |
3353 | residential care which has closed voluntarily or involuntarily; |
3354 | has filed for bankruptcy; has had a receiver appointed; has had |
3355 | a license denied, suspended, or revoked; or has had an |
3356 | injunction issued against it which was initiated by a regulatory |
3357 | agency. The affidavit must disclose the reason any such entity |
3358 | was closed, whether voluntarily or involuntarily. |
3359 | (b)(f) The total number of beds and the total number of |
3360 | Medicare and Medicaid certified beds. |
3361 | (c)(g) Information relating to the number, experience, and |
3362 | training of the employees of the facility and of the moral |
3363 | character of the applicant and employees that which the agency |
3364 | requires by rule, including the name and address of any nursing |
3365 | home with which the applicant or employees have been affiliated |
3366 | through ownership or employment within 5 years of the date of |
3367 | the application for a license and the record of any criminal |
3368 | convictions involving the applicant and any criminal convictions |
3369 | involving an employee if known by the applicant after inquiring |
3370 | of the employee. The applicant must demonstrate that sufficient |
3371 | numbers of qualified staff, by training or experience, will be |
3372 | employed to properly care for the type and number of residents |
3373 | who will reside in the facility. |
3374 | (d)(h) Copies of any civil verdict or judgment involving |
3375 | the applicant rendered within the 10 years preceding the |
3376 | application, relating to medical negligence, violation of |
3377 | residents' rights, or wrongful death. As a condition of |
3378 | licensure, the licensee agrees to provide to the agency copies |
3379 | of any new verdict or judgment involving the applicant, relating |
3380 | to such matters, within 30 days after filing with the clerk of |
3381 | the court. The information required in this paragraph shall be |
3382 | maintained in the facility's licensure file and in an agency |
3383 | database which is available as a public record. |
3384 | (3) The applicant shall submit evidence which establishes |
3385 | the good moral character of the applicant, manager, supervisor, |
3386 | and administrator. No applicant, if the applicant is an |
3387 | individual; no member of a board of directors or officer of an |
3388 | applicant, if the applicant is a firm, partnership, association, |
3389 | or corporation; and no licensed nursing home administrator shall |
3390 | have been convicted, or found guilty, regardless of |
3391 | adjudication, of a crime in any jurisdiction which affects or |
3392 | may potentially affect residents in the facility. |
3393 | (4) Each applicant for licensure must comply with the |
3394 | following requirements: |
3395 | (a) Upon receipt of a completed, signed, and dated |
3396 | application, the agency shall require background screening of |
3397 | the applicant, in accordance with the level 2 standards for |
3398 | screening set forth in chapter 435. As used in this subsection, |
3399 | the term "applicant" means the facility administrator, or |
3400 | similarly titled individual who is responsible for the day-to- |
3401 | day operation of the licensed facility, and the facility |
3402 | financial officer, or similarly titled individual who is |
3403 | responsible for the financial operation of the licensed |
3404 | facility. |
3405 | (b) The agency may require background screening for a |
3406 | member of the board of directors of the licensee or an officer |
3407 | or an individual owning 5 percent or more of the licensee if the |
3408 | agency has probable cause to believe that such individual has |
3409 | been convicted of an offense prohibited under the level 2 |
3410 | standards for screening set forth in chapter 435. |
3411 | (c) Proof of compliance with the level 2 background |
3412 | screening requirements of chapter 435 which has been submitted |
3413 | within the previous 5 years in compliance with any other health |
3414 | care or assisted living licensure requirements of this state is |
3415 | acceptable in fulfillment of paragraph (a). Proof of compliance |
3416 | with background screening which has been submitted within the |
3417 | previous 5 years to fulfill the requirements of the Financial |
3418 | Services Commission and the Office of Insurance Regulation |
3419 | pursuant to chapter 651 as part of an application for a |
3420 | certificate of authority to operate a continuing care retirement |
3421 | community is acceptable in fulfillment of the Department of Law |
3422 | Enforcement and Federal Bureau of Investigation background |
3423 | check. |
3424 | (d) A provisional license may be granted to an applicant |
3425 | when each individual required by this section to undergo |
3426 | background screening has met the standards for the Department of |
3427 | Law Enforcement background check, but the agency has not yet |
3428 | received background screening results from the Federal Bureau of |
3429 | Investigation, or a request for a disqualification exemption has |
3430 | been submitted to the agency as set forth in chapter 435, but a |
3431 | response has not yet been issued. A license may be granted to |
3432 | the applicant upon the agency's receipt of a report of the |
3433 | results of the Federal Bureau of Investigation background |
3434 | screening for each individual required by this section to |
3435 | undergo background screening which confirms that all standards |
3436 | have been met, or upon the granting of a disqualification |
3437 | exemption by the agency as set forth in chapter 435. Any other |
3438 | person who is required to undergo level 2 background screening |
3439 | may serve in his or her capacity pending the agency's receipt of |
3440 | the report from the Federal Bureau of Investigation; however, |
3441 | the person may not continue to serve if the report indicates any |
3442 | violation of background screening standards and a |
3443 | disqualification exemption has not been requested of and granted |
3444 | by the agency as set forth in chapter 435. |
3445 | (e) Each applicant must submit to the agency, with its |
3446 | application, a description and explanation of any exclusions, |
3447 | permanent suspensions, or terminations of the applicant from the |
3448 | Medicare or Medicaid programs. Proof of compliance with |
3449 | disclosure of ownership and control interest requirements of the |
3450 | Medicaid or Medicare programs shall be accepted in lieu of this |
3451 | submission. |
3452 | (f) Each applicant must submit to the agency a description |
3453 | and explanation of any conviction of an offense prohibited under |
3454 | the level 2 standards of chapter 435 by a member of the board of |
3455 | directors of the applicant, its officers, or any individual |
3456 | owning 5 percent or more of the applicant. This requirement |
3457 | shall not apply to a director of a not-for-profit corporation or |
3458 | organization if the director serves solely in a voluntary |
3459 | capacity for the corporation or organization, does not regularly |
3460 | take part in the day-to-day operational decisions of the |
3461 | corporation or organization, receives no remuneration for his or |
3462 | her services on the corporation or organization's board of |
3463 | directors, and has no financial interest and has no family |
3464 | members with a financial interest in the corporation or |
3465 | organization, provided that the director and the not-for-profit |
3466 | corporation or organization include in the application a |
3467 | statement affirming that the director's relationship to the |
3468 | corporation satisfies the requirements of this paragraph. |
3469 | (g) An application for license renewal must contain the |
3470 | information required under paragraphs (e) and (f). |
3471 | (5) The applicant shall furnish satisfactory proof of |
3472 | financial ability to operate and conduct the nursing home in |
3473 | accordance with the requirements of this part and all rules |
3474 | adopted under this part, and the agency shall establish |
3475 | standards for this purpose, including information reported under |
3476 | paragraph (2)(e). The agency also shall establish documentation |
3477 | requirements, to be completed by each applicant, that show |
3478 | anticipated facility revenues and expenditures, the basis for |
3479 | financing the anticipated cash-flow requirements of the |
3480 | facility, and an applicant's access to contingency financing. |
3481 | (6) If the applicant offers continuing care agreements as |
3482 | defined in chapter 651, proof shall be furnished that such |
3483 | applicant has obtained a certificate of authority as required |
3484 | for operation under that chapter. |
3485 | (2)(7) As a condition of licensure, each licensee, except |
3486 | one offering continuing care agreements as defined in chapter |
3487 | 651, must agree to accept recipients of Title XIX of the Social |
3488 | Security Act on a temporary, emergency basis. The persons whom |
3489 | the agency may require such licensees to accept are those |
3490 | recipients of Title XIX of the Social Security Act who are |
3491 | residing in a facility in which existing conditions constitute |
3492 | an immediate danger to the health, safety, or security of the |
3493 | residents of the facility. |
3494 | (3)(8) The agency may not issue a license to a nursing |
3495 | home that fails to receive a certificate of need under the |
3496 | provisions of ss. 408.031-408.045. It is the intent of the |
3497 | Legislature that, in reviewing a certificate-of-need application |
3498 | to add beds to an existing nursing home facility, preference be |
3499 | given to the application of a licensee who has been awarded a |
3500 | Gold Seal as provided for in s. 400.235, if the applicant |
3501 | otherwise meets the review criteria specified in s. 408.035. |
3502 | (4)(9) The agency may develop an abbreviated survey for |
3503 | licensure renewal applicable to a licensee that has continuously |
3504 | operated as a nursing facility since 1991 or earlier, has |
3505 | operated under the same management for at least the preceding 30 |
3506 | months, and has had during the preceding 30 months no class I or |
3507 | class II deficiencies. |
3508 | (5)(10) As a condition of licensure, each facility must |
3509 | establish and submit with its application a plan for quality |
3510 | assurance and for conducting risk management. |
3511 | (11) The applicant must provide the agency with proof of a |
3512 | legal right to occupy the property before a license may be |
3513 | issued. Proof may include, but is not limited to, copies of |
3514 | warranty deeds, lease or rental agreements, contracts for deeds, |
3515 | or quitclaim deeds. |
3516 | Section 69. Subsection (4) of section 400.0712, Florida |
3517 | Statutes, is renumbered as subsection (3) and present subsection |
3518 | (3) of said section is amended to read: |
3519 | 400.0712 Application for inactive license.-- |
3520 | (3) The agency may issue an inactive license to a nursing |
3521 | home that will be temporarily unable to provide services but is |
3522 | reasonably expected to resume services. |
3523 | (a) An inactive license issued under this subsection may |
3524 | be issued for a period not to exceed 12 months and may be |
3525 | renewed by the agency for an additional 6 months upon |
3526 | demonstration of progress toward reopening. |
3527 | (b) All licensure fees must be current and paid in full, |
3528 | and may be prorated as provided by agency rule, before the |
3529 | inactive license is issued. |
3530 | (c) Reactivation of an inactive license requires that the |
3531 | applicant pay all licensure fees and be inspected by the agency |
3532 | to confirm that all of the requirements of this part and |
3533 | applicable rules are met. |
3534 | Section 70. Section 400.102, Florida Statutes, is amended |
3535 | to read: |
3536 | 400.102 Action by agency against licensee; grounds.-- |
3537 | (1) In addition to the grounds listed in part II of |
3538 | chapter 408, any of the following conditions shall be grounds |
3539 | for action by the agency against a licensee: |
3540 | (1)(a) An intentional or negligent act materially |
3541 | affecting the health or safety of residents of the facility; |
3542 | (2)(b) Misappropriation or conversion of the property of a |
3543 | resident of the facility; |
3544 | (3)(c) Failure to follow the criteria and procedures |
3545 | provided under part I of chapter 394 relating to the |
3546 | transportation, voluntary admission, and involuntary examination |
3547 | of a nursing home resident; or |
3548 | (d) Violation of provisions of this part or rules adopted |
3549 | under this part; |
3550 | (4)(e) Fraudulent altering, defacing, or falsifying any |
3551 | medical or nursing home records, or causing or procuring any of |
3552 | these offenses to be committed.; or |
3553 | (f) Any act constituting a ground upon which application |
3554 | for a license may be denied. |
3555 | (2) If the agency has reasonable belief that any of such |
3556 | conditions exist, it shall take the following action: |
3557 | (a) In the case of an applicant for original licensure, |
3558 | denial action as provided in s. 400.121. |
3559 | (b) In the case of an applicant for relicensure or a |
3560 | current licensee, administrative action as provided in s. |
3561 | 400.121 or injunctive action as authorized by s. 400.125. |
3562 | (c) In the case of a facility operating without a license, |
3563 | injunctive action as authorized in s. 400.125. |
3564 | Section 71. Section 400.111, Florida Statutes, is amended |
3565 | to read: |
3566 | 400.111 Disclosure of controlling interest Expiration of |
3567 | license; renewal.-- |
3568 | (1) A license issued for the operation of a facility, |
3569 | unless sooner suspended or revoked, shall expire on the date set |
3570 | forth by the agency on the face of the license or 1 year from |
3571 | the date of issuance, whichever occurs first. Ninety days prior |
3572 | to the expiration date, an application for renewal shall be |
3573 | submitted to the agency. A license shall be renewed upon the |
3574 | filing of an application on forms furnished by the agency if the |
3575 | applicant has first met the requirements established under this |
3576 | part and all rules adopted under this part. The failure to file |
3577 | an application within the period established in this subsection |
3578 | shall result in a late fee charged to the licensee by the agency |
3579 | in an amount equal to 50 percent of the fee in effect on the |
3580 | last preceding regular renewal date. A late fee shall be levied |
3581 | for each and every day the filing of the license application is |
3582 | delayed, but in no event shall such fine aggregate more than |
3583 | $5,000. If an application is received after the required filing |
3584 | date and exhibits a hand-canceled postmark obtained from a |
3585 | United States Post Office dated on or before the required filing |
3586 | date, no fine will be levied. |
3587 | (2) A licensee against whom a revocation or suspension |
3588 | proceeding, or any judicial proceeding instituted by the agency |
3589 | under this part, is pending at the time of license renewal may |
3590 | be issued a temporary license effective until final disposition |
3591 | by the agency of such proceeding. If judicial relief is sought |
3592 | from the aforesaid administrative order, the court having |
3593 | jurisdiction may issue such orders regarding the issuance of a |
3594 | temporary permit during the pendency of the judicial proceeding. |
3595 | (3) The agency may not renew a license if the applicant |
3596 | has failed to pay any fines assessed by final order of the |
3597 | agency or final order of the Health Care Financing |
3598 | Administration under requirements for federal certification. The |
3599 | agency may renew the license of an applicant following the |
3600 | assessment of a fine by final order if such fine has been paid |
3601 | into an escrow account pending an appeal of a final order. |
3602 | (4) In addition to the requirements of part II of chapter |
3603 | 408, the licensee shall submit a signed affidavit disclosing any |
3604 | financial or ownership interest that a controlling interest |
3605 | licensee has held within the last 5 years in any entity licensed |
3606 | by the state or any other state to provide health or residential |
3607 | care which entity has closed voluntarily or involuntarily; has |
3608 | filed for bankruptcy; has had a receiver appointed; has had a |
3609 | license denied, suspended, or revoked; or has had an injunction |
3610 | issued against it which was initiated by a regulatory agency. |
3611 | The affidavit must disclose the reason such entity was closed, |
3612 | whether voluntarily or involuntarily. |
3613 | Section 72. Subsections (2) and (5) of section 400.1183, |
3614 | Florida Statutes, are amended to read: |
3615 | 400.1183 Resident grievance procedures.-- |
3616 | (2) Each facility shall maintain records of all grievances |
3617 | and shall report annually to the agency at the time of |
3618 | relicensure the total number of grievances handled during the |
3619 | prior licensure period, a categorization of the cases underlying |
3620 | the grievances, and the final disposition of the grievances. |
3621 | (5) The agency may impose an administrative fine, in |
3622 | accordance with s. 400.121, against a nursing home facility for |
3623 | noncompliance with this section. |
3624 | Section 73. Section 400.121, Florida Statutes, is amended |
3625 | to read: |
3626 | 400.121 Denial, suspension, revocation of license; |
3627 | moratorium on admissions; administrative fines; procedure; order |
3628 | to increase staffing.-- |
3629 | (1) The agency may deny an application, revoke or suspend |
3630 | a license, and or impose an administrative fine, not to exceed |
3631 | $500 per violation per day for the violation of any provision of |
3632 | this part, part II of chapter 408, or applicable rules, against |
3633 | any applicant or licensee for the following violations by the |
3634 | applicant, licensee, or other controlling interest: |
3635 | (a) A violation of any provision of this part, part II of |
3636 | chapter 408, or applicable rules s. 400.102(1); or |
3637 | (b) A demonstrated pattern of deficient practice; |
3638 | (c) Failure to pay any outstanding fines assessed by final |
3639 | order of the agency or final order of the Health Care Financing |
3640 | Administration pursuant to requirements for federal |
3641 | certification. The agency may renew or approve the license of an |
3642 | applicant following the assessment of a fine by final order if |
3643 | such fine has been paid into an escrow account pending an appeal |
3644 | of a final order; |
3645 | (d) Exclusion from the Medicare or Medicaid program; or |
3646 | (b)(e) An adverse action by a regulatory agency against |
3647 | any other licensed facility that has a common controlling |
3648 | interest with the licensee or applicant against whom the action |
3649 | under this section is being brought. If the adverse action |
3650 | involves solely the management company, the applicant or |
3651 | licensee shall be given 30 days to remedy before final action is |
3652 | taken. If the adverse action is based solely upon actions by a |
3653 | controlling interest, the applicant or licensee may present |
3654 | factors in mitigation of any proposed penalty based upon a |
3655 | showing that such penalty is inappropriate under the |
3656 | circumstances. |
3657 |
|
3658 | All hearings shall be held within the county in which the |
3659 | licensee or applicant operates or applies for a license to |
3660 | operate a facility as defined herein. |
3661 | (2) Except as provided in s. 400.23(8), a $500 fine shall |
3662 | be imposed for each violation. Each day a violation of this part |
3663 | occurs constitutes a separate violation and is subject to a |
3664 | separate fine, but in no event may any fine aggregate more than |
3665 | $5,000. A fine may be levied pursuant to this section in lieu of |
3666 | and notwithstanding the provisions of s. 400.23. Fines paid |
3667 | shall be deposited in the Resident Protection Trust Fund and |
3668 | expended as provided in s. 400.063. |
3669 | (3) The agency shall revoke or deny a nursing home license |
3670 | if the licensee or controlling interest operates a facility in |
3671 | this state that: |
3672 | (a) Has had two moratoria imposed by final order for |
3673 | substandard quality of care, as defined by 42 C.F.R. part 483, |
3674 | within any 30-month period; |
3675 | (b) Is conditionally licensed for 180 or more continuous |
3676 | days; |
3677 | (c) Is cited for two class I deficiencies arising from |
3678 | unrelated circumstances during the same survey or investigation; |
3679 | or |
3680 | (d) Is cited for two class I deficiencies arising from |
3681 | separate surveys or investigations within a 30-month period. |
3682 |
|
3683 | The licensee may present factors in mitigation of revocation, |
3684 | and the agency may make a determination not to revoke a license |
3685 | based upon a showing that revocation is inappropriate under the |
3686 | circumstances. |
3687 | (4) The agency may issue an order immediately suspending |
3688 | or revoking a license when it determines that any condition in |
3689 | the facility presents a danger to the health, safety, or welfare |
3690 | of the residents in the facility. |
3691 | (5)(a) The agency may impose an immediate moratorium on |
3692 | admissions to any facility when the agency determines that any |
3693 | condition in the facility presents a threat to the health, |
3694 | safety, or welfare of the residents in the facility. |
3695 | (4)(b) Where the agency has placed a moratorium on |
3696 | admissions on any facility two times within a 7-year period, the |
3697 | agency may suspend the nursing home license of the nursing home |
3698 | and the facility's management company, if any. During the |
3699 | suspension, the agency shall take the facility into receivership |
3700 | and shall operate the facility. |
3701 | (5)(6) An action taken by the agency to deny, suspend, or |
3702 | revoke a facility's license under this part shall be heard by |
3703 | the Division of Administrative Hearings of the Department of |
3704 | Management Services within 60 days after the assignment of an |
3705 | administrative law judge, unless the time limitation is waived |
3706 | by both parties. The administrative law judge must render a |
3707 | decision within 30 days after receipt of a proposed recommended |
3708 | order. |
3709 | (6)(7) The agency is authorized to require a facility to |
3710 | increase staffing beyond the minimum required by law, if the |
3711 | agency has taken administrative action against the facility for |
3712 | care-related deficiencies directly attributable to insufficient |
3713 | staff. Under such circumstances, the facility may request an |
3714 | expedited interim rate increase. The agency shall process the |
3715 | request within 10 days after receipt of all required |
3716 | documentation from the facility. A facility that fails to |
3717 | maintain the required increased staffing is subject to a fine of |
3718 | $500 per day for each day the staffing is below the level |
3719 | required by the agency. |
3720 | (8) An administrative proceeding challenging an action |
3721 | taken by the agency pursuant to this section shall be reviewed |
3722 | on the basis of the facts and conditions that resulted in such |
3723 | agency action. |
3724 | (7)(9) Notwithstanding any other provision of law to the |
3725 | contrary, agency action in an administrative proceeding under |
3726 | this section may be overcome by the licensee upon a showing by a |
3727 | preponderance of the evidence to the contrary. |
3728 | (8)(10) In addition to any other sanction imposed under |
3729 | this part, in any final order that imposes sanctions, the agency |
3730 | may assess costs related to the investigation and prosecution of |
3731 | the case. Payment of agency costs shall be deposited into the |
3732 | Health Care Trust Fund. |
3733 | Section 74. Section 400.125, Florida Statutes, is |
3734 | repealed. |
3735 | Section 75. Subsections (14), (15), and (16) of section |
3736 | 400.141, Florida Statutes, are amended to read: |
3737 | 400.141 Administration and management of nursing home |
3738 | facilities.--Every licensed facility shall comply with all |
3739 | applicable standards and rules of the agency and shall: |
3740 | (14) Submit to the agency the information specified in s. |
3741 | 400.071(1)(a)(2)(e) for a management company within 30 days |
3742 | after the effective date of the management agreement. |
3743 | (15)(a) By the 15th calendar day of the month following |
3744 | the end of each calendar quarter, submit semiannually to the |
3745 | agency, or more frequently if requested by the agency, |
3746 | information regarding facility staff-to-resident ratios, staff |
3747 | turnover, and staff stability, including information regarding |
3748 | certified nursing assistants, licensed nurses, the director of |
3749 | nursing, and the facility administrator. For purposes of this |
3750 | reporting: |
3751 | 1.(a) Staff-to-resident ratios must be reported in the |
3752 | categories specified in s. 400.23(3)(a) and applicable rules. |
3753 | The ratio must be reported as an average for the most recent |
3754 | calendar quarter. |
3755 | 2.(b) Staff turnover must be reported for the most recent |
3756 | 12-month period ending on the last workday of the most recent |
3757 | calendar quarter prior to the date the information is submitted. |
3758 | The turnover rate must be computed quarterly, with the annual |
3759 | rate being the cumulative sum of the quarterly rates. The |
3760 | turnover rate is the total number of terminations or separations |
3761 | experienced during the quarter, excluding any employee |
3762 | terminated during a probationary period of 3 months or less, |
3763 | divided by the total number of staff employed at the end of the |
3764 | period for which the rate is computed, and expressed as a |
3765 | percentage. |
3766 | 3.(c) The formula for determining staff stability is the |
3767 | total number of employees that have been employed for more than |
3768 | 12 months, divided by the total number of employees employed at |
3769 | the end of the most recent calendar quarter, and expressed as a |
3770 | percentage. |
3771 | (b)(d) A nursing facility that has failed to comply with |
3772 | state minimum-staffing requirements for 2 consecutive days is |
3773 | prohibited from accepting new admissions until the facility has |
3774 | achieved the minimum-staffing requirements for a period of 6 |
3775 | consecutive days. For the purposes of this paragraph, any person |
3776 | who was a resident of the facility and was absent from the |
3777 | facility for the purpose of receiving medical care at a separate |
3778 | location or was on a leave of absence is not considered a new |
3779 | admission. Failure to impose such an admissions moratorium |
3780 | constitutes a class II deficiency. |
3781 | (c)(e) A nursing facility that which does not have a |
3782 | conditional license may be cited for failure to comply with the |
3783 | standards in s. 400.23(3)(a) only if it has failed to meet those |
3784 | standards on 2 consecutive days or if it has failed to meet at |
3785 | least 97 percent of those standards on any one day. |
3786 | (d)(f) A facility that which has a conditional license |
3787 | must be in compliance with the standards in s. 400.23(3)(a) at |
3788 | all times from the effective date of the conditional license |
3789 | until the effective date of a subsequent standard license. |
3790 |
|
3791 | Nothing in this subsection section shall limit the agency's |
3792 | ability to impose a deficiency or take other actions if a |
3793 | facility does not have enough staff to meet the residents' |
3794 | needs. |
3795 | (16) Report by the 10th calendar day of each month monthly |
3796 | the number of vacant beds in the facility that which are |
3797 | available for resident occupancy on the last day of the prior |
3798 | month information is reported. |
3799 |
|
3800 | Facilities that have been awarded a Gold Seal under the program |
3801 | established in s. 400.235 may develop a plan to provide |
3802 | certified nursing assistant training as prescribed by federal |
3803 | regulations and state rules and may apply to the agency for |
3804 | approval of their program. |
3805 | Section 76. Subsection (6) of section 400.162, Florida |
3806 | Statutes, is amended to read: |
3807 | 400.162 Property and personal affairs of residents.-- |
3808 | (6) In the event of the death of a resident, a licensee |
3809 | shall return all refunds and funds held in trust to the |
3810 | resident's personal representative, if one has been appointed at |
3811 | the time the nursing home disburses such funds, and if not, to |
3812 | the resident's spouse or adult next of kin named in a |
3813 | beneficiary designation form provided by the nursing home to the |
3814 | resident. In the event the resident has not completed the |
3815 | beneficiary designation form or the resident's designated spouse |
3816 | or adult next of kin is deceased or cannot be located and no |
3817 | personal representative has been appointed, the nursing home may |
3818 | release funds to the funeral home that is handling the deceased |
3819 | resident's remains for the funeral home's actual charges for the |
3820 | services performed. In all other situations no spouse or adult |
3821 | next of kin or such person cannot be located, funds due to the |
3822 | resident shall be placed in an interest-bearing account in a |
3823 | bank, savings association, trust company, or credit union |
3824 | located in this state and, if possible, located within the same |
3825 | district in which the facility is located, which funds shall not |
3826 | be represented as part of the assets of the facility on a |
3827 | financial statement, and the licensee shall maintain such |
3828 | account until such time as the trust funds are disbursed |
3829 | pursuant to the provisions of the Florida Probate Code. All |
3830 | other property of a deceased resident being held in trust by the |
3831 | licensee shall be returned to the resident's personal |
3832 | representative, if one has been appointed at the time the |
3833 | nursing home disburses such property, and if not, to the |
3834 | resident's spouse or adult next of kin named in a beneficiary |
3835 | designation form provided by the nursing home to the resident. |
3836 | In the event the resident has no spouse or adult next of kin or |
3837 | such person cannot be located, property being held in trust |
3838 | shall be safeguarded until such time as the property is |
3839 | disbursed pursuant to the provisions of the Florida Probate |
3840 | Code. The trust funds and property of deceased residents shall |
3841 | be kept separate from the funds and the property of the licensee |
3842 | and from the funds and property of the residents of the |
3843 | facility. The nursing home needs to maintain only one account in |
3844 | which the trust funds amounting to less than $100 of deceased |
3845 | residents are placed. However, it shall be the obligation of the |
3846 | nursing home to maintain adequate records to permit compilation |
3847 | of interest due each individual resident's account. Separate |
3848 | accounts shall be maintained with respect to trust funds of |
3849 | deceased residents equal to or in excess of $100. In the event |
3850 | the trust funds of the deceased resident are not disbursed |
3851 | pursuant to the provisions of the Florida Probate Code within 2 |
3852 | years of the death of the resident, the trust funds shall be |
3853 | deposited in the Resident Protection Trust Fund and expended as |
3854 | provided for in s. 400.063, notwithstanding the provisions of |
3855 | any other law of this state. Any other property of a deceased |
3856 | resident held in trust by a licensee which is not disbursed in |
3857 | accordance with the provisions of the Florida Probate Code shall |
3858 | escheat to the state as provided by law. |
3859 | Section 77. Section 400.179, Florida Statutes, is amended |
3860 | to read: |
3861 | 400.179 Sale or transfer of ownership of a nursing |
3862 | facility; Liability for Medicaid underpayments and |
3863 | overpayments.-- |
3864 | (1) It is the intent of the Legislature to protect the |
3865 | rights of nursing home residents and the security of public |
3866 | funds when a nursing facility is sold or the ownership is |
3867 | transferred. |
3868 | (2) Whenever a nursing facility is sold or the ownership |
3869 | is transferred, including leasing, the transferee shall make |
3870 | application to the agency for a new license at least 90 days |
3871 | prior to the date of transfer of ownership. |
3872 | (3) The transferor shall notify the agency in writing at |
3873 | least 90 days prior to the date of transfer of ownership. The |
3874 | transferor shall be responsible and liable for the lawful |
3875 | operation of the nursing facility and the welfare of the |
3876 | residents domiciled in the facility until the date the |
3877 | transferee is licensed by the agency. The transferor shall be |
3878 | liable for any and all penalties imposed against the facility |
3879 | for violations occurring prior to the date of transfer of |
3880 | ownership. |
3881 | (4) The transferor shall, prior to transfer of ownership, |
3882 | repay or make arrangements to repay to the agency or the |
3883 | Department of Children and Family Services any amounts owed to |
3884 | the agency or the department. Should the transferor fail to |
3885 | repay or make arrangements to repay the amounts owed to the |
3886 | agency or the department prior to the transfer of ownership, the |
3887 | issuance of a license to the transferee shall be delayed until |
3888 | repayment or until arrangements for repayment are made. |
3889 | (2)(5) Because any transfer of a nursing facility may |
3890 | expose the fact that Medicaid may have underpaid or overpaid the |
3891 | transferor, and because in most instances, any such underpayment |
3892 | or overpayment can only be determined following a formal field |
3893 | audit, the liabilities for any such underpayments or |
3894 | overpayments shall be as follows: |
3895 | (a) The Medicaid program shall be liable to the transferor |
3896 | for any underpayments owed during the transferor's period of |
3897 | operation of the facility. |
3898 | (b) Without regard to whether the transferor had leased or |
3899 | owned the nursing facility, the transferor shall remain liable |
3900 | to the Medicaid program for all Medicaid overpayments received |
3901 | during the transferor's period of operation of the facility, |
3902 | regardless of when determined. |
3903 | (c) Where the facility transfer takes any form of a sale |
3904 | of assets, in addition to the transferor's continuing liability |
3905 | for any such overpayments, if the transferor fails to meet these |
3906 | obligations, the transferee shall be liable for all liabilities |
3907 | that can be readily identifiable 90 days in advance of the |
3908 | transfer. Such liability shall continue in succession until the |
3909 | debt is ultimately paid or otherwise resolved. It shall be the |
3910 | burden of the transferee to determine the amount of all such |
3911 | readily identifiable overpayments from the Agency for Health |
3912 | Care Administration, and the agency shall cooperate in every way |
3913 | with the identification of such amounts. Readily identifiable |
3914 | overpayments shall include overpayments that will result from, |
3915 | but not be limited to: |
3916 | 1. Medicaid rate changes or adjustments; |
3917 | 2. Any depreciation recapture; |
3918 | 3. Any recapture of fair rental value system indexing; or |
3919 | 4. Audits completed by the agency. |
3920 |
|
3921 | The transferor shall remain liable for any such Medicaid |
3922 | overpayments that were not readily identifiable 90 days in |
3923 | advance of the nursing facility transfer. |
3924 | (d) Where the transfer involves a facility that has been |
3925 | leased by the transferor: |
3926 | 1. The transferee shall, as a condition to being issued a |
3927 | license by the agency, acquire, maintain, and provide proof to |
3928 | the agency of a bond with a term of 30 months, renewable |
3929 | annually, in an amount not less than the total of 3 months |
3930 | Medicaid payments to the facility computed on the basis of the |
3931 | preceding 12-month average Medicaid payments to the facility. |
3932 | 2. A leasehold licensee may meet the requirements of |
3933 | subparagraph 1. by payment of a nonrefundable fee, paid at |
3934 | initial licensure, paid at the time of any subsequent change of |
3935 | ownership, and paid annually thereafter at the time of any |
3936 | subsequent annual license renewal, in the amount of 2 percent of |
3937 | the total of 3 months' Medicaid payments to the facility |
3938 | computed on the basis of the preceding 12-month average Medicaid |
3939 | payments to the facility. If a preceding 12-month average is not |
3940 | available, projected Medicaid payments may be used. The fee |
3941 | shall be deposited into the Health Care Trust Fund and shall be |
3942 | accounted for separately as a Medicaid nursing home overpayment |
3943 | account. These fees shall be used at the sole discretion of the |
3944 | agency to repay nursing home Medicaid overpayments. Payment of |
3945 | this fee shall not release the licensee from any liability for |
3946 | any Medicaid overpayments, nor shall payment bar the agency from |
3947 | seeking to recoup overpayments from the licensee and any other |
3948 | liable party. As a condition of exercising this lease bond |
3949 | alternative, licensees paying this fee must maintain an existing |
3950 | lease bond through the end of the 30-month term period of that |
3951 | bond. The agency is herein granted specific authority to |
3952 | promulgate all rules pertaining to the administration and |
3953 | management of this account, including withdrawals from the |
3954 | account, subject to federal review and approval. This provision |
3955 | shall take effect upon becoming law and shall apply to any |
3956 | leasehold license application. |
3957 | a. The financial viability of the Medicaid nursing home |
3958 | overpayment account shall be determined by the agency through |
3959 | annual review of the account balance and the amount of total |
3960 | outstanding, unpaid Medicaid overpayments owing from leasehold |
3961 | licensees to the agency as determined by final agency audits. |
3962 | b. The agency, in consultation with the Florida Health |
3963 | Care Association and the Florida Association of Homes for the |
3964 | Aging, shall study and make recommendations on the minimum |
3965 | amount to be held in reserve to protect against Medicaid |
3966 | overpayments to leasehold licensees and on the issue of |
3967 | successor liability for Medicaid overpayments upon sale or |
3968 | transfer of ownership of a nursing facility. The agency shall |
3969 | submit the findings and recommendations of the study to the |
3970 | Governor, the President of the Senate, and the Speaker of the |
3971 | House of Representatives by January 1, 2003. |
3972 | 3. The leasehold licensee may meet the bond requirement |
3973 | through other arrangements acceptable to the agency. The agency |
3974 | is herein granted specific authority to promulgate rules |
3975 | pertaining to lease bond arrangements. |
3976 | 4. All existing nursing facility licensees, operating the |
3977 | facility as a leasehold, shall acquire, maintain, and provide |
3978 | proof to the agency of the 30-month bond required in |
3979 | subparagraph 1., above, on and after July 1, 1993, for each |
3980 | license renewal. |
3981 | 5. It shall be the responsibility of all nursing facility |
3982 | operators, operating the facility as a leasehold, to renew the |
3983 | 30-month bond and to provide proof of such renewal to the agency |
3984 | annually at the time of application for license renewal. |
3985 | 6. Any failure of the nursing facility operator to |
3986 | acquire, maintain, renew annually, or provide proof to the |
3987 | agency shall be grounds for the agency to deny, cancel, revoke, |
3988 | and or suspend the facility license to operate such facility and |
3989 | to take any further action, including, but not limited to, |
3990 | enjoining the facility, asserting a moratorium pursuant to part |
3991 | II of chapter 408, or applying for a receiver, deemed necessary |
3992 | to ensure compliance with this section and to safeguard and |
3993 | protect the health, safety, and welfare of the facility's |
3994 | residents. A lease agreement required as a condition of bond |
3995 | financing or refinancing under s. 154.213 by a health facilities |
3996 | authority or required under s. 159.30 by a county or |
3997 | municipality is not a leasehold for purposes of this paragraph |
3998 | and is not subject to the bond requirement of this paragraph. |
3999 | Section 78. Subsections (1) and (4) of section 400.18, |
4000 | Florida Statutes, are amended to read: |
4001 | 400.18 Closing of nursing facility.-- |
4002 | (1) In addition to the requirements of part II of chapter |
4003 | 408, Whenever a licensee voluntarily discontinues operation, and |
4004 | during the period when it is preparing for such discontinuance, |
4005 | it shall inform the agency not less than 90 days prior to the |
4006 | discontinuance of operation. the licensee also shall inform each |
4007 | the resident or the next of kin, legal representative, or agency |
4008 | acting on behalf of the resident of the fact, and the proposed |
4009 | time, of such discontinuance of operation and give at least 90 |
4010 | days' notice so that suitable arrangements may be made for the |
4011 | transfer and care of the resident. In the event any resident has |
4012 | no such person to represent him or her, the licensee shall be |
4013 | responsible for securing a suitable transfer of the resident |
4014 | before the discontinuance of operation. The agency shall be |
4015 | responsible for arranging for the transfer of those residents |
4016 | requiring transfer who are receiving assistance under the |
4017 | Medicaid program. |
4018 | (4) Immediately upon discontinuance of operation of a |
4019 | facility, the licensee shall surrender the license therefor to |
4020 | the agency, and the license shall be canceled. |
4021 | Section 79. Subsections (1), (2), and (3) of section |
4022 | 400.19, Florida Statutes, are amended to read: |
4023 | 400.19 Right of entry and inspection.-- |
4024 | (1) In accordance with part II of chapter 408, the agency |
4025 | and any duly designated officer or employee thereof or a member |
4026 | of the State Long-Term Care Ombudsman Council or the local long- |
4027 | term care ombudsman council shall have the right to enter upon |
4028 | and into the premises of any facility licensed pursuant to this |
4029 | part, or any distinct nursing home unit of a hospital licensed |
4030 | under chapter 395 or any freestanding facility licensed under |
4031 | chapter 395 that provides extended care or other long-term care |
4032 | services, at any reasonable time in order to determine the state |
4033 | of compliance with the provisions of this part and rules in |
4034 | force pursuant thereto. The right of entry and inspection shall |
4035 | also extend to any premises which the agency has reason to |
4036 | believe is being operated or maintained as a facility without a |
4037 | license, but no such entry or inspection of any premises shall |
4038 | be made without the permission of the owner or person in charge |
4039 | thereof, unless a warrant is first obtained from the circuit |
4040 | court authorizing same. Any application for a facility license |
4041 | or renewal thereof, made pursuant to this part, shall constitute |
4042 | permission for and complete acquiescence in any entry or |
4043 | inspection of the premises for which the license is sought, in |
4044 | order to facilitate verification of the information submitted on |
4045 | or in connection with the application; to discover, investigate, |
4046 | and determine the existence of abuse or neglect; or to elicit, |
4047 | receive, respond to, and resolve complaints. The agency shall, |
4048 | within 60 days after receipt of a complaint made by a resident |
4049 | or resident's representative, complete its investigation and |
4050 | provide to the complainant its findings and resolution. |
4051 | (2) The agency shall coordinate nursing home facility |
4052 | licensing activities and responsibilities of any duly designated |
4053 | officer or employee involved in nursing home facility inspection |
4054 | to assure necessary, equitable, and consistent supervision of |
4055 | inspection personnel without unnecessary duplication of |
4056 | inspections, consultation services, or complaint investigations. |
4057 | To facilitate such coordination, all rules promulgated by the |
4058 | agency pursuant to this part shall be distributed to nursing |
4059 | homes licensed under s. 400.062 30 days prior to implementation. |
4060 | This requirement does not apply to emergency rules. |
4061 | (3) The agency shall every 15 months conduct at least one |
4062 | unannounced inspection to determine compliance by the licensee |
4063 | with statutes, and with rules promulgated under the provisions |
4064 | of those statutes, governing minimum standards of construction, |
4065 | quality and adequacy of care, and rights of residents. The |
4066 | survey shall be conducted every 6 months for the next 2-year |
4067 | period if the facility has been cited for a class I deficiency, |
4068 | has been cited for two or more class II deficiencies arising |
4069 | from separate surveys or investigations within a 60-day period, |
4070 | or has had three or more substantiated complaints within a 6- |
4071 | month period, each resulting in at least one class I or class II |
4072 | deficiency. In addition to any other fees or fines in this part, |
4073 | the agency shall assess a fine for each facility that is subject |
4074 | to the 6-month survey cycle. The fine for the 2-year period |
4075 | shall be $6,000, one-half to be paid at the completion of each |
4076 | survey. The agency may adjust this fine by the change in the |
4077 | Consumer Price Index, based on the 12 months immediately |
4078 | preceding the increase, to cover the cost of the additional |
4079 | surveys. The agency shall verify through subsequent inspection |
4080 | that any deficiency identified during the annual inspection is |
4081 | corrected. However, the agency may verify the correction of a |
4082 | class III or class IV deficiency unrelated to resident rights or |
4083 | resident care without reinspecting the facility if adequate |
4084 | written documentation has been received from the facility, which |
4085 | provides assurance that the deficiency has been corrected. The |
4086 | giving or causing to be given of advance notice of such |
4087 | unannounced inspections by an employee of the agency to any |
4088 | unauthorized person shall constitute cause for suspension of not |
4089 | fewer than 5 working days according to the provisions of chapter |
4090 | 110. |
4091 | Section 80. Section 400.191, Florida Statutes, is amended |
4092 | to read: |
4093 | 400.191 Availability, distribution, and posting of reports |
4094 | and records.-- |
4095 | (1) The agency shall provide information to the public |
4096 | about all of the licensed nursing home facilities operating in |
4097 | the state. The agency shall, within 60 days after an annual |
4098 | inspection visit or within 30 days after any interim visit to a |
4099 | facility, send copies of the inspection reports to the local |
4100 | long-term care ombudsman council, the agency's local office, and |
4101 | a public library or the county seat for the county in which the |
4102 | facility is located. The agency may provide electronic access to |
4103 | inspection reports as a substitute for sending copies. |
4104 | (2) The agency shall publish the Nursing Home Guide |
4105 | provide additional information in consumer-friendly printed and |
4106 | electronic formats to assist consumers and their families in |
4107 | comparing and evaluating nursing home facilities. |
4108 | (a) The agency shall provide an Internet site which shall |
4109 | include at least the following information either directly or |
4110 | indirectly through a link to another established site or sites |
4111 | of the agency's choosing: |
4112 | 1. A list by name and address of all nursing home |
4113 | facilities in this state, including any prior name a facility |
4114 | was known by during the previous 12-month period. |
4115 | 2. Whether such nursing home facilities are proprietary or |
4116 | nonproprietary. |
4117 | 3. The current owner of the facility's license and the |
4118 | year that that entity became the owner of the license. |
4119 | 4. The name of the owner or owners of each facility and |
4120 | whether the facility is affiliated with a company or other |
4121 | organization owning or managing more than one nursing facility |
4122 | in this state. |
4123 | 5. The total number of beds in each facility and the most |
4124 | recently available occupancy levels. |
4125 | 6. The number of private and semiprivate rooms in each |
4126 | facility. |
4127 | 7. The religious affiliation, if any, of each facility. |
4128 | 8. The languages spoken by the administrator and staff of |
4129 | each facility. |
4130 | 9. Whether or not each facility accepts Medicare or |
4131 | Medicaid recipients or insurance, health maintenance |
4132 | organization, Veterans Administration, CHAMPUS program, or |
4133 | workers' compensation coverage. |
4134 | 10. Recreational and other programs available at each |
4135 | facility. |
4136 | 11. Special care units or programs offered at each |
4137 | facility. |
4138 | 12. Whether the facility is a part of a retirement |
4139 | community that offers other services pursuant to part III, part |
4140 | IV, or part V. |
4141 | 13. Survey and deficiency information contained on the |
4142 | Online Survey Certification and Reporting (OSCAR) system of the |
4143 | federal Health Care Financing Administration, including all |
4144 | federal and state recertification, licensure annual survey, |
4145 | revisit, and complaint survey information, for each facility for |
4146 | the past 30 45 months. For noncertified nursing homes, state |
4147 | survey and deficiency information, including licensure annual |
4148 | survey, revisit, and complaint survey information for the past |
4149 | 30 45 months shall be provided. |
4150 | 14. A summary of the deficiency Online Survey |
4151 | Certification and Reporting (OSCAR) data for each facility over |
4152 | the past 30 45 months. Such summary may include a score, rating, |
4153 | or comparison ranking with respect to other facilities based on |
4154 | the number of citations received by the facility on |
4155 | recertification, licensure of annual, revisit, and complaint |
4156 | surveys; the severity and scope of the citations; and the number |
4157 | of annual recertification surveys the facility has had during |
4158 | the past 30 45 months. The score, rating, or comparison ranking |
4159 | may be presented in either numeric or symbolic form for the |
4160 | intended consumer audience. |
4161 | (b) The agency shall provide the following information in |
4162 | printed form: |
4163 | 1. A list by name and address of all nursing home |
4164 | facilities in this state. |
4165 | 2. Whether such nursing home facilities are proprietary or |
4166 | nonproprietary. |
4167 | 3. The current owner or owners of the facility's license |
4168 | and the year that entity became the owner of the license. |
4169 | 4. The total number of beds, and of private and |
4170 | semiprivate rooms, in each facility. |
4171 | 5. The religious affiliation, if any, of each facility. |
4172 | 6. The name of the owner of each facility and whether the |
4173 | facility is affiliated with a company or other organization |
4174 | owning or managing more than one nursing facility in this state. |
4175 | 7. The languages spoken by the administrator and staff of |
4176 | each facility. |
4177 | 8. Whether or not each facility accepts Medicare or |
4178 | Medicaid recipients or insurance, health maintenance |
4179 | organization, Veterans Administration, CHAMPUS program, or |
4180 | workers' compensation coverage. |
4181 | 9. Recreational programs, special care units, and other |
4182 | programs available at each facility. |
4183 | 10. The Internet address for the site where more detailed |
4184 | information can be seen. |
4185 | 11. A statement advising consumers that each facility will |
4186 | have its own policies and procedures related to protecting |
4187 | resident property. |
4188 | 12. A summary of the deficiency Online Survey |
4189 | Certification and Reporting (OSCAR) data for each facility over |
4190 | the past 45 months. Such summary may include a score, rating, or |
4191 | comparison ranking with respect to other facilities based on the |
4192 | number of citations received by the facility on recertification, |
4193 | licensure annual, revisit, and complaint surveys; the severity |
4194 | and scope of the citations; the number of citations; and the |
4195 | number of annual recertification surveys the facility has had |
4196 | during the past 30 45 months. The score, rating, or comparison |
4197 | ranking may be presented in either numeric or symbolic form for |
4198 | the intended consumer audience. |
4199 | (c) For purposes of this subsection, references to the |
4200 | Online Survey Certification and Reporting (OSCAR) system shall |
4201 | refer to any future system that the Health Care Financing |
4202 | Administration develops to replace the current OSCAR system. |
4203 | (c)(d) The agency may provide the following additional |
4204 | information on an Internet site or in printed form as the |
4205 | information becomes available: |
4206 | 1. The licensure status history of each facility. |
4207 | 2. The rating history of each facility. |
4208 | 3. The regulatory history of each facility, which may |
4209 | include federal sanctions, state sanctions, federal fines, state |
4210 | fines, and other actions. |
4211 | 4. Whether the facility currently possesses the Gold Seal |
4212 | designation awarded pursuant to s. 400.235. |
4213 | 5. Internet links to the Internet sites of the facilities |
4214 | or their affiliates. |
4215 | (3) Each nursing home facility licensee shall maintain as |
4216 | public information, available upon request, records of all cost |
4217 | and inspection reports pertaining to that facility that have |
4218 | been filed with, or issued by, any governmental agency. Copies |
4219 | of such reports shall be retained in such records for not less |
4220 | than 5 years from the date the reports are filed or issued. |
4221 | (a) The agency shall quarterly publish in the Nursing Home |
4222 | Guide a "Nursing Home Guide Watch List" to assist consumers in |
4223 | evaluating the quality of nursing home care in Florida. The |
4224 | watch list must identify each facility that met the criteria for |
4225 | a conditional licensure status to be noticed as specified in |
4226 | this section on any day within the quarter covered by the list |
4227 | and each facility that is was operating under bankruptcy |
4228 | protection on any day within the quarter. The watch list must |
4229 | include, but is not limited to, the facility's name, address, |
4230 | and ownership; the county in which the facility operates; the |
4231 | license expiration date; the number of licensed beds; a |
4232 | description of the deficiency causing the facility to be placed |
4233 | on the list; any corrective action taken; and the cumulative |
4234 | number of days and percentage of days times the facility had a |
4235 | conditional license in the past 30 months has been on a watch |
4236 | list. The watch list must include a brief description regarding |
4237 | how to choose a nursing home, the categories of licensure, the |
4238 | agency's inspection process, an explanation of terms used in the |
4239 | watch list, and the addresses and phone numbers of the agency's |
4240 | managed care and health quality assurance field area offices. |
4241 | (b) Upon publication of each quarterly Nursing Home Guide |
4242 | watch list, the agency must post transmit a copy on its website |
4243 | by the 15th calendar day 2 months following the end of the |
4244 | calendar quarter. Each nursing home licensee must retrieve the |
4245 | most recent version of the Nursing Home Guide from of the watch |
4246 | list to each nursing home facility by mail and must make the |
4247 | watch list available on the agency's Internet website. |
4248 | (4) Any records of a nursing home facility determined by |
4249 | the agency to be necessary and essential to establish lawful |
4250 | compliance with any rules or standards shall be made available |
4251 | to the agency on the premises of the facility and submitted to |
4252 | the agency. Each facility must submit this information |
4253 | electronically when electronic transmission to the agency is |
4254 | available. |
4255 | (5) Every nursing home facility licensee shall: |
4256 | (a) Post, in a sufficient number of prominent positions in |
4257 | the nursing home so as to be accessible to all residents and to |
4258 | the general public: |
4259 | 1. A concise summary of the last inspection report |
4260 | pertaining to the nursing home and issued by the agency, with |
4261 | references to the page numbers of the full reports, noting any |
4262 | deficiencies found by the agency and the actions taken by the |
4263 | licensee to rectify such deficiencies and indicating in such |
4264 | summaries where the full reports may be inspected in the nursing |
4265 | home. |
4266 | 2. A copy of all pages listing the facility from the most |
4267 | recent version of the Florida Nursing Home Guide Watch List. |
4268 | (b) Upon request, provide to any person who has completed |
4269 | a written application with an intent to be admitted to, or to |
4270 | any resident of, such nursing home, or to any relative, spouse, |
4271 | or guardian of such person, a copy of the last inspection report |
4272 | pertaining to the nursing home and issued by the agency, |
4273 | provided the person requesting the report agrees to pay a |
4274 | reasonable charge to cover copying costs. |
4275 | (6) The agency may adopt rules as necessary to administer |
4276 | this section. |
4277 | Section 81. Section 400.20, Florida Statutes, is amended |
4278 | to read: |
4279 | 400.20 Licensed nursing home administrator required.--A No |
4280 | nursing home may not shall operate except under the supervision |
4281 | of a licensed nursing home administrator, and a no person may |
4282 | not shall be a nursing home administrator unless he or she holds |
4283 | is the holder of a current license as provided in chapter 468. |
4284 | Section 82. Subsections (2), (7), and (8) of section |
4285 | 400.23, Florida Statutes, are amended to read: |
4286 | 400.23 Rules; evaluation and deficiencies; licensure |
4287 | status.-- |
4288 | (2) Pursuant to the intention of the Legislature, the |
4289 | agency, in consultation with the Department of Health and the |
4290 | Department of Elderly Affairs, shall adopt and enforce rules to |
4291 | implement this part and part II of chapter 408, which shall |
4292 | include reasonable and fair criteria in relation to: |
4293 | (a) The location of the facility and housing conditions |
4294 | that will ensure the health, safety, and comfort of residents, |
4295 | including an adequate call system. In making such rules, the |
4296 | agency shall be guided by criteria recommended by nationally |
4297 | recognized reputable professional groups and associations with |
4298 | knowledge of such subject matters. The agency shall update or |
4299 | revise such criteria as the need arises. The agency may require |
4300 | alterations to a building if it determines that an existing |
4301 | condition constitutes a distinct hazard to life, health, or |
4302 | safety. In performing any inspections of facilities authorized |
4303 | by this part, the agency may enforce the special-occupancy |
4304 | provisions of the Florida Building Code and the Florida Fire |
4305 | Prevention Code which apply to nursing homes. The agency is |
4306 | directed to provide assistance to the Florida Building |
4307 | Commission in updating the construction standards of the code |
4308 | relative to nursing homes. A resident or the representative of |
4309 | the resident shall be able to request a change in the placement |
4310 | of the bed in his or her room, provided that at admission the |
4311 | resident or the representative of the resident is presented with |
4312 | a room that meets requirements of the Florida Building Code. The |
4313 | location of a bed may be changed if the requested placement does |
4314 | not infringe on the resident's roommate or interfere with the |
4315 | resident's care or safety as determined by the care planning |
4316 | team in accordance with facility policies and procedures. In |
4317 | addition, the bed placement may not be used as a restraint. Each |
4318 | facility shall maintain a log of resident rooms with beds that |
4319 | are not in strict compliance with the Florida Building Code in |
4320 | order for such log to be used by surveyors and nurse monitors |
4321 | during inspections and visits. Any resident or representative of |
4322 | a resident who requests that a bed be moved shall sign a |
4323 | statement indicating that he or she understands the room will |
4324 | not be in compliance with the Florida Building Code, but he or |
4325 | she would prefer to exercise his or her right to self- |
4326 | determination. The statement must be retained as part of the |
4327 | resident's care plan. Any facility that offers this option shall |
4328 | submit to the agency a letter signed by the nursing home |
4329 | administrator of record notifying the agency of this practice |
4330 | and include a copy of the facility's policies and procedures. |
4331 | (b) The number and qualifications of all personnel, |
4332 | including management, medical, nursing, and other professional |
4333 | personnel, and nursing assistants, orderlies, and support |
4334 | personnel, having responsibility for any part of the care given |
4335 | residents. |
4336 | (c) All sanitary conditions within the facility and its |
4337 | surroundings, including water supply, sewage disposal, food |
4338 | handling, and general hygiene which will ensure the health and |
4339 | comfort of residents. |
4340 | (d) The equipment essential to the health and welfare of |
4341 | the residents. |
4342 | (e) A uniform accounting system. |
4343 | (f) The care, treatment, and maintenance of residents and |
4344 | measurement of the quality and adequacy thereof, based on rules |
4345 | developed under this chapter and the Omnibus Budget |
4346 | Reconciliation Act of 1987 (Pub. L. No. 100-203) (December 22, |
4347 | 1987), Title IV (Medicare, Medicaid, and Other Health-Related |
4348 | Programs), Subtitle C (Nursing Home Reform), as amended. |
4349 | (g) The preparation and annual update of a comprehensive |
4350 | emergency management plan. The agency shall adopt rules |
4351 | establishing minimum criteria for the plan after consultation |
4352 | with the Department of Community Affairs. At a minimum, the |
4353 | rules must provide for plan components that address emergency |
4354 | evacuation transportation; adequate sheltering arrangements; |
4355 | postdisaster activities, including emergency power, food, and |
4356 | water; postdisaster transportation; supplies; staffing; |
4357 | emergency equipment; individual identification of residents and |
4358 | transfer of records; and responding to family inquiries. The |
4359 | comprehensive emergency management plan is subject to review and |
4360 | approval by the local emergency management agency. During its |
4361 | review, the local emergency management agency shall ensure that |
4362 | the following agencies, at a minimum, are given the opportunity |
4363 | to review the plan: the Department of Elderly Affairs, the |
4364 | Department of Health, the Agency for Health Care Administration, |
4365 | and the Department of Community Affairs. Also, appropriate |
4366 | volunteer organizations must be given the opportunity to review |
4367 | the plan. The local emergency management agency shall complete |
4368 | its review within 60 days and either approve the plan or advise |
4369 | the facility of necessary revisions. |
4370 | (h) The availability, distribution, and posting of reports |
4371 | and records pursuant to s. 400.191 and the Gold Seal Program |
4372 | pursuant to s. 400.235. |
4373 | (7) The agency shall, at least every 15 months, evaluate |
4374 | all nursing home facilities and make a determination as to the |
4375 | degree of compliance by each licensee with the established rules |
4376 | adopted under this part as a basis for assigning a licensure |
4377 | status to that facility. The agency shall base its evaluation on |
4378 | the most recent inspection report, taking into consideration |
4379 | findings from other official reports, surveys, interviews, |
4380 | investigations, and inspections. The agency shall assign a |
4381 | licensure status of standard or conditional to each nursing |
4382 | home. |
4383 | (a) A standard licensure status means that a facility has |
4384 | no class I or class II deficiencies and has corrected all class |
4385 | III deficiencies within the time established by the agency. |
4386 | (b) A conditional licensure status means that a facility, |
4387 | due to the presence of one or more class I or class II |
4388 | deficiencies, or class III deficiencies not corrected within the |
4389 | time established by the agency, is not in substantial compliance |
4390 | at the time of the survey with criteria established under this |
4391 | part or with rules adopted by the agency. If the facility has no |
4392 | class I, class II, or class III deficiencies at the time of the |
4393 | followup survey, a standard licensure status may be assigned. |
4394 | (c) In evaluating the overall quality of care and services |
4395 | and determining whether the facility will receive a conditional |
4396 | or standard license, the agency shall consider the needs and |
4397 | limitations of residents in the facility and the results of |
4398 | interviews and surveys of a representative sampling of |
4399 | residents, families of residents, ombudsman council members in |
4400 | the planning and service area in which the facility is located, |
4401 | guardians of residents, and staff of the nursing home facility. |
4402 | (d) The current licensure status of each facility must be |
4403 | indicated in bold print on the face of the license. A list of |
4404 | the deficiencies of the facility shall be posted in a prominent |
4405 | place that is in clear and unobstructed public view at or near |
4406 | the place where residents are being admitted to that facility. |
4407 | Licensees receiving a conditional licensure status for a |
4408 | facility shall prepare, within 10 working days after receiving |
4409 | notice of deficiencies, a plan for correction of all |
4410 | deficiencies and shall submit the plan to the agency for |
4411 | approval. |
4412 | (e) Each licensee shall post its license in a prominent |
4413 | place that is in clear and unobstructed public view at or near |
4414 | the place where residents are being admitted to the facility. |
4415 | (e)(f) The agency shall adopt rules that: |
4416 | 1. Establish uniform procedures for the evaluation of |
4417 | facilities. |
4418 | 2. Provide criteria in the areas referenced in paragraph |
4419 | (c). |
4420 | 3. Address other areas necessary for carrying out the |
4421 | intent of this section. |
4422 | (8) The agency shall adopt rules pursuant to this part and |
4423 | part II of chapter 408 to provide that, when the criteria |
4424 | established under subsection (2) are not met, such deficiencies |
4425 | shall be classified according to the nature and the scope of the |
4426 | deficiency. The scope shall be cited as isolated, patterned, or |
4427 | widespread. An isolated deficiency is a deficiency affecting one |
4428 | or a very limited number of residents, or involving one or a |
4429 | very limited number of staff, or a situation that occurred only |
4430 | occasionally or in a very limited number of locations. A |
4431 | patterned deficiency is a deficiency where more than a very |
4432 | limited number of residents are affected, or more than a very |
4433 | limited number of staff are involved, or the situation has |
4434 | occurred in several locations, or the same resident or residents |
4435 | have been affected by repeated occurrences of the same deficient |
4436 | practice but the effect of the deficient practice is not found |
4437 | to be pervasive throughout the facility. A widespread deficiency |
4438 | is a deficiency in which the problems causing the deficiency are |
4439 | pervasive in the facility or represent systemic failure that has |
4440 | affected or has the potential to affect a large portion of the |
4441 | facility's residents. The agency shall indicate the |
4442 | classification on the face of the notice of deficiencies as |
4443 | follows: |
4444 | (a) A class I deficiency is a deficiency that the agency |
4445 | determines presents a situation in which immediate corrective |
4446 | action is necessary because the facility's noncompliance has |
4447 | caused, or is likely to cause, serious injury, harm, impairment, |
4448 | or death to a resident receiving care in a facility. The |
4449 | condition or practice constituting a class I violation shall be |
4450 | abated or eliminated immediately, unless a fixed period of time, |
4451 | as determined by the agency, is required for correction. A class |
4452 | I deficiency is subject to a civil penalty of $10,000 for an |
4453 | isolated deficiency, $12,500 for a patterned deficiency, and |
4454 | $15,000 for a widespread deficiency. The fine amount shall be |
4455 | doubled for each deficiency if the facility was previously cited |
4456 | for one or more class I or class II deficiencies during the last |
4457 | annual inspection or any inspection or complaint investigation |
4458 | since the last annual inspection. A fine must be levied |
4459 | notwithstanding the correction of the deficiency. |
4460 | (b) A class II deficiency is a deficiency that the agency |
4461 | determines has compromised the resident's ability to maintain or |
4462 | reach his or her highest practicable physical, mental, and |
4463 | psychosocial well-being, as defined by an accurate and |
4464 | comprehensive resident assessment, plan of care, and provision |
4465 | of services. A class II deficiency is subject to a civil penalty |
4466 | of $2,500 for an isolated deficiency, $5,000 for a patterned |
4467 | deficiency, and $7,500 for a widespread deficiency. The fine |
4468 | amount shall be doubled for each deficiency if the facility was |
4469 | previously cited for one or more class I or class II |
4470 | deficiencies during the last licensure annual inspection or any |
4471 | inspection or complaint investigation since the last licensure |
4472 | annual inspection. A fine shall be levied notwithstanding the |
4473 | correction of the deficiency. |
4474 | (c) A class III deficiency is a deficiency that the agency |
4475 | determines will result in no more than minimal physical, mental, |
4476 | or psychosocial discomfort to the resident or has the potential |
4477 | to compromise the resident's ability to maintain or reach his or |
4478 | her highest practical physical, mental, or psychosocial well- |
4479 | being, as defined by an accurate and comprehensive resident |
4480 | assessment, plan of care, and provision of services. A class III |
4481 | deficiency is subject to a civil penalty of $1,000 for an |
4482 | isolated deficiency, $2,000 for a patterned deficiency, and |
4483 | $3,000 for a widespread deficiency. The fine amount shall be |
4484 | doubled for each deficiency if the facility was previously cited |
4485 | for one or more class I or class II deficiencies during the last |
4486 | licensure annual inspection or any inspection or complaint |
4487 | investigation since the last annual inspection. A citation for a |
4488 | class III deficiency must specify the time within which the |
4489 | deficiency is required to be corrected. If a class III |
4490 | deficiency is corrected within the time specified, no civil |
4491 | penalty shall be imposed. |
4492 | (d) A class IV deficiency is a deficiency that the agency |
4493 | determines has the potential for causing no more than a minor |
4494 | negative impact on the resident. If the class IV deficiency is |
4495 | isolated, no plan of correction is required. |
4496 | Section 83. Subsections (3) and (4) of section 400.241, |
4497 | Florida Statutes, are renumbered as subsections (1) and (2), |
4498 | respectively, and present subsections (1) and (2) of said |
4499 | section are amended to read: |
4500 | 400.241 Prohibited acts; penalties for violations.-- |
4501 | (1) It is unlawful for any person or public body to |
4502 | establish, conduct, manage, or operate a home as defined in this |
4503 | part without obtaining a valid current license. |
4504 | (2) It is unlawful for any person or public body to offer |
4505 | or advertise to the public, in any way by any medium whatever, |
4506 | nursing home care or service or custodial services without |
4507 | obtaining a valid current license. It is unlawful for any holder |
4508 | of a license issued pursuant to the provisions of this part to |
4509 | advertise or hold out to the public that it holds a license for |
4510 | a facility other than that for which it actually holds a |
4511 | license. |
4512 | Section 84. Subsections (6) through (27) of section |
4513 | 400.402, Florida Statutes, are renumbered as subsections (5) |
4514 | through (26), respectively, and present subsections (5), (12), |
4515 | (14), (17), and (20) are amended to read: |
4516 | 400.402 Definitions.--When used in this part, the term: |
4517 | (5) "Applicant" means an individual owner, corporation, |
4518 | partnership, firm, association, or governmental entity that |
4519 | applies for a license. |
4520 | (11)(12) "Extended congregate care" means acts beyond |
4521 | those authorized in subsection (16) (17) that may be performed |
4522 | pursuant to part I of chapter 464 by persons licensed thereunder |
4523 | while carrying out their professional duties, and other |
4524 | supportive services which may be specified by rule. The purpose |
4525 | of such services is to enable residents to age in place in a |
4526 | residential environment despite mental or physical limitations |
4527 | that might otherwise disqualify them from residency in a |
4528 | facility licensed under this part. |
4529 | (13)(14) "Limited nursing services" means acts that may be |
4530 | performed pursuant to part I of chapter 464 by persons licensed |
4531 | thereunder while carrying out their professional duties but |
4532 | limited to those acts which the agency department specifies by |
4533 | rule. Acts which may be specified by rule as allowable limited |
4534 | nursing services shall be for persons who meet the admission |
4535 | criteria established by the agency department for assisted |
4536 | living facilities and shall not be complex enough to require 24- |
4537 | hour nursing supervision and may include such services as the |
4538 | application and care of routine dressings, and care of casts, |
4539 | braces, and splints. |
4540 | (16)(17) "Personal services" means direct physical |
4541 | assistance with or supervision of the activities of daily living |
4542 | and the self-administration of medication and other similar |
4543 | services which the agency department may define by rule. |
4544 | "Personal services" shall not be construed to mean the provision |
4545 | of medical, nursing, dental, or mental health services. |
4546 | (19)(20) "Resident" means a person 18 years of age or |
4547 | older, residing in and receiving care from a facility, including |
4548 | a person receiving services pursuant to s. 400.553(2). |
4549 | Section 85. Section 400.407, Florida Statutes, is amended |
4550 | to read: |
4551 | 400.407 License required; fee, display.-- |
4552 | (1) The requirements of part II of chapter 408 shall apply |
4553 | to the provision of services that require licensure pursuant |
4554 | this part and part II of chapter 408 and to entities licensed by |
4555 | or applying for such licensure from the agency pursuant to this |
4556 | part. However, each applicant for licensure and each licensee is |
4557 | exempt from s. 408.810(10). A license issued by the agency is |
4558 | required for an assisted living facility operating in this |
4559 | state. |
4560 | (2) Separate licenses shall be required for facilities |
4561 | maintained in separate premises, even though operated under the |
4562 | same management. A separate license shall not be required for |
4563 | separate buildings on the same grounds. |
4564 | (3) In addition to the requirements of 408.806, each Any |
4565 | license granted by the agency must state the maximum resident |
4566 | capacity of the facility, the type of care for which the license |
4567 | is granted, the date the license is issued, the expiration date |
4568 | of the license, and any other information deemed necessary by |
4569 | the agency. Licenses shall be issued for one or more of the |
4570 | following categories of care: standard, extended congregate |
4571 | care, limited nursing services, or limited mental health. |
4572 | (a) A standard license shall be issued to facilities |
4573 | providing one or more of the personal services identified in s. |
4574 | 400.402. Such facilities may also employ or contract with a |
4575 | person licensed under part I of chapter 464 to administer |
4576 | medications and perform other tasks as specified in s. 400.4255. |
4577 | (b) An extended congregate care license shall be issued to |
4578 | facilities providing, directly or through contract, services |
4579 | beyond those authorized in paragraph (a), including acts |
4580 | performed pursuant to part I of chapter 464 by persons licensed |
4581 | thereunder, and supportive services defined by rule to persons |
4582 | who otherwise would be disqualified from continued residence in |
4583 | a facility licensed under this part. |
4584 | 1. In order for extended congregate care services to be |
4585 | provided in a facility licensed under this part, the agency must |
4586 | first determine that all requirements established in law and |
4587 | rule are met and must specifically designate, on the facility's |
4588 | license, that such services may be provided and whether the |
4589 | designation applies to all or part of a facility. Such |
4590 | designation may be made at the time of initial licensure or |
4591 | relicensure, or upon request in writing by a licensee under this |
4592 | part and part II of chapter 408. Notification of approval or |
4593 | denial of such request shall be made in accordance with part II |
4594 | of chapter 408 within 90 days after receipt of such request and |
4595 | all necessary documentation. Existing facilities qualifying to |
4596 | provide extended congregate care services must have maintained a |
4597 | standard license and may not have been subject to administrative |
4598 | sanctions during the previous 2 years, or since initial |
4599 | licensure if the facility has been licensed for less than 2 |
4600 | years, for any of the following reasons: |
4601 | a. A class I or class II violation; |
4602 | b. Three or more repeat or recurring class III violations |
4603 | of identical or similar resident care standards as specified in |
4604 | rule from which a pattern of noncompliance is found by the |
4605 | agency; |
4606 | c. Three or more class III violations that were not |
4607 | corrected in accordance with the corrective action plan approved |
4608 | by the agency; |
4609 | d. Violation of resident care standards resulting in a |
4610 | requirement to employ the services of a consultant pharmacist or |
4611 | consultant dietitian; |
4612 | e. Denial, suspension, or revocation of a license for |
4613 | another facility under this part in which the applicant for an |
4614 | extended congregate care license has at least 25 percent |
4615 | ownership interest; or |
4616 | f. Imposition of a moratorium on admissions or initiation |
4617 | of injunctive proceedings. |
4618 | 2. Facilities that are licensed to provide extended |
4619 | congregate care services shall maintain a written progress |
4620 | report on each person who receives such services, which report |
4621 | describes the type, amount, duration, scope, and outcome of |
4622 | services that are rendered and the general status of the |
4623 | resident's health. A registered nurse, or appropriate designee, |
4624 | representing the agency shall visit such facilities at least |
4625 | quarterly to monitor residents who are receiving extended |
4626 | congregate care services and to determine if the facility is in |
4627 | compliance with this part, part II of chapter 408, and with |
4628 | rules that relate to extended congregate care. One of these |
4629 | visits may be in conjunction with the regular survey. The |
4630 | monitoring visits may be provided through contractual |
4631 | arrangements with appropriate community agencies. A registered |
4632 | nurse shall serve as part of the team that inspects such |
4633 | facility. The agency may waive one of the required yearly |
4634 | monitoring visits for a facility that has been licensed for at |
4635 | least 24 months to provide extended congregate care services, |
4636 | if, during the inspection, the registered nurse determines that |
4637 | extended congregate care services are being provided |
4638 | appropriately, and if the facility has no class I or class II |
4639 | violations and no uncorrected class III violations. Before such |
4640 | decision is made, the agency shall consult with the long-term |
4641 | care ombudsman council for the area in which the facility is |
4642 | located to determine if any complaints have been made and |
4643 | substantiated about the quality of services or care. The agency |
4644 | may not waive one of the required yearly monitoring visits if |
4645 | complaints have been made and substantiated. |
4646 | 3. Facilities that are licensed to provide extended |
4647 | congregate care services shall: |
4648 | a. Demonstrate the capability to meet unanticipated |
4649 | resident service needs. |
4650 | b. Offer a physical environment that promotes a homelike |
4651 | setting, provides for resident privacy, promotes resident |
4652 | independence, and allows sufficient congregate space as defined |
4653 | by rule. |
4654 | c. Have sufficient staff available, taking into account |
4655 | the physical plant and firesafety features of the building, to |
4656 | assist with the evacuation of residents in an emergency, as |
4657 | necessary. |
4658 | d. Adopt and follow policies and procedures that maximize |
4659 | resident independence, dignity, choice, and decisionmaking to |
4660 | permit residents to age in place to the extent possible, so that |
4661 | moves due to changes in functional status are minimized or |
4662 | avoided. |
4663 | e. Allow residents or, if applicable, a resident's |
4664 | representative, designee, surrogate, guardian, or attorney in |
4665 | fact to make a variety of personal choices, participate in |
4666 | developing service plans, and share responsibility in |
4667 | decisionmaking. |
4668 | f. Implement the concept of managed risk. |
4669 | g. Provide, either directly or through contract, the |
4670 | services of a person licensed pursuant to part I of chapter 464. |
4671 | h. In addition to the training mandated in s. 400.452, |
4672 | provide specialized training as defined by rule for facility |
4673 | staff. |
4674 | 4. Facilities licensed to provide extended congregate care |
4675 | services are exempt from the criteria for continued residency as |
4676 | set forth in rules adopted under s. 400.441. Facilities so |
4677 | licensed shall adopt their own requirements within guidelines |
4678 | for continued residency set forth by the department in rule. |
4679 | However, such facilities may not serve residents who require 24- |
4680 | hour nursing supervision. Facilities licensed to provide |
4681 | extended congregate care services shall provide each resident |
4682 | with a written copy of facility policies governing admission and |
4683 | retention. |
4684 | 5. The primary purpose of extended congregate care |
4685 | services is to allow residents, as they become more impaired, |
4686 | the option of remaining in a familiar setting from which they |
4687 | would otherwise be disqualified for continued residency. A |
4688 | facility licensed to provide extended congregate care services |
4689 | may also admit an individual who exceeds the admission criteria |
4690 | for a facility with a standard license, if the individual is |
4691 | determined appropriate for admission to the extended congregate |
4692 | care facility. |
4693 | 6. Before admission of an individual to a facility |
4694 | licensed to provide extended congregate care services, the |
4695 | individual must undergo a medical examination as provided in s. |
4696 | 400.426(4) and the facility must develop a preliminary service |
4697 | plan for the individual. |
4698 | 7. When a facility can no longer provide or arrange for |
4699 | services in accordance with the resident's service plan and |
4700 | needs and the facility's policy, the facility shall make |
4701 | arrangements for relocating the person in accordance with s. |
4702 | 400.428(1)(k). |
4703 | 8. Failure to provide extended congregate care services |
4704 | may result in denial of extended congregate care license |
4705 | renewal. |
4706 | 9. No later than January 1 of each year, the department, |
4707 | in consultation with the agency, shall prepare and submit to the |
4708 | Governor, the President of the Senate, the Speaker of the House |
4709 | of Representatives, and the chairs of appropriate legislative |
4710 | committees, a report on the status of, and recommendations |
4711 | related to, extended congregate care services. The status report |
4712 | must include, but need not be limited to, the following |
4713 | information: |
4714 | a. A description of the facilities licensed to provide |
4715 | such services, including total number of beds licensed under |
4716 | this part. |
4717 | b. The number and characteristics of residents receiving |
4718 | such services. |
4719 | c. The types of services rendered that could not be |
4720 | provided through a standard license. |
4721 | d. An analysis of deficiencies cited during licensure |
4722 | inspections. |
4723 | e. The number of residents who required extended |
4724 | congregate care services at admission and the source of |
4725 | admission. |
4726 | f. Recommendations for statutory or regulatory changes. |
4727 | g. The availability of extended congregate care to state |
4728 | clients residing in facilities licensed under this part and in |
4729 | need of additional services, and recommendations for |
4730 | appropriations to subsidize extended congregate care services |
4731 | for such persons. |
4732 | h. Such other information as the department considers |
4733 | appropriate. |
4734 | (c) A limited nursing services license shall be issued to |
4735 | a facility that provides services beyond those authorized in |
4736 | paragraph (a) and as specified in this paragraph. |
4737 | 1. In order for limited nursing services to be provided in |
4738 | a facility licensed under this part, the agency must first |
4739 | determine that all requirements established in law and rule are |
4740 | met and must specifically designate, on the facility's license, |
4741 | that such services may be provided. Such designation may be made |
4742 | at the time of initial licensure or relicensure, or upon request |
4743 | in writing by a licensee under this part and part II of chapter |
4744 | 408. Notification of approval or denial of such request shall be |
4745 | made in accordance with part II of chapter 408 within 90 days |
4746 | after receipt of such request and all necessary documentation. |
4747 | Existing facilities qualifying to provide limited nursing |
4748 | services shall have maintained a standard license and may not |
4749 | have been subject to administrative sanctions that affect the |
4750 | health, safety, and welfare of residents for the previous 2 |
4751 | years or since initial licensure if the facility has been |
4752 | licensed for less than 2 years. |
4753 | 2. Facilities that are licensed to provide limited nursing |
4754 | services shall maintain a written progress report on each person |
4755 | who receives such nursing services, which report describes the |
4756 | type, amount, duration, scope, and outcome of services that are |
4757 | rendered and the general status of the resident's health. A |
4758 | registered nurse representing the agency shall visit such |
4759 | facilities at least twice a year to monitor residents who are |
4760 | receiving limited nursing services and to determine if the |
4761 | facility is in compliance with applicable provisions of this |
4762 | part, part II of chapter 408, and with related rules. The |
4763 | monitoring visits may be provided through contractual |
4764 | arrangements with appropriate community agencies. A registered |
4765 | nurse shall also serve as part of the team that inspects such |
4766 | facility. |
4767 | 3. A person who receives limited nursing services under |
4768 | this part must meet the admission criteria established by the |
4769 | agency for assisted living facilities. When a resident no longer |
4770 | meets the admission criteria for a facility licensed under this |
4771 | part, arrangements for relocating the person shall be made in |
4772 | accordance with s. 400.428(1)(k), unless the facility is |
4773 | licensed to provide extended congregate care services. |
4774 | (4) In accordance with s. 408.805, an applicant or |
4775 | licensee shall pay a fee for each license application submitted |
4776 | under this part, part II of chapter 408, and applicable rules. |
4777 | The amount of the fee shall be established by rule. |
4778 | (a) The biennial license fee required of a facility is |
4779 | $300 per license, with an additional fee of $50 per resident |
4780 | based on the total licensed resident capacity of the facility, |
4781 | except that no additional fee will be assessed for beds |
4782 | designated for recipients of optional state supplementation |
4783 | payments provided for in s. 409.212. The total fee may not |
4784 | exceed $10,000, no part of which shall be returned to the |
4785 | facility. The agency shall adjust the per bed license fee and |
4786 | the total licensure fee annually by not more than the change in |
4787 | the consumer price index based on the 12 months immediately |
4788 | preceding the increase. |
4789 | (b) In addition to the total fee assessed under paragraph |
4790 | (a), the agency shall require facilities that are licensed to |
4791 | provide extended congregate care services under this part to pay |
4792 | an additional fee per licensed facility. The amount of the |
4793 | biennial fee shall be $400 per license, with an additional fee |
4794 | of $10 per resident based on the total licensed resident |
4795 | capacity of the facility. No part of this fee shall be returned |
4796 | to the facility. The agency may adjust the per bed license fee |
4797 | and the annual license fee once each year by not more than the |
4798 | average rate of inflation for the 12 months immediately |
4799 | preceding the increase. |
4800 | (c) In addition to the total fee assessed under paragraph |
4801 | (a), the agency shall require facilities that are licensed to |
4802 | provide limited nursing services under this part to pay an |
4803 | additional fee per licensed facility. The amount of the biennial |
4804 | fee shall be $250 per license, with an additional fee of $10 per |
4805 | resident based on the total licensed resident capacity of the |
4806 | facility. No part of this fee shall be returned to the facility. |
4807 | The agency may adjust the per bed license fee and the biennial |
4808 | license fee once each year by not more than the average rate of |
4809 | inflation for the 12 months immediately preceding the increase. |
4810 | (5) Counties or municipalities applying for licenses under |
4811 | this part are exempt from the payment of license fees. |
4812 | (6) The license shall be displayed in a conspicuous place |
4813 | inside the facility. |
4814 | (7) A license shall be valid only in the possession of the |
4815 | individual, firm, partnership, association, or corporation to |
4816 | which it is issued and shall not be subject to sale, assignment, |
4817 | or other transfer, voluntary or involuntary; nor shall a license |
4818 | be valid for any premises other than that for which originally |
4819 | issued. |
4820 | (8) A fee may be charged to a facility requesting a |
4821 | duplicate license. The fee shall not exceed the actual cost of |
4822 | duplication and postage. |
4823 | Section 86. Subsection (1) of section 400.4075, Florida |
4824 | Statutes, is amended to read: |
4825 | 400.4075 Limited mental health license.--An assisted |
4826 | living facility that serves three or more mental health |
4827 | residents must obtain a limited mental health license. |
4828 | (1) To obtain a limited mental health license, a facility |
4829 | must hold a standard license as an assisted living facility, |
4830 | must not have any current uncorrected deficiencies or |
4831 | violations, and must ensure that, within 6 months after |
4832 | receiving a limited mental health license, the facility |
4833 | administrator and the staff of the facility who are in direct |
4834 | contact with mental health residents must complete training of |
4835 | no less than 6 hours related to their duties. Such designation |
4836 | may be made at the time of initial licensure or relicensure or |
4837 | upon request in writing by a licensee under this part and part |
4838 | II of chapter 408. Notification of approval or denial of such |
4839 | request shall be made in accordance with this part, part II of |
4840 | chapter 408, and applicable rules. This training will be |
4841 | provided by or approved by the Department of Children and Family |
4842 | Services. |
4843 | Section 87. Section 400.408, Florida Statutes, is amended |
4844 | to read: |
4845 | 400.408 Unlicensed facilities; referral of person for |
4846 | residency to unlicensed facility; penalties; verification of |
4847 | licensure status.-- |
4848 | (1)(a) It is unlawful to own, operate, or maintain an |
4849 | assisted living facility without obtaining a license under this |
4850 | part. |
4851 | (b) Except as provided under paragraph (d), any person who |
4852 | owns, operates, or maintains an unlicensed assisted living |
4853 | facility commits a felony of the third degree, punishable as |
4854 | provided in s. 775.082, s. 775.083, or s. 775.084. Each day of |
4855 | continued operation is a separate offense. |
4856 | (c) Any person found guilty of violating paragraph (a) a |
4857 | second or subsequent time commits a felony of the second degree, |
4858 | punishable as provided under s. 775.082, s. 775.083, or s. |
4859 | 775.084. Each day of continued operation is a separate offense. |
4860 | (d) Any person who owns, operates, or maintains an |
4861 | unlicensed assisted living facility due to a change in this part |
4862 | or a modification in department rule within 6 months after the |
4863 | effective date of such change and who, within 10 working days |
4864 | after receiving notification from the agency, fails to cease |
4865 | operation or apply for a license under this part commits a |
4866 | felony of the third degree, punishable as provided in s. |
4867 | 775.082, s. 775.083, or s. 775.084. Each day of continued |
4868 | operation is a separate offense. |
4869 | (e) Any facility that fails to cease operation after |
4870 | agency notification may be fined for each day of noncompliance |
4871 | pursuant to s. 400.419. |
4872 | (f) When a licensee has an interest in more than one |
4873 | assisted living facility, and fails to license any one of these |
4874 | facilities, the agency may revoke the license, impose a |
4875 | moratorium, or impose a fine pursuant to s. 400.419, on any or |
4876 | all of the licensed facilities until such time as the unlicensed |
4877 | facility is licensed or ceases operation. |
4878 | (g) If the agency determines that an owner is operating or |
4879 | maintaining an assisted living facility without obtaining a |
4880 | license and determines that a condition exists in the facility |
4881 | that poses a threat to the health, safety, or welfare of a |
4882 | resident of the facility, the owner is subject to the same |
4883 | actions and fines imposed against a licensed facility as |
4884 | specified in ss. 400.414 and 400.419. |
4885 | (h) Any person aware of the operation of an unlicensed |
4886 | assisted living facility must report that facility to the |
4887 | agency. The agency shall provide to the department's elder |
4888 | information and referral providers a list, by county, of |
4889 | licensed assisted living facilities, to assist persons who are |
4890 | considering an assisted living facility placement in locating a |
4891 | licensed facility. |
4892 | (2)(i) Each field office of the Agency for Health Care |
4893 | Administration shall establish a local coordinating workgroup |
4894 | which includes representatives of local law enforcement |
4895 | agencies, state attorneys, the Medicaid Fraud Control Unit of |
4896 | the Department of Legal Affairs, local fire authorities, the |
4897 | Department of Children and Family Services, the district long- |
4898 | term care ombudsman council, and the district human rights |
4899 | advocacy committee to assist in identifying the operation of |
4900 | unlicensed facilities and to develop and implement a plan to |
4901 | ensure effective enforcement of state laws relating to such |
4902 | facilities. The workgroup shall report its findings, actions, |
4903 | and recommendations semiannually to the Director of Health |
4904 | Facility Regulation of the agency. |
4905 | (3)(2) It is unlawful to knowingly refer a person for |
4906 | residency to an unlicensed assisted living facility; to an |
4907 | assisted living facility the license of which is under denial or |
4908 | has been suspended or revoked; or to an assisted living facility |
4909 | that has a moratorium pursuant to part II of chapter 408, on |
4910 | admissions. Any person who violates this subsection commits a |
4911 | noncriminal violation, punishable by a fine not exceeding $500 |
4912 | as provided in s. 775.083. |
4913 | (a) Any health care practitioner, as defined in s. |
4914 | 456.001, who is aware of the operation of an unlicensed facility |
4915 | shall report that facility to the agency. Failure to report a |
4916 | facility that the practitioner knows or has reasonable cause to |
4917 | suspect is unlicensed shall be reported to the practitioner's |
4918 | licensing board. |
4919 | (b) Any hospital or community mental health center |
4920 | licensed under chapter 395 or chapter 394 which knowingly |
4921 | discharges a patient or client to an unlicensed facility is |
4922 | subject to sanction by the agency. |
4923 | (c) Any employee of the agency or department, or the |
4924 | Department of Children and Family Services, who knowingly refers |
4925 | a person for residency to an unlicensed facility; to a facility |
4926 | the license of which is under denial or has been suspended or |
4927 | revoked; or to a facility that has a moratorium pursuant to part |
4928 | II of chapter 408 on admissions is subject to disciplinary |
4929 | action by the agency or department, or the Department of |
4930 | Children and Family Services. |
4931 | (d) The employer of any person who is under contract with |
4932 | the agency or department, or the Department of Children and |
4933 | Family Services, and who knowingly refers a person for residency |
4934 | to an unlicensed facility; to a facility the license of which is |
4935 | under denial or has been suspended or revoked; or to a facility |
4936 | that has a moratorium pursuant to part II of chapter 408 on |
4937 | admissions shall be fined and required to prepare a corrective |
4938 | action plan designed to prevent such referrals. |
4939 | (e) The agency shall provide the department and the |
4940 | Department of Children and Family Services with a list of |
4941 | licensed facilities within each county and shall update the list |
4942 | at least quarterly. |
4943 | (f) At least annually, the agency shall notify, in |
4944 | appropriate trade publications, physicians licensed under |
4945 | chapter 458 or chapter 459, hospitals licensed under chapter |
4946 | 395, nursing home facilities licensed under part II of this |
4947 | chapter, and employees of the agency or the department, or the |
4948 | Department of Children and Family Services, who are responsible |
4949 | for referring persons for residency, that it is unlawful to |
4950 | knowingly refer a person for residency to an unlicensed assisted |
4951 | living facility and shall notify them of the penalty for |
4952 | violating such prohibition. The department and the Department of |
4953 | Children and Family Services shall, in turn, notify service |
4954 | providers under contract to the respective departments who have |
4955 | responsibility for resident referrals to facilities. Further, |
4956 | the notice must direct each noticed facility and individual to |
4957 | contact the appropriate agency office in order to verify the |
4958 | licensure status of any facility prior to referring any person |
4959 | for residency. Each notice must include the name, telephone |
4960 | number, and mailing address of the appropriate office to |
4961 | contact. |
4962 | Section 88. Section 400.411, Florida Statutes, is amended |
4963 | to read: |
4964 | 400.411 Initial application for license; provisional |
4965 | license.-- |
4966 | (1) Each applicant for licensure must comply with all |
4967 | provisions of part II of chapter 408 and must: Application for a |
4968 | license shall be made to the agency on forms furnished by it and |
4969 | shall be accompanied by the appropriate license fee. |
4970 | (2) The applicant may be an individual owner, a |
4971 | corporation, a partnership, a firm, an association, or a |
4972 | governmental entity. |
4973 | (3) The application must be signed by the applicant under |
4974 | oath and must contain the following: |
4975 | (a) The name, address, date of birth, and social security |
4976 | number of the applicant and the name by which the facility is to |
4977 | be known. If the applicant is a firm, partnership, or |
4978 | association, the application shall contain the name, address, |
4979 | date of birth, and social security number of every member |
4980 | thereof. If the applicant is a corporation, the application |
4981 | shall contain the corporation's name and address; the name, |
4982 | address, date of birth, and social security number of each of |
4983 | its directors and officers; and the name and address of each |
4984 | person having at least a 5-percent ownership interest in the |
4985 | corporation. |
4986 | (b) The name and address of any professional service, |
4987 | firm, association, partnership, or corporation that is to |
4988 | provide goods, leases, or services to the facility if a 5- |
4989 | percent or greater ownership interest in the service, firm, |
4990 | association, partnership, or corporation is owned by a person |
4991 | whose name must be listed on the application under paragraph |
4992 | (a). |
4993 | (c) The name and address of any long-term care facility |
4994 | with which the applicant, administrator, or financial officer |
4995 | has been affiliated through ownership or employment within 5 |
4996 | years of the date of this license application; and a signed |
4997 | affidavit disclosing any financial or ownership interest that |
4998 | the applicant, or any person listed in paragraph (a), holds or |
4999 | has held within the last 5 years in any facility licensed under |
5000 | this part, or in any other entity licensed by this state or |
5001 | another state to provide health or residential care, which |
5002 | facility or entity closed or ceased to operate as a result of |
5003 | financial problems, or has had a receiver appointed or a license |
5004 | denied, suspended or revoked, or was subject to a moratorium on |
5005 | admissions, or has had an injunctive proceeding initiated |
5006 | against it. |
5007 | (d) A description and explanation of any exclusions, |
5008 | permanent suspensions, or terminations of the applicant from the |
5009 | Medicare or Medicaid programs. Proof of compliance with |
5010 | disclosure of ownership and control interest requirements of the |
5011 | Medicaid or Medicare programs shall be accepted in lieu of this |
5012 | submission. |
5013 | (e) The names and addresses of persons of whom the agency |
5014 | may inquire as to the character, reputation, and financial |
5015 | responsibility of the owner and, if different from the |
5016 | applicant, the administrator and financial officer. |
5017 | (a)(f) Identify Identification of all other homes or |
5018 | facilities, including the addresses and the license or licenses |
5019 | under which they operate, if applicable, which are currently |
5020 | operated by the applicant or administrator and which provide |
5021 | housing, meals, and personal services to residents. |
5022 | (b)(g) Provide the location of the facility for which a |
5023 | license is sought and documentation, signed by the appropriate |
5024 | local government official, which states that the applicant has |
5025 | met local zoning requirements. |
5026 | (c)(h) Provide the name, address, date of birth, social |
5027 | security number, education, and experience of the administrator, |
5028 | if different from the applicant. |
5029 | (4) The applicant shall furnish satisfactory proof of |
5030 | financial ability to operate and conduct the facility in |
5031 | accordance with the requirements of this part. A certificate of |
5032 | authority, pursuant to chapter 651, may be provided as proof of |
5033 | financial ability. |
5034 | (5) If the applicant is a continuing care facility |
5035 | certified under chapter 651, a copy of the facility's |
5036 | certificate of authority must be provided. |
5037 | (2)(6) In addition to the requirements of s. 408.810, the |
5038 | applicant shall provide proof of liability insurance as defined |
5039 | in s. 624.605. |
5040 | (7) If the applicant is a community residential home, the |
5041 | applicant must provide proof that it has met the requirements |
5042 | specified in chapter 419. |
5043 | (8) The applicant must provide the agency with proof of |
5044 | legal right to occupy the property. |
5045 | (3)(9) The applicant must furnish proof that the facility |
5046 | has received a satisfactory firesafety inspection. The local |
5047 | authority having jurisdiction or the State Fire Marshal must |
5048 | conduct the inspection within 30 days after written request by |
5049 | the applicant. |
5050 | (4)(10) The applicant must furnish documentation of a |
5051 | satisfactory sanitation inspection of the facility by the county |
5052 | health department. |
5053 | (11) The applicant must furnish proof of compliance with |
5054 | level 2 background screening as required under s. 400.4174. |
5055 | (5)(12) A provisional license may be issued to an |
5056 | applicant making initial application for licensure or making |
5057 | application for a change of ownership. A provisional license |
5058 | shall be limited in duration to a specific period of time not to |
5059 | exceed 6 months, as determined by the agency. |
5060 | (6)(13) A county or municipality may not issue an |
5061 | occupational license that is being obtained for the purpose of |
5062 | operating a facility regulated under this part without first |
5063 | ascertaining that the applicant has been licensed to operate |
5064 | such facility at the specified location or locations by the |
5065 | agency. The agency shall furnish to local agencies responsible |
5066 | for issuing occupational licenses sufficient instruction for |
5067 | making such determinations. |
5068 | Section 89. Section 400.412, Florida Statutes, is amended |
5069 | to read: |
5070 | 400.412 Sale or transfer of ownership of a facility.--It |
5071 | is the intent of the Legislature to protect the rights of the |
5072 | residents of an assisted living facility when the facility is |
5073 | sold or the ownership thereof is transferred. Therefore, in |
5074 | addition to the requirements of part II of chapter 408, whenever |
5075 | a facility is sold or the ownership thereof is transferred, |
5076 | including leasing: |
5077 | (1) The transferee shall make application to the agency |
5078 | for a new license at least 60 days before the date of transfer |
5079 | of ownership. The application must comply with the provisions of |
5080 | s. 400.411. |
5081 | (2)(a) The transferor shall notify the agency in writing |
5082 | at least 60 days before the date of transfer of ownership. |
5083 | (1)(b) The transferee new owner shall notify the |
5084 | residents, in writing, of the change transfer of ownership |
5085 | within 7 days after of his or her receipt of the new license. |
5086 | (3) The transferor shall be responsible and liable for: |
5087 | (a) The lawful operation of the facility and the welfare |
5088 | of the residents domiciled in the facility until the date the |
5089 | transferee is licensed by the agency. |
5090 | (b) Any and all penalties imposed against the facility for |
5091 | violations occurring before the date of transfer of ownership |
5092 | unless the penalty imposed is a moratorium on admissions or |
5093 | denial of licensure. The moratorium on admissions or denial of |
5094 | licensure remains in effect after the transfer of ownership, |
5095 | unless the agency has approved the transferee's corrective |
5096 | action plan or the conditions which created the moratorium or |
5097 | denial have been corrected, and may be grounds for denial of |
5098 | license to the transferee in accordance with chapter 120. |
5099 | (c) Any outstanding liability to the state, unless the |
5100 | transferee has agreed, as a condition of sale or transfer, to |
5101 | accept the outstanding liabilities and to guarantee payment |
5102 | therefor; except that, if the transferee fails to meet these |
5103 | obligations, the transferor shall remain liable for the |
5104 | outstanding liability. |
5105 | (2)(4) The transferor of a facility the license of which |
5106 | is denied pending an administrative hearing shall, as a part of |
5107 | the written change of ownership transfer-of-ownership contract, |
5108 | advise the transferee that a plan of correction must be |
5109 | submitted by the transferee and approved by the agency at least |
5110 | 7 days before the change transfer of ownership and that failure |
5111 | to correct the condition which resulted in the moratorium |
5112 | pursuant to part II of chapter 408 on admissions or denial of |
5113 | licensure is grounds for denial of the transferee's license. |
5114 | (5) The transferee must provide the agency with proof of |
5115 | legal right to occupy the property before a license may be |
5116 | issued. Proof may include, but is not limited to, copies of |
5117 | warranty deeds, or copies of lease or rental agreements, |
5118 | contracts for deeds, quitclaim deeds, or other such |
5119 | documentation. |
5120 | Section 90. Section 400.414, Florida Statutes, is amended |
5121 | to read: |
5122 | 400.414 Denial, revocation, or suspension of license; |
5123 | moratorium; imposition of administrative fine; grounds.-- |
5124 | (1) The agency may deny, revoke, and or suspend any |
5125 | license issued under this part and, or impose a moratorium and |
5126 | an administrative fine in the manner provided in chapter 120 on |
5127 | an assisted living facility for a violation of any provision of |
5128 | this part, part II of chapter 408, or applicable rules, or for |
5129 | any of the following actions by an assisted living facility, for |
5130 | the actions of any person subject to level 2 background |
5131 | screening under s. 408.809 400.4174, or for the actions of any |
5132 | facility employee: |
5133 | (a) An intentional or negligent act seriously affecting |
5134 | the health, safety, or welfare of a resident of the facility. |
5135 | (b) The determination by the agency that the owner lacks |
5136 | the financial ability to provide continuing adequate care to |
5137 | residents. |
5138 | (c) Misappropriation or conversion of the property of a |
5139 | resident of the facility. |
5140 | (d) Failure to follow the criteria and procedures provided |
5141 | under part I of chapter 394 relating to the transportation, |
5142 | voluntary admission, and involuntary examination of a facility |
5143 | resident. |
5144 | (e) A citation of any of the following deficiencies as |
5145 | defined in s. 400.419: |
5146 | 1. One or more cited class I deficiencies. |
5147 | 2. Three or more cited class II deficiencies. |
5148 | 3. Five or more cited class III deficiencies that have |
5149 | been cited on a single survey and have not been corrected within |
5150 | the times specified. |
5151 | (f) A determination that a person subject to level 2 |
5152 | background screening under s. 408.809 400.4174(1) does not meet |
5153 | the screening standards of s. 435.04 or that the facility is |
5154 | retaining an employee subject to level 1 background screening |
5155 | standards under s. 400.4174(2) who does not meet the screening |
5156 | standards of s. 435.03 and for whom exemptions from |
5157 | disqualification have not been provided by the agency. |
5158 | (g) A determination that an employee, volunteer, |
5159 | administrator, or owner, or person who otherwise has access to |
5160 | the residents of a facility does not meet the criteria specified |
5161 | in s. 435.03(2), and the owner or administrator has not taken |
5162 | action to remove the person. Exemptions from disqualification |
5163 | may be granted as set forth in s. 435.07. No administrative |
5164 | action may be taken against the facility if the person is |
5165 | granted an exemption. |
5166 | (h) Violation of a moratorium. |
5167 | (i) Failure of the license applicant, the licensee during |
5168 | relicensure, or a licensee that holds a provisional license to |
5169 | meet the minimum license requirements of this part, or related |
5170 | rules, at the time of license application or renewal. |
5171 | (j) A fraudulent statement or omission of any material |
5172 | fact on an application for a license or any other document |
5173 | required by the agency, including the submission of a license |
5174 | application that conceals the fact that any board member, |
5175 | officer, or person owning 5 percent or more of the facility may |
5176 | not meet the background screening requirements of s. 400.4174, |
5177 | or that the applicant has been excluded, permanently suspended, |
5178 | or terminated from the Medicaid or Medicare programs. |
5179 | (h)(k) An intentional or negligent life-threatening act in |
5180 | violation of the uniform firesafety standards for assisted |
5181 | living facilities or other firesafety standards that threatens |
5182 | the health, safety, or welfare of a resident of a facility, as |
5183 | communicated to the agency by the local authority having |
5184 | jurisdiction or the State Fire Marshal. |
5185 | (l) Exclusion, permanent suspension, or termination from |
5186 | the Medicare or Medicaid programs. |
5187 | (i)(m) Knowingly operating any unlicensed facility or |
5188 | providing without a license any service that must be licensed |
5189 | under this chapter. |
5190 | (j)(n) Any act constituting a ground upon which |
5191 | application for a license may be denied. |
5192 |
|
5193 | Administrative proceedings challenging agency action under this |
5194 | subsection shall be reviewed on the basis of the facts and |
5195 | conditions that resulted in the agency action. |
5196 | (2) Upon notification by the local authority having |
5197 | jurisdiction or by the State Fire Marshal, the agency may deny |
5198 | or revoke the license of an assisted living facility that fails |
5199 | to correct cited fire code violations that affect or threaten |
5200 | the health, safety, or welfare of a resident of a facility. |
5201 | (3) The agency may deny a license to any applicant or |
5202 | controlling interest as defined in part II of chapter 408 that |
5203 | to any officer or board member of an applicant who is a firm, |
5204 | corporation, partnership, or association or who owns 5 percent |
5205 | or more of the facility, if the applicant, officer, or board |
5206 | member has or had a 25-percent or greater financial or ownership |
5207 | interest in any other facility licensed under this part, or in |
5208 | any entity licensed by this state or another state to provide |
5209 | health or residential care, which facility or entity during the |
5210 | 5 years prior to the application for a license closed due to |
5211 | financial inability to operate; had a receiver appointed or a |
5212 | license denied, suspended, or revoked; was subject to a |
5213 | moratorium pursuant to part II of chapter 408 on admissions; had |
5214 | an injunctive proceeding initiated against it; or has an |
5215 | outstanding fine assessed under this chapter. |
5216 | (4) The agency shall deny or revoke the license of an |
5217 | assisted living facility that has two or more class I violations |
5218 | that are similar or identical to violations identified by the |
5219 | agency during a survey, inspection, monitoring visit, or |
5220 | complaint investigation occurring within the previous 2 years. |
5221 | (5) An action taken by the agency to suspend, deny, or |
5222 | revoke a facility's license under this part, in which the agency |
5223 | claims that the facility owner or an employee of the facility |
5224 | has threatened the health, safety, or welfare of a resident of |
5225 | the facility be heard by the Division of Administrative Hearings |
5226 | of the Department of Management Services within 120 days after |
5227 | receipt of the facility's request for a hearing, unless that |
5228 | time limitation is waived by both parties. The administrative |
5229 | law judge must render a decision within 30 days after receipt of |
5230 | a proposed recommended order. |
5231 | (6) The agency shall provide to the Division of Hotels and |
5232 | Restaurants of the Department of Business and Professional |
5233 | Regulation, on a monthly basis, a list of those assisted living |
5234 | facilities that have had their licenses denied, suspended, or |
5235 | revoked or that are involved in an appellate proceeding pursuant |
5236 | to s. 120.60 related to the denial, suspension, or revocation of |
5237 | a license. |
5238 | (7) Agency notification of a license suspension or |
5239 | revocation, or denial of a license renewal, shall be posted and |
5240 | visible to the public at the facility. |
5241 | (8) The agency may issue a temporary license pending final |
5242 | disposition of a proceeding involving the suspension or |
5243 | revocation of an assisted living facility license. |
5244 | Section 91. Section 400.415, Florida Statutes, is |
5245 | repealed. |
5246 | Section 92. Section 400.417, Florida Statutes, is amended |
5247 | to read: |
5248 | 400.417 Expiration of license; renewal; conditional |
5249 | license.-- |
5250 | (1) Biennial licenses, unless sooner suspended or revoked, |
5251 | shall expire 2 years from the date of issuance. Limited nursing, |
5252 | extended congregate care, and limited mental health licenses |
5253 | shall expire at the same time as the facility's standard |
5254 | license, regardless of when issued. The agency shall notify the |
5255 | facility at least 120 days prior to expiration that a renewal |
5256 | license is necessary to continue operation. The notification |
5257 | must be provided electronically or by mail delivery. Ninety days |
5258 | prior to the expiration date, an application for renewal shall |
5259 | be submitted to the agency. Fees must be prorated. The failure |
5260 | to file a timely renewal application shall result in a late fee |
5261 | charged to the facility in an amount equal to 50 percent of the |
5262 | current fee. |
5263 | (2) A license shall be renewed in accordance with part II |
5264 | of chapter 408 within 90 days upon the timely filing of an |
5265 | application on forms furnished by the agency and the provision |
5266 | of satisfactory proof of ability to operate and conduct the |
5267 | facility in accordance with the requirements of this part and |
5268 | adopted rules, including proof that the facility has received a |
5269 | satisfactory firesafety inspection, conducted by the local |
5270 | authority having jurisdiction or the State Fire Marshal, within |
5271 | the preceding 12 months and an affidavit of compliance with the |
5272 | background screening requirements of s. 400.4174. |
5273 | (3) In addition to the requirements of part II of chapter |
5274 | 408, An applicant for renewal of a license who has complied with |
5275 | the provisions of s. 400.411 with respect to proof of financial |
5276 | ability to operate shall not be required to provide further |
5277 | proof unless the facility or any other facility owned or |
5278 | operated in whole or in part by the same person has demonstrated |
5279 | financial instability as provided under s. 400.447(2) or unless |
5280 | the agency suspects that the facility is not financially stable |
5281 | as a result of the annual survey or complaints from the public |
5282 | or a report from the State Long-Term Care Ombudsman Council. |
5283 | each facility must report to the agency any adverse court action |
5284 | concerning the facility's financial viability, within 7 days |
5285 | after its occurrence. The agency shall have access to books, |
5286 | records, and any other financial documents maintained by the |
5287 | facility to the extent necessary to determine the facility's |
5288 | financial stability. A license for the operation of a facility |
5289 | shall not be renewed if the licensee has any outstanding fines |
5290 | assessed pursuant to this part which are in final order status. |
5291 | (4) A licensee against whom a revocation or suspension |
5292 | proceeding is pending at the time of license renewal may be |
5293 | issued a conditional license effective until final disposition |
5294 | by the agency. If judicial relief is sought from the final |
5295 | disposition, the court having jurisdiction may issue a |
5296 | conditional license for the duration of the judicial proceeding. |
5297 | (4)(5) A conditional license may be issued to an applicant |
5298 | for license renewal if the applicant fails to meet all standards |
5299 | and requirements for licensure. A conditional license issued |
5300 | under this subsection shall be limited in duration to a specific |
5301 | period of time not to exceed 6 months, as determined by the |
5302 | agency, and shall be accompanied by an agency-approved plan of |
5303 | correction. |
5304 | (5)(6) When an extended care or limited nursing license is |
5305 | requested during a facility's biennial license period, the fee |
5306 | shall be prorated in order to permit the additional license to |
5307 | expire at the end of the biennial license period. The fee shall |
5308 | be calculated as of the date the additional license application |
5309 | is received by the agency. |
5310 | (6)(7) The agency department may by rule establish renewal |
5311 | procedures, identify forms, and specify documentation necessary |
5312 | to administer this section and part II of chapter 408. |
5313 | Section 93. Section 400.4174, Florida Statutes, is amended |
5314 | to read: |
5315 | 400.4174 Background screening; exemptions.-- |
5316 | (1)(a) Level 2 background screening must be conducted on |
5317 | each of the following persons, who shall be considered employees |
5318 | for the purposes of conducting screening under chapter 435: |
5319 | 1. The facility owner if an individual, the administrator, |
5320 | and the financial officer. |
5321 | 2. An officer or board member if the facility owner is a |
5322 | firm, corporation, partnership, or association, or any person |
5323 | owning 5 percent or more of the facility if the agency has |
5324 | probable cause to believe that such person has been convicted of |
5325 | any offense prohibited by s. 435.04. For each officer, board |
5326 | member, or person owning 5 percent or more who has been |
5327 | convicted of any such offense, the facility shall submit to the |
5328 | agency a description and explanation of the conviction at the |
5329 | time of license application. This subparagraph does not apply to |
5330 | a board member of a not-for-profit corporation or organization |
5331 | if the board member serves solely in a voluntary capacity, does |
5332 | not regularly take part in the day-to-day operational decisions |
5333 | of the corporation or organization, receives no remuneration for |
5334 | his or her services, and has no financial interest and has no |
5335 | family members with a financial interest in the corporation or |
5336 | organization, provided that the board member and facility submit |
5337 | a statement affirming that the board member's relationship to |
5338 | the facility satisfies the requirements of this subparagraph. |
5339 | (b) Proof of compliance with level 2 screening standards |
5340 | which has been submitted within the previous 5 years to meet any |
5341 | facility or professional licensure requirements of the agency or |
5342 | the Department of Health satisfies the requirements of this |
5343 | subsection, provided that such proof is accompanied, under |
5344 | penalty of perjury, by an affidavit of compliance with the |
5345 | provisions of chapter 435. Proof of compliance with the |
5346 | background screening requirements of the Financial Services |
5347 | Commission and the Office of Insurance Regulation for applicants |
5348 | for a certificate of authority to operate a continuing care |
5349 | retirement community under chapter 651, submitted within the |
5350 | last 5 years, satisfies the Department of Law Enforcement and |
5351 | Federal Bureau of Investigation portions of a level 2 background |
5352 | check. |
5353 | (c) The agency may grant a provisional license to a |
5354 | facility applying for an initial license when each individual |
5355 | required by this subsection to undergo screening has completed |
5356 | the Department of Law Enforcement background checks, but has not |
5357 | yet received results from the Federal Bureau of Investigation, |
5358 | or when a request for an exemption from disqualification has |
5359 | been submitted to the agency pursuant to s. 435.07, but a |
5360 | response has not been issued. |
5361 | (2) The owner or administrator of an assisted living |
5362 | facility must conduct level 1 background screening, as set forth |
5363 | in chapter 435, on all employees hired on or after October 1, |
5364 | 1998, who perform personal services as defined in s. |
5365 | 400.402(16)(17). The agency may exempt an individual from |
5366 | employment disqualification as set forth in chapter 435. Such |
5367 | persons shall be considered as having met this requirement if: |
5368 | (1)(a) Proof of compliance with level 1 screening |
5369 | requirements obtained to meet any professional license |
5370 | requirements in this state is provided and accompanied, under |
5371 | penalty of perjury, by a copy of the person's current |
5372 | professional license and an affidavit of current compliance with |
5373 | the background screening requirements. |
5374 | (2)(b) The person required to be screened has been |
5375 | continuously employed in the same type of occupation for which |
5376 | the person is seeking employment without a breach in service |
5377 | which exceeds 180 days, and proof of compliance with the level 1 |
5378 | screening requirement which is no more than 2 years old is |
5379 | provided. Proof of compliance shall be provided directly from |
5380 | one employer or contractor to another, and not from the person |
5381 | screened. Upon request, a copy of screening results shall be |
5382 | provided by the employer retaining documentation of the |
5383 | screening to the person screened. |
5384 | (3)(c) The person required to be screened is employed by a |
5385 | corporation or business entity or related corporation or |
5386 | business entity that owns, operates, or manages more than one |
5387 | facility or agency licensed under this chapter, and for whom a |
5388 | level 1 screening was conducted by the corporation or business |
5389 | entity as a condition of initial or continued employment. |
5390 | Section 94. Section 400.4176, Florida Statutes, is amended |
5391 | to read: |
5392 | 400.4176 Notice of change of administrator.--If, during |
5393 | the period for which a license is issued, the owner changes |
5394 | administrators, the owner must notify the agency of the change |
5395 | within 10 days and provide documentation within 90 days that the |
5396 | new administrator has completed the applicable core educational |
5397 | requirements under s. 400.452. Background screening shall be |
5398 | completed on any new administrator as specified in s. 400.4174. |
5399 | Section 95. Subsection (8) of section 400.4178, Florida |
5400 | Statutes, is renumbered as subsection (7) and present subsection |
5401 | (7) of said section is amended to read: |
5402 | 400.4178 Special care for persons with Alzheimer's disease |
5403 | or other related disorders.-- |
5404 | (7) Any facility more than 90 percent of whose residents |
5405 | receive monthly optional supplementation payments is not |
5406 | required to pay for the training and education programs required |
5407 | under this section. A facility that has one or more such |
5408 | residents shall pay a reduced fee that is proportional to the |
5409 | percentage of such residents in the facility. A facility that |
5410 | does not have any residents who receive monthly optional |
5411 | supplementation payments must pay a reasonable fee, as |
5412 | established by the department, for such training and education |
5413 | programs. |
5414 | Section 96. Section 400.418, Florida Statutes, is amended |
5415 | to read: |
5416 | 400.418 Disposition of fees and administrative fines.-- |
5417 | (1) Income from license fees, inspection fees, late fees, |
5418 | and administrative fines collected under this part generated |
5419 | pursuant to ss. 400.407, 400.408, 400.417, 400.419, and 400.431 |
5420 | shall be deposited in the Health Care Trust Fund administered by |
5421 | the agency. Such funds shall be directed to and used by the |
5422 | agency for the following purposes: |
5423 | (1)(a) Up to 50 percent of the trust funds accrued each |
5424 | fiscal year under this part may be used to offset the expenses |
5425 | of receivership, pursuant to s. 400.422, if the court determines |
5426 | that the income and assets of the facility are insufficient to |
5427 | provide for adequate management and operation. |
5428 | (2)(b) An amount of $5,000 of the trust funds accrued each |
5429 | year under this part shall be allocated to pay for inspection- |
5430 | related physical and mental health examinations requested by the |
5431 | agency pursuant to s. 400.426 for residents who are either |
5432 | recipients of supplemental security income or have monthly |
5433 | incomes not in excess of the maximum combined federal and state |
5434 | cash subsidies available to supplemental security income |
5435 | recipients, as provided for in s. 409.212. Such funds shall only |
5436 | be used where the resident is ineligible for Medicaid. |
5437 | (3)(c) Any trust funds accrued each year under this part |
5438 | and not used for the purposes specified in subsections (1) and |
5439 | (2) paragraphs (a) and (b) shall be used to offset the costs of |
5440 | the licensure program, including the costs of conducting |
5441 | background investigations, verifying information submitted, |
5442 | defraying the costs of processing the names of applicants, and |
5443 | conducting inspections and monitoring visits pursuant to this |
5444 | part and part II of chapter 408. |
5445 | (2) Income from fees generated pursuant to s. 400.441(5) |
5446 | shall be deposited in the Health Care Trust Fund and used to |
5447 | offset the costs of printing and postage. |
5448 | Section 97. Section 400.419, Florida Statutes, is amended |
5449 | to read: |
5450 | 400.419 Violations; imposition of administrative fines; |
5451 | grounds.-- |
5452 | (1) The agency shall impose an administrative fine in the |
5453 | manner provided in chapter 120 for the violation of any |
5454 | provision of this part, part II of chapter 408, and applicable |
5455 | rules for any of the actions or violations as set forth within |
5456 | this section by an assisted living facility, for the actions of |
5457 | any person subject to level 2 background screening under s. |
5458 | 400.4174, for the actions of any facility employee, or for an |
5459 | intentional or negligent act seriously affecting the health, |
5460 | safety, or welfare of a resident of the facility. |
5461 | (2) Each violation of this part and adopted rules shall be |
5462 | classified according to the nature of the violation and the |
5463 | gravity of its probable effect on facility residents. The agency |
5464 | shall indicate the classification on the written notice of the |
5465 | violation as follows: |
5466 | (a) Class "I" violations are those conditions or |
5467 | occurrences related to the operation and maintenance of a |
5468 | facility or to the personal care of residents which the agency |
5469 | determines present an imminent danger to the residents or guests |
5470 | of the facility or a substantial probability that death or |
5471 | serious physical or emotional harm would result therefrom. The |
5472 | condition or practice constituting a class I violation shall be |
5473 | abated or eliminated within 24 hours, unless a fixed period, as |
5474 | determined by the agency, is required for correction. The agency |
5475 | shall impose an administrative fine for a cited class I |
5476 | violation in an amount not less than $5,000 and not exceeding |
5477 | $10,000 for each violation. A fine may be levied notwithstanding |
5478 | the correction of the violation. |
5479 | (b) Class "II" violations are those conditions or |
5480 | occurrences related to the operation and maintenance of a |
5481 | facility or to the personal care of residents which the agency |
5482 | determines directly threaten the physical or emotional health, |
5483 | safety, or security of the facility residents, other than class |
5484 | I violations. The agency shall impose an administrative fine for |
5485 | a cited class II violation in an amount not less than $1,000 and |
5486 | not exceeding $5,000 for each violation. A fine shall be levied |
5487 | notwithstanding the correction of the violation. |
5488 | (c) Class "III" violations are those conditions or |
5489 | occurrences related to the operation and maintenance of a |
5490 | facility or to the personal care of residents which the agency |
5491 | determines indirectly or potentially threaten the physical or |
5492 | emotional health, safety, or security of facility residents, |
5493 | other than class I or class II violations. The agency shall |
5494 | impose an administrative fine for a cited class III violation in |
5495 | an amount not less than $500 and not exceeding $1,000 for each |
5496 | violation. A citation for a class III violation must specify the |
5497 | time within which the violation is required to be corrected. If |
5498 | a class III violation is corrected within the time specified, no |
5499 | fine may be imposed, unless it is a repeated offense. |
5500 | (d) Class "IV" violations are those conditions or |
5501 | occurrences related to the operation and maintenance of a |
5502 | building or to required reports, forms, or documents that do not |
5503 | have the potential of negatively affecting residents. These |
5504 | violations are of a type that the agency determines do not |
5505 | threaten the health, safety, or security of residents of the |
5506 | facility. The agency shall impose an administrative fine for a |
5507 | cited class IV violation in an amount not less than $100 and not |
5508 | exceeding $200 for each violation. A citation for a class IV |
5509 | violation must specify the time within which the violation is |
5510 | required to be corrected. If a class IV violation is corrected |
5511 | within the time specified, no fine shall be imposed. Any class |
5512 | IV violation that is corrected during the time an agency survey |
5513 | is being conducted will be identified as an agency finding and |
5514 | not as a violation. |
5515 | (3) For purposes of this section, in determining if a |
5516 | penalty is to be imposed and in fixing the amount of the fine, |
5517 | the agency shall consider the following factors: |
5518 | (a) The gravity of the violation, including the |
5519 | probability that death or serious physical or emotional harm to |
5520 | a resident will result or has resulted, the severity of the |
5521 | action or potential harm, and the extent to which the provisions |
5522 | of the applicable laws or rules were violated. |
5523 | (b) Actions taken by the owner or administrator to correct |
5524 | violations. |
5525 | (c) Any previous violations. |
5526 | (d) The financial benefit to the facility of committing or |
5527 | continuing the violation. |
5528 | (e) The licensed capacity of the facility. |
5529 | (4) Each day of continuing violation after the date fixed |
5530 | for termination of the violation, as ordered by the agency, |
5531 | constitutes an additional, separate, and distinct violation. |
5532 | (5) Any action taken to correct a violation shall be |
5533 | documented in writing by the owner or administrator of the |
5534 | facility and verified through followup visits by agency |
5535 | personnel. The agency may impose a fine and, in the case of an |
5536 | owner-operated facility, revoke or deny a facility's license |
5537 | when a facility administrator fraudulently misrepresents action |
5538 | taken to correct a violation. |
5539 | (6) For fines that are upheld following administrative or |
5540 | judicial review, the violator shall pay the fine, plus interest |
5541 | at the rate as specified in s. 55.03, for each day beyond the |
5542 | date set by the agency for payment of the fine. |
5543 | (7) Any unlicensed facility that continues to operate |
5544 | after agency notification is subject to a $1,000 fine per day. |
5545 | (8) Any licensed facility whose owner or administrator |
5546 | concurrently operates an unlicensed facility shall be subject to |
5547 | an administrative fine of $5,000 per day. |
5548 | (9) Any facility whose owner fails to apply for a change- |
5549 | of-ownership license in accordance with s. 400.412 and operates |
5550 | the facility under the new ownership is subject to a fine of |
5551 | $5,000. |
5552 | (6)(10) In addition to any administrative fines imposed, |
5553 | the agency may assess a survey fee, equal to the lesser of one |
5554 | half of the facility's biennial license and bed fee or $500, to |
5555 | cover the cost of conducting initial complaint investigations |
5556 | that result in the finding of a violation that was the subject |
5557 | of the complaint or monitoring visits conducted under s. |
5558 | 400.428(3)(c) to verify the correction of the violations. |
5559 | (7)(11) The agency, as an alternative to or in conjunction |
5560 | with an administrative action against a facility for violations |
5561 | of this part and adopted rules, shall make a reasonable attempt |
5562 | to discuss each violation and recommended corrective action with |
5563 | the owner or administrator of the facility, prior to written |
5564 | notification. The agency, instead of fixing a period within |
5565 | which the facility shall enter into compliance with standards, |
5566 | may request a plan of corrective action from the facility which |
5567 | demonstrates a good faith effort to remedy each violation by a |
5568 | specific date, subject to the approval of the agency. |
5569 | (12) Administrative fines paid by any facility under this |
5570 | section shall be deposited into the Health Care Trust Fund and |
5571 | expended as provided in s. 400.418. |
5572 | (8)(13) The agency shall develop and disseminate an annual |
5573 | list of all facilities sanctioned or fined $5,000 or more for |
5574 | violations of state standards, the number and class of |
5575 | violations involved, the penalties imposed, and the current |
5576 | status of cases. The list shall be disseminated, at no charge, |
5577 | to the Department of Elderly Affairs, the Department of Health, |
5578 | the Department of Children and Family Services, the area |
5579 | agencies on aging, the Florida Statewide Advocacy Council, and |
5580 | the state and local ombudsman councils. The Department of |
5581 | Children and Family Services shall disseminate the list to |
5582 | service providers under contract to the department who are |
5583 | responsible for referring persons to a facility for residency. |
5584 | The agency may charge a fee commensurate with the cost of |
5585 | printing and postage to other interested parties requesting a |
5586 | copy of this list. |
5587 | Section 98. Section 400.421, Florida Statutes, is |
5588 | repealed. |
5589 | Section 99. Subsection (9) of section 400.422, Florida |
5590 | Statutes, is amended to read: |
5591 | 400.422 Receivership proceedings.-- |
5592 | (9) The court may direct the agency to allocate funds from |
5593 | the Health Care Trust Fund to the receiver, subject to the |
5594 | provisions of s. 400.418(1). |
5595 | Section 100. Subsection (10) of section 400.423, Florida |
5596 | Statutes, is amended to read: |
5597 | 400.423 Internal risk management and quality assurance |
5598 | program; adverse incidents and reporting requirements.-- |
5599 | (10) The agency Department of Elderly Affairs may adopt |
5600 | rules necessary to administer this section. |
5601 | Section 101. Subsections (3) and (8) of section 400.424, |
5602 | Florida Statutes, are amended to read: |
5603 | 400.424 Contracts.-- |
5604 | (3)(a) The contract shall include a refund policy to be |
5605 | implemented at the time of a resident's transfer, discharge, or |
5606 | death. The refund policy shall provide that the resident or |
5607 | responsible party is entitled to a prorated refund based on the |
5608 | daily rate for any unused portion of payment beyond the |
5609 | termination date after all charges, including the cost of |
5610 | damages to the residential unit resulting from circumstances |
5611 | other than normal use, have been paid to the licensee. For the |
5612 | purpose of this paragraph, the termination date shall be the |
5613 | date the unit is vacated by the resident and cleared of all |
5614 | personal belongings. If the amount of belongings does not |
5615 | preclude renting the unit, the facility may clear the unit and |
5616 | charge the resident or his or her estate for moving and storing |
5617 | the items at a rate equal to the actual cost to the facility, |
5618 | not to exceed 20 percent of the regular rate for the unit, |
5619 | provided that 14 days' advance written notification is given. If |
5620 | the resident's possessions are not claimed within 45 days after |
5621 | notification, the facility may dispose of them. The contract |
5622 | shall also specify any other conditions under which claims will |
5623 | be made against the refund due the resident. Except in the case |
5624 | of death or a discharge due to medical reasons, the refunds |
5625 | shall be computed in accordance with the notice of relocation |
5626 | requirements specified in the contract. However, a resident may |
5627 | not be required to provide the licensee with more than 30 days' |
5628 | notice of termination. If after a contract is terminated, the |
5629 | facility intends to make a claim against a refund due the |
5630 | resident, the facility shall notify the resident or responsible |
5631 | party in writing of the claim and shall provide said party with |
5632 | a reasonable time period of no less than 14 calendar days to |
5633 | respond. The facility shall provide a refund to the resident or |
5634 | responsible party within 45 days after the transfer, discharge, |
5635 | or death of the resident. The agency shall impose a fine upon a |
5636 | facility that fails to comply with the refund provisions of this |
5637 | the paragraph, which fine shall be equal to three times the |
5638 | amount due to the resident and not subject to the provisions of |
5639 | s. 400.419(3). One-half of the fine shall be remitted to the |
5640 | resident or his or her estate, and the other half to the Health |
5641 | Care Trust Fund to be used for the purpose specified in s. |
5642 | 400.418. |
5643 | (b) If a licensee agrees to reserve a bed for a resident |
5644 | who is admitted to a medical facility, including, but not |
5645 | limited to, a nursing home, health care facility, or psychiatric |
5646 | facility, the resident or his or her responsible party shall |
5647 | notify the licensee of any change in status that would prevent |
5648 | the resident from returning to the facility. Until such notice |
5649 | is received, the agreed-upon daily rate may be charged by the |
5650 | licensee. |
5651 | (c) The purpose of any advance payment and a refund policy |
5652 | for such payment, including any advance payment for housing, |
5653 | meals, or personal services, shall be covered in the contract. |
5654 | (8) The agency department may by rule clarify terms, |
5655 | establish procedures, clarify refund policies and contract |
5656 | provisions, and specify documentation as necessary to administer |
5657 | this section. |
5658 | Section 102. Subsection (3) of section 400.4255, Florida |
5659 | Statutes, is amended to read: |
5660 | 400.4255 Use of personnel; emergency care.-- |
5661 | (3) Facility staff may withhold or withdraw |
5662 | cardiopulmonary resuscitation if presented with an order not to |
5663 | resuscitate executed pursuant to s. 401.45. The agency |
5664 | department shall adopt rules providing for the implementation of |
5665 | such orders. Facility staff and facilities shall not be subject |
5666 | to criminal prosecution or civil liability, nor be considered to |
5667 | have engaged in negligent or unprofessional conduct, for |
5668 | withholding or withdrawing cardiopulmonary resuscitation |
5669 | pursuant to such an order and applicable rules adopted by the |
5670 | department. The absence of an order to resuscitate executed |
5671 | pursuant to s. 401.45 does not preclude a physician from |
5672 | withholding or withdrawing cardiopulmonary resuscitation as |
5673 | otherwise permitted by law. |
5674 | Section 103. Subsection (6) of section 400.4256, Florida |
5675 | Statutes, is amended to read: |
5676 | 400.4256 Assistance with self-administration of |
5677 | medication.-- |
5678 | (6) The agency department may by rule establish facility |
5679 | procedures and interpret terms as necessary to implement this |
5680 | section. |
5681 | Section 104. Subsection (9) of section 400.426, Florida |
5682 | Statutes, is amended to read: |
5683 | 400.426 Appropriateness of placements; examinations of |
5684 | residents.-- |
5685 | (9) If, at any time after admission to a facility, a |
5686 | resident appears to need care beyond that which the facility is |
5687 | licensed to provide, the agency shall require the resident to be |
5688 | physically examined by a licensed physician or licensed nurse |
5689 | practitioner. This examination shall, to the extent possible, be |
5690 | performed by the resident's preferred physician or nurse |
5691 | practitioner and shall be paid for by the resident with personal |
5692 | funds, except as provided in s. 400.418(2)(1)(b). Following this |
5693 | examination, the examining physician or licensed nurse |
5694 | practitioner shall complete and sign a medical form provided by |
5695 | the agency. The completed medical form shall be submitted to the |
5696 | agency within 30 days after the date the facility owner or |
5697 | administrator is notified by the agency that the physical |
5698 | examination is required. After consultation with the physician |
5699 | or licensed nurse practitioner who performed the examination, a |
5700 | medical review team designated by the agency shall then |
5701 | determine whether the resident is appropriately residing in the |
5702 | facility. The medical review team shall base its decision on a |
5703 | comprehensive review of the resident's physical and functional |
5704 | status, including the resident's preferences, and not on an |
5705 | isolated health-related problem. In the case of a mental health |
5706 | resident, if the resident appears to have needs in addition to |
5707 | those identified in the community living support plan, the |
5708 | agency may require an evaluation by a mental health |
5709 | professional, as determined by the Department of Children and |
5710 | Family Services. A facility may not be required to retain a |
5711 | resident who requires more services or care than the facility is |
5712 | able to provide in accordance with its policies and criteria for |
5713 | admission and continued residency. Members of the medical review |
5714 | team making the final determination may not include the agency |
5715 | personnel who initially questioned the appropriateness of a |
5716 | resident's placement. Such determination is final and binding |
5717 | upon the facility and the resident. Any resident who is |
5718 | determined by the medical review team to be inappropriately |
5719 | residing in a facility shall be given 30 days' written notice to |
5720 | relocate by the owner or administrator, unless the resident's |
5721 | continued residence in the facility presents an imminent danger |
5722 | to the health, safety, or welfare of the resident or a |
5723 | substantial probability exists that death or serious physical |
5724 | harm would result to the resident if allowed to remain in the |
5725 | facility. |
5726 | Section 105. Subsection (8) of section 400.427, Florida |
5727 | Statutes, is amended to read: |
5728 | 400.427 Property and personal affairs of residents.-- |
5729 | (8) The agency department may by rule clarify terms and |
5730 | specify procedures and documentation necessary to administer the |
5731 | provisions of this section relating to the proper management of |
5732 | residents' funds and personal property and the execution of |
5733 | surety bonds. |
5734 | Section 106. Subsection (4) of section 400.4275, Florida |
5735 | Statutes, is amended to read: |
5736 | 400.4275 Business practice; personnel records; liability |
5737 | insurance.--The assisted living facility shall be administered |
5738 | on a sound financial basis that is consistent with good business |
5739 | practices. |
5740 | (4) The agency department may by rule clarify terms, |
5741 | establish requirements for financial records, accounting |
5742 | procedures, personnel procedures, insurance coverage, and |
5743 | reporting procedures, and specify documentation as necessary to |
5744 | implement the requirements of this section. |
5745 | Section 107. Subsections (1), (4), and (5) of section |
5746 | 400.431, Florida Statutes, are amended to read: |
5747 | 400.431 Closing of facility; notice; penalty.-- |
5748 | (1) In addition to the requirements of part II of chapter |
5749 | 408, Whenever a facility voluntarily discontinues operation, it |
5750 | shall inform the agency in writing at least 90 days prior to the |
5751 | discontinuance of operation. the facility shall also inform each |
5752 | resident or the next of kin, legal representative, or agency |
5753 | acting on each resident's behalf, of the fact and the proposed |
5754 | time of such discontinuance of operation, following the |
5755 | notification requirements provided in s. 400.428(1)(k). In the |
5756 | event a resident has no person to represent him or her, the |
5757 | facility shall be responsible for referral to an appropriate |
5758 | social service agency for placement. |
5759 | (4) Immediately upon discontinuance of the operation of a |
5760 | facility, the owner shall surrender the license therefor to the |
5761 | agency, and the license shall be canceled. |
5762 | (4)(5) The agency may levy a fine in an amount no greater |
5763 | than $5,000 upon each person or business entity that owns any |
5764 | interest in a facility that terminates operation without |
5765 | providing notice to the agency and the residents of the facility |
5766 | at least 30 days before operation ceases. This fine shall not be |
5767 | levied against any facility involuntarily closed at the |
5768 | initiation of the agency. The agency shall use the proceeds of |
5769 | the fines to operate the facility until all residents of the |
5770 | facility are relocated and shall deposit any balance of the |
5771 | proceeds into the Health Care Trust Fund established pursuant to |
5772 | s. 400.418. |
5773 | Section 108. Section 400.434, Florida Statutes, is amended |
5774 | to read: |
5775 | 400.434 Right of entry and inspection.--Any duly |
5776 | designated officer or employee of the department, the Department |
5777 | of Children and Family Services, the agency, the Medicaid Fraud |
5778 | Control Unit of the Department of Legal Affairs, the state or |
5779 | local fire marshal, or a member of the state or local long-term |
5780 | care ombudsman council, or the agency in accordance with s. |
5781 | 408.811 shall have the right to enter unannounced upon and into |
5782 | the premises of any facility licensed pursuant to this part in |
5783 | order to determine the state of compliance with the provisions |
5784 | of this part, part II of chapter 408, and of applicable rules or |
5785 | standards in force pursuant thereto. The right of entry and |
5786 | inspection shall also extend to any premises which the agency |
5787 | has reason to believe is being operated or maintained as a |
5788 | facility without a license; but no such entry or inspection of |
5789 | any premises may be made without the permission of the owner or |
5790 | person in charge thereof, unless a warrant is first obtained |
5791 | from the circuit court authorizing such entry. The warrant |
5792 | requirement shall extend only to a facility which the agency has |
5793 | reason to believe is being operated or maintained as a facility |
5794 | without a license. Any application for a license or renewal |
5795 | thereof made pursuant to this part shall constitute permission |
5796 | for, and complete acquiescence in, any entry or inspection of |
5797 | the premises for which the license is sought, in order to |
5798 | facilitate verification of the information submitted on or in |
5799 | connection with the application; to discover, investigate, and |
5800 | determine the existence of abuse or neglect; or to elicit, |
5801 | receive, respond to, and resolve complaints. Any current valid |
5802 | license shall constitute unconditional permission for, and |
5803 | complete acquiescence in, any entry or inspection of the |
5804 | premises by authorized personnel. The agency shall retain the |
5805 | right of entry and inspection of facilities that have had a |
5806 | license revoked or suspended within the previous 24 months, to |
5807 | ensure that the facility is not operating unlawfully. However, |
5808 | before entering the facility, a statement of probable cause must |
5809 | be filed with the director of the agency, who must approve or |
5810 | disapprove the action within 48 hours. Probable cause shall |
5811 | include, but is not limited to, evidence that the facility holds |
5812 | itself out to the public as a provider of personal care services |
5813 | or the receipt of a complaint by the long-term care ombudsman |
5814 | council about the facility. Data collected by the state or local |
5815 | long-term care ombudsman councils or the state or local advocacy |
5816 | councils may be used by the agency in investigations involving |
5817 | violations of regulatory standards. |
5818 | Section 109. Subsections (2) and (3) of section 400.435, |
5819 | Florida Statutes, are renumbered as subsections (1) and (2), |
5820 | respectively, and present subsection (1) of said section is |
5821 | amended to read: |
5822 | 400.435 Inspection Maintenance of records; reports.-- |
5823 | (1) Every facility shall maintain, as public information |
5824 | available for public inspection under such conditions as the |
5825 | agency shall prescribe, records containing copies of all |
5826 | inspection reports pertaining to the facility that have been |
5827 | issued by the agency to the facility. Copies of inspection |
5828 | reports shall be retained in the records for 5 years from the |
5829 | date the reports are filed or issued. |
5830 | (1)(2) Within 60 days after the date of the biennial |
5831 | inspection visit required under s. 408.811 or within 30 days |
5832 | after the date of any interim visit, the agency shall forward |
5833 | the results of the inspection to the local ombudsman council in |
5834 | whose planning and service area, as defined in part II, the |
5835 | facility is located; to at least one public library or, in the |
5836 | absence of a public library, the county seat in the county in |
5837 | which the inspected assisted living facility is located; and, |
5838 | when appropriate, to the district Adult Services and Mental |
5839 | Health Program Offices. |
5840 | Section 110. Section 400.441, Florida Statutes, is amended |
5841 | to read: |
5842 | 400.441 Rules establishing standards.-- |
5843 | (1) It is the intent of the Legislature that rules |
5844 | published and enforced pursuant to this section shall include |
5845 | criteria by which a reasonable and consistent quality of |
5846 | resident care and quality of life may be ensured and the results |
5847 | of such resident care may be demonstrated. Such rules shall also |
5848 | ensure a safe and sanitary environment that is residential and |
5849 | noninstitutional in design or nature. It is further intended |
5850 | that reasonable efforts be made to accommodate the needs and |
5851 | preferences of residents to enhance the quality of life in a |
5852 | facility. In order to provide safe and sanitary facilities and |
5853 | the highest quality of resident care accommodating the needs and |
5854 | preferences of residents, the agency department, in consultation |
5855 | with the department agency, the Department of Children and |
5856 | Family Services, and the Department of Health, shall adopt |
5857 | rules, policies, and procedures to administer this part and part |
5858 | II of chapter 408, which must include reasonable and fair |
5859 | minimum standards in relation to: |
5860 | (a) The requirements for and maintenance of facilities, |
5861 | not in conflict with the provisions of chapter 553, relating to |
5862 | plumbing, heating, cooling, lighting, ventilation, living space, |
5863 | and other housing conditions, which will ensure the health, |
5864 | safety, and comfort of residents and protection from fire |
5865 | hazard, including adequate provisions for fire alarm and other |
5866 | fire protection suitable to the size of the structure. Uniform |
5867 | firesafety standards shall be established and enforced by the |
5868 | State Fire Marshal in cooperation with the agency, the |
5869 | department, and the Department of Health. |
5870 | 1. Evacuation capability determination.-- |
5871 | a. The provisions of the National Fire Protection |
5872 | Association, NFPA 101A, Chapter 5, 1995 edition, shall be used |
5873 | for determining the ability of the residents, with or without |
5874 | staff assistance, to relocate from or within a licensed facility |
5875 | to a point of safety as provided in the fire codes adopted |
5876 | herein. An evacuation capability evaluation for initial |
5877 | licensure shall be conducted within 6 months after the date of |
5878 | licensure. For existing licensed facilities that are not |
5879 | equipped with an automatic fire sprinkler system, the |
5880 | administrator shall evaluate the evacuation capability of |
5881 | residents at least annually. The evacuation capability |
5882 | evaluation for each facility not equipped with an automatic fire |
5883 | sprinkler system shall be validated, without liability, by the |
5884 | State Fire Marshal, by the local fire marshal, or by the local |
5885 | authority having jurisdiction over firesafety, before the |
5886 | license renewal date. If the State Fire Marshal, local fire |
5887 | marshal, or local authority having jurisdiction over firesafety |
5888 | has reason to believe that the evacuation capability of a |
5889 | facility as reported by the administrator may have changed, it |
5890 | may, with assistance from the facility administrator, reevaluate |
5891 | the evacuation capability through timed exiting drills. |
5892 | Translation of timed fire exiting drills to evacuation |
5893 | capability may be determined: |
5894 | (I) Three minutes or less: prompt. |
5895 | (II) More than 3 minutes, but not more than 13 minutes: |
5896 | slow. |
5897 | (III) More than 13 minutes: impractical. |
5898 | b. The Office of the State Fire Marshal shall provide or |
5899 | cause the provision of training and education on the proper |
5900 | application of Chapter 5, NFPA 101A, 1995 edition, to its |
5901 | employees, to staff of the Agency for Health Care Administration |
5902 | who are responsible for regulating facilities under this part, |
5903 | and to local governmental inspectors. The Office of the State |
5904 | Fire Marshal shall provide or cause the provision of this |
5905 | training within its existing budget, but may charge a fee for |
5906 | this training to offset its costs. The initial training must be |
5907 | delivered within 6 months after July 1, 1995, and as needed |
5908 | thereafter. |
5909 | c. The Office of the State Fire Marshal, in cooperation |
5910 | with provider associations, shall provide or cause the provision |
5911 | of a training program designed to inform facility operators on |
5912 | how to properly review bid documents relating to the |
5913 | installation of automatic fire sprinklers. The Office of the |
5914 | State Fire Marshal shall provide or cause the provision of this |
5915 | training within its existing budget, but may charge a fee for |
5916 | this training to offset its costs. The initial training must be |
5917 | delivered within 6 months after July 1, 1995, and as needed |
5918 | thereafter. |
5919 | d. The administrator of a licensed facility shall sign an |
5920 | affidavit verifying the number of residents occupying the |
5921 | facility at the time of the evacuation capability evaluation. |
5922 | 2. Firesafety requirements.-- |
5923 | a. Except for the special applications provided herein, |
5924 | effective January 1, 1996, the provisions of the National Fire |
5925 | Protection Association, Life Safety Code, NFPA 101, 1994 |
5926 | edition, Chapter 22 for new facilities and Chapter 23 for |
5927 | existing facilities shall be the uniform fire code applied by |
5928 | the State Fire Marshal for assisted living facilities, pursuant |
5929 | to s. 633.022. |
5930 | b. Any new facility, regardless of size, that applies for |
5931 | a license on or after January 1, 1996, must be equipped with an |
5932 | automatic fire sprinkler system. The exceptions as provided in |
5933 | section 22-2.3.5.1, NFPA 101, 1994 edition, as adopted herein, |
5934 | apply to any new facility housing eight or fewer residents. On |
5935 | July 1, 1995, local governmental entities responsible for the |
5936 | issuance of permits for construction shall inform, without |
5937 | liability, any facility whose permit for construction is |
5938 | obtained prior to January 1, 1996, of this automatic fire |
5939 | sprinkler requirement. As used in this part, the term "a new |
5940 | facility" does not mean an existing facility that has undergone |
5941 | change of ownership. |
5942 | c. Notwithstanding any provision of s. 633.022 or of the |
5943 | National Fire Protection Association, NFPA 101A, Chapter 5, 1995 |
5944 | edition, to the contrary, any existing facility housing eight or |
5945 | fewer residents is not required to install an automatic fire |
5946 | sprinkler system, nor to comply with any other requirement in |
5947 | Chapter 23, NFPA 101, 1994 edition, that exceeds the firesafety |
5948 | requirements of NFPA 101, 1988 edition, that applies to this |
5949 | size facility, unless the facility has been classified as |
5950 | impractical to evacuate. Any existing facility housing eight or |
5951 | fewer residents that is classified as impractical to evacuate |
5952 | must install an automatic fire sprinkler system within the |
5953 | timeframes granted in this section. |
5954 | d. Any existing facility that is required to install an |
5955 | automatic fire sprinkler system under this paragraph need not |
5956 | meet other firesafety requirements of Chapter 23, NFPA 101, 1994 |
5957 | edition, which exceed the provisions of NFPA 101, 1988 edition. |
5958 | The mandate contained in this paragraph which requires certain |
5959 | facilities to install an automatic fire sprinkler system |
5960 | supersedes any other requirement. |
5961 | e. This paragraph does not supersede the exceptions |
5962 | granted in NFPA 101, 1988 edition or 1994 edition. |
5963 | f. This paragraph does not exempt facilities from other |
5964 | firesafety provisions adopted under s. 633.022 and local |
5965 | building code requirements in effect before July 1, 1995. |
5966 | g. A local government may charge fees only in an amount |
5967 | not to exceed the actual expenses incurred by local government |
5968 | relating to the installation and maintenance of an automatic |
5969 | fire sprinkler system in an existing and properly licensed |
5970 | assisted living facility structure as of January 1, 1996. |
5971 | h. If a licensed facility undergoes major reconstruction |
5972 | or addition to an existing building on or after January 1, 1996, |
5973 | the entire building must be equipped with an automatic fire |
5974 | sprinkler system. Major reconstruction of a building means |
5975 | repair or restoration that costs in excess of 50 percent of the |
5976 | value of the building as reported on the tax rolls, excluding |
5977 | land, before reconstruction. Multiple reconstruction projects |
5978 | within a 5-year period the total costs of which exceed 50 |
5979 | percent of the initial value of the building at the time the |
5980 | first reconstruction project was permitted are to be considered |
5981 | as major reconstruction. Application for a permit for an |
5982 | automatic fire sprinkler system is required upon application for |
5983 | a permit for a reconstruction project that creates costs that go |
5984 | over the 50-percent threshold. |
5985 | i. Any facility licensed before January 1, 1996, that is |
5986 | required to install an automatic fire sprinkler system shall |
5987 | ensure that the installation is completed within the following |
5988 | timeframes based upon evacuation capability of the facility as |
5989 | determined under subparagraph 1.: |
5990 | (I) Impractical evacuation capability, 24 months. |
5991 | (II) Slow evacuation capability, 48 months. |
5992 | (III) Prompt evacuation capability, 60 months. |
5993 |
|
5994 | The beginning date from which the deadline for the automatic |
5995 | fire sprinkler installation requirement must be calculated is |
5996 | upon receipt of written notice from the local fire official that |
5997 | an automatic fire sprinkler system must be installed. The local |
5998 | fire official shall send a copy of the document indicating the |
5999 | requirement of a fire sprinkler system to the Agency for Health |
6000 | Care Administration. |
6001 | j. It is recognized that the installation of an automatic |
6002 | fire sprinkler system may create financial hardship for some |
6003 | facilities. The appropriate local fire official shall, without |
6004 | liability, grant two 1-year extensions to the timeframes for |
6005 | installation established herein, if an automatic fire sprinkler |
6006 | installation cost estimate and proof of denial from two |
6007 | financial institutions for a construction loan to install the |
6008 | automatic fire sprinkler system are submitted. However, for any |
6009 | facility with a class I or class II, or a history of uncorrected |
6010 | class III, firesafety deficiencies, an extension must not be |
6011 | granted. The local fire official shall send a copy of the |
6012 | document granting the time extension to the Agency for Health |
6013 | Care Administration. |
6014 | k. A facility owner whose facility is required to be |
6015 | equipped with an automatic fire sprinkler system under Chapter |
6016 | 23, NFPA 101, 1994 edition, as adopted herein, must disclose to |
6017 | any potential buyer of the facility that an installation of an |
6018 | automatic fire sprinkler requirement exists. The sale of the |
6019 | facility does not alter the timeframe for the installation of |
6020 | the automatic fire sprinkler system. |
6021 | l. Existing facilities required to install an automatic |
6022 | fire sprinkler system as a result of construction-type |
6023 | restrictions in Chapter 23, NFPA 101, 1994 edition, as adopted |
6024 | herein, or evacuation capability requirements shall be notified |
6025 | by the local fire official in writing of the automatic fire |
6026 | sprinkler requirement, as well as the appropriate date for final |
6027 | compliance as provided in this subparagraph. The local fire |
6028 | official shall send a copy of the document to the Agency for |
6029 | Health Care Administration. |
6030 | m. Except in cases of life-threatening fire hazards, if an |
6031 | existing facility experiences a change in the evacuation |
6032 | capability, or if the local authority having jurisdiction |
6033 | identifies a construction-type restriction, such that an |
6034 | automatic fire sprinkler system is required, it shall be |
6035 | afforded time for installation as provided in this subparagraph. |
6036 |
|
6037 | Facilities that are fully sprinkled and in compliance with other |
6038 | firesafety standards are not required to conduct more than one |
6039 | of the required fire drills between the hours of 11 p.m. and 7 |
6040 | a.m., per year. In lieu of the remaining drills, staff |
6041 | responsible for residents during such hours may be required to |
6042 | participate in a mock drill that includes a review of evacuation |
6043 | procedures. Such standards must be included or referenced in the |
6044 | rules adopted by the State Fire Marshal. Pursuant to s. |
6045 | 633.022(1)(b), the State Fire Marshal is the final |
6046 | administrative authority for firesafety standards established |
6047 | and enforced pursuant to this section. All licensed facilities |
6048 | must have an annual fire inspection conducted by the local fire |
6049 | marshal or authority having jurisdiction. |
6050 | 3. Resident elopement requirements.--Facilities are |
6051 | required to conduct a minimum of two resident elopement |
6052 | prevention and response drills per year. All administrators and |
6053 | direct care staff must participate in the drills which shall |
6054 | include a review of procedures to address resident elopement. |
6055 | Facilities must document the implementation of the drills and |
6056 | ensure that the drills are conducted in a manner consistent with |
6057 | the facility's resident elopement policies and procedures. |
6058 | (b) The preparation and annual update of a comprehensive |
6059 | emergency management plan. Such standards must be included in |
6060 | the rules adopted by the agency department after consultation |
6061 | with the Department of Community Affairs. At a minimum, the |
6062 | rules must provide for plan components that address emergency |
6063 | evacuation transportation; adequate sheltering arrangements; |
6064 | postdisaster activities, including provision of emergency power, |
6065 | food, and water; postdisaster transportation; supplies; |
6066 | staffing; emergency equipment; individual identification of |
6067 | residents and transfer of records; communication with families; |
6068 | and responses to family inquiries. The comprehensive emergency |
6069 | management plan is subject to review and approval by the local |
6070 | emergency management agency. During its review, the local |
6071 | emergency management agency shall ensure that the following |
6072 | agencies, at a minimum, are given the opportunity to review the |
6073 | plan: the Department of Elderly Affairs, the Department of |
6074 | Health, the Agency for Health Care Administration, and the |
6075 | Department of Community Affairs. Also, appropriate volunteer |
6076 | organizations must be given the opportunity to review the plan. |
6077 | The local emergency management agency shall complete its review |
6078 | within 60 days and either approve the plan or advise the |
6079 | facility of necessary revisions. |
6080 | (c) The number, training, and qualifications of all |
6081 | personnel having responsibility for the care of residents. The |
6082 | rules must require adequate staff to provide for the safety of |
6083 | all residents. Facilities licensed for 17 or more residents are |
6084 | required to maintain an alert staff for 24 hours per day. |
6085 | (d) All sanitary conditions within the facility and its |
6086 | surroundings which will ensure the health and comfort of |
6087 | residents. The rules must clearly delineate the responsibilities |
6088 | of the agency's licensure and survey staff, the county health |
6089 | departments, and the local authority having jurisdiction over |
6090 | fire safety and ensure that inspections are not duplicative. The |
6091 | agency may collect fees for food service inspections conducted |
6092 | by the county health departments and transfer such fees to the |
6093 | Department of Health. |
6094 | (e) License application and license renewal, transfer of |
6095 | ownership, Proper management of resident funds and personal |
6096 | property, surety bonds, resident contracts, refund policies, |
6097 | financial ability to operate, and facility and staff records. |
6098 | (f) Inspections, complaint investigations, moratoriums, |
6099 | classification of deficiencies, levying and enforcement of |
6100 | penalties, and use of income from fees and fines. |
6101 | (g) The enforcement of the resident bill of rights |
6102 | specified in s. 400.428. |
6103 | (h) The care and maintenance of residents, which must |
6104 | include, but is not limited to: |
6105 | 1. The supervision of residents; |
6106 | 2. The provision of personal services; |
6107 | 3. The provision of, or arrangement for, social and |
6108 | leisure activities; |
6109 | 4. The arrangement for appointments and transportation to |
6110 | appropriate medical, dental, nursing, or mental health services, |
6111 | as needed by residents; |
6112 | 5. The management of medication; |
6113 | 6. The nutritional needs of residents; |
6114 | 7. Resident records; and |
6115 | 8. Internal risk management and quality assurance. |
6116 | (i) Facilities holding a limited nursing, extended |
6117 | congregate care, or limited mental health license. |
6118 | (j) The establishment of specific criteria to define |
6119 | appropriateness of resident admission and continued residency in |
6120 | a facility holding a standard, limited nursing, extended |
6121 | congregate care, and limited mental health license. |
6122 | (k) The use of physical or chemical restraints. The use of |
6123 | physical restraints is limited to half-bed rails as prescribed |
6124 | and documented by the resident's physician with the consent of |
6125 | the resident or, if applicable, the resident's representative or |
6126 | designee or the resident's surrogate, guardian, or attorney in |
6127 | fact. The use of chemical restraints is limited to prescribed |
6128 | dosages of medications authorized by the resident's physician |
6129 | and must be consistent with the resident's diagnosis. Residents |
6130 | who are receiving medications that can serve as chemical |
6131 | restraints must be evaluated by their physician at least |
6132 | annually to assess: |
6133 | 1. The continued need for the medication. |
6134 | 2. The level of the medication in the resident's blood. |
6135 | 3. The need for adjustments in the prescription. |
6136 | (l) The establishment of specific policies and procedures |
6137 | on resident elopement. Facilities shall conduct a minimum of two |
6138 | resident elopement drills each year. All administrators and |
6139 | direct care staff shall participate in the drills. Facilities |
6140 | shall document the drills. |
6141 | (2) In adopting any rules pursuant to this part, the |
6142 | agency department, in conjunction with the department agency, |
6143 | shall make distinct standards for facilities based upon facility |
6144 | size; the types of care provided; the physical and mental |
6145 | capabilities and needs of residents; the type, frequency, and |
6146 | amount of services and care offered; and the staffing |
6147 | characteristics of the facility. Rules developed pursuant to |
6148 | this section shall not restrict the use of shared staffing and |
6149 | shared programming in facilities that are part of retirement |
6150 | communities that provide multiple levels of care and otherwise |
6151 | meet the requirements of law and rule. Except for uniform |
6152 | firesafety standards, the agency department shall adopt by rule |
6153 | separate and distinct standards for facilities with 16 or fewer |
6154 | beds and for facilities with 17 or more beds. The standards for |
6155 | facilities with 16 or fewer beds shall be appropriate for a |
6156 | noninstitutional residential environment, provided that the |
6157 | structure is no more than two stories in height and all persons |
6158 | who cannot exit the facility unassisted in an emergency reside |
6159 | on the first floor. The agency department, in conjunction with |
6160 | the department agency, may make other distinctions among types |
6161 | of facilities as necessary to enforce the provisions of this |
6162 | part. Where appropriate, the agency shall offer alternate |
6163 | solutions for complying with established standards, based on |
6164 | distinctions made by the department and the agency relative to |
6165 | the physical characteristics of facilities and the types of care |
6166 | offered therein. |
6167 | (3) The department shall submit a copy of proposed rules |
6168 | to the Speaker of the House of Representatives, the President of |
6169 | the Senate, and appropriate committees of substance for review |
6170 | and comment prior to the promulgation thereof. |
6171 | (a) Rules adopted promulgated by the agency department |
6172 | shall encourage the development of homelike facilities which |
6173 | promote the dignity, individuality, personal strengths, and |
6174 | decisionmaking ability of residents. |
6175 | (4)(b) The agency, in consultation with the department, |
6176 | may waive rules promulgated pursuant to this part in order to |
6177 | demonstrate and evaluate innovative or cost-effective congregate |
6178 | care alternatives which enable individuals to age in place. Such |
6179 | waivers may be granted only in instances where there is |
6180 | reasonable assurance that the health, safety, or welfare of |
6181 | residents will not be endangered. To apply for a waiver, the |
6182 | licensee shall submit to the agency a written description of the |
6183 | concept to be demonstrated, including goals, objectives, and |
6184 | anticipated benefits; the number and types of residents who will |
6185 | be affected, if applicable; a brief description of how the |
6186 | demonstration will be evaluated; and any other information |
6187 | deemed appropriate by the agency. Any facility granted a waiver |
6188 | shall submit a report of findings to the agency and the |
6189 | department within 12 months. At such time, the agency may renew |
6190 | or revoke the waiver or pursue any regulatory or statutory |
6191 | changes necessary to allow other facilities to adopt the same |
6192 | practices. The agency department may by rule clarify terms and |
6193 | establish waiver application procedures, criteria for reviewing |
6194 | waiver proposals, and procedures for reporting findings, as |
6195 | necessary to implement this subsection. |
6196 | (5)(4) The agency may use an abbreviated biennial standard |
6197 | licensure inspection that consists of a review of key quality- |
6198 | of-care standards in lieu of a full inspection in facilities |
6199 | which have a good record of past performance. However, a full |
6200 | inspection shall be conducted in facilities which have had a |
6201 | history of class I or class II violations, uncorrected class III |
6202 | violations, confirmed ombudsman council complaints, or confirmed |
6203 | licensure complaints, within the previous licensure period |
6204 | immediately preceding the inspection or when a potentially |
6205 | serious problem is identified during the abbreviated inspection. |
6206 | The agency, in consultation with the department, shall develop |
6207 | the key quality-of-care standards with input from the State |
6208 | Long-Term Care Ombudsman Council and representatives of provider |
6209 | groups for incorporation into its rules. The department, in |
6210 | consultation with the agency, shall report annually to the |
6211 | Legislature concerning its implementation of this subsection. |
6212 | The report shall include, at a minimum, the key quality-of-care |
6213 | standards which have been developed; the number of facilities |
6214 | identified as being eligible for the abbreviated inspection; the |
6215 | number of facilities which have received the abbreviated |
6216 | inspection and, of those, the number that were converted to full |
6217 | inspection; the number and type of subsequent complaints |
6218 | received by the agency or department on facilities which have |
6219 | had abbreviated inspections; any recommendations for |
6220 | modification to this subsection; any plans by the agency to |
6221 | modify its implementation of this subsection; and any other |
6222 | information which the department believes should be reported. |
6223 | (5) A fee shall be charged by the department to any person |
6224 | requesting a copy of this part or rules promulgated under this |
6225 | part. Such fees shall not exceed the actual cost of duplication |
6226 | and postage. |
6227 | Section 111. Subsection (4) of section 400.442, Florida |
6228 | Statutes, is amended to read: |
6229 | 400.442 Pharmacy and dietary services.-- |
6230 | (4) The agency department may by rule establish procedures |
6231 | and specify documentation as necessary to implement this |
6232 | section. |
6233 | Section 112. Subsection (3) of section 400.444, Florida |
6234 | Statutes, is amended to read: |
6235 | 400.444 Construction and renovation; requirements.-- |
6236 | (3) The agency department may adopt rules to establish |
6237 | procedures and specify the documentation necessary to implement |
6238 | this section. |
6239 | Section 113. Subsections (4) through (7) of section |
6240 | 400.447, Florida Statutes, are renumbered as subsections (1) |
6241 | through (4) and present subsections (1), (2), and (3) of said |
6242 | section are amended to read: |
6243 | 400.447 Prohibited acts; penalties for violation.-- |
6244 | (1) It is unlawful for any person or public body to offer |
6245 | or advertise to the public, in any way by any medium whatever, |
6246 | personal services as defined in this act, without obtaining a |
6247 | valid current license. It is unlawful for any holder of a |
6248 | license issued pursuant to the provisions of this act to |
6249 | advertise or hold out to the public that it holds a license for |
6250 | a facility other than that for which it actually holds a |
6251 | license. |
6252 | (2) It is unlawful for any holder of a license issued |
6253 | pursuant to the provisions of this act to withhold from the |
6254 | agency any evidence of financial instability, including, but not |
6255 | limited to, bad checks, delinquent accounts, nonpayment of |
6256 | withholding taxes, unpaid utility expenses, nonpayment for |
6257 | essential services, or adverse court action concerning the |
6258 | financial viability of the facility or any other facility |
6259 | licensed under part II or part III of this chapter which is |
6260 | owned by the licensee. |
6261 | (3) Any person found guilty of violating subsection (1) or |
6262 | subsection (2) commits a misdemeanor of the second degree, |
6263 | punishable as provided in s. 775.083. Each day of continuing |
6264 | violation shall be considered a separate offense. |
6265 | Section 114. Section 400.451, Florida Statutes, is |
6266 | repealed. |
6267 | Section 115. Subsections (1), (3), and (6) of section |
6268 | 400.452, Florida Statutes, as amended by section 3 of chapter |
6269 | 2003-405, Laws of Florida, are amended to read: |
6270 | 400.452 Staff training and educational programs; core |
6271 | educational requirement.-- |
6272 | (1) Administrators and other assisted living facility |
6273 | staff must meet minimum training and education requirements |
6274 | established by the Department of Elderly Affairs or agency by |
6275 | rule. This training and education is intended to assist |
6276 | facilities to appropriately respond to the needs of residents, |
6277 | to maintain resident care and facility standards, and to meet |
6278 | licensure requirements. |
6279 | (3) Effective January 1, 2004, a new facility |
6280 | administrator must complete the required training and education, |
6281 | including the competency test, within a reasonable time after |
6282 | being employed as an administrator, as determined by the |
6283 | department. Failure to do so is a violation of this part and |
6284 | subjects the violator to an administrative fine as prescribed in |
6285 | s. 400.419. Administrators licensed in accordance with chapter |
6286 | 468, part II, are exempt from this requirement. Other licensed |
6287 | professionals may be exempted, as determined by the department |
6288 | by rule. |
6289 | (6) Other facility staff shall participate in training |
6290 | relevant to their job duties as specified by rule of the |
6291 | department. |
6292 | Section 116. Section 400.454, Florida Statutes, is amended |
6293 | to read: |
6294 | 400.454 Collection of information; local subsidy.-- |
6295 | (1) To enable the agency department to collect the |
6296 | information requested by the Legislature regarding the actual |
6297 | cost of providing room, board, and personal care in facilities, |
6298 | the agency may department is authorized to conduct field visits |
6299 | and audits of facilities as may be necessary. The owners of |
6300 | randomly sampled facilities shall submit such reports, audits, |
6301 | and accountings of cost as required the department may require |
6302 | by rule; provided that such reports, audits, and accountings |
6303 | shall be the minimum necessary to implement the provisions of |
6304 | this section. Any facility selected to participate in the study |
6305 | shall cooperate with the agency department by providing cost of |
6306 | operation information to interviewers. |
6307 | (2) Local governments or organizations may contribute to |
6308 | the cost of care of local facility residents by further |
6309 | subsidizing the rate of state-authorized payment to such |
6310 | facilities. Implementation of local subsidy shall require agency |
6311 | departmental approval and shall not result in reductions in the |
6312 | state supplement. |
6313 | Section 117. Subsections (1) and (4) of section 400.464, |
6314 | Florida Statutes, are amended to read: |
6315 | 400.464 Home health agencies to be licensed; expiration of |
6316 | license; exemptions; unlawful acts; penalties.-- |
6317 | (1) The requirements of part II of chapter 408 shall apply |
6318 | to the provision of services that require licensure pursuant to |
6319 | this part and part II of chapter 408 and entities licensed or |
6320 | registered by or applying for such licensure or registration |
6321 | from the Agency for Health Care Administration pursuant to this |
6322 | part. However, each applicant for licensure and each licensee is |
6323 | exempt from the provisions of ss. 408.806(1)(e)2. and |
6324 | 408.810(10). Any home health agency must be licensed by the |
6325 | agency to operate in this state. A license issued to a home |
6326 | health agency, unless sooner suspended or revoked, expires 1 |
6327 | year after its date of issuance. |
6328 | (4)(a) An organization may not provide, offer, or |
6329 | advertise home health services to the public unless the |
6330 | organization has a valid license or is specifically exempted |
6331 | under this part. An organization that offers or advertises to |
6332 | the public any service for which licensure or registration is |
6333 | required under this part must include in the advertisement the |
6334 | license number or regulation number issued to the organization |
6335 | by the agency. The agency shall assess a fine of not less than |
6336 | $100 to any licensee or registrant who fails to include the |
6337 | license or registration number when submitting the advertisement |
6338 | for publication, broadcast, or printing. The holder of a license |
6339 | issued under this part may not advertise or indicate to the |
6340 | public that it holds a home health agency or nurse registry |
6341 | license other than the one it has been issued. |
6342 | (b) A person who violates paragraph (a) is subject to an |
6343 | injunctive proceeding under s. 408.816 400.515. A violation of |
6344 | paragraph (a) or s. 408.813 is a deceptive and unfair trade |
6345 | practice and constitutes a violation of the Florida Deceptive |
6346 | and Unfair Trade Practices Act. |
6347 | (c) A person who violates the provisions of paragraph (a) |
6348 | commits a misdemeanor of the second degree, punishable as |
6349 | provided in s. 775.082 or s. 775.083. Any person who commits a |
6350 | second or subsequent violation commits a misdemeanor of the |
6351 | first degree, punishable as provided in s. 775.082 or s. |
6352 | 775.083. Each day of continuing violation constitutes a separate |
6353 | offense. |
6354 | Section 118. Section 400.471, Florida Statutes, is amended |
6355 | to read: |
6356 | 400.471 Application for license; fee; provisional license; |
6357 | temporary permit.-- |
6358 | (1) Each applicant for licensure must comply with all |
6359 | provisions of this part and part II of chapter 408. Application |
6360 | for an initial license or for renewal of an existing license |
6361 | must be made under oath to the agency on forms furnished by it |
6362 | and must be accompanied by the appropriate license fee as |
6363 | provided in subsection (8). The agency must take final action on |
6364 | an initial licensure application within 60 days after receipt of |
6365 | all required documentation. |
6366 | (2) In addition to the requirements of part II of chapter |
6367 | 408, the applicant must file with the application satisfactory |
6368 | proof that the home health agency is in compliance with this |
6369 | part and applicable rules, including: |
6370 | (a) A listing of services to be provided, either directly |
6371 | by the applicant or through contractual arrangements with |
6372 | existing providers.; |
6373 | (b) The number and discipline of professional staff to be |
6374 | employed.; and |
6375 | (c) Proof of financial ability to operate. |
6376 | (3) An applicant for initial licensure must demonstrate |
6377 | financial ability to operate by submitting a balance sheet and |
6378 | income and expense statement for the first 2 years of operation |
6379 | which provide evidence of having sufficient assets, credit, and |
6380 | projected revenues to cover liabilities and expenses. The |
6381 | applicant shall have demonstrated financial ability to operate |
6382 | if the applicant's assets, credit, and projected revenues meet |
6383 | or exceed projected liabilities and expenses. All documents |
6384 | required under this subsection must be prepared in accordance |
6385 | with generally accepted accounting principles, and the financial |
6386 | statement must be signed by a certified public accountant. |
6387 | (4) Each applicant for licensure must comply with the |
6388 | following requirements: |
6389 | (a) Upon receipt of a completed, signed, and dated |
6390 | application, the agency shall require background screening of |
6391 | the applicant, in accordance with the level 2 standards for |
6392 | screening set forth in chapter 435. As used in this subsection, |
6393 | the term "applicant" means the administrator, or a similarly |
6394 | titled person who is responsible for the day-to-day operation of |
6395 | the licensed home health agency, and the financial officer, or |
6396 | similarly titled individual who is responsible for the financial |
6397 | operation of the licensed home health agency. |
6398 | (b) The agency may require background screening for a |
6399 | member of the board of directors of the licensee or an officer |
6400 | or an individual owning 5 percent or more of the licensee if the |
6401 | agency reasonably suspects that such individual has been |
6402 | convicted of an offense prohibited under the level 2 standards |
6403 | for screening set forth in chapter 435. |
6404 | (c) Proof of compliance with the level 2 background |
6405 | screening requirements of chapter 435 which has been submitted |
6406 | within the previous 5 years in compliance with any other health |
6407 | care or assisted living licensure requirements of this state is |
6408 | acceptable in fulfillment of paragraph (a). Proof of compliance |
6409 | with background screening which has been submitted within the |
6410 | previous 5 years to fulfill the requirements of the Financial |
6411 | Services Commission and the Office of Insurance Regulation |
6412 | pursuant to chapter 651 as part of an application for a |
6413 | certificate of authority to operate a continuing care retirement |
6414 | community is acceptable in fulfillment of the Department of Law |
6415 | Enforcement and Federal Bureau of Investigation background |
6416 | check. |
6417 | (d) A provisional license may be granted to an applicant |
6418 | when each individual required by this section to undergo |
6419 | background screening has met the standards for the Department of |
6420 | Law Enforcement background check, but the agency has not yet |
6421 | received background screening results from the Federal Bureau of |
6422 | Investigation. A standard license may be granted to the licensee |
6423 | upon the agency's receipt of a report of the results of the |
6424 | Federal Bureau of Investigation background screening for each |
6425 | individual required by this section to undergo background |
6426 | screening which confirms that all standards have been met, or |
6427 | upon the granting of a disqualification exemption by the agency |
6428 | as set forth in chapter 435. Any other person who is required to |
6429 | undergo level 2 background screening may serve in his or her |
6430 | capacity pending the agency's receipt of the report from the |
6431 | Federal Bureau of Investigation. However, the person may not |
6432 | continue to serve if the report indicates any violation of |
6433 | background screening standards and a disqualification exemption |
6434 | has not been requested of and granted by the agency as set forth |
6435 | in chapter 435. |
6436 | (e) Each applicant must submit to the agency, with its |
6437 | application, a description and explanation of any exclusions, |
6438 | permanent suspensions, or terminations of the licensee or |
6439 | potential licensee from the Medicare or Medicaid programs. Proof |
6440 | of compliance with the requirements for disclosure of ownership |
6441 | and control interest under the Medicaid or Medicare programs may |
6442 | be accepted in lieu of this submission. |
6443 | (f) Each applicant must submit to the agency a description |
6444 | and explanation of any conviction of an offense prohibited under |
6445 | the level 2 standards of chapter 435 by a member of the board of |
6446 | directors of the applicant, its officers, or any individual |
6447 | owning 5 percent or more of the applicant. This requirement does |
6448 | not apply to a director of a not-for-profit corporation or |
6449 | organization if the director serves solely in a voluntary |
6450 | capacity for the corporation or organization, does not regularly |
6451 | take part in the day-to-day operational decisions of the |
6452 | corporation or organization, receives no remuneration for his or |
6453 | her services on the corporation or organization's board of |
6454 | directors, and has no financial interest and has no family |
6455 | members with a financial interest in the corporation or |
6456 | organization, provided that the director and the not-for-profit |
6457 | corporation or organization include in the application a |
6458 | statement affirming that the director's relationship to the |
6459 | corporation satisfies the requirements of this paragraph. |
6460 | (g) A license may not be granted to an applicant if the |
6461 | applicant, administrator, or financial officer has been found |
6462 | guilty of, regardless of adjudication, or has entered a plea of |
6463 | nolo contendere or guilty to, any offense prohibited under the |
6464 | level 2 standards for screening set forth in chapter 435, unless |
6465 | an exemption from disqualification has been granted by the |
6466 | agency as set forth in chapter 435. |
6467 | (h) The agency may deny or revoke licensure if the |
6468 | applicant: |
6469 | 1. Has falsely represented a material fact in the |
6470 | application required by paragraph (e) or paragraph (f), or has |
6471 | omitted any material fact from the application required by |
6472 | paragraph (e) or paragraph (f); or |
6473 | 2. Has been or is currently excluded, suspended, |
6474 | terminated from, or has involuntarily withdrawn from |
6475 | participation in this state's Medicaid program, or the Medicaid |
6476 | program of any other state, or from participation in the |
6477 | Medicare program or any other governmental or private health |
6478 | care or health insurance program. |
6479 | (i) An application for license renewal must contain the |
6480 | information required under paragraphs (e) and (f). |
6481 | (3)(5) In addition to the requirements of s. 408.810, the |
6482 | home health agency must also obtain and maintain the following |
6483 | insurance coverages in an amount of not less than $250,000 per |
6484 | claim, and the home health agency must submit proof of coverage |
6485 | with an initial application for licensure and with each annual |
6486 | application for license renewal: |
6487 | (a) Malpractice insurance as defined in s. 624.605(1)(k).; |
6488 | (b) Liability insurance as defined in s. 624.605(1)(b). |
6489 | (6) Ninety days before the expiration date, an application |
6490 | for renewal must be submitted to the agency under oath on forms |
6491 | furnished by it, and a license must be renewed if the applicant |
6492 | has met the requirements established under this part and |
6493 | applicable rules. The home health agency must file with the |
6494 | application satisfactory proof that it is in compliance with |
6495 | this part and applicable rules. If there is evidence of |
6496 | financial instability, the home health agency must submit |
6497 | satisfactory proof of its financial ability to comply with the |
6498 | requirements of this part. |
6499 | (7) When transferring the ownership of a home health |
6500 | agency, the transferee must submit an application for a license |
6501 | at least 60 days before the effective date of the transfer. If |
6502 | the home health agency is being leased, a copy of the lease |
6503 | agreement must be filed with the application. |
6504 | (4)(8) In accordance with s. 408.805, an applicant or |
6505 | licensee shall pay a fee for each license application submitted |
6506 | under this part, part II of chapter 408, and applicable rules. |
6507 | The amount of the fee shall be established by rule and shall be |
6508 | set at The license fee and annual renewal fee required of a home |
6509 | health agency are nonrefundable. The agency shall set the fees |
6510 | in an amount that is sufficient to cover the agency's its costs |
6511 | in carrying out its responsibilities under this part, but not to |
6512 | exceed $2,000 per biennium $1,000. However, state, county, or |
6513 | municipal governments applying for licenses under this part are |
6514 | exempt from the payment of license fees. All fees collected |
6515 | under this part must be deposited in the Health Care Trust Fund |
6516 | for the administration of this part. |
6517 | (9) The license must be displayed in a conspicuous place |
6518 | in the administrative office of the home health agency and is |
6519 | valid only while in the possession of the person to which it is |
6520 | issued. The license may not be sold, assigned, or otherwise |
6521 | transferred, voluntarily or involuntarily, and is valid only for |
6522 | the home health agency and location for which originally issued. |
6523 | (10) A home health agency against whom a revocation or |
6524 | suspension proceeding is pending at the time of license renewal |
6525 | may be issued a provisional license effective until final |
6526 | disposition by the agency of such proceedings. If judicial |
6527 | relief is sought from the final disposition, the court that has |
6528 | jurisdiction may issue a temporary permit for the duration of |
6529 | the judicial proceeding. |
6530 | (5)(11) The agency may not issue a license designated as |
6531 | certified to a home health agency that fails to satisfy the |
6532 | requirements of a Medicare certification survey from the agency. |
6533 | (12) The agency may not issue a license to a home health |
6534 | agency that has any unpaid fines assessed under this part. |
6535 | Section 119. Section 400.474, Florida Statutes, is amended |
6536 | to read: |
6537 | 400.474 Denial, suspension, revocation of license; |
6538 | injunction; grounds; penalties.-- |
6539 | (1) The agency may deny, revoke, and or suspend a license, |
6540 | and or impose an administrative fine in the manner provided in |
6541 | chapter 120, or initiate injunctive proceedings under this part, |
6542 | part II of chapter 408, or applicable rules s. 400.515. |
6543 | (2) Any of the following actions by a home health agency |
6544 | or its employee is grounds for disciplinary action by the |
6545 | agency: |
6546 | (a) Violation of this part, part II of chapter 408, or of |
6547 | applicable rules. |
6548 | (b) An intentional, reckless, or negligent act that |
6549 | materially affects the health or safety of a patient. |
6550 | (c) Knowingly providing home health services in an |
6551 | unlicensed assisted living facility or unlicensed adult family- |
6552 | care home, unless the home health agency or employee reports the |
6553 | unlicensed facility or home to the agency within 72 hours after |
6554 | providing the services. |
6555 | (3) The agency may impose the following penalties for |
6556 | operating without a license upon an applicant or owner who has |
6557 | in the past operated, or who currently operates, a licensed home |
6558 | health agency. |
6559 | (a) If a home health agency that is found to be operating |
6560 | without a license wishes to apply for a license, the home health |
6561 | agency may submit an application only after the agency has |
6562 | verified that the home health agency no longer operates an |
6563 | unlicensed home health agency. |
6564 | (b) Any person, partnership, or corporation that violates |
6565 | paragraph (a) and that previously operated a licensed home |
6566 | health agency or concurrently operates both a licensed home |
6567 | health agency and an unlicensed home health agency commits a |
6568 | felony of the third degree punishable as provided in s. 775.082, |
6569 | s. 775.083, or s. 775.084. If an owner has an interest in more |
6570 | than one home health agency and fails to license any one of |
6571 | those home health agencies, the agency must issue a cease and |
6572 | desist order for the activities of the unlicensed home health |
6573 | agency and impose a moratorium on any or all of the licensed |
6574 | related home health agencies until the unlicensed home health |
6575 | agency is licensed. |
6576 | (3)(c) If any home health agency is found to be operating |
6577 | without a license meets the criteria in paragraph (a) or |
6578 | paragraph (b) and that home health agency has received any |
6579 | government reimbursement for services provided by an unlicensed |
6580 | home health agency, the agency shall make a fraud referral to |
6581 | the appropriate government reimbursement program. |
6582 | (4) The agency may deny, revoke, or suspend the license of |
6583 | a home health agency, or may impose on a home health agency |
6584 | administrative fines not to exceed the aggregate sum of $5,000 |
6585 | if: |
6586 | (a) The agency is unable to obtain entry to the home |
6587 | health agency to conduct a licensure survey, complaint |
6588 | investigation, surveillance visit, or monitoring visit. |
6589 | (b) An applicant or a licensed home health agency has |
6590 | falsely represented a material fact in the application, or has |
6591 | omitted from the application any material fact, including, but |
6592 | not limited to, the fact that the controlling or ownership |
6593 | interest is held by any officer, director, agent, manager, |
6594 | employee, affiliated person, partner, or shareholder who is not |
6595 | eligible to participate. |
6596 | (c) An applicant, owner, or person who has a 5 percent or |
6597 | greater interest in a licensed entity: |
6598 | 1. Has been previously found by any licensing, certifying, |
6599 | or professional standards board or agency to have violated the |
6600 | standards or conditions that relate to home health-related |
6601 | licensure or certification, or to the quality of home health- |
6602 | related services provided; or |
6603 | 2. Has been or is currently excluded, suspended, |
6604 | terminated from, or has involuntarily withdrawn from, |
6605 | participation in the Medicaid program of this state or any other |
6606 | state, the Medicare program, or any other governmental health |
6607 | care or health insurance program. |
6608 | Section 120. Subsection (1) and paragraphs (a) and (b) of |
6609 | subsection (2) of section 400.484, Florida Statutes, are amended |
6610 | to read: |
6611 | 400.484 Right of inspection; deficiencies; fines.-- |
6612 | (1) In accordance with s. 408.811, Any duly authorized |
6613 | officer or employee of the agency may make such inspections and |
6614 | investigations as are necessary in order to determine the state |
6615 | of compliance with this part and with applicable rules. The |
6616 | right of inspection extends to any business that the agency has |
6617 | reason to believe is being operated as a home health agency |
6618 | without a license, but such inspection of any such business may |
6619 | not be made without the permission of the owner or person in |
6620 | charge unless a warrant is first obtained from a circuit court. |
6621 | Any application for a license issued under this part or for |
6622 | license renewal constitutes permission for an appropriate |
6623 | inspection to verify the information submitted on or in |
6624 | connection with the application. |
6625 | (2) The agency shall impose fines for various classes of |
6626 | deficiencies in accordance with the following schedule: |
6627 | (a) A class I deficiency is any act, omission, or practice |
6628 | that results in a patient's death, disablement, or permanent |
6629 | injury, or places a patient at imminent risk of death, |
6630 | disablement, or permanent injury. Upon finding a class I |
6631 | deficiency, the agency may impose an administrative fine in the |
6632 | amount of $5,000 for each occurrence and each day that the |
6633 | deficiency exists. In addition, the agency may immediately |
6634 | revoke the license and, or impose a moratorium pursuant to part |
6635 | II of chapter 408 on the admission of new patients, until the |
6636 | factors causing the deficiency have been corrected. |
6637 | (b) A class II deficiency is any act, omission, or |
6638 | practice that has a direct adverse effect on the health, safety, |
6639 | or security of a patient. Upon finding a class II deficiency, |
6640 | the agency may impose an administrative fine in the amount of |
6641 | $1,000 for each occurrence and each day that the deficiency |
6642 | exists. In addition, the agency may suspend the license and, or |
6643 | impose a moratorium pursuant to part II of chapter 408 on the |
6644 | admission of new patients, until the deficiency has been |
6645 | corrected. |
6646 | Section 121. Subsections (1) and (2) of section 400.487, |
6647 | Florida Statutes, are amended to read: |
6648 | 400.487 Home health service agreements; physician's, |
6649 | physician assistant's, and advanced registered nurse |
6650 | practitioner's treatment orders; patient assessment; |
6651 | establishment and review of plan of care; provision of services; |
6652 | orders not to resuscitate.-- |
6653 | (1) Services provided by a home health agency must be |
6654 | covered by an agreement between the home health agency and the |
6655 | patient or the patient's legal representative specifying the |
6656 | home health services to be provided, the rates or charges for |
6657 | services paid with private funds, and the sources method of |
6658 | payment, which may include Medicare, Medicaid, private |
6659 | insurance, personal funds, or a combination thereof. A home |
6660 | health agency providing skilled care must make an assessment of |
6661 | the patient's needs within 48 hours after the start of services. |
6662 | (2) When required by the provisions of chapter 464; part |
6663 | I, part III, or part V of chapter 468; or chapter 486, the |
6664 | attending physician, physician assistant, or advanced registered |
6665 | nurse practitioner, acting within his or her respective scope of |
6666 | practice, shall for a patient who is to receive skilled care |
6667 | must establish treatment orders for a patient who is to receive |
6668 | skilled care. The treatment orders must be signed by the |
6669 | physician, physician assistant, or advanced registered nurse |
6670 | practitioner before a claim is submitted to a managed care |
6671 | organization and the treatment orders must be signed in the time |
6672 | allowed under the provider agreement. The treatment orders shall |
6673 | within 30 days after the start of care and must be reviewed, as |
6674 | frequently as the patient's illness requires, by the physician, |
6675 | physician assistant, or advanced registered nurse practitioner, |
6676 | in consultation with the home health agency personnel that |
6677 | provide services to the patient. |
6678 | Section 122. Section 400.494, Florida Statutes, is amended |
6679 | to read: |
6680 | 400.494 Information about patients confidential.-- |
6681 | (1) Information about patients received by persons |
6682 | employed by, or providing services to, a home health agency or |
6683 | received by the licensing agency through reports or inspection |
6684 | shall be confidential and exempt from the provisions of s. |
6685 | 119.07(1) and shall not be disclosed to any person other than |
6686 | the patient without the written consent of that patient or the |
6687 | patient's guardian. |
6688 | (2) This section does not apply to information lawfully |
6689 | requested by the Medicaid Fraud Control Unit of the Office of |
6690 | the Attorney General or requested pursuant to 408.811 Department |
6691 | of Legal Affairs. |
6692 | Section 123. Section 400.495, Florida Statutes, is amended |
6693 | to read: |
6694 | 400.495 Notice of toll-free telephone number for central |
6695 | abuse hotline.--In addition to the requirements of 408.810(5), |
6696 | On or before the first day home health services are provided to |
6697 | a patient, any home health agency or nurse registry licensed |
6698 | under this part must inform the patient and his or her immediate |
6699 | family, if appropriate, of the right to report abusive, |
6700 | neglectful, or exploitative practices. The statewide toll-free |
6701 | telephone number for the central abuse hotline must be provided |
6702 | to patients in a manner that is clearly legible and must include |
6703 | the words: "To report abuse, neglect, or exploitation, please |
6704 | call toll-free (phone number) ." the Agency for Health Care |
6705 | Administration shall adopt rules that provide for 90 days' |
6706 | advance notice of a change in the toll-free telephone number and |
6707 | that outline due process procedures, as provided under chapter |
6708 | 120, for home health agency personnel and nurse registry |
6709 | personnel who are reported to the central abuse hotline. Home |
6710 | health agencies and nurse registries shall establish appropriate |
6711 | policies and procedures for providing such notice to patients. |
6712 | Section 124. Section 400.497, Florida Statutes, is amended |
6713 | to read: |
6714 | 400.497 Rules establishing minimum standards.--The agency |
6715 | shall adopt, publish, and enforce rules to implement part II of |
6716 | chapter 408 and this part, including, as applicable, ss. 400.506 |
6717 | and 400.509, which must provide reasonable and fair minimum |
6718 | standards relating to: |
6719 | (1) The home health aide competency test and home health |
6720 | aide training. The agency shall create the home health aide |
6721 | competency test and establish the curriculum and instructor |
6722 | qualifications for home health aide training. Licensed home |
6723 | health agencies may provide this training and shall furnish |
6724 | documentation of such training to other licensed home health |
6725 | agencies upon request. Successful passage of the competency test |
6726 | by home health aides may be substituted for the training |
6727 | required under this section and any rule adopted pursuant |
6728 | thereto. |
6729 | (2) Shared staffing. The agency shall allow shared |
6730 | staffing if the home health agency is part of a retirement |
6731 | community that provides multiple levels of care, is located on |
6732 | one campus, is licensed under this chapter, and otherwise meets |
6733 | the requirements of law and rule. |
6734 | (3) The criteria for the frequency of onsite licensure |
6735 | surveys. |
6736 | (4) Licensure application and renewal. |
6737 | (5) The requirements for onsite and electronic |
6738 | accessibility of supervisory personnel of home health agencies. |
6739 | (6) Information to be included in patients' records. |
6740 | (7) Geographic service areas. |
6741 | (8) Preparation of a comprehensive emergency management |
6742 | plan pursuant to s. 400.492. |
6743 | (a) The Agency for Health Care Administration shall adopt |
6744 | rules establishing minimum criteria for the plan and plan |
6745 | updates, with the concurrence of the Department of Health and in |
6746 | consultation with the Department of Community Affairs. |
6747 | (b) The rules must address the requirements in s. 400.492. |
6748 | In addition, the rules shall provide for the maintenance of |
6749 | patient-specific medication lists that can accompany patients |
6750 | who are transported from their homes. |
6751 | (c) The plan is subject to review and approval by the |
6752 | county health department. During its review, the county health |
6753 | department shall ensure that the following agencies, at a |
6754 | minimum, are given the opportunity to review the plan: |
6755 | 1. The local emergency management agency. |
6756 | 2. The Agency for Health Care Administration. |
6757 | 3. The local chapter of the American Red Cross or other |
6758 | lead sheltering agency. |
6759 | 4. The district office of the Department of Children and |
6760 | Family Services. |
6761 |
|
6762 | The county health department shall complete its review within 60 |
6763 | days after receipt of the plan and shall either approve the plan |
6764 | or advise the home health agency of necessary revisions. |
6765 | (d) For any home health agency that operates in more than |
6766 | one county, the Department of Health shall review the plan, |
6767 | after consulting with all of the county health departments, the |
6768 | agency, and all the local chapters of the American Red Cross or |
6769 | other lead sheltering agencies in the areas of operation for |
6770 | that particular home health agency. The Department of Health |
6771 | shall complete its review within 90 days after receipt of the |
6772 | plan and shall either approve the plan or advise the home health |
6773 | agency of necessary revisions. The Department of Health shall |
6774 | make every effort to avoid imposing differing requirements based |
6775 | on differences between counties on the home health agency. |
6776 | (e) The requirements in this subsection do not apply to: |
6777 | 1. A facility that is certified under chapter 651 and has |
6778 | a licensed home health agency used exclusively by residents of |
6779 | the facility; or |
6780 | 2. A retirement community that consists of residential |
6781 | units for independent living and either a licensed nursing home |
6782 | or an assisted living facility, and has a licensed home health |
6783 | agency used exclusively by the residents of the retirement |
6784 | community, provided the comprehensive emergency management plan |
6785 | for the facility or retirement community provides for continuous |
6786 | care of all residents with special needs during an emergency. |
6787 | Section 125. Section 400.506, Florida Statutes, is amended |
6788 | to read: |
6789 | 400.506 Licensure of nurse registries; requirements; |
6790 | penalties.-- |
6791 | (1) A nurse registry is exempt from the licensing |
6792 | requirements of a home health agency but must be licensed as a |
6793 | nurse registry. The requirements of part II of chapter 408 shall |
6794 | apply to the provision of services that require licensure |
6795 | pursuant to ss. 400.506-400.518 and part II of chapter 408 and |
6796 | to entities licensed by or applying for such license from the |
6797 | Agency for Health Care Administration pursuant to ss. 400.506- |
6798 | 400.518. Each operational site of the nurse registry must be |
6799 | licensed, unless there is more than one site within a county. If |
6800 | there is more than one site within a county, only one license |
6801 | per county is required. Each operational site must be listed on |
6802 | the license. |
6803 | (2) Each applicant for licensure and each licensee must |
6804 | comply with all provisions of part II and chapter 408, except |
6805 | ss. 408.806(1)(e)2., 408.810(6), and 408.810(10). the following |
6806 | requirements: |
6807 | (a) Upon receipt of a completed, signed, and dated |
6808 | application, the agency shall require background screening, in |
6809 | accordance with the level 2 standards for screening set forth in |
6810 | chapter 435, of the managing employee, or other similarly titled |
6811 | individual who is responsible for the daily operation of the |
6812 | nurse registry, and of the financial officer, or other similarly |
6813 | titled individual who is responsible for the financial operation |
6814 | of the registry, including billings for patient care and |
6815 | services. The applicant shall comply with the procedures for |
6816 | level 2 background screening as set forth in chapter 435. |
6817 | (b) The agency may require background screening of any |
6818 | other individual who is an applicant if the agency has probable |
6819 | cause to believe that he or she has been convicted of a crime or |
6820 | has committed any other offense prohibited under the level 2 |
6821 | standards for screening set forth in chapter 435. |
6822 | (c) Proof of compliance with the level 2 background |
6823 | screening requirements of chapter 435 which has been submitted |
6824 | within the previous 5 years in compliance with any other health |
6825 | care or assisted living licensure requirements of this state is |
6826 | acceptable in fulfillment of the requirements of paragraph (a). |
6827 | (d) A provisional license may be granted to an applicant |
6828 | when each individual required by this section to undergo |
6829 | background screening has met the standards for the Department of |
6830 | Law Enforcement background check but the agency has not yet |
6831 | received background screening results from the Federal Bureau of |
6832 | Investigation. A standard license may be granted to the |
6833 | applicant upon the agency's receipt of a report of the results |
6834 | of the Federal Bureau of Investigation background screening for |
6835 | each individual required by this section to undergo background |
6836 | screening which confirms that all standards have been met, or |
6837 | upon the granting of a disqualification exemption by the agency |
6838 | as set forth in chapter 435. Any other person who is required to |
6839 | undergo level 2 background screening may serve in his or her |
6840 | capacity pending the agency's receipt of the report from the |
6841 | Federal Bureau of Investigation. However, the person may not |
6842 | continue to serve if the report indicates any violation of |
6843 | background screening standards and a disqualification exemption |
6844 | has not been requested of and granted by the agency as set forth |
6845 | in chapter 435. |
6846 | (e) Each applicant must submit to the agency, with its |
6847 | application, a description and explanation of any exclusions, |
6848 | permanent suspensions, or terminations of the applicant from the |
6849 | Medicare or Medicaid programs. Proof of compliance with the |
6850 | requirements for disclosure of ownership and control interests |
6851 | under the Medicaid or Medicare programs may be accepted in lieu |
6852 | of this submission. |
6853 | (f) Each applicant must submit to the agency a description |
6854 | and explanation of any conviction of an offense prohibited under |
6855 | the level 2 standards of chapter 435 by a member of the board of |
6856 | directors of the applicant, its officers, or any individual |
6857 | owning 5 percent or more of the applicant. This requirement does |
6858 | not apply to a director of a not-for-profit corporation or |
6859 | organization if the director serves solely in a voluntary |
6860 | capacity for the corporation or organization, does not regularly |
6861 | take part in the day-to-day operational decisions of the |
6862 | corporation or organization, receives no remuneration for his or |
6863 | her services on the corporation or organization's board of |
6864 | directors, and has no financial interest and has no family |
6865 | members with a financial interest in the corporation or |
6866 | organization, provided that the director and the not-for-profit |
6867 | corporation or organization include in the application a |
6868 | statement affirming that the director's relationship to the |
6869 | corporation satisfies the requirements of this paragraph. |
6870 | (g) A license may not be granted to an applicant if the |
6871 | applicant or managing employee has been found guilty of, |
6872 | regardless of adjudication, or has entered a plea of nolo |
6873 | contendere or guilty to, any offense prohibited under the level |
6874 | 2 standards for screening set forth in chapter 435, unless an |
6875 | exemption from disqualification has been granted by the agency |
6876 | as set forth in chapter 435. |
6877 | (h) The agency may deny or revoke the license if any |
6878 | applicant: |
6879 | 1. Has falsely represented a material fact in the |
6880 | application required by paragraph (e) or paragraph (f), or has |
6881 | omitted any material fact from the application required by |
6882 | paragraph (e) or paragraph (f); or |
6883 | 2. Has had prior action taken against the applicant under |
6884 | the Medicaid or Medicare program as set forth in paragraph (e). |
6885 | (i) An application for license renewal must contain the |
6886 | information required under paragraphs (e) and (f). |
6887 | (3) In accordance with s. 408.805, an applicant or |
6888 | licensee shall pay a fee for each license application submitted |
6889 | under ss. 400.508-400.518, part II of chapter 408, and |
6890 | applicable rules. The amount of the fee shall be established by |
6891 | rule and may not exceed $2,000 per biennium. Application for |
6892 | license must be made to the Agency for Health Care |
6893 | Administration on forms furnished by it and must be accompanied |
6894 | by the appropriate licensure fee, as established by rule and not |
6895 | to exceed the cost of regulation under this part. The licensure |
6896 | fee for nurse registries may not exceed $1,000 and must be |
6897 | deposited in the Health Care Trust Fund. |
6898 | (4) The Agency for Health Care Administration may deny, |
6899 | revoke, or suspend a license or impose an administrative fine in |
6900 | the manner provided in chapter 120 against a nurse registry |
6901 | that: |
6902 | (a) Fails to comply with this section or applicable rules. |
6903 | (b) Commits an intentional, reckless, or negligent act |
6904 | that materially affects the health or safety of a person |
6905 | receiving services. |
6906 | (5) A license issued for the operation of a nurse |
6907 | registry, unless sooner suspended or revoked, expires 1 year |
6908 | after its date of issuance. Sixty days before the expiration |
6909 | date, an application for renewal must be submitted to the Agency |
6910 | for Health Care Administration on forms furnished by it. The |
6911 | Agency for Health Care Administration shall renew the license if |
6912 | the applicant has met the requirements of this section and |
6913 | applicable rules. A nurse registry against which a revocation or |
6914 | suspension proceeding is pending at the time of license renewal |
6915 | may be issued a conditional license effective until final |
6916 | disposition by the Agency for Health Care Administration of such |
6917 | proceedings. If judicial relief is sought from the final |
6918 | disposition, the court having jurisdiction may issue a |
6919 | conditional license for the duration of the judicial proceeding. |
6920 | (6) The Agency for Health Care Administration may |
6921 | institute injunctive proceedings under s. 400.515. |
6922 | (4)(7) A person that offers or advertises to the public |
6923 | that it provides any service for which licensure is required |
6924 | under this section must include in such advertisement the |
6925 | license number issued to it by the Agency for Health Care |
6926 | Administration. |
6927 | (8) It is unlawful for a person to offer or advertise to |
6928 | the public services as defined by rule without obtaining a valid |
6929 | license from the Agency for Health Care Administration. It is |
6930 | unlawful for any holder of a license to advertise or hold out to |
6931 | the public that he or she holds a license for other than that |
6932 | for which he or she actually holds a license. A person who |
6933 | violates this subsection is subject to injunctive proceedings |
6934 | under s. 400.515. |
6935 | (9) Any duly authorized officer or employee of the Agency |
6936 | for Health Care Administration may make such inspections and |
6937 | investigations as are necessary to respond to complaints or to |
6938 | determine the state of compliance with this section and |
6939 | applicable rules. |
6940 | (a) If, in responding to a complaint, an agent or employee |
6941 | of the Agency for Health Care Administration has reason to |
6942 | believe that a crime has been committed, he or she shall notify |
6943 | the appropriate law enforcement agency. |
6944 | (b) If, in responding to a complaint, an agent or employee |
6945 | of the Agency for Health Care Administration has reason to |
6946 | believe that abuse, neglect, or exploitation has occurred, |
6947 | according to the definitions in chapter 415, he or she shall |
6948 | file a report under chapter 415. |
6949 | (5)(10)(a) A nurse registry may refer for contract in |
6950 | private residences registered nurses and licensed practical |
6951 | nurses registered and licensed under part I of chapter 464, |
6952 | certified nursing assistants certified under part II of chapter |
6953 | 464, home health aides who present documented proof of |
6954 | successful completion of the training required by rule of the |
6955 | agency, and companions or homemakers for the purposes of |
6956 | providing those services authorized under s. 400.509(1). Each |
6957 | person referred by a nurse registry must provide current |
6958 | documentation that he or she is free from communicable diseases. |
6959 | (b) A certified nursing assistant or home health aide may |
6960 | be referred for a contract to provide care to a patient in his |
6961 | or her home only if that patient is under a physician's care. A |
6962 | certified nursing assistant or home health aide referred for |
6963 | contract in a private residence shall be limited to assisting a |
6964 | patient with bathing, dressing, toileting, grooming, eating, |
6965 | physical transfer, and those normal daily routines the patient |
6966 | could perform for himself or herself were he or she physically |
6967 | capable. A certified nursing assistant or home health aide may |
6968 | not provide medical or other health care services that require |
6969 | specialized training and that may be performed only by licensed |
6970 | health care professionals. The nurse registry shall obtain the |
6971 | name and address of the attending physician and send written |
6972 | notification to the physician within 48 hours after a contract |
6973 | is concluded that a certified nursing assistant or home health |
6974 | aide will be providing care for that patient. |
6975 | (c) A nurse registry shall, at the time of contracting for |
6976 | services through the nurse registry, advise the patient, the |
6977 | patient's family, or a person acting on behalf of the patient of |
6978 | the availability of registered nurses to make visits to the |
6979 | patient's home at an additional cost. A registered nurse shall |
6980 | make monthly visits to the patient's home to assess the |
6981 | patient's condition and quality of care being provided by the |
6982 | certified nursing assistant or home health aide. Any condition |
6983 | that which in the professional judgment of the nurse requires |
6984 | further medical attention shall be reported to the attending |
6985 | physician and the nurse registry. The assessment shall become a |
6986 | part of the patient's file with the nurse registry and may be |
6987 | reviewed by the agency during their survey procedure. |
6988 | (6)(11) A person who is referred by a nurse registry for |
6989 | contract in private residences and who is not a nurse licensed |
6990 | under part I of chapter 464 may perform only those services or |
6991 | care to clients that the person has been certified to perform or |
6992 | trained to perform as required by law or rules of the Agency for |
6993 | Health Care Administration or the Department of Business and |
6994 | Professional Regulation. Providing services beyond the scope |
6995 | authorized under this subsection constitutes the unauthorized |
6996 | practice of medicine or a violation of the Nurse Practice Act |
6997 | and is punishable as provided under chapter 458, chapter 459, or |
6998 | part I of chapter 464. |
6999 | (7)(12) Each nurse registry must require every applicant |
7000 | for contract to complete an application form providing the |
7001 | following information: |
7002 | (a) The name, address, date of birth, and social security |
7003 | number of the applicant. |
7004 | (b) The educational background and employment history of |
7005 | the applicant. |
7006 | (c) The number and date of the applicable license or |
7007 | certification. |
7008 | (d) When appropriate, information concerning the renewal |
7009 | of the applicable license, registration, or certification. |
7010 | (8)(13) Each nurse registry must comply with the |
7011 | procedures set forth in s. 400.512 for maintaining records of |
7012 | the employment history of all persons referred for contract and |
7013 | is subject to the standards and conditions set forth in that |
7014 | section. However, an initial screening may not be required for |
7015 | persons who have been continuously registered with the nurse |
7016 | registry since September 30, 1990. |
7017 | (9)(14) The nurse registry must maintain the application |
7018 | on file, and that file must be open to the inspection of the |
7019 | Agency for Health Care Administration. The nurse registry must |
7020 | maintain on file the name and address of the client to whom the |
7021 | nurse or other nurse registry personnel is sent for contract and |
7022 | the amount of the fee received by the nurse registry. A nurse |
7023 | registry must maintain the file that includes the application |
7024 | and other applicable documentation for 3 years after the date of |
7025 | the last file entry of client-related information. |
7026 | (10)(15) Nurse registries shall assist persons who would |
7027 | need assistance and sheltering during evacuations because of |
7028 | physical, mental, or sensory disabilities in registering with |
7029 | the appropriate local emergency management agency pursuant to s. |
7030 | 252.355. |
7031 | (11)(16) Each nurse registry shall prepare and maintain a |
7032 | comprehensive emergency management plan that is consistent with |
7033 | the criteria in this subsection and with the local special needs |
7034 | plan. The plan shall be updated annually. The plan shall specify |
7035 | how the nurse registry shall facilitate the provision of |
7036 | continuous care by persons referred for contract to persons who |
7037 | are registered pursuant to s. 252.355 during an emergency that |
7038 | interrupts the provision of care or services in private |
7039 | residencies. |
7040 | (a) All persons referred for contract who care for persons |
7041 | registered pursuant to s. 252.355 must include in the patient |
7042 | record a description of how care will be continued during a |
7043 | disaster or emergency that interrupts the provision of care in |
7044 | the patient's home. It shall be the responsibility of the person |
7045 | referred for contract to ensure that continuous care is |
7046 | provided. |
7047 | (b) Each nurse registry shall maintain a current |
7048 | prioritized list of patients in private residences who are |
7049 | registered pursuant to s. 252.355 and are under the care of |
7050 | persons referred for contract and who need continued services |
7051 | during an emergency. This list shall indicate, for each patient, |
7052 | if the client is to be transported to a special needs shelter |
7053 | and if the patient is receiving skilled nursing services. Nurse |
7054 | registries shall make this list available to county health |
7055 | departments and to local emergency management agencies upon |
7056 | request. |
7057 | (c) Each person referred for contract who is caring for a |
7058 | patient who is registered pursuant to s. 252.355 shall provide a |
7059 | list of the patient's medication and equipment needs to the |
7060 | nurse registry. Each person referred for contract shall make |
7061 | this information available to county health departments and to |
7062 | local emergency management agencies upon request. |
7063 | (d) Each person referred for contract shall not be |
7064 | required to continue to provide care to patients in emergency |
7065 | situations that are beyond the person's control and that make it |
7066 | impossible to provide services, such as when roads are |
7067 | impassable or when patients do not go to the location specified |
7068 | in their patient records. |
7069 | (e) The comprehensive emergency management plan required |
7070 | by this subsection is subject to review and approval by the |
7071 | county health department. During its review, the county health |
7072 | department shall ensure that, at a minimum, the local emergency |
7073 | management agency, the Agency for Health Care Administration, |
7074 | and the local chapter of the American Red Cross or other lead |
7075 | sheltering agency are given the opportunity to review the plan. |
7076 | The county health department shall complete its review within 60 |
7077 | days after receipt of the plan and shall either approve the plan |
7078 | or advise the nurse registry of necessary revisions. |
7079 | (f) The Agency for Health Care Administration shall adopt |
7080 | rules establishing minimum criteria for the comprehensive |
7081 | emergency management plan and plan updates required by this |
7082 | subsection, with the concurrence of the Department of Health and |
7083 | in consultation with the Department of Community Affairs. |
7084 | (12)(17) All persons referred for contract in private |
7085 | residences by a nurse registry must comply with the following |
7086 | requirements for a plan of treatment: |
7087 | (a) When, in accordance with the privileges and |
7088 | restrictions imposed upon a nurse under part I of chapter 464, |
7089 | the delivery of care to a patient is under the direction or |
7090 | supervision of a physician or when a physician is responsible |
7091 | for the medical care of the patient, a medical plan of treatment |
7092 | must be established for each patient receiving care or treatment |
7093 | provided by a licensed nurse in the home. The original medical |
7094 | plan of treatment must be timely signed by the physician, |
7095 | physician assistant, or advanced registered nurse practitioner, |
7096 | acting within his or her respective scope of practice, and |
7097 | reviewed by him or her in consultation with the licensed nurse |
7098 | at least every 2 months. Any additional order or change in |
7099 | orders must be obtained from the physician, physician assistant, |
7100 | or advanced registered nurse practitioner and reduced to writing |
7101 | and timely signed by the physician, physician assistant, or |
7102 | advanced registered nurse practitioner. The delivery of care |
7103 | under a medical plan of treatment must be substantiated by the |
7104 | appropriate nursing notes or documentation made by the nurse in |
7105 | compliance with nursing practices established under part I of |
7106 | chapter 464. |
7107 | (b) Whenever a medical plan of treatment is established |
7108 | for a patient, the initial medical plan of treatment, any |
7109 | amendment to the plan, additional order or change in orders, and |
7110 | copy of nursing notes must be filed in the office of the nurse |
7111 | registry. |
7112 | (13)(18) The nurse registry must comply with the notice |
7113 | requirements of s. 400.495, relating to abuse reporting. |
7114 | (14)(19) In addition to any other penalties imposed |
7115 | pursuant to this section or part, the agency may assess costs |
7116 | related to an investigation that results in a successful |
7117 | prosecution., excluding costs associated with an attorney's |
7118 | time. If the agency imposes such an assessment and the |
7119 | assessment is not paid, and if challenged is not the subject of |
7120 | a pending appeal, prior to the renewal of the license, the |
7121 | license shall not be issued until the assessment is paid or |
7122 | arrangements for payment of the assessment are made. |
7123 | (15)(20) The Agency for Health Care Administration shall |
7124 | adopt rules to implement this section and part II of chapter |
7125 | 408. |
7126 | Section 126. Section 400.509, Florida Statutes, is amended |
7127 | to read: |
7128 | 400.509 Registration of particular service providers |
7129 | exempt from licensure; certificate of registration; regulation |
7130 | of registrants.-- |
7131 | (1) Any organization that provides companion services or |
7132 | homemaker services and does not provide a home health service to |
7133 | a person is exempt from licensure under this part. However, any |
7134 | organization that provides companion services or homemaker |
7135 | services must register with the agency. |
7136 | (2) The requirements of part II of chapter 408 shall apply |
7137 | to the provision of services that require registration or |
7138 | licensure pursuant to this section and part II of chapter 408 |
7139 | and entities registered by or applying for such registration |
7140 | from the Agency for Health Care Administration pursuant to this |
7141 | section. Each applicant for registration and each registrant |
7142 | must comply with all provisions of part II of chapter 408 except |
7143 | ss. 408.806(1)(e) and 408.810(6)-(10). Registration consists of |
7144 | annually filing with the agency, under oath, on forms provided |
7145 | by it, the following information: |
7146 | (a) If the registrant is a firm or partnership, the name, |
7147 | address, date of birth, and social security number of every |
7148 | member. |
7149 | (b) If the registrant is a corporation or association, its |
7150 | name and address; the name, address, date of birth, and social |
7151 | security number of each of its directors and officers; and the |
7152 | name and address of each person having at least a 5 percent |
7153 | interest in the corporation or association. |
7154 | (c) The name, address, date of birth, and social security |
7155 | number of each person employed by or under contract with the |
7156 | organization. |
7157 | (3) In accordance with s. 408.805, applicants and |
7158 | registrants shall pay fees for all registrations issued under |
7159 | this part, part II of chapter 408, and applicable rules. The |
7160 | amount of the fee shall be $50 per biennium. The agency shall |
7161 | charge a registration fee of $25 to be submitted with the |
7162 | information required under subsection (2). |
7163 | (4) Each applicant for registration must comply with the |
7164 | following requirements: |
7165 | (a) Upon receipt of a completed, signed, and dated |
7166 | application, the agency shall require background screening, in |
7167 | accordance with the level 1 standards for screening set forth in |
7168 | chapter 435, of every individual who will have contact with the |
7169 | client. The agency shall require background screening of the |
7170 | managing employee or other similarly titled individual who is |
7171 | responsible for the operation of the entity, and of the |
7172 | financial officer or other similarly titled individual who is |
7173 | responsible for the financial operation of the entity, including |
7174 | billings for client services in accordance with the level 2 |
7175 | standards for background screening as set forth in chapter 435. |
7176 | (b) The agency may require background screening of any |
7177 | other individual who is affiliated with the applicant if the |
7178 | agency has a reasonable basis for believing that he or she has |
7179 | been convicted of a crime or has committed any other offense |
7180 | prohibited under the level 2 standards for screening set forth |
7181 | in chapter 435. |
7182 | (c) Proof of compliance with the level 2 background |
7183 | screening requirements of chapter 435 which has been submitted |
7184 | within the previous 5 years in compliance with any other health |
7185 | care or assisted living licensure requirements of this state is |
7186 | acceptable in fulfillment of paragraph (a). |
7187 | (d) A provisional registration may be granted to an |
7188 | applicant when each individual required by this section to |
7189 | undergo background screening has met the standards for the |
7190 | abuse-registry background check through the agency and the |
7191 | Department of Law Enforcement background check, but the agency |
7192 | has not yet received background screening results from the |
7193 | Federal Bureau of Investigation. A standard registration may be |
7194 | granted to the applicant upon the agency's receipt of a report |
7195 | of the results of the Federal Bureau of Investigation background |
7196 | screening for each individual required by this section to |
7197 | undergo background screening which confirms that all standards |
7198 | have been met, or upon the granting of a disqualification |
7199 | exemption by the agency as set forth in chapter 435. Any other |
7200 | person who is required to undergo level 2 background screening |
7201 | may serve in his or her capacity pending the agency's receipt of |
7202 | the report from the Federal Bureau of Investigation. However, |
7203 | the person may not continue to serve if the report indicates any |
7204 | violation of background screening standards and if a |
7205 | disqualification exemption has not been requested of and granted |
7206 | by the agency as set forth in chapter 435. |
7207 | (e) Each applicant must submit to the agency, with its |
7208 | application, a description and explanation of any exclusions, |
7209 | permanent suspensions, or terminations of the applicant from the |
7210 | Medicare or Medicaid programs. Proof of compliance with the |
7211 | requirements for disclosure of ownership and control interests |
7212 | under the Medicaid or Medicare programs may be accepted in lieu |
7213 | of this submission. |
7214 | (f) Each applicant must submit to the agency a description |
7215 | and explanation of any conviction of an offense prohibited under |
7216 | the level 2 standards of chapter 435 which was committed by a |
7217 | member of the board of directors of the applicant, its officers, |
7218 | or any individual owning 5 percent or more of the applicant. |
7219 | This requirement does not apply to a director of a not-for- |
7220 | profit corporation or organization who serves solely in a |
7221 | voluntary capacity for the corporation or organization, does not |
7222 | regularly take part in the day-to-day operational decisions of |
7223 | the corporation or organization, receives no remuneration for |
7224 | his or her services on the corporation's or organization's board |
7225 | of directors, and has no financial interest and no family |
7226 | members having a financial interest in the corporation or |
7227 | organization, if the director and the not-for-profit corporation |
7228 | or organization include in the application a statement affirming |
7229 | that the director's relationship to the corporation satisfies |
7230 | the requirements of this paragraph. |
7231 | (g) A registration may not be granted to an applicant if |
7232 | the applicant or managing employee has been found guilty of, |
7233 | regardless of adjudication, or has entered a plea of nolo |
7234 | contendere or guilty to, any offense prohibited under the level |
7235 | 2 standards for screening set forth in chapter 435, unless an |
7236 | exemption from disqualification has been granted by the agency |
7237 | as set forth in chapter 435. |
7238 | (h) The agency may deny or revoke the registration of any |
7239 | applicant who: |
7240 | 1. Has falsely represented a material fact in the |
7241 | application required by paragraph (e) or paragraph (f), or has |
7242 | omitted any material fact from the application required by |
7243 | paragraph (e) or paragraph (f); or |
7244 | 2. Has had prior action taken against the applicant under |
7245 | the Medicaid or Medicare program as set forth in paragraph (e). |
7246 | (i) An application for licensure renewal must contain the |
7247 | information required under paragraphs (e) and (f). |
7248 | (4)(5) Each registrant must obtain the employment or |
7249 | contract history of persons who are employed by or under |
7250 | contract with the organization and who will have contact at any |
7251 | time with patients or clients in their homes by: |
7252 | (a) Requiring such persons to submit an employment or |
7253 | contractual history to the registrant; and |
7254 | (b) Verifying the employment or contractual history, |
7255 | unless through diligent efforts such verification is not |
7256 | possible. The agency shall prescribe by rule the minimum |
7257 | requirements for establishing that diligent efforts have been |
7258 | made. |
7259 |
|
7260 | There is no monetary liability on the part of, and no cause of |
7261 | action for damages arises against, a former employer of a |
7262 | prospective employee of or prospective independent contractor |
7263 | with a registrant who reasonably and in good faith communicates |
7264 | his or her honest opinions about the former employee's or |
7265 | contractor's job performance. This subsection does not affect |
7266 | the official immunity of an officer or employee of a public |
7267 | corporation. |
7268 | (6) On or before the first day on which services are |
7269 | provided to a patient or client, any registrant under this part |
7270 | must inform the patient or client and his or her immediate |
7271 | family, if appropriate, of the right to report abusive, |
7272 | neglectful, or exploitative practices. The statewide toll-free |
7273 | telephone number for the central abuse hotline must be provided |
7274 | to patients or clients in a manner that is clearly legible and |
7275 | must include the words: "To report abuse, neglect, or |
7276 | exploitation, please call toll-free (phone number) ." |
7277 | Registrants must establish appropriate policies and procedures |
7278 | for providing such notice to patients or clients. |
7279 | (7) The provisions of s. 400.512 regarding screening apply |
7280 | to any person or business entity registered under this section |
7281 | on or after October 1, 1994. |
7282 | (8) Upon verification that all requirements for |
7283 | registration have been met, the Agency for Health Care |
7284 | Administration shall issue a certificate of registration valid |
7285 | for no more than 1 year. |
7286 | (9) The Agency for Health Care Administration may deny, |
7287 | suspend, or revoke the registration of a person that: |
7288 | (a) Fails to comply with this section or applicable rules. |
7289 | (b) Commits an intentional, reckless, or negligent act |
7290 | that materially affects the health or safety of a person |
7291 | receiving services. |
7292 | (10) The Agency for Health Care Administration may |
7293 | institute injunctive proceedings under s. 400.515. |
7294 | (5)(11) A person that offers or advertises to the public a |
7295 | service for which registration is required must include in its |
7296 | advertisement the registration number issued by the Agency for |
7297 | Health Care Administration. |
7298 | (12) It is unlawful for a person to offer or advertise to |
7299 | the public services, as defined by rule, without obtaining a |
7300 | certificate of registration from the Agency for Health Care |
7301 | Administration. It is unlawful for any holder of a certificate |
7302 | of registration to advertise or hold out to the public that he |
7303 | or she holds a certificate of registration for other than that |
7304 | for which he or she actually holds a certificate of |
7305 | registration. Any person who violates this subsection is subject |
7306 | to injunctive proceedings under s. 400.515. |
7307 | (13) Any duly authorized officer or employee of the Agency |
7308 | for Health Care Administration has the right to make such |
7309 | inspections and investigations as are necessary in order to |
7310 | respond to complaints or to determine the state of compliance |
7311 | with this section and applicable rules. |
7312 | (a) If, in responding to a complaint, an officer or |
7313 | employee of the Agency for Health Care Administration has reason |
7314 | to believe that a crime has been committed, he or she shall |
7315 | notify the appropriate law enforcement agency. |
7316 | (b) If, in responding to a complaint, an officer or |
7317 | employee of the Agency for Health Care Administration has reason |
7318 | to believe that abuse, neglect, or exploitation has occurred, |
7319 | according to the definitions in chapter 415, he or she shall |
7320 | file a report under chapter 415. |
7321 | (6)(14) In addition to any other penalties imposed |
7322 | pursuant to this section or part, the agency may assess costs |
7323 | related to an investigation that results in a successful |
7324 | prosecution, excluding costs associated with an attorney's time. |
7325 | If the agency imposes such an assessment and the assessment is |
7326 | not paid, and if challenged is not the subject of a pending |
7327 | appeal, prior to the renewal of the registration, the |
7328 | registration shall not be issued until the assessment is paid or |
7329 | arrangements for payment of the assessment are made. |
7330 | (7)(15) The Agency for Health Care Administration shall |
7331 | adopt rules to administer this section and part II of chapter |
7332 | 408. |
7333 | Section 127. Subsections (3) through (7) of section |
7334 | 400.512, Florida Statutes, are renumbered as subsections (2) |
7335 | through (6) and present subsections (2) and (7) are amended to |
7336 | read: |
7337 | 400.512 Screening of home health agency personnel; nurse |
7338 | registry personnel; and companions and homemakers.--The agency |
7339 | shall require employment or contractor screening as provided in |
7340 | chapter 435, using the level 1 standards for screening set forth |
7341 | in that chapter, for home health agency personnel; persons |
7342 | referred for employment by nurse registries; and persons |
7343 | employed by companion or homemaker services registered under s. |
7344 | 400.509. |
7345 | (2) The administrator of each home health agency, the |
7346 | managing employee of each nurse registry, and the managing |
7347 | employee of each companion or homemaker service registered under |
7348 | s. 400.509 must sign an affidavit annually, under penalty of |
7349 | perjury, stating that all personnel hired, contracted with, or |
7350 | registered on or after October 1, 1994, who enter the home of a |
7351 | patient or client in their service capacity have been screened |
7352 | and that its remaining personnel have worked for the home health |
7353 | agency or registrant continuously since before October 1, 1994. |
7354 | (6)(7)(a) It is a misdemeanor of the first degree, |
7355 | punishable under s. 775.082 or s. 775.083, for any person |
7356 | willfully, knowingly, or intentionally to: |
7357 | 1. Fail, by false statement, misrepresentation, |
7358 | impersonation, or other fraudulent means, to disclose in any |
7359 | application for voluntary or paid employment a material fact |
7360 | used in making a determination as to such person's |
7361 | qualifications to be an employee under this section; or |
7362 | 2. Operate or attempt to operate an entity licensed or |
7363 | registered under this part with persons who do not meet the |
7364 | minimum standards for good moral character as contained in this |
7365 | section; or |
7366 | 2.3. Use information from the criminal records obtained |
7367 | under this section for any purpose other than screening that |
7368 | person for employment as specified in this section or release |
7369 | such information to any other person for any purpose other than |
7370 | screening for employment under this section. |
7371 | (b) It is a felony of the third degree, punishable under |
7372 | s. 775.082, s. 775.083, or s. 775.084, for any person willfully, |
7373 | knowingly, or intentionally to use information from the juvenile |
7374 | records of a person obtained under this section for any purpose |
7375 | other than screening for employment under this section. |
7376 | Section 128. Section 400.515, Florida Statutes, is |
7377 | repealed. |
7378 | Section 129. Subsections (6) and (7) of section 400.551, |
7379 | Florida Statutes, are amended to read: |
7380 | 400.551 Definitions.--As used in this part, the term: |
7381 | (6) "Operator" means the licensee or person having general |
7382 | administrative charge of an adult day care center. |
7383 | (7) "Owner" means the licensee owner of an adult day care |
7384 | center. |
7385 | Section 130. Section 400.554, Florida Statutes, is amended |
7386 | to read: |
7387 | 400.554 License requirement; fee; exemption; display.-- |
7388 | (1) The requirements of part II of chapter 408 shall apply |
7389 | to the provision of services that require licensure pursuant |
7390 | this part and part II of chapter 408 and to entities licensed by |
7391 | or applying for such licensure from the Agency for Health Care |
7392 | Administration pursuant this part. However, each applicant for |
7393 | licensure and each licensee is exempt from the provisions of s. |
7394 | 408.810(10). It is unlawful to operate an adult day care center |
7395 | without first obtaining from the agency a license authorizing |
7396 | such operation. The agency is responsible for licensing adult |
7397 | day care centers in accordance with this part. |
7398 | (2) Separate licenses are required for centers operated on |
7399 | separate premises, even though operated under the same |
7400 | management. Separate licenses are not required for separate |
7401 | buildings on the same premises. |
7402 | (3) In accordance with s. 408.805, an applicant or |
7403 | licensee shall pay a fee for each license application submitted |
7404 | under this part and part II of chapter 408. The amount of the |
7405 | fee shall be established by rule and The biennial license fee |
7406 | required of a center shall be determined by the department, but |
7407 | may not exceed $150. |
7408 | (4) County-operated or municipally operated centers |
7409 | applying for licensure under this part are exempt from the |
7410 | payment of license fees. |
7411 | (5) The license for a center shall be displayed in a |
7412 | conspicuous place inside the center. |
7413 | (6) A license is valid only in the possession of the |
7414 | individual, firm, partnership, association, or corporation to |
7415 | which it is issued and is not subject to sale, assignment, or |
7416 | other transfer, voluntary or involuntary; nor is a license valid |
7417 | for any premises other than the premises for which originally |
7418 | issued. |
7419 | Section 131. Section 400.555, Florida Statutes, is amended |
7420 | to read: |
7421 | 400.555 Application for license.-- |
7422 | (1) An application for a license to operate an adult day |
7423 | care center must be made to the agency on forms furnished by the |
7424 | agency and must be accompanied by the appropriate license fee |
7425 | unless the applicant is exempt from payment of the fee as |
7426 | provided in s. 400.554(4). |
7427 | (2) In addition to all provisions of part II of chapter |
7428 | 408, the applicant for licensure must furnish: |
7429 | (a) a description of the physical and mental capabilities |
7430 | and needs of the participants to be served and the availability, |
7431 | frequency, and intensity of basic services and of supportive and |
7432 | optional services to be provided and proof of adequate liability |
7433 | insurance coverage.; |
7434 | (b) Satisfactory proof of financial ability to operate and |
7435 | conduct the center in accordance with the requirements of this |
7436 | part, which must include, in the case of an initial application, |
7437 | a 1-year operating plan and proof of a 3-month operating reserve |
7438 | fund; and |
7439 | (c) Proof of adequate liability insurance coverage. |
7440 | (d) Proof of compliance with level 2 background screening |
7441 | as required under s. 400.5572. |
7442 | (e) A description and explanation of any exclusions, |
7443 | permanent suspensions, or terminations of the application from |
7444 | the Medicare or Medicaid programs. Proof of compliance with |
7445 | disclosure of ownership and control interest requirements of the |
7446 | Medicare or Medicaid programs shall be accepted in lieu of this |
7447 | submission. |
7448 | Section 132. Section 400.556, Florida Statutes, is amended |
7449 | to read: |
7450 | 400.556 Denial, suspension, revocation of license; |
7451 | emergency action; administrative fines; investigations and |
7452 | inspections.-- |
7453 | (1) The agency may deny, revoke, or suspend a license |
7454 | under this part, impose an action under s. 408.814, and or may |
7455 | impose an administrative fine against the owner of an adult day |
7456 | care center or its operator or employee in the manner provided |
7457 | in chapter 120 for the violation of any provision of this part, |
7458 | part II of chapter 408, or applicable rules. |
7459 | (2) Each of the following actions by the owner of an adult |
7460 | day care center or by its operator or employee is a ground for |
7461 | action by the agency against the owner of the center or its |
7462 | operator or employee: |
7463 | (a) An intentional or negligent act materially affecting |
7464 | the health or safety of center participants. |
7465 | (b) A violation of this part or of any standard or rule |
7466 | under this part. |
7467 | (b)(c) A failure of persons subject to level 2 background |
7468 | screening under s. 408.809 400.4174(1) to meet the screening |
7469 | standards of s. 435.04, or the retention by the center of an |
7470 | employee subject to level 1 background screening standards under |
7471 | s. 400.4174(2) who does not meet the screening standards of s. |
7472 | 435.03 and for whom exemptions from disqualification have not |
7473 | been provided by the agency. |
7474 | (c)(d) Failure to follow the criteria and procedures |
7475 | provided under part I of chapter 394 relating to the |
7476 | transportation, voluntary admission, and involuntary examination |
7477 | of center participants. |
7478 | (d)(e) Multiple or repeated violations of this part or of |
7479 | any standard or rule adopted under this part or part II of |
7480 | chapter 408. |
7481 | (f) Exclusion, permanent suspension, or termination of the |
7482 | owner, if an individual, officer, or board member of the adult |
7483 | day care center, if the owner is a firm, corporation, |
7484 | partnership, or association, or any person owning 5 percent or |
7485 | more of the center, from the Medicare or Medicaid program. |
7486 | (3) The agency is responsible for all investigations and |
7487 | inspections conducted pursuant to this part. |
7488 | Section 133. Section 400.5565, Florida Statutes, is |
7489 | amended to read: |
7490 | 400.5565 Administrative fines; interest.-- |
7491 | (1)(a) If the agency determines that an adult day care |
7492 | center is not operated in compliance with this part, part II of |
7493 | chapter 408, or applicable with rules adopted under this part, |
7494 | the agency, notwithstanding any other administrative action it |
7495 | takes, shall make a reasonable attempt to discuss with the owner |
7496 | each violation and recommended corrective action prior to |
7497 | providing the owner with written notification. The agency may |
7498 | request the submission of a corrective action plan for the |
7499 | center which demonstrates a good faith effort to remedy each |
7500 | violation by a specific date, subject to the approval of the |
7501 | agency. |
7502 | (b) The owner of a center or its operator or employee |
7503 | found in violation of this part, part II of chapter 408, or |
7504 | applicable rules or of rules adopted under this part may be |
7505 | fined by the agency. A fine may not exceed $500 for each |
7506 | violation. In no event, however, may such fines in the aggregate |
7507 | exceed $5,000. |
7508 | (c) The failure to correct a violation by the date set by |
7509 | the agency, or the failure to comply with an approved corrective |
7510 | action plan, is a separate violation for each day such failure |
7511 | continues, unless the agency approves an extension to a specific |
7512 | date. |
7513 | (d) If the owner of a center or its operator or employee |
7514 | appeals an agency action under this section and the fine is |
7515 | upheld, the violator shall pay the fine, plus interest at the |
7516 | legal rate specified in s. 687.01 for each day that the fine |
7517 | remains unpaid after the date set by the agency for payment of |
7518 | the fine. |
7519 | (2) In determining whether to impose a fine and in fixing |
7520 | the amount of any fine, the agency shall consider the following |
7521 | factors: |
7522 | (a) The gravity of the violation, including the |
7523 | probability that death or serious physical or emotional harm to |
7524 | a participant will result or has resulted, the severity of the |
7525 | actual or potential harm, and the extent to which the provisions |
7526 | of the applicable statutes or rules were violated. |
7527 | (b) Actions taken by the owner or operator to correct |
7528 | violations. |
7529 | (c) Any previous violations. |
7530 | (d) The financial benefit to the center of committing or |
7531 | continuing the violation. |
7532 | Section 134. Section 400.557, Florida Statutes, is amended |
7533 | to read: |
7534 | 400.557 Expiration of license; renewal; Conditional |
7535 | license or permit.-- |
7536 | (1) A license issued for the operation of an adult day |
7537 | care center, unless sooner suspended or revoked, expires 2 years |
7538 | after the date of issuance. The agency shall notify a licensee |
7539 | at least 120 days before the expiration date that license |
7540 | renewal is required to continue operation. The notification must |
7541 | be provided electronically or by mail delivery. At least 90 days |
7542 | prior to the expiration date, an application for renewal must be |
7543 | submitted to the agency. A license shall be renewed, upon the |
7544 | filing of an application on forms furnished by the agency, if |
7545 | the applicant has first met the requirements of this part and of |
7546 | the rules adopted under this part. The applicant must file with |
7547 | the application satisfactory proof of financial ability to |
7548 | operate the center in accordance with the requirements of this |
7549 | part and in accordance with the needs of the participants to be |
7550 | served and an affidavit of compliance with the background |
7551 | screening requirements of s. 400.5572. |
7552 | (2) A licensee against whom a revocation or suspension |
7553 | proceeding is pending at the time for license renewal may be |
7554 | issued a conditional license effective until final disposition |
7555 | by the agency of the proceeding. If judicial relief is sought |
7556 | from the final disposition, the court having jurisdiction may |
7557 | issue a conditional permit effective for the duration of the |
7558 | judicial proceeding. |
7559 | (3) The agency may issue a conditional license to an |
7560 | applicant for license renewal or change of ownership if the |
7561 | applicant fails to meet all standards and requirements for |
7562 | licensure. A conditional license issued under this subsection |
7563 | must be limited to a specific period not exceeding 6 months, as |
7564 | determined by the agency, and must be accompanied by an approved |
7565 | plan of correction. |
7566 | Section 135. Section 400.5572, Florida Statutes, is |
7567 | amended to read: |
7568 | 400.5572 Background screening.-- |
7569 | (1)(a) Level 2 background screening must be conducted on |
7570 | each of the following persons, who shall be considered employees |
7571 | for the purposes of conducting screening under chapter 435: |
7572 | 1. The adult day care center owner if an individual, the |
7573 | operator, and the financial officer. |
7574 | 2. An officer or board member if the owner of the adult |
7575 | day care center is a firm, corporation, partnership, or |
7576 | association, or any person owning 5 percent or more of the |
7577 | facility, if the agency has probable cause to believe that such |
7578 | person has been convicted of any offense prohibited by s. |
7579 | 435.04. For each officer, board member, or person owning 5 |
7580 | percent or more who has been convicted of any such offense, the |
7581 | facility shall submit to the agency a description and |
7582 | explanation of the conviction at the time of license |
7583 | application. This subparagraph does not apply to a board member |
7584 | of a not-for-profit corporation or organization if the board |
7585 | member serves solely in a voluntary capacity, does not regularly |
7586 | take part in the day-to-day operational decisions of the |
7587 | corporation or organization, receives no remuneration for his or |
7588 | her services, and has no financial interest and has no family |
7589 | members with a financial interest in the corporation or |
7590 | organization, provided that the board member and facility submit |
7591 | a statement affirming that the board member's relationship to |
7592 | the facility satisfies the requirements of this subparagraph. |
7593 | (b) Proof of compliance with level 2 screening standards |
7594 | which has been submitted within the previous 5 years to meet any |
7595 | facility or professional licensure requirements of the agency or |
7596 | the Department of Health satisfies the requirements of this |
7597 | subsection. |
7598 | (c) The agency may grant a provisional license to an adult |
7599 | day care center applying for an initial license when each |
7600 | individual required by this subsection to undergo screening has |
7601 | completed the Department of Law Enforcement background check, |
7602 | but has not yet received results from the Federal Bureau of |
7603 | Investigation, or when a request for an exemption from |
7604 | disqualification has been submitted to the agency pursuant to s. |
7605 | 435.07, but a response has not been issued. |
7606 | (2) The owner or administrator of an adult day care center |
7607 | must conduct level 1 background screening as set forth in |
7608 | chapter 435 on all employees hired on or after October 1, 1998, |
7609 | who provide basic services or supportive and optional services |
7610 | to the participants. Such persons satisfy this requirement if: |
7611 | (1)(a) Proof of compliance with level 1 screening |
7612 | requirements obtained to meet any professional license |
7613 | requirements in this state is provided and accompanied, under |
7614 | penalty of perjury, by a copy of the person's current |
7615 | professional license and an affidavit of current compliance with |
7616 | the background screening requirements. |
7617 | (2)(b) The person required to be screened has been |
7618 | continuously employed, without a breach in service that exceeds |
7619 | 180 days, in the same type of occupation for which the person is |
7620 | seeking employment and provides proof of compliance with the |
7621 | level 1 screening requirement which is no more than 2 years old. |
7622 | Proof of compliance must be provided directly from one employer |
7623 | or contractor to another, and not from the person screened. Upon |
7624 | request, a copy of screening results shall be provided to the |
7625 | person screened by the employer retaining documentation of the |
7626 | screening. |
7627 | (3)(c) The person required to be screened is employed by a |
7628 | corporation or business entity or related corporation or |
7629 | business entity that owns, operates, or manages more than one |
7630 | facility or agency licensed under this chapter, and for whom a |
7631 | level 1 screening was conducted by the corporation or business |
7632 | entity as a condition of initial or continued employment. |
7633 | Section 136. Section 400.5575, Florida Statutes, is |
7634 | repealed. |
7635 | Section 137. Section 400.558, Florida Statutes, is |
7636 | repealed. |
7637 | Section 138. Section 400.559, Florida Statutes, is amended |
7638 | to read: |
7639 | 400.559 Discontinuance of operation of adult day care |
7640 | centers Closing or change of owner or operator of center.-- |
7641 | (1) Before operation of an adult day care center may be |
7642 | voluntarily discontinued, the operator must inform the agency in |
7643 | writing at least 60 days prior to the discontinuance of |
7644 | operation. The operator must also, at such time, inform each |
7645 | participant of the fact and the proposed date of such |
7646 | discontinuance of operation. |
7647 | (2) Immediately upon discontinuance of the operation of a |
7648 | center, the owner or operator shall surrender the license for |
7649 | the center to the agency, and the license shall be canceled by |
7650 | the agency. |
7651 | (3) If a center has a change of ownership, the new owner |
7652 | shall apply to the agency for a new license at least 60 days |
7653 | before the date of the change of ownership. |
7654 | (4) If a center has a change of operator, the new operator |
7655 | shall notify the agency in writing within 30 days after the |
7656 | change of operator. |
7657 | Section 139. Section 400.56, Florida Statutes, is amended |
7658 | to read: |
7659 | 400.56 Right of entry and inspection.--In accordance with |
7660 | s. 408.811, Any duly designated officer or employee of the |
7661 | agency or department has the right to enter the premises of any |
7662 | adult day care center licensed pursuant to this part, at any |
7663 | reasonable time, in order to determine the state of compliance |
7664 | with this part, part II of chapter 408, and applicable the rules |
7665 | or standards in force pursuant to this part. The right of entry |
7666 | and inspection also extends to any premises that the agency has |
7667 | reason to believe are being operated as a center without a |
7668 | license, but no entry or inspection of any unlicensed premises |
7669 | may be made without the permission of the owner or operator |
7670 | unless a warrant is first obtained from the circuit court |
7671 | authorizing entry or inspection. Any application for a center |
7672 | license or license renewal made pursuant to this part |
7673 | constitutes permission for, and complete acquiescence in, any |
7674 | entry or inspection of the premises for which the license is |
7675 | sought in order to facilitate verification of the information |
7676 | submitted on or in connection with the application. |
7677 | Section 140. Section 400.562, Florida Statutes, is amended |
7678 | to read: |
7679 | 400.562 Rules establishing standards.-- |
7680 | (1) The agency Department of Elderly Affairs, in |
7681 | conjunction with the Department of Elderly Affairs agency, shall |
7682 | adopt rules to implement the provisions of this part and part II |
7683 | of chapter 408. The rules must include reasonable and fair |
7684 | standards. Any conflict between these standards and those that |
7685 | may be set forth in local, county, or municipal ordinances shall |
7686 | be resolved in favor of those having statewide effect. Such |
7687 | standards must relate to: |
7688 | (a) The maintenance of adult day care centers with respect |
7689 | to plumbing, heating, lighting, ventilation, and other building |
7690 | conditions, including adequate meeting space, to ensure the |
7691 | health, safety, and comfort of participants and protection from |
7692 | fire hazard. Such standards may not conflict with chapter 553 |
7693 | and must be based upon the size of the structure and the number |
7694 | of participants. |
7695 | (b) The number and qualifications of all personnel |
7696 | employed by adult day care centers who have responsibilities for |
7697 | the care of participants. |
7698 | (c) All sanitary conditions within adult day care centers |
7699 | and their surroundings, including water supply, sewage disposal, |
7700 | food handling, and general hygiene, and maintenance of sanitary |
7701 | conditions, to ensure the health and comfort of participants. |
7702 | (d) Basic services provided by adult day care centers. |
7703 | (e) Supportive and optional services provided by adult day |
7704 | care centers. |
7705 | (f) Data and information relative to participants and |
7706 | programs of adult day care centers, including, but not limited |
7707 | to, the physical and mental capabilities and needs of the |
7708 | participants, the availability, frequency, and intensity of |
7709 | basic services and of supportive and optional services provided, |
7710 | the frequency of participation, the distances traveled by |
7711 | participants, the hours of operation, the number of referrals to |
7712 | other centers or elsewhere, and the incidence of illness. |
7713 | (g) Components of a comprehensive emergency management |
7714 | plan, developed in consultation with the Department of Health, |
7715 | the Department of Elderly Affairs Agency for Health Care |
7716 | Administration, and the Department of Community Affairs. |
7717 | (2) Pursuant to s. 119.07, the agency may charge a fee for |
7718 | furnishing a copy of this part, or of the rules adopted under |
7719 | this part, to any person upon request for the copy. |
7720 | (2)(3) Pursuant to this part, s. 408.811, and applicable |
7721 | rules adopted by the department, the agency may conduct an |
7722 | abbreviated biennial inspection of key quality-of-care |
7723 | standards, in lieu of a full inspection, of a center that has a |
7724 | record of good performance. However, the agency must conduct a |
7725 | full inspection of a center that has had one or more confirmed |
7726 | complaints within the licensure period immediately preceding the |
7727 | inspection or which has a serious problem identified during the |
7728 | abbreviated inspection. The agency shall by rule develop the key |
7729 | quality-of-care standards, taking into consideration the |
7730 | comments and recommendations of the Department of Elderly |
7731 | Affairs and of provider groups. These standards shall be |
7732 | included in rules adopted by the Department of Elderly Affairs. |
7733 | Section 141. Section 400.564, Florida Statutes, is |
7734 | repealed. |
7735 | Section 142. Section 400.602, Florida Statutes, is amended |
7736 | to read: |
7737 | 400.602 Licensure required; prohibited acts; exemptions; |
7738 | display, transferability of license.-- |
7739 | (1)(a) The requirements of part II of chapter 408 shall |
7740 | apply to the provision of services that require licensure |
7741 | pursuant to this part and part II of chapter 408 and to entities |
7742 | licensed by or applying for such licensure from the agency |
7743 | pursuant to this part. It is unlawful to operate or maintain a |
7744 | hospice without first obtaining a license from the agency. |
7745 | (b) It is unlawful for Any person or legal entity not |
7746 | licensed as a hospice under this part may not to use the word |
7747 | "hospice" in its name, or to offer or advertise hospice services |
7748 | or hospice-like services in such a way as to mislead a person to |
7749 | believe that the offeror is a hospice licensed under this part. |
7750 | (2) Services provided by a hospital, nursing home, or |
7751 | other health care facility, health care provider, or caregiver, |
7752 | or under the Community Care for the Elderly Act, do not |
7753 | constitute a hospice unless the facility, provider, or caregiver |
7754 | establishes a separate and distinct administrative program to |
7755 | provide home, residential, and homelike inpatient hospice |
7756 | services. |
7757 | (3)(a) A separately licensed hospice may not use a name |
7758 | which is substantially the same as the name of another hospice |
7759 | licensed under this part. |
7760 | (b) A licensed hospice which intends to change its name or |
7761 | address must notify the agency at least 60 days before making |
7762 | the change. |
7763 | (4) The license shall be displayed in a conspicuous place |
7764 | inside the hospice program office; shall be valid only in the |
7765 | possession of the person or public agency to which it is issued; |
7766 | shall not be subject to sale, assignment, or other transfer, |
7767 | voluntary or involuntary; and shall not be valid for any hospice |
7768 | other than the hospice for which originally issued. |
7769 | (4)(5) Notwithstanding s. 400.601(3), any hospice |
7770 | operating in corporate form exclusively as a hospice, |
7771 | incorporated on or before July 1, 1978, may be transferred to a |
7772 | for-profit or not-for-profit entity, and may transfer the |
7773 | license to that entity. |
7774 | (5)(6) Notwithstanding s. 400.601(3), at any time after |
7775 | July 1, 1995, any entity entitled to licensure under subsection |
7776 | (5) may obtain a license for up to two additional hospices in |
7777 | accordance with the other requirements of this part and upon |
7778 | receipt of any certificate of need that may be required under |
7779 | the provisions of part I of chapter 408 ss. 408.031-408.045. |
7780 | Section 143. Section 400.605, Florida Statutes, is amended |
7781 | to read: |
7782 | 400.605 Administration; forms; fees; rules; inspections; |
7783 | fines.-- |
7784 | (1) The agency department, in consultation with the |
7785 | department agency, shall by rule establish minimum standards and |
7786 | procedures for a hospice pursuant to this part and part II of |
7787 | chapter 408. The rules must include: |
7788 | (a) License application procedures and requirements. |
7789 | (a)(b) The qualifications of professional and ancillary |
7790 | personnel to ensure the provision of appropriate and adequate |
7791 | hospice care. |
7792 | (b)(c) Standards and procedures for the administrative |
7793 | management of a hospice. |
7794 | (c)(d) Standards for hospice services that ensure the |
7795 | provision of quality patient care. |
7796 | (d)(e) Components of a patient plan of care. |
7797 | (e)(f) Procedures relating to the implementation of |
7798 | advanced directives and do-not-resuscitate orders. |
7799 | (f)(g) Procedures for maintaining and ensuring |
7800 | confidentiality of patient records. |
7801 | (g)(h) Standards for hospice care provided in freestanding |
7802 | inpatient facilities that are not otherwise licensed medical |
7803 | facilities and in residential care facilities such as nursing |
7804 | homes, assisted living facilities, adult family care homes, and |
7805 | hospice residential units and facilities. |
7806 | (h)(i) Physical plant standards for hospice residential |
7807 | and inpatient facilities and units. |
7808 | (i)(j) Components of a comprehensive emergency management |
7809 | plan, developed in consultation with the Department of Health, |
7810 | the Department of Elderly Affairs, and the Department of |
7811 | Community Affairs. |
7812 | (j)(k) Standards and procedures relating to the |
7813 | establishment and activities of a quality assurance and |
7814 | utilization review committee. |
7815 | (k)(l) Components and procedures relating to the |
7816 | collection of patient demographic data and other information on |
7817 | the provision of hospice care in this state. |
7818 | (2) In accordance with s. 408.805, an applicant or |
7819 | licensee shall pay a fee for each license application submitted |
7820 | under this part, part II of chapter 408, and applicable rules. |
7821 | The amount of the fee shall be established by rule and may not |
7822 | exceed $1,200 per biennium. The agency shall: |
7823 | (a) Prepare and furnish all forms necessary under the |
7824 | provisions of this part in relation to applications for |
7825 | licensure or licensure renewals. |
7826 | (b) Collect from the applicant at the time of filing an |
7827 | application for a license or at the time of renewal of a license |
7828 | a fee which must be reasonably calculated to cover the cost of |
7829 | regulation under this part, but may not exceed $600 per program. |
7830 | All fees collected under this part shall be deposited in the |
7831 | Health Care Trust Fund for the administration of this part. |
7832 | (c) Issue hospice licenses to all applicants which meet |
7833 | the provisions of this part and applicable rules. |
7834 | (3)(d) In accordance with s. 408.811, the agency shall |
7835 | conduct annual licensure inspections of all licensees, except |
7836 | that licensure inspections may be conducted biennially for |
7837 | hospices having a 3-year record of substantial compliance. The |
7838 | agency shall |
7839 | (e) conduct such inspections and investigations as are |
7840 | necessary in order to determine the state of compliance with the |
7841 | provisions of this part, part II of chapter 408, and applicable |
7842 | adopted rules. The right of inspection also extends to any |
7843 | program that the agency has reason to believe is offering or |
7844 | advertising itself as a hospice without a license, but no |
7845 | inspection may be made without the permission of the owner or |
7846 | person in charge thereof unless a warrant is first obtained from |
7847 | a circuit court authorizing such inspection. An application for |
7848 | a license or license renewal made pursuant to this part |
7849 | constitutes permission for an inspection of the hospice for |
7850 | which the license is sought in order to facilitate verification |
7851 | of the information submitted on or in connection with the |
7852 | application. |
7853 | (4)(f) In accordance with part II of chapter 408, the |
7854 | agency may impose an administrative fine for any violation of |
7855 | the provisions of this part, part II of chapter 408, or |
7856 | applicable rules. |
7857 | Section 144. Section 400.606, Florida Statutes, is amended |
7858 | to read: |
7859 | 400.606 License; application; renewal; conditional license |
7860 | or permit; certificate of need.-- |
7861 | (1) A license application must be filed on a form provided |
7862 | by the agency and must be accompanied by the appropriate license |
7863 | fee as well as satisfactory proof that the hospice is in |
7864 | compliance with this part and any rules adopted by the |
7865 | department and proof of financial ability to operate and conduct |
7866 | the hospice in accordance with the requirements of this part. |
7867 | The initial application and change of ownership application must |
7868 | be accompanied by a plan for the delivery of home, residential, |
7869 | and homelike inpatient hospice services to terminally ill |
7870 | persons and their families. Such plan must contain, but need not |
7871 | be limited to: |
7872 | (a) The estimated average number of terminally ill persons |
7873 | to be served monthly. |
7874 | (b) The geographic area in which hospice services will be |
7875 | available. |
7876 | (c) A listing of services which are or will be provided, |
7877 | either directly by the applicant or through contractual |
7878 | arrangements with existing providers. |
7879 | (d) Provisions for the implementation of hospice home care |
7880 | within 3 months after licensure. |
7881 | (e) Provisions for the implementation of hospice homelike |
7882 | inpatient care within 12 months after licensure. |
7883 | (f) The number and disciplines of professional staff to be |
7884 | employed. |
7885 | (g) The name and qualifications of any existing or |
7886 | potential contractee. |
7887 | (h) A plan for attracting and training volunteers. |
7888 | (i) The projected annual operating cost of the hospice. |
7889 | (j) A statement of financial resources and personnel |
7890 | available to the applicant to deliver hospice care. |
7891 |
|
7892 | If the applicant is an existing licensed health care provider, |
7893 | the application must be accompanied by a copy of the most recent |
7894 | profit-loss statement and, if applicable, the most recent |
7895 | licensure inspection report. |
7896 | (2) Each applicant must submit to the agency with its |
7897 | application a description and explanation of any exclusions, |
7898 | permanent suspensions, or terminations from the Medicaid or |
7899 | Medicare programs of the owner, if an individual; of any officer |
7900 | or board member of the hospice, if the owner is a firm, |
7901 | corporation, partnership, or association; or of any person |
7902 | owning 5 percent or more of the hospice. Proof of compliance |
7903 | with disclosure of ownership and control interest requirements |
7904 | of the Medicaid or Medicare programs may be accepted in lieu of |
7905 | this submission. |
7906 | (2)(3) A license issued for the operation of a hospice, |
7907 | unless sooner suspended or revoked, shall expire automatically 1 |
7908 | year from the date of issuance. Sixty days prior to the |
7909 | expiration date, a hospice wishing to renew its license shall |
7910 | submit an application for renewal to the agency on forms |
7911 | furnished by the agency. The agency shall renew the license if |
7912 | the applicant has first met the requirements established under |
7913 | this part and all applicable rules and has provided the |
7914 | information described under this section in addition to the |
7915 | application. However, The application for license renewal shall |
7916 | be accompanied by an update of the plan for delivery of hospice |
7917 | care only if information contained in the plan submitted |
7918 | pursuant to subsection (1) is no longer applicable. |
7919 | (4) A hospice against which a revocation or suspension |
7920 | proceeding is pending at the time of license renewal may be |
7921 | issued a conditional license by the agency effective until final |
7922 | disposition of such proceeding. If judicial relief is sought |
7923 | from the final agency action, the court having jurisdiction may |
7924 | issue a conditional permit for the duration of the judicial |
7925 | proceeding. |
7926 | (3)(5) The agency shall not issue a license to a hospice |
7927 | that fails to receive a certificate of need under the provisions |
7928 | of part I of chapter 408 ss. 408.031-408.045. A licensed hospice |
7929 | is a health care facility as that term is used in s. 408.039(5) |
7930 | and is entitled to initiate or intervene in an administrative |
7931 | hearing. |
7932 | (4)(6) A freestanding hospice facility that is primarily |
7933 | engaged in providing inpatient and related services and that is |
7934 | not otherwise licensed as a health care facility shall be |
7935 | required to obtain a certificate of need. However, a |
7936 | freestanding hospice facility with six or fewer beds shall not |
7937 | be required to comply with institutional standards such as, but |
7938 | not limited to, standards requiring sprinkler systems, emergency |
7939 | electrical systems, or special lavatory devices. |
7940 | Section 145. Section 400.6065, Florida Statutes, is |
7941 | amended to read: |
7942 | 400.6065 Background screening.-- |
7943 | (1) Upon receipt of a completed application under s. |
7944 | 400.606, the agency shall require level 2 background screening |
7945 | on each of the following persons, who shall be considered |
7946 | employees for the purposes of conducting screening under chapter |
7947 | 435: |
7948 | (a) The hospice administrator and financial officer. |
7949 | (b) An officer or board member if the hospice is a firm, |
7950 | corporation, partnership, or association, or any person owning 5 |
7951 | percent or more of the hospice if the agency has probable cause |
7952 | to believe that such officer, board member, or owner has been |
7953 | convicted of any offense prohibited by s. 435.04. For each |
7954 | officer, board member, or person owning 5 percent or more who |
7955 | has been convicted of any such offense, the hospice shall submit |
7956 | to the agency a description and explanation of the conviction at |
7957 | the time of license application. This paragraph does not apply |
7958 | to a board member of a not-for-profit corporation or |
7959 | organization if the board member serves solely in a voluntary |
7960 | capacity, does not regularly take part in the day-to-day |
7961 | operational decisions of the corporation or organization, |
7962 | receives no remuneration for his or her services, and has no |
7963 | financial interest and has no family members with a financial |
7964 | interest in the corporation or organization, provided that the |
7965 | board member and the corporation or organization submit a |
7966 | statement affirming that the board member's relationship to the |
7967 | corporation or organization satisfies the requirements of this |
7968 | paragraph. |
7969 | (2) Proof of compliance with level 2 screening standards |
7970 | which has been submitted within the previous 5 years to meet any |
7971 | facility or professional licensure requirements of the agency or |
7972 | the Department of Health satisfies the requirements of this |
7973 | section. |
7974 | (3) The agency may grant a provisional license to a |
7975 | hospice applying for an initial license when each individual |
7976 | required by this section to undergo screening has completed the |
7977 | Department of Law Enforcement background check, but has not yet |
7978 | received results from the Federal Bureau of Investigation. |
7979 | (1)(4) The agency shall require employment or contractor |
7980 | screening as provided in chapter 435, using the level 1 |
7981 | standards for screening set forth in that chapter, for hospice |
7982 | personnel. |
7983 | (2)(5) The agency may grant exemptions from |
7984 | disqualification from employment under this section as provided |
7985 | in s. 435.07. |
7986 | (6) The administration of each hospice must sign an |
7987 | affidavit annually, under penalty of perjury, stating that all |
7988 | personnel employed or contracted with on or after October 1, |
7989 | 1998, who provide hospice services in a facility, or who enter |
7990 | the home of a patient in their service capacity, have been |
7991 | screened. |
7992 | (3)(7) Proof of compliance with the screening requirements |
7993 | of chapter 435 shall be accepted in lieu of the requirements of |
7994 | this section if the person has been continuously employed or |
7995 | registered without a breach in service that exceeds 180 days, |
7996 | the proof of compliance is not more than 2 years old, and the |
7997 | person has been screened, at the discretion of the hospice. |
7998 | (4)(8)(a) It is a misdemeanor of the first degree, |
7999 | punishable under s. 775.082 or s. 775.083, for any person |
8000 | willfully, knowingly, or intentionally to: |
8001 | 1. Fail, by false statement, misrepresentation, |
8002 | impersonation, or other fraudulent means, to disclose in any |
8003 | application for voluntary or paid employment a material fact |
8004 | used in making a determination as to such person's |
8005 | qualifications to be employed or contracted with under this |
8006 | section; |
8007 | 2. Operate or attempt to operate an entity licensed under |
8008 | this part with persons who do not meet the minimum standards for |
8009 | good moral character as contained in this section; or |
8010 | 2.3. Use information from the criminal records obtained |
8011 | under this section for any purpose other than screening as |
8012 | specified in this section, or release such information to any |
8013 | other person for any purpose other than screening under this |
8014 | section. |
8015 | (b) It is a felony of the third degree, punishable under |
8016 | s. 775.082, s. 775.083, or s. 775.084, for any person willfully, |
8017 | knowingly, or intentionally to use information from the juvenile |
8018 | records of a person obtained under this section for any purpose |
8019 | other than screening for employment under this section. |
8020 | Section 146. Section 400.607, Florida Statutes, is amended |
8021 | to read: |
8022 | 400.607 Denial, suspension, or revocation of license; |
8023 | emergency actions; imposition of administrative fine; grounds; |
8024 | injunctions.-- |
8025 | (1) The agency may deny, revoke, and or suspend a license, |
8026 | impose an action under s. 408.814, and or impose an |
8027 | administrative fine, which may not exceed $5,000 per violation, |
8028 | for the violation of any provision of this part, part II of |
8029 | chapter 408, or applicable rules in the manner provided in |
8030 | chapter 120. |
8031 | (2) Any of the following actions by a licensed hospice or |
8032 | any of its employees shall be grounds for action by the agency |
8033 | against a hospice: |
8034 | (a) A violation of the provisions of this part or |
8035 | applicable rules. |
8036 | (b) An intentional or negligent act materially affecting |
8037 | the health or safety of a patient. |
8038 | (3) The agency may deny or revoke a license upon a |
8039 | determination that: |
8040 | (a) Persons subject to level 2 background screening under |
8041 | s. 400.6065 do not meet the screening standards of s. 435.04, |
8042 | and exemptions from disqualification have not been provided by |
8043 | the agency. |
8044 | (b) An officer, board member, or person owning 5 percent |
8045 | or more of the hospice has been excluded, permanently suspended, |
8046 | or terminated from the Medicare or Medicaid programs. |
8047 | (3)(4) If, 3 months after the date of obtaining a license, |
8048 | or at any time thereafter, a hospice does not have in operation |
8049 | the home-care component of hospice care, the agency shall |
8050 | immediately revoke the license of such hospice. |
8051 | (4)(5) If, 12 months after the date of obtaining a license |
8052 | pursuant to s. 400.606, or at any time thereafter, a hospice |
8053 | does not have in operation the inpatient components of hospice |
8054 | care, the agency shall immediately revoke the license of such |
8055 | hospice. |
8056 | (6) The agency may institute a civil action in a court of |
8057 | competent jurisdiction to seek injunctive relief to enforce |
8058 | compliance with this part or any rule adopted pursuant to this |
8059 | part. |
8060 | (5)(7) The remedies set forth in this section are |
8061 | independent of and cumulative to other remedies provided by law. |
8062 | Section 147. Subsection (8) of section 400.6095, Florida |
8063 | Statutes, is amended to read: |
8064 | 400.6095 Patient admission; assessment; plan of care; |
8065 | discharge; death.-- |
8066 | (8) The hospice care team may withhold or withdraw |
8067 | cardiopulmonary resuscitation if presented with an order not to |
8068 | resuscitate executed pursuant to s. 401.45. The agency |
8069 | department shall adopt rules providing for the implementation of |
8070 | such orders. Hospice staff shall not be subject to criminal |
8071 | prosecution or civil liability, nor be considered to have |
8072 | engaged in negligent or unprofessional conduct, for withholding |
8073 | or withdrawing cardiopulmonary resuscitation pursuant to such an |
8074 | order and applicable rules adopted by the department. The |
8075 | absence of an order to resuscitate executed pursuant to s. |
8076 | 401.45 does not preclude a physician from withholding or |
8077 | withdrawing cardiopulmonary resuscitation as otherwise permitted |
8078 | by law. |
8079 | Section 148. Subsection (5) of section 400.617, Florida |
8080 | Statutes, is amended to read: |
8081 | 400.617 Legislative intent; purpose.-- |
8082 | (5) Rules of the agency department relating to adult |
8083 | family-care homes shall be as minimal and flexible as possible |
8084 | to ensure the protection of residents while minimizing the |
8085 | obstacles that could inhibit the establishment of adult family- |
8086 | care homes. |
8087 | Section 149. Section 400.619, Florida Statutes, is amended |
8088 | to read: |
8089 | 400.619 Licensure application and renewal.-- |
8090 | (1) The requirements of part II of chapter 408 shall apply |
8091 | to the provision of services that require licensure pursuant to |
8092 | this part and part II of chapter 408 and to entities licensed by |
8093 | or applying for such licensure from the Agency for Health Care |
8094 | Administration pursuant to this part. However, each applicant |
8095 | for licensure and each licensee is exempt from s. 408.810(7)- |
8096 | (10). Each person who intends to be an adult family-care home |
8097 | provider must apply for a license from the agency at least 90 |
8098 | days before the applicant intends to operate the adult family- |
8099 | care home. |
8100 | (2) A person who intends to be an adult family-care home |
8101 | provider must own or rent the adult family-care home that is to |
8102 | be licensed and reside therein. |
8103 | (3) In accordance with s. 408.805, an applicant or |
8104 | licensee shall pay a fee for each license application submitted |
8105 | under this part, part II of chapter 408, and applicable rules. |
8106 | The amount of the fee shall be $200 per biennium. The agency |
8107 | shall notify a licensee at least 120 days before the expiration |
8108 | date that license renewal is required to continue operation. The |
8109 | notification must be provided electronically or by mail |
8110 | delivery. Application for a license or annual license renewal |
8111 | must be made on a form provided by the agency, signed under |
8112 | oath, and must be accompanied by a licensing fee of $100 per |
8113 | year. |
8114 | (4) Upon receipt of a completed license application or |
8115 | license renewal, and the fee, the agency shall initiate a level |
8116 | 1 background screening as provided under chapter 435 on the |
8117 | adult family-care home provider, the designated relief person, |
8118 | all adult household members, and all staff members. The |
8119 | applicant or licensee is responsible for paying the fees |
8120 | associated with obtaining the required screening. The agency |
8121 | shall conduct an onsite visit to the home that is to be |
8122 | licensed. |
8123 | (a) Proof of compliance with level 1 screening standards |
8124 | which has been submitted within the previous 5 years to meet any |
8125 | facility or professional licensure requirements of the agency or |
8126 | the Department of Health satisfies the requirements of this |
8127 | subsection. Such proof must be accompanied, under penalty of |
8128 | perjury, by a copy of the person's current professional license |
8129 | and an affidavit of current compliance with the background |
8130 | screening requirements. |
8131 | (b) The person required to be screened must have been |
8132 | continuously employed in the same type of occupation for which |
8133 | the person is seeking employment without a breach in service |
8134 | that exceeds 180 days, and proof of compliance with the level 1 |
8135 | screening requirement which is no more than 2 years old must be |
8136 | provided. Proof of compliance shall be provided directly from |
8137 | one employer or contractor to another, and not from the person |
8138 | screened. Upon request, a copy of screening results shall be |
8139 | provided to the person screened by the employer retaining |
8140 | documentation of the screening. |
8141 | (5) The application must be accompanied by a description |
8142 | and explanation of any exclusions, permanent suspensions, or |
8143 | terminations of the applicant from participation in the Medicaid |
8144 | or Medicare programs or any other governmental health care or |
8145 | health insurance program. |
8146 | (6) Unless the adult family-care home is a community |
8147 | residential home subject to chapter 419, the applicant must |
8148 | provide documentation, signed by the appropriate governmental |
8149 | official, that the home has met local zoning requirements for |
8150 | the location for which the license is sought. |
8151 | (5)(7) Access to a licensed adult family-care home must be |
8152 | provided at reasonable times for the appropriate officials of |
8153 | the department, the Department of Health, the Department of |
8154 | Children and Family Services, the agency, and the State Fire |
8155 | Marshal, who are responsible for the development and maintenance |
8156 | of fire, health, sanitary, and safety standards, to inspect the |
8157 | facility to assure compliance with these standards. In addition, |
8158 | access to a licensed adult family-care home must be provided at |
8159 | reasonable times for the local long-term care ombudsman council. |
8160 | (8) A license is effective for 1 year after the date of |
8161 | issuance unless revoked sooner. Each license must state the name |
8162 | of the provider, the address of the home to which the license |
8163 | applies, and the maximum number of residents of the home. |
8164 | Failure to timely file a license renewal application shall |
8165 | result in a late fee equal to 50 percent of the license fee. |
8166 | (9) A license is not transferable or applicable to any |
8167 | location or person other than the location and person indicated |
8168 | on the license. |
8169 | (6)(10) The licensed maximum capacity of each adult |
8170 | family-care home is based on the service needs of the residents |
8171 | and the capability of the provider to meet the needs of the |
8172 | residents. Any relative who lives in the adult family-care home |
8173 | and who is a disabled adult or frail elder must be included in |
8174 | that limitation. |
8175 | (7)(11) Each adult family-care home must designate at |
8176 | least one licensed space for a resident receiving optional state |
8177 | supplementation. The Department of Children and Family Services |
8178 | shall specify by rule the procedures to be followed for |
8179 | referring residents who receive optional state supplementation |
8180 | to adult family-care homes. Those homes licensed as adult foster |
8181 | homes or assisted living facilities prior to January 1, 1994, |
8182 | that convert to adult family-care homes, are exempt from this |
8183 | requirement. |
8184 | (8)(12) The agency may issue a conditional license to a |
8185 | provider for the purpose of bringing the adult family-care home |
8186 | into compliance with licensure requirements. A conditional |
8187 | license must be limited to a specific period, not exceeding 6 |
8188 | months. The agency department shall, by rule, establish criteria |
8189 | for issuing conditional licenses. |
8190 | (13) All moneys collected under this section must be |
8191 | deposited into the Department of Elderly Affairs Administrative |
8192 | Trust Fund. |
8193 | (9)(14) The agency department may adopt rules to establish |
8194 | procedures, identify forms, specify documentation, and clarify |
8195 | terms, as necessary, to administer this section and part II of |
8196 | chapter 408. |
8197 | Section 150. Section 400.6194, Florida Statutes, is |
8198 | amended to read: |
8199 | 400.6194 Denial, revocation, or suspension of a |
8200 | license.--In addition to the requirements of part II of chapter |
8201 | 408 the agency may deny, suspend, and or revoke a license for |
8202 | any of the following reasons: |
8203 | (1) Failure of any of the persons required to undergo |
8204 | background screening under s. 400.619 to meet the level 1 |
8205 | screening standards of s. 435.03, unless an exemption from |
8206 | disqualification has been provided by the agency. |
8207 | (2) An intentional or negligent act materially affecting |
8208 | the health, safety, or welfare of the adult family-care home |
8209 | residents. |
8210 | (3) Submission of fraudulent information or omission of |
8211 | any material fact on a license application or any other document |
8212 | required by the agency. |
8213 | (4) Failure to pay an administrative fine assessed under |
8214 | this part. |
8215 | (5) A violation of this part or adopted rules which |
8216 | results in conditions or practices that directly threaten the |
8217 | physical or emotional health, safety, or welfare of residents. |
8218 | (3)(6) Failure to correct cited fire code violations that |
8219 | threaten the health, safety, or welfare of residents. |
8220 | (7) Failure to submit a completed initial license |
8221 | application or to complete an application for license renewal |
8222 | within the specified timeframes. |
8223 | (8) Exclusion, permanent suspension, or termination of the |
8224 | provider from the Medicare or Medicaid program. |
8225 | Section 151. Section 400.6196, Florida Statutes, is |
8226 | amended to read: |
8227 | 400.6196 Classification of deficiencies; administrative |
8228 | fines Violations; penalties.-- |
8229 | (1) In accordance with part II of chapter 408 and in |
8230 | addition to any other liability or penalty provided by law, the |
8231 | agency may impose an administrative fine a civil penalty on a |
8232 | provider according to the following classification for the |
8233 | violation of any provision of this part, part II of chapter 408, |
8234 | or applicable rules: |
8235 | (a) Class I violations are those conditions or practices |
8236 | related to the operation and maintenance of an adult family-care |
8237 | home or to the care of residents which the agency determines |
8238 | present an imminent danger to the residents or guests of the |
8239 | facility or a substantial probability that death or serious |
8240 | physical or emotional harm would result therefrom. The condition |
8241 | or practice that constitutes a class I violation must be abated |
8242 | or eliminated within 24 hours, unless a fixed period, as |
8243 | determined by the agency, is required for correction. A class I |
8244 | deficiency is subject to an administrative fine in an amount not |
8245 | less than $500 and not exceeding $1,000 for each violation. A |
8246 | fine may be levied notwithstanding the correction of the |
8247 | deficiency. |
8248 | (b) Class II violations are those conditions or practices |
8249 | related to the operation and maintenance of an adult family-care |
8250 | home or to the care of residents which the agency determines |
8251 | directly threaten the physical or emotional health, safety, or |
8252 | security of the residents, other than class I violations. A |
8253 | class II violation is subject to an administrative fine in an |
8254 | amount not less than $250 and not exceeding $500 for each |
8255 | violation. A citation for a class II violation must specify the |
8256 | time within which the violation is required to be corrected. If |
8257 | a class II violation is corrected within the time specified, no |
8258 | civil penalty shall be imposed, unless it is a repeated offense. |
8259 | (c) Class III violations are those conditions or practices |
8260 | related to the operation and maintenance of an adult family-care |
8261 | home or to the care of residents which the agency determines |
8262 | indirectly or potentially threaten the physical or emotional |
8263 | health, safety, or security of residents, other than class I or |
8264 | class II violations. A class III violation is subject to an |
8265 | administrative fine in an amount not less than $100 and not |
8266 | exceeding $250 for each violation. A citation for a class III |
8267 | violation shall specify the time within which the violation is |
8268 | required to be corrected. If a class III violation is corrected |
8269 | within the time specified, no civil penalty shall be imposed, |
8270 | unless it is a repeated offense. |
8271 | (d) Class IV violations are those conditions or |
8272 | occurrences related to the operation and maintenance of an adult |
8273 | family-care home, or related to the required reports, forms, or |
8274 | documents, which do not have the potential of negatively |
8275 | affecting the residents. A provider that does not correct a |
8276 | class IV violation within the time limit specified by the agency |
8277 | is subject to an administrative fine in an amount not less than |
8278 | $50 and not exceeding $100 for each violation. Any class IV |
8279 | violation that is corrected during the time the agency survey is |
8280 | conducted will be identified as an agency finding and not as a |
8281 | violation. |
8282 | (2) The agency may impose an administrative fine for |
8283 | violations which do not qualify as class I, class II, class III, |
8284 | or class IV violations. The amount of the fine shall not exceed |
8285 | $250 for each violation or $2,000 in the aggregate. Unclassified |
8286 | violations include: |
8287 | (a) Violating any term or condition of a license. |
8288 | (b) Violating any provision of rule adopted under this |
8289 | part, part II of chapter 408, or applicable rules. |
8290 | (c) Failure to follow the criteria and procedures provided |
8291 | under part I of chapter 394 relating to the transportation, |
8292 | voluntary admission, and involuntary examination of adult |
8293 | family-care home residents. |
8294 | (d) Exceeding licensed capacity. |
8295 | (e) Providing services beyond the scope of the license. |
8296 | (f) Violating a moratorium. |
8297 | (3) Each day during which a violation occurs constitutes a |
8298 | separate offense. |
8299 | (3)(4) In determining whether a penalty is to be imposed, |
8300 | and in fixing the amount of any penalty to be imposed, the |
8301 | agency must consider: |
8302 | (a) The gravity of the violation. |
8303 | (b) Actions taken by the provider to correct a violation. |
8304 | (c) Any previous violation by the provider. |
8305 | (d) The financial benefit to the provider of committing or |
8306 | continuing the violation. |
8307 | (4)(5) As an alternative to or in conjunction with an |
8308 | administrative action against a provider, the agency may request |
8309 | a plan of corrective action that demonstrates a good faith |
8310 | effort to remedy each violation by a specific date, subject to |
8311 | the approval of the agency. |
8312 | (5)(6) The agency department shall set forth, by rule, |
8313 | notice requirements and procedures for correction of |
8314 | deficiencies. |
8315 | (7) Civil penalties paid by a provider must be deposited |
8316 | into the Department of Elderly Affairs Administrative Trust Fund |
8317 | and used to offset the expenses of departmental training and |
8318 | education for adult family-care home providers. |
8319 | (8) The agency may impose an immediate moratorium on |
8320 | admissions to any adult family-care home if the agency finds |
8321 | that a condition in the home presents a threat to the health, |
8322 | safety, or welfare of its residents. The department may by rule |
8323 | establish facility conditions that constitute grounds for |
8324 | imposing a moratorium and establish procedures for imposing and |
8325 | lifting a moratorium. |
8326 | Section 152. Section 400.621, Florida Statutes, is amended |
8327 | to read: |
8328 | 400.621 Rules and standards relating to adult family-care |
8329 | homes.-- |
8330 | (1) The agency department, in consultation with the |
8331 | Department of Health, the Department of Children and Family |
8332 | Services, and the department agency shall, by rule, establish |
8333 | minimum standards to ensure the health, safety, and well-being |
8334 | of each resident in the adult family-care home pursuant to this |
8335 | part and part II of chapter 408. The rules must address: |
8336 | (a) Requirements for the physical site of the facility and |
8337 | facility maintenance. |
8338 | (b) Services that must be provided to all residents of an |
8339 | adult family-care home and standards for such services, which |
8340 | must include, but need not be limited to: |
8341 | 1. Room and board. |
8342 | 2. Assistance necessary to perform the activities of daily |
8343 | living. |
8344 | 3. Assistance necessary to administer medication. |
8345 | 4. Supervision of residents. |
8346 | 5. Health monitoring. |
8347 | 6. Social and leisure activities. |
8348 | (c) Standards and procedures for license application and |
8349 | annual license renewal, advertising, proper management of each |
8350 | resident's funds and personal property and personal affairs, |
8351 | financial ability to operate, medication management, |
8352 | inspections, complaint investigations, and facility, staff, and |
8353 | resident records. |
8354 | (d) Qualifications, training, standards, and |
8355 | responsibilities for providers and staff. |
8356 | (e) Compliance with chapter 419, relating to community |
8357 | residential homes. |
8358 | (f) Criteria and procedures for determining the |
8359 | appropriateness of a resident's placement and continued |
8360 | residency in an adult family-care home. A resident who requires |
8361 | 24-hour nursing supervision may not be retained in an adult |
8362 | family-care home unless such resident is an enrolled hospice |
8363 | patient and the resident's continued residency is mutually |
8364 | agreeable to the resident and the provider. |
8365 | (g) Procedures for providing notice and assuring the least |
8366 | possible disruption of residents' lives when residents are |
8367 | relocated, an adult family-care home is closed, or the ownership |
8368 | of an adult family-care home is transferred. |
8369 | (h) Procedures to protect the residents' rights as |
8370 | provided in s. 400.628. |
8371 | (i) Procedures to promote the growth of adult family-care |
8372 | homes as a component of a long-term care system. |
8373 | (j) Procedures to promote the goal of aging in place for |
8374 | residents of adult family-care homes. |
8375 | (2) The agency department shall by rule provide minimum |
8376 | standards and procedures for emergencies. Pursuant to s. |
8377 | 633.022, the State Fire Marshal, in consultation with the |
8378 | department and the agency, shall adopt uniform firesafety |
8379 | standards for adult family-care homes. |
8380 | (3) The agency department shall adopt rules providing for |
8381 | the implementation of orders not to resuscitate. The provider |
8382 | may withhold or withdraw cardiopulmonary resuscitation if |
8383 | presented with an order not to resuscitate executed pursuant to |
8384 | s. 401.45. The provider shall not be subject to criminal |
8385 | prosecution or civil liability, nor be considered to have |
8386 | engaged in negligent or unprofessional conduct, for withholding |
8387 | or withdrawing cardiopulmonary resuscitation pursuant to such an |
8388 | order and applicable rules adopted by the department. |
8389 | (4) The provider of any adult family-care home that is in |
8390 | operation at the time any rules are adopted or amended under |
8391 | this part may be given a reasonable time, not exceeding 6 |
8392 | months, within which to comply with the new or revised rules and |
8393 | standards. |
8394 | Section 153. Subsection (3) of section 400.6211, Florida |
8395 | Statutes, is amended to read: |
8396 | 400.6211 Training and education programs.-- |
8397 | (3) Effective January 1, 2004, providers must complete the |
8398 | training and education program within a reasonable time |
8399 | determined by the agency department. Failure to complete the |
8400 | training and education program within the time set by the agency |
8401 | department is a violation of this part and subjects the provider |
8402 | to revocation of the license. |
8403 | Section 154. Section 400.622, Florida Statutes, is |
8404 | repealed. |
8405 | Section 155. Subsection (2) of section 400.625, Florida |
8406 | Statutes, is amended to read: |
8407 | 400.625 Residency agreements.-- |
8408 | (2) Each residency agreement must specify the personal |
8409 | care and accommodations to be provided by the adult family-care |
8410 | home, the rates or charges, a requirement of at least 30 days' |
8411 | notice before a rate increase, and any other provisions required |
8412 | by rule of the agency department. |
8413 | Section 156. Section 400.801, Florida Statutes, is amended |
8414 | to read: |
8415 | 400.801 Homes for special services.-- |
8416 | (1) As used in this section, the term: |
8417 | (a) "Agency" means the "Agency for Health Care |
8418 | Administration." |
8419 | (b) "Home for special services" means a site where |
8420 | specialized health care services are provided, including |
8421 | personal and custodial care, but not continuous nursing |
8422 | services. |
8423 | (2) The requirements of part II of chapter 408 shall apply |
8424 | to the provision of services that require licensure pursuant to |
8425 | this section and part II of chapter 408 and entities licensed by |
8426 | or applying for such licensure from the agency pursuant to this |
8427 | section. However, each applicant for licensure and each licensee |
8428 | is exempt from the provisions of s. 408.810(7)-(10). A person |
8429 | must obtain a license from the agency to operate a home for |
8430 | special services. A license is valid for 1 year. |
8431 | (3) In accordance with s. 408.805, an applicant or |
8432 | licensee shall pay a fee for each license application submitted |
8433 | under this part, part II of chapter 408, and applicable rules. |
8434 | The amount of the fee shall be established by rule and shall not |
8435 | be more than $2,000 per biennium. The application for a license |
8436 | under this section must be made on a form provided by the |
8437 | agency. A nonrefundable license fee of not more than $1,000 must |
8438 | be submitted with the license application. |
8439 | (4) Each applicant for licensure must comply with the |
8440 | following requirements: |
8441 | (a) Upon receipt of a completed, signed, and dated |
8442 | application, the agency shall require background screening, in |
8443 | accordance with the level 2 standards for screening set forth in |
8444 | chapter 435, of the managing employee, or other similarly titled |
8445 | individual who is responsible for the daily operation of the |
8446 | facility, and of the financial officer, or other similarly |
8447 | titled individual who is responsible for the financial operation |
8448 | of the facility, including billings for client care and |
8449 | services, in accordance with the level 2 standards for screening |
8450 | set forth in chapter 435. The applicant must comply with the |
8451 | procedures for level 2 background screening as set forth in |
8452 | chapter 435. |
8453 | (b) The agency may require background screening of any |
8454 | other individual who is an applicant if the agency has probable |
8455 | cause to believe that he or she has been convicted of a crime or |
8456 | has committed any other offense prohibited under the level 2 |
8457 | standards for screening set forth in chapter 435. |
8458 | (c) Proof of compliance with the level 2 background |
8459 | screening requirements of chapter 435 which has been submitted |
8460 | within the previous 5 years in compliance with any other health |
8461 | care or assisted living licensure requirements of this state is |
8462 | acceptable in fulfillment of the requirements of paragraph (a). |
8463 | (d) A provisional license may be granted to an applicant |
8464 | when each individual required by this section to undergo |
8465 | background screening has met the standards for the Department of |
8466 | Law Enforcement background check, but the agency has not yet |
8467 | received background screening results from the Federal Bureau of |
8468 | Investigation, or a request for a disqualification exemption has |
8469 | been submitted to the agency as set forth in chapter 435, but a |
8470 | response has not yet been issued. A standard license may be |
8471 | granted to the applicant upon the agency's receipt of a report |
8472 | of the results of the Federal Bureau of Investigation background |
8473 | screening for each individual required by this section to |
8474 | undergo background screening which confirms that all standards |
8475 | have been met, or upon the granting of a disqualification |
8476 | exemption by the agency as set forth in chapter 435. Any other |
8477 | person who is required to undergo level 2 background screening |
8478 | may serve in his or her capacity pending the agency's receipt of |
8479 | the report from the Federal Bureau of Investigation. However, |
8480 | the person may not continue to serve if the report indicates any |
8481 | violation of background screening standards and a |
8482 | disqualification exemption has not been requested of and granted |
8483 | by the agency as set forth in chapter 435. |
8484 | (e) Each applicant must submit to the agency, with its |
8485 | application, a description and explanation of any exclusions, |
8486 | permanent suspensions, or terminations of the applicant from the |
8487 | Medicare or Medicaid programs. Proof of compliance with the |
8488 | requirements for disclosure of ownership and control interests |
8489 | under the Medicaid or Medicare programs may be accepted in lieu |
8490 | of this submission. |
8491 | (f) Each applicant must submit to the agency a description |
8492 | and explanation of any conviction of an offense prohibited under |
8493 | the level 2 standards of chapter 435 by a member of the board of |
8494 | directors of the applicant, its officers, or any individual |
8495 | owning 5 percent or more of the applicant. This requirement does |
8496 | not apply to a director of a not-for-profit corporation or |
8497 | organization if the director serves solely in a voluntary |
8498 | capacity for the corporation or organization, does not regularly |
8499 | take part in the day-to-day operational decisions of the |
8500 | corporation or organization, receives no remuneration for his or |
8501 | her services on the corporation or organization's board of |
8502 | directors, and has no financial interest and has no family |
8503 | members with a financial interest in the corporation or |
8504 | organization, provided that the director and the not-for-profit |
8505 | corporation or organization include in the application a |
8506 | statement affirming that the director's relationship to the |
8507 | corporation satisfies the requirements of this paragraph. |
8508 | (g) A license may not be granted to an applicant if the |
8509 | applicant or managing employee has been found guilty of, |
8510 | regardless of adjudication, or has entered a plea of nolo |
8511 | contendere or guilty to, any offense prohibited under the level |
8512 | 2 standards for screening set forth in chapter 435, unless an |
8513 | exemption from disqualification has been granted by the agency |
8514 | as set forth in chapter 435. |
8515 | (h) The agency may deny or revoke licensure if the |
8516 | applicant: |
8517 | 1. Has falsely represented a material fact in the |
8518 | application required by paragraph (e) or paragraph (f), or has |
8519 | omitted any material fact from the application required by |
8520 | paragraph (e) or paragraph (f); or |
8521 | 2. Has had prior action taken against the applicant under |
8522 | the Medicaid or Medicare program as set forth in paragraph (e). |
8523 | (i) An application for license renewal must contain the |
8524 | information required under paragraphs (e) and (f). |
8525 | (5) Application for license renewal must be submitted 90 |
8526 | days before the expiration of the license. |
8527 | (6) A change of ownership or control of a home for special |
8528 | services must be reported to the agency in writing at least 60 |
8529 | days before the change is scheduled to take effect. |
8530 | (4)(7) The agency may shall adopt rules for implementing |
8531 | and enforcing this section and part II of chapter 408. |
8532 | (8)(a) It is unlawful for any person to establish, |
8533 | conduct, manage, or operate a home for special services without |
8534 | obtaining a license from the agency. |
8535 | (b) It is unlawful for any person to offer or advertise to |
8536 | the public, in any medium whatever, specialized health care |
8537 | services without obtaining a license from the agency. |
8538 | (c) It is unlawful for a holder of a license issued under |
8539 | this section to advertise or represent to the public that it |
8540 | holds a license for a type of facility other than the facility |
8541 | for which its license is issued. |
8542 | (5)(9)(a) In accordance with part II of chapter 408, a |
8543 | violation of any provision of this section, part II of chapter |
8544 | 408, or applicable rules adopted by the agency for implementing |
8545 | this section is punishable by payment of an administrative fine |
8546 | not to exceed $5,000. |
8547 | (b) A violation of subsection (8) or rules adopted under |
8548 | that subsection is a misdemeanor of the first degree, punishable |
8549 | as provided in s. 775.082 or s. 775.083. Each day of continuing |
8550 | violation is a separate offense. |
8551 | Section 157. Section 400.805, Florida Statutes, is amended |
8552 | to read: |
8553 | 400.805 Transitional living facilities.-- |
8554 | (1) As used in this section, the term: |
8555 | (a) "Agency" means the Agency for Health Care |
8556 | Administration. |
8557 | (b) "Department" means the Department of Health. |
8558 | (c) "Transitional living facility" means a site where |
8559 | specialized health care services are provided, including, but |
8560 | not limited to, rehabilitative services, community reentry |
8561 | training, aids for independent living, and counseling to spinal- |
8562 | cord-injured persons and head-injured persons. This term does |
8563 | not include a hospital licensed under chapter 395 or any |
8564 | federally operated hospital or facility. |
8565 | (2)(a) The requirements of part II of chapter 408 shall |
8566 | apply to the provision of services that require licensure |
8567 | pursuant to this section and part II of chapter 408 and to |
8568 | entities licensed by or applying for such licensure from the |
8569 | agency pursuant to this section. However, each applicant for |
8570 | licensure and each licensee is exempt from the provisions of s. |
8571 | 408.810(7)-(10). A person must obtain a license from the agency |
8572 | to operate a transitional living facility. A license issued |
8573 | under this section is valid for 1 year. |
8574 | (b) In accordance with this section, an applicant or a |
8575 | licensee shall pay a fee for each license application submitted |
8576 | under this part, part II of chapter 408, and applicable rules. |
8577 | The fee shall consist of a $4,000 license fee and a $78.50 per |
8578 | bed fee per biennium, unless modified by rule. The application |
8579 | for a license must be made on a form provided by the agency. A |
8580 | nonrefundable license fee of $2,000 and a fee of up to $39.25 |
8581 | per bed must be submitted with the license application. |
8582 | (c) The agency may not issue a license to an applicant |
8583 | until the agency receives notice from the department as provided |
8584 | in paragraph (3)(6)(b). |
8585 | (3) Each applicant for licensure must comply with the |
8586 | following requirements: |
8587 | (a) Upon receipt of a completed, signed, and dated |
8588 | application, the agency shall require background screening, in |
8589 | accordance with the level 2 standards for screening set forth in |
8590 | chapter 435, of the managing employee, or other similarly titled |
8591 | individual who is responsible for the daily operation of the |
8592 | facility, and of the financial officer, or other similarly |
8593 | titled individual who is responsible for the financial operation |
8594 | of the facility, including billings for client care and |
8595 | services. The applicant must comply with the procedures for |
8596 | level 2 background screening as set forth in chapter 435. |
8597 | (b) The agency may require background screening of any |
8598 | other individual who is an applicant if the agency has probable |
8599 | cause to believe that he or she has been convicted of a crime or |
8600 | has committed any other offense prohibited under the level 2 |
8601 | standards for screening set forth in chapter 435. |
8602 | (c) Proof of compliance with the level 2 background |
8603 | screening requirements of chapter 435 which has been submitted |
8604 | within the previous 5 years in compliance with any other health |
8605 | care or assisted living licensure requirements of this state is |
8606 | acceptable in fulfillment of the requirements of paragraph (a). |
8607 | (d) A provisional license may be granted to an applicant |
8608 | when each individual required by this section to undergo |
8609 | background screening has met the standards for the Department of |
8610 | Law Enforcement background check, but the agency has not yet |
8611 | received background screening results from the Federal Bureau of |
8612 | Investigation, or a request for a disqualification exemption has |
8613 | been submitted to the agency as set forth in chapter 435, but a |
8614 | response has not yet been issued. A standard license may be |
8615 | granted to the applicant upon the agency's receipt of a report |
8616 | of the results of the Federal Bureau of Investigation background |
8617 | screening for each individual required by this section to |
8618 | undergo background screening which confirms that all standards |
8619 | have been met, or upon the granting of a disqualification |
8620 | exemption by the agency as set forth in chapter 435. Any other |
8621 | person who is required to undergo level 2 background screening |
8622 | may serve in his or her capacity pending the agency's receipt of |
8623 | the report from the Federal Bureau of Investigation. However, |
8624 | the person may not continue to serve if the report indicates any |
8625 | violation of background screening standards and a |
8626 | disqualification exemption has not been requested of and granted |
8627 | by the agency as set forth in chapter 435. |
8628 | (e) Each applicant must submit to the agency, with its |
8629 | application, a description and explanation of any exclusions, |
8630 | permanent suspensions, or terminations of the applicant from the |
8631 | Medicare or Medicaid programs. Proof of compliance with the |
8632 | requirements for disclosure of ownership and control interests |
8633 | under the Medicaid or Medicare programs may be accepted in lieu |
8634 | of this submission. |
8635 | (f) Each applicant must submit to the agency a description |
8636 | and explanation of any conviction of an offense prohibited under |
8637 | the level 2 standards of chapter 435 by a member of the board of |
8638 | directors of the applicant, its officers, or any individual |
8639 | owning 5 percent or more of the applicant. This requirement does |
8640 | not apply to a director of a not-for-profit corporation or |
8641 | organization if the director serves solely in a voluntary |
8642 | capacity for the corporation or organization, does not regularly |
8643 | take part in the day-to-day operational decisions of the |
8644 | corporation or organization, receives no remuneration for his or |
8645 | her services on the corporation or organization's board of |
8646 | directors, and has no financial interest and has no family |
8647 | members with a financial interest in the corporation or |
8648 | organization, provided that the director and the not-for-profit |
8649 | corporation or organization include in the application a |
8650 | statement affirming that the director's relationship to the |
8651 | corporation satisfies the requirements of this paragraph. |
8652 | (g) A license may not be granted to an applicant if the |
8653 | applicant or managing employee has been found guilty of, |
8654 | regardless of adjudication, or has entered a plea of nolo |
8655 | contendere or guilty to, any offense prohibited under the level |
8656 | 2 standards for screening set forth in chapter 435, unless an |
8657 | exemption from disqualification has been granted by the agency |
8658 | as set forth in chapter 435. |
8659 | (h) The agency may deny or revoke licensure if the |
8660 | applicant: |
8661 | 1. Has falsely represented a material fact in the |
8662 | application required by paragraph (e) or paragraph (f), or has |
8663 | omitted any material fact from the application required by |
8664 | paragraph (e) or paragraph (f); or |
8665 | 2. Has had prior action taken against the applicant under |
8666 | the Medicaid or Medicare program as set forth in paragraph (e). |
8667 | (i) An application for license renewal must contain the |
8668 | information required under paragraphs (e) and (f). |
8669 | (4) An application for renewal of license must be |
8670 | submitted 90 days before the expiration of the license. Upon |
8671 | renewal of licensure, each applicant must submit to the agency, |
8672 | under penalty of perjury, an affidavit as set forth in paragraph |
8673 | (3)(d). |
8674 | (5) A change of ownership or control of a transitional |
8675 | living facility must be reported to the agency in writing at |
8676 | least 60 days before the change is scheduled to take effect. |
8677 | (3)(6)(a) The agency shall adopt rules in consultation |
8678 | with the department governing the physical plant of transitional |
8679 | living facilities and the fiscal management of transitional |
8680 | living facilities. |
8681 | (b) The department shall adopt rules in consultation with |
8682 | the agency governing the services provided to clients of |
8683 | transitional living facilities. The department shall enforce all |
8684 | requirements for providing services to the facility's clients. |
8685 | The department must notify the agency when it determines that an |
8686 | applicant for licensure meets the service requirements adopted |
8687 | by the department. |
8688 | (c) The agency and the department shall enforce |
8689 | requirements under this section, as such requirements relate to |
8690 | them respectively, and their respective adopted rules. |
8691 | (7)(a) It is unlawful for any person to establish, |
8692 | conduct, manage, or operate a transitional living facility |
8693 | without obtaining a license from the agency. |
8694 | (b) It is unlawful for any person to offer or advertise to |
8695 | the public, in any medium whatever, services or care defined in |
8696 | paragraph (1)(c) without obtaining a license from the agency. |
8697 | (c) It is unlawful for a holder of a license issued under |
8698 | this section to advertise or represent to the public that it |
8699 | holds a license for a type of facility other than the facility |
8700 | for which its license is issued. |
8701 | (4)(8) Any designated officer or employee of the agency, |
8702 | of the state, or of the local fire marshal may enter unannounced |
8703 | upon and into the premises of any facility licensed under this |
8704 | section in order to determine the state of compliance with this |
8705 | section and the rules or standards in force under this section. |
8706 | The right of entry and inspection also extends to any premises |
8707 | that the agency has reason to believe are being operated or |
8708 | maintained as a facility without a license; but such an entry or |
8709 | inspection may not be made without the permission of the owner |
8710 | or person in charge of the facility unless a warrant that |
8711 | authorizes the entry is first obtained from the circuit court. |
8712 | The warrant requirement extends only to a facility that the |
8713 | agency has reason to believe is being operated or maintained as |
8714 | a facility without a license. An application for a license or |
8715 | renewal thereof which is made under this section constitutes |
8716 | permission for, and acquiescence in, any entry or inspection of |
8717 | the premises for which the license is sought, in order to |
8718 | facilitate verification of the information submitted on or in |
8719 | connection with the application; to discover, investigate, and |
8720 | determine the existence of abuse or neglect; or to elicit, |
8721 | receive, respond to, and resolve complaints. A current valid |
8722 | license constitutes unconditional permission for, and |
8723 | acquiescence in, any entry or inspection of the premises by |
8724 | authorized personnel. The agency retains the right of entry and |
8725 | inspection of facilities that have had a license revoked or |
8726 | suspended within the previous 24 months, to ensure that the |
8727 | facility is not operating unlawfully. However, before the |
8728 | facility is entered, a statement of probable cause must be filed |
8729 | with the director of the agency, who must approve or disapprove |
8730 | the action within 48 hours. Probable cause includes, but is not |
8731 | limited to, evidence that the facility holds itself out to the |
8732 | public as a provider of personal assistance services, or the |
8733 | receipt by the advisory council on brain and spinal cord |
8734 | injuries of a complaint about the facility. |
8735 | (5)(9) The agency may institute injunctive proceedings in |
8736 | a court of competent jurisdiction for temporary or permanent |
8737 | relief to: |
8738 | (a) Enforce this section or any minimum standard, rule, or |
8739 | order issued pursuant thereto if the agency's effort to correct |
8740 | a violation through administrative fines has failed or when the |
8741 | violation materially affects the health, safety, or welfare of |
8742 | residents; or |
8743 | (b) Terminate the operation of a facility if a violation |
8744 | of this section or of any standard or rule adopted pursuant |
8745 | thereto exists which materially affects the health, safety, or |
8746 | welfare of residents. |
8747 |
|
8748 | The Legislature recognizes that, in some instances, action is |
8749 | necessary to protect residents of facilities from immediately |
8750 | life-threatening situations. If it appears by competent evidence |
8751 | or a sworn, substantiated affidavit that a temporary injunction |
8752 | should issue, the court, pending the determination on final |
8753 | hearing, shall enjoin operation of the facility. |
8754 | (10) The agency may impose an immediate moratorium on |
8755 | admissions to a facility when the agency determines that any |
8756 | condition in the facility presents a threat to the health, |
8757 | safety, or welfare of the residents in the facility. If a |
8758 | facility's license is denied, revoked, or suspended, the |
8759 | facility may be subject to the immediate imposition of a |
8760 | moratorium on admissions to run concurrently with licensure |
8761 | denial, revocation, or suspension. |
8762 | (6)(11)(a) In accordance with part II of chapter 408, a |
8763 | violation of any provision of this section, part II of chapter |
8764 | 408, or applicable rules adopted by the agency or department |
8765 | under this section is punishable by payment of an administrative |
8766 | or a civil penalty fine not to exceed $5,000. |
8767 | (b) A violation of subsection (7) or rules adopted under |
8768 | that subsection is a misdemeanor of the first degree, punishable |
8769 | as provided in s. 775.082 or s. 775.083. Each day of a |
8770 | continuing violation is a separate offense. |
8771 | Section 158. Subsection (4) of section 400.902, Florida |
8772 | Statutes, is amended to read: |
8773 | 400.902 Definitions.--As used in this part, the term: |
8774 | (4) "Owner or operator" means a licensee any individual |
8775 | who has general administrative charge of a PPEC center. |
8776 | Section 159. Subsection (3) is added to section 400.903, |
8777 | Florida Statutes, to read: |
8778 | 400.903 PPEC centers to be licensed; exemptions.-- |
8779 | (3) The requirements of part II of chapter 408 shall apply |
8780 | to the provision of services that require licensure pursuant to |
8781 | this part and part II of chapter 408 and to entities licensed by |
8782 | or applying for such licensure from the agency pursuant to this |
8783 | part. However, each applicant for licensure and each licensee is |
8784 | exempt from the provisions of s. 408.810(10). |
8785 | Section 160. Section 400.905, Florida Statutes, is amended |
8786 | to read: |
8787 | 400.905 License required; fee; exemption; display.-- |
8788 | (1)(a) It is unlawful to operate or maintain a PPEC center |
8789 | without first obtaining from the agency a license authorizing |
8790 | such operation. The agency is responsible for licensing PPEC |
8791 | centers in accordance with the provisions of this part. |
8792 | (b) Any person who violates paragraph (a) is guilty of a |
8793 | felony of the third degree, punishable as provided in s. |
8794 | 775.082, s. 775.083, or s. 775.084. |
8795 | (1)(2) Separate licenses are required for PPEC centers |
8796 | maintained on separate premises, even though they are operated |
8797 | under the same management. Separate licenses are not required |
8798 | for separate buildings on the same grounds. |
8799 | (2)(3) In accordance with s. 408.805, an applicant or |
8800 | licensee shall pay a fee for each license application submitted |
8801 | under this part, part II of chapter 408, and applicable rules. |
8802 | The amount of the fee shall be established by rule and shall not |
8803 | be less than $1,000 or more than $3,000 per biennium. The annual |
8804 | license fee required of a PPEC center shall be in an amount |
8805 | determined by the agency to be sufficient to cover the agency's |
8806 | costs in carrying out its responsibilities under this part, but |
8807 | shall not be less than $500 or more than $1,500. |
8808 | (3)(4) County-operated or municipally operated PPEC |
8809 | centers applying for licensure under this part are exempt from |
8810 | the payment of license fees. |
8811 | (5) The license shall be displayed in a conspicuous place |
8812 | inside the PPEC center. |
8813 | (6) A license shall be valid only in the possession of the |
8814 | individual, firm, partnership, association, or corporation to |
8815 | whom it is issued and shall not be subject to sale, assignment, |
8816 | or other transfer, voluntary or involuntary; nor shall a license |
8817 | be valid for any premises other than that for which originally |
8818 | issued. |
8819 | (7) Any license granted by the agency shall state the |
8820 | maximum capacity of the facility, the date the license was |
8821 | issued, the expiration date of the license, and any other |
8822 | information deemed necessary by the agency. |
8823 | Section 161. Section 400.906, Florida Statutes, is |
8824 | repealed. |
8825 | Section 162. Section 400.907, Florida Statutes, is amended |
8826 | to read: |
8827 | 400.907 Denial, suspension, revocation of licensure; |
8828 | administrative fines; grounds.-- |
8829 | (1) In accordance with part II of chapter 408, the agency |
8830 | may deny, revoke, and or suspend a license and or impose an |
8831 | administrative fine for the violation of any provision of this |
8832 | part, part II of chapter 408, or applicable rules in the manner |
8833 | provided in chapter 120. |
8834 | (2) Any of the following actions by a PPEC center or its |
8835 | employee is grounds for action by the agency against a PPEC |
8836 | center or its employee: |
8837 | (a) An intentional or negligent act materially affecting |
8838 | the health or safety of children in the PPEC center. |
8839 | (b) A violation of the provisions of this part, part II of |
8840 | chapter 408, or applicable rules or of any standards or rules |
8841 | adopted pursuant to this part. |
8842 | (c) Multiple and repeated violations of this part or of |
8843 | minimum standards or rules adopted pursuant to this part. |
8844 | (3) The agency shall be responsible for all investigations |
8845 | and inspections conducted pursuant to this part. |
8846 | Section 163. Section 400.908, Florida Statutes, is amended |
8847 | to read: |
8848 | 400.908 Administrative fines; disposition of fees and |
8849 | fines.-- |
8850 | (1)(a) If the agency determines that a PPEC center is |
8851 | being operated without a license or is otherwise not in |
8852 | compliance with rules adopted under this part, part II of |
8853 | chapter 408, or applicable rules, the agency, notwithstanding |
8854 | any other administrative action it takes, shall make a |
8855 | reasonable attempt to discuss each violation and recommended |
8856 | corrective action with the owner of the PPEC center prior to |
8857 | written notification thereof. The agency may request that the |
8858 | PPEC center submit a corrective action plan which demonstrates a |
8859 | good faith effort to remedy each violation by a specific date, |
8860 | subject to the approval of the agency. |
8861 | (b) In accordance with part II of chapter 408, the agency |
8862 | may fine a PPEC center or employee found in violation of rules |
8863 | adopted pursuant to this part, part II of chapter 408, or |
8864 | applicable rules, in an amount not to exceed $500 for each |
8865 | violation. Such fine may not exceed $5,000 in the aggregate. |
8866 | (c) The failure to correct a violation by the date set by |
8867 | the agency, or the failure to comply with an approved corrective |
8868 | action plan, is a separate violation for each day such failure |
8869 | continues, unless the agency approves an extension to a specific |
8870 | date. |
8871 | (d) If a PPEC center desires to appeal any agency action |
8872 | under this section and the fine is upheld, the violator shall |
8873 | pay the fine, plus interest at the legal rate specified in s. |
8874 | 687.01, for each day beyond the date set by the agency for |
8875 | payment of the fine. |
8876 | (2) In determining if a fine is to be imposed and in |
8877 | fixing the amount of any fine, the agency shall consider the |
8878 | following factors: |
8879 | (a) The gravity of the violation, including the |
8880 | probability that death or serious physical or emotional harm to |
8881 | a child will result or has resulted, the severity of the actual |
8882 | or potential harm, and the extent to which the provisions of the |
8883 | applicable statutes or rules were violated. |
8884 | (b) Actions taken by the owner or operator to correct |
8885 | violations. |
8886 | (c) Any previous violations. |
8887 | (d) The financial benefit to the PPEC center of committing |
8888 | or continuing the violation. |
8889 | (3) Fees and fines received by the agency under this part |
8890 | shall be deposited in the Health Care Trust Fund created in s. |
8891 | 408.16. |
8892 | Section 164. Section 400.910, Florida Statutes, is |
8893 | repealed. |
8894 | Section 165. Section 400.911, Florida Statutes, is |
8895 | repealed. |
8896 | Section 166. Section 400.912, Florida Statutes, is amended |
8897 | to read: |
8898 | 400.912 Closing of a PPEC center.-- |
8899 | (1) Whenever a PPEC center voluntarily discontinues |
8900 | operation, it shall, inform the agency in writing at least 30 |
8901 | days before the discontinuance of operation. The PPEC center |
8902 | shall also, at such time, inform each child's legal guardian of |
8903 | the fact and the proposed time of such discontinuance. |
8904 | (2) Immediately upon discontinuance of the operation of a |
8905 | PPEC center, the owner or operator shall surrender the license |
8906 | therefor to the agency and the license shall be canceled. |
8907 | Section 167. Section 400.913, Florida Statutes, is |
8908 | repealed. |
8909 | Section 168. Subsection (1) of section 400.914, Florida |
8910 | Statutes, is amended to read: |
8911 | 400.914 Rules establishing standards.-- |
8912 | (1) Pursuant to the intention of the Legislature to |
8913 | provide safe and sanitary facilities and healthful programs, the |
8914 | agency in conjunction with the Division of Children's Medical |
8915 | Services Prevention and Intervention of the Department of Health |
8916 | shall adopt and publish rules to implement the provisions of |
8917 | this part and part II of chapter 408, which shall include |
8918 | reasonable and fair standards. Any conflict between these |
8919 | standards and those that may be set forth in local, county, or |
8920 | city ordinances shall be resolved in favor of those having |
8921 | statewide effect. Such standards shall relate to: |
8922 | (a) The assurance that PPEC services are family centered |
8923 | and provide individualized medical, developmental, and family |
8924 | training services. |
8925 | (b) The maintenance of PPEC centers, not in conflict with |
8926 | the provisions of chapter 553 and based upon the size of the |
8927 | structure and number of children, relating to plumbing, heating, |
8928 | lighting, ventilation, and other building conditions, including |
8929 | adequate space, which will ensure the health, safety, comfort, |
8930 | and protection from fire of the children served. |
8931 | (c) The appropriate provisions of the most recent edition |
8932 | of the "Life Safety Code" (NFPA-101) shall be applied. |
8933 | (d) The number and qualifications of all personnel who |
8934 | have responsibility for the care of the children served. |
8935 | (e) All sanitary conditions within the PPEC center and its |
8936 | surroundings, including water supply, sewage disposal, food |
8937 | handling, and general hygiene, and maintenance thereof, which |
8938 | will ensure the health and comfort of children served. |
8939 | (f) Programs and basic services promoting and maintaining |
8940 | the health and development of the children served and meeting |
8941 | the training needs of the children's legal guardians. |
8942 | (g) Supportive, contracted, other operational, and |
8943 | transportation services. |
8944 | (h) Maintenance of appropriate medical records, data, and |
8945 | information relative to the children and programs. Such records |
8946 | shall be maintained in the facility for inspection by the |
8947 | agency. |
8948 | Section 169. Subsection (3) of section 400.915, Florida |
8949 | Statutes, is amended to read: |
8950 | 400.915 Construction and renovation; requirements.--The |
8951 | requirements for the construction or renovation of a PPEC center |
8952 | shall comply with: |
8953 | (3) The standards or rules adopted pursuant to this part |
8954 | and part II of chapter 408. |
8955 | Section 170. Section 400.916, Florida Statutes, is |
8956 | repealed. |
8957 | Section 171. Section 400.917, Florida Statutes, is |
8958 | repealed. |
8959 | Section 172. Section 400.925, Florida Statutes, is amended |
8960 | to read: |
8961 | 400.925 Definitions.--As used in this part, the term: |
8962 | (1) "Accrediting organizations" means the Joint Commission |
8963 | on Accreditation of Healthcare Organizations or other national |
8964 | accreditation agencies whose standards for accreditation are |
8965 | comparable to those required by this part for licensure. |
8966 | (2) "Affiliated person" means any person who directly or |
8967 | indirectly manages, controls, or oversees the operation of a |
8968 | corporation or other business entity that is a licensee, |
8969 | regardless of whether such person is a partner, shareholder, |
8970 | owner, officer, director, agent, or employee of the entity. |
8971 | (2)(3) "Agency" means the Agency for Health Care |
8972 | Administration. |
8973 | (4) "Applicant" means an individual applicant in the case |
8974 | of a sole proprietorship, or any officer, director, agent, |
8975 | managing employee, general manager, or affiliated person, or any |
8976 | partner or shareholder having an ownership interest equal to 5 |
8977 | percent or greater in the corporation, partnership, or other |
8978 | business entity. |
8979 | (3)(5) "Consumer" or "patient" means any person who uses |
8980 | home medical equipment in his or her place of residence. |
8981 | (4)(6) "Department" means the Department of Children and |
8982 | Family Services. |
8983 | (5)(7) "General manager" means the individual who has the |
8984 | general administrative charge of the premises of a licensed home |
8985 | medical equipment provider. |
8986 | (6)(8) "Home medical equipment" includes any product as |
8987 | defined by the Federal Drug Administration's Drugs, Devices and |
8988 | Cosmetics Act, any products reimbursed under the Medicare Part B |
8989 | Durable Medical Equipment benefits, or any products reimbursed |
8990 | under the Florida Medicaid durable medical equipment program. |
8991 | Home medical equipment includes oxygen and related respiratory |
8992 | equipment; manual, motorized, or customized wheelchairs and |
8993 | related seating and positioning, but does not include |
8994 | prosthetics or orthotics or any splints, braces, or aids custom |
8995 | fabricated by a licensed health care practitioner; motorized |
8996 | scooters; personal transfer systems; and specialty beds, for use |
8997 | by a person with a medical need. |
8998 | (7)(9) "Home medical equipment provider" means any person |
8999 | or entity that sells or rents or offers to sell or rent to or |
9000 | for a consumer: |
9001 | (a) Any home medical equipment and services; or |
9002 | (b) Home medical equipment that requires any home medical |
9003 | equipment services. |
9004 | (8)(10) "Home medical equipment provider personnel" means |
9005 | persons who are employed by or under contract with a home |
9006 | medical equipment provider. |
9007 | (9)(11) "Home medical equipment services" means equipment |
9008 | management and consumer instruction, including selection, |
9009 | delivery, setup, and maintenance of equipment, and other related |
9010 | services for the use of home medical equipment in the consumer's |
9011 | regular or temporary place of residence. |
9012 | (10)(12) "Licensee" means the person or entity to whom a |
9013 | license to operate as a home medical equipment provider is |
9014 | issued by the agency. |
9015 | (11)(13) "Moratorium" has the same meaning as in s. |
9016 | 408.803, except that means a mandated temporary cessation or |
9017 | suspension of the sale, rental, or offering of equipment after |
9018 | the imposition of the moratorium. services related to equipment |
9019 | sold or rented prior to the moratorium must be continued without |
9020 | interruption, unless deemed otherwise by the agency. |
9021 | (12)(14) "Person" means any individual, firm, partnership, |
9022 | corporation, or association. |
9023 | (13)(15) "Premises" means those buildings and equipment |
9024 | which are located at the address of the licensed home medical |
9025 | equipment provider for the provision of home medical equipment |
9026 | services, which are in such reasonable proximity as to appear to |
9027 | the public to be a single provider location, and which comply |
9028 | with zoning ordinances. |
9029 | (14)(16) "Residence" means the consumer's home or place of |
9030 | residence, which may include nursing homes, assisted living |
9031 | facilities, transitional living facilities, adult family-care |
9032 | homes, or other congregate residential facilities. |
9033 | Section 173. Subsection (3) and paragraphs (b), (d), and |
9034 | (e) of subsection (6) of section 400.93, Florida Statutes, are |
9035 | amended to read: |
9036 | 400.93 Licensure required; exemptions; unlawful acts; |
9037 | penalties.-- |
9038 | (3) The requirements of part II of chapter 408 shall apply |
9039 | to the provision of services that require licensure pursuant to |
9040 | this part and part II of chapter 408 and to entities licensed by |
9041 | or applying for such licensure from the agency pursuant to this |
9042 | part. However, each applicant for licensure and each licensee is |
9043 | exempt from the provisions of s. 408.810(10). A home medical |
9044 | equipment provider must be licensed by the agency to operate in |
9045 | this state or to provide home medical equipment and services to |
9046 | consumers in this state. A standard license issued to a home |
9047 | medical equipment provider, unless sooner suspended or revoked, |
9048 | expires 2 years after its effective date. |
9049 | (6) |
9050 | (b) A person who violates paragraph (a) is subject to an |
9051 | injunctive proceeding under this part, part II of chapter 408, |
9052 | or applicable rules s. 400.956. A violation of paragraph (a) is |
9053 | a deceptive and unfair trade practice and constitutes a |
9054 | violation of the Florida Deceptive and Unfair Trade Practices |
9055 | Act. |
9056 | (d) The following penalties shall be imposed for operating |
9057 | an unlicensed home medical equipment provider: |
9058 | 1. Any person or entity who operates an unlicensed |
9059 | provider commits a felony of the third degree. |
9060 | 2. For any person or entity who has received government |
9061 | reimbursement for services provided by an unlicensed provider, |
9062 | the agency shall make a fraud referral to the appropriate |
9063 | government reimbursement program. |
9064 | 3. For any licensee found to be concurrently operating |
9065 | licensed and unlicensed provider premises, the agency may impose |
9066 | a fine or moratorium, or revoke existing licenses of any or all |
9067 | of the licensee's licensed provider locations until such time as |
9068 | the unlicensed provider premises is licensed. |
9069 | (e) A provider found to be operating without a license may |
9070 | apply for licensure, and must cease operations until a license |
9071 | is awarded by the agency. |
9072 | Section 174. Section 400.931, Florida Statutes, is amended |
9073 | to read: |
9074 | 400.931 Application for license; fee; provisional license; |
9075 | temporary permit.-- |
9076 | (1) Application for an initial license or for renewal of |
9077 | an existing license must be made under oath to the agency on |
9078 | forms furnished by it and must be accompanied by the appropriate |
9079 | license fee as provided in subsection (12). |
9080 | (1)(2) The applicant must file with the application |
9081 | satisfactory proof that the home medical equipment provider is |
9082 | in compliance with this part and applicable rules, including: |
9083 | (a) A report, by category, of the equipment to be |
9084 | provided, indicating those offered either directly by the |
9085 | applicant or through contractual arrangements with existing |
9086 | providers. Categories of equipment include: |
9087 | 1. Respiratory modalities. |
9088 | 2. Ambulation aids. |
9089 | 3. Mobility aids. |
9090 | 4. Sickroom setup. |
9091 | 5. Disposables. |
9092 | (b) A report, by category, of the services to be provided, |
9093 | indicating those offered either directly by the applicant or |
9094 | through contractual arrangements with existing providers. |
9095 | Categories of services include: |
9096 | 1. Intake. |
9097 | 2. Equipment selection. |
9098 | 3. Delivery. |
9099 | 4. Setup and installation. |
9100 | 5. Patient training. |
9101 | 6. Ongoing service and maintenance. |
9102 | 7. Retrieval. |
9103 | (c) A listing of those with whom the applicant contracts, |
9104 | both the providers the applicant uses to provide equipment or |
9105 | services to its consumers and the providers for whom the |
9106 | applicant provides services or equipment. |
9107 | (2)(3) As an alternative to submitting proof of financial |
9108 | ability to operate as required in s. 408.810(8) The applicant |
9109 | for initial licensure must demonstrate financial ability to |
9110 | operate, the applicant may submit which may be accomplished by |
9111 | the submission of a $50,000 surety bond to the agency. |
9112 | (4) An applicant for renewal who has demonstrated |
9113 | financial inability to operate must demonstrate financial |
9114 | ability to operate. |
9115 | (5) Each applicant for licensure must comply with the |
9116 | following requirements: |
9117 | (a) Upon receipt of a completed, signed, and dated |
9118 | application, the agency shall require background screening of |
9119 | the applicant, in accordance with the level 2 standards for |
9120 | screening set forth in chapter 435. As used in this subsection, |
9121 | the term "applicant" means the general manager and the financial |
9122 | officer or similarly titled individual who is responsible for |
9123 | the financial operation of the licensed facility. |
9124 | (b) The agency may require background screening for a |
9125 | member of the board of directors of the licensee or an officer |
9126 | or an individual owning 5 percent or more of the licensee if the |
9127 | agency has probable cause to believe that such individual has |
9128 | been convicted of an offense prohibited under the level 2 |
9129 | standards for screening set forth in chapter 435. |
9130 | (c) Proof of compliance with the level 2 background |
9131 | screening requirements of chapter 435 which has been submitted |
9132 | within the previous 5 years in compliance with any other health |
9133 | care licensure requirements of this state is acceptable in |
9134 | fulfillment of paragraph (a). |
9135 | (d) Each applicant must submit to the agency, with its |
9136 | application, a description and explanation of any exclusions, |
9137 | permanent suspensions, or terminations of the applicant from the |
9138 | Medicare or Medicaid programs. Proof of compliance with |
9139 | disclosure of ownership and control interest requirements of the |
9140 | Medicaid or Medicare programs shall be accepted in lieu of this |
9141 | submission. |
9142 | (e) Each applicant must submit to the agency a description |
9143 | and explanation of any conviction of an offense prohibited under |
9144 | the level 2 standards of chapter 435 by a member of the board of |
9145 | directors of the applicant, its officers, or any individual |
9146 | owning 5 percent or more of the applicant. This requirement does |
9147 | not apply to a director of a not-for-profit corporation or |
9148 | organization if the director serves solely in a voluntary |
9149 | capacity for the corporation or organization, does not regularly |
9150 | take part in the day-to-day operational decisions of the |
9151 | corporation or organization, receives no remuneration for his or |
9152 | her services on the corporation's or organization's board of |
9153 | directors, and has no financial interest and has no family |
9154 | members with a financial interest in the corporation or |
9155 | organization, provided that the director and the not-for-profit |
9156 | corporation or organization include in the application a |
9157 | statement affirming that the director's relationship to the |
9158 | corporation satisfies the requirements of this provision. |
9159 | (f) A license may not be granted to any potential licensee |
9160 | if any applicant, administrator, or financial officer has been |
9161 | found guilty of, regardless of adjudication, or has entered a |
9162 | plea of nolo contendere or guilty to, any offense prohibited |
9163 | under the level 2 standards for screening set forth in chapter |
9164 | 435, unless an exemption from disqualification has been granted |
9165 | by the agency as set forth in chapter 435. |
9166 | (g) The agency may deny or revoke licensure to any |
9167 | potential licensee if any applicant: |
9168 | 1. Has falsely represented a material fact in the |
9169 | application required by paragraphs (d) and (e), or has omitted |
9170 | any material fact from the application required by paragraphs |
9171 | (d) and (e); or |
9172 | 2. Has had prior Medicaid or Medicare action taken against |
9173 | the applicant as set forth in paragraph (d). |
9174 | (h) Upon licensure renewal, each applicant must submit to |
9175 | the agency, under penalty of perjury, an affidavit of compliance |
9176 | with the background screening provisions of this section. |
9177 | (3)(6) As specified in part II of chapter 408, the home |
9178 | medical equipment provider must also obtain and maintain |
9179 | professional and commercial liability insurance. Proof of |
9180 | liability insurance, as defined in s. 624.605, must be submitted |
9181 | with the application. The agency shall set the required amounts |
9182 | of liability insurance by rule, but the required amount must not |
9183 | be less than $250,000 per claim. In the case of contracted |
9184 | services, it is required that the contractor have liability |
9185 | insurance not less than $250,000 per claim. |
9186 | (7) A provisional license shall be issued to an approved |
9187 | applicant for initial licensure for a period of 90 days, during |
9188 | which time a survey must be conducted demonstrating substantial |
9189 | compliance with this section. A provisional license shall also |
9190 | be issued pending the results of an applicant's Federal Bureau |
9191 | of Investigation report of background screening confirming that |
9192 | all standards have been met. If substantial compliance is |
9193 | demonstrated, a standard license shall be issued to expire 2 |
9194 | years after the effective date of the provisional license. |
9195 | (8) Ninety days before the expiration date, an application |
9196 | for license renewal must be submitted to the agency under oath |
9197 | on forms furnished by the agency, and a license shall be renewed |
9198 | if the applicant has met the requirements established under this |
9199 | part and applicable rules. The home medical equipment provider |
9200 | must file with the application satisfactory proof that it is in |
9201 | compliance with this part and applicable rules. The home medical |
9202 | equipment provider must submit satisfactory proof of its |
9203 | financial ability to comply with the requirements of this part. |
9204 | (9) When a change of ownership of a home medical equipment |
9205 | provider occurs, the prospective owner must submit an initial |
9206 | application for a license at least 15 days before the effective |
9207 | date of the change of ownership. An application for change of |
9208 | ownership of a license is required when ownership, a majority of |
9209 | the ownership, or controlling interest of a licensed home |
9210 | medical equipment provider is transferred or assigned and when a |
9211 | licensee agrees to undertake or provide services to the extent |
9212 | that legal liability for operation of the home medical equipment |
9213 | provider rests with the licensee. A provisional license shall be |
9214 | issued to the new owner for a period of 90 days, during which |
9215 | time all required documentation must be submitted and a survey |
9216 | must be conducted demonstrating substantial compliance with this |
9217 | section. If substantial compliance is demonstrated, a standard |
9218 | license shall be issued to expire 2 years after the issuance of |
9219 | the provisional license. |
9220 | (4)(10) When a change of the general manager of a home |
9221 | medical equipment provider occurs, the licensee must notify the |
9222 | agency of the change within 45 days. thereof and must provide |
9223 | evidence of compliance with the background screening |
9224 | requirements in subsection (5); except that a general manager |
9225 | who has met the standards for the Department of Law Enforcement |
9226 | background check, but for whom background screening results from |
9227 | the Federal Bureau of Investigation have not yet been received, |
9228 | may be employed pending receipt of the Federal Bureau of |
9229 | Investigation background screening report. An individual may not |
9230 | continue to serve as general manager if the Federal Bureau of |
9231 | Investigation background screening report indicates any |
9232 | violation of background screening standards. |
9233 | (5)(11) In accordance with s. 408.805, an applicant or a |
9234 | licensee shall pay a fee for each license application submitted |
9235 | under this part, part II of chapter 408, and applicable rules. |
9236 | The amount of the fee shall be established by rule and shall not |
9237 | exceed $300 per biennium. All licensure fees required of a home |
9238 | medical equipment provider are nonrefundable. The agency shall |
9239 | set the fees in an amount that is sufficient to cover its costs |
9240 | in carrying out its responsibilities under this part. However, |
9241 | state, county, or municipal governments applying for licenses |
9242 | under this part are exempt from the payment of license fees. All |
9243 | fees collected under this part must be deposited in the Health |
9244 | Care Trust Fund for the administration of this part. |
9245 | (6)(12) An applicant for initial licensure, renewal, or |
9246 | change of ownership shall also pay a license processing fee not |
9247 | to exceed $300, to be paid by all applicants, and an inspection |
9248 | fee not to exceed $400, which shall to be paid by all applicants |
9249 | except those not subject to licensure inspection by the agency |
9250 | as described in s. 400.933(2). |
9251 | (13) When a change is reported which requires issuance of |
9252 | a license, a fee must be assessed. The fee must be based on the |
9253 | actual cost of processing and issuing the license. |
9254 | (14) When a duplicate license is issued, a fee must be |
9255 | assessed, not to exceed the actual cost of duplicating and |
9256 | mailing. |
9257 | (15) When applications are mailed out upon request, a fee |
9258 | must be assessed, not to exceed the cost of the printing, |
9259 | preparation, and mailing. |
9260 | (16) The license must be displayed in a conspicuous place |
9261 | in the administrative office of the home medical equipment |
9262 | provider and is valid only while in the possession of the person |
9263 | or entity to which it is issued. The license may not be sold, |
9264 | assigned, or otherwise transferred, voluntarily or |
9265 | involuntarily, and is valid only for the home medical equipment |
9266 | provider and location for which originally issued. |
9267 | (17) A home medical equipment provider against whom a |
9268 | proceeding for revocation or suspension, or for denial of a |
9269 | renewal application, is pending at the time of license renewal |
9270 | may be issued a provisional license effective until final |
9271 | disposition by the agency of such proceedings. If judicial |
9272 | relief is sought from the final disposition, the court that has |
9273 | jurisdiction may issue a temporary permit for the duration of |
9274 | the judicial proceeding. |
9275 | Section 175. Section 400.932, Florida Statutes, is amended |
9276 | to read: |
9277 | 400.932 Administrative penalties; injunctions; emergency |
9278 | orders; moratoriums.-- |
9279 | (1) The agency may deny, revoke, and or suspend a license, |
9280 | and or impose an administrative fine not to exceed $5,000 per |
9281 | violation, per day, or initiate injunctive proceedings under s. |
9282 | 408.816 400.956. |
9283 | (2) Any of the following actions by an employee of a home |
9284 | medical equipment provider or any of its employees is grounds |
9285 | for administrative action or penalties by the agency: |
9286 | (a) Violation of this part or of applicable rules. |
9287 | (b) An intentional, reckless, or negligent act that |
9288 | materially affects the health or safety of a patient. |
9289 | (3) The agency may deny and or revoke the license of any |
9290 | applicant that: |
9291 | (a) Made a false representation or omission of any |
9292 | material fact in making the application, including the |
9293 | submission of an application that conceals the controlling or |
9294 | ownership interest or any officer, director, agent, managing |
9295 | employee, affiliated person, partner, or shareholder who may not |
9296 | be eligible to participate; |
9297 | (a)(b) Has been previously found by any professional |
9298 | licensing, certifying, or standards board or agency to have |
9299 | violated the standards or conditions relating to licensure or |
9300 | certification or the quality of services provided. "Professional |
9301 | licensing, certifying, or standards board or agency" shall |
9302 | include, but is not limited to, practitioners, health care |
9303 | facilities, programs, or services, or residential care, |
9304 | treatment programs, or other human services; or |
9305 | (b)(c) Has been or is currently excluded, suspended, or |
9306 | terminated from, or has involuntarily withdrawn from, |
9307 | participation in Florida's Medicaid program or any other state's |
9308 | Medicaid program, or participation in the Medicare program or |
9309 | any other governmental or private health care or health |
9310 | insurance program. |
9311 | (4) The agency may issue an emergency order immediately |
9312 | suspending or revoking a license when it determines that any |
9313 | condition within the responsibility of the home medical |
9314 | equipment provider presents a clear and present danger to public |
9315 | health and safety. |
9316 | (5) The agency may impose an immediate moratorium on any |
9317 | licensed home medical equipment provider when the agency |
9318 | determines that any condition within the responsibility of the |
9319 | home medical equipment provider presents a threat to public |
9320 | health or safety. |
9321 | Section 176. Section 400.933, Florida Statutes, is amended |
9322 | to read: |
9323 | 400.933 Licensure inspections; alternatives and |
9324 | investigations.-- |
9325 | (1) The agency shall make or cause to be made such |
9326 | inspections and investigations as it considers necessary, |
9327 | including: |
9328 | (a) Licensure inspections. |
9329 | (b) Inspections directed by the federal Health Care |
9330 | Financing Administration. |
9331 | (c) Licensure complaint investigations, including full |
9332 | licensure investigations with a review of all licensure |
9333 | standards as outlined in the administrative rules. Complaints |
9334 | received by the agency from individuals, organizations, or other |
9335 | sources are subject to review and investigation by the agency. |
9336 | (2) The agency shall accept, in lieu of its own periodic |
9337 | inspections for licensure, submission of the following: |
9338 | (1)(a) The survey or inspection of an accrediting |
9339 | organization, provided the accreditation of the licensed home |
9340 | medical equipment provider is not provisional and provided the |
9341 | licensed home medical equipment provider authorizes release of, |
9342 | and the agency receives the report of, the accrediting |
9343 | organization; or |
9344 | (2)(b) A copy of a valid medical oxygen retail |
9345 | establishment permit issued by the Department of Health, |
9346 | pursuant to chapter 499. |
9347 | Section 177. Section 400.935, Florida Statutes, is amended |
9348 | to read: |
9349 | 400.935 Rules establishing minimum standards.--The agency |
9350 | shall adopt, publish, and enforce rules to implement this part |
9351 | and part II of chapter 408, which must provide reasonable and |
9352 | fair minimum standards relating to: |
9353 | (1) The qualifications and minimum training requirements |
9354 | of all home medical equipment provider personnel. |
9355 | (2) License application and renewal. |
9356 | (3) License and inspection fees. |
9357 | (2)(4) Financial ability to operate. |
9358 | (3)(5) The administration of the home medical equipment |
9359 | provider. |
9360 | (4)(6) Procedures for maintaining patient records. |
9361 | (5)(7) Ensuring that the home medical equipment and |
9362 | services provided by a home medical equipment provider are in |
9363 | accordance with the plan of treatment established for each |
9364 | patient, when provided as a part of a plan of treatment. |
9365 | (6)(8) Contractual arrangements for the provision of home |
9366 | medical equipment and services by providers not employed by the |
9367 | home medical equipment provider providing for the consumer's |
9368 | needs. |
9369 | (7)(9) Physical location and zoning requirements. |
9370 | (8)(10) Home medical equipment requiring home medical |
9371 | equipment services. |
9372 | Section 178. Section 400.95, Florida Statutes, is |
9373 | repealed. |
9374 | Section 179. Subsections (3) through (7) of section |
9375 | 400.953, Florida Statutes, are renumbered as subsections (2) |
9376 | through (6), respectively, and present subsection (2) is amended |
9377 | to read: |
9378 | 400.953 Background screening of home medical equipment |
9379 | provider personnel.--The agency shall require employment |
9380 | screening as provided in chapter 435, using the level 1 |
9381 | standards for screening set forth in that chapter, for home |
9382 | medical equipment provider personnel. |
9383 | (2) The general manager of each home medical equipment |
9384 | provider must sign an affidavit annually, under penalty of |
9385 | perjury, stating that all home medical equipment provider |
9386 | personnel hired on or after July 1, 1999, who enter the home of |
9387 | a patient in the capacity of their employment have been screened |
9388 | and that its remaining personnel have worked for the home |
9389 | medical equipment provider continuously since before July 1, |
9390 | 1999. |
9391 | Section 180. Subsection (4) of section 400.955, Florida |
9392 | Statutes, is amended to read: |
9393 | 400.955 Procedures for screening of home medical equipment |
9394 | provider personnel.-- |
9395 | (4) The general manager of each home medical equipment |
9396 | provider must sign an affidavit annually, under penalty of |
9397 | perjury, stating that all personnel hired on or after July 1, |
9398 | 1999, have been screened and that its remaining personnel have |
9399 | worked for the home medical equipment provider continuously |
9400 | since before July 1, 1999. |
9401 | Section 181. Section 400.956, Florida Statutes, is |
9402 | repealed. |
9403 | Section 182. Section 400.960, Florida Statutes, is amended |
9404 | to read: |
9405 | 400.960 Definitions.--As used in this part, the term: |
9406 | (1) "Active treatment" means the provision of services by |
9407 | an interdisciplinary team which are necessary to maximize a |
9408 | resident's client's individual independence or prevent |
9409 | regression or loss of functional status. |
9410 | (2) "Agency" means the Agency for Health Care |
9411 | Administration. |
9412 | (3) "Autism" means a pervasive, neurologically based |
9413 | developmental disability of extended duration which causes |
9414 | severe learning, communication, and behavior disorders with age |
9415 | of onset during infancy or childhood. Individuals with autism |
9416 | exhibit impairment in reciprocal social interaction, impairment |
9417 | in verbal and nonverbal communication and imaginative ability, |
9418 | and a markedly restricted repertoire of activities and |
9419 | interests. |
9420 | (4) "Cerebral palsy" means a group of disabling symptoms |
9421 | of extended duration which results from damage to the developing |
9422 | brain occurring before, during, or after birth and resulting in |
9423 | the loss or impairment of control over voluntary muscles. The |
9424 | term does not include those symptoms or impairments resulting |
9425 | solely from a stroke. |
9426 | (5) "Client" means any person determined by the department |
9427 | to be eligible for developmental services. |
9428 | (6) "Client advocate" means a friend or relative of the |
9429 | client, or of the client's immediate family, who advocates for |
9430 | the best interests of the client in any proceedings under this |
9431 | part in which the client or his or her family has the right or |
9432 | duty to participate. |
9433 | (5)(7) "Department" means the Department of Children and |
9434 | Family Services. |
9435 | (6)(8) "Developmental disability" means a disorder or |
9436 | syndrome that is attributable to retardation, cerebral palsy, |
9437 | autism, spina bifida, or Prader-Willi syndrome and that |
9438 | constitutes a substantial handicap that can reasonably be |
9439 | expected to continue indefinitely. |
9440 | (7)(9) "Direct service provider" means a person 18 years |
9441 | of age or older who has direct contact with individuals with |
9442 | developmental disabilities and who is unrelated to the |
9443 | individuals with developmental disabilities. |
9444 | (8)(10) "Epilepsy" means a chronic brain disorder of |
9445 | various causes which is characterized by recurrent seizures due |
9446 | to excessive discharge of cerebral neurons. When found |
9447 | concurrently with retardation, autism, or cerebral palsy, |
9448 | epilepsy is considered a secondary disability for which the |
9449 | resident client is eligible to receive services to ameliorate |
9450 | this condition according to the provisions of this part. |
9451 | (9)(11) "Guardian advocate" means a person appointed by |
9452 | the circuit court to represent a person with developmental |
9453 | disabilities in any proceedings brought pursuant to s. 393.12, |
9454 | and is distinct from a guardian advocate for mentally ill |
9455 | persons under chapter 394. |
9456 | (10)(12) "Intermediate care facility for the |
9457 | developmentally disabled" means a residential facility licensed |
9458 | and certified in accordance with state law, and certified by the |
9459 | Federal Government, pursuant to the Social Security Act, as a |
9460 | provider of Medicaid services to persons who are developmentally |
9461 | disabled. |
9462 | (11)(13) "Prader-Willi syndrome" means an inherited |
9463 | condition typified by neonatal hypotonia with failure to thrive, |
9464 | hyperphagia, or an excessive drive to eat which leads to |
9465 | obesity, usually at 18 to 36 months of age, mild to moderate |
9466 | retardation, hypogonadism, short stature, mild facial |
9467 | dysmorphism, and a characteristic neurobehavior. |
9468 | (12) "Resident" means any person receiving services in an |
9469 | intermediate care facility. |
9470 | (13) "Resident advocate" means a friend or relative of the |
9471 | resident, or of the resident's immediate family, who advocates |
9472 | for the best interests of the resident in any proceedings under |
9473 | this part in which the resident or his or her family has the |
9474 | right or duty to participate. |
9475 | (14) "Retardation" means significantly subaverage general |
9476 | intellectual functioning existing concurrently with deficits in |
9477 | adaptive behavior and manifested during the period from |
9478 | conception to age 18. "Significantly subaverage general |
9479 | intellectual functioning," for the purpose of this definition, |
9480 | means performance that is two or more standard deviations from |
9481 | the mean score on a standardized intelligence test specified in |
9482 | rules of the department. "Deficits in adaptive behavior," for |
9483 | the purpose of this definition, means deficits in the |
9484 | effectiveness or degree with which an individual meets the |
9485 | standards of personal independence and social responsibility |
9486 | expected of his or her age, cultural group, and community. |
9487 | (15) "Spina bifida" means a medical diagnosis of spina |
9488 | bifida cystica or myelomeningocele. |
9489 | Section 183. Section 400.962, Florida Statutes, is amended |
9490 | to read: |
9491 | 400.962 License required; license application.-- |
9492 | (1) The requirements of part II of chapter 408 shall apply |
9493 | to the provision of services that require licensure pursuant to |
9494 | this part and part II of chapter 408 and to entities licensed by |
9495 | or applying for such licensure from the Agency for Health Care |
9496 | Administration pursuant to this part. However, each applicant |
9497 | for licensure and each licensee is exempt from s. 408.810(7). It |
9498 | is unlawful to operate an intermediate care facility for the |
9499 | developmentally disabled without a license. |
9500 | (2) Separate licenses are required for facilities |
9501 | maintained on separate premises even if operated under the same |
9502 | management. However, a separate license is not required for |
9503 | separate buildings on the same grounds. |
9504 | (3) In accordance with s. 408.805, an applicant or |
9505 | licensee shall pay a fee for each license application submitted |
9506 | under this part, part II of chapter 408, and applicable rules. |
9507 | The amount of the fee shall be $234 per bed unless modified by |
9508 | rule. |
9509 | (3) The basic license fee collected shall be deposited in |
9510 | the Health Care Trust Fund, established for carrying out the |
9511 | purposes of this chapter. |
9512 | (4) The license must be conspicuously displayed inside the |
9513 | facility. |
9514 | (5) A license is valid only in the hands of the |
9515 | individual, firm, partnership, association, or corporation to |
9516 | whom it is issued. A license is not valid for any premises other |
9517 | than those for which it was originally issued and may not be |
9518 | sold, assigned, or otherwise transferred, voluntarily or |
9519 | involuntarily. |
9520 | (6) An application for a license shall be made to the |
9521 | agency on forms furnished by it and must be accompanied by the |
9522 | appropriate license fee. |
9523 | (7) The application must be under oath and must contain |
9524 | the following: |
9525 | (a) The name, address, and social security number of the |
9526 | applicant if an individual; if the applicant is a firm, |
9527 | partnership, or association, its name, address, and employer |
9528 | identification number (EIN), and the name and address of every |
9529 | member; if the applicant is a corporation, its name, address, |
9530 | and employer identification number (EIN), and the name and |
9531 | address of its director and officers and of each person having |
9532 | at least a 5 percent interest in the corporation; and the name |
9533 | by which the facility is to be known. |
9534 | (b) The name of any person whose name is required on the |
9535 | application under paragraph (a) and who owns at least a 10 |
9536 | percent interest in any professional service, firm, association, |
9537 | partnership, or corporation providing goods, leases, or services |
9538 | to the facility for which the application is made, and the name |
9539 | and address of the professional service, firm, association, |
9540 | partnership, or corporation in which such interest is held. |
9541 | (c) The location of the facility for which a license is |
9542 | sought and an indication that such location conforms to the |
9543 | local zoning ordinances. |
9544 | (d) The name of the persons under whose management or |
9545 | supervision the facility will be operated. |
9546 | (e) The total number of beds. |
9547 | (4)(8) The applicant must demonstrate that sufficient |
9548 | numbers of staff, qualified by training or experience, will be |
9549 | employed to properly care for the type and number of residents |
9550 | who will reside in the facility. |
9551 | (9) The applicant must submit evidence that establishes |
9552 | the good moral character of the applicant, manager, supervisor, |
9553 | and administrator. An applicant who is an individual or a member |
9554 | of a board of directors or officer of an applicant that is a |
9555 | firm, partnership, association, or corporation must not have |
9556 | been convicted, or found guilty, regardless of adjudication, of |
9557 | a crime in any jurisdiction which affects or may potentially |
9558 | affect residents in the facility. |
9559 | (10)(a) Upon receipt of a completed, signed, and dated |
9560 | application, the agency shall require background screening of |
9561 | the applicant, in accordance with the level 2 standards for |
9562 | screening set forth in chapter 435. As used in this subsection, |
9563 | the term "applicant" means the facility administrator, or |
9564 | similarly titled individual who is responsible for the day-to- |
9565 | day operation of the licensed facility, and the facility |
9566 | financial officer, or similarly titled individual who is |
9567 | responsible for the financial operation of the licensed |
9568 | facility. |
9569 | (b) The agency may require background screening for a |
9570 | member of the board of directors of the licensee or an officer |
9571 | or an individual owning 5 percent or more of the licensee if the |
9572 | agency has probable cause to believe that such individual has |
9573 | been convicted of an offense prohibited under the level 2 |
9574 | standards for screening set forth in chapter 435. |
9575 | (c) Proof of compliance with the level 2 background |
9576 | screening requirements of chapter 435 which has been submitted |
9577 | within the previous 5 years in compliance with any other |
9578 | licensure requirements under this chapter satisfies the |
9579 | requirements of paragraph (a). Proof of compliance with |
9580 | background screening which has been submitted within the |
9581 | previous 5 years to fulfill the requirements of the Financial |
9582 | Services Commission and the Office of Insurance Regulation under |
9583 | chapter 651 as part of an application for a certificate of |
9584 | authority to operate a continuing care retirement community |
9585 | satisfies the requirements for the Department of Law Enforcement |
9586 | and Federal Bureau of Investigation background checks. |
9587 | (d) A provisional license may be granted to an applicant |
9588 | when each individual required by this section to undergo |
9589 | background screening has met the standards for the Department of |
9590 | Law Enforcement background check, but the agency has not yet |
9591 | received background screening results from the Federal Bureau of |
9592 | Investigation, or a request for a disqualification exemption has |
9593 | been submitted to the agency as set forth in chapter 435, but a |
9594 | response has not yet been issued. A license may be granted to |
9595 | the applicant upon the agency's receipt of a report of the |
9596 | results of the Federal Bureau of Investigation background |
9597 | screening for each individual required by this section to |
9598 | undergo background screening which confirms that all standards |
9599 | have been met, or upon the granting of a disqualification |
9600 | exemption by the agency as set forth in chapter 435. Any other |
9601 | person who is required to undergo level 2 background screening |
9602 | may serve in his or her capacity pending the agency's receipt of |
9603 | the report from the Federal Bureau of Investigation; however, |
9604 | the person may not continue to serve if the report indicates any |
9605 | violation of background screening standards and a |
9606 | disqualification exemption has not been granted by the agency as |
9607 | set forth in chapter 435. |
9608 | (e) Each applicant must submit to the agency, with its |
9609 | application, a description and explanation of any exclusions, |
9610 | permanent suspensions, or terminations of the applicant from the |
9611 | Medicare or Medicaid programs. Proof of compliance with |
9612 | disclosure of ownership and control interest requirements of the |
9613 | Medicaid or Medicare programs shall be accepted in lieu of this |
9614 | submission. |
9615 | (f) Each applicant must submit to the agency a description |
9616 | and explanation of any conviction of an offense prohibited under |
9617 | the level 2 standards of chapter 435 by a member of the board of |
9618 | directors of the applicant, its officers, or any individual |
9619 | owning 5 percent or more of the applicant. This requirement does |
9620 | not apply to a director of a not-for-profit corporation or |
9621 | organization if the director serves solely in a voluntary |
9622 | capacity for the corporation or organization, does not regularly |
9623 | take part in the day-to-day operational decisions of the |
9624 | corporation or organization, receives no remuneration for his or |
9625 | her services on the corporation's or organization's board of |
9626 | directors, and has no financial interest and has no family |
9627 | members with a financial interest in the corporation or |
9628 | organization, provided that the director and the not-for-profit |
9629 | corporation or organization include in the application a |
9630 | statement affirming that the director's relationship to the |
9631 | corporation satisfies the requirements of this paragraph. |
9632 | (g) An application for license renewal must contain the |
9633 | information required under paragraphs (e) and (f). |
9634 | (11) The applicant must furnish satisfactory proof of |
9635 | financial ability to operate and conduct the facility in |
9636 | accordance with the requirements of this part and all rules |
9637 | adopted under this part, and the agency shall establish |
9638 | standards for this purpose. |
9639 | Section 184. Section 400.963, Florida Statutes, is |
9640 | repealed. |
9641 | Section 185. Section 400.965, Florida Statutes, is |
9642 | repealed. |
9643 | Section 186. Section 400.967, Florida Statutes, is amended |
9644 | to read: |
9645 | 400.967 Rules and classification of deficiencies.-- |
9646 | (1) It is the intent of the Legislature that rules adopted |
9647 | and enforced under this part and part II of chapter 408 include |
9648 | criteria by which a reasonable and consistent quality of |
9649 | resident care may be ensured, the results of such resident care |
9650 | can be demonstrated, and safe and sanitary facilities can be |
9651 | provided. |
9652 | (2) Pursuant to the intention of the Legislature, the |
9653 | agency, in consultation with the Agency for Persons with |
9654 | Disabilities Department of Children and Family Services and the |
9655 | Department of Elderly Affairs, shall adopt and enforce rules to |
9656 | administer this part, which shall include reasonable and fair |
9657 | criteria governing: |
9658 | (a) The location and construction of the facility; |
9659 | including fire and life safety, plumbing, heating, cooling, |
9660 | lighting, ventilation, and other housing conditions that will |
9661 | ensure the health, safety, and comfort of residents. The agency |
9662 | shall establish standards for facilities and equipment to |
9663 | increase the extent to which new facilities and a new wing or |
9664 | floor added to an existing facility after July 1, 2000, are |
9665 | structurally capable of serving as shelters only for residents, |
9666 | staff, and families of residents and staff, and equipped to be |
9667 | self-supporting during and immediately following disasters. The |
9668 | Agency for Health Care Administration shall work with facilities |
9669 | licensed under this part and report to the Governor and the |
9670 | Legislature by April 1, 2000, its recommendations for cost- |
9671 | effective renovation standards to be applied to existing |
9672 | facilities. In making such rules, the agency shall be guided by |
9673 | criteria recommended by nationally recognized, reputable |
9674 | professional groups and associations having knowledge concerning |
9675 | such subject matters. The agency shall update or revise such |
9676 | criteria as the need arises. All facilities must comply with |
9677 | those lifesafety code requirements and building code standards |
9678 | applicable at the time of approval of their construction plans. |
9679 | The agency may require alterations to a building if it |
9680 | determines that an existing condition constitutes a distinct |
9681 | hazard to life, health, or safety. The agency shall adopt fair |
9682 | and reasonable rules setting forth conditions under which |
9683 | existing facilities undergoing additions, alterations, |
9684 | conversions, renovations, or repairs are required to comply with |
9685 | the most recent updated or revised standards. |
9686 | (b) The number and qualifications of all personnel, |
9687 | including management, medical nursing, and other personnel, |
9688 | having responsibility for any part of the care given to |
9689 | residents. |
9690 | (c) All sanitary conditions within the facility and its |
9691 | surroundings, including water supply, sewage disposal, food |
9692 | handling, and general hygiene, which will ensure the health and |
9693 | comfort of residents. |
9694 | (d) The equipment essential to the health and welfare of |
9695 | the residents. |
9696 | (e) A uniform accounting system. |
9697 | (f) The care, treatment, and maintenance of residents and |
9698 | measurement of the quality and adequacy thereof. |
9699 | (g) The preparation and annual update of a comprehensive |
9700 | emergency management plan. The agency shall adopt rules |
9701 | establishing minimum criteria for the plan after consultation |
9702 | with the Department of Community Affairs. At a minimum, the |
9703 | rules must provide for plan components that address emergency |
9704 | evacuation transportation; adequate sheltering arrangements; |
9705 | postdisaster activities, including emergency power, food, and |
9706 | water; postdisaster transportation; supplies; staffing; |
9707 | emergency equipment; individual identification of residents and |
9708 | transfer of records; and responding to family inquiries. The |
9709 | comprehensive emergency management plan is subject to review and |
9710 | approval by the local emergency management agency. During its |
9711 | review, the local emergency management agency shall ensure that |
9712 | the following agencies, at a minimum, are given the opportunity |
9713 | to review the plan: the Department of Elderly Affairs, the |
9714 | Department of Children and Family Services, the Agency for |
9715 | Health Care Administration, and the Department of Community |
9716 | Affairs. Also, appropriate volunteer organizations must be given |
9717 | the opportunity to review the plan. The local emergency |
9718 | management agency shall complete its review within 60 days and |
9719 | either approve the plan or advise the facility of necessary |
9720 | revisions. |
9721 | (h) Each licensee shall post its license in a prominent |
9722 | place that is in clear and unobstructed public view at or near |
9723 | the place where residents are being admitted to the facility. |
9724 | (3) In accordance with part II of chapter 408, the agency |
9725 | shall adopt rules to provide that, when the criteria established |
9726 | under this part and part II of chapter 408 subsection (2) are |
9727 | not met, such deficiencies shall be classified according to the |
9728 | nature of the deficiency. The agency shall indicate the |
9729 | classification on the face of the notice of deficiencies as |
9730 | follows: |
9731 | (a) Class I deficiencies are those which the agency |
9732 | determines present an and imminent danger to the residents or |
9733 | guests of the facility or a substantial probability that death |
9734 | or serious physical harm would result therefrom. The condition |
9735 | or practice constituting a class I violation must be abated or |
9736 | eliminated immediately, unless a fixed period of time, as |
9737 | determined by the agency, is required for correction. |
9738 | Notwithstanding s. 400.121(2), A class I deficiency is subject |
9739 | to a civil penalty in an amount not less than $5,000 and not |
9740 | exceeding $10,000 for each deficiency. A fine may be levied |
9741 | notwithstanding the correction of the deficiency. |
9742 | (b) Class II deficiencies are those which the agency |
9743 | determines have a direct or immediate relationship to the |
9744 | health, safety, or security of the facility residents, other |
9745 | than class I deficiencies. A class II deficiency is subject to a |
9746 | civil penalty in an amount not less than $1,000 and not |
9747 | exceeding $5,000 for each deficiency. A citation for a class II |
9748 | deficiency shall specify the time within which the deficiency |
9749 | must be corrected. If a class II deficiency is corrected within |
9750 | the time specified, no civil penalty shall be imposed, unless it |
9751 | is a repeated offense. |
9752 | (c) Class III deficiencies are those which the agency |
9753 | determines to have an indirect or potential relationship to the |
9754 | health, safety, or security of the facility residents, other |
9755 | than class I or class II deficiencies. A class III deficiency is |
9756 | subject to a civil penalty of not less than $500 and not |
9757 | exceeding $1,000 for each deficiency. A citation for a class III |
9758 | deficiency shall specify the time within which the deficiency |
9759 | must be corrected. If a class III deficiency is corrected within |
9760 | the time specified, no civil penalty shall be imposed, unless it |
9761 | is a repeated offense. |
9762 | (4) Civil penalties paid by any licensee under subsection |
9763 | (3) shall be deposited in the Health Care Trust Fund and |
9764 | expended as provided in s. 400.063. |
9765 | (4)(5) The agency shall approve or disapprove the plans |
9766 | and specifications within 60 days after receipt of the final |
9767 | plans and specifications. The agency may be granted one 15-day |
9768 | extension for the review period, if the secretary of the agency |
9769 | so approves. If the agency fails to act within the specified |
9770 | time, it is deemed to have approved the plans and |
9771 | specifications. When the agency disapproves plans and |
9772 | specifications, it must set forth in writing the reasons for |
9773 | disapproval. Conferences and consultations may be provided as |
9774 | necessary. |
9775 | (5)(6) The agency may charge an initial fee of $2,000 for |
9776 | review of plans and construction on all projects, no part of |
9777 | which is refundable. The agency may also collect a fee, not to |
9778 | exceed 1 percent of the estimated construction cost or the |
9779 | actual cost of review, whichever is less, for the portion of the |
9780 | review which encompasses initial review through the initial |
9781 | revised construction document review. The agency may collect its |
9782 | actual costs on all subsequent portions of the review and |
9783 | construction inspections. Initial fee payment must accompany the |
9784 | initial submission of plans and specifications. Any subsequent |
9785 | payment that is due is payable upon receipt of the invoice from |
9786 | the agency. Notwithstanding any other provision of law, all |
9787 | money received by the agency under this section shall be deemed |
9788 | to be trust funds, to be held and applied solely for the |
9789 | operations required under this section. |
9790 | (6) Each licensee of an intermediate care facility for |
9791 | persons with developmental disabilities shall adhere to all |
9792 | rights specified in s. 393.13, the Bill of Rights of Persons Who |
9793 | are Developmentally Disabled. |
9794 | Section 187. Section 400.968, Florida Statutes, is amended |
9795 | to read: |
9796 | 400.968 Right of entry; protection of health, safety, and |
9797 | welfare.-- |
9798 | (1) Any designated officer or employee of the agency, of |
9799 | the state, or of the local fire marshal may enter unannounced |
9800 | the premises of any facility licensed under this part in order |
9801 | to determine the state of compliance with this part and the |
9802 | rules or standards in force under this part. The right of entry |
9803 | and inspection also extends to any premises that the agency has |
9804 | reason to believe are being operated or maintained as a facility |
9805 | without a license; but such an entry or inspection may not be |
9806 | made without the permission of the owner or person in charge of |
9807 | the facility unless a warrant that authorizes the entry is first |
9808 | obtained from the circuit court. The warrant requirement extends |
9809 | only to a facility that the agency has reason to believe is |
9810 | being operated or maintained as a facility without a license. An |
9811 | application for a license or renewal thereof which is made under |
9812 | this section constitutes permission for, and acquiescence in, |
9813 | any entry or inspection of the premises for which the license is |
9814 | sought, in order to facilitate verification of the information |
9815 | submitted in connection with the application; to discover, |
9816 | investigate, and determine the existence of abuse or neglect; or |
9817 | to elicit, receive, respond to, and resolve complaints. A |
9818 | current valid license constitutes unconditional permission for, |
9819 | and acquiescence in, any entry or inspection of the premises by |
9820 | authorized personnel. The agency retains the right of entry and |
9821 | inspection of facilities that have had a license revoked or |
9822 | suspended within the previous 24 months, to ensure that the |
9823 | facility is not operating unlawfully. However, before the |
9824 | facility is entered, a statement of probable cause must be filed |
9825 | with the director of the agency, who must approve or disapprove |
9826 | the action within 48 hours. |
9827 | (2) The agency may institute injunctive proceedings in a |
9828 | court of competent jurisdiction for temporary or permanent |
9829 | relief to: |
9830 | (a) Enforce this section or any minimum standard, rule, or |
9831 | order issued pursuant thereto if the agency's effort to correct |
9832 | a violation through administrative fines has failed or when the |
9833 | violation materially affects the health, safety, or welfare of |
9834 | residents; or |
9835 | (b) Terminate the operation of a facility if a violation |
9836 | of this section or of any standard or rule adopted pursuant |
9837 | thereto exists which materially affects the health, safety, or |
9838 | welfare of residents. |
9839 |
|
9840 | The Legislature recognizes that, in some instances, action is |
9841 | necessary to protect residents of facilities from immediately |
9842 | life-threatening situations. If it appears by competent evidence |
9843 | or a sworn, substantiated affidavit that a temporary injunction |
9844 | should issue, the court, pending the determination on final |
9845 | hearing, shall enjoin operation of the facility. |
9846 | (3) The agency may impose an immediate moratorium on |
9847 | admissions to a facility when the agency determines that any |
9848 | condition in the facility presents a threat to the health, |
9849 | safety, or welfare of the residents in the facility. If a |
9850 | facility's license is denied, revoked, or suspended, the |
9851 | facility may be subject to the immediate imposition of a |
9852 | moratorium on admissions to run concurrently with licensure |
9853 | denial, revocation, or suspension. |
9854 | Section 188. Section 400.9685, Florida Statutes, is |
9855 | amended to read: |
9856 | 400.9685 Administration of medication.-- |
9857 | (1) Notwithstanding the provisions of the Nurse Practice |
9858 | Act, part I of chapter 464, unlicensed direct care services |
9859 | staff who are providing services to residents clients in |
9860 | intermediate care facilities for the developmentally disabled, |
9861 | licensed pursuant to this part, may administer prescribed, |
9862 | prepackaged, premeasured medications under the general |
9863 | supervision of a registered nurse as provided in this section |
9864 | and applicable rules. Training required by this section and |
9865 | applicable rules must be conducted by a registered nurse |
9866 | licensed pursuant to chapter 464 or a physician licensed |
9867 | pursuant to chapter 458 or chapter 459. |
9868 | (2) Each facility that allows unlicensed direct care |
9869 | service staff to administer medications pursuant to this section |
9870 | must: |
9871 | (a) Develop and implement policies and procedures that |
9872 | include a plan to ensure the safe handling, storage, and |
9873 | administration of prescription medication. |
9874 | (b) Maintain written evidence of the expressed and |
9875 | informed consent for each resident client. |
9876 | (c) Maintain a copy of the written prescription including |
9877 | the name of the medication, the dosage, and administration |
9878 | schedule. |
9879 | (d) Maintain documentation regarding the prescription |
9880 | including the name, dosage, and administration schedule, reason |
9881 | for prescription, and the termination date. |
9882 | (e) Maintain documentation of compliance with required |
9883 | training. |
9884 | (3) Agency rules shall specify the following as it relates |
9885 | to the administration of medications by unlicensed staff: |
9886 | (a) Medications authorized and packaging required. |
9887 | (b) Acceptable methods of administration. |
9888 | (c) A definition of "general supervision." |
9889 | (d) Minimum educational requirements of staff. |
9890 | (e) Criteria of required training and competency that must |
9891 | be demonstrated prior to the administration of medications by |
9892 | unlicensed staff including inservice training. |
9893 | (f) Requirements for safe handling, storage, and |
9894 | administration of medications. |
9895 | Section 189. Subsection (1) of section 400.969, Florida |
9896 | Statutes, is amended to read: |
9897 | 400.969 Violation of part; penalties.-- |
9898 | (1) In accordance with part II of chapter 408, and except |
9899 | as provided in s. 400.967(3), a violation of any provision of |
9900 | this part, part II of chapter 408, or applicable rules adopted |
9901 | by the agency under this part is punishable by payment of an |
9902 | administrative or civil penalty not to exceed $5,000. |
9903 | Section 190. Section 400.980, Florida Statutes, is amended |
9904 | to read: |
9905 | 400.980 Health care services pools.-- |
9906 | (1) As used in this section, the term: |
9907 | (a) "Agency" means the Agency for Health Care |
9908 | Administration. |
9909 | (b) "Health care services pool" means any person, firm, |
9910 | corporation, partnership, or association engaged for hire in the |
9911 | business of providing temporary employment in health care |
9912 | facilities, residential facilities, and agencies for licensed, |
9913 | certified, or trained health care personnel including, without |
9914 | limitation, nursing assistants, nurses' aides, and orderlies. |
9915 | However, the term does not include nursing registries, a |
9916 | facility licensed under chapter 400, a health care services pool |
9917 | established within a health care facility to provide services |
9918 | only within the confines of such facility, or any individual |
9919 | contractor directly providing temporary services to a health |
9920 | care facility without use or benefit of a contracting agent. |
9921 | (2) The requirements of part II of chapter 408 shall apply |
9922 | to the provision of services that require licensure or |
9923 | registration pursuant to this part and part II of chapter 408 |
9924 | and to entities registered by or applying for such registration |
9925 | from the agency pursuant to this part. However, each applicant |
9926 | for licensure and each licensee is exempt from ss. |
9927 | 408.806(1)(e)2. and 408.810(6)-(10). Each person who operates a |
9928 | health care services pool must register each separate business |
9929 | location with the agency. The agency shall adopt rules and |
9930 | provide forms required for such registration and shall impose a |
9931 | registration fee in an amount sufficient to cover the cost of |
9932 | administering this section. In addition, the registrant must |
9933 | provide the agency with any change of information contained on |
9934 | the original registration application within 14 days prior to |
9935 | the change. The agency may inspect the offices of any health |
9936 | care services pool at any reasonable time for the purpose of |
9937 | determining compliance with this section or the rules adopted |
9938 | under this section. |
9939 | (3) Each application for registration must include: |
9940 | (a) The name and address of any person who has an |
9941 | ownership interest in the business, and, in the case of a |
9942 | corporate owner, copies of the articles of incorporation, |
9943 | bylaws, and names and addresses of all officers and directors of |
9944 | the corporation. |
9945 | (b) Any other information required by the agency. |
9946 | (3)(4) Each applicant for registration must comply with |
9947 | the following requirements: |
9948 | (a) Upon receipt of a completed, signed, and dated |
9949 | application, the agency shall require background screening, in |
9950 | accordance with the level 1 standards for screening set forth in |
9951 | chapter 435, of every individual who will have contact with |
9952 | patients. The agency shall require background screening of the |
9953 | managing employee or other similarly titled individual who is |
9954 | responsible for the operation of the entity, and of the |
9955 | financial officer or other similarly titled individual who is |
9956 | responsible for the financial operation of the entity, including |
9957 | billings for services in accordance with the level 2 standards |
9958 | for background screening as set forth in chapter 435. |
9959 | (b) The agency may require background screening of any |
9960 | other individual who is affiliated with the applicant if the |
9961 | agency has a reasonable basis for believing that he or she has |
9962 | been convicted of a crime or has committed any other offense |
9963 | prohibited under the level 2 standards for screening set forth |
9964 | in chapter 435. |
9965 | (c) Proof of compliance with the level 2 background |
9966 | screening requirements of chapter 435 which has been submitted |
9967 | within the previous 5 years in compliance with any other health |
9968 | care or assisted living licensure requirements of this state is |
9969 | acceptable in fulfillment of paragraph (a). |
9970 | (d) A provisional registration may be granted to an |
9971 | applicant when each individual required by this section to |
9972 | undergo background screening has met the standards for the |
9973 | Department of Law Enforcement background check but the agency |
9974 | has not yet received background screening results from the |
9975 | Federal Bureau of Investigation. A standard registration may be |
9976 | granted to the applicant upon the agency's receipt of a report |
9977 | of the results of the Federal Bureau of Investigation background |
9978 | screening for each individual required by this section to |
9979 | undergo background screening which confirms that all standards |
9980 | have been met, or upon the granting of a disqualification |
9981 | exemption by the agency as set forth in chapter 435. Any other |
9982 | person who is required to undergo level 2 background screening |
9983 | may serve in his or her capacity pending the agency's receipt of |
9984 | the report from the Federal Bureau of Investigation. However, |
9985 | the person may not continue to serve if the report indicates any |
9986 | violation of background screening standards and if a |
9987 | disqualification exemption has not been requested of and granted |
9988 | by the agency as set forth in chapter 435. |
9989 | (e) Each applicant must submit to the agency, with its |
9990 | application, a description and explanation of any exclusions, |
9991 | permanent suspensions, or terminations of the applicant from the |
9992 | Medicare or Medicaid programs. Proof of compliance with the |
9993 | requirements for disclosure of ownership and controlling |
9994 | interests under the Medicaid or Medicare programs may be |
9995 | accepted in lieu of this submission. |
9996 | (f) Each applicant must submit to the agency a description |
9997 | and explanation of any conviction of an offense prohibited under |
9998 | the level 2 standards of chapter 435 which was committed by a |
9999 | member of the board of directors of the applicant, its officers, |
10000 | or any individual owning 5 percent or more of the applicant. |
10001 | This requirement does not apply to a director of a not-for- |
10002 | profit corporation or organization who serves solely in a |
10003 | voluntary capacity for the corporation or organization, does not |
10004 | regularly take part in the day-to-day operational decisions of |
10005 | the corporation or organization, receives no remuneration for |
10006 | his or her services on the corporation's or organization's board |
10007 | of directors, and has no financial interest and no family |
10008 | members having a financial interest in the corporation or |
10009 | organization, if the director and the not-for-profit corporation |
10010 | or organization include in the application a statement affirming |
10011 | that the director's relationship to the corporation satisfies |
10012 | the requirements of this paragraph. |
10013 | (g) A registration may not be granted to an applicant if |
10014 | the applicant or managing employee has been found guilty of, |
10015 | regardless of adjudication, or has entered a plea of nolo |
10016 | contendere or guilty to, any offense prohibited under the level |
10017 | 2 standards for screening set forth in chapter 435, unless an |
10018 | exemption from disqualification has been granted by the agency |
10019 | as set forth in chapter 435. |
10020 | (h) Failure to provide all required documentation within |
10021 | 30 days after a written request from the agency will result in |
10022 | denial of the application for registration. |
10023 | (i) The agency must take final action on an application |
10024 | for registration within 60 days after receipt of all required |
10025 | documentation. |
10026 | (j) The agency may deny, revoke, or suspend the |
10027 | registration of any applicant or registrant who: |
10028 | 1. Has falsely represented a material fact in the |
10029 | application required by paragraph (e) or paragraph (f), or has |
10030 | omitted any material fact from the application required by |
10031 | paragraph (e) or paragraph (f); or |
10032 | 2. Has had prior action taken against the applicant under |
10033 | the Medicaid or Medicare program as set forth in paragraph (e). |
10034 | 3. Fails to comply with this section or applicable rules. |
10035 | 4. Commits an intentional, reckless, or negligent act that |
10036 | materially affects the health or safety of a person receiving |
10037 | services. |
10038 | (4)(5) It is a misdemeanor of the first degree, punishable |
10039 | under s. 775.082 or s. 775.083, for any person willfully, |
10040 | knowingly, or intentionally to: |
10041 | (a) Fail, by false statement, misrepresentation, |
10042 | impersonation, or other fraudulent means, to disclose in any |
10043 | application for voluntary or paid employment a material fact |
10044 | used in making a determination as to an applicant's |
10045 | qualifications to be a contractor under this section; |
10046 | (b) Operate or attempt to operate an entity registered |
10047 | under this part with persons who do not meet the minimum |
10048 | standards of chapter 435 as contained in this section; or |
10049 | (c) Use information from the criminal records obtained |
10050 | under this section for any purpose other than screening an |
10051 | applicant for temporary employment as specified in this section, |
10052 | or release such information to any other person for any purpose |
10053 | other than screening for employment under this section. |
10054 | (5)(6) It is a felony of the third degree, punishable |
10055 | under s. 775.082, s. 775.083, or s. 775.084, for any person |
10056 | willfully, knowingly, or intentionally to use information from |
10057 | the juvenile records of a person obtained under this section for |
10058 | any purpose other than screening for employment under this |
10059 | section. |
10060 | (7) It is unlawful for a person to offer or advertise |
10061 | services, as defined by rule, to the public without obtaining a |
10062 | certificate of registration from the Agency for Health Care |
10063 | Administration. It is unlawful for any holder of a certificate |
10064 | of registration to advertise or hold out to the public that he |
10065 | or she holds a certificate of registration for other than that |
10066 | for which he or she actually holds a certificate of |
10067 | registration. Any person who violates this subsection is subject |
10068 | to injunctive proceedings under s. 400.515. |
10069 | (8) Each registration shall be for a period of 2 years. |
10070 | The application for renewal must be received by the agency at |
10071 | least 30 days before the expiration date of the registration. An |
10072 | application for a new registration is required within 30 days |
10073 | prior to the sale of a controlling interest in a health care |
10074 | services pool. |
10075 | (6)(9) A health care services pool may not require an |
10076 | employee to recruit new employees from persons employed at a |
10077 | health care facility to which the health care services pool |
10078 | employee is assigned. Nor shall a health care facility to which |
10079 | employees of a health care services pool are assigned recruit |
10080 | new employees from the health care services pool. |
10081 | (7)(10) A health care services pool shall document that |
10082 | each temporary employee provided to a health care facility has |
10083 | met the licensing, certification, training, or continuing |
10084 | education requirements, as established by the appropriate |
10085 | regulatory agency, for the position in which he or she will be |
10086 | working. |
10087 | (8)(11) When referring persons for temporary employment in |
10088 | health care facilities, a health care services pool shall comply |
10089 | with all pertinent state and federal laws, rules, and |
10090 | regulations relating to health, background screening, and other |
10091 | qualifications required of persons working in a facility of that |
10092 | type. |
10093 | (9)(12)(a) As a condition of registration and prior to the |
10094 | issuance or renewal of a certificate of registration, a health |
10095 | care services pool applicant must prove financial responsibility |
10096 | to pay claims, and costs ancillary thereto, arising out of the |
10097 | rendering of services or failure to render services by the pool |
10098 | or by its employees in the course of their employment with the |
10099 | pool. The agency shall promulgate rules establishing minimum |
10100 | financial responsibility coverage amounts which shall be |
10101 | adequate to pay potential claims and costs ancillary thereto. |
10102 | (b) Each health care services pool shall give written |
10103 | notification to the agency within 20 days after any change in |
10104 | the method of assuring financial responsibility or upon |
10105 | cancellation or nonrenewal of professional liability insurance. |
10106 | Unless the pool demonstrates that it is otherwise in compliance |
10107 | with the requirements of this section, the agency shall suspend |
10108 | the registration of the pool pursuant to ss. 120.569 and 120.57. |
10109 | Any suspension under this section shall remain in effect until |
10110 | the pool demonstrates compliance with the requirements of this |
10111 | section. |
10112 | (c) Proof of financial responsibility must be demonstrated |
10113 | to the satisfaction of the agency, through one of the following |
10114 | methods: |
10115 | 1. Establishing and maintaining an escrow account |
10116 | consisting of cash or assets eligible for deposit in accordance |
10117 | with s. 625.52; |
10118 | 2. Obtaining and maintaining an unexpired irrevocable |
10119 | letter of credit established pursuant to chapter 675. Such |
10120 | letters of credit shall be nontransferable and nonassignable and |
10121 | shall be issued by any bank or savings association organized and |
10122 | existing under the laws of this state or any bank or savings |
10123 | association organized under the laws of the United States that |
10124 | has its principal place of business in this state or has a |
10125 | branch office which is authorized under the laws of this state |
10126 | or of the United States to receive deposits in this state; or |
10127 | 3. Obtaining and maintaining professional liability |
10128 | coverage from one of the following: |
10129 | a. An authorized insurer as defined under s. 624.09; |
10130 | b. An eligible surplus lines insurer as defined under s. |
10131 | 626.918(2); |
10132 | c. A risk retention group or purchasing group as defined |
10133 | under s. 627.942; or |
10134 | d. A plan of self-insurance as provided in s. 627.357. |
10135 | (d) If financial responsibility requirements are met by |
10136 | maintaining an escrow account or letter of credit, as provided |
10137 | in this section, upon the entry of an adverse final judgment |
10138 | arising from a medical malpractice arbitration award from a |
10139 | claim of medical malpractice either in contract or tort, or from |
10140 | noncompliance with the terms of a settlement agreement arising |
10141 | from a claim of medical malpractice either in contract or tort, |
10142 | the financial institution holding the escrow account or the |
10143 | letter of credit shall pay directly to the claimant the entire |
10144 | amount of the judgment together with all accrued interest or the |
10145 | amount maintained in the escrow account or letter of credit as |
10146 | required by this section, whichever is less, within 60 days |
10147 | after the date such judgment became final and subject to |
10148 | execution, unless otherwise mutually agreed to in writing by the |
10149 | parties. If timely payment is not made, the agency shall suspend |
10150 | the registration of the pool pursuant to procedures set forth by |
10151 | the agency through rule. Nothing in this paragraph shall |
10152 | abrogate a judgment debtor's obligation to satisfy the entire |
10153 | amount of any judgment. |
10154 | (e) Each health care services pool carrying claims-made |
10155 | coverage must demonstrate proof of extended reporting coverage |
10156 | through either tail or nose coverage, in the event the policy is |
10157 | canceled, replaced, or not renewed. Such extended coverage shall |
10158 | provide coverage for incidents that occurred during the claims- |
10159 | made policy period but were reported after the policy period. |
10160 | (f) The financial responsibility requirements of this |
10161 | section shall apply to claims for incidents that occur on or |
10162 | after January 1, 1991, or the initial date of registration in |
10163 | this state, whichever is later. |
10164 | (g) Meeting the financial responsibility requirements of |
10165 | this section must be established at the time of issuance or |
10166 | renewal of a certificate of registration. |
10167 | (10)(13) The agency shall adopt rules to implement this |
10168 | section and part II of chapter 408, including rules providing |
10169 | for the establishment of: |
10170 | (a) Minimum standards for the operation and administration |
10171 | of health care personnel pools, including procedures for |
10172 | recordkeeping and personnel. |
10173 | (b) In accordance with part II of chapter 408, fines for |
10174 | the violation of this part, part II of chapter 408, or |
10175 | applicable rules section in an amount not to exceed $2,500 and |
10176 | suspension or revocation of registration. |
10177 | (c) Disciplinary sanctions for failure to comply with this |
10178 | section or the rules adopted under this section. |
10179 | Section 191. Section 400.991, Florida Statutes, is amended |
10180 | to read: |
10181 | 400.991 License requirements; background screenings; |
10182 | prohibitions.-- |
10183 | (1)(a) The requirements of part II of chapter 408 shall |
10184 | apply to the provision of services that require licensure |
10185 | pursuant to this part and part II of chapter 408 and to entities |
10186 | licensed by or applying for such licensure from the agency |
10187 | pursuant to this part. However, each applicant for licensure and |
10188 | each licensee is exempt from the provisions of s. 408.810(6), |
10189 | (7), and (10). Each clinic, as defined in s. 400.9905, must be |
10190 | licensed and shall at all times maintain a valid license with |
10191 | the agency. Each clinic location shall be licensed separately |
10192 | regardless of whether the clinic is operated under the same |
10193 | business name or management as another clinic. |
10194 | (b) Each mobile clinic must obtain a separate health care |
10195 | clinic license and must provide to the agency, at least |
10196 | quarterly, its projected street location to enable the agency to |
10197 | locate and inspect such clinic. A portable equipment provider |
10198 | must obtain a health care clinic license for a single |
10199 | administrative office and is not required to submit quarterly |
10200 | projected street locations. |
10201 | (2) The initial clinic license application shall be filed |
10202 | with the agency by all clinics, as defined in s. 400.9905, on or |
10203 | before July 1, 2004. A clinic license must be renewed |
10204 | biennially. |
10205 | (3) Applicants that submit an application on or before |
10206 | July 1, 2004, which meets all requirements for initial licensure |
10207 | as specified in this section shall receive a temporary license |
10208 | until the completion of an initial inspection verifying that the |
10209 | applicant meets all requirements in rules authorized in s. |
10210 | 400.9925. However, a clinic engaged in magnetic resonance |
10211 | imaging services may not receive a temporary license unless it |
10212 | presents evidence satisfactory to the agency that such clinic is |
10213 | making a good faith effort and substantial progress in seeking |
10214 | accreditation required under s. 400.9935. |
10215 | (4) Application for an initial clinic license or for |
10216 | renewal of an existing license shall be notarized on forms |
10217 | furnished by the agency and must be accompanied by the |
10218 | appropriate license fee as provided in s. 400.9925. The agency |
10219 | shall take final action on an initial license application within |
10220 | 60 days after receipt of all required documentation. |
10221 | (4)(5) The application shall contain information that |
10222 | includes, but need not be limited to, information pertaining to |
10223 | the name, residence and business address, phone number, social |
10224 | security number, and license number of the medical or clinic |
10225 | director, of the licensed medical providers employed or under |
10226 | contract with the clinic, and of each person who, directly or |
10227 | indirectly, owns or controls 5 percent or more of an interest in |
10228 | the clinic, or general partners in limited liability |
10229 | partnerships. |
10230 | (5)(6) The applicant must file with the application |
10231 | satisfactory proof that the clinic is in compliance with this |
10232 | part and applicable rules, including: |
10233 | (a) A listing of services to be provided either directly |
10234 | by the applicant or through contractual arrangements with |
10235 | existing providers; |
10236 | (b) The number and discipline of each professional staff |
10237 | member to be employed; and |
10238 | (c) Proof of financial ability to operate. An applicant |
10239 | must demonstrate financial ability to operate a clinic by |
10240 | submitting a balance sheet and an income and expense statement |
10241 | for the first year of operation which provide evidence of the |
10242 | applicant's having sufficient assets, credit, and projected |
10243 | revenues to cover liabilities and expenses. The applicant shall |
10244 | have demonstrated financial ability to operate if the |
10245 | applicant's assets, credit, and projected revenues meet or |
10246 | exceed projected liabilities and expenses. All documents |
10247 | required under this subsection must be prepared in accordance |
10248 | with generally accepted accounting principles, may be in a |
10249 | compilation form, and the financial statement must be signed by |
10250 | a certified public accountant. As an alternative to submitting |
10251 | proof of financial ability to operate as required under s. |
10252 | 408.810(8) a balance sheet and an income and expense statement |
10253 | for the first year of operation, the applicant may file a surety |
10254 | bond of at least $500,000 which guarantees that the clinic will |
10255 | act in full conformity with all legal requirements for operating |
10256 | a clinic, payable to the agency. The agency may adopt rules to |
10257 | specify related requirements for such surety bond. |
10258 | (6)(7) Background screening required under s. 408.809 |
10259 | shall apply to licensed health care practitioners at the clinic. |
10260 | Each applicant for licensure shall comply with the following |
10261 | requirements: |
10262 | (a) As used in this subsection, the term "applicant" means |
10263 | individuals owning or controlling, directly or indirectly, 5 |
10264 | percent or more of an interest in a clinic; the medical or |
10265 | clinic director, or a similarly titled person who is responsible |
10266 | for the day-to-day operation of the licensed clinic; the |
10267 | financial officer or similarly titled individual who is |
10268 | responsible for the financial operation of the clinic; and |
10269 | licensed health care practitioners at the clinic. |
10270 | (b) Upon receipt of a completed, signed, and dated |
10271 | application, the agency shall require background screening of |
10272 | the applicant, in accordance with the level 2 standards for |
10273 | screening set forth in chapter 435. Proof of compliance with the |
10274 | level 2 background screening requirements of chapter 435 which |
10275 | has been submitted within the previous 5 years in compliance |
10276 | with any other health care licensure requirements of this state |
10277 | is acceptable in fulfillment of this paragraph. Applicants who |
10278 | own less than 10 percent of a health care clinic are not |
10279 | required to submit fingerprints under this section. |
10280 | (c) Each applicant must submit to the agency, with the |
10281 | application, a description and explanation of any exclusions, |
10282 | permanent suspensions, or terminations of an applicant from the |
10283 | Medicare or Medicaid programs. Proof of compliance with the |
10284 | requirements for disclosure of ownership and control interest |
10285 | under the Medicaid or Medicare programs may be accepted in lieu |
10286 | of this submission. The description and explanation may indicate |
10287 | whether such exclusions, suspensions, or terminations were |
10288 | voluntary or not voluntary on the part of the applicant. |
10289 | (d) A license may not be granted to a clinic if the |
10290 | applicant has been found guilty of, regardless of adjudication, |
10291 | or has entered a plea of nolo contendere or guilty to, any |
10292 | offense prohibited under the level 2 standards for screening set |
10293 | forth in chapter 435, or a violation of insurance fraud under s. |
10294 | 817.234, within the past 5 years. If the applicant has been |
10295 | convicted of an offense prohibited under the level 2 standards |
10296 | or insurance fraud in any jurisdiction, the applicant must show |
10297 | that his or her civil rights have been restored prior to |
10298 | submitting an application. |
10299 | (e) The agency may deny or revoke licensure if the |
10300 | applicant has falsely represented any material fact or omitted |
10301 | any material fact from the application required by this part. |
10302 | (8) Requested information omitted from an application for |
10303 | licensure, license renewal, or transfer of ownership must be |
10304 | filed with the agency within 21 days after receipt of the |
10305 | agency's request for omitted information, or the application |
10306 | shall be deemed incomplete and shall be withdrawn from further |
10307 | consideration. |
10308 | (9) The failure to file a timely renewal application shall |
10309 | result in a late fee charged to the facility in an amount equal |
10310 | to 50 percent of the current license fee. |
10311 | Section 192. Section 400.9915, Florida Statutes, is |
10312 | amended to read: |
10313 | 400.9915 Clinic inspections; Emergency suspension; |
10314 | costs.-- |
10315 | (1) Any authorized officer or employee of the agency shall |
10316 | make inspections of the clinic as part of the initial license |
10317 | application or renewal application. The application for a clinic |
10318 | license issued under this part or for a renewal license |
10319 | constitutes permission for an appropriate agency inspection to |
10320 | verify the information submitted on or in connection with the |
10321 | application or renewal. |
10322 | (2) An authorized officer or employee of the agency may |
10323 | make unannounced inspections of clinics licensed pursuant to |
10324 | this part as are necessary to determine that the clinic is in |
10325 | compliance with this part and with applicable rules. A licensed |
10326 | clinic shall allow full and complete access to the premises and |
10327 | to billing records or information to any representative of the |
10328 | agency who makes an inspection to determine compliance with this |
10329 | part and with applicable rules. |
10330 | (1)(3) Failure by a clinic licensed under this part to |
10331 | allow full and complete access to the premises and to billing |
10332 | records or information to any representative of the agency who |
10333 | makes a request to inspect the clinic to determine compliance |
10334 | with this part or failure by a clinic to employ a qualified |
10335 | medical director or clinic director constitutes a ground for |
10336 | emergency suspension of the license by the agency pursuant to s. |
10337 | 120.60(6) and part II of chapter 408. |
10338 | (2)(4) In addition to any administrative fines imposed, |
10339 | the agency may assess a fee equal to the cost of conducting a |
10340 | complaint investigation. |
10341 | Section 193. Section 400.992, Florida Statutes, is |
10342 | repealed. |
10343 | Section 194. Section 400.9925, Florida Statutes, is |
10344 | amended to read: |
10345 | 400.9925 Rulemaking authority; license fees.-- |
10346 | (1) The agency shall adopt rules necessary to administer |
10347 | the clinic administration, regulation, and licensure program, |
10348 | including rules pursuant to this part and part II of chapter |
10349 | 408, establishing the specific licensure requirements, |
10350 | procedures, forms, and fees. It shall adopt rules establishing a |
10351 | procedure for the biennial renewal of licenses. The agency may |
10352 | issue initial licenses for less than the full 2-year period by |
10353 | charging a prorated licensure fee and specifying a different |
10354 | renewal date than would otherwise be required for biennial |
10355 | licensure. The rules shall specify the expiration dates of |
10356 | licenses, the process of tracking compliance with financial |
10357 | responsibility requirements, and any other conditions of renewal |
10358 | required by law or rule. |
10359 | (2) The agency shall adopt rules specifying limitations on |
10360 | the number of licensed clinics and licensees for which a medical |
10361 | director or a clinic director may assume responsibility for |
10362 | purposes of this part. In determining the quality of supervision |
10363 | a medical director or a clinic director can provide, the agency |
10364 | shall consider the number of clinic employees, the clinic |
10365 | location, and the health care services provided by the clinic. |
10366 | (3) In accordance with s. 408.805, an applicant or a |
10367 | licensee shall pay a fee for each license application submitted |
10368 | under this part, part II of chapter 408, and applicable rules. |
10369 | The amount of the fee shall be established by rule and shall not |
10370 | exceed $2,000 per biennium. License application and renewal fees |
10371 | must be reasonably calculated by the agency to cover its costs |
10372 | in carrying out its responsibilities under this part, including |
10373 | the cost of licensure, inspection, and regulation of clinics, |
10374 | and must be of such amount that the total fees collected do not |
10375 | exceed the cost of administering and enforcing compliance with |
10376 | this part. Clinic licensure fees are nonrefundable and may not |
10377 | exceed $2,000. The agency shall adjust the license fee annually |
10378 | by not more than the change in the Consumer Price Index based on |
10379 | the 12 months immediately preceding the increase. All fees |
10380 | collected under this part must be deposited in the Health Care |
10381 | Trust Fund for the administration of this part. |
10382 | Section 195. Section 400.993, Florida Statutes, is amended |
10383 | to read: |
10384 | 400.993 Unlicensed clinics; reporting penalties; fines; |
10385 | verification of licensure status.-- |
10386 | (1) It is unlawful to own, operate, or maintain a clinic |
10387 | without obtaining a license under this part. |
10388 | (2) Any person who owns, operates, or maintains an |
10389 | unlicensed clinic commits a felony of the third degree, |
10390 | punishable as provided in s. 775.082, s. 775.083, or s. 775.084. |
10391 | Each day of continued operation is a separate offense. |
10392 | (3) Any person found guilty of violating subsection (2) a |
10393 | second or subsequent time commits a felony of the second degree, |
10394 | punishable as provided under s. 775.082, s. 775.083, or s. |
10395 | 775.084. Each day of continued operation is a separate offense. |
10396 | (4) Any person who owns, operates, or maintains an |
10397 | unlicensed clinic due to a change in this part or a modification |
10398 | in agency rules within 6 months after the effective date of such |
10399 | change or modification and who, within 10 working days after |
10400 | receiving notification from the agency, fails to cease operation |
10401 | or apply for a license under this part commits a felony of the |
10402 | third degree, punishable as provided in s. 775.082, s. 775.083, |
10403 | or s. 775.084. Each day of continued operation is a separate |
10404 | offense. |
10405 | (5) Any clinic that fails to cease operation after agency |
10406 | notification may be fined for each day of noncompliance pursuant |
10407 | to this part. |
10408 | (6) When a person has an interest in more than one clinic, |
10409 | and fails to obtain a license for any one of these clinics, the |
10410 | agency may revoke the license, impose a moratorium, or impose a |
10411 | fine pursuant to this part on any or all of the licensed clinics |
10412 | until such time as the unlicensed clinic is licensed or ceases |
10413 | operation. |
10414 | (7) Any person aware of the operation of an unlicensed |
10415 | clinic must report that facility to the agency. |
10416 | (8) In addition to the requirements of part II of chapter |
10417 | 408, any health care provider who is aware of the operation of |
10418 | an unlicensed clinic shall report that facility to the agency. |
10419 | Failure to report a clinic that the provider knows or has |
10420 | reasonable cause to suspect is unlicensed shall be reported to |
10421 | the provider's licensing board. |
10422 | (9) The agency may not issue a license to a clinic that |
10423 | has any unpaid fines assessed under this part. |
10424 | Section 196. Section 400.9935, Florida Statutes, is |
10425 | amended to read: |
10426 | 400.9935 Clinic responsibilities.-- |
10427 | (1) Each clinic shall appoint a medical director or clinic |
10428 | director who shall agree in writing to accept legal |
10429 | responsibility for the following activities on behalf of the |
10430 | clinic. The medical director or the clinic director shall: |
10431 | (a) Have signs identifying the medical director or clinic |
10432 | director posted in a conspicuous location within the clinic |
10433 | readily visible to all patients. |
10434 | (b) Ensure that all practitioners providing health care |
10435 | services or supplies to patients maintain a current active and |
10436 | unencumbered Florida license. |
10437 | (c) Review any patient referral contracts or agreements |
10438 | executed by the clinic. |
10439 | (d) Ensure that all health care practitioners at the |
10440 | clinic have active appropriate certification or licensure for |
10441 | the level of care being provided. |
10442 | (e) Serve as the clinic records owner as defined in s. |
10443 | 456.057. |
10444 | (f) Ensure compliance with the recordkeeping, office |
10445 | surgery, and adverse incident reporting requirements of chapter |
10446 | 456, the respective practice acts, and rules adopted under this |
10447 | part and part II of chapter 408. |
10448 | (g) Conduct systematic reviews of clinic billings to |
10449 | ensure that the billings are not fraudulent or unlawful. Upon |
10450 | discovery of an unlawful charge, the medical director or clinic |
10451 | director shall take immediate corrective action. If the clinic |
10452 | performs only the technical component of magnetic resonance |
10453 | imaging, static radiographs, computed tomography, or positron |
10454 | emission tomography, and provides the professional |
10455 | interpretation of such services, in a fixed facility that is |
10456 | accredited by the Joint Commission on Accreditation of |
10457 | Healthcare Organizations or the Accreditation Association for |
10458 | Ambulatory Health Care, and the American College of Radiology; |
10459 | and if, in the preceding quarter, the percentage of scans |
10460 | performed by that clinic which was billed to all personal injury |
10461 | protection insurance carriers was less than 15 percent, the |
10462 | chief financial officer of the clinic may, in a written |
10463 | acknowledgment provided to the agency, assume the responsibility |
10464 | for the conduct of the systematic reviews of clinic billings to |
10465 | ensure that the billings are not fraudulent or unlawful. |
10466 | (2) Any business that becomes a clinic after commencing |
10467 | operations must, within 5 days after becoming a clinic, file a |
10468 | license application under this part and shall be subject to all |
10469 | provisions of this part applicable to a clinic. |
10470 | (2)(3) Any contract to serve as a medical director or a |
10471 | clinic director entered into or renewed by a physician or a |
10472 | licensed health care practitioner in violation of this part is |
10473 | void as contrary to public policy. This subsection shall apply |
10474 | to contracts entered into or renewed on or after March 1, 2004. |
10475 | (3)(4) All charges or reimbursement claims made by or on |
10476 | behalf of a clinic that is required to be licensed under this |
10477 | part, but that is not so licensed, or that is otherwise |
10478 | operating in violation of this part, are unlawful charges, and |
10479 | therefore are noncompensable and unenforceable. |
10480 | (4)(5) Any person establishing, operating, or managing an |
10481 | unlicensed clinic otherwise required to be licensed under this |
10482 | part, or any person who knowingly files a false or misleading |
10483 | license application or license renewal application, or false or |
10484 | misleading information related to such application or department |
10485 | rule, commits a felony of the third degree, punishable as |
10486 | provided in s. 775.082, s. 775.083, or s. 775.084. |
10487 | (5)(6) Any licensed health care provider who violates this |
10488 | part is subject to discipline in accordance with this chapter |
10489 | and his or her respective practice act. |
10490 | (7) The agency may fine, or suspend or revoke the license |
10491 | of, any clinic licensed under this part for operating in |
10492 | violation of the requirements of this part or the rules adopted |
10493 | by the agency. |
10494 | (8) The agency shall investigate allegations of |
10495 | noncompliance with this part and the rules adopted under this |
10496 | part. |
10497 | (6)(9) Any person or entity providing health care services |
10498 | which is not a clinic, as defined under s. 400.9905, may |
10499 | voluntarily apply for a certificate of exemption from licensure |
10500 | under its exempt status with the agency on a form that sets |
10501 | forth its name or names and addresses, a statement of the |
10502 | reasons why it cannot be defined as a clinic, and other |
10503 | information deemed necessary by the agency. An exemption is not |
10504 | transferable. The agency may charge an applicant for a |
10505 | certificate of exemption in an amount equal to $100 or the |
10506 | actual cost of processing the certificate, whichever is less. |
10507 | (10) The clinic shall display its license in a conspicuous |
10508 | location within the clinic readily visible to all patients. |
10509 | (7)(11)(a) Each clinic engaged in magnetic resonance |
10510 | imaging services must be accredited by the Joint Commission on |
10511 | Accreditation of Healthcare Organizations, the American College |
10512 | of Radiology, or the Accreditation Association for Ambulatory |
10513 | Health Care, within 1 year after licensure. However, a clinic |
10514 | may request a single, 6-month extension if it provides evidence |
10515 | to the agency establishing that, for good cause shown, such |
10516 | clinic can not be accredited within 1 year after licensure, and |
10517 | that such accreditation will be completed within the 6-month |
10518 | extension. After obtaining accreditation as required by this |
10519 | subsection, each such clinic must maintain accreditation as a |
10520 | condition of renewal of its license. |
10521 | (b) The agency may deny the application or revoke the |
10522 | license of any entity formed for the purpose of avoiding |
10523 | compliance with the accreditation provisions of this subsection |
10524 | and whose principals were previously principals of an entity |
10525 | that was unable to meet the accreditation requirements within |
10526 | the specified timeframes. The agency may adopt rules as to the |
10527 | accreditation of magnetic resonance imaging clinics. |
10528 | (8)(12) The agency shall give full faith and credit |
10529 | pertaining to any past variance and waiver granted to a magnetic |
10530 | resonance imaging clinic from rule 64-2002, Florida |
10531 | Administrative Code, by the Department of Health, until |
10532 | September 2004. After that date, such clinic must request a |
10533 | variance and waiver from the agency under s. 120.542. |
10534 | Section 197. Section 400.994, Florida Statutes, is |
10535 | repealed. |
10536 | Section 198. Section 400.9945, Florida Statutes, is |
10537 | repealed. |
10538 | Section 199. Section 400.995, Florida Statutes, is amended |
10539 | to read: |
10540 | 400.995 Agency administrative penalties.-- |
10541 | (1) The agency may deny the application for a license |
10542 | renewal, revoke or suspend the license, and impose |
10543 | administrative fines of up to $5,000 per violation for |
10544 | violations of the requirements of this part or rules of the |
10545 | agency. In determining if a penalty is to be imposed and in |
10546 | fixing the amount of the fine, the agency shall consider the |
10547 | following factors: |
10548 | (a) The gravity of the violation, including the |
10549 | probability that death or serious physical or emotional harm to |
10550 | a patient will result or has resulted, the severity of the |
10551 | action or potential harm, and the extent to which the provisions |
10552 | of the applicable laws or rules were violated. |
10553 | (b) Actions taken by the owner, medical director, or |
10554 | clinic director to correct violations. |
10555 | (c) Any previous violations. |
10556 | (d) The financial benefit to the clinic of committing or |
10557 | continuing the violation. |
10558 | (2) Each day of continuing violation after the date fixed |
10559 | for termination of the violation, as ordered by the agency, |
10560 | constitutes an additional, separate, and distinct violation. |
10561 | (2)(3) Any action taken to correct a violation shall be |
10562 | documented in writing by the owner, medical director, or clinic |
10563 | director of the clinic and verified through followup visits by |
10564 | agency personnel. The agency may impose a fine and, in the case |
10565 | of an owner-operated clinic, revoke and or deny a clinic's |
10566 | license when a clinic medical director or clinic director |
10567 | knowingly misrepresents actions taken to correct a violation. |
10568 | (4) For fines that are upheld following administrative or |
10569 | judicial review, the violator shall pay the fine, plus interest |
10570 | at the rate as specified in s. 55.03, for each day beyond the |
10571 | date set by the agency for payment of the fine. |
10572 | (5) Any unlicensed clinic that continues to operate after |
10573 | agency notification is subject to a $1,000 fine per day. |
10574 | (3)(6) Any licensed clinic whose owner, medical director, |
10575 | or clinic director concurrently operates an unlicensed clinic |
10576 | shall be subject to an administrative fine of $5,000 per day. |
10577 | (7) Any clinic whose owner fails to apply for a change-of- |
10578 | ownership license in accordance with s. 400.992 and operates the |
10579 | clinic under the new ownership is subject to a fine of $5,000. |
10580 | (4)(8) The agency, as an alternative to or in conjunction |
10581 | with an administrative action against a clinic for violations of |
10582 | this part, part II of chapter 408, and adopted rules, shall make |
10583 | a reasonable attempt to discuss each violation and recommended |
10584 | corrective action with the owner, medical director, or clinic |
10585 | director of the clinic, prior to written notification. The |
10586 | agency, instead of fixing a period within which the clinic shall |
10587 | enter into compliance with standards, may request a plan of |
10588 | corrective action from the clinic which demonstrates a good |
10589 | faith effort to remedy each violation by a specific date, |
10590 | subject to the approval of the agency. |
10591 | (9) Administrative fines paid by any clinic under this |
10592 | section shall be deposited into the Health Care Trust Fund. |
10593 | (5)(10) If the agency issues a notice of intent to deny a |
10594 | license application after a temporary license has been issued |
10595 | pursuant to s. 400.991(3), the temporary license shall expire on |
10596 | the date of the notice and may not be extended during any |
10597 | proceeding for administrative or judicial review pursuant to |
10598 | chapter 120. |
10599 | Section 200. Subsection (2) of section 401.265, Florida |
10600 | Statutes, is amended to read: |
10601 | 401.265 Medical directors.-- |
10602 | (2) Each licensee medical director shall establish a |
10603 | quality assurance committee to provide for quality assurance |
10604 | review of all emergency medical technicians and paramedics |
10605 | providing basic life support or advanced life support services |
10606 | for that licensee. The medical director employed by the licensee |
10607 | or with whom the licensee has a contract shall provide medical |
10608 | direction and oversight of the licensee's quality assurance |
10609 | committee operating under his or her supervision. If the medical |
10610 | director has reasonable belief that conduct by an emergency |
10611 | medical technician or paramedic may constitute one or more |
10612 | grounds for discipline as provided by this part, he or she shall |
10613 | document facts and other information related to the alleged |
10614 | violation. The medical director shall report to the department |
10615 | any emergency medical technician or paramedic whom the medical |
10616 | director reasonably believes to have acted in a manner which |
10617 | might constitute grounds for disciplinary action. Such a report |
10618 | of disciplinary concern must include a statement and |
10619 | documentation of the specific acts of the disciplinary concern. |
10620 | Within 7 days after receipt of such a report, the department |
10621 | shall provide the emergency medical technician or paramedic a |
10622 | copy of the report of the disciplinary concern and documentation |
10623 | of the specific acts related to the disciplinary concern. If the |
10624 | department determines that the report is insufficient for |
10625 | disciplinary action against the emergency medical technician or |
10626 | paramedic pursuant to s. 401.411, the report shall be expunged |
10627 | from the record of the emergency medical technician or |
10628 | paramedic. |
10629 | Section 201. Paragraph (b) of subsection (2) of section |
10630 | 402.164, Florida Statutes, is amended to read: |
10631 | 402.164 Legislative intent; definitions.-- |
10632 | (2) As used in ss. 402.164-402.167, the term: |
10633 | (b) "Client" means a client as defined in s. 393.063, s. |
10634 | 394.67, or s. 397.311, or s. 400.960, a forensic client or |
10635 | client as defined in s. 916.106, a child or youth as defined in |
10636 | s. 39.01, a child as defined in s. 827.01, a family as defined |
10637 | in s. 414.0252, a participant as defined in s. 400.551, a |
10638 | resident as defined in s. 400.402 or s. 400.960, a Medicaid |
10639 | recipient or recipient as defined in s. 409.901, a child |
10640 | receiving child care as defined in s. 402.302, a disabled adult |
10641 | as defined in s. 410.032 or s. 410.603, or a victim as defined |
10642 | in s. 39.01 or s. 415.102 as each definition applies within its |
10643 | respective chapter. |
10644 | Section 202. Section 408.831, Florida Statutes, is amended |
10645 | to read: |
10646 | 408.831 Denial, suspension, or revocation of a license, |
10647 | registration, certificate, or application.-- |
10648 | (1) In addition to any other remedies provided by law, the |
10649 | agency may deny each application or suspend or revoke each |
10650 | license, registration, or certificate of entities regulated or |
10651 | licensed by it: |
10652 | (a) If the applicant, the licensee, or a licensee subject |
10653 | to this part that shares a common controlling interest with the |
10654 | applicant registrant, or certificateholder, or, in the case of a |
10655 | corporation, partnership, or other business entity, if any |
10656 | officer, director, agent, or managing employee of that business |
10657 | entity or any affiliated person, partner, or shareholder having |
10658 | an ownership interest equal to 5 percent or greater in that |
10659 | business entity, has failed to pay all outstanding fines, liens, |
10660 | or overpayments assessed by final order of the agency or final |
10661 | order of the Centers for Medicare and Medicaid Services, not |
10662 | subject to further appeal, unless a repayment plan is approved |
10663 | by the agency; or |
10664 | (b) For failure to comply with any repayment plan. |
10665 | (2) In reviewing any application requesting a change of |
10666 | ownership or change of the licensee, registrant, or |
10667 | certificateholder, the transferor shall, prior to agency |
10668 | approval of the change, repay or make arrangements to repay any |
10669 | amounts owed to the agency. Should the transferor fail to repay |
10670 | or make arrangements to repay the amounts owed to the agency, |
10671 | the issuance of a license, registration, or certificate to the |
10672 | transferee shall be delayed until repayment or until |
10673 | arrangements for repayment are made. |
10674 | (3) This section provides standards of enforcement |
10675 | applicable to all entities licensed or regulated by the Agency |
10676 | for Health Care Administration. This section controls over any |
10677 | conflicting provisions of chapters 39, 381, 383, 390, 391, 393, |
10678 | 394, 395, 400, 408, 468, 483, and 641, and 765 or rules adopted |
10679 | pursuant to those chapters. |
10680 | Section 203. Paragraph (g) of subsection (2) of section |
10681 | 409.815, Florida Statutes, is amended to read: |
10682 | 409.815 Health benefits coverage; limitations.-- |
10683 | (2) BENCHMARK BENEFITS.--In order for health benefits |
10684 | coverage to qualify for premium assistance payments for an |
10685 | eligible child under ss. 409.810-409.820, the health benefits |
10686 | coverage, except for coverage under Medicaid and Medikids, must |
10687 | include the following minimum benefits, as medically necessary. |
10688 | (g) Behavioral health services.-- |
10689 | 1. Mental health benefits include: |
10690 | a. Inpatient services, limited to not more than 30 |
10691 | inpatient days per contract year for psychiatric admissions, or |
10692 | residential services in facilities licensed under s. |
10693 | 394.875(6)(8) or s. 395.003 in lieu of inpatient psychiatric |
10694 | admissions; however, a minimum of 10 of the 30 days shall be |
10695 | available only for inpatient psychiatric services when |
10696 | authorized by a physician; and |
10697 | b. Outpatient services, including outpatient visits for |
10698 | psychological or psychiatric evaluation, diagnosis, and |
10699 | treatment by a licensed mental health professional, limited to a |
10700 | maximum of 40 outpatient visits each contract year. |
10701 | 2. Substance abuse services include: |
10702 | a. Inpatient services, limited to not more than 7 |
10703 | inpatient days per contract year for medical detoxification only |
10704 | and 30 days of residential services; and |
10705 | b. Outpatient services, including evaluation, diagnosis, |
10706 | and treatment by a licensed practitioner, limited to a maximum |
10707 | of 40 outpatient visits per contract year. |
10708 | Section 204. Subsection (8) of section 409.905, Florida |
10709 | Statutes, is amended to read: |
10710 | 409.905 Mandatory Medicaid services.--The agency may make |
10711 | payments for the following services, which are required of the |
10712 | state by Title XIX of the Social Security Act, furnished by |
10713 | Medicaid providers to recipients who are determined to be |
10714 | eligible on the dates on which the services were provided. Any |
10715 | service under this section shall be provided only when medically |
10716 | necessary and in accordance with state and federal law. |
10717 | Mandatory services rendered by providers in mobile units to |
10718 | Medicaid recipients may be restricted by the agency. Nothing in |
10719 | this section shall be construed to prevent or limit the agency |
10720 | from adjusting fees, reimbursement rates, lengths of stay, |
10721 | number of visits, number of services, or any other adjustments |
10722 | necessary to comply with the availability of moneys and any |
10723 | limitations or directions provided for in the General |
10724 | Appropriations Act or chapter 216. |
10725 | (8) NURSING FACILITY SERVICES.--The agency shall pay for |
10726 | 24-hour-a-day nursing and rehabilitative services for a |
10727 | recipient in a nursing facility licensed under part II of |
10728 | chapter 400 or in a rural hospital, as defined in s. 395.602, or |
10729 | in a Medicare certified skilled nursing facility operated by a |
10730 | hospital, as defined by s. 395.002(10)(11), that is licensed |
10731 | under part I of chapter 395, and in accordance with provisions |
10732 | set forth in s. 409.908(2)(a), which services are ordered by and |
10733 | provided under the direction of a licensed physician. However, |
10734 | if a nursing facility has been destroyed or otherwise made |
10735 | uninhabitable by natural disaster or other emergency and another |
10736 | nursing facility is not available, the agency must pay for |
10737 | similar services temporarily in a hospital licensed under part I |
10738 | of chapter 395 provided federal funding is approved and |
10739 | available. The agency shall pay only for bed-hold days if the |
10740 | facility has an occupancy rate of 95 percent or greater. The |
10741 | agency is authorized to seek any federal waivers to implement |
10742 | this policy. |
10743 | Section 205. Subsection (7) of section 409.907, Florida |
10744 | Statutes, is amended to read: |
10745 | 409.907 Medicaid provider agreements.--The agency may make |
10746 | payments for medical assistance and related services rendered to |
10747 | Medicaid recipients only to an individual or entity who has a |
10748 | provider agreement in effect with the agency, who is performing |
10749 | services or supplying goods in accordance with federal, state, |
10750 | and local law, and who agrees that no person shall, on the |
10751 | grounds of handicap, race, color, or national origin, or for any |
10752 | other reason, be subjected to discrimination under any program |
10753 | or activity for which the provider receives payment from the |
10754 | agency. |
10755 | (7) The agency may require, as a condition of |
10756 | participating in the Medicaid program and before entering into |
10757 | the provider agreement, that the provider submit information, in |
10758 | an initial and any required renewal applications, concerning the |
10759 | professional, business, and personal background of the provider |
10760 | and permit an onsite inspection of the provider's service |
10761 | location by agency staff or other personnel designated by the |
10762 | agency to perform this function. The agency shall perform a |
10763 | random onsite inspection, within 60 days after receipt of a |
10764 | fully complete new provider's application, of the provider's |
10765 | service location prior to making its first payment to the |
10766 | provider for Medicaid services to determine the applicant's |
10767 | ability to provide the services that the applicant is proposing |
10768 | to provide for Medicaid reimbursement. The agency is not |
10769 | required to perform an onsite inspection of a provider or |
10770 | program that is licensed by the agency, that provides services |
10771 | under waiver programs for home and community-based services, or |
10772 | that is licensed as a medical foster home by the Department of |
10773 | Children and Family Services. As a continuing condition of |
10774 | participation in the Medicaid program, a provider shall |
10775 | immediately notify the agency of any current or pending |
10776 | bankruptcy filing. Before entering into the provider agreement, |
10777 | or as a condition of continuing participation in the Medicaid |
10778 | program, the agency may also require that Medicaid providers |
10779 | reimbursed on a fee-for-services basis or fee schedule basis |
10780 | which is not cost-based, post a surety bond not to exceed |
10781 | $50,000 or the total amount billed by the provider to the |
10782 | program during the current or most recent calendar year, |
10783 | whichever is greater. For new providers, the amount of the |
10784 | surety bond shall be determined by the agency based on the |
10785 | provider's estimate of its first year's billing. If the |
10786 | provider's billing during the first year exceeds the bond |
10787 | amount, the agency may require the provider to acquire an |
10788 | additional bond equal to the actual billing level of the |
10789 | provider. A provider's bond shall not exceed $50,000 if a |
10790 | physician or group of physicians licensed under chapter 458, |
10791 | chapter 459, or chapter 460 has a 50 percent or greater |
10792 | ownership interest in the provider or if the provider is an |
10793 | assisted living facility licensed under part III of chapter 400. |
10794 | The bonds permitted by this section are in addition to the bonds |
10795 | referenced in s. 400.179(2)(4)(d). If the provider is a |
10796 | corporation, partnership, association, or other entity, the |
10797 | agency may require the provider to submit information concerning |
10798 | the background of that entity and of any principal of the |
10799 | entity, including any partner or shareholder having an ownership |
10800 | interest in the entity equal to 5 percent or greater, and any |
10801 | treating provider who participates in or intends to participate |
10802 | in Medicaid through the entity. The information must include: |
10803 | (a) Proof of holding a valid license or operating |
10804 | certificate, as applicable, if required by the state or local |
10805 | jurisdiction in which the provider is located or if required by |
10806 | the Federal Government. |
10807 | (b) Information concerning any prior violation, fine, |
10808 | suspension, termination, or other administrative action taken |
10809 | under the Medicaid laws, rules, or regulations of this state or |
10810 | of any other state or the Federal Government; any prior |
10811 | violation of the laws, rules, or regulations relating to the |
10812 | Medicare program; any prior violation of the rules or |
10813 | regulations of any other public or private insurer; and any |
10814 | prior violation of the laws, rules, or regulations of any |
10815 | regulatory body of this or any other state. |
10816 | (c) Full and accurate disclosure of any financial or |
10817 | ownership interest that the provider, or any principal, partner, |
10818 | or major shareholder thereof, may hold in any other Medicaid |
10819 | provider or health care related entity or any other entity that |
10820 | is licensed by the state to provide health or residential care |
10821 | and treatment to persons. |
10822 | (d) If a group provider, identification of all members of |
10823 | the group and attestation that all members of the group are |
10824 | enrolled in or have applied to enroll in the Medicaid program. |
10825 | Section 206. Subsections (9) and (10) of section 440.102, |
10826 | Florida Statutes, are amended to read: |
10827 | 440.102 Drug-free workplace program requirements.--The |
10828 | following provisions apply to a drug-free workplace program |
10829 | implemented pursuant to law or to rules adopted by the Agency |
10830 | for Health Care Administration: |
10831 | (9) DRUG-TESTING STANDARDS FOR LABORATORIES.-- |
10832 | (a) The requirements of part II of chapter 408 shall apply |
10833 | to the provision of services that require licensure pursuant to |
10834 | this section and part II of chapter 408 and to entities licensed |
10835 | by or applying for such licensure from the agency pursuant to |
10836 | this section. |
10837 | (b)(a) A laboratory may analyze initial or confirmation |
10838 | test specimens only if: |
10839 | 1. The laboratory obtains a license under part II of |
10840 | chapter 408 and s. 112.0455(17). Each applicant for licensure |
10841 | and each licensee must comply with all requirements of this |
10842 | section, part II of chapter 408, and applicable rules, except s. |
10843 | 408.810(5)-(10). is licensed and approved by the Agency for |
10844 | Health Care Administration using criteria established by the |
10845 | United States Department of Health and Human Services as general |
10846 | guidelines for modeling the state drug-testing program pursuant |
10847 | to this section or the laboratory is certified by the United |
10848 | States Department of Health and Human Services. |
10849 | 2. The laboratory has written procedures to ensure the |
10850 | chain of custody. |
10851 | 3. The laboratory follows proper quality control |
10852 | procedures, including, but not limited to: |
10853 | a. The use of internal quality controls, including the use |
10854 | of samples of known concentrations which are used to check the |
10855 | performance and calibration of testing equipment, and periodic |
10856 | use of blind samples for overall accuracy. |
10857 | b. An internal review and certification process for drug |
10858 | test results, conducted by a person qualified to perform that |
10859 | function in the testing laboratory. |
10860 | c. Security measures implemented by the testing laboratory |
10861 | to preclude adulteration of specimens and drug test results. |
10862 | d. Other necessary and proper actions taken to ensure |
10863 | reliable and accurate drug test results. |
10864 | (c)(b) A laboratory shall disclose to the medical review |
10865 | officer a written positive confirmed test result report within 7 |
10866 | working days after receipt of the sample. All laboratory reports |
10867 | of a drug test result must, at a minimum, state: |
10868 | 1. The name and address of the laboratory that performed |
10869 | the test and the positive identification of the person tested. |
10870 | 2. Positive results on confirmation tests only, or |
10871 | negative results, as applicable. |
10872 | 3. A list of the drugs for which the drug analyses were |
10873 | conducted. |
10874 | 4. The type of tests conducted for both initial tests and |
10875 | confirmation tests and the minimum cutoff levels of the tests. |
10876 | 5. Any correlation between medication reported by the |
10877 | employee or job applicant pursuant to subparagraph (5)(b)2. and |
10878 | a positive confirmed drug test result. |
10879 |
|
10880 | A report must not disclose the presence or absence of any drug |
10881 | other than a specific drug and its metabolites listed pursuant |
10882 | to this section. |
10883 | (d)(c) The laboratory shall submit to the Agency for |
10884 | Health Care Administration a monthly report with statistical |
10885 | information regarding the testing of employees and job |
10886 | applicants. The report must include information on the methods |
10887 | of analysis conducted, the drugs tested for, the number of |
10888 | positive and negative results for both initial tests and |
10889 | confirmation tests, and any other information deemed appropriate |
10890 | by the Agency for Health Care Administration. A monthly report |
10891 | must not identify specific employees or job applicants. |
10892 | (10) RULES.--The Agency for Health Care Administration |
10893 | shall adopt rules pursuant to s. 112.0455, part II of chapter |
10894 | 408, and criteria established by the United States Department of |
10895 | Health and Human Services as general guidelines for modeling |
10896 | drug-free workplace laboratories the state drug-testing program, |
10897 | concerning, but not limited to: |
10898 | (a) Standards for licensing drug-testing laboratories and |
10899 | suspension and revocation of such licenses. |
10900 | (b) Urine, hair, blood, and other body specimens and |
10901 | minimum specimen amounts that are appropriate for drug testing. |
10902 | (c) Methods of analysis and procedures to ensure reliable |
10903 | drug-testing results, including standards for initial tests and |
10904 | confirmation tests. |
10905 | (d) Minimum cutoff detection levels for each drug or |
10906 | metabolites of such drug for the purposes of determining a |
10907 | positive test result. |
10908 | (e) Chain-of-custody procedures to ensure proper |
10909 | identification, labeling, and handling of specimens tested. |
10910 | (f) Retention, storage, and transportation procedures to |
10911 | ensure reliable results on confirmation tests and retests. |
10912 | Section 207. Subsections (5), (6), and (7) of section |
10913 | 464.015, Florida Statutes, are renumbered as subsections (6), |
10914 | (7), and (8), respectively, present subsection (6) is amended, |
10915 | and a new subsection (5) is added to said section, to read: |
10916 | 464.015 Titles and abbreviations; restrictions; penalty.-- |
10917 | (5) Only persons who hold valid certificates to practice |
10918 | as certified registered nurse anesthetists in this state shall |
10919 | have the right to use the title "Certified Registered Nurse |
10920 | Anesthetist," the term "anesthetist," and the abbreviation |
10921 | "C.R.N.A." |
10922 | (7)(6) No person shall practice or advertise as, or assume |
10923 | the title of, "Registered nurse," "Licensed Practical Nurse," |
10924 | "Certified Registered Nurse Anesthetist," "anesthetist," or |
10925 | "Advanced Registered Nurse Practitioner" or use the abbreviation |
10926 | "R.N.," "L.P.N.," "C.R.N.A.," or "A.R.N.P." or take any other |
10927 | action that would lead the public to believe that person was |
10928 | certified as such or is performing nursing services pursuant to |
10929 | the exception set forth in s. 464.022(8), unless that person is |
10930 | licensed or certified to practice as such. |
10931 | Section 208. Paragraph (a) of subsection (2) of section |
10932 | 464.016, Florida Statutes, is amended to read: |
10933 | 464.016 Violations and penalties.-- |
10934 | (2) Each of the following acts constitutes a misdemeanor |
10935 | of the first degree, punishable as provided in s. 775.082 or s. |
10936 | 775.083: |
10937 | (a) Using the name or title "Nurse," "Registered Nurse," |
10938 | "Licensed Practical Nurse," "Certified Registered Nurse |
10939 | Anesthetist," "Advanced Registered Nurse Practitioner," or any |
10940 | other name or title which implies that a person was licensed or |
10941 | certified as same, unless such person is duly licensed or |
10942 | certified. |
10943 | Section 209. Paragraph (l) of subsection (1) of section |
10944 | 468.505, Florida Statutes, is amended to read: |
10945 | 468.505 Exemptions; exceptions.-- |
10946 | (1) Nothing in this part may be construed as prohibiting |
10947 | or restricting the practice, services, or activities of: |
10948 | (l) A person employed by a nursing facility exempt from |
10949 | licensing under s. 395.002(12)(13), or a person exempt from |
10950 | licensing under s. 464.022. |
10951 | Section 210. Subsection (3) is added to section 483.035, |
10952 | Florida Statutes, to read: |
10953 | 483.035 Clinical laboratories operated by practitioners |
10954 | for exclusive use; licensure and regulation.-- |
10955 | (3) The requirements of part II of chapter 408 shall apply |
10956 | to the provision of services that require licensure pursuant to |
10957 | this part and part II of chapter 408 and to entities licensed by |
10958 | or applying for such licensure from the agency pursuant to this |
10959 | part. However, each applicant for licensure and each licensee is |
10960 | exempt from s. 408.810(5)-(10). |
10961 | Section 211. Subsection (1) of section 483.051, Florida |
10962 | Statutes, is amended to read: |
10963 | 483.051 Powers and duties of the agency.--The agency shall |
10964 | adopt rules to implement this part, which rules must include, |
10965 | but are not limited to, the following: |
10966 | (1) LICENSING; QUALIFICATIONS.--The agency shall provide |
10967 | for biennial licensure of all clinical laboratories meeting the |
10968 | requirements of this part and shall prescribe the qualifications |
10969 | necessary for such licensure. A license issued for operating a |
10970 | clinical laboratory, unless sooner suspended or revoked, expires |
10971 | on the date set forth by the agency on the face of the license. |
10972 | Section 212. Section 483.061, Florida Statutes, is amended |
10973 | to read: |
10974 | 483.061 Inspection of clinical laboratories.-- |
10975 | (1) The agency shall ensure that each clinical laboratory |
10976 | subject to this part is inspected either onsite or offsite when |
10977 | deemed necessary by the agency, but at least every 2 years, for |
10978 | the purpose of evaluating the operation, supervision, and |
10979 | procedures of the facility to ensure compliance with this part. |
10980 | Collection stations and branch offices may be inspected either |
10981 | onsite or offsite, when deemed necessary by the agency. The |
10982 | agency may conduct or cause to be conducted the following |
10983 | announced or unannounced inspections at any reasonable time: |
10984 | (a) An inspection conducted at the direction of the |
10985 | federal Health Care Financing Administration. |
10986 | (b) A licensure inspection. |
10987 | (c) A validation inspection. |
10988 | (d) a complaint investigation, including a full licensure |
10989 | investigation with a review of all licensure standards as |
10990 | outlined in rule. Complaints received by the agency from |
10991 | individuals, organizations, or other sources are subject to |
10992 | review and investigation by the agency. If a complaint has been |
10993 | filed against a laboratory or if a laboratory has a substantial |
10994 | licensure deficiency, the agency may inspect the laboratory |
10995 | annually or as the agency considers necessary. |
10996 | (2) However, For laboratories operated under s. 483.035, |
10997 | biennial licensure inspections shall be scheduled so as to cause |
10998 | the least disruption to the practitioner's scheduled patients. |
10999 | (2) The right of entry and inspection is extended to any |
11000 | premises that is maintained as a laboratory without a license, |
11001 | but such entry or inspection may not be made without the |
11002 | permission of the owner or person in charge of the laboratory, |
11003 | unless an inspection warrant as defined in s. 933.20 is first |
11004 | obtained. |
11005 | (3) The agency may shall inspect an out-of-state clinical |
11006 | laboratory under this section at the expense of the out-of-state |
11007 | clinical laboratory to determine whether the laboratory meets |
11008 | the requirements of this part and part II of chapter 408. |
11009 | (4) The agency shall accept, in lieu of its own periodic |
11010 | inspections for licensure, the survey of or inspection by |
11011 | private accrediting organizations that perform inspections of |
11012 | clinical laboratories accredited by such organizations, |
11013 | including postinspection activities required by the agency. |
11014 | (a) The agency shall accept inspections performed by such |
11015 | organizations if the accreditation is not provisional, if such |
11016 | organizations perform postinspection activities required by the |
11017 | agency and provide the agency with all necessary inspection and |
11018 | postinspection reports and information necessary for |
11019 | enforcement, if such organizations apply standards equal to or |
11020 | exceeding standards established and approved by the agency, and |
11021 | if such accrediting organizations are approved by the federal |
11022 | Health Care Financing Administration to perform such |
11023 | inspections. |
11024 | (b) The agency may conduct complaint investigations made |
11025 | against laboratories inspected by accrediting organizations. |
11026 | (c) The agency may conduct sample validation inspections |
11027 | of laboratories inspected by accrediting organizations to |
11028 | evaluate the accreditation process used by an accrediting |
11029 | organization. |
11030 | (d) The agency may conduct a full inspection if an |
11031 | accrediting survey has not been conducted within the previous 24 |
11032 | months, and the laboratory must pay the appropriate inspection |
11033 | fee under s. 483.172. |
11034 | (e) The agency shall develop, and adopt, by rule, criteria |
11035 | for accepting inspection and postinspection reports of |
11036 | accrediting organizations in lieu of conducting a state |
11037 | licensure inspection. |
11038 | Section 213. Section 483.091, Florida Statutes, is amended |
11039 | to read: |
11040 | 483.091 Clinical laboratory license.--A person may not |
11041 | conduct, maintain, or operate a clinical laboratory in this |
11042 | state, except a laboratory that is exempt under s. 483.031, |
11043 | unless the clinical laboratory has obtained a license from the |
11044 | agency. A clinical laboratory may not send a specimen drawn |
11045 | within this state to any clinical laboratory outside the state |
11046 | for examination unless the out-of-state laboratory has obtained |
11047 | a license from the agency. A license is valid only for the |
11048 | person or persons to whom it is issued and may not be sold, |
11049 | assigned, or transferred, voluntarily or involuntarily, and is |
11050 | not valid for any premises other than those for which the |
11051 | license is issued. However, A new license may be secured for the |
11052 | new location before the actual change, if the contemplated |
11053 | change complies with this part, part II of chapter 408, and the |
11054 | applicable rules adopted under this part. Application for a new |
11055 | clinical laboratory license must be made 60 days before a change |
11056 | in the ownership of the clinical laboratory. |
11057 | Section 214. Section 483.101, Florida Statutes, is amended |
11058 | to read: |
11059 | 483.101 Application for Clinical laboratory license.-- |
11060 | (1) An application for a clinical laboratory license must |
11061 | be made under oath by the owner or director of the clinical |
11062 | laboratory or by the public official responsible for operating a |
11063 | state, municipal, or county clinical laboratory or institution |
11064 | that contains a clinical laboratory, upon forms provided by the |
11065 | agency. |
11066 | (2) Each applicant for licensure must comply with the |
11067 | following requirements: |
11068 | (a) Upon receipt of a completed, signed, and dated |
11069 | application, the agency shall require background screening, in |
11070 | accordance with the level 2 standards for screening set forth in |
11071 | chapter 435, of the managing director or other similarly titled |
11072 | individual who is responsible for the daily operation of the |
11073 | laboratory and of the financial officer, or other similarly |
11074 | titled individual who is responsible for the financial operation |
11075 | of the laboratory, including billings for patient services. The |
11076 | applicant must comply with the procedures for level 2 background |
11077 | screening as set forth in chapter 435, as well as the |
11078 | requirements of s. 435.03(3). |
11079 | (b) The agency may require background screening of any |
11080 | other individual who is an applicant if the agency has probable |
11081 | cause to believe that he or she has been convicted of a crime or |
11082 | has committed any other offense prohibited under the level 2 |
11083 | standards for screening set forth in chapter 435. |
11084 | (c) Proof of compliance with the level 2 background |
11085 | screening requirements of chapter 435 which has been submitted |
11086 | within the previous 5 years in compliance with any other health |
11087 | care licensure requirements of this state is acceptable in |
11088 | fulfillment of the requirements of paragraph (a). |
11089 | (d) A provisional license may be granted to an applicant |
11090 | when each individual required by this section to undergo |
11091 | background screening has met the standards for the Department of |
11092 | Law Enforcement background check but the agency has not yet |
11093 | received background screening results from the Federal Bureau of |
11094 | Investigation, or a request for a disqualification exemption has |
11095 | been submitted to the agency as set forth in chapter 435 but a |
11096 | response has not yet been issued. A license may be granted to |
11097 | the applicant upon the agency's receipt of a report of the |
11098 | results of the Federal Bureau of Investigation background |
11099 | screening for each individual required by this section to |
11100 | undergo background screening which confirms that all standards |
11101 | have been met, or upon the granting of a disqualification |
11102 | exemption by the agency as set forth in chapter 435. Any other |
11103 | person who is required to undergo level 2 background screening |
11104 | may serve in his or her capacity pending the agency's receipt of |
11105 | the report from the Federal Bureau of Investigation. However, |
11106 | the person may not continue to serve if the report indicates any |
11107 | violation of background screening standards and a |
11108 | disqualification exemption has not been requested of and granted |
11109 | by the agency as set forth in chapter 435. |
11110 | (e) Each applicant must submit to the agency, with its |
11111 | application, a description and explanation of any exclusions, |
11112 | permanent suspensions, or terminations of the applicant from the |
11113 | Medicare or Medicaid programs. Proof of compliance with the |
11114 | requirements for disclosure of ownership and control interests |
11115 | under the Medicaid or Medicare programs may be accepted in lieu |
11116 | of this submission. |
11117 | (f) Each applicant must submit to the agency a description |
11118 | and explanation of any conviction of an offense prohibited under |
11119 | the level 2 standards of chapter 435 by a member of the board of |
11120 | directors of the applicant, its officers, or any individual |
11121 | owning 5 percent or more of the applicant. This requirement does |
11122 | not apply to a director of a not-for-profit corporation or |
11123 | organization if the director serves solely in a voluntary |
11124 | capacity for the corporation or organization, does not regularly |
11125 | take part in the day-to-day operational decisions of the |
11126 | corporation or organization, receives no remuneration for his or |
11127 | her services on the corporation or organization's board of |
11128 | directors, and has no financial interest and has no family |
11129 | members with a financial interest in the corporation or |
11130 | organization, provided that the director and the not-for-profit |
11131 | corporation or organization include in the application a |
11132 | statement affirming that the director's relationship to the |
11133 | corporation satisfies the requirements of this paragraph. |
11134 | (g) A license may not be granted to an applicant if the |
11135 | applicant or managing employee has been found guilty of, |
11136 | regardless of adjudication, or has entered a plea of nolo |
11137 | contendere or guilty to, any offense prohibited under the level |
11138 | 2 standards for screening set forth in chapter 435, unless an |
11139 | exemption from disqualification has been granted by the agency |
11140 | as set forth in chapter 435. |
11141 | (h) The agency may deny or revoke licensure if the |
11142 | applicant: |
11143 | 1. Has falsely represented a material fact in the |
11144 | application required by paragraph (e) or paragraph (f), or has |
11145 | omitted any material fact from the application required by |
11146 | paragraph (e) or paragraph (f); or |
11147 | 2. Has had prior action taken against the applicant under |
11148 | the Medicaid or Medicare program as set forth in paragraph (e). |
11149 | (i) An application for license renewal must contain the |
11150 | information required under paragraphs (e) and (f). |
11151 | (3) A license must be issued authorizing the performance |
11152 | of one or more clinical laboratory procedures or one or more |
11153 | tests on each specialty or subspecialty. A separate license is |
11154 | required of all laboratories maintained on separate premises |
11155 | even if the laboratories are operated under the same management. |
11156 | Upon receipt of a request for an application for a clinical |
11157 | laboratory license, the agency shall provide to the applicant a |
11158 | copy of the rules relating to licensure and operations |
11159 | applicable to the laboratory for which licensure is sought. |
11160 | Section 215. Section 483.106, Florida Statutes, is amended |
11161 | to read: |
11162 | 483.106 Application for a certificate of exemption.--An |
11163 | application for a certificate of exemption must be made under |
11164 | oath by the owner or director of a clinical laboratory that |
11165 | performs only waived tests as defined in s. 483.041. A |
11166 | certificate of exemption authorizes a clinical laboratory to |
11167 | perform waived tests. Laboratories maintained on separate |
11168 | premises and operated under the same management may apply for a |
11169 | single certificate of exemption or multiple certificates of |
11170 | exemption. The agency shall, by rule, specify the process for |
11171 | biennially issuing certificates of exemption. Sections 483.011, |
11172 | 483.021, 483.031, 483.041, 483.172, and 483.23, and 483.25 apply |
11173 | to a clinical laboratory that obtains a certificate of exemption |
11174 | under this section. |
11175 | Section 216. Section 483.111, Florida Statutes, is amended |
11176 | to read: |
11177 | 483.111 Limitations on licensure.--A license may be issued |
11178 | to a clinical laboratory to perform only those clinical |
11179 | laboratory procedures and tests that are within the specialties |
11180 | or subspecialties in which the clinical laboratory personnel are |
11181 | qualified. A license may not be issued unless the agency |
11182 | determines that the clinical laboratory is adequately staffed |
11183 | and equipped to operate in conformity with the requirements of |
11184 | this part, part II of chapter 408, and applicable the rules |
11185 | adopted under this part. |
11186 | Section 217. Section 483.131, Florida Statutes, is |
11187 | repealed. |
11188 | Section 218. Subsections (1) and (2) of section 483.172, |
11189 | Florida Statutes, are amended to read: |
11190 | 483.172 License fees.-- |
11191 | (1) In accordance with s. 408.805, an applicant or a |
11192 | licensee shall pay a fee for each license application submitted |
11193 | under this part, part II of chapter 408, and applicable rules. |
11194 | The agency shall collect fees for all licenses issued under this |
11195 | part. Each fee is due at the time of application and must be |
11196 | payable to the agency to be deposited in the Health Care Trust |
11197 | Fund administered by the agency. |
11198 | (2) The biennial license fee schedule is as follows, |
11199 | unless modified by rule: |
11200 | (a) If a laboratory performs not more than 2,000 tests |
11201 | annually, the fee is $400. |
11202 | (b) If a laboratory performs not more than 3 categories of |
11203 | procedures with a total annual volume of more than 2,000 but no |
11204 | more than 10,000 tests, the license fee is $965. |
11205 | (c) If a laboratory performs at least 4 categories of |
11206 | procedures with a total annual volume of not more than 10,000 |
11207 | tests, the license fee is $1,294. |
11208 | (d) If a laboratory performs not more than 3 categories of |
11209 | procedures with a total annual volume of more than 10,000 but |
11210 | not more than 25,000 tests, the license fee is $1,592. |
11211 | (e) If a laboratory performs at least 4 categories of |
11212 | procedures with a total annual volume of more than 10,000 but |
11213 | not more than 25,000 tests, the license fee is $2,103. |
11214 | (f) If a laboratory performs a total of more than 25,000 |
11215 | but not more than 50,000 tests annually, the license fee is |
11216 | $2,364. |
11217 | (g) If a laboratory performs a total of more than 50,000 |
11218 | but not more than 75,000 tests annually, the license fee is |
11219 | $2,625. |
11220 | (h) If a laboratory performs a total of more than 75,000 |
11221 | but not more than 100,000 tests annually, the license fee is |
11222 | $2,886. |
11223 | (i) If a laboratory performs a total of more than 100,000 |
11224 | but not more than 500,000 tests annually, the license fee is |
11225 | $3,397. |
11226 | (j) If a laboratory performs a total of more than 500,000 |
11227 | but not more than 1 million tests annually, the license fee is |
11228 | $3,658. |
11229 | (k) If a laboratory performs a total of more than 1 |
11230 | million tests annually, the license fee is $3,919. |
11231 | Section 219. Section 483.201, Florida Statutes, is amended |
11232 | to read: |
11233 | 483.201 Grounds for disciplinary action against clinical |
11234 | laboratories.--In addition to the requirements of part II of |
11235 | chapter 408, the following acts constitute grounds for which a |
11236 | disciplinary action specified in s. 483.221 may be taken against |
11237 | a clinical laboratory: |
11238 | (1) Making a fraudulent statement on an application for a |
11239 | clinical laboratory license or any other document required by |
11240 | the agency. |
11241 | (1)(2) Permitting unauthorized persons to perform |
11242 | technical procedures or to issue reports. |
11243 | (2)(3) Demonstrating incompetence or making consistent |
11244 | errors in the performance of clinical laboratory examinations |
11245 | and procedures or erroneous reporting. |
11246 | (3)(4) Performing a test and rendering a report thereon to |
11247 | a person not authorized by law to receive such services. |
11248 | (4)(5) Knowingly having professional connection with or |
11249 | knowingly lending the use of the name of the licensed clinical |
11250 | laboratory or its director to an unlicensed clinical laboratory. |
11251 | (5)(6) Violating or aiding and abetting in the violation |
11252 | of any provision of this part or the rules adopted under this |
11253 | part. |
11254 | (6)(7) Failing to file any report required by the |
11255 | provisions of this part or the rules adopted under this part. |
11256 | (7)(8) Reporting a test result for a clinical specimen if |
11257 | the test was not performed on the clinical specimen. |
11258 | (8)(9) Performing and reporting tests in a specialty or |
11259 | subspecialty in which the laboratory is not licensed. |
11260 | (9)(10) Knowingly advertising false services or |
11261 | credentials. |
11262 | (10)(11) Failing to correct deficiencies within the time |
11263 | required by the agency. |
11264 | Section 220. Section 483.221, Florida Statutes, is amended |
11265 | to read: |
11266 | 483.221 Administrative fines penalties.-- |
11267 | (1)(a) In accordance with part II of chapter 408, the |
11268 | agency may deny, suspend, revoke, annul, limit, or deny renewal |
11269 | of a license or impose an administrative fine, not to exceed |
11270 | $1,000 per violation, for the violation of any provision of this |
11271 | part or rules adopted under this part. Each day of violation |
11272 | constitutes a separate violation and is subject to a separate |
11273 | fine. |
11274 | (2)(b) In determining the penalty to be imposed for a |
11275 | violation, as provided in subsection (1) paragraph (a), the |
11276 | following factors must be considered: |
11277 | (a)1. The severity of the violation, including the |
11278 | probability that death or serious harm to the health or safety |
11279 | of any person will result or has resulted; the severity of the |
11280 | actual or potential harm; and the extent to which the provisions |
11281 | of this part were violated. |
11282 | (b)2. Actions taken by the licensee to correct the |
11283 | violation or to remedy complaints. |
11284 | (c)3. Any previous violation by the licensee. |
11285 | (d)4. The financial benefit to the licensee of committing |
11286 | or continuing the violation. |
11287 | (c) All amounts collected under this section must be |
11288 | deposited into the Health Care Trust Fund administered by the |
11289 | agency. |
11290 | (2) The agency may issue an emergency order immediately |
11291 | suspending, revoking, annulling, or limiting a license if it |
11292 | determines that any condition in the licensed facility presents |
11293 | a clear and present danger to public health or safety. |
11294 | Section 221. Section 483.23, Florida Statutes, is amended |
11295 | to read: |
11296 | 483.23 Offenses; criminal penalties.-- |
11297 | (1)(a) It is unlawful for any person to: |
11298 | 1. Operate, maintain, direct, or engage in the business of |
11299 | operating a clinical laboratory unless she or he has obtained a |
11300 | clinical laboratory license from the agency or is exempt under |
11301 | s. 483.031. |
11302 | 1.2. Conduct, maintain, or operate a clinical laboratory, |
11303 | other than an exempt laboratory or a laboratory operated under |
11304 | s. 483.035, unless the clinical laboratory is under the direct |
11305 | and responsible supervision and direction of a person licensed |
11306 | under part III of this chapter. |
11307 | 2.3. Allow any person other than an individual licensed |
11308 | under part III of this chapter to perform clinical laboratory |
11309 | procedures, except in the operation of a laboratory exempt under |
11310 | s. 483.031 or a laboratory operated under s. 483.035. |
11311 | 3.4. Violate or aid and abet in the violation of any |
11312 | provision of this part or the rules adopted under this part. |
11313 | (b) The performance of any act specified in paragraph (a) |
11314 | constitutes a misdemeanor of the second degree, punishable as |
11315 | provided in s. 775.082 or s. 775.083. |
11316 | (2) Any use or attempted use of a forged license under |
11317 | this part or part IV III of this chapter constitutes the crime |
11318 | of forgery. |
11319 | Section 222. Section 483.25, Florida Statutes, is |
11320 | repealed. |
11321 | Section 223. Section 483.291, Florida Statutes, is amended |
11322 | to read: |
11323 | 483.291 Powers and duties of the agency; rules.--The |
11324 | agency shall adopt rules to implement this part and part II of |
11325 | chapter 408, which rules must include the following: |
11326 | (1) LICENSING STANDARDS.--The agency shall license all |
11327 | multiphasic health testing centers meeting the requirements of |
11328 | this part and shall prescribe standards necessary for licensure. |
11329 | (2) FEES.-- In accordance with s. 408.805, an applicant or |
11330 | a licensee shall pay a fee for each license application |
11331 | submitted under this part, part II of chapter 408, and |
11332 | applicable rules. The agency shall establish annual fees, which |
11333 | shall be reasonable in amount, for licensing of centers. The |
11334 | fees must be sufficient in amount to cover the cost of licensing |
11335 | and inspecting centers. |
11336 | (a) The annual licensure fee is due at the time of |
11337 | application and is payable to the agency to be deposited in the |
11338 | Health Care Trust Fund administered by the agency. The license |
11339 | fee must be not less than $600 $300 or more than $2,000 per |
11340 | biennium $1,000. |
11341 | (b) The fee for late filing of an application for license |
11342 | renewal is $200 and is in addition to the licensure fee due for |
11343 | renewing the license. |
11344 | (3) ANNUAL LICENSING.--The agency shall provide for annual |
11345 | licensing of centers. Any center that fails to pay the proper |
11346 | fee or otherwise fails to qualify by the date of expiration of |
11347 | its license is delinquent, and its license is automatically |
11348 | canceled without notice or further proceeding. Upon cancellation |
11349 | of its license under this subsection, a center may have its |
11350 | license reinstated only upon application and qualification as |
11351 | provided for initial applicants and upon payment of all |
11352 | delinquent fees. |
11353 | (3)(4) STANDARDS OF PERFORMANCE.--The agency shall |
11354 | prescribe standards for the performance of health testing |
11355 | procedures. |
11356 | (4)(5) CONSTRUCTION OF CENTERS.--The agency may adopt |
11357 | rules to ensure that centers comply with all local, county, |
11358 | state, and federal standards for the construction, renovation, |
11359 | maintenance, or repair of centers, which standards must ensure |
11360 | the conduct and operation of the centers in a manner that will |
11361 | protect the public health. |
11362 | (5)(6) SAFETY AND SANITARY CONDITIONS WITHIN THE CENTER |
11363 | AND ITS SURROUNDINGS.--The agency shall establish standards |
11364 | relating to safety and sanitary conditions within the center and |
11365 | its surroundings, including water supply; sewage; the handling |
11366 | of specimens; identification, segregation, and separation of |
11367 | biohazardous waste as required by s. 381.0098; storage of |
11368 | chemicals; workspace; firesafety; and general measures, which |
11369 | standards must ensure the protection of the public health. The |
11370 | agency shall determine compliance by a multiphasic health |
11371 | testing center with the requirements of s. 381.0098 by verifying |
11372 | that the center has obtained all required permits. |
11373 | (6)(7) EQUIPMENT.--The agency shall establish minimum |
11374 | standards for center equipment essential to the proper conduct |
11375 | and operation of the center. |
11376 | (7)(8) PERSONNEL.--The agency shall prescribe minimum |
11377 | qualifications for center personnel. A center may employ as a |
11378 | medical assistant a person who has at least one of the following |
11379 | qualifications: |
11380 | (a) Prior experience of not less than 6 months as a |
11381 | medical assistant in the office of a licensed medical doctor or |
11382 | osteopathic physician or in a hospital, an ambulatory surgical |
11383 | center, a home health agency, or a health maintenance |
11384 | organization. |
11385 | (b) Certification and registration by the American Medical |
11386 | Technologists Association or other similar professional |
11387 | association approved by the agency. |
11388 | (c) Prior employment as a medical assistant in a licensed |
11389 | center for at least 6 consecutive months at some time during the |
11390 | preceding 2 years. |
11391 | Section 224. Section 483.294, Florida Statutes, is amended |
11392 | to read: |
11393 | 483.294 Inspection of centers.--The agency shall, at least |
11394 | once annually, inspect the premises and operations of all |
11395 | centers subject to licensure under this part, without prior |
11396 | notice to the centers, for the purpose of studying and |
11397 | evaluating the operation, supervision, and procedures of such |
11398 | facilities, to determine their compliance with agency standards |
11399 | and to determine their effect upon the health and safety of the |
11400 | people of this state. |
11401 | Section 225. Section 483.30, Florida Statutes, is amended |
11402 | to read: |
11403 | 483.30 Licensing of centers.--The requirements of part II |
11404 | of chapter 408 shall apply to the provision of services that |
11405 | require licensure pursuant to this part and part II of chapter |
11406 | 408 and to entities licensed by or applying for such licensure |
11407 | from the agency pursuant to this part. However, each applicant |
11408 | for licensure and each licensee is exempt from s. 408.810(5)- |
11409 | (10). |
11410 | (1) A person may not conduct, maintain, or operate a |
11411 | multiphasic health testing center in this state without |
11412 | obtaining a multiphasic health testing center license from the |
11413 | agency. The license is valid only for the person or persons to |
11414 | whom it is issued and may not be sold, assigned, or transferred, |
11415 | voluntarily or involuntarily. A license is not valid for any |
11416 | premises other than the center for which it is issued. However, |
11417 | a new license may be secured for the new location for a fixed |
11418 | center before the actual change, if the contemplated change is |
11419 | in compliance with this part and the rules adopted under this |
11420 | part. A center must be relicensed if a change of ownership |
11421 | occurs. Application for relicensure must be made 60 days before |
11422 | the change of ownership. |
11423 | (2) Each applicant for licensure must comply with the |
11424 | following requirements: |
11425 | (a) Upon receipt of a completed, signed, and dated |
11426 | application, the agency shall require background screening, in |
11427 | accordance with the level 2 standards for screening set forth in |
11428 | chapter 435, of the managing employee, or other similarly titled |
11429 | individual who is responsible for the daily operation of the |
11430 | center, and of the financial officer, or other similarly titled |
11431 | individual who is responsible for the financial operation of the |
11432 | center, including billings for patient services. The applicant |
11433 | must comply with the procedures for level 2 background screening |
11434 | as set forth in chapter 435, as well as the requirements of s. |
11435 | 435.03(3). |
11436 | (b) The agency may require background screening of any |
11437 | other individual who is an applicant if the agency has probable |
11438 | cause to believe that he or she has been convicted of a crime or |
11439 | has committed any other offense prohibited under the level 2 |
11440 | standards for screening set forth in chapter 435. |
11441 | (c) Proof of compliance with the level 2 background |
11442 | screening requirements of chapter 435 which has been submitted |
11443 | within the previous 5 years in compliance with any other health |
11444 | care licensure requirements of this state is acceptable in |
11445 | fulfillment of the requirements of paragraph (a). |
11446 | (d) A provisional license may be granted to an applicant |
11447 | when each individual required by this section to undergo |
11448 | background screening has met the standards for the Department of |
11449 | Law Enforcement background check, but the agency has not yet |
11450 | received background screening results from the Federal Bureau of |
11451 | Investigation, or a request for a disqualification exemption has |
11452 | been submitted to the agency as set forth in chapter 435 but a |
11453 | response has not yet been issued. A license may be granted to |
11454 | the applicant upon the agency's receipt of a report of the |
11455 | results of the Federal Bureau of Investigation background |
11456 | screening for each individual required by this section to |
11457 | undergo background screening which confirms that all standards |
11458 | have been met, or upon the granting of a disqualification |
11459 | exemption by the agency as set forth in chapter 435. Any other |
11460 | person who is required to undergo level 2 background screening |
11461 | may serve in his or her capacity pending the agency's receipt of |
11462 | the report from the Federal Bureau of Investigation. However, |
11463 | the person may not continue to serve if the report indicates any |
11464 | violation of background screening standards and a |
11465 | disqualification exemption has not been requested of and granted |
11466 | by the agency as set forth in chapter 435. |
11467 | (e) Each applicant must submit to the agency, with its |
11468 | application, a description and explanation of any exclusions, |
11469 | permanent suspensions, or terminations of the applicant from the |
11470 | Medicare or Medicaid programs. Proof of compliance with the |
11471 | requirements for disclosure of ownership and control interests |
11472 | under the Medicaid or Medicare programs may be accepted in lieu |
11473 | of this submission. |
11474 | (f) Each applicant must submit to the agency a description |
11475 | and explanation of any conviction of an offense prohibited under |
11476 | the level 2 standards of chapter 435 by a member of the board of |
11477 | directors of the applicant, its officers, or any individual |
11478 | owning 5 percent or more of the applicant. This requirement does |
11479 | not apply to a director of a not-for-profit corporation or |
11480 | organization if the director serves solely in a voluntary |
11481 | capacity for the corporation or organization, does not regularly |
11482 | take part in the day-to-day operational decisions of the |
11483 | corporation or organization, receives no remuneration for his or |
11484 | her services on the corporation or organization's board of |
11485 | directors, and has no financial interest and has no family |
11486 | members with a financial interest in the corporation or |
11487 | organization, provided that the director and the not-for-profit |
11488 | corporation or organization include in the application a |
11489 | statement affirming that the director's relationship to the |
11490 | corporation satisfies the requirements of this paragraph. |
11491 | (g) A license may not be granted to an applicant if the |
11492 | applicant or managing employee has been found guilty of, |
11493 | regardless of adjudication, or has entered a plea of nolo |
11494 | contendere or guilty to, any offense prohibited under the level |
11495 | 2 standards for screening set forth in chapter 435, unless an |
11496 | exemption from disqualification has been granted by the agency |
11497 | as set forth in chapter 435. |
11498 | (h) The agency may deny or revoke licensure if the |
11499 | applicant: |
11500 | 1. Has falsely represented a material fact in the |
11501 | application required by paragraph (e) or paragraph (f), or has |
11502 | omitted any material fact from the application required by |
11503 | paragraph (e) or paragraph (f); or |
11504 | 2. Has had prior action taken against the applicant under |
11505 | the Medicaid or Medicare program as set forth in paragraph (e). |
11506 | (i) An application for license renewal must contain the |
11507 | information required under paragraphs (e) and (f). |
11508 | Section 226. Section 483.302, Florida Statutes, is amended |
11509 | to read: |
11510 | 483.302 Application for license.-- |
11511 | (1) Application for a license as required by s. 483.30 |
11512 | must be made to the agency on forms furnished by it and must be |
11513 | accompanied by the appropriate license fee. |
11514 | (2) The application for a license must shall contain: |
11515 | (1)(a) A determination as to whether the facility will be |
11516 | fixed or mobile and the location for a fixed facility. |
11517 | (b) The name and address of the owner if an individual; if |
11518 | the owner is a firm, partnership, or association, the name and |
11519 | address of every member thereof; if the owner is a corporation, |
11520 | its name and address and the name and address of its medical |
11521 | director and officers and of each person having at least a 10 |
11522 | percent interest in the corporation. |
11523 | (2)(c) The name of any person whose name is required on |
11524 | the application under the provisions of paragraph (b) and who |
11525 | owns at least a 10 percent interest in any professional service, |
11526 | firm, association, partnership, or corporation providing goods, |
11527 | leases, or services to the center for which the application is |
11528 | made, and the name and address of the professional service, |
11529 | firm, association, partnership, or corporation in which such |
11530 | interest is held. |
11531 | (d) The name by which the facility is to be known. |
11532 | (3)(e) The name, address, and Florida physician's license |
11533 | number of the medical director. |
11534 | Section 227. Section 483.311, Florida Statutes, is |
11535 | repealed. |
11536 | Section 228. Subsections (2) through (8) of section |
11537 | 483.317, Florida Statutes, are renumbered as subsections (1) |
11538 | through (7), respectively, and present subsection (1) is amended |
11539 | to read: |
11540 | 483.317 Grounds for disciplinary action against |
11541 | centers.--The following acts constitute grounds for which a |
11542 | disciplinary action specified in s. 483.32 may be taken against |
11543 | a center: |
11544 | (1) Making a fraudulent statement on an application for a |
11545 | license or on any other document required by the agency pursuant |
11546 | to this part. |
11547 | Section 229. Section 483.32, Florida Statutes, is amended |
11548 | to read: |
11549 | 483.32 Administrative fines penalties.-- |
11550 | (1)(a) The agency may deny, suspend, revoke, annul, limit, |
11551 | or deny renewal of a license or impose an administrative fine, |
11552 | not to exceed $500 per violation, for the violation of any |
11553 | provision of this part, part II of chapter 408, or applicable |
11554 | rules adopted under this part. Each day of violation constitutes |
11555 | a separate violation and is subject to a separate fine. |
11556 | (2)(b) In determining the amount of the fine to be levied |
11557 | for a violation, as provided in subsection (1) paragraph (a), |
11558 | the following factors shall be considered: |
11559 | (a)1. The severity of the violation, including the |
11560 | probability that death or serious harm to the health or safety |
11561 | of any person will result or has resulted; the severity of the |
11562 | actual or potential harm; and the extent to which the provisions |
11563 | of this part were violated. |
11564 | (b)2. Actions taken by the licensee to correct the |
11565 | violation or to remedy complaints. |
11566 | (c)3. Any previous violation by the licensee. |
11567 | (d)4. The financial benefit to the licensee of committing |
11568 | or continuing the violation. |
11569 | (c) All amounts collected under this section must be |
11570 | deposited into the Health Care Trust Fund administered by the |
11571 | agency. |
11572 | (2) The agency may issue an emergency order immediately |
11573 | suspending, revoking, annulling, or limiting a license when it |
11574 | determines that any condition in the licensed facility presents |
11575 | a clear and present danger to public health and safety. |
11576 | Section 230. Subsections (2) and (3) of section 483.322, |
11577 | Florida Statutes, are renumbered as subsections (1) and (2), |
11578 | respectively, and present subsection (1) of said section is |
11579 | amended to read: |
11580 | 483.322 Offenses.--It is unlawful for any person to: |
11581 | (1) Operate, maintain, direct, or engage in the business |
11582 | of operating a multiphasic health testing center unless the |
11583 | person has obtained a license for the center. |
11584 | Section 231. Section 483.328, Florida Statutes, is |
11585 | repealed. |
11586 | Section 232. Subsection (2) of section 765.541, Florida |
11587 | Statutes, is amended to read: |
11588 | 765.541 Certification of organizations engaged in the |
11589 | practice of cadaveric organ and tissue procurement.--The Agency |
11590 | for Health Care Administration shall: |
11591 | (2) Adopt rules that set forth appropriate standards and |
11592 | guidelines for the program in accordance with ss. 765.541- |
11593 | 765.546 and part II of chapter 408. These standards and |
11594 | guidelines must be substantially based on the existing laws of |
11595 | the Federal Government and this state and the existing standards |
11596 | and guidelines of the United Network for Organ Sharing (UNOS), |
11597 | the American Association of Tissue Banks (AATB), the South- |
11598 | Eastern Organ Procurement Foundation (SEOPF), the North American |
11599 | Transplant Coordinators Organization (NATCO), and the Eye Bank |
11600 | Association of America (EBAA). In addition, the Agency for |
11601 | Health Care Administration shall, before adopting these |
11602 | standards and guidelines, seek input from all organ procurement |
11603 | organizations, tissue banks, and eye banks based in this state; |
11604 | Section 233. Subsection (1) of section 765.542, Florida |
11605 | Statutes, is amended to read: |
11606 | 765.542 Certification of organ procurement organizations, |
11607 | tissue banks, and eye banks.-- |
11608 | (1) The requirements of part II of chapter 408 shall apply |
11609 | to the provision of services that require licensure pursuant to |
11610 | ss. 765.541-765.546 and part II of chapter 408 and to entities |
11611 | licensed or certified by or applying for such licensure or |
11612 | certification from the Agency for Health Care Administration |
11613 | pursuant to ss. 765.541-765.546. However, each applicant for |
11614 | licensure or certification and each certificateholder is exempt |
11615 | from s. 408.810(5)-(10). An organization, agency, or other |
11616 | entity may not engage in the practice of organ procurement in |
11617 | this state without being designated as an organ procurement |
11618 | organization by the secretary of the United States Department of |
11619 | Health and Human Services and being appropriately certified by |
11620 | the Agency for Health Care Administration. As used in this |
11621 | subsection, the term "procurement" includes the retrieval, |
11622 | processing, or distribution of human organs. A physician or |
11623 | organ procurement organization based outside this state is |
11624 | exempt from these certification requirements if: |
11625 | (a) The organs are procured for an out-of-state patient |
11626 | who is listed on, or referred through, the United Network for |
11627 | Organ Sharing System; and |
11628 | (b) The organs are procured through an agreement of an |
11629 | organ procurement organization certified by the state. |
11630 | Section 234. Section 765.544, Florida Statutes, is amended |
11631 | to read: |
11632 | 765.544 Fees; Florida Organ and Tissue Donor Education and |
11633 | Procurement Trust Fund.-- |
11634 | (1) In accordance with s. 408.805, an applicant or a |
11635 | certificateholder shall pay a fee for each application submitted |
11636 | under this part, part II of chapter 408, and applicable rules. |
11637 | The amount of the fee shall be as follows unless modified by |
11638 | rule: The Agency for Health Care Administration shall collect |
11639 | (a) An initial application fee of $1,000 from organ |
11640 | procurement organizations and tissue banks and $500 from eye |
11641 | banks. The fee must be submitted with each application for |
11642 | initial certification and is nonrefundable. |
11643 | (b)(2) The Agency for Health Care Administration shall |
11644 | assess Annual fees to be used, in the following order of |
11645 | priority, for the certification program, the advisory board, |
11646 | maintenance of the organ and tissue donor registry, and the |
11647 | organ and tissue donor education program in the following |
11648 | amounts, which may not exceed $35,000 per organization: |
11649 | 1.(a) Each general organ procurement organization shall |
11650 | pay the greater of $1,000 or 0.25 percent of its total revenues |
11651 | produced from procurement activity in this state by the |
11652 | certificateholder during its most recently completed fiscal year |
11653 | or operational year. |
11654 | 2.(b) Each bone and tissue procurement agency or bone and |
11655 | tissue bank shall pay the greater of $1,000 or 0.25 percent of |
11656 | its total revenues from procurement and processing activity in |
11657 | this state by the certificateholder during its most recently |
11658 | completed fiscal year or operational year. |
11659 | 3.(c) Each eye bank shall pay the greater of $500 or 0.25 |
11660 | percent of its total revenues produced from procurement activity |
11661 | in this state by the certificateholder during its most recently |
11662 | completed fiscal year or operational year. |
11663 | (2)(3) The Agency for Health Care Administration shall |
11664 | specify provide by rule the for administrative penalties for the |
11665 | purpose of ensuring adherence to the standards of quality and |
11666 | practice required by this chapter, part II of chapter 408, and |
11667 | applicable rules of the agency for continued certification. |
11668 | (3)(4)(a) Proceeds from fees, administrative penalties, |
11669 | and surcharges collected pursuant to this section subsections |
11670 | (2) and (3) must be deposited into the Florida Organ and Tissue |
11671 | Donor Education and Procurement Trust Fund created by s. |
11672 | 765.52155. |
11673 | (b) Moneys deposited in the trust fund pursuant to this |
11674 | section must be used exclusively for the implementation, |
11675 | administration, and operation of the certification program and |
11676 | the advisory board, for maintaining the organ and tissue donor |
11677 | registry, and for organ and tissue donor education. |
11678 | (4)(5) As used in this section, the term "procurement |
11679 | activity in this state" includes the bringing into this state |
11680 | for processing, storage, distribution, or transplantation of |
11681 | organs or tissues that are initially procured in another state |
11682 | or country. |
11683 | Section 235. Subsection (4) of section 766.118, Florida |
11684 | Statutes, is amended to read: |
11685 | 766.118 Determination of noneconomic damages.-- |
11686 | (4) LIMITATION ON NONECONOMIC DAMAGES FOR NEGLIGENCE OF |
11687 | PRACTITIONERS PROVIDING EMERGENCY SERVICES AND |
11688 | CARE.--Notwithstanding subsections (2) and (3), with respect to |
11689 | a cause of action for personal injury or wrongful death arising |
11690 | from medical negligence of practitioners providing emergency |
11691 | services and care, as defined in s. 395.002(9)(10), or providing |
11692 | services as provided in s. 401.265, or providing services |
11693 | pursuant to obligations imposed by 42 U.S.C. s. 1395dd to |
11694 | persons with whom the practitioner does not have a then-existing |
11695 | health care patient-practitioner relationship for that medical |
11696 | condition: |
11697 | (a) Regardless of the number of such practitioner |
11698 | defendants, noneconomic damages shall not exceed $150,000 per |
11699 | claimant. |
11700 | (b) Notwithstanding paragraph (a), the total noneconomic |
11701 | damages recoverable by all claimants from all such practitioners |
11702 | shall not exceed $300,000. |
11703 |
|
11704 | The limitation provided by this subsection applies only to |
11705 | noneconomic damages awarded as a result of any act or omission |
11706 | of providing medical care or treatment, including diagnosis that |
11707 | occurs prior to the time the patient is stabilized and is |
11708 | capable of receiving medical treatment as a nonemergency |
11709 | patient, unless surgery is required as a result of the emergency |
11710 | within a reasonable time after the patient is stabilized, in |
11711 | which case the limitation provided by this subsection applies to |
11712 | any act or omission of providing medical care or treatment which |
11713 | occurs prior to the stabilization of the patient following the |
11714 | surgery. |
11715 | Section 236. Section 766.316, Florida Statutes, is amended |
11716 | to read: |
11717 | 766.316 Notice to obstetrical patients of participation in |
11718 | the plan.--Each hospital with a participating physician on its |
11719 | staff and each participating physician, other than residents, |
11720 | assistant residents, and interns deemed to be participating |
11721 | physicians under s. 766.314(4)(c), under the Florida Birth- |
11722 | Related Neurological Injury Compensation Plan shall provide |
11723 | notice to the obstetrical patients as to the limited no-fault |
11724 | alternative for birth-related neurological injuries. Such notice |
11725 | shall be provided on forms furnished by the association and |
11726 | shall include a clear and concise explanation of a patient's |
11727 | rights and limitations under the plan. The hospital or the |
11728 | participating physician may elect to have the patient sign a |
11729 | form acknowledging receipt of the notice form. Signature of the |
11730 | patient acknowledging receipt of the notice form raises a |
11731 | rebuttable presumption that the notice requirements of this |
11732 | section have been met. Notice need not be given to a patient |
11733 | when the patient has an emergency medical condition as defined |
11734 | in s. 395.002(8)(9)(b) or when notice is not practicable. |
11735 | Section 237. Paragraph (b) of subsection (2) of section |
11736 | 812.014, Florida Statutes, is amended to read: |
11737 | 812.014 Theft.-- |
11738 | (2) |
11739 | (b)1. If the property stolen is valued at $20,000 or more, |
11740 | but less than $100,000; |
11741 | 2. The property stolen is cargo valued at less than |
11742 | $50,000 that has entered the stream of interstate or intrastate |
11743 | commerce from the shipper's loading platform to the consignee's |
11744 | receiving dock; or |
11745 | 3. The property stolen is emergency medical equipment, |
11746 | valued at $300 or more, that is taken from a facility licensed |
11747 | under chapter 395 or from an aircraft or vehicle permitted under |
11748 | chapter 401, |
11749 |
|
11750 | the offender commits grand theft in the second degree, |
11751 | punishable as a felony of the second degree, as provided in s. |
11752 | 775.082, s. 775.083, or s. 775.084. Emergency medical equipment |
11753 | means mechanical or electronic apparatus used to provide |
11754 | emergency services and care as defined in s. 395.002(9)(10) or |
11755 | to treat medical emergencies. |
11756 | Section 238. In case of conflict between the provisions of |
11757 | part II of chapter 408, Florida Statutes, and the authorizing |
11758 | statutes governing the licensure of health care providers by the |
11759 | Agency for Health Care Administration found in chapter 112, |
11760 | chapter 383, chapter 390, chapter 394, chapter 395, chapter 400, |
11761 | chapter 440, chapter 483, and chapter 765, Florida Statutes, the |
11762 | provisions of part II of chapter 408, Florida Statutes, shall |
11763 | prevail. |
11764 | Section 239. Rules adopted by the Department of Elderly |
11765 | Affairs under parts III, V, VI, and VII of chapter 400, Florida |
11766 | Statutes, shall be transferred by a type two transfer, as |
11767 | defined in s. 20.06, Florida Statutes, to the Agency for Health |
11768 | Care Administration. |
11769 | Section 240. Between October 1, 2005, and September 30, |
11770 | 2006, inclusive, the Agency for Health Care Administration may |
11771 | issue any license for less than a 2-year period by charging a |
11772 | prorated licensure fee and specifying a different renewal date |
11773 | than would otherwise be required for biennial licensure. |
11774 | Section 241. This act shall take effect October 1, 2005. |