HB 0467

CS

CHAMBER ACTION

1	The Elder & Long-Term Care Committee 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 assisted care communities; creating ch.
7	429, F.S., and transferring pt. III of ch. 400, F.S.,
8	relating to assisted living facilities, to ch. 429, F.S.;
9	amending ss. 101.655, 189.428, 196.1975, 202.125,
10	205.1965, 212.031, 212.08, 296.02, 381.0035, 394.455,
11	394.4574, 394.463, 400.0063, 400.0069, 400.0073, 400.0077,
12	400.0239, 400.119, 400.141, 400.142, 400.191, 400.215,
13	400.23, 400.232, 400.401, 400.402, 400.404, 400.407,
14	400.408, 400.411, 400.412, 400.414, 400.415, 400.417,
15	400.4174, 400.4176, 400.4177, 400.4178, 400.418, 400.419,
16	400.4195, 400.42, 400.421, 400.422, 400.423, 400.424,
17	400.4255, 400.4256, 400.426, 400.427, 400.4275, 400.428,
18	400.429, 400.4293, 400.4294, 400.4295, 400.4296, 400.4297,
19	400.431, 400.434, 400.441, 400.442, 400.444, 400.4445,
20	400.447, 400.451, 400.452, 400.453, 400.462, 400.464,
21	400.497, 400.556, 400.5572, 400.601, 400.618, 400.628,
22	400.93, 400.962, 400.980, 400.9905, 400.9935, 401.23,
23	402.164, 408.033, 408.831, 409.212, 409.907, 410.031,
24	410.034, 415.1111, 430.601, 430.703, 435.03, 435.04,
25	440.13, 456.0375, 465.0235, 468.505, 477.025, 509.032,
26	509.241, 627.732, 651.011, 651.022, 651.023, 651.055,
27	651.095, 651.118, 765.1103, 765.205, 768.735, and
28	943.0585, F.S.; conforming references to changes made by
29	the act; providing a directive to the Division of
30	Statutory Revision to make necessary conforming changes to
31	the Florida Statutes; providing an effective date.
32
33	Be It Enacted by the Legislature of the State of Florida:
34
35	Section 1.  Sections 400.401, 400.402, 400.404, 400.407,
36	400.4075, 400.408, 400.411, 400.412, 400.414, 400.415, 400.417,
37	400.4174, 400.4176, 400.4177, 400.4178, 400.418, 400.419,
38	400.4195, 400.42, 400.421, 400.422, 400.423, 400.424, 400.4255,
39	400.4256, 400.426, 400.427, 400.4275, 400.428, 400.429,
40	400.4293, 400.4294, 400.4295, 400.4296, 400.4297, 400.4298,
41	400.431, 400.434, 400.435, 400.441, 400.422, 400.444, 400.4445,
42	400.447, 400.449, 400.451, 400.452, 400.453, and 400.454,
43	Florida Statutes, are renumbered as sections 429.01, 429.02,
44	429.04, 429.07, 429.075, 429.08, 429.11, 429.12, 429.14, 429.15,
45	429.17, 429.174, 429.176, 429.177, 429.178, 429.18, 429.19,
46	429.195, 429.20, 429.21, 429.22, 429.23, 429.24, 429.255,
47	429.256, 429.26, 429.27, 429.275, 429.28, 429.29, 429.293,
48	429.294, 429.295, 429.296, 429.297, 429.298, 429.31, 429.34,
49	429.35, 429.41, 429.42, 429.44, 429.445, 429.47, 429.49, 429.51,
50	429.52, 429.53, and 429.54, Florida Statutes, respectively, and
51	designated as chapter 429, Florida Statutes, entitled "ASSISTED
52	CARE COMMUNITIES."
53	Section 2.  Subsection (1) of section 101.655, Florida
54	Statutes, is amended to read:
55	101.655  Supervised voting by absent electors in certain
56	facilities.--
57	(1)  The supervisor of elections of a county shall provide
58	supervised voting for absent electors residing in any assisted
59	living facility, as defined in s. 429.02 400.402, or nursing
60	home facility, as defined in s. 400.021, within that county at
61	the request of any administrator of such a facility. Such
62	request for supervised voting in the facility shall be made by
63	submitting a written request to the supervisor of elections no
64	later than 21 days prior to the election for which that request
65	is submitted. The request shall specify the name and address of
66	the facility and the name of the electors who wish to vote
67	absentee in that election. If the request contains the names of
68	fewer than five voters, the supervisor of elections is not
69	required to provide supervised voting.
70	Section 3.  Subsection (9) of section 189.428, Florida
71	Statutes, is amended to read:
72	189.428  Special districts; oversight review process.--
73	(9)  This section does not apply to a deepwater port listed
74	in s. 311.09(1) which is in compliance with a port master plan
75	adopted pursuant to s. 163.3178(2)(k), or to an airport
76	authority operating in compliance with an airport master plan
77	approved by the Federal Aviation Administration, or to any
78	special district organized to operate health systems and
79	facilities licensed under chapter 395, or chapter 400, or
80	chapter 429.
81	Section 4.  Paragraph (b) of subsection (2) of section
82	196.1975, Florida Statutes, is amended to read:
83	196.1975  Exemption for property used by nonprofit homes
84	for the aged.--Nonprofit homes for the aged are exempt to the
85	extent that they meet the following criteria:
86	(2)  A facility will not qualify as a "home for the aged"
87	unless at least 75 percent of the occupants are over the age of
88	62 years or totally and permanently disabled.  For homes for the
89	aged which are exempt from paying income taxes to the United
90	States as specified in subsection (1), licensing by the Agency
91	for Health Care Administration is required for ad valorem tax
92	exemption hereunder only if the home:
93	(b)  Qualifies as an assisted living facility under part
94	III of chapter 429 400.
95	Section 5.  Paragraph (c) of subsection (4) of section
96	202.125, Florida Statutes, is amended to read:
97	202.125  Sales of communications services; specified
98	exemptions.--
99	(4)  The sale of communications services to a home for the
100	aged, religious institution or educational institution that is
101	exempt from federal income tax under s. 501(c)(3) of the
102	Internal Revenue Code, or by a religious institution that is
103	exempt from federal income tax under s. 501(c)(3) of the
104	Internal Revenue Code having an established physical place for
105	worship at which nonprofit religious services and activities are
106	regularly conducted and carried on, is exempt from the taxes
107	imposed or administered pursuant to ss. 202.12 and 202.19. As
108	used in this subsection, the term:
109	(c)  "Home for the aged" includes any nonprofit
110	corporation:
111	1.  In which at least 75 percent of the occupants are 62
112	years of age or older or totally and permanently disabled; which
113	qualifies for an ad valorem property tax exemption under s.
114	196.196, s. 196.197, or s. 196.1975; and which is exempt from
115	the sales tax imposed under chapter 212.
116	2.  Licensed as a nursing home under chapter 400 or an
117	assisted living facility under chapter 429 400 and which is
118	exempt from the sales tax imposed under chapter 212.
119	Section 6.  Section 205.1965, Florida Statutes, is amended
120	to read:
121	205.1965  Assisted living facilities.--A county or
122	municipality may not issue an occupational license for the
123	operation of an assisted living facility pursuant to part III of
124	chapter 429 400 without first ascertaining that the applicant
125	has been licensed by the Agency for Health Care Administration
126	to operate such facility at the specified location or locations.
127	The Agency for Health Care Administration shall furnish to local
128	agencies responsible for issuing occupational licenses
129	sufficient instructions for making the above required
130	determinations.
131	Section 7.  Paragraph (b) of subsection (1) of section
132	212.031, Florida Statutes, is amended to read:
133	212.031  Tax on rental or license fee for use of real
134	property.--
135	(1)
136	(b)  When a lease involves multiple use of real property
137	wherein a part of the real property is subject to the tax
138	herein, and a part of the property would be excluded from the
139	tax under subparagraph (a)1., subparagraph (a)2., subparagraph
140	(a)3., or subparagraph (a)5., the department shall determine,
141	from the lease or license and such other information as may be
142	available, that portion of the total rental charge which is
143	exempt from the tax imposed by this section. The portion of the
144	premises leased or rented by a for-profit entity providing a
145	residential facility for the aged will be exempt on the basis of
146	a pro rata portion calculated by combining the square footage of
147	the areas used for residential units by the aged and for the
148	care of such residents and dividing the resultant sum by the
149	total square footage of the rented premises. For purposes of
150	this section, the term "residential facility for the aged" means
151	a facility that is licensed or certified in whole or in part
152	under chapter 400, chapter 429, or chapter 651; or that provides
153	residences to the elderly and is financed by a mortgage or loan
154	made or insured by the United States Department of Housing and
155	Urban Development under s. 202, s. 202 with a s. 8 subsidy, s.
156	221(d)(3) or (4), s. 232, or s. 236 of the National Housing Act;
157	or other such similar facility that provides residences
158	primarily for the elderly.
159	Section 8.  Paragraph (i) of subsection (7) of section
160	212.08, Florida Statutes, is amended to read:
161	212.08  Sales, rental, use, consumption, distribution, and
162	storage tax; specified exemptions.--The sale at retail, the
163	rental, the use, the consumption, the distribution, and the
164	storage to be used or consumed in this state of the following
165	are hereby specifically exempt from the tax imposed by this
166	chapter.
167	(7)  MISCELLANEOUS EXEMPTIONS.--Exemptions provided to any
168	entity by this chapter do not inure to any transaction that is
169	otherwise taxable under this chapter when payment is made by a
170	representative or employee of the entity by any means,
171	including, but not limited to, cash, check, or credit card, even
172	when that representative or employee is subsequently reimbursed
173	by the entity. In addition, exemptions provided to any entity by
174	this subsection do not inure to any transaction that is
175	otherwise taxable under this chapter unless the entity has
176	obtained a sales tax exemption certificate from the department
177	or the entity obtains or provides other documentation as
178	required by the department. Eligible purchases or leases made
179	with such a certificate must be in strict compliance with this
180	subsection and departmental rules, and any person who makes an
181	exempt purchase with a certificate that is not in strict
182	compliance with this subsection and the rules is liable for and
183	shall pay the tax. The department may adopt rules to administer
184	this subsection.
185	(i)  Hospital meals and rooms.--Also exempt from payment of
186	the tax imposed by this chapter on rentals and meals are
187	patients and inmates of any hospital or other physical plant or
188	facility designed and operated primarily for the care of persons
189	who are ill, aged, infirm, mentally or physically incapacitated,
190	or otherwise dependent on special care or attention. Residents
191	of a home for the aged are exempt from payment of taxes on meals
192	provided through the facility.  A home for the aged is defined
193	as a facility that is licensed or certified in part or in whole
194	under chapter 400, chapter 429, or chapter 651, or that is
195	financed by a mortgage loan made or insured by the United States
196	Department of Housing and Urban Development under s. 202, s. 202
197	with a s. 8 subsidy, s. 221(d)(3) or (4), s. 232, or s. 236 of
198	the National Housing Act, or other such similar facility
199	designed and operated primarily for the care of the aged.
200	Section 9.  Subsection (5) of section 296.02, Florida
201	Statutes, is amended to read:
202	296.02  Definitions.--For the purposes of this part, except
203	where the context clearly indicates otherwise:
204	(5)  "Extended congregate care" has the meaning given to
205	that term under s. 429.02 400.402.
206	Section 10.  Subsections (1) and (3) of section 381.0035,
207	Florida Statutes, are amended to read:
208	381.0035  Educational course on HIV and AIDS; employees and
209	clients of certain health care facilities.--
210	(1)  The Department of Health shall require all employees
211	and clients of facilities licensed under chapters 393, 394, and
212	397 and employees of facilities licensed under chapter 395, and
213	parts II, III, IV, and VI of chapter 400, and chapter 429 to
214	complete, biennially, a continuing educational course on the
215	modes of transmission, infection control procedures, clinical
216	management, and prevention of human immunodeficiency virus and
217	acquired immune deficiency syndrome with an emphasis on
218	appropriate behavior and attitude change. Such instruction shall
219	include information on current Florida law and its impact on
220	testing, confidentiality of test results, and treatment of
221	patients and any protocols and procedures applicable to human
222	immunodeficiency counseling and testing, reporting, the offering
223	of HIV testing to pregnant women, and partner notification
224	issues pursuant to ss. 381.004 and 384.25.
225	(3)  Facilities licensed under chapters 393, 394, 395, and
226	397, and parts II, III, IV, and VI of chapter 400, and chapter
227	429 shall maintain a record of employees and dates of attendance
228	at human immunodeficiency virus and acquired immune deficiency
229	syndrome educational courses.
230	Section 11.  Subsection (10) of section 394.455, Florida
231	Statutes, is amended to read:
232	394.455  Definitions.--As used in this part, unless the
233	context clearly requires otherwise, the term:
234	(10)  "Facility" means any hospital, community facility,
235	public or private facility, or receiving or treatment facility
236	providing for the evaluation, diagnosis, care, treatment,
237	training, or hospitalization of persons who appear to have a
238	mental illness or have been diagnosed as having a mental
239	illness.  "Facility" does not include any program or entity
240	licensed pursuant to chapter 400 or chapter 429.
241	Section 12.  Paragraphs (b), (c), and (e) of subsection (2)
242	of section 394.4574, Florida Statutes, are amended to read:
243	394.4574  Department responsibilities for a mental health
244	resident who resides in an assisted living facility that holds a
245	limited mental health license.--
246	(2)  The department must ensure that:
247	(b)  A cooperative agreement, as required in s. 429.075
248	400.4075, is developed between the mental health care services
249	provider that serves a mental health resident and the
250	administrator of the assisted living facility with a limited
251	mental health license in which the mental health resident is
252	living. Any entity that provides Medicaid prepaid health plan
253	services shall ensure the appropriate coordination of health
254	care services with an assisted living facility in cases where a
255	Medicaid recipient is both a member of the entity's prepaid
256	health plan and a resident of the assisted living facility. If
257	the entity is at risk for Medicaid targeted case management and
258	behavioral health services, the entity shall inform the assisted
259	living facility of the procedures to follow should an emergent
260	condition arise.
261	(c)  The community living support plan, as defined in s.
262	429.02 400.402, has been prepared by a mental health resident
263	and a mental health case manager of that resident in
264	consultation with the administrator of the facility or the
265	administrator's designee. The plan must be provided to the
266	administrator of the assisted living facility with a limited
267	mental health license in which the mental health resident lives.
268	The support plan and the agreement may be in one document.
269	(e)  The mental health services provider assigns a case
270	manager to each mental health resident who lives in an assisted
271	living facility with a limited mental health license. The case
272	manager is responsible for coordinating the development of and
273	implementation of the community living support plan defined in
274	s. 429.02 400.402. The plan must be updated at least annually.
275	Section 13.  Paragraph (b) of subsection (2) of section
276	394.463, Florida Statutes, is amended to read:
277	394.463  Involuntary examination.--
278	(2)  INVOLUNTARY EXAMINATION.--
279	(b)  A person shall not be removed from any program or
280	residential placement licensed under chapter 400 or chapter 429
281	and transported to a receiving facility for involuntary
282	examination unless an ex parte order, a professional
283	certificate, or a law enforcement officer's report is first
284	prepared.  If the condition of the person is such that
285	preparation of a law enforcement officer's report is not
286	practicable before removal, the report shall be completed as
287	soon as possible after removal, but in any case before the
288	person is transported to a receiving facility.  A receiving
289	facility admitting a person for involuntary examination who is
290	not accompanied by the required ex parte order, professional
291	certificate, or law enforcement officer's report shall notify
292	the Agency for Health Care Administration of such admission by
293	certified mail no later than the next working day.  The
294	provisions of this paragraph do not apply when transportation is
295	provided by the patient's family or guardian.
296	Section 14.  Paragraph (b) of subsection (3) of section
297	400.0063, Florida Statutes, is amended to read:
298	400.0063  Establishment of Office of State Long-Term Care
299	Ombudsman; designation of ombudsman and legal advocate.--
300	(3)
301	(b)  The duties of the legal advocate shall include, but
302	not be limited to:
303	1.  Assisting the ombudsman in carrying out the duties of
304	the office with respect to the abuse, neglect, or violation of
305	rights of residents of long-term care facilities.
306	2.  Assisting the state and local ombudsman councils in
307	carrying out their responsibilities under this part.
308	3.  Initiating and prosecuting legal and equitable actions
309	to enforce the rights of long-term care facility residents as
310	defined in this chapter or chapter 429.
311	4.  Serving as legal counsel to the state and local
312	ombudsman councils, or individual members thereof, against whom
313	any suit or other legal action is initiated in connection with
314	the performance of the official duties of the councils or an
315	individual member.
316	Section 15.  Subsection (3) of section 400.0069, Florida
317	Statutes, is amended to read:
318	400.0069  Local long-term care ombudsman councils; duties;
319	membership.--
320	(3)  In order to carry out the duties specified in
321	subsection (2), the local ombudsman council is authorized,
322	pursuant to ss. 400.19(1) and 429.34 400.434, to enter any long-
323	term care facility without notice or first obtaining a warrant,
324	subject to the provisions of s. 400.0073(5).
325	Section 16.  Paragraphs (c) and (f) of subsection (5) and
326	subsection (6) of section 400.0073, Florida Statutes, are
327	amended to read:
328	400.0073  State and local ombudsman council
329	investigations.--
330	(5)  Any onsite administrative inspection conducted by an
331	ombudsman council shall be subject to the following:
332	(c)  Inspections shall be conducted in a manner which will
333	impose no unreasonable burden on nursing homes or long-term care
334	facilities, consistent with the underlying purposes of this part
335	and chapter 429. Unnecessary duplication of efforts among
336	council members or the councils shall be reduced to the extent
337	possible.
338	(f)  All inspections shall be limited to compliance with
339	part parts II, III, and VII of this chapter, chapter 429, and 42
340	U.S.C. ss. 1396(a) et seq., and any rules or regulations
341	promulgated pursuant to such laws.
342	(6)  An inspection may not be accomplished by forcible
343	entry. Refusal of a long-term care facility to allow entry of
344	any ombudsman council member constitutes a violation of part II,
345	part III, or part VII of this chapter or chapter 429.
346	Section 17.  Subsection (4) of section 400.0077, Florida
347	Statutes, is amended to read:
348	400.0077  Confidentiality.--
349	(4)  Members of any state or local ombudsman council shall
350	not be required to testify in any court with respect to matters
351	held to be confidential under s. 429.14 400.414 except as may be
352	necessary to enforce the provisions of this act.
353	Section 18.  Subsection (1) of section 400.0239, Florida
354	Statutes, is amended to read:
355	400.0239  Quality of Long-Term Care Facility Improvement
356	Trust Fund.--
357	(1)  There is created within the Agency for Health Care
358	Administration a Quality of Long-Term Care Facility Improvement
359	Trust Fund to support activities and programs directly related
360	to improvement of the care of nursing home and assisted living
361	facility residents. The trust fund shall be funded through
362	proceeds generated pursuant to ss. 400.0238 and 429.298
363	400.4298, through funds specifically appropriated by the
364	Legislature, through gifts, endowments, and other charitable
365	contributions allowed under federal and state law, and through
366	federal nursing home civil monetary penalties collected by the
367	Centers for Medicare and Medicaid Services and returned to the
368	state. These funds must be utilized in accordance with federal
369	requirements.
370	Section 19.  Subsections (1) and (4) of section 400.119,
371	Florida Statutes, are amended to read:
372	400.119  Confidentiality of records and meetings of risk
373	management and quality assurance committees.--
374	(1)  Records of meetings of the risk management and quality
375	assurance committee of a long-term care facility licensed under
376	this part or part III of this chapter 429, as well as incident
377	reports filed with the facility's risk manager and
378	administrator, notifications of the occurrence of an adverse
379	incident, and adverse incident reports from the facility are
380	confidential and exempt from s. 119.07(1) and s. 24(a), Art. I
381	of the State Constitution. However, if the Agency for Health
382	Care Administration has a reasonable belief that conduct by a
383	staff member or employee of a facility is criminal activity or
384	grounds for disciplinary action by a regulatory board, the
385	agency may disclose such records to the appropriate law
386	enforcement agency or regulatory board.
387	(4)  The meetings of an internal risk management and
388	quality assurance committee of a long-term care facility
389	licensed under this part or part III of this chapter 429 are
390	exempt from s. 286.011 and s. 24(b), Art. I of the State
391	Constitution and are not open to the public.
392	Section 20.  Subsections (4) and (7) of section 400.141,
393	Florida Statutes, are amended to read:
394	400.141  Administration and management of nursing home
395	facilities.--Every licensed facility shall comply with all
396	applicable standards and rules of the agency and shall:
397	(4)  Provide for resident use of a community pharmacy as
398	specified in s. 400.022(1)(q). Any other law to the contrary
399	notwithstanding, a registered pharmacist licensed in Florida,
400	that is under contract with a facility licensed under this
401	chapter or chapter 429, shall repackage a nursing facility
402	resident's bulk prescription medication which has been packaged
403	by another pharmacist licensed in any state in the United States
404	into a unit dose system compatible with the system used by the
405	nursing facility, if the pharmacist is requested to offer such
406	service. In order to be eligible for the repackaging, a resident
407	or the resident's spouse must receive prescription medication
408	benefits provided through a former employer as part of his or
409	her retirement benefits, a qualified pension plan as specified
410	in s. 4972 of the Internal Revenue Code, a federal retirement
411	program as specified under 5 C.F.R. s. 831, or a long-term care
412	policy as defined in s. 627.9404(1). A pharmacist who correctly
413	repackages and relabels the medication and the nursing facility
414	which correctly administers such repackaged medication under the
415	provisions of this subsection shall not be held liable in any
416	civil or administrative action arising from the repackaging. In
417	order to be eligible for the repackaging, a nursing facility
418	resident for whom the medication is to be repackaged shall sign
419	an informed consent form provided by the facility which includes
420	an explanation of the repackaging process and which notifies the
421	resident of the immunities from liability provided herein. A
422	pharmacist who repackages and relabels prescription medications,
423	as authorized under this subsection, may charge a reasonable fee
424	for costs resulting from the implementation of this provision.
425	(7)  If the facility has a standard license or is a Gold
426	Seal facility, exceeds the minimum required hours of licensed
427	nursing and certified nursing assistant direct care per resident
428	per day, and is part of a continuing care facility licensed
429	under chapter 651 or a retirement community that offers other
430	services pursuant to part III, part IV, or part V of this
431	chapter or chapter 429 on a single campus, be allowed to share
432	programming and staff. At the time of inspection and in the
433	semiannual report required pursuant to subsection (15), a
434	continuing care facility or retirement community that uses this
435	option must demonstrate through staffing records that minimum
436	staffing requirements for the facility were met. Licensed nurses
437	and certified nursing assistants who work in the nursing home
438	facility may be used to provide services elsewhere on campus if
439	the facility exceeds the minimum number of direct care hours
440	required per resident per day and the total number of residents
441	receiving direct care services from a licensed nurse or a
442	certified nursing assistant does not cause the facility to
443	violate the staffing ratios required under s. 400.23(3)(a).
444	Compliance with the minimum staffing ratios shall be based on
445	total number of residents receiving direct care services,
446	regardless of where they reside on campus. If the facility
447	receives a conditional license, it may not share staff until the
448	conditional license status ends. This subsection does not
449	restrict the agency's authority under federal or state law to
450	require additional staff if a facility is cited for deficiencies
451	in care which are caused by an insufficient number of certified
452	nursing assistants or licensed nurses. The agency may adopt
453	rules for the documentation necessary to determine compliance
454	with this provision.
455
456	Facilities that have been awarded a Gold Seal under the program
457	established in s. 400.235 may develop a plan to provide
458	certified nursing assistant training as prescribed by federal
459	regulations and state rules and may apply to the agency for
460	approval of their program.
461	Section 21.  Subsection (1) of section 400.142, Florida
462	Statutes, is amended to read:
463	400.142  Emergency medication kits; orders not to
464	resuscitate.--
465	(1)  Other provisions of this chapter or of chapter 429,
466	chapter 465, chapter 499, or chapter 893 to the contrary
467	notwithstanding, each nursing home operating pursuant to a
468	license issued by the agency may maintain an emergency
469	medication kit for the purpose of storing medicinal drugs to be
470	administered under emergency conditions to residents residing in
471	such facility.
472	Section 22.  Paragraph (a) of subsection (2) of section
473	400.191, Florida Statutes, is amended to read:
474	400.191  Availability, distribution, and posting of reports
475	and records.--
476	(2)  The agency shall provide additional information in
477	consumer-friendly printed and electronic formats to assist
478	consumers and their families in comparing and evaluating nursing
479	home facilities.
480	(a)  The agency shall provide an Internet site which shall
481	include at least the following information either directly or
482	indirectly through a link to another established site or sites
483	of the agency's choosing:
484	1.  A list by name and address of all nursing home
485	facilities in this state.
486	2.  Whether such nursing home facilities are proprietary or
487	nonproprietary.
488	3.  The current owner of the facility's license and the
489	year that that entity became the owner of the license.
490	4.  The name of the owner or owners of each facility and
491	whether the facility is affiliated with a company or other
492	organization owning or managing more than one nursing facility
493	in this state.
494	5.  The total number of beds in each facility.
495	6.  The number of private and semiprivate rooms in each
496	facility.
497	7.  The religious affiliation, if any, of each facility.
498	8.  The languages spoken by the administrator and staff of
499	each facility.
500	9.  Whether or not each facility accepts Medicare or
501	Medicaid recipients or insurance, health maintenance
502	organization, Veterans Administration, CHAMPUS program, or
503	workers' compensation coverage.
504	10.  Recreational and other programs available at each
505	facility.
506	11.  Special care units or programs offered at each
507	facility.
508	12.  Whether the facility is a part of a retirement
509	community that offers other services pursuant to part III, part
510	IV, or part V of this chapter or chapter 429.
511	13.  Survey and deficiency information contained on the
512	Online Survey Certification and Reporting (OSCAR) system of the
513	federal Health Care Financing Administration, including annual
514	survey, revisit, and complaint survey information, for each
515	facility for the past 45 months.  For noncertified nursing
516	homes, state survey and deficiency information, including annual
517	survey, revisit, and complaint survey information for the past
518	45 months shall be provided.
519	14.  A summary of the Online Survey Certification and
520	Reporting (OSCAR) data for each facility over the past 45
521	months. Such summary may include a score, rating, or comparison
522	ranking with respect to other facilities based on the number of
523	citations received by the facility of annual, revisit, and
524	complaint surveys; the severity and scope of the citations; and
525	the number of annual recertification surveys the facility has
526	had during the past 45 months. The score, rating, or comparison
527	ranking may be presented in either numeric or symbolic form for
528	the intended consumer audience.
529	Section 23.  Paragraph (b) of subsection (2) of section
530	400.215, Florida Statutes, is amended to read:
531	400.215  Personnel screening requirement.--
532	(2)  Employers and employees shall comply with the
533	requirements of s. 435.05.
534	(b)  Employees qualified under the provisions of paragraph
535	(a) who have not maintained continuous residency within the
536	state for the 5 years immediately preceding the date of request
537	for background screening must complete level 2 screening, as
538	provided in chapter 435. Such employees may work in a
539	conditional status up to 180 days pending the receipt of written
540	findings evidencing the completion of level 2 screening. Level 2
541	screening shall not be required of employees or prospective
542	employees who attest in writing under penalty of perjury that
543	they meet the residency requirement. Completion of level 2
544	screening shall require the employee or prospective employee to
545	furnish to the nursing facility a full set of fingerprints to
546	enable a criminal background investigation to be conducted. The
547	nursing facility shall submit the completed fingerprint card to
548	the agency. The agency shall establish a record of the request
549	in the database provided for in paragraph (c) and forward the
550	request to the Department of Law Enforcement, which is
551	authorized to submit the fingerprints to the Federal Bureau of
552	Investigation for a national criminal history records check. The
553	results of the national criminal history records check shall be
554	returned to the agency, which shall maintain the results in the
555	database provided for in paragraph (c). The agency shall notify
556	the administrator of the requesting nursing facility or the
557	administrator of any other facility licensed under chapter 393,
558	chapter 394, chapter 395, chapter 397, chapter 429, or this
559	chapter, as requested by such facility, as to whether or not the
560	employee has qualified under level 1 or level 2 screening. An
561	employee or prospective employee who has qualified under level 2
562	screening and has maintained such continuous residency within
563	the state shall not be required to complete a subsequent level 2
564	screening as a condition of employment at another facility.
565	Section 24.  Paragraph (f) of subsection (2) of section
566	400.23, Florida Statutes, is amended to read:
567	400.23  Rules; evaluation and deficiencies; licensure
568	status.--
569	(2)  Pursuant to the intention of the Legislature, the
570	agency, in consultation with the Department of Health and the
571	Department of Elderly Affairs, shall adopt and enforce rules to
572	implement this part, which shall include reasonable and fair
573	criteria in relation to:
574	(f)  The care, treatment, and maintenance of residents and
575	measurement of the quality and adequacy thereof, based on rules
576	developed under this chapter or chapter 429 and the Omnibus
577	Budget Reconciliation Act of 1987 (Pub. L. No. 100-203)
578	(December 22, 1987), Title IV (Medicare, Medicaid, and Other
579	Health-Related Programs), Subtitle C (Nursing Home Reform), as
580	amended.
581	Section 25.  Section 400.232, Florida Statutes, is amended
582	to read:
583	400.232  Review and approval of plans; fees and costs.--The
584	design, construction, erection, alteration, modification,
585	repair, and demolition of all public and private health care
586	facilities are governed by the Florida Building Code and the
587	Florida Fire Prevention Code under ss. 553.73 and 633.022. In
588	addition to the requirements of ss. 553.79 and 553.80, the
589	agency shall review the facility plans and survey the
590	construction of facilities licensed under this chapter or
591	chapter 429.
592	(1)  The agency shall approve or disapprove the plans and
593	specifications within 60 days after receipt of the final plans
594	and specifications.  The agency may be granted one 15-day
595	extension for the review period, if the director of the agency
596	so approves. If the agency fails to act within the specified
597	time, it shall be deemed to have approved the plans and
598	specifications. When the agency disapproves plans and
599	specifications, it shall set forth in writing the reasons for
600	disapproval. Conferences and consultations may be provided as
601	necessary.
602	(2)  The agency is authorized to charge an initial fee of
603	$2,000 for review of plans and construction on all projects, no
604	part of which is refundable.  The agency may also collect a fee,
605	not to exceed 1 percent of the estimated construction cost or
606	the actual cost of review, whichever is less, for the portion of
607	the review which encompasses initial review through the initial
608	revised construction document review.  The agency is further
609	authorized to collect its actual costs on all subsequent
610	portions of the review and construction inspections.  Initial
611	fee payment shall accompany the initial submission of plans and
612	specifications.  Any subsequent payment that is due is payable
613	upon receipt of the invoice from the agency. Notwithstanding any
614	other provisions of law to the contrary, all money received by
615	the agency pursuant to the provisions of this section shall be
616	deemed to be trust funds, to be held and applied solely for the
617	operations required under this section.
618	Section 26.  Section 400.401, Florida Statutes, is
619	renumbered as section 429.01, Florida Statutes, and subsection
620	(3) is amended to read:
621	429.01 400.401  Popular name Short title; purpose.--
622	(3)  The principle that a license issued under this chapter
623	part is a public trust and a privilege and is not an entitlement
624	should guide the finder of fact or trier of law at any
625	administrative proceeding or in a court action initiated by the
626	Agency for Health Care Administration to enforce this chapter
627	part.
628	Section 27.  Section 400.402, Florida Statutes, is
629	renumbered as section 429.02, Florida Statutes, and amended to
630	read:
631	429.02 400.402  Definitions.--When used in this chapter
632	part, the term:
633	(1)  "Activities of daily living" means functions and tasks
634	for self-care, including ambulation, bathing, dressing, eating,
635	grooming, and toileting, and other similar tasks.
636	(2)  "Administrator" means an individual at least 21 years
637	of age who is responsible for the operation and maintenance of
638	an assisted living facility.
639	(3)  "Agency" means the Agency for Health Care
640	Administration.
641	(4)  "Aging in place" or "age in place" means the process
642	of providing increased or adjusted services to a person to
643	compensate for the physical or mental decline that may occur
644	with the aging process, in order to maximize the person's
645	dignity and independence and permit them to remain in a
646	familiar, noninstitutional, residential environment for as long
647	as possible. Such services may be provided by facility staff,
648	volunteers, family, or friends, or through contractual
649	arrangements with a third party.
650	(5)  "Applicant" means an individual owner, corporation,
651	partnership, firm, association, or governmental entity that
652	applies for a license.
653	(6)  "Assisted living facility" means any building or
654	buildings, section or distinct part of a building, private home,
655	boarding home, home for the aged, or other residential facility,
656	whether operated for profit or not, which undertakes through its
657	ownership or management to provide housing, meals, and one or
658	more personal services for a period exceeding 24 hours to one or
659	more adults who are not relatives of the owner or administrator.
660	(7)  "Chemical restraint" means a pharmacologic drug that
661	physically limits, restricts, or deprives an individual of
662	movement or mobility, and is used for discipline or convenience
663	and not required for the treatment of medical symptoms.
664	(8)  "Community living support plan" means a written
665	document prepared by a mental health resident and the resident's
666	mental health case manager in consultation with the
667	administrator of an assisted living facility with a limited
668	mental health license or the administrator's designee. A copy
669	must be provided to the administrator. The plan must include
670	information about the supports, services, and special needs of
671	the resident which enable the resident to live in the assisted
672	living facility and a method by which facility staff can
673	recognize and respond to the signs and symptoms particular to
674	that resident which indicate the need for professional services.
675	(9)  "Cooperative agreement" means a written statement of
676	understanding between a mental health care provider and the
677	administrator of the assisted living facility with a limited
678	mental health license in which a mental health resident is
679	living. The agreement must specify directions for accessing
680	emergency and after-hours care for the mental health resident. A
681	single cooperative agreement may service all mental health
682	residents who are clients of the same mental health care
683	provider.
684	(10)  "Department" means the Department of Elderly Affairs.
685	(11)  "Emergency" means a situation, physical condition, or
686	method of operation which presents imminent danger of death or
687	serious physical or mental harm to facility residents.
688	(12)  "Extended congregate care" means acts beyond those
689	authorized in subsection (17) that may be performed pursuant to
690	part I of chapter 464 by persons licensed thereunder while
691	carrying out their professional duties, and other supportive
692	services which may be specified by rule.  The purpose of such
693	services is to enable residents to age in place in a residential
694	environment despite mental or physical limitations that might
695	otherwise disqualify them from residency in a facility licensed
696	under this chapter part.
697	(13)  "Guardian" means a person to whom the law has
698	entrusted the custody and control of the person or property, or
699	both, of a person who has been legally adjudged incapacitated.
700	(14)  "Limited nursing services" means acts that may be
701	performed pursuant to part I of chapter 464 by persons licensed
702	thereunder while carrying out their professional duties but
703	limited to those acts which the department specifies by rule.
704	Acts which may be specified by rule as allowable limited nursing
705	services shall be for persons who meet the admission criteria
706	established by the department for assisted living facilities and
707	shall not be complex enough to require 24-hour nursing
708	supervision and may include such services as the application and
709	care of routine dressings, and care of casts, braces, and
710	splints.
711	(15)  "Managed risk" means the process by which the
712	facility staff discuss the service plan and the needs of the
713	resident with the resident and, if applicable, the resident's
714	representative or designee or the resident's surrogate,
715	guardian, or attorney in fact, in such a way that the
716	consequences of a decision, including any inherent risk, are
717	explained to all parties and reviewed periodically in
718	conjunction with the service plan, taking into account changes
719	in the resident's status and the ability of the facility to
720	respond accordingly.
721	(16)  "Mental health resident" means an individual who
722	receives social security disability income due to a mental
723	disorder as determined by the Social Security Administration or
724	receives supplemental security income due to a mental disorder
725	as determined by the Social Security Administration and receives
726	optional state supplementation.
727	(17)  "Personal services" means direct physical assistance
728	with or supervision of the activities of daily living and the
729	self-administration of medication and other similar services
730	which the department may define by rule.  "Personal services"
731	shall not be construed to mean the provision of medical,
732	nursing, dental, or mental health services.
733	(18)  "Physical restraint" means a device which physically
734	limits, restricts, or deprives an individual of movement or
735	mobility, including, but not limited to, a half-bed rail, a
736	full-bed rail, a geriatric chair, and a posey restraint. The
737	term "physical restraint" shall also include any device which
738	was not specifically manufactured as a restraint but which has
739	been altered, arranged, or otherwise used for this purpose. The
740	term shall not include bandage material used for the purpose of
741	binding a wound or injury.
742	(19)  "Relative" means an individual who is the father,
743	mother, stepfather, stepmother, son, daughter, brother, sister,
744	grandmother, grandfather, great-grandmother, great-grandfather,
745	grandson, granddaughter, uncle, aunt, first cousin, nephew,
746	niece, husband, wife, father-in-law, mother-in-law, son-in-law,
747	daughter-in-law, brother-in-law, sister-in-law, stepson,
748	stepdaughter, stepbrother, stepsister, half brother, or half
749	sister of an owner or administrator.
750	(20)  "Resident" means a person 18 years of age or older,
751	residing in and receiving care from a facility.
752	(21)  "Resident's representative or designee" means a
753	person other than the owner, or an agent or employee of the
754	facility, designated in writing by the resident, if legally
755	competent, to receive notice of changes in the contract executed
756	pursuant to s. 429.24 400.424; to receive notice of and to
757	participate in meetings between the resident and the facility
758	owner, administrator, or staff concerning the rights of the
759	resident; to assist the resident in contacting the ombudsman
760	council if the resident has a complaint against the facility; or
761	to bring legal action on behalf of the resident pursuant to s.
762	400.429.
763	(22)  "Service plan" means a written plan, developed and
764	agreed upon by the resident and, if applicable, the resident's
765	representative or designee or the resident's surrogate,
766	guardian, or attorney in fact, if any, and the administrator or
767	designee representing the facility, which addresses the unique
768	physical and psychosocial needs, abilities, and personal
769	preferences of each resident receiving extended congregate care
770	services. The plan shall include a brief written description, in
771	easily understood language, of what services shall be provided,
772	who shall provide the services, when the services shall be
773	rendered, and the purposes and benefits of the services.
774	(23)  "Shared responsibility" means exploring the options
775	available to a resident within a facility and the risks involved
776	with each option when making decisions pertaining to the
777	resident's abilities, preferences, and service needs, thereby
778	enabling the resident and, if applicable, the resident's
779	representative or designee, or the resident's surrogate,
780	guardian, or attorney in fact, and the facility to develop a
781	service plan which best meets the resident's needs and seeks to
782	improve the resident's quality of life.
783	(24)  "Supervision" means reminding residents to engage in
784	activities of daily living and the self-administration of
785	medication, and, when necessary, observing or providing verbal
786	cuing to residents while they perform these activities.
787	(25)  "Supplemental security income," Title XVI of the
788	Social Security Act, means a program through which the Federal
789	Government guarantees a minimum monthly income to every person
790	who is age 65 or older, or disabled, or blind and meets the
791	income and asset requirements.
792	(26)  "Supportive services" means services designed to
793	encourage and assist aged persons or adults with disabilities to
794	remain in the least restrictive living environment and to
795	maintain their independence as long as possible.
796	(27)  "Twenty-four-hour nursing supervision" means services
797	that are ordered by a physician for a resident whose condition
798	requires the supervision of a physician and continued monitoring
799	of vital signs and physical status.  Such services shall be:
800	medically complex enough to require constant supervision,
801	assessment, planning, or intervention by a nurse; required to be
802	performed by or under the direct supervision of licensed nursing
803	personnel or other professional personnel for safe and effective
804	performance; required on a daily basis; and consistent with the
805	nature and severity of the resident's condition or the disease
806	state or stage.
807	Section 28.  Section 400.404, Florida Statutes, is
808	renumbered as section 429.04, Florida Statutes, and amended to
809	read:
810	429.04 400.404  Facilities to be licensed; exemptions.--
811	(1)  For the administration of this chapter part,
812	facilities to be licensed by the agency shall include all
813	assisted living facilities as defined in this chapter part.
814	(2)  The following are exempt from licensure under this
815	chapter part:
816	(a)  Any facility, institution, or other place operated by
817	the Federal Government or any agency of the Federal Government.
818	(b)  Any facility or part of a facility licensed under
819	chapter 393 or chapter 394.
820	(c)  Any facility licensed as an adult family-care home
821	under part VII of chapter 400.
822	(d)  Any person who provides housing, meals, and one or
823	more personal services on a 24-hour basis in the person's own
824	home to not more than two adults who do not receive optional
825	state supplementation. The person who provides the housing,
826	meals, and personal services must own or rent the home and
827	reside therein.
828	(e)  Any home or facility approved by the United States
829	Department of Veterans Affairs as a residential care home
830	wherein care is provided exclusively to three or fewer veterans.
831	(f)  Any facility that has been incorporated in this state
832	for 50 years or more on or before July 1, 1983, and the board of
833	directors of which is nominated or elected by the residents,
834	until the facility is sold or its ownership is transferred; or
835	any facility, with improvements or additions thereto, which has
836	existed and operated continuously in this state for 60 years or
837	more on or before July 1, 1989, is directly or indirectly owned
838	and operated by a nationally recognized fraternal organization,
839	is not open to the public, and accepts only its own members and
840	their spouses as residents.
841	(g)  Any facility certified under chapter 651, or a
842	retirement community, may provide services authorized under this
843	chapter part or part IV of this chapter 400 to its residents who
844	live in single-family homes, duplexes, quadruplexes, or
845	apartments located on the campus without obtaining a license to
846	operate an assisted living facility if residential units within
847	such buildings are used by residents who do not require staff
848	supervision for that portion of the day when personal services
849	are not being delivered and the owner obtains a home health
850	license to provide such services.  However, any building or
851	distinct part of a building on the campus that is designated for
852	persons who receive personal services and require supervision
853	beyond that which is available while such services are being
854	rendered must be licensed in accordance with this chapter part.
855	If a facility provides personal services to residents who do not
856	otherwise require supervision and the owner is not licensed as a
857	home health agency, the buildings or distinct parts of buildings
858	where such services are rendered must be licensed under this
859	chapter part. A resident of a facility that obtains a home
860	health license may contract with a home health agency of his or
861	her choice, provided that the home health agency provides
862	liability insurance and workers' compensation coverage for its
863	employees. Facilities covered by this exemption may establish
864	policies that give residents the option of contracting for
865	services and care beyond that which is provided by the facility
866	to enable them to age in place.  For purposes of this section, a
867	retirement community consists of a facility licensed under this
868	chapter part or under part II of chapter 400, and apartments
869	designed for independent living located on the same campus.
870	(h)  Any residential unit for independent living which is
871	located within a facility certified under chapter 651, or any
872	residential unit which is colocated with a nursing home licensed
873	under part II of chapter 400 or colocated with a facility
874	licensed under this chapter part in which services are provided
875	through an outpatient clinic or a nursing home on an outpatient
876	basis.
877	Section 29.  Section 400.407, Florida Statutes, is
878	renumbered as section 429.07, Florida Statutes, and paragraphs
879	(a), (b), and (c) of subsection (3), paragraphs (b) and (c) of
880	subsection (4), and subsection (5) are amended to read:
881	429.07 400.407  License required; fee, display.--
882	(3)  Any license granted by the agency must state the
883	maximum resident capacity of the facility, the type of care for
884	which the license is granted, the date the license is issued,
885	the expiration date of the license, and any other information
886	deemed necessary by the agency. Licenses shall be issued for one
887	or more of the following categories of care: standard, extended
888	congregate care, limited nursing services, or limited mental
889	health.
890	(a)  A standard license shall be issued to facilities
891	providing one or more of the personal services identified in s.
892	429.02 400.402. Such facilities may also employ or contract with
893	a person licensed under part I of chapter 464 to administer
894	medications and perform other tasks as specified in s. 429.255
895	400.4255.
896	(b)  An extended congregate care license shall be issued to
897	facilities providing, directly or through contract, services
898	beyond those authorized in paragraph (a), including acts
899	performed pursuant to part I of chapter 464 by persons licensed
900	thereunder, and supportive services defined by rule to persons
901	who otherwise would be disqualified from continued residence in
902	a facility licensed under this chapter part.
903	1.  In order for extended congregate care services to be
904	provided in a facility licensed under this chapter part, the
905	agency must first determine that all requirements established in
906	law and rule are met and must specifically designate, on the
907	facility's license, that such services may be provided and
908	whether the designation applies to all or part of a facility.
909	Such designation may be made at the time of initial licensure or
910	relicensure, or upon request in writing by a licensee under this
911	chapter part. Notification of approval or denial of such request
912	shall be made within 90 days after receipt of such request and
913	all necessary documentation. Existing facilities qualifying to
914	provide extended congregate care services must have maintained a
915	standard license and may not have been subject to administrative
916	sanctions during the previous 2 years, or since initial
917	licensure if the facility has been licensed for less than 2
918	years, for any of the following reasons:
919	a.  A class I or class II violation;
920	b.  Three or more repeat or recurring class III violations
921	of identical or similar resident care standards as specified in
922	rule from which a pattern of noncompliance is found by the
923	agency;
924	c.  Three or more class III violations that were not
925	corrected in accordance with the corrective action plan approved
926	by the agency;
927	d.  Violation of resident care standards resulting in a
928	requirement to employ the services of a consultant pharmacist or
929	consultant dietitian;
930	e.  Denial, suspension, or revocation of a license for
931	another facility under this chapter part in which the applicant
932	for an extended congregate care license has at least 25 percent
933	ownership interest; or
934	f.  Imposition of a moratorium on admissions or initiation
935	of injunctive proceedings.
936	2.  Facilities that are licensed to provide extended
937	congregate care services shall maintain a written progress
938	report on each person who receives such services, which report
939	describes the type, amount, duration, scope, and outcome of
940	services that are rendered and the general status of the
941	resident's health.  A registered nurse, or appropriate designee,
942	representing the agency shall visit such facilities at least
943	quarterly to monitor residents who are receiving extended
944	congregate care services and to determine if the facility is in
945	compliance with this chapter part and with rules that relate to
946	extended congregate care. One of these visits may be in
947	conjunction with the regular survey.  The monitoring visits may
948	be provided through contractual arrangements with appropriate
949	community agencies.  A registered nurse shall serve as part of
950	the team that inspects such facility. The agency may waive one
951	of the required yearly monitoring visits for a facility that has
952	been licensed for at least 24 months to provide extended
953	congregate care services, if, during the inspection, the
954	registered nurse determines that extended congregate care
955	services are being provided appropriately, and if the facility
956	has no class I or class II violations and no uncorrected class
957	III violations. Before such decision is made, the agency shall
958	consult with the long-term care ombudsman council for the area
959	in which the facility is located to determine if any complaints
960	have been made and substantiated about the quality of services
961	or care.  The agency may not waive one of the required yearly
962	monitoring visits if complaints have been made and
963	substantiated.
964	3.  Facilities that are licensed to provide extended
965	congregate care services shall:
966	a.  Demonstrate the capability to meet unanticipated
967	resident service needs.
968	b.  Offer a physical environment that promotes a homelike
969	setting, provides for resident privacy, promotes resident
970	independence, and allows sufficient congregate space as defined
971	by rule.
972	c.  Have sufficient staff available, taking into account
973	the physical plant and firesafety features of the building, to
974	assist with the evacuation of residents in an emergency, as
975	necessary.
976	d.  Adopt and follow policies and procedures that maximize
977	resident independence, dignity, choice, and decisionmaking to
978	permit residents to age in place to the extent possible, so that
979	moves due to changes in functional status are minimized or
980	avoided.
981	e.  Allow residents or, if applicable, a resident's
982	representative, designee, surrogate, guardian, or attorney in
983	fact to make a variety of personal choices, participate in
984	developing service plans, and share responsibility in
985	decisionmaking.
986	f.  Implement the concept of managed risk.
987	g.  Provide, either directly or through contract, the
988	services of a person licensed pursuant to part I of chapter 464.
989	h.  In addition to the training mandated in s. 429.52
990	400.452, provide specialized training as defined by rule for
991	facility staff.
992	4.  Facilities licensed to provide extended congregate care
993	services are exempt from the criteria for continued residency as
994	set forth in rules adopted under s. 429.41 400.441.  Facilities
995	so licensed shall adopt their own requirements within guidelines
996	for continued residency set forth by the department in rule.
997	However, such facilities may not serve residents who require 24-
998	hour nursing supervision. Facilities licensed to provide
999	extended congregate care services shall provide each resident
1000	with a written copy of facility policies governing admission and
1001	retention.
1002	5.  The primary purpose of extended congregate care
1003	services is to allow residents, as they become more impaired,
1004	the option of remaining in a familiar setting from which they
1005	would otherwise be disqualified for continued residency.  A
1006	facility licensed to provide extended congregate care services
1007	may also admit an individual who exceeds the admission criteria
1008	for a facility with a standard license, if the individual is
1009	determined appropriate for admission to the extended congregate
1010	care facility.
1011	6.  Before admission of an individual to a facility
1012	licensed to provide extended congregate care services, the
1013	individual must undergo a medical examination as provided in s.
1014	429.26 400.426(4) and the facility must develop a preliminary
1015	service plan for the individual.
1016	7.  When a facility can no longer provide or arrange for
1017	services in accordance with the resident's service plan and
1018	needs and the facility's policy, the facility shall make
1019	arrangements for relocating the person in accordance with s.
1020	429.28 400.428(1)(k).
1021	8.  Failure to provide extended congregate care services
1022	may result in denial of extended congregate care license
1023	renewal.
1024	9.  No later than January 1 of each year, the department,
1025	in consultation with the agency, shall prepare and submit to the
1026	Governor, the President of the Senate, the Speaker of the House
1027	of Representatives, and the chairs of appropriate legislative
1028	committees, a report on the status of, and recommendations
1029	related to, extended congregate care services. The status report
1030	must include, but need not be limited to, the following
1031	information:
1032	a.  A description of the facilities licensed to provide
1033	such services, including total number of beds licensed under
1034	this chapter part.
1035	b.  The number and characteristics of residents receiving
1036	such services.
1037	c.  The types of services rendered that could not be
1038	provided through a standard license.
1039	d.  An analysis of deficiencies cited during licensure
1040	inspections.
1041	e.  The number of residents who required extended
1042	congregate care services at admission and the source of
1043	admission.
1044	f.  Recommendations for statutory or regulatory changes.
1045	g.  The availability of extended congregate care to state
1046	clients residing in facilities licensed under this chapter part
1047	and in need of additional services, and recommendations for
1048	appropriations to subsidize extended congregate care services
1049	for such persons.
1050	h.  Such other information as the department considers
1051	appropriate.
1052	(c)  A limited nursing services license shall be issued to
1053	a facility that provides services beyond those authorized in
1054	paragraph (a) and as specified in this paragraph.
1055	1.  In order for limited nursing services to be provided in
1056	a facility licensed under this chapter part, the agency must
1057	first determine that all requirements established in law and
1058	rule are met and must specifically designate, on the facility's
1059	license, that such services may be provided. Such designation
1060	may be made at the time of initial licensure or relicensure, or
1061	upon request in writing by a licensee under this chapter part.
1062	Notification of approval or denial of such request shall be made
1063	within 90 days after receipt of such request and all necessary
1064	documentation. Existing facilities qualifying to provide limited
1065	nursing services shall have maintained a standard license and
1066	may not have been subject to administrative sanctions that
1067	affect the health, safety, and welfare of residents for the
1068	previous 2 years or since initial licensure if the facility has
1069	been licensed for less than 2 years.
1070	2.  Facilities that are licensed to provide limited nursing
1071	services shall maintain a written progress report on each person
1072	who receives such nursing services, which report describes the
1073	type, amount, duration, scope, and outcome of services that are
1074	rendered and the general status of the resident's health.  A
1075	registered nurse representing the agency shall visit such
1076	facilities at least twice a year to monitor residents who are
1077	receiving limited nursing services and to determine if the
1078	facility is in compliance with applicable provisions of this
1079	chapter part and with related rules. The monitoring visits may
1080	be provided through contractual arrangements with appropriate
1081	community agencies.  A registered nurse shall also serve as part
1082	of the team that inspects such facility.
1083	3.  A person who receives limited nursing services under
1084	this chapter part must meet the admission criteria established
1085	by the agency for assisted living facilities.  When a resident
1086	no longer meets the admission criteria for a facility licensed
1087	under this chapter part, arrangements for relocating the person
1088	shall be made in accordance with s. 429.28 400.428(1)(k), unless
1089	the facility is licensed to provide extended congregate care
1090	services.
1091	(4)
1092	(b)  In addition to the total fee assessed under paragraph
1093	(a), the agency shall require facilities that are licensed to
1094	provide extended congregate care services under this chapter
1095	part to pay an additional fee per licensed facility.  The amount
1096	of the biennial fee shall be $400 per license, with an
1097	additional fee of $10 per resident based on the total licensed
1098	resident capacity of the facility. No part of this fee shall be
1099	returned to the facility. The agency may adjust the per bed
1100	license fee and the annual license fee once each year by not
1101	more than the average rate of inflation for the 12 months
1102	immediately preceding the increase.
1103	(c)  In addition to the total fee assessed under paragraph
1104	(a), the agency shall require facilities that are licensed to
1105	provide limited nursing services under this chapter part to pay
1106	an additional fee per licensed facility.  The amount of the
1107	biennial fee shall be $250 per license, with an additional fee
1108	of $10 per resident based on the total licensed resident
1109	capacity of the facility.  No part of this fee shall be returned
1110	to the facility.  The agency may adjust the per bed license fee
1111	and the biennial license fee once each year by not more than the
1112	average rate of inflation for the 12 months immediately
1113	preceding the increase.
1114	(5)  Counties or municipalities applying for licenses under
1115	this chapter part are exempt from the payment of license fees.
1116	Section 30.  Section 400.408, Florida Statutes, is
1117	renumbered as section 429.08, Florida Statutes, and paragraphs
1118	(a), (d), (e), (f), and (g) of subsection (1) and paragraph (f)
1119	of subsection (2) are amended to read:
1120	400.408  Unlicensed facilities; referral of person for
1121	residency to unlicensed facility; penalties; verification of
1122	licensure status.--
1123	(1)(a)  It is unlawful to own, operate, or maintain an
1124	assisted living facility without obtaining a license under this
1125	chapter part.
1126	(d)  Any person who owns, operates, or maintains an
1127	unlicensed assisted living facility due to a change in this
1128	chapter part or a modification in department rule within 6
1129	months after the effective date of such change and who, within
1130	10 working days after receiving notification from the agency,
1131	fails to cease operation or apply for a license under this
1132	chapter part commits a felony of the third degree, punishable as
1133	provided in s. 775.082, s. 775.083, or s. 775.084. Each day of
1134	continued operation is a separate offense.
1135	(e)  Any facility that fails to cease operation after
1136	agency notification may be fined for each day of noncompliance
1137	pursuant to s. 429.19 400.419.
1138	(f)  When a licensee has an interest in more than one
1139	assisted living facility, and fails to license any one of these
1140	facilities, the agency may revoke the license, impose a
1141	moratorium, or impose a fine pursuant to s. 429.19 400.419, on
1142	any or all of the licensed facilities until such time as the
1143	unlicensed facility is licensed or ceases operation.
1144	(g)  If the agency determines that an owner is operating or
1145	maintaining an assisted living facility without obtaining a
1146	license and determines that a condition exists in the facility
1147	that poses a threat to the health, safety, or welfare of a
1148	resident of the facility, the owner is subject to the same
1149	actions and fines imposed against a licensed facility as
1150	specified in ss. 429.14 and 429.19 400.414 and 400.419.
1151	(2)  It is unlawful to knowingly refer a person for
1152	residency to an unlicensed assisted living facility; to an
1153	assisted living facility the license of which is under denial or
1154	has been suspended or revoked; or to an assisted living facility
1155	that has a moratorium on admissions.  Any person who violates
1156	this subsection commits a noncriminal violation, punishable by a
1157	fine not exceeding $500 as provided in s. 775.083.
1158	(f)  At least annually, the agency shall notify, in
1159	appropriate trade publications, physicians licensed under
1160	chapter 458 or chapter 459, hospitals licensed under chapter
1161	395, nursing home facilities licensed under part II of this
1162	chapter 400, and employees of the agency or the department, or
1163	the Department of Children and Family Services, who are
1164	responsible for referring persons for residency, that it is
1165	unlawful to knowingly refer a person for residency to an
1166	unlicensed assisted living facility and shall notify them of the
1167	penalty for violating such prohibition. The department and the
1168	Department of Children and Family Services shall, in turn,
1169	notify service providers under contract to the respective
1170	departments who have responsibility for resident referrals to
1171	facilities. Further, the notice must direct each noticed
1172	facility and individual to contact the appropriate agency office
1173	in order to verify the licensure status of any facility prior to
1174	referring any person for residency. Each notice must include the
1175	name, telephone number, and mailing address of the appropriate
1176	office to contact.
1177	Section 31.  Section 400.411, Florida Statutes, is
1178	renumbered as section 429.11, Florida Statutes, and paragraph
1179	(c) of subsection (3) and subsections (4), (11), and (13) are
1180	amended to read:
1181	429.11 400.411  Initial application for license;
1182	provisional license.--
1183	(3)  The application must be signed by the applicant under
1184	oath and must contain the following:
1185	(c)  The name and address of any long-term care facility
1186	with which the applicant, administrator, or financial officer
1187	has been affiliated through ownership or employment within 5
1188	years of the date of this license application; and a signed
1189	affidavit disclosing any financial or ownership interest that
1190	the applicant, or any person listed in paragraph (a), holds or
1191	has held within the last 5 years in any facility licensed under
1192	this chapter part, or in any other entity licensed by this state
1193	or another state to provide health or residential care, which
1194	facility or entity closed or ceased to operate as a result of
1195	financial problems, or has had a receiver appointed or a license
1196	denied, suspended or revoked, or was subject to a moratorium on
1197	admissions, or has had an injunctive proceeding initiated
1198	against it.
1199	(4)  The applicant shall furnish satisfactory proof of
1200	financial ability to operate and conduct the facility in
1201	accordance with the requirements of this chapter part. A
1202	certificate of authority, pursuant to chapter 651, may be
1203	provided as proof of financial ability.
1204	(11)  The applicant must furnish proof of compliance with
1205	level 2 background screening as required under s. 429.174
1206	400.4174.
1207	(13)  A county or municipality may not issue an
1208	occupational license that is being obtained for the purpose of
1209	operating a facility regulated under this chapter part without
1210	first ascertaining that the applicant has been licensed to
1211	operate such facility at the specified location or locations by
1212	the agency. The agency shall furnish to local agencies
1213	responsible for issuing occupational licenses sufficient
1214	instruction for making such determinations.
1215	Section 32.  Section 400.412, Florida Statutes, is
1216	renumbered as section 429.12, Florida Statutes, and subsection
1217	(1) is amended to read:
1218	429.12 400.412  Sale or transfer of ownership of a
1219	facility.--It is the intent of the Legislature to protect the
1220	rights of the residents of an assisted living facility when the
1221	facility is sold or the ownership thereof is transferred.
1222	Therefore, whenever a facility is sold or the ownership thereof
1223	is transferred, including leasing:
1224	(1)  The transferee shall make application to the agency
1225	for a new license at least 60 days before the date of transfer
1226	of ownership. The application must comply with the provisions of
1227	s. 429.11 400.411.
1228	Section 33.  Section 400.414, Florida Statutes, is
1229	renumbered as section 429.14, Florida Statutes, and subsections
1230	(1), (3), and (5) are amended to read:
1231	429.14 400.414  Denial, revocation, or suspension of
1232	license; imposition of administrative fine; grounds.--
1233	(1)  The agency may deny, revoke, or suspend any license
1234	issued under this chapter part, or impose an administrative fine
1235	in the manner provided in chapter 120, for any of the following
1236	actions by an assisted living facility, for the actions of any
1237	person subject to level 2 background screening under s. 429.174
1238	400.4174, or for the actions of any facility employee:
1239	(a)  An intentional or negligent act seriously affecting
1240	the health, safety, or welfare of a resident of the facility.
1241	(b)  The determination by the agency that the owner lacks
1242	the financial ability to provide continuing adequate care to
1243	residents.
1244	(c)  Misappropriation or conversion of the property of a
1245	resident of the facility.
1246	(d)  Failure to follow the criteria and procedures provided
1247	under part I of chapter 394 relating to the transportation,
1248	voluntary admission, and involuntary examination of a facility
1249	resident.
1250	(e)  A citation of any of the following deficiencies as
1251	defined in s. 429.19 400.419:
1252	1.  One or more cited class I deficiencies.
1253	2.  Three or more cited class II deficiencies.
1254	3.  Five or more cited class III deficiencies that have
1255	been cited on a single survey and have not been corrected within
1256	the times specified.
1257	(f)  A determination that a person subject to level 2
1258	background screening under s. 429.174 400.4174(1) does not meet
1259	the screening standards of s. 435.04 or that the facility is
1260	retaining an employee subject to level 1 background screening
1261	standards under s. 429.174 400.4174(2) who does not meet the
1262	screening standards of s. 435.03 and for whom exemptions from
1263	disqualification have not been provided by the agency.
1264	(g)  A determination that an employee, volunteer,
1265	administrator, or owner, or person who otherwise has access to
1266	the residents of a facility does not meet the criteria specified
1267	in s. 435.03(2), and the owner or administrator has not taken
1268	action to remove the person. Exemptions from disqualification
1269	may be granted as set forth in s. 435.07. No administrative
1270	action may be taken against the facility if the person is
1271	granted an exemption.
1272	(h)  Violation of a moratorium.
1273	(i)  Failure of the license applicant, the licensee during
1274	relicensure, or a licensee that holds a provisional license to
1275	meet the minimum license requirements of this chapter part, or
1276	related rules, at the time of license application or renewal.
1277	(j)  A fraudulent statement or omission of any material
1278	fact on an application for a license or any other document
1279	required by the agency, including the submission of a license
1280	application that conceals the fact that any board member,
1281	officer, or person owning 5 percent or more of the facility may
1282	not meet the background screening requirements of s. 429.174
1283	400.4174, or that the applicant has been excluded, permanently
1284	suspended, or terminated from the Medicaid or Medicare programs.
1285	(k)  An intentional or negligent life-threatening act in
1286	violation of the uniform firesafety standards for assisted
1287	living facilities or other firesafety standards that threatens
1288	the health, safety, or welfare of a resident of a facility, as
1289	communicated to the agency by the local authority having
1290	jurisdiction or the State Fire Marshal.
1291	(l)  Exclusion, permanent suspension, or termination from
1292	the Medicare or Medicaid programs.
1293	(m)  Knowingly operating any unlicensed facility or
1294	providing without a license any service that must be licensed
1295	under this chapter or chapter 400.
1296	(n)  Any act constituting a ground upon which application
1297	for a license may be denied.
1298
1299	Administrative proceedings challenging agency action under this
1300	subsection shall be reviewed on the basis of the facts and
1301	conditions that resulted in the agency action.
1302	(3)  The agency may deny a license to any applicant or to
1303	any officer or board member of an applicant who is a firm,
1304	corporation, partnership, or association or who owns 5 percent
1305	or more of the facility, if the applicant, officer, or board
1306	member has or had a 25-percent or greater financial or ownership
1307	interest in any other facility licensed under this chapter part,
1308	or in any entity licensed by this state or another state to
1309	provide health or residential care, which facility or entity
1310	during the 5 years prior to the application for a license closed
1311	due to financial inability to operate; had a receiver appointed
1312	or a license denied, suspended, or revoked; was subject to a
1313	moratorium on admissions; had an injunctive proceeding initiated
1314	against it; or has an outstanding fine assessed under this
1315	chapter or chapter 400.
1316	(5)  An action taken by the agency to suspend, deny, or
1317	revoke a facility's license under this chapter part, in which
1318	the agency claims that the facility owner or an employee of the
1319	facility has threatened the health, safety, or welfare of a
1320	resident of the facility be heard by the Division of
1321	Administrative Hearings of the Department of Management Services
1322	within 120 days after receipt of the facility's request for a
1323	hearing, unless that time limitation is waived by both parties.
1324	The administrative law judge must render a decision within 30
1325	days after receipt of a proposed recommended order.
1326	Section 34.  Section 400.415, Florida Statutes, is
1327	renumbered as section 429.15, Florida Statutes, and subsection
1328	(1) is amended to read:
1329	429.15 400.415  Moratorium on admissions; notice.--The
1330	agency may impose an immediate moratorium on admissions to any
1331	assisted living facility if the agency determines that any
1332	condition in the facility presents a threat to the health,
1333	safety, or welfare of the residents in the facility.
1334	(1)  A facility the license of which is denied, revoked, or
1335	suspended pursuant to s. 429.14 400.414 may be subject to
1336	immediate imposition of a moratorium on admissions to run
1337	concurrently with licensure denial, revocation, or suspension.
1338	Section 35.  Section 400.417, Florida Statutes, is
1339	renumbered as section 429.17, Florida Statutes, and subsections
1340	(2) and (3) are amended to read:
1341	429.17 400.417  Expiration of license; renewal; conditional
1342	license.--
1343	(2)  A license shall be renewed within 90 days upon the
1344	timely filing of an application on forms furnished by the agency
1345	and the provision of satisfactory proof of ability to operate
1346	and conduct the facility in accordance with the requirements of
1347	this chapter part and adopted rules, including proof that the
1348	facility has received a satisfactory firesafety inspection,
1349	conducted by the local authority having jurisdiction or the
1350	State Fire Marshal, within the preceding 12 months and an
1351	affidavit of compliance with the background screening
1352	requirements of s. 429.174 400.4174.
1353	(3)  An applicant for renewal of a license who has complied
1354	with the provisions of s. 429.11 400.411 with respect to proof
1355	of financial ability to operate shall not be required to provide
1356	further proof unless the facility or any other facility owned or
1357	operated in whole or in part by the same person has demonstrated
1358	financial instability as provided under s. 429.47 400.447(2) or
1359	unless the agency suspects that the facility is not financially
1360	stable as a result of the annual survey or complaints from the
1361	public or a report from the State Long-Term Care Ombudsman
1362	Council.  Each facility must report to the agency any adverse
1363	court action concerning the facility's financial viability,
1364	within 7 days after its occurrence.  The agency shall have
1365	access to books, records, and any other financial documents
1366	maintained by the facility to the extent necessary to determine
1367	the facility's financial stability.  A license for the operation
1368	of a facility shall not be renewed if the licensee has any
1369	outstanding fines assessed pursuant to this chapter part which
1370	are in final order status.
1371	Section 36.  Section 400.4174, Florida Statutes, is
1372	renumbered as section 429.174, Florida Statutes, and subsection
1373	(2) is amended to read:
1374	429.174 400.4174  Background screening; exemptions.--
1375	(2)  The owner or administrator of an assisted living
1376	facility must conduct level 1 background screening, as set forth
1377	in chapter 435, on all employees hired on or after October 1,
1378	1998, who perform personal services as defined in s. 429.02
1379	400.402(17). The agency may exempt an individual from employment
1380	disqualification as set forth in chapter 435. Such persons shall
1381	be considered as having met this requirement if:
1382	(a)  Proof of compliance with level 1 screening
1383	requirements obtained to meet any professional license
1384	requirements in this state is provided and accompanied, under
1385	penalty of perjury, by a copy of the person's current
1386	professional license and an affidavit of current compliance with
1387	the background screening requirements.
1388	(b)  The person required to be screened has been
1389	continuously employed in the same type of occupation for which
1390	the person is seeking employment without a breach in service
1391	which exceeds 180 days, and proof of compliance with the level 1
1392	screening requirement which is no more than 2 years old is
1393	provided. Proof of compliance shall be provided directly from
1394	one employer or contractor to another, and not from the person
1395	screened. Upon request, a copy of screening results shall be
1396	provided by the employer retaining documentation of the
1397	screening to the person screened.
1398	(c)  The person required to be screened is employed by a
1399	corporation or business entity or related corporation or
1400	business entity that owns, operates, or manages more than one
1401	facility or agency licensed under this chapter or chapter 400,
1402	and for whom a level 1 screening was conducted by the
1403	corporation or business entity as a condition of initial or
1404	continued employment.
1405	Section 37.  Section 400.4176, Florida Statutes, is
1406	renumbered as section 429.176, Florida Statutes, and amended to
1407	read:
1408	429.176 400.4176  Notice of change of administrator.--If,
1409	during the period for which a license is issued, the owner
1410	changes administrators, the owner must notify the agency of the
1411	change within 10 days and provide documentation within 90 days
1412	that the new administrator has completed the applicable core
1413	educational requirements under s. 429.52 400.452. Background
1414	screening shall be completed on any new administrator as
1415	specified in s. 429.174 400.4174.
1416	Section 38.  Section 400.4177, Florida Statutes, is
1417	renumbered as section 429.177, Florida Statutes, and amended to
1418	read:
1419	429.177 400.4177  Patients with Alzheimer's disease or
1420	other related disorders; certain disclosures.--A facility
1421	licensed under this chapter part which claims that it provides
1422	special care for persons who have Alzheimer's disease or other
1423	related disorders must disclose in its advertisements or in a
1424	separate document those services that distinguish the care as
1425	being especially applicable to, or suitable for, such persons.
1426	The facility must give a copy of all such advertisements or a
1427	copy of the document to each person who requests information
1428	about programs and services for persons with Alzheimer's disease
1429	or other related disorders offered by the facility and must
1430	maintain a copy of all such advertisements and documents in its
1431	records. The agency shall examine all such advertisements and
1432	documents in the facility's records as part of the license
1433	renewal procedure.
1434	Section 39.  Section 400.4178, Florida Statutes, is
1435	renumbered as section 429.178, Florida Statutes, and paragraphs
1436	(a) and (b) of subsection (2) are amended to read:
1437	429.178 400.4178  Special care for persons with Alzheimer's
1438	disease or other related disorders.--
1439	(2)(a)  An individual who is employed by a facility that
1440	provides special care for residents with Alzheimer's disease or
1441	other related disorders, and who has regular contact with such
1442	residents, must complete up to 4 hours of initial dementia-
1443	specific training developed or approved by the department. The
1444	training shall be completed within 3 months after beginning
1445	employment and shall satisfy the core training requirements of
1446	s. 429.52 400.452(2)(g).
1447	(b)  A direct caregiver who is employed by a facility that
1448	provides special care for residents with Alzheimer's disease or
1449	other related disorders, and who provides direct care to such
1450	residents, must complete the required initial training and 4
1451	additional hours of training developed or approved by the
1452	department. The training shall be completed within 9 months
1453	after beginning employment and shall satisfy the core training
1454	requirements of s. 429.52 400.452(2)(g).
1455	Section 40.  Section 400.418, Florida Statutes, is
1456	renumbered as section 429.18, Florida Statutes, and amended to
1457	read:
1458	429.18 400.418  Disposition of fees and administrative
1459	fines.--
1460	(1)  Income from license fees, inspection fees, late fees,
1461	and administrative fines generated pursuant to ss. 429.07,
1462	429.08, 429.17, 429.19, and 429.31 400.407, 400.408, 400.417,
1463	400.419, and 400.431 shall be deposited in the Health Care Trust
1464	Fund administered by the agency.  Such funds shall be directed
1465	to and used by the agency for the following purposes:
1466	(a)  Up to 50 percent of the trust funds accrued each
1467	fiscal year under this chapter part may be used to offset the
1468	expenses of receivership, pursuant to s. 429.22 400.422, if the
1469	court determines that the income and assets of the facility are
1470	insufficient to provide for adequate management and operation.
1471	(b)  An amount of $5,000 of the trust funds accrued each
1472	year under this chapter part shall be allocated to pay for
1473	inspection-related physical and mental health examinations
1474	requested by the agency pursuant to s. 429.26 400.426 for
1475	residents who are either recipients of supplemental security
1476	income or have monthly incomes not in excess of the maximum
1477	combined federal and state cash subsidies available to
1478	supplemental security income recipients, as provided for in s.
1479	409.212.  Such funds shall only be used where the resident is
1480	ineligible for Medicaid.
1481	(c)  Any trust funds accrued each year under this chapter
1482	part and not used for the purposes specified in paragraphs (a)
1483	and (b) shall be used to offset the costs of the licensure
1484	program, including the costs of conducting background
1485	investigations, verifying information submitted, defraying the
1486	costs of processing the names of applicants, and conducting
1487	inspections and monitoring visits pursuant to this chapter part.
1488	(2)  Income from fees generated pursuant to s. 429.41
1489	400.441(5) shall be deposited in the Health Care Trust Fund and
1490	used to offset the costs of printing and postage.
1491	Section 41.  Section 400.419, Florida Statutes, is
1492	renumbered as section 429.19, Florida Statutes, and subsections
1493	(1), (2), (9), (10), (11), and (12) are amended to read:
1494	429.19 400.419  Violations; imposition of administrative
1495	fines; grounds.--
1496	(1)  The agency shall impose an administrative fine in the
1497	manner provided in chapter 120 for any of the actions or
1498	violations as set forth within this section by an assisted
1499	living facility, for the actions of any person subject to level
1500	2 background screening under s. 429.174 400.4174, for the
1501	actions of any facility employee, or for an intentional or
1502	negligent act seriously affecting the health, safety, or welfare
1503	of a resident of the facility.
1504	(2)  Each violation of this chapter part and adopted rules
1505	shall be classified according to the nature of the violation and
1506	the gravity of its probable effect on facility residents. The
1507	agency shall indicate the classification on the written notice
1508	of the violation as follows:
1509	(a)  Class "I" violations are those conditions or
1510	occurrences related to the operation and maintenance of a
1511	facility or to the personal care of residents which the agency
1512	determines present an imminent danger to the residents or guests
1513	of the facility or a substantial probability that death or
1514	serious physical or emotional harm would result therefrom. The
1515	condition or practice constituting a class I violation shall be
1516	abated or eliminated within 24 hours, unless a fixed period, as
1517	determined by the agency, is required for correction. The agency
1518	shall impose an administrative fine for a cited class I
1519	violation in an amount not less than $5,000 and not exceeding
1520	$10,000 for each violation. A fine may be levied notwithstanding
1521	the correction of the violation.
1522	(b)  Class "II" violations are those conditions or
1523	occurrences related to the operation and maintenance of a
1524	facility or to the personal care of residents which the agency
1525	determines directly threaten the physical or emotional health,
1526	safety, or security of the facility residents, other than class
1527	I violations. The agency shall impose an administrative fine for
1528	a cited class II violation in an amount not less than $1,000 and
1529	not exceeding $5,000 for each violation. A fine shall be levied
1530	notwithstanding the correction of the violation.
1531	(c)  Class "III" violations are those conditions or
1532	occurrences related to the operation and maintenance of a
1533	facility or to the personal care of residents which the agency
1534	determines indirectly or potentially threaten the physical or
1535	emotional health, safety, or security of facility residents,
1536	other than class I or class II violations. The agency shall
1537	impose an administrative fine for a cited class III violation in
1538	an amount not less than $500 and not exceeding $1,000 for each
1539	violation. A citation for a class III violation must specify the
1540	time within which the violation is required to be corrected. If
1541	a class III violation is corrected within the time specified, no
1542	fine may be imposed, unless it is a repeated offense.
1543	(d)  Class "IV" violations are those conditions or
1544	occurrences related to the operation and maintenance of a
1545	building or to required reports, forms, or documents that do not
1546	have the potential of negatively affecting residents. These
1547	violations are of a type that the agency determines do not
1548	threaten the health, safety, or security of residents of the
1549	facility. The agency shall impose an administrative fine for a
1550	cited class IV violation in an amount not less than $100 and not
1551	exceeding $200 for each violation. A citation for a class IV
1552	violation must specify the time within which the violation is
1553	required to be corrected. If a class IV violation is corrected
1554	within the time specified, no fine shall be imposed. Any class
1555	IV violation that is corrected during the time an agency survey
1556	is being conducted will be identified as an agency finding and
1557	not as a violation.
1558	(9)  Any facility whose owner fails to apply for a change-
1559	of-ownership license in accordance with s. 429.12 400.412 and
1560	operates the facility under the new ownership is subject to a
1561	fine of $5,000.
1562	(10)  In addition to any administrative fines imposed, the
1563	agency may assess a survey fee, equal to the lesser of one half
1564	of the facility's biennial license and bed fee or $500, to cover
1565	the cost of conducting initial complaint investigations that
1566	result in the finding of a violation that was the subject of the
1567	complaint or monitoring visits conducted under s. 429.28
1568	400.428(3)(c) to verify the correction of the violations.
1569	(11)  The agency, as an alternative to or in conjunction
1570	with an administrative action against a facility for violations
1571	of this chapter part and adopted rules, shall make a reasonable
1572	attempt to discuss each violation and recommended corrective
1573	action with the owner or administrator of the facility, prior to
1574	written notification. The agency, instead of fixing a period
1575	within which the facility shall enter into compliance with
1576	standards, may request a plan of corrective action from the
1577	facility which demonstrates a good faith effort to remedy each
1578	violation by a specific date, subject to the approval of the
1579	agency.
1580	(12)  Administrative fines paid by any facility under this
1581	section shall be deposited into the Health Care Trust Fund and
1582	expended as provided in s. 429.18 400.418.
1583	Section 42.  Section 400.4195, Florida Statutes, is
1584	renumbered as section 429.195, Florida Statutes, and subsection
1585	(1) is amended to read:
1586	429.195 400.4195  Rebates prohibited; penalties.--
1587	(1)  It is unlawful for any assisted living facility
1588	licensed under this chapter part to contract or promise to pay
1589	or receive any commission, bonus, kickback, or rebate or engage
1590	in any split-fee arrangement in any form whatsoever with any
1591	physician, surgeon, organization, agency, or person, either
1592	directly or indirectly, for residents referred to an assisted
1593	living facility licensed under this chapter part. A facility may
1594	employ or contract with persons to market the facility, provided
1595	the employee or contract provider clearly indicates that he or
1596	she represents the facility. A person or agency independent of
1597	the facility may provide placement or referral services for a
1598	fee to individuals seeking assistance in finding a suitable
1599	facility; however, any fee paid for placement or referral
1600	services must be paid by the individual looking for a facility,
1601	not by the facility.
1602	Section 43.  Section 400.42, Florida Statutes, is
1603	renumbered as section 429.20, Florida Statutes, and subsection
1604	(3) is amended to read:
1605	429.20 400.42  Certain solicitation prohibited; third-party
1606	supplementation.--
1607	(3)  The admission or maintenance of assisted living
1608	facility residents whose care is supported, in whole or in part,
1609	by state funds may not be conditioned upon the receipt of any
1610	manner of contribution or donation from any person. The
1611	solicitation or receipt of contributions in violation of this
1612	subsection is grounds for denial, suspension, or revocation of
1613	license, as provided in s. 429.14 400.414, for any assisted
1614	living facility by or on behalf of which such contributions were
1615	solicited.
1616	Section 44.  Section 400.421, Florida Statutes, is
1617	renumbered as section 429.21, Florida Statutes, and subsection
1618	(1) is amended to read:
1619	429.21 400.421  Injunctive proceedings.--
1620	(1)  The agency may institute injunctive proceedings in a
1621	court of competent jurisdiction to:
1622	(a)  Enforce the provisions of this chapter part or any
1623	minimum standard, rule, or order issued or entered into pursuant
1624	thereto when the attempt by the agency to correct a violation
1625	through administrative fines has failed or when the violation
1626	materially affects the health, safety, or welfare of residents;
1627	or
1628	(b)  Terminate the operation of a facility when violations
1629	of any provisions of this chapter part or of any standard or
1630	rule promulgated pursuant thereto exist which materially affect
1631	the health, safety, or welfare of residents.
1632	Section 45.  Section 400.422, Florida Statutes, is
1633	renumbered as section 429.22, Florida Statutes, and paragraph
1634	(a) of subsection (1) and subsection (9) are amended to read:
1635	429.22 400.422  Receivership proceedings.--
1636	(1)  As an alternative to or in conjunction with an
1637	injunctive proceeding, the agency may petition a court of
1638	competent jurisdiction for the appointment of a receiver, if
1639	suitable alternate placements are not available, when any of the
1640	following conditions exist:
1641	(a)  The facility is operating without a license and
1642	refuses to make application for a license as required by ss.
1643	429.07 400.407 and 429.08 400.408.
1644	(9)  The court may direct the agency to allocate funds from
1645	the Health Care Trust Fund to the receiver, subject to the
1646	provisions of s. 429.18 400.418(1).
1647	Section 46.  Section 400.423, Florida Statutes, is
1648	renumbered as section 429.23, Florida Statutes, and subsections
1649	(1), (2), (5), and (8) are amended to read:
1650	429.23 400.423  Internal risk management and quality
1651	assurance program; adverse incidents and reporting
1652	requirements.--
1653	(1)  Every facility licensed under this chapter part may,
1654	as part of its administrative functions, voluntarily establish a
1655	risk management and quality assurance program, the purpose of
1656	which is to assess resident care practices, facility incident
1657	reports, deficiencies cited by the agency, adverse incident
1658	reports, and resident grievances and develop plans of action to
1659	correct and respond quickly to identify quality differences.
1660	(2)  Every facility licensed under this chapter part is
1661	required to maintain adverse incident reports. For purposes of
1662	this section, the term, "adverse incident" means:
1663	(a)  An event over which facility personnel could exercise
1664	control rather than as a result of the resident's condition and
1665	results in:
1666	1.  Death;
1667	2.  Brain or spinal damage;
1668	3.  Permanent disfigurement;
1669	4.  Fracture or dislocation of bones or joints;
1670	5.  Any condition that required medical attention to which
1671	the resident has not given his or her consent, including failure
1672	to honor advanced directives;
1673	6.  Any condition that requires the transfer of the
1674	resident from the facility to a unit providing more acute care
1675	due to the incident rather than the resident's condition before
1676	the incident.
1677	(b)  Abuse, neglect, or exploitation as defined in s.
1678	415.102;
1679	(c)  Events reported to law enforcement; or
1680	(d)  Elopement.
1681	(5)  Each facility shall report monthly to the agency any
1682	liability claim filed against it. The report must include the
1683	name of the resident, the dates of the incident leading to the
1684	claim, if applicable, and the type of injury or violation of
1685	rights alleged to have occurred. This report is not discoverable
1686	in any civil or administrative action, except in such actions
1687	brought by the agency to enforce the provisions of this chapter
1688	part.
1689	(8)  If the agency, through its receipt of the adverse
1690	incident reports prescribed in this chapter part or through any
1691	investigation, has reasonable belief that conduct by a staff
1692	member or employee of a licensed facility is grounds for
1693	disciplinary action by the appropriate board, the agency shall
1694	report this fact to such regulatory board.
1695	Section 47.  Section 400.424, Florida Statutes, is
1696	renumbered as section 429.24, Florida Statutes, and subsection
1697	(2), paragraph (a) of subsection (3), and subsection (5) are
1698	amended to read:
1699	429.24 400.424  Contracts.--
1700	(2)  Each contract must contain express provisions
1701	specifically setting forth the services and accommodations to be
1702	provided by the facility; the rates or charges; provision for at
1703	least 30 days' written notice of a rate increase; the rights,
1704	duties, and obligations of the residents, other than those
1705	specified in s. 429.28 400.428; and other matters that the
1706	parties deem appropriate. Whenever money is deposited or
1707	advanced by a resident in a contract as security for performance
1708	of the contract agreement or as advance rent for other than the
1709	next immediate rental period:
1710	(a)  Such funds shall be deposited in a banking institution
1711	in this state that is located, if possible, in the same
1712	community in which the facility is located; shall be kept
1713	separate from the funds and property of the facility; may not be
1714	represented as part of the assets of the facility on financial
1715	statements; and shall be used, or otherwise expended, only for
1716	the account of the resident.
1717	(b)  The licensee shall, within 30 days of receipt of
1718	advance rent or a security deposit, notify the resident or
1719	residents in writing of the manner in which the licensee is
1720	holding the advance rent or security deposit and state the name
1721	and address of the depository where the moneys are being held.
1722	The licensee shall notify residents of the facility's policy on
1723	advance deposits.
1724	(3)(a)  The contract shall include a refund policy to be
1725	implemented at the time of a resident's transfer, discharge, or
1726	death. The refund policy shall provide that the resident or
1727	responsible party is entitled to a prorated refund based on the
1728	daily rate for any unused portion of payment beyond the
1729	termination date after all charges, including the cost of
1730	damages to the residential unit resulting from circumstances
1731	other than normal use, have been paid to the licensee. For the
1732	purpose of this paragraph, the termination date shall be the
1733	date the unit is vacated by the resident and cleared of all
1734	personal belongings. If the amount of belongings does not
1735	preclude renting the unit, the facility may clear the unit and
1736	charge the resident or his or her estate for moving and storing
1737	the items at a rate equal to the actual cost to the facility,
1738	not to exceed 20 percent of the regular rate for the unit,
1739	provided that 14 days' advance written notification is given. If
1740	the resident's possessions are not claimed within 45 days after
1741	notification, the facility may dispose of them. The contract
1742	shall also specify any other conditions under which claims will
1743	be made against the refund due the resident. Except in the case
1744	of death or a discharge due to medical reasons, the refunds
1745	shall be computed in accordance with the notice of relocation
1746	requirements specified in the contract. However, a resident may
1747	not be required to provide the licensee with more than 30 days'
1748	notice of termination. If after a contract is terminated, the
1749	facility intends to make a claim against a refund due the
1750	resident, the facility shall notify the resident or responsible
1751	party in writing of the claim and shall provide said party with
1752	a reasonable time period of no less than 14 calendar days to
1753	respond. The facility shall provide a refund to the resident or
1754	responsible party within 45 days after the transfer, discharge,
1755	or death of the resident. The agency shall impose a fine upon a
1756	facility that fails to comply with the refund provisions of the
1757	paragraph, which fine shall be equal to three times the amount
1758	due to the resident. One-half of the fine shall be remitted to
1759	the resident or his or her estate, and the other half to the
1760	Health Care Trust Fund to be used for the purpose specified in
1761	s. 429.18 400.418.
1762	(5)  Neither the contract nor any provision thereof
1763	relieves any licensee of any requirement or obligation imposed
1764	upon it by this chapter part or rules adopted under this chapter
1765	part.
1766	Section 48.  Section 400.4255, Florida Statutes, is
1767	renumbered as section 429.255, Florida Statutes, and paragraphs
1768	(a) and (b) of subsection (1) and subsection (2) are amended to
1769	read:
1770	429.255 400.4255  Use of personnel; emergency care.--
1771	(1) (a)  Persons under contract to the facility, facility
1772	staff, or volunteers, who are licensed according to part I of
1773	chapter 464, or those persons exempt under s. 464.022(1), and
1774	others as defined by rule, may administer medications to
1775	residents, take residents' vital signs, manage individual weekly
1776	pill organizers for residents who self-administer medication,
1777	give prepackaged enemas ordered by a physician, observe
1778	residents, document observations on the appropriate resident's
1779	record, report observations to the resident's physician, and
1780	contract or allow residents or a resident's representative,
1781	designee, surrogate, guardian, or attorney in fact to contract
1782	with a third party, provided residents meet the criteria for
1783	appropriate placement as defined in s. 429.26 400.426. Nursing
1784	assistants certified pursuant to part II of chapter 464 may take
1785	residents' vital signs as directed by a licensed nurse or
1786	physician.
1787	(b)  All staff in facilities licensed under this chapter
1788	part shall exercise their professional responsibility to observe
1789	residents, to document observations on the appropriate
1790	resident's record, and to report the observations to the
1791	resident's physician.  However, the owner or administrator of
1792	the facility shall be responsible for determining that the
1793	resident receiving services is appropriate for residence in the
1794	facility.
1795	(2)  In facilities licensed to provide extended congregate
1796	care, persons under contract to the facility, facility staff, or
1797	volunteers, who are licensed according to part I of chapter 464,
1798	or those persons exempt under s. 464.022(1), or those persons
1799	certified as nursing assistants pursuant to part II of chapter
1800	464, may also perform all duties within the scope of their
1801	license or certification, as approved by the facility
1802	administrator and pursuant to this chapter part.
1803	Section 49.  Section 400.4256, Florida Statutes, is
1804	renumbered as section 429.256, Florida Statutes, and paragraph
1805	(b) of subsection (1) is amended to read:
1806	429.256 400.4256  Assistance with self-administration of
1807	medication.--
1808	(1)  For the purposes of this section, the term:
1809	(b)  "Unlicensed person" means an individual not currently
1810	licensed to practice nursing or medicine who is employed by or
1811	under contract to an assisted living facility and who has
1812	received training with respect to assisting with the self-
1813	administration of medication in an assisted living facility as
1814	provided under s. 429.52 400.452 prior to providing such
1815	assistance as described in this section.
1816	Section 50.  Section 400.426, Florida Statutes, is
1817	renumbered as section 429.26, Florida Statutes, and subsections
1818	(1), (4), (5), (9), and (12) are amended to read:
1819	429.26 400.426  Appropriateness of placements; examinations
1820	of residents.--
1821	(1)  The owner or administrator of a facility is
1822	responsible for determining the appropriateness of admission of
1823	an individual to the facility and for determining the continued
1824	appropriateness of residence of an individual in the facility. A
1825	determination shall be based upon an assessment of the
1826	strengths, needs, and preferences of the resident, the care and
1827	services offered or arranged for by the facility in accordance
1828	with facility policy, and any limitations in law or rule related
1829	to admission criteria or continued residency for the type of
1830	license held by the facility under this chapter part. A resident
1831	may not be moved from one facility to another without
1832	consultation with and agreement from the resident or, if
1833	applicable, the resident's representative or designee or the
1834	resident's family, guardian, surrogate, or attorney in fact. In
1835	the case of a resident who has been placed by the department or
1836	the Department of Children and Family Services, the
1837	administrator must notify the appropriate contact person in the
1838	applicable department.
1839	(4)  If possible, each resident shall have been examined by
1840	a licensed physician or a licensed nurse practitioner within 60
1841	days before admission to the facility. The signed and completed
1842	medical examination report shall be submitted to the owner or
1843	administrator of the facility who shall use the information
1844	contained therein to assist in the determination of the
1845	appropriateness of the resident's admission and continued stay
1846	in the facility. The medical examination report shall become a
1847	permanent part of the record of the resident at the facility and
1848	shall be made available to the agency during inspection or upon
1849	request. An assessment that has been completed through the
1850	Comprehensive Assessment and Review for Long-Term Care Services
1851	(CARES) Program fulfills the requirements for a medical
1852	examination under this subsection and s. 429.07 400.407(3)(b)6.
1853	(5)  Except as provided in s. 429.07 400.407, if a medical
1854	examination has not been completed within 60 days before the
1855	admission of the resident to the facility, a licensed physician
1856	or licensed nurse practitioner shall examine the resident and
1857	complete a medical examination form provided by the agency
1858	within 30 days following the admission to the facility to enable
1859	the facility owner or administrator to determine the
1860	appropriateness of the admission. The medical examination form
1861	shall become a permanent part of the record of the resident at
1862	the facility and shall be made available to the agency during
1863	inspection by the agency or upon request.
1864	(9)  If, at any time after admission to a facility, a
1865	resident appears to need care beyond that which the facility is
1866	licensed to provide, the agency shall require the resident to be
1867	physically examined by a licensed physician or licensed nurse
1868	practitioner. This examination shall, to the extent possible, be
1869	performed by the resident's preferred physician or nurse
1870	practitioner and shall be paid for by the resident with personal
1871	funds, except as provided in s. 429.18 400.418(1)(b). Following
1872	this examination, the examining physician or licensed nurse
1873	practitioner shall complete and sign a medical form provided by
1874	the agency. The completed medical form shall be submitted to the
1875	agency within 30 days after the date the facility owner or
1876	administrator is notified by the agency that the physical
1877	examination is required. After consultation with the physician
1878	or licensed nurse practitioner who performed the examination, a
1879	medical review team designated by the agency shall then
1880	determine whether the resident is appropriately residing in the
1881	facility. The medical review team shall base its decision on a
1882	comprehensive review of the resident's physical and functional
1883	status, including the resident's preferences, and not on an
1884	isolated health-related problem. In the case of a mental health
1885	resident, if the resident appears to have needs in addition to
1886	those identified in the community living support plan, the
1887	agency may require an evaluation by a mental health
1888	professional, as determined by the Department of Children and
1889	Family Services. A facility may not be required to retain a
1890	resident who requires more services or care than the facility is
1891	able to provide in accordance with its policies and criteria for
1892	admission and continued residency. Members of the medical review
1893	team making the final determination may not include the agency
1894	personnel who initially questioned the appropriateness of a
1895	resident's placement. Such determination is final and binding
1896	upon the facility and the resident. Any resident who is
1897	determined by the medical review team to be inappropriately
1898	residing in a facility shall be given 30 days' written notice to
1899	relocate by the owner or administrator, unless the resident's
1900	continued residence in the facility presents an imminent danger
1901	to the health, safety, or welfare of the resident or a
1902	substantial probability exists that death or serious physical
1903	harm would result to the resident if allowed to remain in the
1904	facility.
1905	(12)  No resident who requires 24-hour nursing supervision,
1906	except for a resident who is an enrolled hospice patient
1907	pursuant to part VI of this chapter 400, shall be retained in a
1908	facility licensed under this chapter part.
1909	Section 51.  Section 400.427, Florida Statutes, is
1910	renumbered as section 429.27, Florida Statutes, and paragraph
1911	(a) of subsection (6) is amended to read:
1912	429.27 400.427  Property and personal affairs of
1913	residents.--
1914	(6)(a)  In addition to any damages or civil penalties to
1915	which a person is subject, any person who:
1916	1.  Intentionally withholds a resident's personal funds,
1917	personal property, or personal needs allowance, or who demands,
1918	beneficially receives, or contracts for payment of all or any
1919	part of a resident's personal property or personal needs
1920	allowance in satisfaction of the facility rate for supplies and
1921	services; or
1922	2.  Borrows from or pledges any personal funds of a
1923	resident, other than the amount agreed to by written contract
1924	under s. 429.24 400.424,
1925
1926	commits a misdemeanor of the first degree, punishable as
1927	provided in s. 775.082 or s. 775.083.
1928	Section 52.  Section 400.4275, Florida Statutes, is
1929	renumbered as section 429.275, Florida Statutes, and subsection
1930	(2) is amended to read:
1931	429.275 400.4275  Business practice; personnel records;
1932	liability insurance.--The assisted living facility shall be
1933	administered on a sound financial basis that is consistent with
1934	good business practices.
1935	(2)  The administrator or owner of a facility shall
1936	maintain personnel records for each staff member which contain,
1937	at a minimum, documentation of background screening, if
1938	applicable, documentation of compliance with all training
1939	requirements of this chapter part or applicable rule, and a copy
1940	of all licenses or certification held by each staff who performs
1941	services for which licensure or certification is required under
1942	this chapter part or rule.
1943	Section 53.  Section 400.428, Florida Statutes, is
1944	renumbered as section 429.28, Florida Statutes, and paragraph
1945	(f) of subsection (1), subsection (2), paragraph (e) of
1946	subsection (3), paragraph (c) of subsection (5), and subsection
1947	(7) are amended to read:
1948	429.28 400.428  Resident bill of rights.--
1949	(1)  No resident of a facility shall be deprived of any
1950	civil or legal rights, benefits, or privileges guaranteed by
1951	law, the Constitution of the State of Florida, or the
1952	Constitution of the United States as a resident of a facility.
1953	Every resident of a facility shall have the right to:
1954	(f)  Manage his or her financial affairs unless the
1955	resident or, if applicable, the resident's representative,
1956	designee, surrogate, guardian, or attorney in fact authorizes
1957	the administrator of the facility to provide safekeeping for
1958	funds as provided in s. 429.27 400.427.
1959	(2)  The administrator of a facility shall ensure that a
1960	written notice of the rights, obligations, and prohibitions set
1961	forth in this chapter part is posted in a prominent place in
1962	each facility and read or explained to residents who cannot
1963	read. This notice shall include the name, address, and telephone
1964	numbers of the local ombudsman council and central abuse hotline
1965	and, when applicable, the Advocacy Center for Persons with
1966	Disabilities, Inc., and the Florida local advocacy council,
1967	where complaints may be lodged.  The facility must ensure a
1968	resident's access to a telephone to call the local ombudsman
1969	council, central abuse hotline, Advocacy Center for Persons with
1970	Disabilities, Inc., and the Florida local advocacy council.
1971	(3)
1972	(e)  The agency may conduct complaint investigations as
1973	warranted to investigate any allegations of noncompliance with
1974	requirements required under this chapter part or rules adopted
1975	under this chapter part.
1976	(5)  No facility or employee of a facility may serve notice
1977	upon a resident to leave the premises or take any other
1978	retaliatory action against any person who:
1979	(c)  Files a civil action alleging a violation of the
1980	provisions of this chapter part or notifies a state attorney or
1981	the Attorney General of a possible violation of such provisions.
1982	(7)  Any person who submits or reports a complaint
1983	concerning a suspected violation of the provisions of this
1984	chapter part or concerning services and conditions in
1985	facilities, or who testifies in any administrative or judicial
1986	proceeding arising from such a complaint, shall have immunity
1987	from any civil or criminal liability therefor, unless such
1988	person has acted in bad faith or with malicious purpose or the
1989	court finds that there was a complete absence of a justiciable
1990	issue of either law or fact raised by the losing party.
1991	Section 54.  Section 400.429, Florida Statutes, is
1992	renumbered as section 429.29, Florida Statutes, and subsections
1993	(1), (2), and (7) are amended to read:
1994	429.29 400.429  Civil actions to enforce rights.--
1995	(1)  Any person or resident whose rights as specified in
1996	this chapter part are violated shall have a cause of action.
1997	The action may be brought by the resident or his or her
1998	guardian, or by a person or organization acting on behalf of a
1999	resident with the consent of the resident or his or her
2000	guardian, or by the personal representative of the estate of a
2001	deceased resident regardless of the cause of death. If the
2002	action alleges a claim for the resident's rights or for
2003	negligence that caused the death of the resident, the claimant
2004	shall be required to elect either survival damages pursuant to
2005	s. 46.021 or wrongful death damages pursuant to s. 768.21. If
2006	the action alleges a claim for the resident's rights or for
2007	negligence that did not cause the death of the resident, the
2008	personal representative of the estate may recover damages for
2009	the negligence that caused injury to the resident. The action
2010	may be brought in any court of competent jurisdiction to enforce
2011	such rights and to recover actual damages, and punitive damages
2012	for violation of the rights of a resident or negligence. Any
2013	resident who prevails in seeking injunctive relief or a claim
2014	for an administrative remedy is entitled to recover the costs of
2015	the action and a reasonable attorney's fee assessed against the
2016	defendant not to exceed $25,000. Fees shall be awarded solely
2017	for the injunctive or administrative relief and not for any
2018	claim or action for damages whether such claim or action is
2019	brought together with a request for an injunction or
2020	administrative relief or as a separate action, except as
2021	provided under s. 768.79 or the Florida Rules of Civil
2022	Procedure. Sections 429.29-429.298 400.429-400.4303 provide the
2023	exclusive remedy for a cause of action for recovery of damages
2024	for the personal injury or death of a resident arising out of
2025	negligence or a violation of rights specified in s. 429.28
2026	400.428. This section does not preclude theories of recovery not
2027	arising out of negligence or s. 429.28 400.428 which are
2028	available to a resident or to the agency. The provisions of
2029	chapter 766 do not apply to any cause of action brought under
2030	ss. 429.29-429.298 400.429-400.4303.
2031	(2)  In any claim brought pursuant to this chapter part
2032	alleging a violation of resident's rights or negligence causing
2033	injury to or the death of a resident, the claimant shall have
2034	the burden of proving, by a preponderance of the evidence, that:
2035	(a)  The defendant owed a duty to the resident;
2036	(b)  The defendant breached the duty to the resident;
2037	(c)  The breach of the duty is a legal cause of loss,
2038	injury, death, or damage to the resident; and
2039	(d)  The resident sustained loss, injury, death, or damage
2040	as a result of the breach.
2041
2042	Nothing in this chapter part shall be interpreted to create
2043	strict liability. A violation of the rights set forth in s.
2044	429.28 400.428 or in any other standard or guidelines specified
2045	in this chapter part or in any applicable administrative
2046	standard or guidelines of this state or a federal regulatory
2047	agency shall be evidence of negligence but shall not be
2048	considered negligence per se.
2049	(7)  The resident or the resident's legal representative
2050	shall serve a copy of any complaint alleging in whole or in part
2051	a violation of any rights specified in this chapter part to the
2052	Agency for Health Care Administration at the time of filing the
2053	initial complaint with the clerk of the court for the county in
2054	which the action is pursued. The requirement of providing a copy
2055	of the complaint to the agency does not impair the resident's
2056	legal rights or ability to seek relief for his or her claim.
2057	Section 55.  Section 400.4293, Florida Statutes, is
2058	renumbered as section 429.293, Florida Statutes, and paragraph
2059	(a) of subsection (1) and subsections (2) and (10) are amended
2060	to read:
2061	429.293 400.4293  Presuit notice; investigation;
2062	notification of violation of residents' rights or alleged
2063	negligence; claims evaluation procedure; informal discovery;
2064	review; settlement offer; mediation.--
2065	(1)  As used in this section, the term:
2066	(a)  "Claim for residents' rights violation or negligence"
2067	means a negligence claim alleging injury to or the death of a
2068	resident arising out of an asserted violation of the rights of a
2069	resident under s. 429.28 400.428 or an asserted deviation from
2070	the applicable standard of care.
2071	(2)  Prior to filing a claim for a violation of a
2072	resident's rights or a claim for negligence, a claimant alleging
2073	injury to or the death of a resident shall notify each
2074	prospective defendant by certified mail, return receipt
2075	requested, of an asserted violation of a resident's rights
2076	provided in s. 429.28 400.428 or deviation from the standard of
2077	care. Such notification shall include an identification of the
2078	rights the prospective defendant has violated and the negligence
2079	alleged to have caused the incident or incidents and a brief
2080	description of the injuries sustained by the resident which are
2081	reasonably identifiable at the time of notice. The notice shall
2082	contain a certificate of counsel that counsel's reasonable
2083	investigation gave rise to a good faith belief that grounds
2084	exist for an action against each prospective defendant.
2085	(10)  To the extent not inconsistent with this chapter
2086	part, the provisions of the Florida Mediation Code, Florida
2087	Rules of Civil Procedure, shall be applicable to such
2088	proceedings.
2089	Section 56.  Section 400.4294, Florida Statutes, is
2090	renumbered as section 429.294, Florida Statutes, and subsection
2091	(1) is amended to read:
2092	429.294 400.4294  Availability of facility records for
2093	investigation of resident's rights violations and defenses;
2094	penalty.--
2095	(1)  Failure to provide complete copies of a resident's
2096	records, including, but not limited to, all medical records and
2097	the resident's chart, within the control or possession of the
2098	facility within 10 days, in accordance with the provisions of s.
2099	400.145, shall constitute evidence of failure of that party to
2100	comply with good faith discovery requirements and shall waive
2101	the good faith certificate and presuit notice requirements under
2102	this chapter part by the requesting party.
2103	Section 57.  Section 400.4295, Florida Statutes, is
2104	renumbered as section 429.295, Florida Statutes, and amended to
2105	read:
2106	429.295 400.4295  Certain provisions not applicable to
2107	actions under this chapter part.--An action under this chapter
2108	part for a violation of rights or negligence recognized herein
2109	is not a claim for medical malpractice, and the provisions of s.
2110	768.21(8) do not apply to a claim alleging death of the
2111	resident.
2112	Section 58.  Section 400.4296, Florida Statutes, is
2113	renumbered as section 429.296, Florida Statutes, and subsection
2114	(1) is amended to read:
2115	429.296 400.4296  Statute of limitations.--
2116	(1)  Any action for damages brought under this chapter part
2117	shall be commenced within 2 years from the time the incident
2118	giving rise to the action occurred or within 2 years from the
2119	time the incident is discovered, or should have been discovered
2120	with the exercise of due diligence; however, in no event shall
2121	the action be commenced later than 4 years from the date of the
2122	incident or occurrence out of which the cause of action accrued.
2123	Section 59.  Section 400.4297, Florida Statutes, is
2124	renumbered as section 429.297, Florida Statutes, and subsection
2125	(1) is amended to read:
2126	429.297 400.4297  Punitive damages; pleading; burden of
2127	proof.--
2128	(1)  In any action for damages brought under this chapter
2129	part, no claim for punitive damages shall be permitted unless
2130	there is a reasonable showing by evidence in the record or
2131	proffered by the claimant which would provide a reasonable basis
2132	for recovery of such damages. The claimant may move to amend her
2133	or his complaint to assert a claim for punitive damages as
2134	allowed by the rules of civil procedure. The rules of civil
2135	procedure shall be liberally construed so as to allow the
2136	claimant discovery of evidence which appears reasonably
2137	calculated to lead to admissible evidence on the issue of
2138	punitive damages. No discovery of financial worth shall proceed
2139	until after the pleading concerning punitive damages is
2140	permitted.
2141	Section 60.  Section 400.431, Florida Statutes, is
2142	renumbered as section 429.31, Florida Statutes, and subsections
2143	(1) and (5) are amended to read:
2144	429.31 400.431  Closing of facility; notice; penalty.--
2145	(1)  Whenever a facility voluntarily discontinues
2146	operation, it shall inform the agency in writing at least 90
2147	days prior to the discontinuance of operation. The facility
2148	shall also inform each resident or the next of kin, legal
2149	representative, or agency acting on each resident's behalf, of
2150	the fact and the proposed time of such discontinuance, following
2151	the notification requirements provided in s. 429.28
2152	400.428(1)(k). In the event a resident has no person to
2153	represent him or her, the facility shall be responsible for
2154	referral to an appropriate social service agency for placement.
2155	(5)  The agency may levy a fine in an amount no greater
2156	than $5,000 upon each person or business entity that owns any
2157	interest in a facility that terminates operation without
2158	providing notice to the agency and the residents of the facility
2159	at least 30 days before operation ceases. This fine shall not be
2160	levied against any facility involuntarily closed at the
2161	initiation of the agency. The agency shall use the proceeds of
2162	the fines to operate the facility until all residents of the
2163	facility are relocated and shall deposit any balance of the
2164	proceeds into the Health Care Trust Fund established pursuant to
2165	s. 429.18 400.418.
2166	Section 61.  Section 400.434, Florida Statutes, is
2167	renumbered as section 429.34, Florida Statutes, and amended to
2168	read:
2169	429.34 400.434  Right of entry and inspection.--Any duly
2170	designated officer or employee of the department, the Department
2171	of Children and Family Services, the agency, the Medicaid Fraud
2172	Control Unit of the Department of Legal Affairs, the state or
2173	local fire marshal, or a member of the state or local long-term
2174	care ombudsman council shall have the right to enter unannounced
2175	upon and into the premises of any facility licensed pursuant to
2176	this chapter part in order to determine the state of compliance
2177	with the provisions of this chapter part and of rules or
2178	standards in force pursuant thereto. The right of entry and
2179	inspection shall also extend to any premises which the agency
2180	has reason to believe is being operated or maintained as a
2181	facility without a license; but no such entry or inspection of
2182	any premises may be made without the permission of the owner or
2183	person in charge thereof, unless a warrant is first obtained
2184	from the circuit court authorizing such entry.  The warrant
2185	requirement shall extend only to a facility which the agency has
2186	reason to believe is being operated or maintained as a facility
2187	without a license.  Any application for a license or renewal
2188	thereof made pursuant to this chapter part shall constitute
2189	permission for, and complete acquiescence in, any entry or
2190	inspection of the premises for which the license is sought, in
2191	order to facilitate verification of the information submitted on
2192	or in connection with the application; to discover, investigate,
2193	and determine the existence of abuse or neglect; or to elicit,
2194	receive, respond to, and resolve complaints. Any current valid
2195	license shall constitute unconditional permission for, and
2196	complete acquiescence in, any entry or inspection of the
2197	premises by authorized personnel. The agency shall retain the
2198	right of entry and inspection of facilities that have had a
2199	license revoked or suspended within the previous 24 months, to
2200	ensure that the facility is not operating unlawfully. However,
2201	before entering the facility, a statement of probable cause must
2202	be filed with the director of the agency, who must approve or
2203	disapprove the action within 48 hours. Probable cause shall
2204	include, but is not limited to, evidence that the facility holds
2205	itself out to the public as a provider of personal care services
2206	or the receipt of a complaint by the long-term care ombudsman
2207	council about the facility. Data collected by the state or local
2208	long-term care ombudsman councils or the state or local advocacy
2209	councils may be used by the agency in investigations involving
2210	violations of regulatory standards.
2211	Section 62.  Section 400.441, Florida Statutes, is
2212	renumbered as section 429.41, Florida Statutes, and subsections
2213	(1) and (2), paragraph (b) of subsection (3), and subsection (5)
2214	are amended to read:
2215	429.41 400.441  Rules establishing standards.--
2216	(1)  It is the intent of the Legislature that rules
2217	published and enforced pursuant to this section shall include
2218	criteria by which a reasonable and consistent quality of
2219	resident care and quality of life may be ensured and the results
2220	of such resident care may be demonstrated.  Such rules shall
2221	also ensure a safe and sanitary environment that is residential
2222	and noninstitutional in design or nature.  It is further
2223	intended that reasonable efforts be made to accommodate the
2224	needs and preferences of residents to enhance the quality of
2225	life in a facility. In order to provide safe and sanitary
2226	facilities and the highest quality of resident care
2227	accommodating the needs and preferences of residents, the
2228	department, in consultation with the agency, the Department of
2229	Children and Family Services, and the Department of Health,
2230	shall adopt rules, policies, and procedures to administer this
2231	chapter part, which must include reasonable and fair minimum
2232	standards in relation to:
2233	(a)  The requirements for and maintenance of facilities,
2234	not in conflict with the provisions of chapter 553, relating to
2235	plumbing, heating, cooling, lighting, ventilation, living space,
2236	and other housing conditions, which will ensure the health,
2237	safety, and comfort of residents and protection from fire
2238	hazard, including adequate provisions for fire alarm and other
2239	fire protection suitable to the size of the structure. Uniform
2240	firesafety standards shall be established and enforced by the
2241	State Fire Marshal in cooperation with the agency, the
2242	department, and the Department of Health.
2243	1.  Evacuation capability determination.--
2244	a.  The provisions of the National Fire Protection
2245	Association, NFPA 101A, Chapter 5, 1995 edition, shall be used
2246	for determining the ability of the residents, with or without
2247	staff assistance, to relocate from or within a licensed facility
2248	to a point of safety as provided in the fire codes adopted
2249	herein. An evacuation capability evaluation for initial
2250	licensure shall be conducted within 6 months after the date of
2251	licensure. For existing licensed facilities that are not
2252	equipped with an automatic fire sprinkler system, the
2253	administrator shall evaluate the evacuation capability of
2254	residents at least annually. The evacuation capability
2255	evaluation for each facility not equipped with an automatic fire
2256	sprinkler system shall be validated, without liability, by the
2257	State Fire Marshal, by the local fire marshal, or by the local
2258	authority having jurisdiction over firesafety, before the
2259	license renewal date. If the State Fire Marshal, local fire
2260	marshal, or local authority having jurisdiction over firesafety
2261	has reason to believe that the evacuation capability of a
2262	facility as reported by the administrator may have changed, it
2263	may, with assistance from the facility administrator, reevaluate
2264	the evacuation capability through timed exiting drills.
2265	Translation of timed fire exiting drills to evacuation
2266	capability may be determined:
2267	(I)  Three minutes or less: prompt.
2268	(II)  More than 3 minutes, but not more than 13 minutes:
2269	slow.
2270	(III)  More than 13 minutes: impractical.
2271	b.  The Office of the State Fire Marshal shall provide or
2272	cause the provision of training and education on the proper
2273	application of Chapter 5, NFPA 101A, 1995 edition, to its
2274	employees, to staff of the Agency for Health Care Administration
2275	who are responsible for regulating facilities under this chapter
2276	part, and to local governmental inspectors. The Office of the
2277	State Fire Marshal shall provide or cause the provision of this
2278	training within its existing budget, but may charge a fee for
2279	this training to offset its costs. The initial training must be
2280	delivered within 6 months after July 1, 1995, and as needed
2281	thereafter.
2282	c.  The Office of the State Fire Marshal, in cooperation
2283	with provider associations, shall provide or cause the provision
2284	of a training program designed to inform facility operators on
2285	how to properly review bid documents relating to the
2286	installation of automatic fire sprinklers. The Office of the
2287	State Fire Marshal shall provide or cause the provision of this
2288	training within its existing budget, but may charge a fee for
2289	this training to offset its costs. The initial training must be
2290	delivered within 6 months after July 1, 1995, and as needed
2291	thereafter.
2292	d.  The administrator of a licensed facility shall sign an
2293	affidavit verifying the number of residents occupying the
2294	facility at the time of the evacuation capability evaluation.
2295	2.  Firesafety requirements.--
2296	a.  Except for the special applications provided herein,
2297	effective January 1, 1996, the provisions of the National Fire
2298	Protection Association, Life Safety Code, NFPA 101, 1994
2299	edition, Chapter 22 for new facilities and Chapter 23 for
2300	existing facilities shall be the uniform fire code applied by
2301	the State Fire Marshal for assisted living facilities, pursuant
2302	to s. 633.022.
2303	b.  Any new facility, regardless of size, that applies for
2304	a license on or after January 1, 1996, must be equipped with an
2305	automatic fire sprinkler system. The exceptions as provided in
2306	section 22-2.3.5.1, NFPA 101, 1994 edition, as adopted herein,
2307	apply to any new facility housing eight or fewer residents. On
2308	July 1, 1995, local governmental entities responsible for the
2309	issuance of permits for construction shall inform, without
2310	liability, any facility whose permit for construction is
2311	obtained prior to January 1, 1996, of this automatic fire
2312	sprinkler requirement. As used in this chapter part, the term "a
2313	new facility" does not mean an existing facility that has
2314	undergone change of ownership.
2315	c.  Notwithstanding any provision of s. 633.022 or of the
2316	National Fire Protection Association, NFPA 101A, Chapter 5, 1995
2317	edition, to the contrary, any existing facility housing eight or
2318	fewer residents is not required to install an automatic fire
2319	sprinkler system, nor to comply with any other requirement in
2320	Chapter 23, NFPA 101, 1994 edition, that exceeds the firesafety
2321	requirements of NFPA 101, 1988 edition, that applies to this
2322	size facility, unless the facility has been classified as
2323	impractical to evacuate. Any existing facility housing eight or
2324	fewer residents that is classified as impractical to evacuate
2325	must install an automatic fire sprinkler system within the
2326	timeframes granted in this section.
2327	d.  Any existing facility that is required to install an
2328	automatic fire sprinkler system under this paragraph need not
2329	meet other firesafety requirements of Chapter 23, NFPA 101, 1994
2330	edition, which exceed the provisions of NFPA 101, 1988 edition.
2331	The mandate contained in this paragraph which requires certain
2332	facilities to install an automatic fire sprinkler system
2333	supersedes any other requirement.
2334	e.  This paragraph does not supersede the exceptions
2335	granted in NFPA 101, 1988 edition or 1994 edition.
2336	f.  This paragraph does not exempt facilities from other
2337	firesafety provisions adopted under s. 633.022 and local
2338	building code requirements in effect before July 1, 1995.
2339	g.  A local government may charge fees only in an amount
2340	not to exceed the actual expenses incurred by local government
2341	relating to the installation and maintenance of an automatic
2342	fire sprinkler system in an existing and properly licensed
2343	assisted living facility structure as of January 1, 1996.
2344	h.  If a licensed facility undergoes major reconstruction
2345	or addition to an existing building on or after January 1, 1996,
2346	the entire building must be equipped with an automatic fire
2347	sprinkler system. Major reconstruction of a building means
2348	repair or restoration that costs in excess of 50 percent of the
2349	value of the building as reported on the tax rolls, excluding
2350	land, before reconstruction. Multiple reconstruction projects
2351	within a 5-year period the total costs of which exceed 50
2352	percent of the initial value of the building at the time the
2353	first reconstruction project was permitted are to be considered
2354	as major reconstruction. Application for a permit for an
2355	automatic fire sprinkler system is required upon application for
2356	a permit for a reconstruction project that creates costs that go
2357	over the 50-percent threshold.
2358	i.  Any facility licensed before January 1, 1996, that is
2359	required to install an automatic fire sprinkler system shall
2360	ensure that the installation is completed within the following
2361	timeframes based upon evacuation capability of the facility as
2362	determined under subparagraph 1.:
2363	(I)  Impractical evacuation capability, 24 months.
2364	(II)  Slow evacuation capability, 48 months.
2365	(III)  Prompt evacuation capability, 60 months.
2366
2367	The beginning date from which the deadline for the automatic
2368	fire sprinkler installation requirement must be calculated is
2369	upon receipt of written notice from the local fire official that
2370	an automatic fire sprinkler system must be installed. The local
2371	fire official shall send a copy of the document indicating the
2372	requirement of a fire sprinkler system to the Agency for Health
2373	Care Administration.
2374	j.  It is recognized that the installation of an automatic
2375	fire sprinkler system may create financial hardship for some
2376	facilities. The appropriate local fire official shall, without
2377	liability, grant two 1-year extensions to the timeframes for
2378	installation established herein, if an automatic fire sprinkler
2379	installation cost estimate and proof of denial from two
2380	financial institutions for a construction loan to install the
2381	automatic fire sprinkler system are submitted. However, for any
2382	facility with a class I or class II, or a history of uncorrected
2383	class III, firesafety deficiencies, an extension must not be
2384	granted. The local fire official shall send a copy of the
2385	document granting the time extension to the Agency for Health
2386	Care Administration.
2387	k.  A facility owner whose facility is required to be
2388	equipped with an automatic fire sprinkler system under Chapter
2389	23, NFPA 101, 1994 edition, as adopted herein, must disclose to
2390	any potential buyer of the facility that an installation of an
2391	automatic fire sprinkler requirement exists. The sale of the
2392	facility does not alter the timeframe for the installation of
2393	the automatic fire sprinkler system.
2394	l.  Existing facilities required to install an automatic
2395	fire sprinkler system as a result of construction-type
2396	restrictions in Chapter 23, NFPA 101, 1994 edition, as adopted
2397	herein, or evacuation capability requirements shall be notified
2398	by the local fire official in writing of the automatic fire
2399	sprinkler requirement, as well as the appropriate date for final
2400	compliance as provided in this subparagraph. The local fire
2401	official shall send a copy of the document to the Agency for
2402	Health Care Administration.
2403	m.  Except in cases of life-threatening fire hazards, if an
2404	existing facility experiences a change in the evacuation
2405	capability, or if the local authority having jurisdiction
2406	identifies a construction-type restriction, such that an
2407	automatic fire sprinkler system is required, it shall be
2408	afforded time for installation as provided in this subparagraph.
2409
2410	Facilities that are fully sprinkled and in compliance with other
2411	firesafety standards are not required to conduct more than one
2412	of the required fire drills between the hours of 11 p.m. and 7
2413	a.m., per year. In lieu of the remaining drills, staff
2414	responsible for residents during such hours may be required to
2415	participate in a mock drill that includes a review of evacuation
2416	procedures. Such standards must be included or referenced in the
2417	rules adopted by the State Fire Marshal. Pursuant to s.
2418	633.022(1)(b), the State Fire Marshal is the final
2419	administrative authority for firesafety standards established
2420	and enforced pursuant to this section. All licensed facilities
2421	must have an annual fire inspection conducted by the local fire
2422	marshal or authority having jurisdiction.
2423	3.  Resident elopement requirements.--Facilities are
2424	required to conduct a minimum of two resident elopement
2425	prevention and response drills per year. All administrators and
2426	direct care staff must participate in the drills which shall
2427	include a review of procedures to address resident elopement.
2428	Facilities must document the implementation of the drills and
2429	ensure that the drills are conducted in a manner consistent with
2430	the facility's resident elopement policies and procedures.
2431	(b)  The preparation and annual update of a comprehensive
2432	emergency management plan.  Such standards must be included in
2433	the rules adopted by the department after consultation with the
2434	Department of Community Affairs.  At a minimum, the rules must
2435	provide for plan components that address emergency evacuation
2436	transportation; adequate sheltering arrangements; postdisaster
2437	activities, including provision of emergency power, food, and
2438	water; postdisaster transportation; supplies; staffing;
2439	emergency equipment; individual identification of residents and
2440	transfer of records; communication with families; and responses
2441	to family inquiries.  The comprehensive emergency management
2442	plan is subject to review and approval by the local emergency
2443	management agency. During its review, the local emergency
2444	management agency shall ensure that the following agencies, at a
2445	minimum, are given the opportunity to review the plan:  the
2446	Department of Elderly Affairs, the Department of Health, the
2447	Agency for Health Care Administration, and the Department of
2448	Community Affairs.  Also, appropriate volunteer organizations
2449	must be given the opportunity to review the plan.  The local
2450	emergency management agency shall complete its review within 60
2451	days and either approve the plan or advise the facility of
2452	necessary revisions.
2453	(c)  The number, training, and qualifications of all
2454	personnel having responsibility for the care of residents.  The
2455	rules must require adequate staff to provide for the safety of
2456	all residents.  Facilities licensed for 17 or more residents are
2457	required to maintain an alert staff for 24 hours per day.
2458	(d)  All sanitary conditions within the facility and its
2459	surroundings which will ensure the health and comfort of
2460	residents.  The rules must clearly delineate the
2461	responsibilities of the agency's licensure and survey staff, the
2462	county health departments, and the local authority having
2463	jurisdiction over fire safety and ensure that inspections are
2464	not duplicative.  The agency may collect fees for food service
2465	inspections conducted by the county health departments and
2466	transfer such fees to the Department of Health.
2467	(e)  License application and license renewal, transfer of
2468	ownership, proper management of resident funds and personal
2469	property, surety bonds, resident contracts, refund policies,
2470	financial ability to operate, and facility and staff records.
2471	(f)  Inspections, complaint investigations, moratoriums,
2472	classification of deficiencies, levying and enforcement of
2473	penalties, and use of income from fees and fines.
2474	(g)  The enforcement of the resident bill of rights
2475	specified in s. 429.28 400.428.
2476	(h)  The care and maintenance of residents, which must
2477	include, but is not limited to:
2478	1.  The supervision of residents;
2479	2.  The provision of personal services;
2480	3.  The provision of, or arrangement for, social and
2481	leisure activities;
2482	4.  The arrangement for appointments and transportation to
2483	appropriate medical, dental, nursing, or mental health services,
2484	as needed by residents;
2485	5.  The management of medication;
2486	6.  The nutritional needs of residents;
2487	7.  Resident records; and
2488	8.  Internal risk management and quality assurance.
2489	(i)  Facilities holding a limited nursing, extended
2490	congregate care, or limited mental health license.
2491	(j)  The establishment of specific criteria to define
2492	appropriateness of resident admission and continued residency in
2493	a facility holding a standard, limited nursing, extended
2494	congregate care, and limited mental health license.
2495	(k)  The use of physical or chemical restraints.  The use
2496	of physical restraints is limited to half-bed rails as
2497	prescribed and documented by the resident's physician with the
2498	consent of the resident or, if applicable, the resident's
2499	representative or designee or the resident's surrogate,
2500	guardian, or attorney in fact.  The use of chemical restraints
2501	is limited to prescribed dosages of medications authorized by
2502	the resident's physician and must be consistent with the
2503	resident's diagnosis. Residents who are receiving medications
2504	that can serve as chemical restraints must be evaluated by their
2505	physician at least annually to assess:
2506	1.  The continued need for the medication.
2507	2.  The level of the medication in the resident's blood.
2508	3.  The need for adjustments in the prescription.
2509	(l)  The establishment of specific policies and procedures
2510	on resident elopement. Facilities shall conduct a minimum of two
2511	resident elopement drills each year. All administrators and
2512	direct care staff shall participate in the drills. Facilities
2513	shall document the drills.
2514	(2)  In adopting any rules pursuant to this chapter part,
2515	the department, in conjunction with the agency, shall make
2516	distinct standards for facilities based upon facility size; the
2517	types of care provided; the physical and mental capabilities and
2518	needs of residents; the type, frequency, and amount of services
2519	and care offered; and the staffing characteristics of the
2520	facility. Rules developed pursuant to this section shall not
2521	restrict the use of shared staffing and shared programming in
2522	facilities that are part of retirement communities that provide
2523	multiple levels of care and otherwise meet the requirements of
2524	law and rule.  Except for uniform firesafety standards, the
2525	department shall adopt by rule separate and distinct standards
2526	for facilities with 16 or fewer beds and for facilities with 17
2527	or more beds.  The standards for facilities with 16 or fewer
2528	beds shall be appropriate for a noninstitutional residential
2529	environment, provided that the structure is no more than two
2530	stories in height and all persons who cannot exit the facility
2531	unassisted in an emergency reside on the first floor.  The
2532	department, in conjunction with the agency, may make other
2533	distinctions among types of facilities as necessary to enforce
2534	the provisions of this chapter part. Where appropriate, the
2535	agency shall offer alternate solutions for complying with
2536	established standards, based on distinctions made by the
2537	department and the agency relative to the physical
2538	characteristics of facilities and the types of care offered
2539	therein.
2540	(3)  The department shall submit a copy of proposed rules
2541	to the Speaker of the House of Representatives, the President of
2542	the Senate, and appropriate committees of substance for review
2543	and comment prior to the promulgation thereof.
2544	(b)  The agency, in consultation with the department, may
2545	waive rules promulgated pursuant to this chapter part in order
2546	to demonstrate and evaluate innovative or cost-effective
2547	congregate care alternatives which enable individuals to age in
2548	place.  Such waivers may be granted only in instances where
2549	there is reasonable assurance that the health, safety, or
2550	welfare of residents will not be endangered.  To apply for a
2551	waiver, the licensee shall submit to the agency a written
2552	description of the concept to be demonstrated, including goals,
2553	objectives, and anticipated benefits; the number and types of
2554	residents who will be affected, if applicable; a brief
2555	description of how the demonstration will be evaluated; and any
2556	other information deemed appropriate by the agency.  Any
2557	facility granted a waiver shall submit a report of findings to
2558	the agency and the department within 12 months.  At such time,
2559	the agency may renew or revoke the waiver or pursue any
2560	regulatory or statutory changes necessary to allow other
2561	facilities to adopt the same practices. The department may by
2562	rule clarify terms and establish waiver application procedures,
2563	criteria for reviewing waiver proposals, and procedures for
2564	reporting findings, as necessary to implement this subsection.
2565	(5)  A fee shall be charged by the department to any person
2566	requesting a copy of this chapter part or rules promulgated
2567	under this chapter part. Such fees shall not exceed the actual
2568	cost of duplication and postage.
2569	Section 63.  Section 400.442, Florida Statutes, is
2570	renumbered as section 429.42, Florida Statutes, and subsections
2571	(1) and (3) are amended to read:
2572	429.42 400.442  Pharmacy and dietary services.--
2573	(1)  Any assisted living facility in which the agency has
2574	documented a class I or class II deficiency or uncorrected class
2575	III deficiencies regarding medicinal drugs or over-the-counter
2576	preparations, including their storage, use, delivery, or
2577	administration, or dietary services, or both, during a biennial
2578	survey or a monitoring visit or an investigation in response to
2579	a complaint, shall, in addition to or as an alternative to any
2580	penalties imposed under s. 429.19 400.419, be required to employ
2581	the consultant services of a licensed pharmacist, a licensed
2582	registered nurse, or a registered or licensed dietitian, as
2583	applicable. The consultant shall, at a minimum, provide onsite
2584	quarterly consultation until the inspection team from the agency
2585	determines that such consultation services are no longer
2586	required.
2587	(3)  The agency shall employ at least two pharmacists
2588	licensed pursuant to chapter 465 among its personnel who
2589	biennially inspect assisted living facilities licensed under
2590	this chapter part, to participate in biennial inspections or
2591	consult with the agency regarding deficiencies relating to
2592	medicinal drugs or over-the-counter preparations.
2593	Section 64.  Section 400.444, Florida Statutes, is
2594	renumbered as section 429.44, Florida Statutes, and subsection
2595	(2) is amended to read:
2596	429.44 400.444  Construction and renovation;
2597	requirements.--
2598	(2)  Upon notification by the local authority having
2599	jurisdiction over life-threatening violations which seriously
2600	threaten the health, safety, or welfare of a resident of a
2601	facility, the agency shall take action as specified in s. 429.14
2602	400.414.
2603	Section 65.  Section 400.4445, Florida Statutes, is
2604	renumbered as section 429.445, Florida Statutes, and amended to
2605	read:
2606	429.445 400.4445  Compliance with local zoning
2607	requirements.--No facility licensed under this chapter part may
2608	commence any construction which will expand the size of the
2609	existing structure unless the licensee first submits to the
2610	agency proof that such construction will be in compliance with
2611	applicable local zoning requirements.  Facilities with a
2612	licensed capacity of less than 15 persons shall comply with the
2613	provisions of chapter 419.
2614	Section 66.  Section 400.447, Florida Statutes, is
2615	renumbered as section 429.47, Florida Statutes, and subsections
2616	(2), (5), and (7) are amended to read:
2617	429.47 400.447  Prohibited acts; penalties for violation.--
2618	(2)  It is unlawful for any holder of a license issued
2619	pursuant to the provisions of this act to withhold from the
2620	agency any evidence of financial instability, including, but not
2621	limited to, bad checks, delinquent accounts, nonpayment of
2622	withholding taxes, unpaid utility expenses, nonpayment for
2623	essential services, or adverse court action concerning the
2624	financial viability of the facility or any other facility
2625	licensed under part II of chapter 400 or under part III of this
2626	chapter which is owned by the licensee.
2627	(5)  A freestanding facility shall not advertise or imply
2628	that any part of it is a nursing home. For the purpose of this
2629	subsection, "freestanding facility" means a facility that is not
2630	operated in conjunction with a nursing home to which residents
2631	of the facility are given priority when nursing care is
2632	required. A person who violates this subsection is subject to
2633	fine as specified in s. 429.19 400.419.
2634	(7)  A facility licensed under this chapter part which is
2635	not part of a facility authorized under chapter 651 shall
2636	include the facility's license number as given by the agency in
2637	all advertising.  A company or person owning more than one
2638	facility shall include at least one license number per
2639	advertisement.  All advertising shall include the term "assisted
2640	living facility" before the license number.
2641	Section 67.  Section 400.451, Florida Statutes, is
2642	renumbered as section 429.51, Florida Statutes, and amended to
2643	read:
2644	429.51 400.451  Existing facilities to be given reasonable
2645	time to comply with rules and standards.--Any facility as
2646	defined in this chapter part which is in operation at the time
2647	of promulgation of any applicable rules or standards adopted or
2648	amended pursuant to this chapter part may be given a reasonable
2649	time, not to exceed 6 months, within which to comply with such
2650	rules and standards.
2651	Section 68.  Section 400.452, Florida Statutes, is
2652	renumbered as section 429.52, Florida Statutes, and subsections
2653	(3) and (5) are amended to read:
2654	429.52 400.452  Staff training and educational programs;
2655	core educational requirement.--
2656	(3)  Effective January 1, 2004, a new facility
2657	administrator must complete the required training and education,
2658	including the competency test, within a reasonable time after
2659	being employed as an administrator, as determined by the
2660	department. Failure to do so is a violation of this chapter part
2661	and subjects the violator to an administrative fine as
2662	prescribed in s. 429.19 400.419. Administrators licensed in
2663	accordance with chapter 468, part II, are exempt from this
2664	requirement. Other licensed professionals may be exempted, as
2665	determined by the department by rule.
2666	(5)  Staff involved with the management of medications and
2667	assisting with the self-administration of medications under s.
2668	429.256 400.4256 must complete a minimum of 4 additional hours
2669	of training provided by a registered nurse, licensed pharmacist,
2670	or department staff. The department shall establish by rule the
2671	minimum requirements of this additional training.
2672	Section 69.  Section 400.453, Florida Statutes, is
2673	renumbered as section 429.53, Florida Statutes, and paragraph
2674	(b) of subsection (1) and paragraphs (a), (e), and (f) of
2675	subsection (2) are amended to read:
2676	429.53 400.453  Consultation by the agency.--
2677	(1)  The area offices of licensure and certification of the
2678	agency shall provide consultation to the following upon request:
2679	(b)  A person interested in obtaining a license to operate
2680	a facility under this chapter part.
2681	(2)  As used in this section, "consultation" includes:
2682	(a)  An explanation of the requirements of this chapter
2683	part and rules adopted pursuant thereto;
2684	(e)  Any other information which the agency deems necessary
2685	to promote compliance with the requirements of this chapter
2686	part; and
2687	(f)  A preconstruction review of a facility to ensure
2688	compliance with agency rules and this chapter part.
2689	Section 70.  Subsections (1), (7), and (15) of section
2690	400.462, Florida Statutes, are amended to read:
2691	400.462  Definitions.--As used in this part, the term:
2692	(1)  "Administrator" means a direct employee of the home
2693	health agency or a related organization, or of a management
2694	company that has a contract to manage the home health agency, to
2695	whom the governing body has delegated the responsibility for
2696	day-to-day administration of the home health agency.  The
2697	administrator must be a licensed physician, physician assistant,
2698	or registered nurse licensed to practice in this state or an
2699	individual having at least 1 year of supervisory or
2700	administrative experience in home health care or in a facility
2701	licensed under chapter 395, or under part II or part III of this
2702	chapter, or under chapter 429. An administrator may manage a
2703	maximum of five licensed home health agencies located within one
2704	agency service district or within an immediately contiguous
2705	county. If the home health agency is licensed under this chapter
2706	and is part of a retirement community that provides multiple
2707	levels of care, an employee of the retirement community may
2708	administer the home health agency and up to a maximum of four
2709	entities licensed under this chapter or chapter 429 that are
2710	owned, operated, or managed by the same corporate entity. An
2711	administrator shall designate, in writing, for each licensed
2712	entity, a qualified alternate administrator to serve during
2713	absences.
2714	(7)  "Director of nursing" means a registered nurse and
2715	direct employee of the agency or related business entity who is
2716	a graduate of an approved school of nursing and is licensed in
2717	this state; who has at least 1 year of supervisory experience as
2718	a registered nurse in a licensed home health agency, a facility
2719	licensed under chapter 395, or a facility licensed under part II
2720	or part III of this chapter or under chapter 429; and who is
2721	responsible for overseeing the professional nursing and home
2722	health aid delivery of services of the agency. An employee may
2723	be the director of nursing of a maximum of five licensed home
2724	health agencies operated by a related business entity and
2725	located within one agency service district or within an
2726	immediately contiguous county.  If the home health agency is
2727	licensed under this chapter and is part of a retirement
2728	community that provides multiple levels of care, an employee of
2729	the retirement community may serve as the director of nursing of
2730	the home health agency and of up to four entities licensed under
2731	this chapter or chapter 429 which are owned, operated, or
2732	managed by the same corporate entity. A director of nursing
2733	shall designate, in writing, for each licensed entity, a
2734	qualified alternate registered nurse to serve during the absence
2735	of the director of nursing.
2736	(15)  "Nurse registry" means any person that procures,
2737	offers, promises, or attempts to secure health-care-related
2738	contracts for registered nurses, licensed practical nurses,
2739	certified nursing assistants, home health aides, companions, or
2740	homemakers, who are compensated by fees as independent
2741	contractors, including, but not limited to, contracts for the
2742	provision of services to patients and contracts to provide
2743	private duty or staffing services to health care facilities
2744	licensed under chapter 395, or this chapter, or chapter 429, or
2745	other business entities.
2746	Section 71.  Paragraph (h) of subsection (5) of section
2747	400.464, Florida Statutes, is amended to read:
2748	400.464  Home health agencies to be licensed; expiration of
2749	license; exemptions; unlawful acts; penalties.--
2750	(5)  The following are exempt from the licensure
2751	requirements of this part:
2752	(h)  The delivery of assisted living facility services for
2753	which the assisted living facility is licensed under part III of
2754	this chapter 429, to serve its residents in its facility.
2755	Section 72.  Subsection (2) of section 400.497, Florida
2756	Statutes, is amended to read:
2757	400.497  Rules establishing minimum standards.--The agency
2758	shall adopt, publish, and enforce rules to implement this part,
2759	including, as applicable, ss. 400.506 and 400.509, which must
2760	provide reasonable and fair minimum standards relating to:
2761	(2)  Shared staffing. The agency shall allow shared
2762	staffing if the home health agency is part of a retirement
2763	community that provides multiple levels of care, is located on
2764	one campus, is licensed under this chapter or chapter 429, and
2765	otherwise meets the requirements of law and rule.
2766	Section 73.  Paragraph (c) of subsection (2) of section
2767	400.556, Florida Statutes, is amended to read:
2768	400.556  Denial, suspension, revocation of license;
2769	administrative fines; investigations and inspections.--
2770	(2)  Each of the following actions by the owner of an adult
2771	day care center or by its operator or employee is a ground for
2772	action by the agency against the owner of the center or its
2773	operator or employee:
2774	(c)  A failure of persons subject to level 2 background
2775	screening under s. 429.174 400.4174(1) to meet the screening
2776	standards of s. 435.04, or the retention by the center of an
2777	employee subject to level 1 background screening standards under
2778	s. 429.174 400.4174(2) who does not meet the screening standards
2779	of s. 435.03 and for whom exemptions from disqualification have
2780	not been provided by the agency.
2781	Section 74.  Paragraph (c) of subsection (2) of section
2782	400.5572, Florida Statutes, is amended to read:
2783	400.5572  Background screening.--
2784	(2)  The owner or administrator of an adult day care center
2785	must conduct level 1 background screening as set forth in
2786	chapter 435 on all employees hired on or after October 1, 1998,
2787	who provide basic services or supportive and optional services
2788	to the participants. Such persons satisfy this requirement if:
2789	(c)  The person required to be screened is employed by a
2790	corporation or business entity or related corporation or
2791	business entity that owns, operates, or manages more than one
2792	facility or agency licensed under this chapter or chapter 429,
2793	and for whom a level 1 screening was conducted by the
2794	corporation or business entity as a condition of initial or
2795	continued employment.
2796	Section 75.  Subsection (5) of section 400.601, Florida
2797	Statutes, is amended to read:
2798	400.601  Definitions.--As used in this part, the term:
2799	(5)  "Hospice residential unit" means a homelike living
2800	facility, other than a facility licensed under other parts of
2801	this chapter, or under chapter 395, or under chapter 429, that
2802	is operated by a hospice for the benefit of its patients and is
2803	considered by a patient who lives there to be his or her primary
2804	residence.
2805	Section 76.  Paragraph (c) of subsection (2) of section
2806	400.618, Florida Statutes, is amended to read:
2807	400.618  Definitions.--As used in this part, the term:
2808	(2)  "Adult family-care home" means a full-time,
2809	family-type living arrangement, in a private home, under which a
2810	person who owns or rents the home provides room, board, and
2811	personal care, on a 24-hour basis, for no more than five
2812	disabled adults or frail elders who are not relatives. The
2813	following family-type living arrangements are not required to be
2814	licensed as an adult family-care home:
2815	(c)  An establishment that is licensed as an assisted
2816	living facility under chapter 429 part III.
2817	Section 77.  Paragraph (f) of subsection (1) of section
2818	400.628, Florida Statutes, is amended to read:
2819	400.628  Residents' bill of rights.--
2820	(1)  A resident of an adult family-care home may not be
2821	deprived of any civil or legal rights, benefits, or privileges
2822	guaranteed by law, the State Constitution, or the Constitution
2823	of the United States solely by reason of status as a resident of
2824	the home. Each resident has the right to:
2825	(f)  Manage the resident's own financial affairs unless the
2826	resident or the resident's guardian authorizes the provider to
2827	provide safekeeping for funds in accordance with procedures
2828	equivalent to those provided in s. 429.27 400.427.
2829	Section 78.  Paragraph (c) of subsection (5) of section
2830	400.93, Florida Statutes, is amended to read:
2831	400.93  Licensure required; exemptions; unlawful acts;
2832	penalties.--
2833	(5)  The following are exempt from home medical equipment
2834	provider licensure, unless they have a separate company,
2835	corporation, or division that is in the business of providing
2836	home medical equipment and services for sale or rent to
2837	consumers at their regular or temporary place of residence
2838	pursuant to the provisions of this part:
2839	(c)  Assisted living facilities licensed under chapter 429
2840	part III, when serving their residents.
2841	Section 79.  Subsection (3) and paragraph (c) of subsection
2842	(10) of section 400.962, Florida Statutes, are amended to read:
2843	400.962  License required; license application.--
2844	(3)  The basic license fee collected shall be deposited in
2845	the Health Care Trust Fund, established for carrying out the
2846	purposes of this chapter or chapter 429.
2847	(10)
2848	(c)  Proof of compliance with the level 2 background
2849	screening requirements of chapter 435 which has been submitted
2850	within the previous 5 years in compliance with any other
2851	licensure requirements under this chapter or chapter 429
2852	satisfies the requirements of paragraph (a). Proof of compliance
2853	with background screening which has been submitted within the
2854	previous 5 years to fulfill the requirements of the Financial
2855	Services Commission and the Office of Insurance Regulation under
2856	chapter 651 as part of an application for a certificate of
2857	authority to operate a continuing care retirement community
2858	satisfies the requirements for the Department of Law Enforcement
2859	and Federal Bureau of Investigation background checks.
2860	Section 80.  Paragraph (b) of subsection (1) of section
2861	400.980, Florida Statutes, is amended to read:
2862	400.980  Health care services pools.--
2863	(1)  As used in this section, the term:
2864	(b)  "Health care services pool" means any person, firm,
2865	corporation, partnership, or association engaged for hire in the
2866	business of providing temporary employment in health care
2867	facilities, residential facilities, and agencies for licensed,
2868	certified, or trained health care personnel including, without
2869	limitation, nursing assistants, nurses' aides, and orderlies.
2870	However, the term does not include nursing registries, a
2871	facility licensed under this chapter or chapter 429 400, a
2872	health care services pool established within a health care
2873	facility to provide services only within the confines of such
2874	facility, or any individual contractor directly providing
2875	temporary services to a health care facility without use or
2876	benefit of a contracting agent.
2877	Section 81.  Paragraphs (a), (b), (c), and (d) of
2878	subsection (4) of section 400.9905, Florida Statutes, are
2879	amended to read:
2880	400.9905  Definitions.--
2881	(4)  "Clinic" means an entity at which health care services
2882	are provided to individuals and which tenders charges for
2883	reimbursement for such services, including a mobile clinic and a
2884	portable equipment provider. For purposes of this part, the term
2885	does not include and the licensure requirements of this part do
2886	not apply to:
2887	(a)  Entities licensed or registered by the state under
2888	chapter 395; or entities licensed or registered by the state and
2889	providing only health care services within the scope of services
2890	authorized under their respective licenses granted under ss.
2891	383.30-383.335, chapter 390, chapter 394, chapter 397, this
2892	chapter except part XIII, chapter 429, chapter 463, chapter 465,
2893	chapter 466, chapter 478, part I of chapter 483, chapter 484, or
2894	chapter 651; end-stage renal disease providers authorized under
2895	42 C.F.R. part 405, subpart U; or providers certified under 42
2896	C.F.R. part 485, subpart B or subpart H; or any entity that
2897	provides neonatal or pediatric hospital-based health care
2898	services by licensed practitioners solely within a hospital
2899	licensed under chapter 395.
2900	(b)  Entities that own, directly or indirectly, entities
2901	licensed or registered by the state pursuant to chapter 395; or
2902	entities that own, directly or indirectly, entities licensed or
2903	registered by the state and providing only health care services
2904	within the scope of services authorized pursuant to their
2905	respective licenses granted under ss. 383.30-383.335, chapter
2906	390, chapter 394, chapter 397, this chapter except part XIII,
2907	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
2908	part I of chapter 483, chapter 484, chapter 651; end-stage renal
2909	disease providers authorized under 42 C.F.R. part 405, subpart
2910	U; or providers certified under 42 C.F.R. part 485, subpart B or
2911	subpart H; or any entity that provides neonatal or pediatric
2912	hospital-based health care services by licensed practitioners
2913	solely within a hospital licensed under chapter 395.
2914	(c)  Entities that are owned, directly or indirectly, by an
2915	entity licensed or registered by the state pursuant to chapter
2916	395; or entities that are owned, directly or indirectly, by an
2917	entity licensed or registered by the state and providing only
2918	health care services within the scope of services authorized
2919	pursuant to their respective licenses granted under ss. 383.30-
2920	383.335, chapter 390, chapter 394, chapter 397, this chapter
2921	except part XIII, chapter 429, chapter 463, chapter 465, chapter
2922	466, chapter 478, part I of chapter 483, chapter 484, or chapter
2923	651; end-stage renal disease providers authorized under 42
2924	C.F.R. part 405, subpart U; or providers certified under 42
2925	C.F.R. part 485, subpart B or subpart H; or any entity that
2926	provides neonatal or pediatric hospital-based health care
2927	services by licensed practitioners solely within a hospital
2928	under chapter 395.
2929	(d)  Entities that are under common ownership, directly or
2930	indirectly, with an entity licensed or registered by the state
2931	pursuant to chapter 395; or entities that are under common
2932	ownership, directly or indirectly, with an entity licensed or
2933	registered by the state and providing only health care services
2934	within the scope of services authorized pursuant to their
2935	respective licenses granted under ss. 383.30-383.335, chapter
2936	390, chapter 394, chapter 397, this chapter except part XIII,
2937	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
2938	part I of chapter 483, chapter 484, or chapter 651; end-stage
2939	renal disease providers authorized under 42 C.F.R. part 405,
2940	subpart U; or providers certified under 42 C.F.R. part 485,
2941	subpart B or subpart H; or any entity that provides neonatal or
2942	pediatric hospital-based health care services by licensed
2943	practitioners solely within a hospital licensed under chapter
2944	395.
2945	Section 82.  Subsection (6) of section 400.9935, Florida
2946	Statutes, is amended to read:
2947	400.9935  Clinic responsibilities.--
2948	(6)  Any licensed health care provider who violates this
2949	part is subject to discipline in accordance with this chapter or
2950	chapter 429 and his or her respective practice act.
2951	Section 83.  Subsection (12) of section 401.23, Florida
2952	Statutes, is amended to read:
2953	401.23  Definitions.--As used in this part, the term:
2954	(12)  "Interfacility transfer" means the transportation by
2955	ambulance of a patient between two facilities licensed under
2956	chapter 393, chapter 395, or chapter 400, or chapter 429,
2957	pursuant to this part.
2958	Section 84.  Paragraph (b) of subsection (2) of section
2959	402.164, Florida Statutes, is amended to read:
2960	402.164  Legislative intent; definitions.--
2961	(2)  As used in ss. 402.164-402.167, the term:
2962	(b)  "Client" means a client as defined in s. 393.063, s.
2963	394.67, s. 397.311, or s. 400.960, a forensic client or client
2964	as defined in s. 916.106, a child or youth as defined in s.
2965	39.01, a child as defined in s. 827.01, a family as defined in
2966	s. 414.0252, a participant as defined in s. 400.551, a resident
2967	as defined in s. 429.02 400.402, a Medicaid recipient or
2968	recipient as defined in s. 409.901, a child receiving child care
2969	as defined in s. 402.302, a disabled adult as defined in s.
2970	410.032 or s. 410.603, or a victim as defined in s. 39.01 or s.
2971	415.102 as each definition applies within its respective
2972	chapter.
2973	Section 85.  Paragraph (b) of subsection (2) of section
2974	408.033, Florida Statutes, is amended to read:
2975	408.033  Local and state health planning.--
2976	(2)  FUNDING.--
2977	(b)1.  A hospital licensed under chapter 395, a nursing
2978	home licensed under chapter 400, and an assisted living facility
2979	licensed under chapter 429 400 shall be assessed an annual fee
2980	based on number of beds.
2981	2.  All other facilities and organizations listed in
2982	paragraph (a) shall each be assessed an annual fee of $150.
2983	3.  Facilities operated by the Department of Children and
2984	Family Services, the Department of Health, or the Department of
2985	Corrections and any hospital which meets the definition of rural
2986	hospital pursuant to s. 395.602 are exempt from the assessment
2987	required in this subsection.
2988	Section 86.  Subsection (3) of section 408.831, Florida
2989	Statutes, is amended to read:
2990	408.831  Denial, suspension, or revocation of a license,
2991	registration, certificate, or application.--
2992	(3)  This section provides standards of enforcement
2993	applicable to all entities licensed or regulated by the Agency
2994	for Health Care Administration. This section controls over any
2995	conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
2996	394, 395, 400, 408, 429, 468, 483, and 641 or rules adopted
2997	pursuant to those chapters.
2998	Section 87.  Subsection (2) of section 409.212, Florida
2999	Statutes, is amended to read:
3000	409.212  Optional supplementation.--
3001	(2)  The base rate of payment for optional state
3002	supplementation shall be established by the department within
3003	funds appropriated. Additional amounts may be provided for
3004	mental health residents in facilities designed to provide
3005	limited mental health services as provided for in s. 429.075
3006	400.4075. The base rate of payment does not include the personal
3007	needs allowance.
3008	Section 88.  Subsection (7) and paragraph (a) of subsection
3009	(8) of section 409.907, Florida Statutes, are amended to read:
3010	409.907  Medicaid provider agreements.--The agency may make
3011	payments for medical assistance and related services rendered to
3012	Medicaid recipients only to an individual or entity who has a
3013	provider agreement in effect with the agency, who is performing
3014	services or supplying goods in accordance with federal, state,
3015	and local law, and who agrees that no person shall, on the
3016	grounds of handicap, race, color, or national origin, or for any
3017	other reason, be subjected to discrimination under any program
3018	or activity for which the provider receives payment from the
3019	agency.
3020	(7)  The agency may require, as a condition of
3021	participating in the Medicaid program and before entering into
3022	the provider agreement, that the provider submit information, in
3023	an initial and any required renewal applications, concerning the
3024	professional, business, and personal background of the provider
3025	and permit an onsite inspection of the provider's service
3026	location by agency staff or other personnel designated by the
3027	agency to perform this function. The agency shall perform a
3028	random onsite inspection, within 60 days after receipt of a
3029	fully complete new provider's application, of the provider's
3030	service location prior to making its first payment to the
3031	provider for Medicaid services to determine the applicant's
3032	ability to provide the services that the applicant is proposing
3033	to provide for Medicaid reimbursement. The agency is not
3034	required to perform an onsite inspection of a provider or
3035	program that is licensed by the agency, that provides services
3036	under waiver programs for home and community-based services, or
3037	that is licensed as a medical foster home by the Department of
3038	Children and Family Services. As a continuing condition of
3039	participation in the Medicaid program, a provider shall
3040	immediately notify the agency of any current or pending
3041	bankruptcy filing. Before entering into the provider agreement,
3042	or as a condition of continuing participation in the Medicaid
3043	program, the agency may also require that Medicaid providers
3044	reimbursed on a fee-for-services basis or fee schedule basis
3045	which is not cost-based, post a surety bond not to exceed
3046	$50,000 or the total amount billed by the provider to the
3047	program during the current or most recent calendar year,
3048	whichever is greater. For new providers, the amount of the
3049	surety bond shall be determined by the agency based on the
3050	provider's estimate of its first year's billing. If the
3051	provider's billing during the first year exceeds the bond
3052	amount, the agency may require the provider to acquire an
3053	additional bond equal to the actual billing level of the
3054	provider. A provider's bond shall not exceed $50,000 if a
3055	physician or group of physicians licensed under chapter 458,
3056	chapter 459, or chapter 460 has a 50 percent or greater
3057	ownership interest in the provider or if the provider is an
3058	assisted living facility licensed under part III of chapter 429
3059	400. The bonds permitted by this section are in addition to the
3060	bonds referenced in s. 400.179(4)(d). If the provider is a
3061	corporation, partnership, association, or other entity, the
3062	agency may require the provider to submit information concerning
3063	the background of that entity and of any principal of the
3064	entity, including any partner or shareholder having an ownership
3065	interest in the entity equal to 5 percent or greater, and any
3066	treating provider who participates in or intends to participate
3067	in Medicaid through the entity. The information must include:
3068	(a)  Proof of holding a valid license or operating
3069	certificate, as applicable, if required by the state or local
3070	jurisdiction in which the provider is located or if required by
3071	the Federal Government.
3072	(b)  Information concerning any prior violation, fine,
3073	suspension, termination, or other administrative action taken
3074	under the Medicaid laws, rules, or regulations of this state or
3075	of any other state or the Federal Government; any prior
3076	violation of the laws, rules, or regulations relating to the
3077	Medicare program; any prior violation of the rules or
3078	regulations of any other public or private insurer; and any
3079	prior violation of the laws, rules, or regulations of any
3080	regulatory body of this or any other state.
3081	(c)  Full and accurate disclosure of any financial or
3082	ownership interest that the provider, or any principal, partner,
3083	or major shareholder thereof, may hold in any other Medicaid
3084	provider or health care related entity or any other entity that
3085	is licensed by the state to provide health or residential care
3086	and treatment to persons.
3087	(d)  If a group provider, identification of all members of
3088	the group and attestation that all members of the group are
3089	enrolled in or have applied to enroll in the Medicaid program.
3090	(8)(a)  Each provider, or each principal of the provider if
3091	the provider is a corporation, partnership, association, or
3092	other entity, seeking to participate in the Medicaid program
3093	must submit a complete set of his or her fingerprints to the
3094	agency for the purpose of conducting a criminal history record
3095	check.  Principals of the provider include any officer,
3096	director, billing agent, managing employee, or affiliated
3097	person, or any partner or shareholder who has an ownership
3098	interest equal to 5 percent or more in the provider. However, a
3099	director of a not-for-profit corporation or organization is not
3100	a principal for purposes of a background investigation as
3101	required by this section if the director: serves solely in a
3102	voluntary capacity for the corporation or organization, does not
3103	regularly take part in the day-to-day operational decisions of
3104	the corporation or organization, receives no remuneration from
3105	the not-for-profit corporation or organization for his or her
3106	service on the board of directors, has no financial interest in
3107	the not-for-profit corporation or organization, and has no
3108	family members with a financial interest in the not-for-profit
3109	corporation or organization; and if the director submits an
3110	affidavit, under penalty of perjury, to this effect to the
3111	agency and the not-for-profit corporation or organization
3112	submits an affidavit, under penalty of perjury, to this effect
3113	to the agency as part of the corporation's or organization's
3114	Medicaid provider agreement application. Notwithstanding the
3115	above, the agency may require a background check for any person
3116	reasonably suspected by the agency to have been convicted of a
3117	crime. This subsection shall not apply to:
3118	1.  A hospital licensed under chapter 395;
3119	2.  A nursing home licensed under chapter 400;
3120	3.  A hospice licensed under chapter 400;
3121	4.  An assisted living facility licensed under chapter 429
3122	400.
3123	5.  A unit of local government, except that requirements of
3124	this subsection apply to nongovernmental providers and entities
3125	when contracting with the local government to provide Medicaid
3126	services. The actual cost of the state and national criminal
3127	history record checks must be borne by the nongovernmental
3128	provider or entity; or
3129	6.  Any business that derives more than 50 percent of its
3130	revenue from the sale of goods to the final consumer, and the
3131	business or its controlling parent either is required to file a
3132	form 10-K or other similar statement with the Securities and
3133	Exchange Commission or has a net worth of $50 million or more.
3134	Section 89.  Section 410.031, Florida Statutes, is amended
3135	to read:
3136	410.031  Legislative intent.--It is the intent of the
3137	Legislature to encourage the provision of care for disabled
3138	adults in family-type living arrangements in private homes as an
3139	alternative to institutional or nursing home care for such
3140	persons. The provisions of ss. 410.031-410.036 are intended to
3141	be supplemental to the provisions of chapters chapter 400 and
3142	429, relating to the licensing and regulation of nursing homes
3143	and assisted living facilities, and do not exempt any person who
3144	is otherwise subject to regulation under chapter 400 or chapter
3145	429.
3146	Section 90.  Section 410.034, Florida Statutes, is amended
3147	to read:
3148	410.034  Department determination of fitness to provide
3149	home care.--In accordance with s. 429.02 400.402, a person
3150	caring for an adult who is related to such person by blood or
3151	marriage is not subject to the Assisted Living Facilities Act.
3152	If, however, the person who plans to provide home care under
3153	this act is found by the department to be unable to provide this
3154	care, the department shall notify the person wishing to provide
3155	home care of this determination, and the person shall not be
3156	eligible for subsidy payments under ss. 410.031-410.036.
3157	Section 91.  Section 415.1111, Florida Statutes, is amended
3158	to read:
3159	415.1111  Civil actions.--A vulnerable adult who has been
3160	abused, neglected, or exploited as specified in this chapter has
3161	a cause of action against any perpetrator and may recover actual
3162	and punitive damages for such abuse, neglect, or exploitation.
3163	The action may be brought by the vulnerable adult, or that
3164	person's guardian, by a person or organization acting on behalf
3165	of the vulnerable adult with the consent of that person or that
3166	person's guardian, or by the personal representative of the
3167	estate of a deceased victim without regard to whether the cause
3168	of death resulted from the abuse, neglect, or exploitation. The
3169	action may be brought in any court of competent jurisdiction to
3170	enforce such action and to recover actual and punitive damages
3171	for any deprivation of or infringement on the rights of a
3172	vulnerable adult.  A party who prevails in any such action may
3173	be entitled to recover reasonable attorney's fees, costs of the
3174	action, and damages. The remedies provided in this section are
3175	in addition to and cumulative with other legal and
3176	administrative remedies available to a vulnerable adult.
3177	Notwithstanding the foregoing, any civil action for damages
3178	against any licensee or entity who establishes, controls,
3179	conducts, manages, or operates a facility licensed under part II
3180	of chapter 400 relating to its operation of the licensed
3181	facility shall be brought pursuant to s. 400.023, or against any
3182	licensee or entity who establishes, controls, conducts, manages,
3183	or operates a facility licensed under part III of chapter 429
3184	400 relating to its operation of the licensed facility shall be
3185	brought pursuant to s. 429.29 400.429. Such licensee or entity
3186	shall not be vicariously liable for the acts or omissions of its
3187	employees or agents or any other third party in an action
3188	brought under this section.
3189	Section 92.  Section 430.601, Florida Statutes, is amended
3190	to read:
3191	430.601  Home care for the elderly; legislative intent.--It
3192	is the intent of the Legislature to encourage the provision of
3193	care for the elderly in family-type living arrangements in
3194	private homes as an alternative to institutional or nursing home
3195	care for such persons. The provisions of ss. 430.601-430.606 are
3196	intended to be supplemental to the provisions of chapters
3197	chapter 400 and 429, relating to the licensing and regulation of
3198	nursing homes and assisted living facilities, and do not exempt
3199	any person who is otherwise subject to regulation under those
3200	chapters the provisions of that chapter.
3201	Section 93.  Subsection (7) of section 430.703, Florida
3202	Statutes, is amended to read:
3203	430.703  Definitions.--As used in this act, the term:
3204	(7)  "Other qualified provider" means an entity licensed
3205	under chapter 400 or chapter 429 that demonstrates a long-term
3206	care continuum and meets all requirements pursuant to an
3207	interagency agreement between the agency and the department.
3208	Section 94.  Paragraph (a) of subsection (3) of section
3209	435.03, Florida Statutes, is amended to read:
3210	435.03  Level 1 screening standards.--
3211	(3)  Standards must also ensure that the person:
3212	(a)  For employees and employers licensed or registered
3213	pursuant to chapter 400 or chapter 429, and for employees and
3214	employers of developmental services institutions as defined in
3215	s. 393.063, intermediate care facilities for the developmentally
3216	disabled as defined in s. 393.063, and mental health treatment
3217	facilities as defined in s. 394.455, meets the requirements of
3218	this chapter.
3219	Section 95.  Paragraph (a) of subsection (4) of section
3220	435.04, Florida Statutes, is amended to read:
3221	435.04  Level 2 screening standards.--
3222	(4)  Standards must also ensure that the person:
3223	(a)  For employees or employers licensed or registered
3224	pursuant to chapter 400 or chapter 429, does not have a
3225	confirmed report of abuse, neglect, or exploitation as defined
3226	in s. 415.102(6), which has been uncontested or upheld under s.
3227	415.103.
3228	Section 96.  Paragraph (g) of subsection (1) of section
3229	440.13, Florida Statutes, is amended to read:
3230	440.13  Medical services and supplies; penalty for
3231	violations; limitations.--
3232	(1)  DEFINITIONS.--As used in this section, the term:
3233	(g)  "Health care facility" means any hospital licensed
3234	under chapter 395 and any health care institution licensed under
3235	chapter 400 or chapter 429.
3236	Section 97.  Paragraph (b) of subsection (1) of section
3237	456.0375, Florida Statutes, is amended to read:
3238	456.0375  Registration of certain clinics; requirements;
3239	discipline; exemptions.--
3240	(1)
3241	(b)  For purposes of this section, the term "clinic" does
3242	not include and the registration requirements herein do not
3243	apply to:
3244	1.  Entities licensed or registered by the state pursuant
3245	to chapter 390, chapter 394, chapter 395, chapter 397, chapter
3246	400, chapter 429, chapter 463, chapter 465, chapter 466, chapter
3247	478, chapter 480, chapter 484, or chapter 651.
3248	2.  Entities that own, directly or indirectly, entities
3249	licensed or registered by the state pursuant to chapter 390,
3250	chapter 394, chapter 395, chapter 397, chapter 400, chapter 429,
3251	chapter 463, chapter 465, chapter 466, chapter 478, chapter 480,
3252	chapter 484, or chapter 651.
3253	3.  Entities that are owned, directly or indirectly, by an
3254	entity licensed or registered by the state pursuant to chapter
3255	390, chapter 394, chapter 395, chapter 397, chapter 400, chapter
3256	429, chapter 463, chapter 465, chapter 466, chapter 478, chapter
3257	480, chapter 484, or chapter 651.
3258	4.  Entities that are under common ownership, directly or
3259	indirectly, with an entity licensed or registered by the state
3260	pursuant to chapter 390, chapter 394, chapter 395, chapter 397,
3261	chapter 400, chapter 429, chapter 463, chapter 465, chapter 466,
3262	chapter 478, chapter 480, chapter 484, or chapter 651.
3263	5.  Entities exempt from federal taxation under 26 U.S.C.
3264	s. 501(c)(3) and community college and university clinics.
3265	6.  Sole proprietorships, group practices, partnerships, or
3266	corporations that provide health care services by licensed
3267	health care practitioners pursuant to chapters 457, 458, 459,
3268	460, 461, 462, 463, 466, 467, 484, 486, 490, 491, or part I,
3269	part III, part X, part XIII, or part XIV of chapter 468, or s.
3270	464.012, which are wholly owned by licensed health care
3271	practitioners or the licensed health care practitioner and the
3272	spouse, parent, or child of a licensed health care practitioner,
3273	so long as one of the owners who is a licensed health care
3274	practitioner is supervising the services performed therein and
3275	is legally responsible for the entity's compliance with all
3276	federal and state laws. However, no health care practitioner may
3277	supervise services beyond the scope of the practitioner's
3278	license.
3279	7.  Clinical facilities affiliated with an accredited
3280	medical school at which training is provided for medical
3281	students, residents, or fellows.
3282	Section 98.  Subsection (1) of section 465.0235, Florida
3283	Statutes, is amended to read:
3284	465.0235  Automated pharmacy systems used by long-term care
3285	facilities, hospices, or state correctional institutions.--
3286	(1)  A pharmacy may provide pharmacy services to a
3287	long-term care facility or hospice licensed under chapter 400 or
3288	chapter 429 or a state correctional institution operated under
3289	chapter 944 through the use of an automated pharmacy system that
3290	need not be located at the same location as the pharmacy.
3291	Section 99.  Paragraph (k) of subsection (1) of section
3292	468.505, Florida Statutes, is amended to read:
3293	468.505  Exemptions; exceptions.--
3294	(1)  Nothing in this part may be construed as prohibiting
3295	or restricting the practice, services, or activities of:
3296	(k)  A person employed by a hospital licensed under chapter
3297	395, or by a nursing home or assisted living facility licensed
3298	under part II or part III of chapter 400 or under chapter 429,
3299	or by a continuing care facility certified under chapter 651, if
3300	the person is employed in compliance with the laws and rules
3301	adopted thereunder regarding the operation of its dietetic
3302	department.
3303	Section 100.  Subsection (11) of section 477.025, Florida
3304	Statutes, is amended to read:
3305	477.025  Cosmetology salons; specialty salons; requisites;
3306	licensure; inspection; mobile cosmetology salons.--
3307	(11)  Facilities licensed under part II or part III of
3308	chapter 400 or under chapter 429 shall be exempt from the
3309	provisions of this section and a cosmetologist licensed pursuant
3310	to s. 477.019 may provide salon services exclusively for
3311	facility residents.
3312	Section 101.  Paragraph (a) of subsection (2) of section
3313	509.032, Florida Statutes, is amended to read:
3314	509.032  Duties.--
3315	(2)  INSPECTION OF PREMISES.--
3316	(a)  The division has responsibility and jurisdiction for
3317	all inspections required by this chapter.  The division has
3318	responsibility for quality assurance.  Each licensed
3319	establishment shall be inspected at least biannually, except for
3320	transient and nontransient apartments, which shall be inspected
3321	at least annually, and shall be inspected at such other times as
3322	the division determines is necessary to ensure the public's
3323	health, safety, and welfare.  The division shall establish a
3324	system to determine inspection frequency.  Public lodging units
3325	classified as resort condominiums or resort dwellings are not
3326	subject to this requirement, but shall be made available to the
3327	division upon request.  If, during the inspection of a public
3328	lodging establishment classified for renting to transient or
3329	nontransient tenants, an inspector identifies vulnerable adults
3330	who appear to be victims of neglect, as defined in s. 415.102,
3331	or, in the case of a building that is not equipped with
3332	automatic sprinkler systems, tenants or clients who may be
3333	unable to self-preserve in an emergency, the division shall
3334	convene meetings with the following agencies as appropriate to
3335	the individual situation: the Department of Health, the
3336	Department of Elderly Affairs, the area agency on aging, the
3337	local fire marshal, the landlord and affected tenants and
3338	clients, and other relevant organizations, to develop a plan
3339	which improves the prospects for safety of affected residents
3340	and, if necessary, identifies alternative living arrangements
3341	such as facilities licensed under part II or part III of chapter
3342	400 or under chapter 429.
3343	Section 102.  Subsection (1) of section 509.241, Florida
3344	Statutes, is amended to read:
3345	509.241  Licenses required; exceptions.--
3346	(1)  LICENSES; ANNUAL RENEWALS.--Each public lodging
3347	establishment and public food service establishment shall obtain
3348	a license from the division. Such license may not be transferred
3349	from one place or individual to another. It shall be a
3350	misdemeanor of the second degree, punishable as provided in s.
3351	775.082 or s. 775.083, for such an establishment to operate
3352	without a license. Local law enforcement shall provide immediate
3353	assistance in pursuing an illegally operating establishment. The
3354	division may refuse a license, or a renewal thereof, to any
3355	establishment that is not constructed and maintained in
3356	accordance with law and with the rules of the division. The
3357	division may refuse to issue a license, or a renewal thereof, to
3358	any establishment an operator of which, within the preceding 5
3359	years, has been adjudicated guilty of, or has forfeited a bond
3360	when charged with, any crime reflecting on professional
3361	character, including soliciting for prostitution, pandering,
3362	letting premises for prostitution, keeping a disorderly place,
3363	or illegally dealing in controlled substances as defined in
3364	chapter 893, whether in this state or in any other jurisdiction
3365	within the United States, or has had a license denied, revoked,
3366	or suspended pursuant to s. 429.14 400.414. Licenses shall be
3367	renewed annually, and the division shall adopt a rule
3368	establishing a staggered schedule for license renewals. If any
3369	license expires while administrative charges are pending against
3370	the license, the proceedings against the license shall continue
3371	to conclusion as if the license were still in effect.
3372	Section 103.  Subsection (1) of section 627.732, Florida
3373	Statutes, is amended to read:
3374	627.732  Definitions.--As used in ss. 627.730-627.7405, the
3375	term:
3376	(1)  "Broker" means any person not possessing a license
3377	under chapter 395, chapter 400, chapter 429, chapter 458,
3378	chapter 459, chapter 460, chapter 461, or chapter 641 who
3379	charges or receives compensation for any use of medical
3380	equipment and is not the 100-percent owner or the 100-percent
3381	lessee of such equipment. For purposes of this section, such
3382	owner or lessee may be an individual, a corporation, a
3383	partnership, or any other entity and any of its 100-percent-
3384	owned affiliates and subsidiaries. For purposes of this
3385	subsection, the term "lessee" means a long-term lessee under a
3386	capital or operating lease, but does not include a part-time
3387	lessee. The term "broker" does not include a hospital or
3388	physician management company whose medical equipment is
3389	ancillary to the practices managed, a debt collection agency, or
3390	an entity that has contracted with the insurer to obtain a
3391	discounted rate for such services; nor does the term include a
3392	management company that has contracted to provide general
3393	management services for a licensed physician or health care
3394	facility and whose compensation is not materially affected by
3395	the usage or frequency of usage of medical equipment or an
3396	entity that is 100-percent owned by one or more hospitals or
3397	physicians. The term "broker" does not include a person or
3398	entity that certifies, upon request of an insurer, that:
3399	(a)  It is a clinic registered under s. 456.0375 or
3400	licensed under ss. 400.990-400.995;
3401	(b)  It is a 100-percent owner of medical equipment; and
3402	(c)  The owner's only part-time lease of medical equipment
3403	for personal injury protection patients is on a temporary basis
3404	not to exceed 30 days in a 12-month period, and such lease is
3405	solely for the purposes of necessary repair or maintenance of
3406	the 100-percent-owned medical equipment or pending the arrival
3407	and installation of the newly purchased or a replacement for the
3408	100-percent-owned medical equipment, or for patients for whom,
3409	because of physical size or claustrophobia, it is determined by
3410	the medical director or clinical director to be medically
3411	necessary that the test be performed in medical equipment that
3412	is open-style. The leased medical equipment cannot be used by
3413	patients who are not patients of the registered clinic for
3414	medical treatment of services. Any person or entity making a
3415	false certification under this subsection commits insurance
3416	fraud as defined in s. 817.234. However, the 30-day period
3417	provided in this paragraph may be extended for an additional 60
3418	days as applicable to magnetic resonance imaging equipment if
3419	the owner certifies that the extension otherwise complies with
3420	this paragraph.
3421	Section 104.  Subsection (2) of section 651.011, Florida
3422	Statutes, is amended to read:
3423	651.011  Definitions.--For the purposes of this chapter,
3424	the term:
3425	(2)  "Continuing care" or "care" means furnishing pursuant
3426	to a contract shelter and either nursing care or personal
3427	services as defined in s. 429.02 400.402, whether such nursing
3428	care or personal services are provided in the facility or in
3429	another setting designated by the contract for continuing care,
3430	to an individual not related by consanguinity or affinity to the
3431	provider furnishing such care, upon payment of an entrance fee.
3432	Other personal services provided shall be designated in the
3433	continuing care contract. Contracts to provide continuing care
3434	include agreements to provide care for any duration, including
3435	contracts that are terminable by either party.
3436	Section 105.  Paragraph (c) of subsection (2) of section
3437	651.022, Florida Statutes, is amended to read:
3438	651.022  Provisional certificate of authority;
3439	application.--
3440	(2)  The application for a provisional certificate of
3441	authority shall be on a form prescribed by the commission and
3442	shall contain the following information:
3443	(c)1.  Evidence that the applicant is reputable and of
3444	responsible character.  If the applicant is a firm, association,
3445	organization, partnership, business trust, corporation, or
3446	company, the form shall require evidence that the members or
3447	shareholders are reputable and of responsible character, and the
3448	person in charge of providing care under a certificate of
3449	authority shall likewise be required to produce evidence of
3450	being reputable and of responsible character.
3451	2.  Evidence satisfactory to the office of the ability of
3452	the applicant to comply with the provisions of this chapter and
3453	with rules adopted by the commission pursuant to this chapter.
3454	3.  A statement of whether a person identified in the
3455	application for a provisional certificate of authority or the
3456	administrator or manager of the facility, if such person has
3457	been designated, or any such person living in the same location:
3458	a.  Has been convicted of a felony or has pleaded nolo
3459	contendere to a felony charge, or has been held liable or has
3460	been enjoined in a civil action by final judgment, if the felony
3461	or civil action involved fraud, embezzlement, fraudulent
3462	conversion, or misappropriation of property.
3463	b.  Is subject to a currently effective injunctive or
3464	restrictive order or federal or state administrative order
3465	relating to business activity or health care as a result of an
3466	action brought by a public agency or department, including,
3467	without limitation, an action affecting a license under chapter
3468	400 or chapter 429.
3469
3470	The statement shall set forth the court or agency, the date of
3471	conviction or judgment, and the penalty imposed or damages
3472	assessed, or the date, nature, and issuer of the order.  Before
3473	determining whether a provisional certificate of authority is to
3474	be issued, the office may make an inquiry to determine the
3475	accuracy of the information submitted pursuant to subparagraphs
3476	1. and 2.
3477	Section 106.  Subsection (6) of section 651.023, Florida
3478	Statutes, is amended to read:
3479	651.023  Certificate of authority; application.--
3480	(6)  The timeframes provided under s. 651.022(5) and (6)
3481	apply to applications submitted under s. 651.021(2). The office
3482	may not issue a certificate of authority under this chapter to
3483	any facility which does not have a component which is to be
3484	licensed pursuant to part II or part III of chapter 400 or to
3485	chapter 429 or which will not offer personal services or nursing
3486	services through written contractual agreement. Any written
3487	contractual agreement must be disclosed in the continuing care
3488	contract and is subject to the provisions of s. 651.1151,
3489	relating to administrative, vendor, and management contracts.
3490	Section 107.  Subsection (8) of section 651.055, Florida
3491	Statutes, is amended to read:
3492	651.055  Contracts; right to rescind.--
3493	(8)  The provisions of this section shall control over any
3494	conflicting provisions contained in part II or part III of
3495	chapter 400 or in chapter 429.
3496	Section 108.  Subsection (5) of section 651.095, Florida
3497	Statutes, is amended to read:
3498	651.095  Advertisements; requirements; penalties.--
3499	(5)  The provisions of this section shall control over any
3500	conflicting provisions contained in part II or part III of
3501	chapter 400 or in chapter 429.
3502	Section 109.  Subsections (1), (4), (6), and (8) of section
3503	651.118, Florida Statutes, are amended to read:
3504	651.118  Agency for Health Care Administration;
3505	certificates of need; sheltered beds; community beds.--
3506	(1)  The provisions of this section shall control in the
3507	case of conflict with the provisions of the Health Facility and
3508	Services Development Act, ss. 408.031-408.045; the provisions of
3509	chapter 395; or the provisions of part II parts II and III of
3510	chapter 400; or the provisions of chapter 429.
3511	(4)  The Agency for Health Care Administration shall
3512	approve one sheltered nursing home bed for every four proposed
3513	residential units, including those that are licensed under
3514	chapter 429 part III of chapter 400, in the continuing care
3515	facility unless the provider demonstrates the need for a lesser
3516	number of sheltered nursing home beds based on proposed
3517	utilization by prospective residents or demonstrates the need
3518	for additional sheltered nursing home beds based on actual
3519	utilization and demand by current residents.
3520	(6)  Unless the provider already has a component that is to
3521	be a part of the continuing care facility and that is licensed
3522	under chapter 395, or part II or part III of chapter 400, or
3523	chapter 429 at the time of construction of the continuing care
3524	facility, the provider must construct the nonnursing home
3525	portion of the facility and the nursing home portion of the
3526	facility at the same time. If a provider constructs less than
3527	the number of residential units approved in the certificate of
3528	authority, the number of licensed sheltered nursing home beds
3529	shall be reduced by a proportionate share.
3530	(8)  A provider may petition the Agency for Health Care
3531	Administration to use a designated number of sheltered nursing
3532	home beds to provide extended congregate care as defined in s.
3533	429.02 400.402 if the beds are in a distinct area of the nursing
3534	home which can be adapted to meet the requirements for extended
3535	congregate care. The provider may subsequently use such beds as
3536	sheltered beds after notifying the agency of the intended
3537	change. Any sheltered beds used to provide extended congregate
3538	care pursuant to this subsection may not qualify for funding
3539	under the Medicaid waiver. Any sheltered beds used to provide
3540	extended congregate care pursuant to this subsection may share
3541	common areas, services, and staff with beds designated for
3542	nursing home care, provided that all of the beds are under
3543	common ownership. For the purposes of this subsection, fire and
3544	life safety codes applicable to nursing home facilities shall
3545	apply.
3546	Section 110.  Subsection (2) of section 765.1103, Florida
3547	Statutes, is amended to read:
3548	765.1103  Pain management and palliative care.--
3549	(2)  Health care providers and practitioners regulated
3550	under chapter 458, chapter 459, or chapter 464 must, as
3551	appropriate, comply with a request for pain management or
3552	palliative care from a patient under their care or, for an
3553	incapacitated patient under their care, from a surrogate, proxy,
3554	guardian, or other representative permitted to make health care
3555	decisions for the incapacitated patient. Facilities regulated
3556	under chapter 395, or chapter 400, or chapter 429 must comply
3557	with the pain management or palliative care measures ordered by
3558	the patient's physician.
3559	Section 111.  Subsection (2) of section 765.205, Florida
3560	Statutes, is amended to read:
3561	765.205  Responsibility of the surrogate.--
3562	(2)  The surrogate may authorize the release of information
3563	and medical records to appropriate persons to ensure the
3564	continuity of the principal's health care and may authorize the
3565	admission, discharge, or transfer of the principal to or from a
3566	health care facility or other facility or program licensed under
3567	chapter 400 or chapter 429.
3568	Section 112.  Subsection (1) of section 768.735, Florida
3569	Statutes, is amended to read:
3570	768.735  Punitive damages; exceptions; limitation.--
3571	(1)  Sections 768.72(2)-(4), 768.725, and 768.73 do not
3572	apply to any civil action based upon child abuse, abuse of the
3573	elderly under chapter 415, or abuse of the developmentally
3574	disabled. Such actions are governed by applicable statutes and
3575	controlling judicial precedent. This section does not apply to
3576	claims brought pursuant to s. 400.023 or s. 429.29 400.429.
3577	Section 113.  Paragraph (a) of subsection (4) of section
3578	943.0585, Florida Statutes, is amended to read:
3579	943.0585  Court-ordered expunction of criminal history
3580	records.--The courts of this state have jurisdiction over their
3581	own procedures, including the maintenance, expunction, and
3582	correction of judicial records containing criminal history
3583	information to the extent such procedures are not inconsistent
3584	with the conditions, responsibilities, and duties established by
3585	this section. Any court of competent jurisdiction may order a
3586	criminal justice agency to expunge the criminal history record
3587	of a minor or an adult who complies with the requirements of
3588	this section. The court shall not order a criminal justice
3589	agency to expunge a criminal history record until the person
3590	seeking to expunge a criminal history record has applied for and
3591	received a certificate of eligibility for expunction pursuant to
3592	subsection (2). A criminal history record that relates to a
3593	violation of s. 393.135, s. 394.4593, s. 787.025, chapter 794,
3594	s. 796.03, s. 800.04, s. 817.034, s. 825.1025, s. 827.071,
3595	chapter 839, s. 847.0133, s. 847.0135, s. 847.0145, s. 893.135,
3596	s. 916.1075, or a violation enumerated in s. 907.041 may not be
3597	expunged, without regard to whether adjudication was withheld,
3598	if the defendant was found guilty of or pled guilty or nolo
3599	contendere to the offense, or if the defendant, as a minor, was
3600	found to have committed, or pled guilty or nolo contendere to
3601	committing, the offense as a delinquent act. The court may only
3602	order expunction of a criminal history record pertaining to one
3603	arrest or one incident of alleged criminal activity, except as
3604	provided in this section. The court may, at its sole discretion,
3605	order the expunction of a criminal history record pertaining to
3606	more than one arrest if the additional arrests directly relate
3607	to the original arrest. If the court intends to order the
3608	expunction of records pertaining to such additional arrests,
3609	such intent must be specified in the order. A criminal justice
3610	agency may not expunge any record pertaining to such additional
3611	arrests if the order to expunge does not articulate the
3612	intention of the court to expunge a record pertaining to more
3613	than one arrest. This section does not prevent the court from
3614	ordering the expunction of only a portion of a criminal history
3615	record pertaining to one arrest or one incident of alleged
3616	criminal activity. Notwithstanding any law to the contrary, a
3617	criminal justice agency may comply with laws, court orders, and
3618	official requests of other jurisdictions relating to expunction,
3619	correction, or confidential handling of criminal history records
3620	or information derived therefrom. This section does not confer
3621	any right to the expunction of any criminal history record, and
3622	any request for expunction of a criminal history record may be
3623	denied at the sole discretion of the court.
3624	(4)  EFFECT OF CRIMINAL HISTORY RECORD EXPUNCTION.--Any
3625	criminal history record of a minor or an adult which is ordered
3626	expunged by a court of competent jurisdiction pursuant to this
3627	section must be physically destroyed or obliterated by any
3628	criminal justice agency having custody of such record; except
3629	that any criminal history record in the custody of the
3630	department must be retained in all cases. A criminal history
3631	record ordered expunged that is retained by the department is
3632	confidential and exempt from the provisions of s. 119.07(1) and
3633	s. 24(a), Art. I of the State Constitution and not available to
3634	any person or entity except upon order of a court of competent
3635	jurisdiction. A criminal justice agency may retain a notation
3636	indicating compliance with an order to expunge.
3637	(a)  The person who is the subject of a criminal history
3638	record that is expunged under this section or under other
3639	provisions of law, including former s. 893.14, former s. 901.33,
3640	and former s. 943.058, may lawfully deny or fail to acknowledge
3641	the arrests covered by the expunged record, except when the
3642	subject of the record:
3643	1.  Is a candidate for employment with a criminal justice
3644	agency;
3645	2.  Is a defendant in a criminal prosecution;
3646	3.  Concurrently or subsequently petitions for relief under
3647	this section or s. 943.059;
3648	4.  Is a candidate for admission to The Florida Bar;
3649	5.  Is seeking to be employed or licensed by or to contract
3650	with the Department of Children and Family Services or the
3651	Department of Juvenile Justice or to be employed or used by such
3652	contractor or licensee in a sensitive position having direct
3653	contact with children, the developmentally disabled, the aged,
3654	or the elderly as provided in s. 110.1127(3), s. 393.063, s.
3655	394.4572(1), s. 397.451, s. 402.302(3), s. 402.313(3), s.
3656	409.175(2)(i), s. 415.102(4), s. 916.106(10) and (13), s.
3657	985.407, or chapter 400, or chapter 429; or
3658	6.  Is seeking to be employed or licensed by the Department
3659	of Education, any district school board, any university
3660	laboratory school, any charter school, any private or parochial
3661	school, or any local governmental entity that licenses child
3662	care facilities.
3663	Section 114.  The Division of Statutory Revision of the
3664	Office of Legislative Services shall prepare a reviser's bill
3665	for introduction at a subsequent session of the Legislature to
3666	conform the Florida Statutes to changes made by this act.
3667	Section 115.  This act shall take effect July 1, 2005.

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