HB 0467

CS

CHAMBER ACTION

1	The Health & Families Council recommends the following:
2
3	Council/Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to assisted care communities; creating ch.
7	429, F.S., entitled "Assisted Care Communities," and
8	transferring pt. III of ch. 400, F.S., relating to
9	assisted living facilities, to pt. I of ch. 429, F.S., pt.
10	VII of ch. 400, F.S., relating to adult family-care homes,
11	to pt. II of ch. 429, F.S., and pt. V of ch. 400, F.S.,
12	relating to adult day care centers, to pt. III of ch. 429,
13	F.S.; amending ss. 101.655, 189.428, 196.1975, 202.125,
14	205.1965, 212.031, 212.08, 296.02, 381.0035, 394.455,
15	394.4574, 394.463, 400.0063, 400.0069, 400.0073, 400.0077,
16	400.0239, 400.119, 400.141, 400.142, 400.191, 400.215,
17	400.23, 400.232, 400.401, 400.402, 400.404, 400.407,
18	400.408, 400.411, 400.412, 400.414, 400.415, 400.417,
19	400.4174, 400.4176, 400.4177, 400.4178, 400.418, 400.419,
20	400.4195, 400.42, 400.421, 400.422, 400.423, 400.424,
21	400.4255, 400.4256, 400.426, 400.427, 400.4275, 400.428,
22	400.429, 400.4293, 400.4294, 400.4295, 400.4296, 400.4297,
23	400.431, 400.434, 400.441, 400.442, 400.444, 400.4445,
24	400.447, 400.451, 400.452, 400.453, 400.462, 400.464,
25	400.497, 400.552, 400.555, 400.556, 400.557, 400.5572,
26	400.601, 400.618, 400.6194, 400.621, 400.628, 400.93,
27	400.962, 400.980, 400.9905, 400.9935, 401.23, 402.164,
28	408.033, 408.831, 409.212, 409.221, 409.907, 410.031,
29	410.034, 415.1111, 419.001, 430.601, 430.703, 435.03,
30	435.04, 440.13, 456.0375, 465.0235, 468.505, 477.025,
31	509.032, 509.241, 627.732, 651.011, 651.022, 651.023,
32	651.055, 651.095, 651.118, 765.1103, 765.205, 768.735, and
33	943.0585, F.S.; conforming references to changes made by
34	the act; providing a directive to the Division of
35	Statutory Revision to make necessary conforming changes to
36	the Florida Statutes; providing an effective date.
37
38	Be It Enacted by the Legislature of the State of Florida:
39
40	Section 1.  Chapter 429, Florida Statutes, is created and
41	shall be entitled "Assisted Care Communities."
42	Section 2.  Sections 400.401, 400.402, 400.404, 400.407,
43	400.4075, 400.408, 400.411, 400.412, 400.414, 400.415, 400.417,
44	400.4174, 400.4176, 400.4177, 400.4178, 400.418, 400.419,
45	400.4195, 400.42, 400.421, 400.422, 400.423, 400.424, 400.4255,
46	400.4256, 400.426, 400.427, 400.4275, 400.428, 400.429,
47	400.4293, 400.4294, 400.4295, 400.4296, 400.4297, 400.4298,
48	400.431, 400.434, 400.435, 400.441, 400.422, 400.444, 400.4445,
49	400.447, 400.449, 400.451, 400.452, 400.453, and 400.454,
50	Florida Statutes, are renumbered as sections 429.01, 429.02,
51	429.04, 429.07, 429.075, 429.08, 429.11, 429.12, 429.14, 429.15,
52	429.17, 429.174, 429.176, 429.177, 429.178, 429.18, 429.19,
53	429.195, 429.20, 429.21, 429.22, 429.23, 429.24, 429.255,
54	429.256, 429.26, 429.27, 429.275, 429.28, 429.29, 429.293,
55	429.294, 429.295, 429.296, 429.297, 429.298, 429.31, 429.34,
56	429.35, 429.41, 429.42, 429.44, 429.445, 429.47, 429.49, 429.51,
57	429.52, 429.53, and 429.54, Florida Statutes, respectively, and
58	designated as part I of chapter 429, Florida Statutes, entitled
59	"ASSISTED LIVING FACILITIES."
60	Section 3.  Sections 400.616, 400.617, 400.618, 400.619,
61	400.6194, 400.6196, 400.621, 400.6211, 400.622, 400.625,
62	400.6255, 400.628, and 400.629, Florida Statutes, are renumbered
63	as sections 429.60, 429.63, 429.65, 429.67, 429.69, 429.71,
64	429.73, 429.75, 429.77, 429.81, 429.83, 429.85, and 429.87,
65	Florida Statutes, respectively, and designated as part II of
66	chapter 429, Florida Statutes, entitled "ADULT FAMILY-CARE
67	HOMES."
68	Section 4.  Sections 400.55, 400.551, 400.552, 400.553,
69	400.554, 400.555, 400.556, 400.5565, 400.557, 400.5571,
70	400.5572, 400.5575, 400.558, 400.559, 400.56, 400.562, 400.563,
71	and 400.564, Florida Statutes, are renumbered as sections
72	429.90, 429.901, 429.903, 429.905, 429.907, 429.909, 429.911,
73	429.913, 429.915, 429.917, 429.919, 429.921, 429.923, 429.925,
74	429.927, 429.929, 429.931, and 429.933, Florida Statutes, and
75	designated as part III of chapter 429, Florida Statutes,
76	entitled "ADULT DAY CARE CENTERS."
77	Section 5.  Subsection (1) of section 101.655, Florida
78	Statutes, is amended to read:
79	101.655  Supervised voting by absent electors in certain
80	facilities.--
81	(1)  The supervisor of elections of a county shall provide
82	supervised voting for absent electors residing in any assisted
83	living facility, as defined in s. 429.02 400.402, or nursing
84	home facility, as defined in s. 400.021, within that county at
85	the request of any administrator of such a facility. Such
86	request for supervised voting in the facility shall be made by
87	submitting a written request to the supervisor of elections no
88	later than 21 days prior to the election for which that request
89	is submitted. The request shall specify the name and address of
90	the facility and the name of the electors who wish to vote
91	absentee in that election. If the request contains the names of
92	fewer than five voters, the supervisor of elections is not
93	required to provide supervised voting.
94	Section 6.  Subsection (9) of section 189.428, Florida
95	Statutes, is amended to read:
96	189.428  Special districts; oversight review process.--
97	(9)  This section does not apply to a deepwater port listed
98	in s. 311.09(1) which is in compliance with a port master plan
99	adopted pursuant to s. 163.3178(2)(k), or to an airport
100	authority operating in compliance with an airport master plan
101	approved by the Federal Aviation Administration, or to any
102	special district organized to operate health systems and
103	facilities licensed under chapter 395, or chapter 400, or
104	chapter 429.
105	Section 7.  Paragraph (b) of subsection (2) of section
106	196.1975, Florida Statutes, is amended to read:
107	196.1975  Exemption for property used by nonprofit homes
108	for the aged.--Nonprofit homes for the aged are exempt to the
109	extent that they meet the following criteria:
110	(2)  A facility will not qualify as a "home for the aged"
111	unless at least 75 percent of the occupants are over the age of
112	62 years or totally and permanently disabled.  For homes for the
113	aged which are exempt from paying income taxes to the United
114	States as specified in subsection (1), licensing by the Agency
115	for Health Care Administration is required for ad valorem tax
116	exemption hereunder only if the home:
117	(b)  Qualifies as an assisted living facility under part
118	III of chapter 429 400.
119	Section 8.  Paragraph (c) of subsection (4) of section
120	202.125, Florida Statutes, is amended to read:
121	202.125  Sales of communications services; specified
122	exemptions.--
123	(4)  The sale of communications services to a home for the
124	aged, religious institution or educational institution that is
125	exempt from federal income tax under s. 501(c)(3) of the
126	Internal Revenue Code, or by a religious institution that is
127	exempt from federal income tax under s. 501(c)(3) of the
128	Internal Revenue Code having an established physical place for
129	worship at which nonprofit religious services and activities are
130	regularly conducted and carried on, is exempt from the taxes
131	imposed or administered pursuant to ss. 202.12 and 202.19. As
132	used in this subsection, the term:
133	(c)  "Home for the aged" includes any nonprofit
134	corporation:
135	1.  In which at least 75 percent of the occupants are 62
136	years of age or older or totally and permanently disabled; which
137	qualifies for an ad valorem property tax exemption under s.
138	196.196, s. 196.197, or s. 196.1975; and which is exempt from
139	the sales tax imposed under chapter 212.
140	2.  Licensed as a nursing home under chapter 400 or an
141	assisted living facility under chapter 429 400 and which is
142	exempt from the sales tax imposed under chapter 212.
143	Section 9.  Section 205.1965, Florida Statutes, is amended
144	to read:
145	205.1965  Assisted living facilities.--A county or
146	municipality may not issue an occupational license for the
147	operation of an assisted living facility pursuant to part III of
148	chapter 429 400 without first ascertaining that the applicant
149	has been licensed by the Agency for Health Care Administration
150	to operate such facility at the specified location or locations.
151	The Agency for Health Care Administration shall furnish to local
152	agencies responsible for issuing occupational licenses
153	sufficient instructions for making the above required
154	determinations.
155	Section 10.  Paragraph (b) of subsection (1) of section
156	212.031, Florida Statutes, is amended to read:
157	212.031  Tax on rental or license fee for use of real
158	property.--
159	(1)
160	(b)  When a lease involves multiple use of real property
161	wherein a part of the real property is subject to the tax
162	herein, and a part of the property would be excluded from the
163	tax under subparagraph (a)1., subparagraph (a)2., subparagraph
164	(a)3., or subparagraph (a)5., the department shall determine,
165	from the lease or license and such other information as may be
166	available, that portion of the total rental charge which is
167	exempt from the tax imposed by this section. The portion of the
168	premises leased or rented by a for-profit entity providing a
169	residential facility for the aged will be exempt on the basis of
170	a pro rata portion calculated by combining the square footage of
171	the areas used for residential units by the aged and for the
172	care of such residents and dividing the resultant sum by the
173	total square footage of the rented premises. For purposes of
174	this section, the term "residential facility for the aged" means
175	a facility that is licensed or certified in whole or in part
176	under chapter 400, chapter 429, or chapter 651; or that provides
177	residences to the elderly and is financed by a mortgage or loan
178	made or insured by the United States Department of Housing and
179	Urban Development under s. 202, s. 202 with a s. 8 subsidy, s.
180	221(d)(3) or (4), s. 232, or s. 236 of the National Housing Act;
181	or other such similar facility that provides residences
182	primarily for the elderly.
183	Section 11.  Paragraph (i) of subsection (7) of section
184	212.08, Florida Statutes, is amended to read:
185	212.08  Sales, rental, use, consumption, distribution, and
186	storage tax; specified exemptions.--The sale at retail, the
187	rental, the use, the consumption, the distribution, and the
188	storage to be used or consumed in this state of the following
189	are hereby specifically exempt from the tax imposed by this
190	chapter.
191	(7)  MISCELLANEOUS EXEMPTIONS.--Exemptions provided to any
192	entity by this chapter do not inure to any transaction that is
193	otherwise taxable under this chapter when payment is made by a
194	representative or employee of the entity by any means,
195	including, but not limited to, cash, check, or credit card, even
196	when that representative or employee is subsequently reimbursed
197	by the entity. In addition, exemptions provided to any entity by
198	this subsection do not inure to any transaction that is
199	otherwise taxable under this chapter unless the entity has
200	obtained a sales tax exemption certificate from the department
201	or the entity obtains or provides other documentation as
202	required by the department. Eligible purchases or leases made
203	with such a certificate must be in strict compliance with this
204	subsection and departmental rules, and any person who makes an
205	exempt purchase with a certificate that is not in strict
206	compliance with this subsection and the rules is liable for and
207	shall pay the tax. The department may adopt rules to administer
208	this subsection.
209	(i)  Hospital meals and rooms.--Also exempt from payment of
210	the tax imposed by this chapter on rentals and meals are
211	patients and inmates of any hospital or other physical plant or
212	facility designed and operated primarily for the care of persons
213	who are ill, aged, infirm, mentally or physically incapacitated,
214	or otherwise dependent on special care or attention. Residents
215	of a home for the aged are exempt from payment of taxes on meals
216	provided through the facility.  A home for the aged is defined
217	as a facility that is licensed or certified in part or in whole
218	under chapter 400, chapter 429, or chapter 651, or that is
219	financed by a mortgage loan made or insured by the United States
220	Department of Housing and Urban Development under s. 202, s. 202
221	with a s. 8 subsidy, s. 221(d)(3) or (4), s. 232, or s. 236 of
222	the National Housing Act, or other such similar facility
223	designed and operated primarily for the care of the aged.
224	Section 12.  Subsection (5) of section 296.02, Florida
225	Statutes, is amended to read:
226	296.02  Definitions.--For the purposes of this part, except
227	where the context clearly indicates otherwise:
228	(5)  "Extended congregate care" has the meaning given to
229	that term under s. 429.02 400.402.
230	Section 13.  Subsections (1) and (3) of section 381.0035,
231	Florida Statutes, are amended to read:
232	381.0035  Educational course on HIV and AIDS; employees and
233	clients of certain health care facilities.--
234	(1)  The Department of Health shall require all employees
235	and clients of facilities licensed under chapters 393, 394, and
236	397 and employees of facilities licensed under chapter 395, and
237	parts II, III, IV, and VI of chapter 400, and chapter 429 to
238	complete, biennially, a continuing educational course on the
239	modes of transmission, infection control procedures, clinical
240	management, and prevention of human immunodeficiency virus and
241	acquired immune deficiency syndrome with an emphasis on
242	appropriate behavior and attitude change. Such instruction shall
243	include information on current Florida law and its impact on
244	testing, confidentiality of test results, and treatment of
245	patients and any protocols and procedures applicable to human
246	immunodeficiency counseling and testing, reporting, the offering
247	of HIV testing to pregnant women, and partner notification
248	issues pursuant to ss. 381.004 and 384.25.
249	(3)  Facilities licensed under chapters 393, 394, 395, and
250	397, and parts II, III, IV, and VI of chapter 400, and chapter
251	429 shall maintain a record of employees and dates of attendance
252	at human immunodeficiency virus and acquired immune deficiency
253	syndrome educational courses.
254	Section 14.  Subsection (10) of section 394.455, Florida
255	Statutes, is amended to read:
256	394.455  Definitions.--As used in this part, unless the
257	context clearly requires otherwise, the term:
258	(10)  "Facility" means any hospital, community facility,
259	public or private facility, or receiving or treatment facility
260	providing for the evaluation, diagnosis, care, treatment,
261	training, or hospitalization of persons who appear to have a
262	mental illness or have been diagnosed as having a mental
263	illness.  "Facility" does not include any program or entity
264	licensed pursuant to chapter 400 or chapter 429.
265	Section 15.  Paragraphs (b), (c), and (e) of subsection (2)
266	of section 394.4574, Florida Statutes, are amended to read:
267	394.4574  Department responsibilities for a mental health
268	resident who resides in an assisted living facility that holds a
269	limited mental health license.--
270	(2)  The department must ensure that:
271	(b)  A cooperative agreement, as required in s. 429.075
272	400.4075, is developed between the mental health care services
273	provider that serves a mental health resident and the
274	administrator of the assisted living facility with a limited
275	mental health license in which the mental health resident is
276	living. Any entity that provides Medicaid prepaid health plan
277	services shall ensure the appropriate coordination of health
278	care services with an assisted living facility in cases where a
279	Medicaid recipient is both a member of the entity's prepaid
280	health plan and a resident of the assisted living facility. If
281	the entity is at risk for Medicaid targeted case management and
282	behavioral health services, the entity shall inform the assisted
283	living facility of the procedures to follow should an emergent
284	condition arise.
285	(c)  The community living support plan, as defined in s.
286	429.02 400.402, has been prepared by a mental health resident
287	and a mental health case manager of that resident in
288	consultation with the administrator of the facility or the
289	administrator's designee. The plan must be provided to the
290	administrator of the assisted living facility with a limited
291	mental health license in which the mental health resident lives.
292	The support plan and the agreement may be in one document.
293	(e)  The mental health services provider assigns a case
294	manager to each mental health resident who lives in an assisted
295	living facility with a limited mental health license. The case
296	manager is responsible for coordinating the development of and
297	implementation of the community living support plan defined in
298	s. 429.02 400.402. The plan must be updated at least annually.
299	Section 16.  Paragraph (b) of subsection (2) of section
300	394.463, Florida Statutes, is amended to read:
301	394.463  Involuntary examination.--
302	(2)  INVOLUNTARY EXAMINATION.--
303	(b)  A person shall not be removed from any program or
304	residential placement licensed under chapter 400 or chapter 429
305	and transported to a receiving facility for involuntary
306	examination unless an ex parte order, a professional
307	certificate, or a law enforcement officer's report is first
308	prepared.  If the condition of the person is such that
309	preparation of a law enforcement officer's report is not
310	practicable before removal, the report shall be completed as
311	soon as possible after removal, but in any case before the
312	person is transported to a receiving facility.  A receiving
313	facility admitting a person for involuntary examination who is
314	not accompanied by the required ex parte order, professional
315	certificate, or law enforcement officer's report shall notify
316	the Agency for Health Care Administration of such admission by
317	certified mail no later than the next working day.  The
318	provisions of this paragraph do not apply when transportation is
319	provided by the patient's family or guardian.
320	Section 17.  Paragraph (b) of subsection (3) of section
321	400.0063, Florida Statutes, is amended to read:
322	400.0063  Establishment of Office of State Long-Term Care
323	Ombudsman; designation of ombudsman and legal advocate.--
324	(3)
325	(b)  The duties of the legal advocate shall include, but
326	not be limited to:
327	1.  Assisting the ombudsman in carrying out the duties of
328	the office with respect to the abuse, neglect, or violation of
329	rights of residents of long-term care facilities.
330	2.  Assisting the state and local ombudsman councils in
331	carrying out their responsibilities under this part.
332	3.  Initiating and prosecuting legal and equitable actions
333	to enforce the rights of long-term care facility residents as
334	defined in this chapter or chapter 429.
335	4.  Serving as legal counsel to the state and local
336	ombudsman councils, or individual members thereof, against whom
337	any suit or other legal action is initiated in connection with
338	the performance of the official duties of the councils or an
339	individual member.
340	Section 18.  Subsection (3) of section 400.0069, Florida
341	Statutes, is amended to read:
342	400.0069  Local long-term care ombudsman councils; duties;
343	membership.--
344	(3)  In order to carry out the duties specified in
345	subsection (2), the local ombudsman council is authorized,
346	pursuant to ss. 400.19(1) and 429.34 400.434, to enter any long-
347	term care facility without notice or first obtaining a warrant,
348	subject to the provisions of s. 400.0073(5).
349	Section 19.  Paragraphs (c) and (f) of subsection (5) and
350	subsection (6) of section 400.0073, Florida Statutes, are
351	amended to read:
352	400.0073  State and local ombudsman council
353	investigations.--
354	(5)  Any onsite administrative inspection conducted by an
355	ombudsman council shall be subject to the following:
356	(c)  Inspections shall be conducted in a manner which will
357	impose no unreasonable burden on nursing homes or long-term care
358	facilities, consistent with the underlying purposes of this part
359	and chapter 429. Unnecessary duplication of efforts among
360	council members or the councils shall be reduced to the extent
361	possible.
362	(f)  All inspections shall be limited to compliance with
363	part parts II, III, and VII of this chapter, chapter 429, and 42
364	U.S.C. ss. 1396(a) et seq., and any rules or regulations
365	promulgated pursuant to such laws.
366	(6)  An inspection may not be accomplished by forcible
367	entry. Refusal of a long-term care facility to allow entry of
368	any ombudsman council member constitutes a violation of part II,
369	part III, or part VII of this chapter or chapter 429.
370	Section 20.  Subsection (4) of section 400.0077, Florida
371	Statutes, is amended to read:
372	400.0077  Confidentiality.--
373	(4)  Members of any state or local ombudsman council shall
374	not be required to testify in any court with respect to matters
375	held to be confidential under s. 429.14 400.414 except as may be
376	necessary to enforce the provisions of this act.
377	Section 21.  Subsection (1) of section 400.0239, Florida
378	Statutes, is amended to read:
379	400.0239  Quality of Long-Term Care Facility Improvement
380	Trust Fund.--
381	(1)  There is created within the Agency for Health Care
382	Administration a Quality of Long-Term Care Facility Improvement
383	Trust Fund to support activities and programs directly related
384	to improvement of the care of nursing home and assisted living
385	facility residents. The trust fund shall be funded through
386	proceeds generated pursuant to ss. 400.0238 and 429.298
387	400.4298, through funds specifically appropriated by the
388	Legislature, through gifts, endowments, and other charitable
389	contributions allowed under federal and state law, and through
390	federal nursing home civil monetary penalties collected by the
391	Centers for Medicare and Medicaid Services and returned to the
392	state. These funds must be utilized in accordance with federal
393	requirements.
394	Section 22.  Subsections (1) and (4) of section 400.119,
395	Florida Statutes, are amended to read:
396	400.119  Confidentiality of records and meetings of risk
397	management and quality assurance committees.--
398	(1)  Records of meetings of the risk management and quality
399	assurance committee of a long-term care facility licensed under
400	this part or part III of this chapter 429, as well as incident
401	reports filed with the facility's risk manager and
402	administrator, notifications of the occurrence of an adverse
403	incident, and adverse incident reports from the facility are
404	confidential and exempt from s. 119.07(1) and s. 24(a), Art. I
405	of the State Constitution. However, if the Agency for Health
406	Care Administration has a reasonable belief that conduct by a
407	staff member or employee of a facility is criminal activity or
408	grounds for disciplinary action by a regulatory board, the
409	agency may disclose such records to the appropriate law
410	enforcement agency or regulatory board.
411	(4)  The meetings of an internal risk management and
412	quality assurance committee of a long-term care facility
413	licensed under this part or part III of this chapter 429 are
414	exempt from s. 286.011 and s. 24(b), Art. I of the State
415	Constitution and are not open to the public.
416	Section 23.  Subsections (4) and (7) of section 400.141,
417	Florida Statutes, are amended to read:
418	400.141  Administration and management of nursing home
419	facilities.--Every licensed facility shall comply with all
420	applicable standards and rules of the agency and shall:
421	(4)  Provide for resident use of a community pharmacy as
422	specified in s. 400.022(1)(q). Any other law to the contrary
423	notwithstanding, a registered pharmacist licensed in Florida,
424	that is under contract with a facility licensed under this
425	chapter or chapter 429, shall repackage a nursing facility
426	resident's bulk prescription medication which has been packaged
427	by another pharmacist licensed in any state in the United States
428	into a unit dose system compatible with the system used by the
429	nursing facility, if the pharmacist is requested to offer such
430	service. In order to be eligible for the repackaging, a resident
431	or the resident's spouse must receive prescription medication
432	benefits provided through a former employer as part of his or
433	her retirement benefits, a qualified pension plan as specified
434	in s. 4972 of the Internal Revenue Code, a federal retirement
435	program as specified under 5 C.F.R. s. 831, or a long-term care
436	policy as defined in s. 627.9404(1). A pharmacist who correctly
437	repackages and relabels the medication and the nursing facility
438	which correctly administers such repackaged medication under the
439	provisions of this subsection shall not be held liable in any
440	civil or administrative action arising from the repackaging. In
441	order to be eligible for the repackaging, a nursing facility
442	resident for whom the medication is to be repackaged shall sign
443	an informed consent form provided by the facility which includes
444	an explanation of the repackaging process and which notifies the
445	resident of the immunities from liability provided herein. A
446	pharmacist who repackages and relabels prescription medications,
447	as authorized under this subsection, may charge a reasonable fee
448	for costs resulting from the implementation of this provision.
449	(7)  If the facility has a standard license or is a Gold
450	Seal facility, exceeds the minimum required hours of licensed
451	nursing and certified nursing assistant direct care per resident
452	per day, and is part of a continuing care facility licensed
453	under chapter 651 or a retirement community that offers other
454	services pursuant to part III, part IV, or part V of this
455	chapter or chapter 429 on a single campus, be allowed to share
456	programming and staff. At the time of inspection and in the
457	semiannual report required pursuant to subsection (15), a
458	continuing care facility or retirement community that uses this
459	option must demonstrate through staffing records that minimum
460	staffing requirements for the facility were met. Licensed nurses
461	and certified nursing assistants who work in the nursing home
462	facility may be used to provide services elsewhere on campus if
463	the facility exceeds the minimum number of direct care hours
464	required per resident per day and the total number of residents
465	receiving direct care services from a licensed nurse or a
466	certified nursing assistant does not cause the facility to
467	violate the staffing ratios required under s. 400.23(3)(a).
468	Compliance with the minimum staffing ratios shall be based on
469	total number of residents receiving direct care services,
470	regardless of where they reside on campus. If the facility
471	receives a conditional license, it may not share staff until the
472	conditional license status ends. This subsection does not
473	restrict the agency's authority under federal or state law to
474	require additional staff if a facility is cited for deficiencies
475	in care which are caused by an insufficient number of certified
476	nursing assistants or licensed nurses. The agency may adopt
477	rules for the documentation necessary to determine compliance
478	with this provision.
479
480	Facilities that have been awarded a Gold Seal under the program
481	established in s. 400.235 may develop a plan to provide
482	certified nursing assistant training as prescribed by federal
483	regulations and state rules and may apply to the agency for
484	approval of their program.
485	Section 24.  Subsection (1) of section 400.142, Florida
486	Statutes, is amended to read:
487	400.142  Emergency medication kits; orders not to
488	resuscitate.--
489	(1)  Other provisions of this chapter or of chapter 429,
490	chapter 465, chapter 499, or chapter 893 to the contrary
491	notwithstanding, each nursing home operating pursuant to a
492	license issued by the agency may maintain an emergency
493	medication kit for the purpose of storing medicinal drugs to be
494	administered under emergency conditions to residents residing in
495	such facility.
496	Section 25.  Paragraph (a) of subsection (2) of section
497	400.191, Florida Statutes, is amended to read:
498	400.191  Availability, distribution, and posting of reports
499	and records.--
500	(2)  The agency shall provide additional information in
501	consumer-friendly printed and electronic formats to assist
502	consumers and their families in comparing and evaluating nursing
503	home facilities.
504	(a)  The agency shall provide an Internet site which shall
505	include at least the following information either directly or
506	indirectly through a link to another established site or sites
507	of the agency's choosing:
508	1.  A list by name and address of all nursing home
509	facilities in this state.
510	2.  Whether such nursing home facilities are proprietary or
511	nonproprietary.
512	3.  The current owner of the facility's license and the
513	year that that entity became the owner of the license.
514	4.  The name of the owner or owners of each facility and
515	whether the facility is affiliated with a company or other
516	organization owning or managing more than one nursing facility
517	in this state.
518	5.  The total number of beds in each facility.
519	6.  The number of private and semiprivate rooms in each
520	facility.
521	7.  The religious affiliation, if any, of each facility.
522	8.  The languages spoken by the administrator and staff of
523	each facility.
524	9.  Whether or not each facility accepts Medicare or
525	Medicaid recipients or insurance, health maintenance
526	organization, Veterans Administration, CHAMPUS program, or
527	workers' compensation coverage.
528	10.  Recreational and other programs available at each
529	facility.
530	11.  Special care units or programs offered at each
531	facility.
532	12.  Whether the facility is a part of a retirement
533	community that offers other services pursuant to part III, part
534	IV, or part V of this chapter or chapter 429.
535	13.  Survey and deficiency information contained on the
536	Online Survey Certification and Reporting (OSCAR) system of the
537	federal Health Care Financing Administration, including annual
538	survey, revisit, and complaint survey information, for each
539	facility for the past 45 months.  For noncertified nursing
540	homes, state survey and deficiency information, including annual
541	survey, revisit, and complaint survey information for the past
542	45 months shall be provided.
543	14.  A summary of the Online Survey Certification and
544	Reporting (OSCAR) data for each facility over the past 45
545	months. Such summary may include a score, rating, or comparison
546	ranking with respect to other facilities based on the number of
547	citations received by the facility of annual, revisit, and
548	complaint surveys; the severity and scope of the citations; and
549	the number of annual recertification surveys the facility has
550	had during the past 45 months. The score, rating, or comparison
551	ranking may be presented in either numeric or symbolic form for
552	the intended consumer audience.
553	Section 26.  Paragraph (b) of subsection (2) of section
554	400.215, Florida Statutes, is amended to read:
555	400.215  Personnel screening requirement.--
556	(2)  Employers and employees shall comply with the
557	requirements of s. 435.05.
558	(b)  Employees qualified under the provisions of paragraph
559	(a) who have not maintained continuous residency within the
560	state for the 5 years immediately preceding the date of request
561	for background screening must complete level 2 screening, as
562	provided in chapter 435. Such employees may work in a
563	conditional status up to 180 days pending the receipt of written
564	findings evidencing the completion of level 2 screening. Level 2
565	screening shall not be required of employees or prospective
566	employees who attest in writing under penalty of perjury that
567	they meet the residency requirement. Completion of level 2
568	screening shall require the employee or prospective employee to
569	furnish to the nursing facility a full set of fingerprints to
570	enable a criminal background investigation to be conducted. The
571	nursing facility shall submit the completed fingerprint card to
572	the agency. The agency shall establish a record of the request
573	in the database provided for in paragraph (c) and forward the
574	request to the Department of Law Enforcement, which is
575	authorized to submit the fingerprints to the Federal Bureau of
576	Investigation for a national criminal history records check. The
577	results of the national criminal history records check shall be
578	returned to the agency, which shall maintain the results in the
579	database provided for in paragraph (c). The agency shall notify
580	the administrator of the requesting nursing facility or the
581	administrator of any other facility licensed under chapter 393,
582	chapter 394, chapter 395, chapter 397, chapter 429, or this
583	chapter, as requested by such facility, as to whether or not the
584	employee has qualified under level 1 or level 2 screening. An
585	employee or prospective employee who has qualified under level 2
586	screening and has maintained such continuous residency within
587	the state shall not be required to complete a subsequent level 2
588	screening as a condition of employment at another facility.
589	Section 27.  Paragraph (f) of subsection (2) of section
590	400.23, Florida Statutes, is amended to read:
591	400.23  Rules; evaluation and deficiencies; licensure
592	status.--
593	(2)  Pursuant to the intention of the Legislature, the
594	agency, in consultation with the Department of Health and the
595	Department of Elderly Affairs, shall adopt and enforce rules to
596	implement this part, which shall include reasonable and fair
597	criteria in relation to:
598	(f)  The care, treatment, and maintenance of residents and
599	measurement of the quality and adequacy thereof, based on rules
600	developed under this chapter or chapter 429 and the Omnibus
601	Budget Reconciliation Act of 1987 (Pub. L. No. 100-203)
602	(December 22, 1987), Title IV (Medicare, Medicaid, and Other
603	Health-Related Programs), Subtitle C (Nursing Home Reform), as
604	amended.
605	Section 28.  Section 400.232, Florida Statutes, is amended
606	to read:
607	400.232  Review and approval of plans; fees and costs.--The
608	design, construction, erection, alteration, modification,
609	repair, and demolition of all public and private health care
610	facilities are governed by the Florida Building Code and the
611	Florida Fire Prevention Code under ss. 553.73 and 633.022. In
612	addition to the requirements of ss. 553.79 and 553.80, the
613	agency shall review the facility plans and survey the
614	construction of facilities licensed under this chapter or
615	chapter 429.
616	(1)  The agency shall approve or disapprove the plans and
617	specifications within 60 days after receipt of the final plans
618	and specifications.  The agency may be granted one 15-day
619	extension for the review period, if the director of the agency
620	so approves. If the agency fails to act within the specified
621	time, it shall be deemed to have approved the plans and
622	specifications. When the agency disapproves plans and
623	specifications, it shall set forth in writing the reasons for
624	disapproval. Conferences and consultations may be provided as
625	necessary.
626	(2)  The agency is authorized to charge an initial fee of
627	$2,000 for review of plans and construction on all projects, no
628	part of which is refundable.  The agency may also collect a fee,
629	not to exceed 1 percent of the estimated construction cost or
630	the actual cost of review, whichever is less, for the portion of
631	the review which encompasses initial review through the initial
632	revised construction document review.  The agency is further
633	authorized to collect its actual costs on all subsequent
634	portions of the review and construction inspections.  Initial
635	fee payment shall accompany the initial submission of plans and
636	specifications.  Any subsequent payment that is due is payable
637	upon receipt of the invoice from the agency. Notwithstanding any
638	other provisions of law to the contrary, all money received by
639	the agency pursuant to the provisions of this section shall be
640	deemed to be trust funds, to be held and applied solely for the
641	operations required under this section.
642	Section 29.  Section 400.401, Florida Statutes, is
643	renumbered as section 429.01, Florida Statutes, and subsection
644	(3) is amended to read:
645	429.01 400.401  Popular name Short title; purpose.--
646	(3)  The principle that a license issued under this chapter
647	part is a public trust and a privilege and is not an entitlement
648	should guide the finder of fact or trier of law at any
649	administrative proceeding or in a court action initiated by the
650	Agency for Health Care Administration to enforce this chapter
651	part.
652	Section 30.  Section 400.402, Florida Statutes, is
653	renumbered as section 429.02, Florida Statutes, and amended to
654	read:
655	429.02 400.402  Definitions.--When used in this chapter
656	part, the term:
657	(1)  "Activities of daily living" means functions and tasks
658	for self-care, including ambulation, bathing, dressing, eating,
659	grooming, and toileting, and other similar tasks.
660	(2)  "Administrator" means an individual at least 21 years
661	of age who is responsible for the operation and maintenance of
662	an assisted living facility.
663	(3)  "Agency" means the Agency for Health Care
664	Administration.
665	(4)  "Aging in place" or "age in place" means the process
666	of providing increased or adjusted services to a person to
667	compensate for the physical or mental decline that may occur
668	with the aging process, in order to maximize the person's
669	dignity and independence and permit them to remain in a
670	familiar, noninstitutional, residential environment for as long
671	as possible. Such services may be provided by facility staff,
672	volunteers, family, or friends, or through contractual
673	arrangements with a third party.
674	(5)  "Applicant" means an individual owner, corporation,
675	partnership, firm, association, or governmental entity that
676	applies for a license.
677	(6)  "Assisted living facility" means any building or
678	buildings, section or distinct part of a building, private home,
679	boarding home, home for the aged, or other residential facility,
680	whether operated for profit or not, which undertakes through its
681	ownership or management to provide housing, meals, and one or
682	more personal services for a period exceeding 24 hours to one or
683	more adults who are not relatives of the owner or administrator.
684	(7)  "Chemical restraint" means a pharmacologic drug that
685	physically limits, restricts, or deprives an individual of
686	movement or mobility, and is used for discipline or convenience
687	and not required for the treatment of medical symptoms.
688	(8)  "Community living support plan" means a written
689	document prepared by a mental health resident and the resident's
690	mental health case manager in consultation with the
691	administrator of an assisted living facility with a limited
692	mental health license or the administrator's designee. A copy
693	must be provided to the administrator. The plan must include
694	information about the supports, services, and special needs of
695	the resident which enable the resident to live in the assisted
696	living facility and a method by which facility staff can
697	recognize and respond to the signs and symptoms particular to
698	that resident which indicate the need for professional services.
699	(9)  "Cooperative agreement" means a written statement of
700	understanding between a mental health care provider and the
701	administrator of the assisted living facility with a limited
702	mental health license in which a mental health resident is
703	living. The agreement must specify directions for accessing
704	emergency and after-hours care for the mental health resident. A
705	single cooperative agreement may service all mental health
706	residents who are clients of the same mental health care
707	provider.
708	(10)  "Department" means the Department of Elderly Affairs.
709	(11)  "Emergency" means a situation, physical condition, or
710	method of operation which presents imminent danger of death or
711	serious physical or mental harm to facility residents.
712	(12)  "Extended congregate care" means acts beyond those
713	authorized in subsection (17) that may be performed pursuant to
714	part I of chapter 464 by persons licensed thereunder while
715	carrying out their professional duties, and other supportive
716	services which may be specified by rule.  The purpose of such
717	services is to enable residents to age in place in a residential
718	environment despite mental or physical limitations that might
719	otherwise disqualify them from residency in a facility licensed
720	under this chapter part.
721	(13)  "Guardian" means a person to whom the law has
722	entrusted the custody and control of the person or property, or
723	both, of a person who has been legally adjudged incapacitated.
724	(14)  "Limited nursing services" means acts that may be
725	performed pursuant to part I of chapter 464 by persons licensed
726	thereunder while carrying out their professional duties but
727	limited to those acts which the department specifies by rule.
728	Acts which may be specified by rule as allowable limited nursing
729	services shall be for persons who meet the admission criteria
730	established by the department for assisted living facilities and
731	shall not be complex enough to require 24-hour nursing
732	supervision and may include such services as the application and
733	care of routine dressings, and care of casts, braces, and
734	splints.
735	(15)  "Managed risk" means the process by which the
736	facility staff discuss the service plan and the needs of the
737	resident with the resident and, if applicable, the resident's
738	representative or designee or the resident's surrogate,
739	guardian, or attorney in fact, in such a way that the
740	consequences of a decision, including any inherent risk, are
741	explained to all parties and reviewed periodically in
742	conjunction with the service plan, taking into account changes
743	in the resident's status and the ability of the facility to
744	respond accordingly.
745	(16)  "Mental health resident" means an individual who
746	receives social security disability income due to a mental
747	disorder as determined by the Social Security Administration or
748	receives supplemental security income due to a mental disorder
749	as determined by the Social Security Administration and receives
750	optional state supplementation.
751	(17)  "Personal services" means direct physical assistance
752	with or supervision of the activities of daily living and the
753	self-administration of medication and other similar services
754	which the department may define by rule.  "Personal services"
755	shall not be construed to mean the provision of medical,
756	nursing, dental, or mental health services.
757	(18)  "Physical restraint" means a device which physically
758	limits, restricts, or deprives an individual of movement or
759	mobility, including, but not limited to, a half-bed rail, a
760	full-bed rail, a geriatric chair, and a posey restraint. The
761	term "physical restraint" shall also include any device which
762	was not specifically manufactured as a restraint but which has
763	been altered, arranged, or otherwise used for this purpose. The
764	term shall not include bandage material used for the purpose of
765	binding a wound or injury.
766	(19)  "Relative" means an individual who is the father,
767	mother, stepfather, stepmother, son, daughter, brother, sister,
768	grandmother, grandfather, great-grandmother, great-grandfather,
769	grandson, granddaughter, uncle, aunt, first cousin, nephew,
770	niece, husband, wife, father-in-law, mother-in-law, son-in-law,
771	daughter-in-law, brother-in-law, sister-in-law, stepson,
772	stepdaughter, stepbrother, stepsister, half brother, or half
773	sister of an owner or administrator.
774	(20)  "Resident" means a person 18 years of age or older,
775	residing in and receiving care from a facility.
776	(21)  "Resident's representative or designee" means a
777	person other than the owner, or an agent or employee of the
778	facility, designated in writing by the resident, if legally
779	competent, to receive notice of changes in the contract executed
780	pursuant to s. 429.24 400.424; to receive notice of and to
781	participate in meetings between the resident and the facility
782	owner, administrator, or staff concerning the rights of the
783	resident; to assist the resident in contacting the ombudsman
784	council if the resident has a complaint against the facility; or
785	to bring legal action on behalf of the resident pursuant to s.
786	400.429.
787	(22)  "Service plan" means a written plan, developed and
788	agreed upon by the resident and, if applicable, the resident's
789	representative or designee or the resident's surrogate,
790	guardian, or attorney in fact, if any, and the administrator or
791	designee representing the facility, which addresses the unique
792	physical and psychosocial needs, abilities, and personal
793	preferences of each resident receiving extended congregate care
794	services. The plan shall include a brief written description, in
795	easily understood language, of what services shall be provided,
796	who shall provide the services, when the services shall be
797	rendered, and the purposes and benefits of the services.
798	(23)  "Shared responsibility" means exploring the options
799	available to a resident within a facility and the risks involved
800	with each option when making decisions pertaining to the
801	resident's abilities, preferences, and service needs, thereby
802	enabling the resident and, if applicable, the resident's
803	representative or designee, or the resident's surrogate,
804	guardian, or attorney in fact, and the facility to develop a
805	service plan which best meets the resident's needs and seeks to
806	improve the resident's quality of life.
807	(24)  "Supervision" means reminding residents to engage in
808	activities of daily living and the self-administration of
809	medication, and, when necessary, observing or providing verbal
810	cuing to residents while they perform these activities.
811	(25)  "Supplemental security income," Title XVI of the
812	Social Security Act, means a program through which the Federal
813	Government guarantees a minimum monthly income to every person
814	who is age 65 or older, or disabled, or blind and meets the
815	income and asset requirements.
816	(26)  "Supportive services" means services designed to
817	encourage and assist aged persons or adults with disabilities to
818	remain in the least restrictive living environment and to
819	maintain their independence as long as possible.
820	(27)  "Twenty-four-hour nursing supervision" means services
821	that are ordered by a physician for a resident whose condition
822	requires the supervision of a physician and continued monitoring
823	of vital signs and physical status.  Such services shall be:
824	medically complex enough to require constant supervision,
825	assessment, planning, or intervention by a nurse; required to be
826	performed by or under the direct supervision of licensed nursing
827	personnel or other professional personnel for safe and effective
828	performance; required on a daily basis; and consistent with the
829	nature and severity of the resident's condition or the disease
830	state or stage.
831	Section 31.  Section 400.404, Florida Statutes, is
832	renumbered as section 429.04, Florida Statutes, and amended to
833	read:
834	429.04 400.404  Facilities to be licensed; exemptions.--
835	(1)  For the administration of this chapter part,
836	facilities to be licensed by the agency shall include all
837	assisted living facilities as defined in this chapter part.
838	(2)  The following are exempt from licensure under this
839	chapter part:
840	(a)  Any facility, institution, or other place operated by
841	the Federal Government or any agency of the Federal Government.
842	(b)  Any facility or part of a facility licensed under
843	chapter 393 or chapter 394.
844	(c)  Any facility licensed as an adult family-care home
845	under part VII of chapter 400.
846	(d)  Any person who provides housing, meals, and one or
847	more personal services on a 24-hour basis in the person's own
848	home to not more than two adults who do not receive optional
849	state supplementation. The person who provides the housing,
850	meals, and personal services must own or rent the home and
851	reside therein.
852	(e)  Any home or facility approved by the United States
853	Department of Veterans Affairs as a residential care home
854	wherein care is provided exclusively to three or fewer veterans.
855	(f)  Any facility that has been incorporated in this state
856	for 50 years or more on or before July 1, 1983, and the board of
857	directors of which is nominated or elected by the residents,
858	until the facility is sold or its ownership is transferred; or
859	any facility, with improvements or additions thereto, which has
860	existed and operated continuously in this state for 60 years or
861	more on or before July 1, 1989, is directly or indirectly owned
862	and operated by a nationally recognized fraternal organization,
863	is not open to the public, and accepts only its own members and
864	their spouses as residents.
865	(g)  Any facility certified under chapter 651, or a
866	retirement community, may provide services authorized under this
867	chapter part or part IV of this chapter 400 to its residents who
868	live in single-family homes, duplexes, quadruplexes, or
869	apartments located on the campus without obtaining a license to
870	operate an assisted living facility if residential units within
871	such buildings are used by residents who do not require staff
872	supervision for that portion of the day when personal services
873	are not being delivered and the owner obtains a home health
874	license to provide such services.  However, any building or
875	distinct part of a building on the campus that is designated for
876	persons who receive personal services and require supervision
877	beyond that which is available while such services are being
878	rendered must be licensed in accordance with this chapter part.
879	If a facility provides personal services to residents who do not
880	otherwise require supervision and the owner is not licensed as a
881	home health agency, the buildings or distinct parts of buildings
882	where such services are rendered must be licensed under this
883	chapter part. A resident of a facility that obtains a home
884	health license may contract with a home health agency of his or
885	her choice, provided that the home health agency provides
886	liability insurance and workers' compensation coverage for its
887	employees. Facilities covered by this exemption may establish
888	policies that give residents the option of contracting for
889	services and care beyond that which is provided by the facility
890	to enable them to age in place.  For purposes of this section, a
891	retirement community consists of a facility licensed under this
892	chapter part or under part II of chapter 400, and apartments
893	designed for independent living located on the same campus.
894	(h)  Any residential unit for independent living which is
895	located within a facility certified under chapter 651, or any
896	residential unit which is colocated with a nursing home licensed
897	under part II of chapter 400 or colocated with a facility
898	licensed under this chapter part in which services are provided
899	through an outpatient clinic or a nursing home on an outpatient
900	basis.
901	Section 32.  Section 400.407, Florida Statutes, is
902	renumbered as section 429.07, Florida Statutes, and paragraphs
903	(a), (b), and (c) of subsection (3), paragraphs (b) and (c) of
904	subsection (4), and subsection (5) are amended to read:
905	429.07 400.407  License required; fee, display.--
906	(3)  Any license granted by the agency must state the
907	maximum resident capacity of the facility, the type of care for
908	which the license is granted, the date the license is issued,
909	the expiration date of the license, and any other information
910	deemed necessary by the agency. Licenses shall be issued for one
911	or more of the following categories of care: standard, extended
912	congregate care, limited nursing services, or limited mental
913	health.
914	(a)  A standard license shall be issued to facilities
915	providing one or more of the personal services identified in s.
916	429.02 400.402. Such facilities may also employ or contract with
917	a person licensed under part I of chapter 464 to administer
918	medications and perform other tasks as specified in s. 429.255
919	400.4255.
920	(b)  An extended congregate care license shall be issued to
921	facilities providing, directly or through contract, services
922	beyond those authorized in paragraph (a), including acts
923	performed pursuant to part I of chapter 464 by persons licensed
924	thereunder, and supportive services defined by rule to persons
925	who otherwise would be disqualified from continued residence in
926	a facility licensed under this chapter part.
927	1.  In order for extended congregate care services to be
928	provided in a facility licensed under this chapter part, the
929	agency must first determine that all requirements established in
930	law and rule are met and must specifically designate, on the
931	facility's license, that such services may be provided and
932	whether the designation applies to all or part of a facility.
933	Such designation may be made at the time of initial licensure or
934	relicensure, or upon request in writing by a licensee under this
935	chapter part. Notification of approval or denial of such request
936	shall be made within 90 days after receipt of such request and
937	all necessary documentation. Existing facilities qualifying to
938	provide extended congregate care services must have maintained a
939	standard license and may not have been subject to administrative
940	sanctions during the previous 2 years, or since initial
941	licensure if the facility has been licensed for less than 2
942	years, for any of the following reasons:
943	a.  A class I or class II violation;
944	b.  Three or more repeat or recurring class III violations
945	of identical or similar resident care standards as specified in
946	rule from which a pattern of noncompliance is found by the
947	agency;
948	c.  Three or more class III violations that were not
949	corrected in accordance with the corrective action plan approved
950	by the agency;
951	d.  Violation of resident care standards resulting in a
952	requirement to employ the services of a consultant pharmacist or
953	consultant dietitian;
954	e.  Denial, suspension, or revocation of a license for
955	another facility under this chapter part in which the applicant
956	for an extended congregate care license has at least 25 percent
957	ownership interest; or
958	f.  Imposition of a moratorium on admissions or initiation
959	of injunctive proceedings.
960	2.  Facilities that are licensed to provide extended
961	congregate care services shall maintain a written progress
962	report on each person who receives such services, which report
963	describes the type, amount, duration, scope, and outcome of
964	services that are rendered and the general status of the
965	resident's health.  A registered nurse, or appropriate designee,
966	representing the agency shall visit such facilities at least
967	quarterly to monitor residents who are receiving extended
968	congregate care services and to determine if the facility is in
969	compliance with this chapter part and with rules that relate to
970	extended congregate care. One of these visits may be in
971	conjunction with the regular survey.  The monitoring visits may
972	be provided through contractual arrangements with appropriate
973	community agencies.  A registered nurse shall serve as part of
974	the team that inspects such facility. The agency may waive one
975	of the required yearly monitoring visits for a facility that has
976	been licensed for at least 24 months to provide extended
977	congregate care services, if, during the inspection, the
978	registered nurse determines that extended congregate care
979	services are being provided appropriately, and if the facility
980	has no class I or class II violations and no uncorrected class
981	III violations. Before such decision is made, the agency shall
982	consult with the long-term care ombudsman council for the area
983	in which the facility is located to determine if any complaints
984	have been made and substantiated about the quality of services
985	or care.  The agency may not waive one of the required yearly
986	monitoring visits if complaints have been made and
987	substantiated.
988	3.  Facilities that are licensed to provide extended
989	congregate care services shall:
990	a.  Demonstrate the capability to meet unanticipated
991	resident service needs.
992	b.  Offer a physical environment that promotes a homelike
993	setting, provides for resident privacy, promotes resident
994	independence, and allows sufficient congregate space as defined
995	by rule.
996	c.  Have sufficient staff available, taking into account
997	the physical plant and firesafety features of the building, to
998	assist with the evacuation of residents in an emergency, as
999	necessary.
1000	d.  Adopt and follow policies and procedures that maximize
1001	resident independence, dignity, choice, and decisionmaking to
1002	permit residents to age in place to the extent possible, so that
1003	moves due to changes in functional status are minimized or
1004	avoided.
1005	e.  Allow residents or, if applicable, a resident's
1006	representative, designee, surrogate, guardian, or attorney in
1007	fact to make a variety of personal choices, participate in
1008	developing service plans, and share responsibility in
1009	decisionmaking.
1010	f.  Implement the concept of managed risk.
1011	g.  Provide, either directly or through contract, the
1012	services of a person licensed pursuant to part I of chapter 464.
1013	h.  In addition to the training mandated in s. 429.52
1014	400.452, provide specialized training as defined by rule for
1015	facility staff.
1016	4.  Facilities licensed to provide extended congregate care
1017	services are exempt from the criteria for continued residency as
1018	set forth in rules adopted under s. 429.41 400.441.  Facilities
1019	so licensed shall adopt their own requirements within guidelines
1020	for continued residency set forth by the department in rule.
1021	However, such facilities may not serve residents who require 24-
1022	hour nursing supervision. Facilities licensed to provide
1023	extended congregate care services shall provide each resident
1024	with a written copy of facility policies governing admission and
1025	retention.
1026	5.  The primary purpose of extended congregate care
1027	services is to allow residents, as they become more impaired,
1028	the option of remaining in a familiar setting from which they
1029	would otherwise be disqualified for continued residency.  A
1030	facility licensed to provide extended congregate care services
1031	may also admit an individual who exceeds the admission criteria
1032	for a facility with a standard license, if the individual is
1033	determined appropriate for admission to the extended congregate
1034	care facility.
1035	6.  Before admission of an individual to a facility
1036	licensed to provide extended congregate care services, the
1037	individual must undergo a medical examination as provided in s.
1038	429.26 400.426(4) and the facility must develop a preliminary
1039	service plan for the individual.
1040	7.  When a facility can no longer provide or arrange for
1041	services in accordance with the resident's service plan and
1042	needs and the facility's policy, the facility shall make
1043	arrangements for relocating the person in accordance with s.
1044	429.28 400.428(1)(k).
1045	8.  Failure to provide extended congregate care services
1046	may result in denial of extended congregate care license
1047	renewal.
1048	9.  No later than January 1 of each year, the department,
1049	in consultation with the agency, shall prepare and submit to the
1050	Governor, the President of the Senate, the Speaker of the House
1051	of Representatives, and the chairs of appropriate legislative
1052	committees, a report on the status of, and recommendations
1053	related to, extended congregate care services. The status report
1054	must include, but need not be limited to, the following
1055	information:
1056	a.  A description of the facilities licensed to provide
1057	such services, including total number of beds licensed under
1058	this chapter part.
1059	b.  The number and characteristics of residents receiving
1060	such services.
1061	c.  The types of services rendered that could not be
1062	provided through a standard license.
1063	d.  An analysis of deficiencies cited during licensure
1064	inspections.
1065	e.  The number of residents who required extended
1066	congregate care services at admission and the source of
1067	admission.
1068	f.  Recommendations for statutory or regulatory changes.
1069	g.  The availability of extended congregate care to state
1070	clients residing in facilities licensed under this chapter part
1071	and in need of additional services, and recommendations for
1072	appropriations to subsidize extended congregate care services
1073	for such persons.
1074	h.  Such other information as the department considers
1075	appropriate.
1076	(c)  A limited nursing services license shall be issued to
1077	a facility that provides services beyond those authorized in
1078	paragraph (a) and as specified in this paragraph.
1079	1.  In order for limited nursing services to be provided in
1080	a facility licensed under this chapter part, the agency must
1081	first determine that all requirements established in law and
1082	rule are met and must specifically designate, on the facility's
1083	license, that such services may be provided. Such designation
1084	may be made at the time of initial licensure or relicensure, or
1085	upon request in writing by a licensee under this chapter part.
1086	Notification of approval or denial of such request shall be made
1087	within 90 days after receipt of such request and all necessary
1088	documentation. Existing facilities qualifying to provide limited
1089	nursing services shall have maintained a standard license and
1090	may not have been subject to administrative sanctions that
1091	affect the health, safety, and welfare of residents for the
1092	previous 2 years or since initial licensure if the facility has
1093	been licensed for less than 2 years.
1094	2.  Facilities that are licensed to provide limited nursing
1095	services shall maintain a written progress report on each person
1096	who receives such nursing services, which report describes the
1097	type, amount, duration, scope, and outcome of services that are
1098	rendered and the general status of the resident's health.  A
1099	registered nurse representing the agency shall visit such
1100	facilities at least twice a year to monitor residents who are
1101	receiving limited nursing services and to determine if the
1102	facility is in compliance with applicable provisions of this
1103	chapter part and with related rules. The monitoring visits may
1104	be provided through contractual arrangements with appropriate
1105	community agencies.  A registered nurse shall also serve as part
1106	of the team that inspects such facility.
1107	3.  A person who receives limited nursing services under
1108	this chapter part must meet the admission criteria established
1109	by the agency for assisted living facilities.  When a resident
1110	no longer meets the admission criteria for a facility licensed
1111	under this chapter part, arrangements for relocating the person
1112	shall be made in accordance with s. 429.28 400.428(1)(k), unless
1113	the facility is licensed to provide extended congregate care
1114	services.
1115	(4)
1116	(b)  In addition to the total fee assessed under paragraph
1117	(a), the agency shall require facilities that are licensed to
1118	provide extended congregate care services under this chapter
1119	part to pay an additional fee per licensed facility.  The amount
1120	of the biennial fee shall be $400 per license, with an
1121	additional fee of $10 per resident based on the total licensed
1122	resident capacity of the facility. No part of this fee shall be
1123	returned to the facility. The agency may adjust the per bed
1124	license fee and the annual license fee once each year by not
1125	more than the average rate of inflation for the 12 months
1126	immediately preceding the increase.
1127	(c)  In addition to the total fee assessed under paragraph
1128	(a), the agency shall require facilities that are licensed to
1129	provide limited nursing services under this chapter part to pay
1130	an additional fee per licensed facility.  The amount of the
1131	biennial fee shall be $250 per license, with an additional fee
1132	of $10 per resident based on the total licensed resident
1133	capacity of the facility.  No part of this fee shall be returned
1134	to the facility.  The agency may adjust the per bed license fee
1135	and the biennial license fee once each year by not more than the
1136	average rate of inflation for the 12 months immediately
1137	preceding the increase.
1138	(5)  Counties or municipalities applying for licenses under
1139	this chapter part are exempt from the payment of license fees.
1140	Section 33.  Section 400.408, Florida Statutes, is
1141	renumbered as section 429.08, Florida Statutes, and paragraphs
1142	(a), (d), (e), (f), and (g) of subsection (1) and paragraph (f)
1143	of subsection (2) are amended to read:
1144	400.408  Unlicensed facilities; referral of person for
1145	residency to unlicensed facility; penalties; verification of
1146	licensure status.--
1147	(1)(a)  It is unlawful to own, operate, or maintain an
1148	assisted living facility without obtaining a license under this
1149	chapter part.
1150	(d)  Any person who owns, operates, or maintains an
1151	unlicensed assisted living facility due to a change in this
1152	chapter part or a modification in department rule within 6
1153	months after the effective date of such change and who, within
1154	10 working days after receiving notification from the agency,
1155	fails to cease operation or apply for a license under this
1156	chapter part commits a felony of the third degree, punishable as
1157	provided in s. 775.082, s. 775.083, or s. 775.084. Each day of
1158	continued operation is a separate offense.
1159	(e)  Any facility that fails to cease operation after
1160	agency notification may be fined for each day of noncompliance
1161	pursuant to s. 429.19 400.419.
1162	(f)  When a licensee has an interest in more than one
1163	assisted living facility, and fails to license any one of these
1164	facilities, the agency may revoke the license, impose a
1165	moratorium, or impose a fine pursuant to s. 429.19 400.419, on
1166	any or all of the licensed facilities until such time as the
1167	unlicensed facility is licensed or ceases operation.
1168	(g)  If the agency determines that an owner is operating or
1169	maintaining an assisted living facility without obtaining a
1170	license and determines that a condition exists in the facility
1171	that poses a threat to the health, safety, or welfare of a
1172	resident of the facility, the owner is subject to the same
1173	actions and fines imposed against a licensed facility as
1174	specified in ss. 429.14 and 429.19 400.414 and 400.419.
1175	(2)  It is unlawful to knowingly refer a person for
1176	residency to an unlicensed assisted living facility; to an
1177	assisted living facility the license of which is under denial or
1178	has been suspended or revoked; or to an assisted living facility
1179	that has a moratorium on admissions.  Any person who violates
1180	this subsection commits a noncriminal violation, punishable by a
1181	fine not exceeding $500 as provided in s. 775.083.
1182	(f)  At least annually, the agency shall notify, in
1183	appropriate trade publications, physicians licensed under
1184	chapter 458 or chapter 459, hospitals licensed under chapter
1185	395, nursing home facilities licensed under part II of this
1186	chapter 400, and employees of the agency or the department, or
1187	the Department of Children and Family Services, who are
1188	responsible for referring persons for residency, that it is
1189	unlawful to knowingly refer a person for residency to an
1190	unlicensed assisted living facility and shall notify them of the
1191	penalty for violating such prohibition. The department and the
1192	Department of Children and Family Services shall, in turn,
1193	notify service providers under contract to the respective
1194	departments who have responsibility for resident referrals to
1195	facilities. Further, the notice must direct each noticed
1196	facility and individual to contact the appropriate agency office
1197	in order to verify the licensure status of any facility prior to
1198	referring any person for residency. Each notice must include the
1199	name, telephone number, and mailing address of the appropriate
1200	office to contact.
1201	Section 34.  Section 400.411, Florida Statutes, is
1202	renumbered as section 429.11, Florida Statutes, and paragraph
1203	(c) of subsection (3) and subsections (4), (11), and (13) are
1204	amended to read:
1205	429.11 400.411  Initial application for license;
1206	provisional license.--
1207	(3)  The application must be signed by the applicant under
1208	oath and must contain the following:
1209	(c)  The name and address of any long-term care facility
1210	with which the applicant, administrator, or financial officer
1211	has been affiliated through ownership or employment within 5
1212	years of the date of this license application; and a signed
1213	affidavit disclosing any financial or ownership interest that
1214	the applicant, or any person listed in paragraph (a), holds or
1215	has held within the last 5 years in any facility licensed under
1216	this chapter part, or in any other entity licensed by this state
1217	or another state to provide health or residential care, which
1218	facility or entity closed or ceased to operate as a result of
1219	financial problems, or has had a receiver appointed or a license
1220	denied, suspended or revoked, or was subject to a moratorium on
1221	admissions, or has had an injunctive proceeding initiated
1222	against it.
1223	(4)  The applicant shall furnish satisfactory proof of
1224	financial ability to operate and conduct the facility in
1225	accordance with the requirements of this chapter part. A
1226	certificate of authority, pursuant to chapter 651, may be
1227	provided as proof of financial ability.
1228	(11)  The applicant must furnish proof of compliance with
1229	level 2 background screening as required under s. 429.174
1230	400.4174.
1231	(13)  A county or municipality may not issue an
1232	occupational license that is being obtained for the purpose of
1233	operating a facility regulated under this chapter part without
1234	first ascertaining that the applicant has been licensed to
1235	operate such facility at the specified location or locations by
1236	the agency. The agency shall furnish to local agencies
1237	responsible for issuing occupational licenses sufficient
1238	instruction for making such determinations.
1239	Section 35.  Section 400.412, Florida Statutes, is
1240	renumbered as section 429.12, Florida Statutes, and subsection
1241	(1) is amended to read:
1242	429.12 400.412  Sale or transfer of ownership of a
1243	facility.--It is the intent of the Legislature to protect the
1244	rights of the residents of an assisted living facility when the
1245	facility is sold or the ownership thereof is transferred.
1246	Therefore, whenever a facility is sold or the ownership thereof
1247	is transferred, including leasing:
1248	(1)  The transferee shall make application to the agency
1249	for a new license at least 60 days before the date of transfer
1250	of ownership. The application must comply with the provisions of
1251	s. 429.11 400.411.
1252	Section 36.  Section 400.414, Florida Statutes, is
1253	renumbered as section 429.14, Florida Statutes, and subsections
1254	(1), (3), and (5) are amended to read:
1255	429.14 400.414  Denial, revocation, or suspension of
1256	license; imposition of administrative fine; grounds.--
1257	(1)  The agency may deny, revoke, or suspend any license
1258	issued under this chapter part, or impose an administrative fine
1259	in the manner provided in chapter 120, for any of the following
1260	actions by an assisted living facility, for the actions of any
1261	person subject to level 2 background screening under s. 429.174
1262	400.4174, or for the actions of any facility employee:
1263	(a)  An intentional or negligent act seriously affecting
1264	the health, safety, or welfare of a resident of the facility.
1265	(b)  The determination by the agency that the owner lacks
1266	the financial ability to provide continuing adequate care to
1267	residents.
1268	(c)  Misappropriation or conversion of the property of a
1269	resident of the facility.
1270	(d)  Failure to follow the criteria and procedures provided
1271	under part I of chapter 394 relating to the transportation,
1272	voluntary admission, and involuntary examination of a facility
1273	resident.
1274	(e)  A citation of any of the following deficiencies as
1275	defined in s. 429.19 400.419:
1276	1.  One or more cited class I deficiencies.
1277	2.  Three or more cited class II deficiencies.
1278	3.  Five or more cited class III deficiencies that have
1279	been cited on a single survey and have not been corrected within
1280	the times specified.
1281	(f)  A determination that a person subject to level 2
1282	background screening under s. 429.174 400.4174(1) does not meet
1283	the screening standards of s. 435.04 or that the facility is
1284	retaining an employee subject to level 1 background screening
1285	standards under s. 429.174 400.4174(2) who does not meet the
1286	screening standards of s. 435.03 and for whom exemptions from
1287	disqualification have not been provided by the agency.
1288	(g)  A determination that an employee, volunteer,
1289	administrator, or owner, or person who otherwise has access to
1290	the residents of a facility does not meet the criteria specified
1291	in s. 435.03(2), and the owner or administrator has not taken
1292	action to remove the person. Exemptions from disqualification
1293	may be granted as set forth in s. 435.07. No administrative
1294	action may be taken against the facility if the person is
1295	granted an exemption.
1296	(h)  Violation of a moratorium.
1297	(i)  Failure of the license applicant, the licensee during
1298	relicensure, or a licensee that holds a provisional license to
1299	meet the minimum license requirements of this chapter part, or
1300	related rules, at the time of license application or renewal.
1301	(j)  A fraudulent statement or omission of any material
1302	fact on an application for a license or any other document
1303	required by the agency, including the submission of a license
1304	application that conceals the fact that any board member,
1305	officer, or person owning 5 percent or more of the facility may
1306	not meet the background screening requirements of s. 429.174
1307	400.4174, or that the applicant has been excluded, permanently
1308	suspended, or terminated from the Medicaid or Medicare programs.
1309	(k)  An intentional or negligent life-threatening act in
1310	violation of the uniform firesafety standards for assisted
1311	living facilities or other firesafety standards that threatens
1312	the health, safety, or welfare of a resident of a facility, as
1313	communicated to the agency by the local authority having
1314	jurisdiction or the State Fire Marshal.
1315	(l)  Exclusion, permanent suspension, or termination from
1316	the Medicare or Medicaid programs.
1317	(m)  Knowingly operating any unlicensed facility or
1318	providing without a license any service that must be licensed
1319	under this chapter or chapter 400.
1320	(n)  Any act constituting a ground upon which application
1321	for a license may be denied.
1322
1323	Administrative proceedings challenging agency action under this
1324	subsection shall be reviewed on the basis of the facts and
1325	conditions that resulted in the agency action.
1326	(3)  The agency may deny a license to any applicant or to
1327	any officer or board member of an applicant who is a firm,
1328	corporation, partnership, or association or who owns 5 percent
1329	or more of the facility, if the applicant, officer, or board
1330	member has or had a 25-percent or greater financial or ownership
1331	interest in any other facility licensed under this chapter part,
1332	or in any entity licensed by this state or another state to
1333	provide health or residential care, which facility or entity
1334	during the 5 years prior to the application for a license closed
1335	due to financial inability to operate; had a receiver appointed
1336	or a license denied, suspended, or revoked; was subject to a
1337	moratorium on admissions; had an injunctive proceeding initiated
1338	against it; or has an outstanding fine assessed under this
1339	chapter or chapter 400.
1340	(5)  An action taken by the agency to suspend, deny, or
1341	revoke a facility's license under this chapter part, in which
1342	the agency claims that the facility owner or an employee of the
1343	facility has threatened the health, safety, or welfare of a
1344	resident of the facility be heard by the Division of
1345	Administrative Hearings of the Department of Management Services
1346	within 120 days after receipt of the facility's request for a
1347	hearing, unless that time limitation is waived by both parties.
1348	The administrative law judge must render a decision within 30
1349	days after receipt of a proposed recommended order.
1350	Section 37.  Section 400.415, Florida Statutes, is
1351	renumbered as section 429.15, Florida Statutes, and subsection
1352	(1) is amended to read:
1353	429.15 400.415  Moratorium on admissions; notice.--The
1354	agency may impose an immediate moratorium on admissions to any
1355	assisted living facility if the agency determines that any
1356	condition in the facility presents a threat to the health,
1357	safety, or welfare of the residents in the facility.
1358	(1)  A facility the license of which is denied, revoked, or
1359	suspended pursuant to s. 429.14 400.414 may be subject to
1360	immediate imposition of a moratorium on admissions to run
1361	concurrently with licensure denial, revocation, or suspension.
1362	Section 38.  Section 400.417, Florida Statutes, is
1363	renumbered as section 429.17, Florida Statutes, and subsections
1364	(2) and (3) are amended to read:
1365	429.17 400.417  Expiration of license; renewal; conditional
1366	license.--
1367	(2)  A license shall be renewed within 90 days upon the
1368	timely filing of an application on forms furnished by the agency
1369	and the provision of satisfactory proof of ability to operate
1370	and conduct the facility in accordance with the requirements of
1371	this chapter part and adopted rules, including proof that the
1372	facility has received a satisfactory firesafety inspection,
1373	conducted by the local authority having jurisdiction or the
1374	State Fire Marshal, within the preceding 12 months and an
1375	affidavit of compliance with the background screening
1376	requirements of s. 429.174 400.4174.
1377	(3)  An applicant for renewal of a license who has complied
1378	with the provisions of s. 429.11 400.411 with respect to proof
1379	of financial ability to operate shall not be required to provide
1380	further proof unless the facility or any other facility owned or
1381	operated in whole or in part by the same person has demonstrated
1382	financial instability as provided under s. 429.47 400.447(2) or
1383	unless the agency suspects that the facility is not financially
1384	stable as a result of the annual survey or complaints from the
1385	public or a report from the State Long-Term Care Ombudsman
1386	Council.  Each facility must report to the agency any adverse
1387	court action concerning the facility's financial viability,
1388	within 7 days after its occurrence.  The agency shall have
1389	access to books, records, and any other financial documents
1390	maintained by the facility to the extent necessary to determine
1391	the facility's financial stability.  A license for the operation
1392	of a facility shall not be renewed if the licensee has any
1393	outstanding fines assessed pursuant to this chapter part which
1394	are in final order status.
1395	Section 39.  Section 400.4174, Florida Statutes, is
1396	renumbered as section 429.174, Florida Statutes, and subsection
1397	(2) is amended to read:
1398	429.174 400.4174  Background screening; exemptions.--
1399	(2)  The owner or administrator of an assisted living
1400	facility must conduct level 1 background screening, as set forth
1401	in chapter 435, on all employees hired on or after October 1,
1402	1998, who perform personal services as defined in s. 429.02
1403	400.402(17). The agency may exempt an individual from employment
1404	disqualification as set forth in chapter 435. Such persons shall
1405	be considered as having met this requirement if:
1406	(a)  Proof of compliance with level 1 screening
1407	requirements obtained to meet any professional license
1408	requirements in this state is provided and accompanied, under
1409	penalty of perjury, by a copy of the person's current
1410	professional license and an affidavit of current compliance with
1411	the background screening requirements.
1412	(b)  The person required to be screened has been
1413	continuously employed in the same type of occupation for which
1414	the person is seeking employment without a breach in service
1415	which exceeds 180 days, and proof of compliance with the level 1
1416	screening requirement which is no more than 2 years old is
1417	provided. Proof of compliance shall be provided directly from
1418	one employer or contractor to another, and not from the person
1419	screened. Upon request, a copy of screening results shall be
1420	provided by the employer retaining documentation of the
1421	screening to the person screened.
1422	(c)  The person required to be screened is employed by a
1423	corporation or business entity or related corporation or
1424	business entity that owns, operates, or manages more than one
1425	facility or agency licensed under this chapter or chapter 400,
1426	and for whom a level 1 screening was conducted by the
1427	corporation or business entity as a condition of initial or
1428	continued employment.
1429	Section 40.  Section 400.4176, Florida Statutes, is
1430	renumbered as section 429.176, Florida Statutes, and amended to
1431	read:
1432	429.176 400.4176  Notice of change of administrator.--If,
1433	during the period for which a license is issued, the owner
1434	changes administrators, the owner must notify the agency of the
1435	change within 10 days and provide documentation within 90 days
1436	that the new administrator has completed the applicable core
1437	educational requirements under s. 429.52 400.452. Background
1438	screening shall be completed on any new administrator as
1439	specified in s. 429.174 400.4174.
1440	Section 41.  Section 400.4177, Florida Statutes, is
1441	renumbered as section 429.177, Florida Statutes, and amended to
1442	read:
1443	429.177 400.4177  Patients with Alzheimer's disease or
1444	other related disorders; certain disclosures.--A facility
1445	licensed under this chapter part which claims that it provides
1446	special care for persons who have Alzheimer's disease or other
1447	related disorders must disclose in its advertisements or in a
1448	separate document those services that distinguish the care as
1449	being especially applicable to, or suitable for, such persons.
1450	The facility must give a copy of all such advertisements or a
1451	copy of the document to each person who requests information
1452	about programs and services for persons with Alzheimer's disease
1453	or other related disorders offered by the facility and must
1454	maintain a copy of all such advertisements and documents in its
1455	records. The agency shall examine all such advertisements and
1456	documents in the facility's records as part of the license
1457	renewal procedure.
1458	Section 42.  Section 400.4178, Florida Statutes, is
1459	renumbered as section 429.178, Florida Statutes, and paragraphs
1460	(a) and (b) of subsection (2) are amended to read:
1461	429.178 400.4178  Special care for persons with Alzheimer's
1462	disease or other related disorders.--
1463	(2)(a)  An individual who is employed by a facility that
1464	provides special care for residents with Alzheimer's disease or
1465	other related disorders, and who has regular contact with such
1466	residents, must complete up to 4 hours of initial dementia-
1467	specific training developed or approved by the department. The
1468	training shall be completed within 3 months after beginning
1469	employment and shall satisfy the core training requirements of
1470	s. 429.52 400.452(2)(g).
1471	(b)  A direct caregiver who is employed by a facility that
1472	provides special care for residents with Alzheimer's disease or
1473	other related disorders, and who provides direct care to such
1474	residents, must complete the required initial training and 4
1475	additional hours of training developed or approved by the
1476	department. The training shall be completed within 9 months
1477	after beginning employment and shall satisfy the core training
1478	requirements of s. 429.52 400.452(2)(g).
1479	Section 43.  Section 400.418, Florida Statutes, is
1480	renumbered as section 429.18, Florida Statutes, and amended to
1481	read:
1482	429.18 400.418  Disposition of fees and administrative
1483	fines.--
1484	(1)  Income from license fees, inspection fees, late fees,
1485	and administrative fines generated pursuant to ss. 429.07,
1486	429.08, 429.17, 429.19, and 429.31 400.407, 400.408, 400.417,
1487	400.419, and 400.431 shall be deposited in the Health Care Trust
1488	Fund administered by the agency.  Such funds shall be directed
1489	to and used by the agency for the following purposes:
1490	(a)  Up to 50 percent of the trust funds accrued each
1491	fiscal year under this chapter part may be used to offset the
1492	expenses of receivership, pursuant to s. 429.22 400.422, if the
1493	court determines that the income and assets of the facility are
1494	insufficient to provide for adequate management and operation.
1495	(b)  An amount of $5,000 of the trust funds accrued each
1496	year under this chapter part shall be allocated to pay for
1497	inspection-related physical and mental health examinations
1498	requested by the agency pursuant to s. 429.26 400.426 for
1499	residents who are either recipients of supplemental security
1500	income or have monthly incomes not in excess of the maximum
1501	combined federal and state cash subsidies available to
1502	supplemental security income recipients, as provided for in s.
1503	409.212.  Such funds shall only be used where the resident is
1504	ineligible for Medicaid.
1505	(c)  Any trust funds accrued each year under this chapter
1506	part and not used for the purposes specified in paragraphs (a)
1507	and (b) shall be used to offset the costs of the licensure
1508	program, including the costs of conducting background
1509	investigations, verifying information submitted, defraying the
1510	costs of processing the names of applicants, and conducting
1511	inspections and monitoring visits pursuant to this chapter part.
1512	(2)  Income from fees generated pursuant to s. 429.41
1513	400.441(5) shall be deposited in the Health Care Trust Fund and
1514	used to offset the costs of printing and postage.
1515	Section 44.  Section 400.419, Florida Statutes, is
1516	renumbered as section 429.19, Florida Statutes, and subsections
1517	(1), (2), (9), (10), (11), and (12) are amended to read:
1518	429.19 400.419  Violations; imposition of administrative
1519	fines; grounds.--
1520	(1)  The agency shall impose an administrative fine in the
1521	manner provided in chapter 120 for any of the actions or
1522	violations as set forth within this section by an assisted
1523	living facility, for the actions of any person subject to level
1524	2 background screening under s. 429.174 400.4174, for the
1525	actions of any facility employee, or for an intentional or
1526	negligent act seriously affecting the health, safety, or welfare
1527	of a resident of the facility.
1528	(2)  Each violation of this chapter part and adopted rules
1529	shall be classified according to the nature of the violation and
1530	the gravity of its probable effect on facility residents. The
1531	agency shall indicate the classification on the written notice
1532	of the violation as follows:
1533	(a)  Class "I" violations are those conditions or
1534	occurrences related to the operation and maintenance of a
1535	facility or to the personal care of residents which the agency
1536	determines present an imminent danger to the residents or guests
1537	of the facility or a substantial probability that death or
1538	serious physical or emotional harm would result therefrom. The
1539	condition or practice constituting a class I violation shall be
1540	abated or eliminated within 24 hours, unless a fixed period, as
1541	determined by the agency, is required for correction. The agency
1542	shall impose an administrative fine for a cited class I
1543	violation in an amount not less than $5,000 and not exceeding
1544	$10,000 for each violation. A fine may be levied notwithstanding
1545	the correction of the violation.
1546	(b)  Class "II" violations are those conditions or
1547	occurrences related to the operation and maintenance of a
1548	facility or to the personal care of residents which the agency
1549	determines directly threaten the physical or emotional health,
1550	safety, or security of the facility residents, other than class
1551	I violations. The agency shall impose an administrative fine for
1552	a cited class II violation in an amount not less than $1,000 and
1553	not exceeding $5,000 for each violation. A fine shall be levied
1554	notwithstanding the correction of the violation.
1555	(c)  Class "III" violations are those conditions or
1556	occurrences related to the operation and maintenance of a
1557	facility or to the personal care of residents which the agency
1558	determines indirectly or potentially threaten the physical or
1559	emotional health, safety, or security of facility residents,
1560	other than class I or class II violations. The agency shall
1561	impose an administrative fine for a cited class III violation in
1562	an amount not less than $500 and not exceeding $1,000 for each
1563	violation. A citation for a class III violation must specify the
1564	time within which the violation is required to be corrected. If
1565	a class III violation is corrected within the time specified, no
1566	fine may be imposed, unless it is a repeated offense.
1567	(d)  Class "IV" violations are those conditions or
1568	occurrences related to the operation and maintenance of a
1569	building or to required reports, forms, or documents that do not
1570	have the potential of negatively affecting residents. These
1571	violations are of a type that the agency determines do not
1572	threaten the health, safety, or security of residents of the
1573	facility. The agency shall impose an administrative fine for a
1574	cited class IV violation in an amount not less than $100 and not
1575	exceeding $200 for each violation. A citation for a class IV
1576	violation must specify the time within which the violation is
1577	required to be corrected. If a class IV violation is corrected
1578	within the time specified, no fine shall be imposed. Any class
1579	IV violation that is corrected during the time an agency survey
1580	is being conducted will be identified as an agency finding and
1581	not as a violation.
1582	(9)  Any facility whose owner fails to apply for a change-
1583	of-ownership license in accordance with s. 429.12 400.412 and
1584	operates the facility under the new ownership is subject to a
1585	fine of $5,000.
1586	(10)  In addition to any administrative fines imposed, the
1587	agency may assess a survey fee, equal to the lesser of one half
1588	of the facility's biennial license and bed fee or $500, to cover
1589	the cost of conducting initial complaint investigations that
1590	result in the finding of a violation that was the subject of the
1591	complaint or monitoring visits conducted under s. 429.28
1592	400.428(3)(c) to verify the correction of the violations.
1593	(11)  The agency, as an alternative to or in conjunction
1594	with an administrative action against a facility for violations
1595	of this chapter part and adopted rules, shall make a reasonable
1596	attempt to discuss each violation and recommended corrective
1597	action with the owner or administrator of the facility, prior to
1598	written notification. The agency, instead of fixing a period
1599	within which the facility shall enter into compliance with
1600	standards, may request a plan of corrective action from the
1601	facility which demonstrates a good faith effort to remedy each
1602	violation by a specific date, subject to the approval of the
1603	agency.
1604	(12)  Administrative fines paid by any facility under this
1605	section shall be deposited into the Health Care Trust Fund and
1606	expended as provided in s. 429.18 400.418.
1607	Section 45.  Section 400.4195, Florida Statutes, is
1608	renumbered as section 429.195, Florida Statutes, and subsection
1609	(1) is amended to read:
1610	429.195 400.4195  Rebates prohibited; penalties.--
1611	(1)  It is unlawful for any assisted living facility
1612	licensed under this chapter part to contract or promise to pay
1613	or receive any commission, bonus, kickback, or rebate or engage
1614	in any split-fee arrangement in any form whatsoever with any
1615	physician, surgeon, organization, agency, or person, either
1616	directly or indirectly, for residents referred to an assisted
1617	living facility licensed under this chapter part. A facility may
1618	employ or contract with persons to market the facility, provided
1619	the employee or contract provider clearly indicates that he or
1620	she represents the facility. A person or agency independent of
1621	the facility may provide placement or referral services for a
1622	fee to individuals seeking assistance in finding a suitable
1623	facility; however, any fee paid for placement or referral
1624	services must be paid by the individual looking for a facility,
1625	not by the facility.
1626	Section 46.  Section 400.42, Florida Statutes, is
1627	renumbered as section 429.20, Florida Statutes, and subsection
1628	(3) is amended to read:
1629	429.20 400.42  Certain solicitation prohibited; third-party
1630	supplementation.--
1631	(3)  The admission or maintenance of assisted living
1632	facility residents whose care is supported, in whole or in part,
1633	by state funds may not be conditioned upon the receipt of any
1634	manner of contribution or donation from any person. The
1635	solicitation or receipt of contributions in violation of this
1636	subsection is grounds for denial, suspension, or revocation of
1637	license, as provided in s. 429.14 400.414, for any assisted
1638	living facility by or on behalf of which such contributions were
1639	solicited.
1640	Section 47.  Section 400.421, Florida Statutes, is
1641	renumbered as section 429.21, Florida Statutes, and subsection
1642	(1) is amended to read:
1643	429.21 400.421  Injunctive proceedings.--
1644	(1)  The agency may institute injunctive proceedings in a
1645	court of competent jurisdiction to:
1646	(a)  Enforce the provisions of this chapter part or any
1647	minimum standard, rule, or order issued or entered into pursuant
1648	thereto when the attempt by the agency to correct a violation
1649	through administrative fines has failed or when the violation
1650	materially affects the health, safety, or welfare of residents;
1651	or
1652	(b)  Terminate the operation of a facility when violations
1653	of any provisions of this chapter part or of any standard or
1654	rule promulgated pursuant thereto exist which materially affect
1655	the health, safety, or welfare of residents.
1656	Section 48.  Section 400.422, Florida Statutes, is
1657	renumbered as section 429.22, Florida Statutes, and paragraph
1658	(a) of subsection (1) and subsection (9) are amended to read:
1659	429.22 400.422  Receivership proceedings.--
1660	(1)  As an alternative to or in conjunction with an
1661	injunctive proceeding, the agency may petition a court of
1662	competent jurisdiction for the appointment of a receiver, if
1663	suitable alternate placements are not available, when any of the
1664	following conditions exist:
1665	(a)  The facility is operating without a license and
1666	refuses to make application for a license as required by ss.
1667	429.07 400.407 and 429.08 400.408.
1668	(9)  The court may direct the agency to allocate funds from
1669	the Health Care Trust Fund to the receiver, subject to the
1670	provisions of s. 429.18 400.418(1).
1671	Section 49.  Section 400.423, Florida Statutes, is
1672	renumbered as section 429.23, Florida Statutes, and subsections
1673	(1), (2), (5), and (8) are amended to read:
1674	429.23 400.423  Internal risk management and quality
1675	assurance program; adverse incidents and reporting
1676	requirements.--
1677	(1)  Every facility licensed under this chapter part may,
1678	as part of its administrative functions, voluntarily establish a
1679	risk management and quality assurance program, the purpose of
1680	which is to assess resident care practices, facility incident
1681	reports, deficiencies cited by the agency, adverse incident
1682	reports, and resident grievances and develop plans of action to
1683	correct and respond quickly to identify quality differences.
1684	(2)  Every facility licensed under this chapter part is
1685	required to maintain adverse incident reports. For purposes of
1686	this section, the term, "adverse incident" means:
1687	(a)  An event over which facility personnel could exercise
1688	control rather than as a result of the resident's condition and
1689	results in:
1690	1.  Death;
1691	2.  Brain or spinal damage;
1692	3.  Permanent disfigurement;
1693	4.  Fracture or dislocation of bones or joints;
1694	5.  Any condition that required medical attention to which
1695	the resident has not given his or her consent, including failure
1696	to honor advanced directives;
1697	6.  Any condition that requires the transfer of the
1698	resident from the facility to a unit providing more acute care
1699	due to the incident rather than the resident's condition before
1700	the incident.
1701	(b)  Abuse, neglect, or exploitation as defined in s.
1702	415.102;
1703	(c)  Events reported to law enforcement; or
1704	(d)  Elopement.
1705	(5)  Each facility shall report monthly to the agency any
1706	liability claim filed against it. The report must include the
1707	name of the resident, the dates of the incident leading to the
1708	claim, if applicable, and the type of injury or violation of
1709	rights alleged to have occurred. This report is not discoverable
1710	in any civil or administrative action, except in such actions
1711	brought by the agency to enforce the provisions of this chapter
1712	part.
1713	(8)  If the agency, through its receipt of the adverse
1714	incident reports prescribed in this chapter part or through any
1715	investigation, has reasonable belief that conduct by a staff
1716	member or employee of a licensed facility is grounds for
1717	disciplinary action by the appropriate board, the agency shall
1718	report this fact to such regulatory board.
1719	Section 50.  Section 400.424, Florida Statutes, is
1720	renumbered as section 429.24, Florida Statutes, and subsection
1721	(2), paragraph (a) of subsection (3), and subsection (5) are
1722	amended to read:
1723	429.24 400.424  Contracts.--
1724	(2)  Each contract must contain express provisions
1725	specifically setting forth the services and accommodations to be
1726	provided by the facility; the rates or charges; provision for at
1727	least 30 days' written notice of a rate increase; the rights,
1728	duties, and obligations of the residents, other than those
1729	specified in s. 429.28 400.428; and other matters that the
1730	parties deem appropriate. Whenever money is deposited or
1731	advanced by a resident in a contract as security for performance
1732	of the contract agreement or as advance rent for other than the
1733	next immediate rental period:
1734	(a)  Such funds shall be deposited in a banking institution
1735	in this state that is located, if possible, in the same
1736	community in which the facility is located; shall be kept
1737	separate from the funds and property of the facility; may not be
1738	represented as part of the assets of the facility on financial
1739	statements; and shall be used, or otherwise expended, only for
1740	the account of the resident.
1741	(b)  The licensee shall, within 30 days of receipt of
1742	advance rent or a security deposit, notify the resident or
1743	residents in writing of the manner in which the licensee is
1744	holding the advance rent or security deposit and state the name
1745	and address of the depository where the moneys are being held.
1746	The licensee shall notify residents of the facility's policy on
1747	advance deposits.
1748	(3)(a)  The contract shall include a refund policy to be
1749	implemented at the time of a resident's transfer, discharge, or
1750	death. The refund policy shall provide that the resident or
1751	responsible party is entitled to a prorated refund based on the
1752	daily rate for any unused portion of payment beyond the
1753	termination date after all charges, including the cost of
1754	damages to the residential unit resulting from circumstances
1755	other than normal use, have been paid to the licensee. For the
1756	purpose of this paragraph, the termination date shall be the
1757	date the unit is vacated by the resident and cleared of all
1758	personal belongings. If the amount of belongings does not
1759	preclude renting the unit, the facility may clear the unit and
1760	charge the resident or his or her estate for moving and storing
1761	the items at a rate equal to the actual cost to the facility,
1762	not to exceed 20 percent of the regular rate for the unit,
1763	provided that 14 days' advance written notification is given. If
1764	the resident's possessions are not claimed within 45 days after
1765	notification, the facility may dispose of them. The contract
1766	shall also specify any other conditions under which claims will
1767	be made against the refund due the resident. Except in the case
1768	of death or a discharge due to medical reasons, the refunds
1769	shall be computed in accordance with the notice of relocation
1770	requirements specified in the contract. However, a resident may
1771	not be required to provide the licensee with more than 30 days'
1772	notice of termination. If after a contract is terminated, the
1773	facility intends to make a claim against a refund due the
1774	resident, the facility shall notify the resident or responsible
1775	party in writing of the claim and shall provide said party with
1776	a reasonable time period of no less than 14 calendar days to
1777	respond. The facility shall provide a refund to the resident or
1778	responsible party within 45 days after the transfer, discharge,
1779	or death of the resident. The agency shall impose a fine upon a
1780	facility that fails to comply with the refund provisions of the
1781	paragraph, which fine shall be equal to three times the amount
1782	due to the resident. One-half of the fine shall be remitted to
1783	the resident or his or her estate, and the other half to the
1784	Health Care Trust Fund to be used for the purpose specified in
1785	s. 429.18 400.418.
1786	(5)  Neither the contract nor any provision thereof
1787	relieves any licensee of any requirement or obligation imposed
1788	upon it by this chapter part or rules adopted under this chapter
1789	part.
1790	Section 51.  Section 400.4255, Florida Statutes, is
1791	renumbered as section 429.255, Florida Statutes, and paragraphs
1792	(a) and (b) of subsection (1) and subsection (2) are amended to
1793	read:
1794	429.255 400.4255  Use of personnel; emergency care.--
1795	(1) (a)  Persons under contract to the facility, facility
1796	staff, or volunteers, who are licensed according to part I of
1797	chapter 464, or those persons exempt under s. 464.022(1), and
1798	others as defined by rule, may administer medications to
1799	residents, take residents' vital signs, manage individual weekly
1800	pill organizers for residents who self-administer medication,
1801	give prepackaged enemas ordered by a physician, observe
1802	residents, document observations on the appropriate resident's
1803	record, report observations to the resident's physician, and
1804	contract or allow residents or a resident's representative,
1805	designee, surrogate, guardian, or attorney in fact to contract
1806	with a third party, provided residents meet the criteria for
1807	appropriate placement as defined in s. 429.26 400.426. Nursing
1808	assistants certified pursuant to part II of chapter 464 may take
1809	residents' vital signs as directed by a licensed nurse or
1810	physician.
1811	(b)  All staff in facilities licensed under this chapter
1812	part shall exercise their professional responsibility to observe
1813	residents, to document observations on the appropriate
1814	resident's record, and to report the observations to the
1815	resident's physician.  However, the owner or administrator of
1816	the facility shall be responsible for determining that the
1817	resident receiving services is appropriate for residence in the
1818	facility.
1819	(2)  In facilities licensed to provide extended congregate
1820	care, persons under contract to the facility, facility staff, or
1821	volunteers, who are licensed according to part I of chapter 464,
1822	or those persons exempt under s. 464.022(1), or those persons
1823	certified as nursing assistants pursuant to part II of chapter
1824	464, may also perform all duties within the scope of their
1825	license or certification, as approved by the facility
1826	administrator and pursuant to this chapter part.
1827	Section 52.  Section 400.4256, Florida Statutes, is
1828	renumbered as section 429.256, Florida Statutes, and paragraph
1829	(b) of subsection (1) is amended to read:
1830	429.256 400.4256  Assistance with self-administration of
1831	medication.--
1832	(1)  For the purposes of this section, the term:
1833	(b)  "Unlicensed person" means an individual not currently
1834	licensed to practice nursing or medicine who is employed by or
1835	under contract to an assisted living facility and who has
1836	received training with respect to assisting with the self-
1837	administration of medication in an assisted living facility as
1838	provided under s. 429.52 400.452 prior to providing such
1839	assistance as described in this section.
1840	Section 53.  Section 400.426, Florida Statutes, is
1841	renumbered as section 429.26, Florida Statutes, and subsections
1842	(1), (4), (5), (9), and (12) are amended to read:
1843	429.26 400.426  Appropriateness of placements; examinations
1844	of residents.--
1845	(1)  The owner or administrator of a facility is
1846	responsible for determining the appropriateness of admission of
1847	an individual to the facility and for determining the continued
1848	appropriateness of residence of an individual in the facility. A
1849	determination shall be based upon an assessment of the
1850	strengths, needs, and preferences of the resident, the care and
1851	services offered or arranged for by the facility in accordance
1852	with facility policy, and any limitations in law or rule related
1853	to admission criteria or continued residency for the type of
1854	license held by the facility under this chapter part. A resident
1855	may not be moved from one facility to another without
1856	consultation with and agreement from the resident or, if
1857	applicable, the resident's representative or designee or the
1858	resident's family, guardian, surrogate, or attorney in fact. In
1859	the case of a resident who has been placed by the department or
1860	the Department of Children and Family Services, the
1861	administrator must notify the appropriate contact person in the
1862	applicable department.
1863	(4)  If possible, each resident shall have been examined by
1864	a licensed physician or a licensed nurse practitioner within 60
1865	days before admission to the facility. The signed and completed
1866	medical examination report shall be submitted to the owner or
1867	administrator of the facility who shall use the information
1868	contained therein to assist in the determination of the
1869	appropriateness of the resident's admission and continued stay
1870	in the facility. The medical examination report shall become a
1871	permanent part of the record of the resident at the facility and
1872	shall be made available to the agency during inspection or upon
1873	request. An assessment that has been completed through the
1874	Comprehensive Assessment and Review for Long-Term Care Services
1875	(CARES) Program fulfills the requirements for a medical
1876	examination under this subsection and s. 429.07 400.407(3)(b)6.
1877	(5)  Except as provided in s. 429.07 400.407, if a medical
1878	examination has not been completed within 60 days before the
1879	admission of the resident to the facility, a licensed physician
1880	or licensed nurse practitioner shall examine the resident and
1881	complete a medical examination form provided by the agency
1882	within 30 days following the admission to the facility to enable
1883	the facility owner or administrator to determine the
1884	appropriateness of the admission. The medical examination form
1885	shall become a permanent part of the record of the resident at
1886	the facility and shall be made available to the agency during
1887	inspection by the agency or upon request.
1888	(9)  If, at any time after admission to a facility, a
1889	resident appears to need care beyond that which the facility is
1890	licensed to provide, the agency shall require the resident to be
1891	physically examined by a licensed physician or licensed nurse
1892	practitioner. This examination shall, to the extent possible, be
1893	performed by the resident's preferred physician or nurse
1894	practitioner and shall be paid for by the resident with personal
1895	funds, except as provided in s. 429.18 400.418(1)(b). Following
1896	this examination, the examining physician or licensed nurse
1897	practitioner shall complete and sign a medical form provided by
1898	the agency. The completed medical form shall be submitted to the
1899	agency within 30 days after the date the facility owner or
1900	administrator is notified by the agency that the physical
1901	examination is required. After consultation with the physician
1902	or licensed nurse practitioner who performed the examination, a
1903	medical review team designated by the agency shall then
1904	determine whether the resident is appropriately residing in the
1905	facility. The medical review team shall base its decision on a
1906	comprehensive review of the resident's physical and functional
1907	status, including the resident's preferences, and not on an
1908	isolated health-related problem. In the case of a mental health
1909	resident, if the resident appears to have needs in addition to
1910	those identified in the community living support plan, the
1911	agency may require an evaluation by a mental health
1912	professional, as determined by the Department of Children and
1913	Family Services. A facility may not be required to retain a
1914	resident who requires more services or care than the facility is
1915	able to provide in accordance with its policies and criteria for
1916	admission and continued residency. Members of the medical review
1917	team making the final determination may not include the agency
1918	personnel who initially questioned the appropriateness of a
1919	resident's placement. Such determination is final and binding
1920	upon the facility and the resident. Any resident who is
1921	determined by the medical review team to be inappropriately
1922	residing in a facility shall be given 30 days' written notice to
1923	relocate by the owner or administrator, unless the resident's
1924	continued residence in the facility presents an imminent danger
1925	to the health, safety, or welfare of the resident or a
1926	substantial probability exists that death or serious physical
1927	harm would result to the resident if allowed to remain in the
1928	facility.
1929	(12)  No resident who requires 24-hour nursing supervision,
1930	except for a resident who is an enrolled hospice patient
1931	pursuant to part VI of this chapter 400, shall be retained in a
1932	facility licensed under this chapter part.
1933	Section 54.  Section 400.427, Florida Statutes, is
1934	renumbered as section 429.27, Florida Statutes, and paragraph
1935	(a) of subsection (6) is amended to read:
1936	429.27 400.427  Property and personal affairs of
1937	residents.--
1938	(6)(a)  In addition to any damages or civil penalties to
1939	which a person is subject, any person who:
1940	1.  Intentionally withholds a resident's personal funds,
1941	personal property, or personal needs allowance, or who demands,
1942	beneficially receives, or contracts for payment of all or any
1943	part of a resident's personal property or personal needs
1944	allowance in satisfaction of the facility rate for supplies and
1945	services; or
1946	2.  Borrows from or pledges any personal funds of a
1947	resident, other than the amount agreed to by written contract
1948	under s. 429.24 400.424,
1949
1950	commits a misdemeanor of the first degree, punishable as
1951	provided in s. 775.082 or s. 775.083.
1952	Section 55.  Section 400.4275, Florida Statutes, is
1953	renumbered as section 429.275, Florida Statutes, and subsection
1954	(2) is amended to read:
1955	429.275 400.4275  Business practice; personnel records;
1956	liability insurance.--The assisted living facility shall be
1957	administered on a sound financial basis that is consistent with
1958	good business practices.
1959	(2)  The administrator or owner of a facility shall
1960	maintain personnel records for each staff member which contain,
1961	at a minimum, documentation of background screening, if
1962	applicable, documentation of compliance with all training
1963	requirements of this chapter part or applicable rule, and a copy
1964	of all licenses or certification held by each staff who performs
1965	services for which licensure or certification is required under
1966	this chapter part or rule.
1967	Section 56.  Section 400.428, Florida Statutes, is
1968	renumbered as section 429.28, Florida Statutes, and paragraph
1969	(f) of subsection (1), subsection (2), paragraph (e) of
1970	subsection (3), paragraph (c) of subsection (5), and subsection
1971	(7) are amended to read:
1972	429.28 400.428  Resident bill of rights.--
1973	(1)  No resident of a facility shall be deprived of any
1974	civil or legal rights, benefits, or privileges guaranteed by
1975	law, the Constitution of the State of Florida, or the
1976	Constitution of the United States as a resident of a facility.
1977	Every resident of a facility shall have the right to:
1978	(f)  Manage his or her financial affairs unless the
1979	resident or, if applicable, the resident's representative,
1980	designee, surrogate, guardian, or attorney in fact authorizes
1981	the administrator of the facility to provide safekeeping for
1982	funds as provided in s. 429.27 400.427.
1983	(2)  The administrator of a facility shall ensure that a
1984	written notice of the rights, obligations, and prohibitions set
1985	forth in this chapter part is posted in a prominent place in
1986	each facility and read or explained to residents who cannot
1987	read. This notice shall include the name, address, and telephone
1988	numbers of the local ombudsman council and central abuse hotline
1989	and, when applicable, the Advocacy Center for Persons with
1990	Disabilities, Inc., and the Florida local advocacy council,
1991	where complaints may be lodged.  The facility must ensure a
1992	resident's access to a telephone to call the local ombudsman
1993	council, central abuse hotline, Advocacy Center for Persons with
1994	Disabilities, Inc., and the Florida local advocacy council.
1995	(3)
1996	(e)  The agency may conduct complaint investigations as
1997	warranted to investigate any allegations of noncompliance with
1998	requirements required under this chapter part or rules adopted
1999	under this chapter part.
2000	(5)  No facility or employee of a facility may serve notice
2001	upon a resident to leave the premises or take any other
2002	retaliatory action against any person who:
2003	(c)  Files a civil action alleging a violation of the
2004	provisions of this chapter part or notifies a state attorney or
2005	the Attorney General of a possible violation of such provisions.
2006	(7)  Any person who submits or reports a complaint
2007	concerning a suspected violation of the provisions of this
2008	chapter part or concerning services and conditions in
2009	facilities, or who testifies in any administrative or judicial
2010	proceeding arising from such a complaint, shall have immunity
2011	from any civil or criminal liability therefor, unless such
2012	person has acted in bad faith or with malicious purpose or the
2013	court finds that there was a complete absence of a justiciable
2014	issue of either law or fact raised by the losing party.
2015	Section 57.  Section 400.429, Florida Statutes, is
2016	renumbered as section 429.29, Florida Statutes, and subsections
2017	(1), (2), and (7) are amended to read:
2018	429.29 400.429  Civil actions to enforce rights.--
2019	(1)  Any person or resident whose rights as specified in
2020	this chapter part are violated shall have a cause of action.
2021	The action may be brought by the resident or his or her
2022	guardian, or by a person or organization acting on behalf of a
2023	resident with the consent of the resident or his or her
2024	guardian, or by the personal representative of the estate of a
2025	deceased resident regardless of the cause of death. If the
2026	action alleges a claim for the resident's rights or for
2027	negligence that caused the death of the resident, the claimant
2028	shall be required to elect either survival damages pursuant to
2029	s. 46.021 or wrongful death damages pursuant to s. 768.21. If
2030	the action alleges a claim for the resident's rights or for
2031	negligence that did not cause the death of the resident, the
2032	personal representative of the estate may recover damages for
2033	the negligence that caused injury to the resident. The action
2034	may be brought in any court of competent jurisdiction to enforce
2035	such rights and to recover actual damages, and punitive damages
2036	for violation of the rights of a resident or negligence. Any
2037	resident who prevails in seeking injunctive relief or a claim
2038	for an administrative remedy is entitled to recover the costs of
2039	the action and a reasonable attorney's fee assessed against the
2040	defendant not to exceed $25,000. Fees shall be awarded solely
2041	for the injunctive or administrative relief and not for any
2042	claim or action for damages whether such claim or action is
2043	brought together with a request for an injunction or
2044	administrative relief or as a separate action, except as
2045	provided under s. 768.79 or the Florida Rules of Civil
2046	Procedure. Sections 429.29-429.298 400.429-400.4303 provide the
2047	exclusive remedy for a cause of action for recovery of damages
2048	for the personal injury or death of a resident arising out of
2049	negligence or a violation of rights specified in s. 429.28
2050	400.428. This section does not preclude theories of recovery not
2051	arising out of negligence or s. 429.28 400.428 which are
2052	available to a resident or to the agency. The provisions of
2053	chapter 766 do not apply to any cause of action brought under
2054	ss. 429.29-429.298 400.429-400.4303.
2055	(2)  In any claim brought pursuant to this chapter part
2056	alleging a violation of resident's rights or negligence causing
2057	injury to or the death of a resident, the claimant shall have
2058	the burden of proving, by a preponderance of the evidence, that:
2059	(a)  The defendant owed a duty to the resident;
2060	(b)  The defendant breached the duty to the resident;
2061	(c)  The breach of the duty is a legal cause of loss,
2062	injury, death, or damage to the resident; and
2063	(d)  The resident sustained loss, injury, death, or damage
2064	as a result of the breach.
2065
2066	Nothing in this chapter part shall be interpreted to create
2067	strict liability. A violation of the rights set forth in s.
2068	429.28 400.428 or in any other standard or guidelines specified
2069	in this chapter part or in any applicable administrative
2070	standard or guidelines of this state or a federal regulatory
2071	agency shall be evidence of negligence but shall not be
2072	considered negligence per se.
2073	(7)  The resident or the resident's legal representative
2074	shall serve a copy of any complaint alleging in whole or in part
2075	a violation of any rights specified in this chapter part to the
2076	Agency for Health Care Administration at the time of filing the
2077	initial complaint with the clerk of the court for the county in
2078	which the action is pursued. The requirement of providing a copy
2079	of the complaint to the agency does not impair the resident's
2080	legal rights or ability to seek relief for his or her claim.
2081	Section 58.  Section 400.4293, Florida Statutes, is
2082	renumbered as section 429.293, Florida Statutes, and paragraph
2083	(a) of subsection (1) and subsections (2) and (10) are amended
2084	to read:
2085	429.293 400.4293  Presuit notice; investigation;
2086	notification of violation of residents' rights or alleged
2087	negligence; claims evaluation procedure; informal discovery;
2088	review; settlement offer; mediation.--
2089	(1)  As used in this section, the term:
2090	(a)  "Claim for residents' rights violation or negligence"
2091	means a negligence claim alleging injury to or the death of a
2092	resident arising out of an asserted violation of the rights of a
2093	resident under s. 429.28 400.428 or an asserted deviation from
2094	the applicable standard of care.
2095	(2)  Prior to filing a claim for a violation of a
2096	resident's rights or a claim for negligence, a claimant alleging
2097	injury to or the death of a resident shall notify each
2098	prospective defendant by certified mail, return receipt
2099	requested, of an asserted violation of a resident's rights
2100	provided in s. 429.28 400.428 or deviation from the standard of
2101	care. Such notification shall include an identification of the
2102	rights the prospective defendant has violated and the negligence
2103	alleged to have caused the incident or incidents and a brief
2104	description of the injuries sustained by the resident which are
2105	reasonably identifiable at the time of notice. The notice shall
2106	contain a certificate of counsel that counsel's reasonable
2107	investigation gave rise to a good faith belief that grounds
2108	exist for an action against each prospective defendant.
2109	(10)  To the extent not inconsistent with this chapter
2110	part, the provisions of the Florida Mediation Code, Florida
2111	Rules of Civil Procedure, shall be applicable to such
2112	proceedings.
2113	Section 59.  Section 400.4294, Florida Statutes, is
2114	renumbered as section 429.294, Florida Statutes, and subsection
2115	(1) is amended to read:
2116	429.294 400.4294  Availability of facility records for
2117	investigation of resident's rights violations and defenses;
2118	penalty.--
2119	(1)  Failure to provide complete copies of a resident's
2120	records, including, but not limited to, all medical records and
2121	the resident's chart, within the control or possession of the
2122	facility within 10 days, in accordance with the provisions of s.
2123	400.145, shall constitute evidence of failure of that party to
2124	comply with good faith discovery requirements and shall waive
2125	the good faith certificate and presuit notice requirements under
2126	this chapter part by the requesting party.
2127	Section 60.  Section 400.4295, Florida Statutes, is
2128	renumbered as section 429.295, Florida Statutes, and amended to
2129	read:
2130	429.295 400.4295  Certain provisions not applicable to
2131	actions under this chapter part.--An action under this chapter
2132	part for a violation of rights or negligence recognized herein
2133	is not a claim for medical malpractice, and the provisions of s.
2134	768.21(8) do not apply to a claim alleging death of the
2135	resident.
2136	Section 61.  Section 400.4296, Florida Statutes, is
2137	renumbered as section 429.296, Florida Statutes, and subsection
2138	(1) is amended to read:
2139	429.296 400.4296  Statute of limitations.--
2140	(1)  Any action for damages brought under this chapter part
2141	shall be commenced within 2 years from the time the incident
2142	giving rise to the action occurred or within 2 years from the
2143	time the incident is discovered, or should have been discovered
2144	with the exercise of due diligence; however, in no event shall
2145	the action be commenced later than 4 years from the date of the
2146	incident or occurrence out of which the cause of action accrued.
2147	Section 62.  Section 400.4297, Florida Statutes, is
2148	renumbered as section 429.297, Florida Statutes, and subsection
2149	(1) is amended to read:
2150	429.297 400.4297  Punitive damages; pleading; burden of
2151	proof.--
2152	(1)  In any action for damages brought under this chapter
2153	part, no claim for punitive damages shall be permitted unless
2154	there is a reasonable showing by evidence in the record or
2155	proffered by the claimant which would provide a reasonable basis
2156	for recovery of such damages. The claimant may move to amend her
2157	or his complaint to assert a claim for punitive damages as
2158	allowed by the rules of civil procedure. The rules of civil
2159	procedure shall be liberally construed so as to allow the
2160	claimant discovery of evidence which appears reasonably
2161	calculated to lead to admissible evidence on the issue of
2162	punitive damages. No discovery of financial worth shall proceed
2163	until after the pleading concerning punitive damages is
2164	permitted.
2165	Section 63.  Section 400.431, Florida Statutes, is
2166	renumbered as section 429.31, Florida Statutes, and subsections
2167	(1) and (5) are amended to read:
2168	429.31 400.431  Closing of facility; notice; penalty.--
2169	(1)  Whenever a facility voluntarily discontinues
2170	operation, it shall inform the agency in writing at least 90
2171	days prior to the discontinuance of operation. The facility
2172	shall also inform each resident or the next of kin, legal
2173	representative, or agency acting on each resident's behalf, of
2174	the fact and the proposed time of such discontinuance, following
2175	the notification requirements provided in s. 429.28
2176	400.428(1)(k). In the event a resident has no person to
2177	represent him or her, the facility shall be responsible for
2178	referral to an appropriate social service agency for placement.
2179	(5)  The agency may levy a fine in an amount no greater
2180	than $5,000 upon each person or business entity that owns any
2181	interest in a facility that terminates operation without
2182	providing notice to the agency and the residents of the facility
2183	at least 30 days before operation ceases. This fine shall not be
2184	levied against any facility involuntarily closed at the
2185	initiation of the agency. The agency shall use the proceeds of
2186	the fines to operate the facility until all residents of the
2187	facility are relocated and shall deposit any balance of the
2188	proceeds into the Health Care Trust Fund established pursuant to
2189	s. 429.18 400.418.
2190	Section 64.  Section 400.434, Florida Statutes, is
2191	renumbered as section 429.34, Florida Statutes, and amended to
2192	read:
2193	429.34 400.434  Right of entry and inspection.--Any duly
2194	designated officer or employee of the department, the Department
2195	of Children and Family Services, the agency, the Medicaid Fraud
2196	Control Unit of the Department of Legal Affairs, the state or
2197	local fire marshal, or a member of the state or local long-term
2198	care ombudsman council shall have the right to enter unannounced
2199	upon and into the premises of any facility licensed pursuant to
2200	this chapter part in order to determine the state of compliance
2201	with the provisions of this chapter part and of rules or
2202	standards in force pursuant thereto. The right of entry and
2203	inspection shall also extend to any premises which the agency
2204	has reason to believe is being operated or maintained as a
2205	facility without a license; but no such entry or inspection of
2206	any premises may be made without the permission of the owner or
2207	person in charge thereof, unless a warrant is first obtained
2208	from the circuit court authorizing such entry.  The warrant
2209	requirement shall extend only to a facility which the agency has
2210	reason to believe is being operated or maintained as a facility
2211	without a license.  Any application for a license or renewal
2212	thereof made pursuant to this chapter part shall constitute
2213	permission for, and complete acquiescence in, any entry or
2214	inspection of the premises for which the license is sought, in
2215	order to facilitate verification of the information submitted on
2216	or in connection with the application; to discover, investigate,
2217	and determine the existence of abuse or neglect; or to elicit,
2218	receive, respond to, and resolve complaints. Any current valid
2219	license shall constitute unconditional permission for, and
2220	complete acquiescence in, any entry or inspection of the
2221	premises by authorized personnel. The agency shall retain the
2222	right of entry and inspection of facilities that have had a
2223	license revoked or suspended within the previous 24 months, to
2224	ensure that the facility is not operating unlawfully. However,
2225	before entering the facility, a statement of probable cause must
2226	be filed with the director of the agency, who must approve or
2227	disapprove the action within 48 hours. Probable cause shall
2228	include, but is not limited to, evidence that the facility holds
2229	itself out to the public as a provider of personal care services
2230	or the receipt of a complaint by the long-term care ombudsman
2231	council about the facility. Data collected by the state or local
2232	long-term care ombudsman councils or the state or local advocacy
2233	councils may be used by the agency in investigations involving
2234	violations of regulatory standards.
2235	Section 65.  Section 400.441, Florida Statutes, is
2236	renumbered as section 429.41, Florida Statutes, and subsections
2237	(1) and (2), paragraph (b) of subsection (3), and subsection (5)
2238	are amended to read:
2239	429.41 400.441  Rules establishing standards.--
2240	(1)  It is the intent of the Legislature that rules
2241	published and enforced pursuant to this section shall include
2242	criteria by which a reasonable and consistent quality of
2243	resident care and quality of life may be ensured and the results
2244	of such resident care may be demonstrated.  Such rules shall
2245	also ensure a safe and sanitary environment that is residential
2246	and noninstitutional in design or nature.  It is further
2247	intended that reasonable efforts be made to accommodate the
2248	needs and preferences of residents to enhance the quality of
2249	life in a facility. In order to provide safe and sanitary
2250	facilities and the highest quality of resident care
2251	accommodating the needs and preferences of residents, the
2252	department, in consultation with the agency, the Department of
2253	Children and Family Services, and the Department of Health,
2254	shall adopt rules, policies, and procedures to administer this
2255	chapter part, which must include reasonable and fair minimum
2256	standards in relation to:
2257	(a)  The requirements for and maintenance of facilities,
2258	not in conflict with the provisions of chapter 553, relating to
2259	plumbing, heating, cooling, lighting, ventilation, living space,
2260	and other housing conditions, which will ensure the health,
2261	safety, and comfort of residents and protection from fire
2262	hazard, including adequate provisions for fire alarm and other
2263	fire protection suitable to the size of the structure. Uniform
2264	firesafety standards shall be established and enforced by the
2265	State Fire Marshal in cooperation with the agency, the
2266	department, and the Department of Health.
2267	1.  Evacuation capability determination.--
2268	a.  The provisions of the National Fire Protection
2269	Association, NFPA 101A, Chapter 5, 1995 edition, shall be used
2270	for determining the ability of the residents, with or without
2271	staff assistance, to relocate from or within a licensed facility
2272	to a point of safety as provided in the fire codes adopted
2273	herein. An evacuation capability evaluation for initial
2274	licensure shall be conducted within 6 months after the date of
2275	licensure. For existing licensed facilities that are not
2276	equipped with an automatic fire sprinkler system, the
2277	administrator shall evaluate the evacuation capability of
2278	residents at least annually. The evacuation capability
2279	evaluation for each facility not equipped with an automatic fire
2280	sprinkler system shall be validated, without liability, by the
2281	State Fire Marshal, by the local fire marshal, or by the local
2282	authority having jurisdiction over firesafety, before the
2283	license renewal date. If the State Fire Marshal, local fire
2284	marshal, or local authority having jurisdiction over firesafety
2285	has reason to believe that the evacuation capability of a
2286	facility as reported by the administrator may have changed, it
2287	may, with assistance from the facility administrator, reevaluate
2288	the evacuation capability through timed exiting drills.
2289	Translation of timed fire exiting drills to evacuation
2290	capability may be determined:
2291	(I)  Three minutes or less: prompt.
2292	(II)  More than 3 minutes, but not more than 13 minutes:
2293	slow.
2294	(III)  More than 13 minutes: impractical.
2295	b.  The Office of the State Fire Marshal shall provide or
2296	cause the provision of training and education on the proper
2297	application of Chapter 5, NFPA 101A, 1995 edition, to its
2298	employees, to staff of the Agency for Health Care Administration
2299	who are responsible for regulating facilities under this chapter
2300	part, and to local governmental inspectors. The Office of the
2301	State Fire Marshal shall provide or cause the provision of this
2302	training within its existing budget, but may charge a fee for
2303	this training to offset its costs. The initial training must be
2304	delivered within 6 months after July 1, 1995, and as needed
2305	thereafter.
2306	c.  The Office of the State Fire Marshal, in cooperation
2307	with provider associations, shall provide or cause the provision
2308	of a training program designed to inform facility operators on
2309	how to properly review bid documents relating to the
2310	installation of automatic fire sprinklers. The Office of the
2311	State Fire Marshal shall provide or cause the provision of this
2312	training within its existing budget, but may charge a fee for
2313	this training to offset its costs. The initial training must be
2314	delivered within 6 months after July 1, 1995, and as needed
2315	thereafter.
2316	d.  The administrator of a licensed facility shall sign an
2317	affidavit verifying the number of residents occupying the
2318	facility at the time of the evacuation capability evaluation.
2319	2.  Firesafety requirements.--
2320	a.  Except for the special applications provided herein,
2321	effective January 1, 1996, the provisions of the National Fire
2322	Protection Association, Life Safety Code, NFPA 101, 1994
2323	edition, Chapter 22 for new facilities and Chapter 23 for
2324	existing facilities shall be the uniform fire code applied by
2325	the State Fire Marshal for assisted living facilities, pursuant
2326	to s. 633.022.
2327	b.  Any new facility, regardless of size, that applies for
2328	a license on or after January 1, 1996, must be equipped with an
2329	automatic fire sprinkler system. The exceptions as provided in
2330	section 22-2.3.5.1, NFPA 101, 1994 edition, as adopted herein,
2331	apply to any new facility housing eight or fewer residents. On
2332	July 1, 1995, local governmental entities responsible for the
2333	issuance of permits for construction shall inform, without
2334	liability, any facility whose permit for construction is
2335	obtained prior to January 1, 1996, of this automatic fire
2336	sprinkler requirement. As used in this chapter part, the term "a
2337	new facility" does not mean an existing facility that has
2338	undergone change of ownership.
2339	c.  Notwithstanding any provision of s. 633.022 or of the
2340	National Fire Protection Association, NFPA 101A, Chapter 5, 1995
2341	edition, to the contrary, any existing facility housing eight or
2342	fewer residents is not required to install an automatic fire
2343	sprinkler system, nor to comply with any other requirement in
2344	Chapter 23, NFPA 101, 1994 edition, that exceeds the firesafety
2345	requirements of NFPA 101, 1988 edition, that applies to this
2346	size facility, unless the facility has been classified as
2347	impractical to evacuate. Any existing facility housing eight or
2348	fewer residents that is classified as impractical to evacuate
2349	must install an automatic fire sprinkler system within the
2350	timeframes granted in this section.
2351	d.  Any existing facility that is required to install an
2352	automatic fire sprinkler system under this paragraph need not
2353	meet other firesafety requirements of Chapter 23, NFPA 101, 1994
2354	edition, which exceed the provisions of NFPA 101, 1988 edition.
2355	The mandate contained in this paragraph which requires certain
2356	facilities to install an automatic fire sprinkler system
2357	supersedes any other requirement.
2358	e.  This paragraph does not supersede the exceptions
2359	granted in NFPA 101, 1988 edition or 1994 edition.
2360	f.  This paragraph does not exempt facilities from other
2361	firesafety provisions adopted under s. 633.022 and local
2362	building code requirements in effect before July 1, 1995.
2363	g.  A local government may charge fees only in an amount
2364	not to exceed the actual expenses incurred by local government
2365	relating to the installation and maintenance of an automatic
2366	fire sprinkler system in an existing and properly licensed
2367	assisted living facility structure as of January 1, 1996.
2368	h.  If a licensed facility undergoes major reconstruction
2369	or addition to an existing building on or after January 1, 1996,
2370	the entire building must be equipped with an automatic fire
2371	sprinkler system. Major reconstruction of a building means
2372	repair or restoration that costs in excess of 50 percent of the
2373	value of the building as reported on the tax rolls, excluding
2374	land, before reconstruction. Multiple reconstruction projects
2375	within a 5-year period the total costs of which exceed 50
2376	percent of the initial value of the building at the time the
2377	first reconstruction project was permitted are to be considered
2378	as major reconstruction. Application for a permit for an
2379	automatic fire sprinkler system is required upon application for
2380	a permit for a reconstruction project that creates costs that go
2381	over the 50-percent threshold.
2382	i.  Any facility licensed before January 1, 1996, that is
2383	required to install an automatic fire sprinkler system shall
2384	ensure that the installation is completed within the following
2385	timeframes based upon evacuation capability of the facility as
2386	determined under subparagraph 1.:
2387	(I)  Impractical evacuation capability, 24 months.
2388	(II)  Slow evacuation capability, 48 months.
2389	(III)  Prompt evacuation capability, 60 months.
2390
2391	The beginning date from which the deadline for the automatic
2392	fire sprinkler installation requirement must be calculated is
2393	upon receipt of written notice from the local fire official that
2394	an automatic fire sprinkler system must be installed. The local
2395	fire official shall send a copy of the document indicating the
2396	requirement of a fire sprinkler system to the Agency for Health
2397	Care Administration.
2398	j.  It is recognized that the installation of an automatic
2399	fire sprinkler system may create financial hardship for some
2400	facilities. The appropriate local fire official shall, without
2401	liability, grant two 1-year extensions to the timeframes for
2402	installation established herein, if an automatic fire sprinkler
2403	installation cost estimate and proof of denial from two
2404	financial institutions for a construction loan to install the
2405	automatic fire sprinkler system are submitted. However, for any
2406	facility with a class I or class II, or a history of uncorrected
2407	class III, firesafety deficiencies, an extension must not be
2408	granted. The local fire official shall send a copy of the
2409	document granting the time extension to the Agency for Health
2410	Care Administration.
2411	k.  A facility owner whose facility is required to be
2412	equipped with an automatic fire sprinkler system under Chapter
2413	23, NFPA 101, 1994 edition, as adopted herein, must disclose to
2414	any potential buyer of the facility that an installation of an
2415	automatic fire sprinkler requirement exists. The sale of the
2416	facility does not alter the timeframe for the installation of
2417	the automatic fire sprinkler system.
2418	l.  Existing facilities required to install an automatic
2419	fire sprinkler system as a result of construction-type
2420	restrictions in Chapter 23, NFPA 101, 1994 edition, as adopted
2421	herein, or evacuation capability requirements shall be notified
2422	by the local fire official in writing of the automatic fire
2423	sprinkler requirement, as well as the appropriate date for final
2424	compliance as provided in this subparagraph. The local fire
2425	official shall send a copy of the document to the Agency for
2426	Health Care Administration.
2427	m.  Except in cases of life-threatening fire hazards, if an
2428	existing facility experiences a change in the evacuation
2429	capability, or if the local authority having jurisdiction
2430	identifies a construction-type restriction, such that an
2431	automatic fire sprinkler system is required, it shall be
2432	afforded time for installation as provided in this subparagraph.
2433
2434	Facilities that are fully sprinkled and in compliance with other
2435	firesafety standards are not required to conduct more than one
2436	of the required fire drills between the hours of 11 p.m. and 7
2437	a.m., per year. In lieu of the remaining drills, staff
2438	responsible for residents during such hours may be required to
2439	participate in a mock drill that includes a review of evacuation
2440	procedures. Such standards must be included or referenced in the
2441	rules adopted by the State Fire Marshal. Pursuant to s.
2442	633.022(1)(b), the State Fire Marshal is the final
2443	administrative authority for firesafety standards established
2444	and enforced pursuant to this section. All licensed facilities
2445	must have an annual fire inspection conducted by the local fire
2446	marshal or authority having jurisdiction.
2447	3.  Resident elopement requirements.--Facilities are
2448	required to conduct a minimum of two resident elopement
2449	prevention and response drills per year. All administrators and
2450	direct care staff must participate in the drills which shall
2451	include a review of procedures to address resident elopement.
2452	Facilities must document the implementation of the drills and
2453	ensure that the drills are conducted in a manner consistent with
2454	the facility's resident elopement policies and procedures.
2455	(b)  The preparation and annual update of a comprehensive
2456	emergency management plan.  Such standards must be included in
2457	the rules adopted by the department after consultation with the
2458	Department of Community Affairs.  At a minimum, the rules must
2459	provide for plan components that address emergency evacuation
2460	transportation; adequate sheltering arrangements; postdisaster
2461	activities, including provision of emergency power, food, and
2462	water; postdisaster transportation; supplies; staffing;
2463	emergency equipment; individual identification of residents and
2464	transfer of records; communication with families; and responses
2465	to family inquiries.  The comprehensive emergency management
2466	plan is subject to review and approval by the local emergency
2467	management agency. During its review, the local emergency
2468	management agency shall ensure that the following agencies, at a
2469	minimum, are given the opportunity to review the plan:  the
2470	Department of Elderly Affairs, the Department of Health, the
2471	Agency for Health Care Administration, and the Department of
2472	Community Affairs.  Also, appropriate volunteer organizations
2473	must be given the opportunity to review the plan.  The local
2474	emergency management agency shall complete its review within 60
2475	days and either approve the plan or advise the facility of
2476	necessary revisions.
2477	(c)  The number, training, and qualifications of all
2478	personnel having responsibility for the care of residents.  The
2479	rules must require adequate staff to provide for the safety of
2480	all residents.  Facilities licensed for 17 or more residents are
2481	required to maintain an alert staff for 24 hours per day.
2482	(d)  All sanitary conditions within the facility and its
2483	surroundings which will ensure the health and comfort of
2484	residents.  The rules must clearly delineate the
2485	responsibilities of the agency's licensure and survey staff, the
2486	county health departments, and the local authority having
2487	jurisdiction over fire safety and ensure that inspections are
2488	not duplicative.  The agency may collect fees for food service
2489	inspections conducted by the county health departments and
2490	transfer such fees to the Department of Health.
2491	(e)  License application and license renewal, transfer of
2492	ownership, proper management of resident funds and personal
2493	property, surety bonds, resident contracts, refund policies,
2494	financial ability to operate, and facility and staff records.
2495	(f)  Inspections, complaint investigations, moratoriums,
2496	classification of deficiencies, levying and enforcement of
2497	penalties, and use of income from fees and fines.
2498	(g)  The enforcement of the resident bill of rights
2499	specified in s. 429.28 400.428.
2500	(h)  The care and maintenance of residents, which must
2501	include, but is not limited to:
2502	1.  The supervision of residents;
2503	2.  The provision of personal services;
2504	3.  The provision of, or arrangement for, social and
2505	leisure activities;
2506	4.  The arrangement for appointments and transportation to
2507	appropriate medical, dental, nursing, or mental health services,
2508	as needed by residents;
2509	5.  The management of medication;
2510	6.  The nutritional needs of residents;
2511	7.  Resident records; and
2512	8.  Internal risk management and quality assurance.
2513	(i)  Facilities holding a limited nursing, extended
2514	congregate care, or limited mental health license.
2515	(j)  The establishment of specific criteria to define
2516	appropriateness of resident admission and continued residency in
2517	a facility holding a standard, limited nursing, extended
2518	congregate care, and limited mental health license.
2519	(k)  The use of physical or chemical restraints.  The use
2520	of physical restraints is limited to half-bed rails as
2521	prescribed and documented by the resident's physician with the
2522	consent of the resident or, if applicable, the resident's
2523	representative or designee or the resident's surrogate,
2524	guardian, or attorney in fact.  The use of chemical restraints
2525	is limited to prescribed dosages of medications authorized by
2526	the resident's physician and must be consistent with the
2527	resident's diagnosis. Residents who are receiving medications
2528	that can serve as chemical restraints must be evaluated by their
2529	physician at least annually to assess:
2530	1.  The continued need for the medication.
2531	2.  The level of the medication in the resident's blood.
2532	3.  The need for adjustments in the prescription.
2533	(l)  The establishment of specific policies and procedures
2534	on resident elopement. Facilities shall conduct a minimum of two
2535	resident elopement drills each year. All administrators and
2536	direct care staff shall participate in the drills. Facilities
2537	shall document the drills.
2538	(2)  In adopting any rules pursuant to this chapter part,
2539	the department, in conjunction with the agency, shall make
2540	distinct standards for facilities based upon facility size; the
2541	types of care provided; the physical and mental capabilities and
2542	needs of residents; the type, frequency, and amount of services
2543	and care offered; and the staffing characteristics of the
2544	facility. Rules developed pursuant to this section shall not
2545	restrict the use of shared staffing and shared programming in
2546	facilities that are part of retirement communities that provide
2547	multiple levels of care and otherwise meet the requirements of
2548	law and rule.  Except for uniform firesafety standards, the
2549	department shall adopt by rule separate and distinct standards
2550	for facilities with 16 or fewer beds and for facilities with 17
2551	or more beds.  The standards for facilities with 16 or fewer
2552	beds shall be appropriate for a noninstitutional residential
2553	environment, provided that the structure is no more than two
2554	stories in height and all persons who cannot exit the facility
2555	unassisted in an emergency reside on the first floor.  The
2556	department, in conjunction with the agency, may make other
2557	distinctions among types of facilities as necessary to enforce
2558	the provisions of this chapter part. Where appropriate, the
2559	agency shall offer alternate solutions for complying with
2560	established standards, based on distinctions made by the
2561	department and the agency relative to the physical
2562	characteristics of facilities and the types of care offered
2563	therein.
2564	(3)  The department shall submit a copy of proposed rules
2565	to the Speaker of the House of Representatives, the President of
2566	the Senate, and appropriate committees of substance for review
2567	and comment prior to the promulgation thereof.
2568	(b)  The agency, in consultation with the department, may
2569	waive rules promulgated pursuant to this chapter part in order
2570	to demonstrate and evaluate innovative or cost-effective
2571	congregate care alternatives which enable individuals to age in
2572	place.  Such waivers may be granted only in instances where
2573	there is reasonable assurance that the health, safety, or
2574	welfare of residents will not be endangered.  To apply for a
2575	waiver, the licensee shall submit to the agency a written
2576	description of the concept to be demonstrated, including goals,
2577	objectives, and anticipated benefits; the number and types of
2578	residents who will be affected, if applicable; a brief
2579	description of how the demonstration will be evaluated; and any
2580	other information deemed appropriate by the agency.  Any
2581	facility granted a waiver shall submit a report of findings to
2582	the agency and the department within 12 months.  At such time,
2583	the agency may renew or revoke the waiver or pursue any
2584	regulatory or statutory changes necessary to allow other
2585	facilities to adopt the same practices. The department may by
2586	rule clarify terms and establish waiver application procedures,
2587	criteria for reviewing waiver proposals, and procedures for
2588	reporting findings, as necessary to implement this subsection.
2589	(5)  A fee shall be charged by the department to any person
2590	requesting a copy of this chapter part or rules promulgated
2591	under this chapter part. Such fees shall not exceed the actual
2592	cost of duplication and postage.
2593	Section 66.  Section 400.442, Florida Statutes, is
2594	renumbered as section 429.42, Florida Statutes, and subsections
2595	(1) and (3) are amended to read:
2596	429.42 400.442  Pharmacy and dietary services.--
2597	(1)  Any assisted living facility in which the agency has
2598	documented a class I or class II deficiency or uncorrected class
2599	III deficiencies regarding medicinal drugs or over-the-counter
2600	preparations, including their storage, use, delivery, or
2601	administration, or dietary services, or both, during a biennial
2602	survey or a monitoring visit or an investigation in response to
2603	a complaint, shall, in addition to or as an alternative to any
2604	penalties imposed under s. 429.19 400.419, be required to employ
2605	the consultant services of a licensed pharmacist, a licensed
2606	registered nurse, or a registered or licensed dietitian, as
2607	applicable. The consultant shall, at a minimum, provide onsite
2608	quarterly consultation until the inspection team from the agency
2609	determines that such consultation services are no longer
2610	required.
2611	(3)  The agency shall employ at least two pharmacists
2612	licensed pursuant to chapter 465 among its personnel who
2613	biennially inspect assisted living facilities licensed under
2614	this chapter part, to participate in biennial inspections or
2615	consult with the agency regarding deficiencies relating to
2616	medicinal drugs or over-the-counter preparations.
2617	Section 67.  Section 400.444, Florida Statutes, is
2618	renumbered as section 429.44, Florida Statutes, and subsection
2619	(2) is amended to read:
2620	429.44 400.444  Construction and renovation;
2621	requirements.--
2622	(2)  Upon notification by the local authority having
2623	jurisdiction over life-threatening violations which seriously
2624	threaten the health, safety, or welfare of a resident of a
2625	facility, the agency shall take action as specified in s. 429.14
2626	400.414.
2627	Section 68.  Section 400.4445, Florida Statutes, is
2628	renumbered as section 429.445, Florida Statutes, and amended to
2629	read:
2630	429.445 400.4445  Compliance with local zoning
2631	requirements.--No facility licensed under this chapter part may
2632	commence any construction which will expand the size of the
2633	existing structure unless the licensee first submits to the
2634	agency proof that such construction will be in compliance with
2635	applicable local zoning requirements.  Facilities with a
2636	licensed capacity of less than 15 persons shall comply with the
2637	provisions of chapter 419.
2638	Section 69.  Section 400.447, Florida Statutes, is
2639	renumbered as section 429.47, Florida Statutes, and subsections
2640	(2), (5), and (7) are amended to read:
2641	429.47 400.447  Prohibited acts; penalties for violation.--
2642	(2)  It is unlawful for any holder of a license issued
2643	pursuant to the provisions of this act to withhold from the
2644	agency any evidence of financial instability, including, but not
2645	limited to, bad checks, delinquent accounts, nonpayment of
2646	withholding taxes, unpaid utility expenses, nonpayment for
2647	essential services, or adverse court action concerning the
2648	financial viability of the facility or any other facility
2649	licensed under part II of chapter 400 or under part III of this
2650	chapter which is owned by the licensee.
2651	(5)  A freestanding facility shall not advertise or imply
2652	that any part of it is a nursing home. For the purpose of this
2653	subsection, "freestanding facility" means a facility that is not
2654	operated in conjunction with a nursing home to which residents
2655	of the facility are given priority when nursing care is
2656	required. A person who violates this subsection is subject to
2657	fine as specified in s. 429.19 400.419.
2658	(7)  A facility licensed under this chapter part which is
2659	not part of a facility authorized under chapter 651 shall
2660	include the facility's license number as given by the agency in
2661	all advertising.  A company or person owning more than one
2662	facility shall include at least one license number per
2663	advertisement.  All advertising shall include the term "assisted
2664	living facility" before the license number.
2665	Section 70.  Section 400.451, Florida Statutes, is
2666	renumbered as section 429.51, Florida Statutes, and amended to
2667	read:
2668	429.51 400.451  Existing facilities to be given reasonable
2669	time to comply with rules and standards.--Any facility as
2670	defined in this chapter part which is in operation at the time
2671	of promulgation of any applicable rules or standards adopted or
2672	amended pursuant to this chapter part may be given a reasonable
2673	time, not to exceed 6 months, within which to comply with such
2674	rules and standards.
2675	Section 71.  Section 400.452, Florida Statutes, is
2676	renumbered as section 429.52, Florida Statutes, and subsections
2677	(3) and (5) are amended to read:
2678	429.52 400.452  Staff training and educational programs;
2679	core educational requirement.--
2680	(3)  Effective January 1, 2004, a new facility
2681	administrator must complete the required training and education,
2682	including the competency test, within a reasonable time after
2683	being employed as an administrator, as determined by the
2684	department. Failure to do so is a violation of this chapter part
2685	and subjects the violator to an administrative fine as
2686	prescribed in s. 429.19 400.419. Administrators licensed in
2687	accordance with chapter 468, part II, are exempt from this
2688	requirement. Other licensed professionals may be exempted, as
2689	determined by the department by rule.
2690	(5)  Staff involved with the management of medications and
2691	assisting with the self-administration of medications under s.
2692	429.256 400.4256 must complete a minimum of 4 additional hours
2693	of training provided by a registered nurse, licensed pharmacist,
2694	or department staff. The department shall establish by rule the
2695	minimum requirements of this additional training.
2696	Section 72.  Section 400.453, Florida Statutes, is
2697	renumbered as section 429.53, Florida Statutes, and paragraph
2698	(b) of subsection (1) and paragraphs (a), (e), and (f) of
2699	subsection (2) are amended to read:
2700	429.53 400.453  Consultation by the agency.--
2701	(1)  The area offices of licensure and certification of the
2702	agency shall provide consultation to the following upon request:
2703	(b)  A person interested in obtaining a license to operate
2704	a facility under this chapter part.
2705	(2)  As used in this section, "consultation" includes:
2706	(a)  An explanation of the requirements of this chapter
2707	part and rules adopted pursuant thereto;
2708	(e)  Any other information which the agency deems necessary
2709	to promote compliance with the requirements of this chapter
2710	part; and
2711	(f)  A preconstruction review of a facility to ensure
2712	compliance with agency rules and this chapter part.
2713	Section 73.  Subsections (1), (7), and (15) of section
2714	400.462, Florida Statutes, are amended to read:
2715	400.462  Definitions.--As used in this part, the term:
2716	(1)  "Administrator" means a direct employee of the home
2717	health agency or a related organization, or of a management
2718	company that has a contract to manage the home health agency, to
2719	whom the governing body has delegated the responsibility for
2720	day-to-day administration of the home health agency.  The
2721	administrator must be a licensed physician, physician assistant,
2722	or registered nurse licensed to practice in this state or an
2723	individual having at least 1 year of supervisory or
2724	administrative experience in home health care or in a facility
2725	licensed under chapter 395, or under part II or part III of this
2726	chapter, or under chapter 429. An administrator may manage a
2727	maximum of five licensed home health agencies located within one
2728	agency service district or within an immediately contiguous
2729	county. If the home health agency is licensed under this chapter
2730	and is part of a retirement community that provides multiple
2731	levels of care, an employee of the retirement community may
2732	administer the home health agency and up to a maximum of four
2733	entities licensed under this chapter or chapter 429 that are
2734	owned, operated, or managed by the same corporate entity. An
2735	administrator shall designate, in writing, for each licensed
2736	entity, a qualified alternate administrator to serve during
2737	absences.
2738	(7)  "Director of nursing" means a registered nurse and
2739	direct employee of the agency or related business entity who is
2740	a graduate of an approved school of nursing and is licensed in
2741	this state; who has at least 1 year of supervisory experience as
2742	a registered nurse in a licensed home health agency, a facility
2743	licensed under chapter 395, or a facility licensed under part II
2744	or part III of this chapter or under chapter 429; and who is
2745	responsible for overseeing the professional nursing and home
2746	health aid delivery of services of the agency. An employee may
2747	be the director of nursing of a maximum of five licensed home
2748	health agencies operated by a related business entity and
2749	located within one agency service district or within an
2750	immediately contiguous county.  If the home health agency is
2751	licensed under this chapter and is part of a retirement
2752	community that provides multiple levels of care, an employee of
2753	the retirement community may serve as the director of nursing of
2754	the home health agency and of up to four entities licensed under
2755	this chapter or chapter 429 which are owned, operated, or
2756	managed by the same corporate entity. A director of nursing
2757	shall designate, in writing, for each licensed entity, a
2758	qualified alternate registered nurse to serve during the absence
2759	of the director of nursing.
2760	(15)  "Nurse registry" means any person that procures,
2761	offers, promises, or attempts to secure health-care-related
2762	contracts for registered nurses, licensed practical nurses,
2763	certified nursing assistants, home health aides, companions, or
2764	homemakers, who are compensated by fees as independent
2765	contractors, including, but not limited to, contracts for the
2766	provision of services to patients and contracts to provide
2767	private duty or staffing services to health care facilities
2768	licensed under chapter 395, or this chapter, or chapter 429, or
2769	other business entities.
2770	Section 74.  Paragraph (h) of subsection (5) of section
2771	400.464, Florida Statutes, is amended to read:
2772	400.464  Home health agencies to be licensed; expiration of
2773	license; exemptions; unlawful acts; penalties.--
2774	(5)  The following are exempt from the licensure
2775	requirements of this part:
2776	(h)  The delivery of assisted living facility services for
2777	which the assisted living facility is licensed under part III of
2778	this chapter 429, to serve its residents in its facility.
2779	Section 75.  Subsection (2) of section 400.497, Florida
2780	Statutes, is amended to read:
2781	400.497  Rules establishing minimum standards.--The agency
2782	shall adopt, publish, and enforce rules to implement this part,
2783	including, as applicable, ss. 400.506 and 400.509, which must
2784	provide reasonable and fair minimum standards relating to:
2785	(2)  Shared staffing. The agency shall allow shared
2786	staffing if the home health agency is part of a retirement
2787	community that provides multiple levels of care, is located on
2788	one campus, is licensed under this chapter or chapter 429, and
2789	otherwise meets the requirements of law and rule.
2790	Section 76.  Section 400.552, Florida Statutes, is amended
2791	to read:
2792	400.552  Applicability.--Any facility that comes within the
2793	definition of an adult day care center which is not exempt under
2794	s. 429.905 400.553 must be licensed by the agency as an adult
2795	day care center.
2796	Section 77.  Subsection (1) and paragraph (d) of subsection
2797	(2) of section 400.555, Florida Statutes, are amended to read:
2798	400.555  Application for license.--
2799	(1)  An application for a license to operate an adult day
2800	care center must be made to the agency on forms furnished by the
2801	agency and must be accompanied by the appropriate license fee
2802	unless the applicant is exempt from payment of the fee as
2803	provided in s. 429.907(4) 400.554(4).
2804	(2)  The applicant for licensure must furnish:
2805	(d)  Proof of compliance with level 2 background screening
2806	as required under s. 429.919 400.5572.
2807	Section 78.  Paragraph (c) of subsection (2) of section
2808	400.556, Florida Statutes, is amended to read:
2809	400.556  Denial, suspension, revocation of license;
2810	administrative fines; investigations and inspections.--
2811	(2)  Each of the following actions by the owner of an adult
2812	day care center or by its operator or employee is a ground for
2813	action by the agency against the owner of the center or its
2814	operator or employee:
2815	(c)  A failure of persons subject to level 2 background
2816	screening under s. 429.174 400.4174(1) to meet the screening
2817	standards of s. 435.04, or the retention by the center of an
2818	employee subject to level 1 background screening standards under
2819	s. 429.174 400.4174(2) who does not meet the screening standards
2820	of s. 435.03 and for whom exemptions from disqualification have
2821	not been provided by the agency.
2822	Section 79.  Subsection (1) of section 400.557, Florida
2823	Statutes, is amended to read:
2824	400.557  Expiration of license; renewal; conditional
2825	license or permit.--
2826	(1)  A license issued for the operation of an adult day
2827	care center, unless sooner suspended or revoked, expires 2 years
2828	after the date of issuance. The agency shall notify a licensee
2829	at least 120 days before the expiration date that license
2830	renewal is required to continue operation. The notification must
2831	be provided electronically or by mail delivery. At least 90 days
2832	prior to the expiration date, an application for renewal must be
2833	submitted to the agency. A license shall be renewed, upon the
2834	filing of an application on forms furnished by the agency, if
2835	the applicant has first met the requirements of this part and of
2836	the rules adopted under this part. The applicant must file with
2837	the application satisfactory proof of financial ability to
2838	operate the center in accordance with the requirements of this
2839	part and in accordance with the needs of the participants to be
2840	served and an affidavit of compliance with the background
2841	screening requirements of s. 429.919 400.5572.
2842	Section 80.  Paragraph (c) of subsection (2) of section
2843	400.5572, Florida Statutes, is amended to read:
2844	400.5572  Background screening.--
2845	(2)  The owner or administrator of an adult day care center
2846	must conduct level 1 background screening as set forth in
2847	chapter 435 on all employees hired on or after October 1, 1998,
2848	who provide basic services or supportive and optional services
2849	to the participants. Such persons satisfy this requirement if:
2850	(c)  The person required to be screened is employed by a
2851	corporation or business entity or related corporation or
2852	business entity that owns, operates, or manages more than one
2853	facility or agency licensed under this chapter or chapter 429,
2854	and for whom a level 1 screening was conducted by the
2855	corporation or business entity as a condition of initial or
2856	continued employment.
2857	Section 81.  Subsection (5) of section 400.601, Florida
2858	Statutes, is amended to read:
2859	400.601  Definitions.--As used in this part, the term:
2860	(5)  "Hospice residential unit" means a homelike living
2861	facility, other than a facility licensed under other parts of
2862	this chapter, or under chapter 395, or under chapter 429, that
2863	is operated by a hospice for the benefit of its patients and is
2864	considered by a patient who lives there to be his or her primary
2865	residence.
2866	Section 82.  Paragraph (c) of subsection (2) of section
2867	400.618, Florida Statutes, is amended to read:
2868	400.618  Definitions.--As used in this part, the term:
2869	(2)  "Adult family-care home" means a full-time,
2870	family-type living arrangement, in a private home, under which a
2871	person who owns or rents the home provides room, board, and
2872	personal care, on a 24-hour basis, for no more than five
2873	disabled adults or frail elders who are not relatives. The
2874	following family-type living arrangements are not required to be
2875	licensed as an adult family-care home:
2876	(c)  An establishment that is licensed as an assisted
2877	living facility under chapter 429 part III.
2878	Section 83.  Subsection (1) of section 400.6194, Florida
2879	Statutes, is amended to read:
2880	400.6194  Denial, revocation, or suspension of a
2881	license.--The agency may deny, suspend, or revoke a license for
2882	any of the following reasons:
2883	(1)  Failure of any of the persons required to undergo
2884	background screening under s. 429.67 400.619 to meet the level 1
2885	screening standards of s. 435.03, unless an exemption from
2886	disqualification has been provided by the agency.
2887	Section 84.  Paragraph (h) of subsection (1) of section
2888	400.621, Florida Statutes, is amended to read:
2889	400.621  Rules and standards relating to adult family-care
2890	homes.--
2891	(1)  The department, in consultation with the Department of
2892	Health, the Department of Children and Family Services, and the
2893	agency shall, by rule, establish minimum standards to ensure the
2894	health, safety, and well-being of each resident in the adult
2895	family-care home. The rules must address:
2896	(h)  Procedures to protect the residents' rights as
2897	provided in s. 429.85 400.628.
2898	Section 85.  Paragraph (f) of subsection (1) of section
2899	400.628, Florida Statutes, is amended to read:
2900	429.85 400.628  Residents' bill of rights.--
2901	(1)  A resident of an adult family-care home may not be
2902	deprived of any civil or legal rights, benefits, or privileges
2903	guaranteed by law, the State Constitution, or the Constitution
2904	of the United States solely by reason of status as a resident of
2905	the home. Each resident has the right to:
2906	(f)  Manage the resident's own financial affairs unless the
2907	resident or the resident's guardian authorizes the provider to
2908	provide safekeeping for funds in accordance with procedures
2909	equivalent to those provided in s. 429.27 400.427.
2910	Section 86.  Paragraph (c) of subsection (5) of section
2911	400.93, Florida Statutes, is amended to read:
2912	400.93  Licensure required; exemptions; unlawful acts;
2913	penalties.--
2914	(5)  The following are exempt from home medical equipment
2915	provider licensure, unless they have a separate company,
2916	corporation, or division that is in the business of providing
2917	home medical equipment and services for sale or rent to
2918	consumers at their regular or temporary place of residence
2919	pursuant to the provisions of this part:
2920	(c)  Assisted living facilities licensed under chapter 429
2921	part III, when serving their residents.
2922	Section 87.  Subsection (3) and paragraph (c) of subsection
2923	(10) of section 400.962, Florida Statutes, are amended to read:
2924	400.962  License required; license application.--
2925	(3)  The basic license fee collected shall be deposited in
2926	the Health Care Trust Fund, established for carrying out the
2927	purposes of this chapter or chapter 429.
2928	(10)
2929	(c)  Proof of compliance with the level 2 background
2930	screening requirements of chapter 435 which has been submitted
2931	within the previous 5 years in compliance with any other
2932	licensure requirements under this chapter or chapter 429
2933	satisfies the requirements of paragraph (a). Proof of compliance
2934	with background screening which has been submitted within the
2935	previous 5 years to fulfill the requirements of the Financial
2936	Services Commission and the Office of Insurance Regulation under
2937	chapter 651 as part of an application for a certificate of
2938	authority to operate a continuing care retirement community
2939	satisfies the requirements for the Department of Law Enforcement
2940	and Federal Bureau of Investigation background checks.
2941	Section 88.  Paragraph (b) of subsection (1) of section
2942	400.980, Florida Statutes, is amended to read:
2943	400.980  Health care services pools.--
2944	(1)  As used in this section, the term:
2945	(b)  "Health care services pool" means any person, firm,
2946	corporation, partnership, or association engaged for hire in the
2947	business of providing temporary employment in health care
2948	facilities, residential facilities, and agencies for licensed,
2949	certified, or trained health care personnel including, without
2950	limitation, nursing assistants, nurses' aides, and orderlies.
2951	However, the term does not include nursing registries, a
2952	facility licensed under this chapter or chapter 429 400, a
2953	health care services pool established within a health care
2954	facility to provide services only within the confines of such
2955	facility, or any individual contractor directly providing
2956	temporary services to a health care facility without use or
2957	benefit of a contracting agent.
2958	Section 89.  Paragraphs (a), (b), (c), and (d) of
2959	subsection (4) of section 400.9905, Florida Statutes, are
2960	amended to read:
2961	400.9905  Definitions.--
2962	(4)  "Clinic" means an entity at which health care services
2963	are provided to individuals and which tenders charges for
2964	reimbursement for such services, including a mobile clinic and a
2965	portable equipment provider. For purposes of this part, the term
2966	does not include and the licensure requirements of this part do
2967	not apply to:
2968	(a)  Entities licensed or registered by the state under
2969	chapter 395; or entities licensed or registered by the state and
2970	providing only health care services within the scope of services
2971	authorized under their respective licenses granted under ss.
2972	383.30-383.335, chapter 390, chapter 394, chapter 397, this
2973	chapter except part XIII, chapter 429, chapter 463, chapter 465,
2974	chapter 466, chapter 478, part I of chapter 483, chapter 484, or
2975	chapter 651; end-stage renal disease providers authorized under
2976	42 C.F.R. part 405, subpart U; or providers certified under 42
2977	C.F.R. part 485, subpart B or subpart H; or any entity that
2978	provides neonatal or pediatric hospital-based health care
2979	services by licensed practitioners solely within a hospital
2980	licensed under chapter 395.
2981	(b)  Entities that own, directly or indirectly, entities
2982	licensed or registered by the state pursuant to chapter 395; or
2983	entities that own, directly or indirectly, entities licensed or
2984	registered by the state and providing only health care services
2985	within the scope of services authorized pursuant to their
2986	respective licenses granted under ss. 383.30-383.335, chapter
2987	390, chapter 394, chapter 397, this chapter except part XIII,
2988	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
2989	part I of chapter 483, chapter 484, chapter 651; end-stage renal
2990	disease providers authorized under 42 C.F.R. part 405, subpart
2991	U; or providers certified under 42 C.F.R. part 485, subpart B or
2992	subpart H; or any entity that provides neonatal or pediatric
2993	hospital-based health care services by licensed practitioners
2994	solely within a hospital licensed under chapter 395.
2995	(c)  Entities that are owned, directly or indirectly, by an
2996	entity licensed or registered by the state pursuant to chapter
2997	395; or entities that are owned, directly or indirectly, by an
2998	entity licensed or registered by the state and providing only
2999	health care services within the scope of services authorized
3000	pursuant to their respective licenses granted under ss. 383.30-
3001	383.335, chapter 390, chapter 394, chapter 397, this chapter
3002	except part XIII, chapter 429, chapter 463, chapter 465, chapter
3003	466, chapter 478, part I of chapter 483, chapter 484, or chapter
3004	651; end-stage renal disease providers authorized under 42
3005	C.F.R. part 405, subpart U; or providers certified under 42
3006	C.F.R. part 485, subpart B or subpart H; or any entity that
3007	provides neonatal or pediatric hospital-based health care
3008	services by licensed practitioners solely within a hospital
3009	under chapter 395.
3010	(d)  Entities that are under common ownership, directly or
3011	indirectly, with an entity licensed or registered by the state
3012	pursuant to chapter 395; or entities that are under common
3013	ownership, directly or indirectly, with an entity licensed or
3014	registered by the state and providing only health care services
3015	within the scope of services authorized pursuant to their
3016	respective licenses granted under ss. 383.30-383.335, chapter
3017	390, chapter 394, chapter 397, this chapter except part XIII,
3018	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
3019	part I of chapter 483, chapter 484, or chapter 651; end-stage
3020	renal disease providers authorized under 42 C.F.R. part 405,
3021	subpart U; or providers certified under 42 C.F.R. part 485,
3022	subpart B or subpart H; or any entity that provides neonatal or
3023	pediatric hospital-based health care services by licensed
3024	practitioners solely within a hospital licensed under chapter
3025	395.
3026	Section 90.  Subsection (6) of section 400.9935, Florida
3027	Statutes, is amended to read:
3028	400.9935  Clinic responsibilities.--
3029	(6)  Any licensed health care provider who violates this
3030	part is subject to discipline in accordance with this chapter or
3031	chapter 429 and his or her respective practice act.
3032	Section 91.  Subsection (12) of section 401.23, Florida
3033	Statutes, is amended to read:
3034	401.23  Definitions.--As used in this part, the term:
3035	(12)  "Interfacility transfer" means the transportation by
3036	ambulance of a patient between two facilities licensed under
3037	chapter 393, chapter 395, or chapter 400, or chapter 429,
3038	pursuant to this part.
3039	Section 92.  Paragraph (b) of subsection (2) of section
3040	402.164, Florida Statutes, is amended to read:
3041	402.164  Legislative intent; definitions.--
3042	(2)  As used in ss. 402.164-402.167, the term:
3043	(b)  "Client" means a client as defined in s. 393.063, s.
3044	394.67, s. 397.311, or s. 400.960, a forensic client or client
3045	as defined in s. 916.106, a child or youth as defined in s.
3046	39.01, a child as defined in s. 827.01, a family as defined in
3047	s. 414.0252, a participant as defined in s. 429.901 400.551, a
3048	resident as defined in s. 429.02 400.402, a Medicaid recipient
3049	or recipient as defined in s. 409.901, a child receiving child
3050	care as defined in s. 402.302, a disabled adult as defined in s.
3051	410.032 or s. 410.603, or a victim as defined in s. 39.01 or s.
3052	415.102 as each definition applies within its respective
3053	chapter.
3054	Section 93.  Paragraph (b) of subsection (2) of section
3055	408.033, Florida Statutes, is amended to read:
3056	408.033  Local and state health planning.--
3057	(2)  FUNDING.--
3058	(b)1.  A hospital licensed under chapter 395, a nursing
3059	home licensed under chapter 400, and an assisted living facility
3060	licensed under chapter 429 400 shall be assessed an annual fee
3061	based on number of beds.
3062	2.  All other facilities and organizations listed in
3063	paragraph (a) shall each be assessed an annual fee of $150.
3064	3.  Facilities operated by the Department of Children and
3065	Family Services, the Department of Health, or the Department of
3066	Corrections and any hospital which meets the definition of rural
3067	hospital pursuant to s. 395.602 are exempt from the assessment
3068	required in this subsection.
3069	Section 94.  Subsection (3) of section 408.831, Florida
3070	Statutes, is amended to read:
3071	408.831  Denial, suspension, or revocation of a license,
3072	registration, certificate, or application.--
3073	(3)  This section provides standards of enforcement
3074	applicable to all entities licensed or regulated by the Agency
3075	for Health Care Administration. This section controls over any
3076	conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
3077	394, 395, 400, 408, 429, 468, 483, and 641 or rules adopted
3078	pursuant to those chapters.
3079	Section 95.  Subsection (2) of section 409.212, Florida
3080	Statutes, is amended to read:
3081	409.212  Optional supplementation.--
3082	(2)  The base rate of payment for optional state
3083	supplementation shall be established by the department within
3084	funds appropriated. Additional amounts may be provided for
3085	mental health residents in facilities designed to provide
3086	limited mental health services as provided for in s. 429.075
3087	400.4075. The base rate of payment does not include the personal
3088	needs allowance.
3089	Section 96.  Paragraph (e) of subsection (4) of section
3090	409.221, Florida Statutes, is amended to read:
3091	409.221  Consumer-directed care program.--
3092	(4)  CONSUMER-DIRECTED CARE.--
3093	(e)  Services.--Consumers shall use the budget allowance
3094	only to pay for home and community-based services that meet the
3095	consumer's long-term care needs and are a cost-efficient use of
3096	funds. Such services may include, but are not limited to, the
3097	following:
3098	1.  Personal care.
3099	2.  Homemaking and chores, including housework, meals,
3100	shopping, and transportation.
3101	3.  Home modifications and assistive devices which may
3102	increase the consumer's independence or make it possible to
3103	avoid institutional placement.
3104	4.  Assistance in taking self-administered medication.
3105	5.  Day care and respite care services, including those
3106	provided by nursing home facilities pursuant to s. 400.141(6) or
3107	by adult day care facilities licensed pursuant to s. 429.907
3108	400.554.
3109	6.  Personal care and support services provided in an
3110	assisted living facility.
3111	Section 97.  Subsection (7) and paragraph (a) of subsection
3112	(8) of section 409.907, Florida Statutes, are amended to read:
3113	409.907  Medicaid provider agreements.--The agency may make
3114	payments for medical assistance and related services rendered to
3115	Medicaid recipients only to an individual or entity who has a
3116	provider agreement in effect with the agency, who is performing
3117	services or supplying goods in accordance with federal, state,
3118	and local law, and who agrees that no person shall, on the
3119	grounds of handicap, race, color, or national origin, or for any
3120	other reason, be subjected to discrimination under any program
3121	or activity for which the provider receives payment from the
3122	agency.
3123	(7)  The agency may require, as a condition of
3124	participating in the Medicaid program and before entering into
3125	the provider agreement, that the provider submit information, in
3126	an initial and any required renewal applications, concerning the
3127	professional, business, and personal background of the provider
3128	and permit an onsite inspection of the provider's service
3129	location by agency staff or other personnel designated by the
3130	agency to perform this function. The agency shall perform a
3131	random onsite inspection, within 60 days after receipt of a
3132	fully complete new provider's application, of the provider's
3133	service location prior to making its first payment to the
3134	provider for Medicaid services to determine the applicant's
3135	ability to provide the services that the applicant is proposing
3136	to provide for Medicaid reimbursement. The agency is not
3137	required to perform an onsite inspection of a provider or
3138	program that is licensed by the agency, that provides services
3139	under waiver programs for home and community-based services, or
3140	that is licensed as a medical foster home by the Department of
3141	Children and Family Services. As a continuing condition of
3142	participation in the Medicaid program, a provider shall
3143	immediately notify the agency of any current or pending
3144	bankruptcy filing. Before entering into the provider agreement,
3145	or as a condition of continuing participation in the Medicaid
3146	program, the agency may also require that Medicaid providers
3147	reimbursed on a fee-for-services basis or fee schedule basis
3148	which is not cost-based, post a surety bond not to exceed
3149	$50,000 or the total amount billed by the provider to the
3150	program during the current or most recent calendar year,
3151	whichever is greater. For new providers, the amount of the
3152	surety bond shall be determined by the agency based on the
3153	provider's estimate of its first year's billing. If the
3154	provider's billing during the first year exceeds the bond
3155	amount, the agency may require the provider to acquire an
3156	additional bond equal to the actual billing level of the
3157	provider. A provider's bond shall not exceed $50,000 if a
3158	physician or group of physicians licensed under chapter 458,
3159	chapter 459, or chapter 460 has a 50 percent or greater
3160	ownership interest in the provider or if the provider is an
3161	assisted living facility licensed under part III of chapter 429
3162	400. The bonds permitted by this section are in addition to the
3163	bonds referenced in s. 400.179(4)(d). If the provider is a
3164	corporation, partnership, association, or other entity, the
3165	agency may require the provider to submit information concerning
3166	the background of that entity and of any principal of the
3167	entity, including any partner or shareholder having an ownership
3168	interest in the entity equal to 5 percent or greater, and any
3169	treating provider who participates in or intends to participate
3170	in Medicaid through the entity. The information must include:
3171	(a)  Proof of holding a valid license or operating
3172	certificate, as applicable, if required by the state or local
3173	jurisdiction in which the provider is located or if required by
3174	the Federal Government.
3175	(b)  Information concerning any prior violation, fine,
3176	suspension, termination, or other administrative action taken
3177	under the Medicaid laws, rules, or regulations of this state or
3178	of any other state or the Federal Government; any prior
3179	violation of the laws, rules, or regulations relating to the
3180	Medicare program; any prior violation of the rules or
3181	regulations of any other public or private insurer; and any
3182	prior violation of the laws, rules, or regulations of any
3183	regulatory body of this or any other state.
3184	(c)  Full and accurate disclosure of any financial or
3185	ownership interest that the provider, or any principal, partner,
3186	or major shareholder thereof, may hold in any other Medicaid
3187	provider or health care related entity or any other entity that
3188	is licensed by the state to provide health or residential care
3189	and treatment to persons.
3190	(d)  If a group provider, identification of all members of
3191	the group and attestation that all members of the group are
3192	enrolled in or have applied to enroll in the Medicaid program.
3193	(8)(a)  Each provider, or each principal of the provider if
3194	the provider is a corporation, partnership, association, or
3195	other entity, seeking to participate in the Medicaid program
3196	must submit a complete set of his or her fingerprints to the
3197	agency for the purpose of conducting a criminal history record
3198	check.  Principals of the provider include any officer,
3199	director, billing agent, managing employee, or affiliated
3200	person, or any partner or shareholder who has an ownership
3201	interest equal to 5 percent or more in the provider. However, a
3202	director of a not-for-profit corporation or organization is not
3203	a principal for purposes of a background investigation as
3204	required by this section if the director: serves solely in a
3205	voluntary capacity for the corporation or organization, does not
3206	regularly take part in the day-to-day operational decisions of
3207	the corporation or organization, receives no remuneration from
3208	the not-for-profit corporation or organization for his or her
3209	service on the board of directors, has no financial interest in
3210	the not-for-profit corporation or organization, and has no
3211	family members with a financial interest in the not-for-profit
3212	corporation or organization; and if the director submits an
3213	affidavit, under penalty of perjury, to this effect to the
3214	agency and the not-for-profit corporation or organization
3215	submits an affidavit, under penalty of perjury, to this effect
3216	to the agency as part of the corporation's or organization's
3217	Medicaid provider agreement application. Notwithstanding the
3218	above, the agency may require a background check for any person
3219	reasonably suspected by the agency to have been convicted of a
3220	crime. This subsection shall not apply to:
3221	1.  A hospital licensed under chapter 395;
3222	2.  A nursing home licensed under chapter 400;
3223	3.  A hospice licensed under chapter 400;
3224	4.  An assisted living facility licensed under chapter 429
3225	400.
3226	5.  A unit of local government, except that requirements of
3227	this subsection apply to nongovernmental providers and entities
3228	when contracting with the local government to provide Medicaid
3229	services. The actual cost of the state and national criminal
3230	history record checks must be borne by the nongovernmental
3231	provider or entity; or
3232	6.  Any business that derives more than 50 percent of its
3233	revenue from the sale of goods to the final consumer, and the
3234	business or its controlling parent either is required to file a
3235	form 10-K or other similar statement with the Securities and
3236	Exchange Commission or has a net worth of $50 million or more.
3237	Section 98.  Section 410.031, Florida Statutes, is amended
3238	to read:
3239	410.031  Legislative intent.--It is the intent of the
3240	Legislature to encourage the provision of care for disabled
3241	adults in family-type living arrangements in private homes as an
3242	alternative to institutional or nursing home care for such
3243	persons. The provisions of ss. 410.031-410.036 are intended to
3244	be supplemental to the provisions of chapters chapter 400 and
3245	429, relating to the licensing and regulation of nursing homes
3246	and assisted living facilities, and do not exempt any person who
3247	is otherwise subject to regulation under chapter 400 or chapter
3248	429.
3249	Section 99.  Section 410.034, Florida Statutes, is amended
3250	to read:
3251	410.034  Department determination of fitness to provide
3252	home care.--In accordance with s. 429.02 400.402, a person
3253	caring for an adult who is related to such person by blood or
3254	marriage is not subject to the Assisted Living Facilities Act.
3255	If, however, the person who plans to provide home care under
3256	this act is found by the department to be unable to provide this
3257	care, the department shall notify the person wishing to provide
3258	home care of this determination, and the person shall not be
3259	eligible for subsidy payments under ss. 410.031-410.036.
3260	Section 100.  Section 415.1111, Florida Statutes, is
3261	amended to read:
3262	415.1111  Civil actions.--A vulnerable adult who has been
3263	abused, neglected, or exploited as specified in this chapter has
3264	a cause of action against any perpetrator and may recover actual
3265	and punitive damages for such abuse, neglect, or exploitation.
3266	The action may be brought by the vulnerable adult, or that
3267	person's guardian, by a person or organization acting on behalf
3268	of the vulnerable adult with the consent of that person or that
3269	person's guardian, or by the personal representative of the
3270	estate of a deceased victim without regard to whether the cause
3271	of death resulted from the abuse, neglect, or exploitation. The
3272	action may be brought in any court of competent jurisdiction to
3273	enforce such action and to recover actual and punitive damages
3274	for any deprivation of or infringement on the rights of a
3275	vulnerable adult.  A party who prevails in any such action may
3276	be entitled to recover reasonable attorney's fees, costs of the
3277	action, and damages. The remedies provided in this section are
3278	in addition to and cumulative with other legal and
3279	administrative remedies available to a vulnerable adult.
3280	Notwithstanding the foregoing, any civil action for damages
3281	against any licensee or entity who establishes, controls,
3282	conducts, manages, or operates a facility licensed under part II
3283	of chapter 400 relating to its operation of the licensed
3284	facility shall be brought pursuant to s. 400.023, or against any
3285	licensee or entity who establishes, controls, conducts, manages,
3286	or operates a facility licensed under part III of chapter 429
3287	400 relating to its operation of the licensed facility shall be
3288	brought pursuant to s. 429.29 400.429. Such licensee or entity
3289	shall not be vicariously liable for the acts or omissions of its
3290	employees or agents or any other third party in an action
3291	brought under this section.
3292	Section 101.  Paragraph (d) of subsection (1) of section
3293	419.001, Florida Statutes, is amended to read:
3294	419.001  Site selection of community residential homes.--
3295	(1)  For the purposes of this section, the following
3296	definitions shall apply:
3297	(d)  "Resident" means any of the following: a frail elder
3298	as defined in s. 429.65 400.618; a physically disabled or
3299	handicapped person as defined in s. 760.22(7)(a); a
3300	developmentally disabled person as defined in s. 393.063; a
3301	nondangerous mentally ill person as defined in s. 394.455(18);
3302	or a child as defined in s. 39.01(14), s. 984.03(9) or (12), or
3303	s. 985.03(8).
3304	Section 102.  Section 430.601, Florida Statutes, is amended
3305	to read:
3306	430.601  Home care for the elderly; legislative intent.--It
3307	is the intent of the Legislature to encourage the provision of
3308	care for the elderly in family-type living arrangements in
3309	private homes as an alternative to institutional or nursing home
3310	care for such persons. The provisions of ss. 430.601-430.606 are
3311	intended to be supplemental to the provisions of chapters
3312	chapter 400 and 429, relating to the licensing and regulation of
3313	nursing homes and assisted living facilities, and do not exempt
3314	any person who is otherwise subject to regulation under those
3315	chapters the provisions of that chapter.
3316	Section 103.  Subsection (7) of section 430.703, Florida
3317	Statutes, is amended to read:
3318	430.703  Definitions.--As used in this act, the term:
3319	(7)  "Other qualified provider" means an entity licensed
3320	under chapter 400 or chapter 429 that demonstrates a long-term
3321	care continuum and meets all requirements pursuant to an
3322	interagency agreement between the agency and the department.
3323	Section 104.  Paragraph (a) of subsection (3) of section
3324	435.03, Florida Statutes, is amended to read:
3325	435.03  Level 1 screening standards.--
3326	(3)  Standards must also ensure that the person:
3327	(a)  For employees and employers licensed or registered
3328	pursuant to chapter 400 or chapter 429, and for employees and
3329	employers of developmental services institutions as defined in
3330	s. 393.063, intermediate care facilities for the developmentally
3331	disabled as defined in s. 393.063, and mental health treatment
3332	facilities as defined in s. 394.455, meets the requirements of
3333	this chapter.
3334	Section 105.  Paragraph (a) of subsection (4) of section
3335	435.04, Florida Statutes, is amended to read:
3336	435.04  Level 2 screening standards.--
3337	(4)  Standards must also ensure that the person:
3338	(a)  For employees or employers licensed or registered
3339	pursuant to chapter 400 or chapter 429, does not have a
3340	confirmed report of abuse, neglect, or exploitation as defined
3341	in s. 415.102(6), which has been uncontested or upheld under s.
3342	415.103.
3343	Section 106.  Paragraph (g) of subsection (1) of section
3344	440.13, Florida Statutes, is amended to read:
3345	440.13  Medical services and supplies; penalty for
3346	violations; limitations.--
3347	(1)  DEFINITIONS.--As used in this section, the term:
3348	(g)  "Health care facility" means any hospital licensed
3349	under chapter 395 and any health care institution licensed under
3350	chapter 400 or chapter 429.
3351	Section 107.  Paragraph (b) of subsection (1) of section
3352	456.0375, Florida Statutes, is amended to read:
3353	456.0375  Registration of certain clinics; requirements;
3354	discipline; exemptions.--
3355	(1)
3356	(b)  For purposes of this section, the term "clinic" does
3357	not include and the registration requirements herein do not
3358	apply to:
3359	1.  Entities licensed or registered by the state pursuant
3360	to chapter 390, chapter 394, chapter 395, chapter 397, chapter
3361	400, chapter 429, chapter 463, chapter 465, chapter 466, chapter
3362	478, chapter 480, chapter 484, or chapter 651.
3363	2.  Entities that own, directly or indirectly, entities
3364	licensed or registered by the state pursuant to chapter 390,
3365	chapter 394, chapter 395, chapter 397, chapter 400, chapter 429,
3366	chapter 463, chapter 465, chapter 466, chapter 478, chapter 480,
3367	chapter 484, or chapter 651.
3368	3.  Entities that are owned, directly or indirectly, by an
3369	entity licensed or registered by the state pursuant to chapter
3370	390, chapter 394, chapter 395, chapter 397, chapter 400, chapter
3371	429, chapter 463, chapter 465, chapter 466, chapter 478, chapter
3372	480, chapter 484, or chapter 651.
3373	4.  Entities that are under common ownership, directly or
3374	indirectly, with an entity licensed or registered by the state
3375	pursuant to chapter 390, chapter 394, chapter 395, chapter 397,
3376	chapter 400, chapter 429, chapter 463, chapter 465, chapter 466,
3377	chapter 478, chapter 480, chapter 484, or chapter 651.
3378	5.  Entities exempt from federal taxation under 26 U.S.C.
3379	s. 501(c)(3) and community college and university clinics.
3380	6.  Sole proprietorships, group practices, partnerships, or
3381	corporations that provide health care services by licensed
3382	health care practitioners pursuant to chapters 457, 458, 459,
3383	460, 461, 462, 463, 466, 467, 484, 486, 490, 491, or part I,
3384	part III, part X, part XIII, or part XIV of chapter 468, or s.
3385	464.012, which are wholly owned by licensed health care
3386	practitioners or the licensed health care practitioner and the
3387	spouse, parent, or child of a licensed health care practitioner,
3388	so long as one of the owners who is a licensed health care
3389	practitioner is supervising the services performed therein and
3390	is legally responsible for the entity's compliance with all
3391	federal and state laws. However, no health care practitioner may
3392	supervise services beyond the scope of the practitioner's
3393	license.
3394	7.  Clinical facilities affiliated with an accredited
3395	medical school at which training is provided for medical
3396	students, residents, or fellows.
3397	Section 108.  Subsection (1) of section 465.0235, Florida
3398	Statutes, is amended to read:
3399	465.0235  Automated pharmacy systems used by long-term care
3400	facilities, hospices, or state correctional institutions.--
3401	(1)  A pharmacy may provide pharmacy services to a
3402	long-term care facility or hospice licensed under chapter 400 or
3403	chapter 429 or a state correctional institution operated under
3404	chapter 944 through the use of an automated pharmacy system that
3405	need not be located at the same location as the pharmacy.
3406	Section 109.  Paragraph (k) of subsection (1) of section
3407	468.505, Florida Statutes, is amended to read:
3408	468.505  Exemptions; exceptions.--
3409	(1)  Nothing in this part may be construed as prohibiting
3410	or restricting the practice, services, or activities of:
3411	(k)  A person employed by a hospital licensed under chapter
3412	395, or by a nursing home or assisted living facility licensed
3413	under part II or part III of chapter 400 or under chapter 429,
3414	or by a continuing care facility certified under chapter 651, if
3415	the person is employed in compliance with the laws and rules
3416	adopted thereunder regarding the operation of its dietetic
3417	department.
3418	Section 110.  Subsection (11) of section 477.025, Florida
3419	Statutes, is amended to read:
3420	477.025  Cosmetology salons; specialty salons; requisites;
3421	licensure; inspection; mobile cosmetology salons.--
3422	(11)  Facilities licensed under part II or part III of
3423	chapter 400 or under chapter 429 shall be exempt from the
3424	provisions of this section and a cosmetologist licensed pursuant
3425	to s. 477.019 may provide salon services exclusively for
3426	facility residents.
3427	Section 111.  Paragraph (a) of subsection (2) of section
3428	509.032, Florida Statutes, is amended to read:
3429	509.032  Duties.--
3430	(2)  INSPECTION OF PREMISES.--
3431	(a)  The division has responsibility and jurisdiction for
3432	all inspections required by this chapter.  The division has
3433	responsibility for quality assurance.  Each licensed
3434	establishment shall be inspected at least biannually, except for
3435	transient and nontransient apartments, which shall be inspected
3436	at least annually, and shall be inspected at such other times as
3437	the division determines is necessary to ensure the public's
3438	health, safety, and welfare.  The division shall establish a
3439	system to determine inspection frequency.  Public lodging units
3440	classified as resort condominiums or resort dwellings are not
3441	subject to this requirement, but shall be made available to the
3442	division upon request.  If, during the inspection of a public
3443	lodging establishment classified for renting to transient or
3444	nontransient tenants, an inspector identifies vulnerable adults
3445	who appear to be victims of neglect, as defined in s. 415.102,
3446	or, in the case of a building that is not equipped with
3447	automatic sprinkler systems, tenants or clients who may be
3448	unable to self-preserve in an emergency, the division shall
3449	convene meetings with the following agencies as appropriate to
3450	the individual situation: the Department of Health, the
3451	Department of Elderly Affairs, the area agency on aging, the
3452	local fire marshal, the landlord and affected tenants and
3453	clients, and other relevant organizations, to develop a plan
3454	which improves the prospects for safety of affected residents
3455	and, if necessary, identifies alternative living arrangements
3456	such as facilities licensed under part II or part III of chapter
3457	400 or under chapter 429.
3458	Section 112.  Subsection (1) of section 509.241, Florida
3459	Statutes, is amended to read:
3460	509.241  Licenses required; exceptions.--
3461	(1)  LICENSES; ANNUAL RENEWALS.--Each public lodging
3462	establishment and public food service establishment shall obtain
3463	a license from the division. Such license may not be transferred
3464	from one place or individual to another. It shall be a
3465	misdemeanor of the second degree, punishable as provided in s.
3466	775.082 or s. 775.083, for such an establishment to operate
3467	without a license. Local law enforcement shall provide immediate
3468	assistance in pursuing an illegally operating establishment. The
3469	division may refuse a license, or a renewal thereof, to any
3470	establishment that is not constructed and maintained in
3471	accordance with law and with the rules of the division. The
3472	division may refuse to issue a license, or a renewal thereof, to
3473	any establishment an operator of which, within the preceding 5
3474	years, has been adjudicated guilty of, or has forfeited a bond
3475	when charged with, any crime reflecting on professional
3476	character, including soliciting for prostitution, pandering,
3477	letting premises for prostitution, keeping a disorderly place,
3478	or illegally dealing in controlled substances as defined in
3479	chapter 893, whether in this state or in any other jurisdiction
3480	within the United States, or has had a license denied, revoked,
3481	or suspended pursuant to s. 429.14 400.414. Licenses shall be
3482	renewed annually, and the division shall adopt a rule
3483	establishing a staggered schedule for license renewals. If any
3484	license expires while administrative charges are pending against
3485	the license, the proceedings against the license shall continue
3486	to conclusion as if the license were still in effect.
3487	Section 113.  Subsection (1) of section 627.732, Florida
3488	Statutes, is amended to read:
3489	627.732  Definitions.--As used in ss. 627.730-627.7405, the
3490	term:
3491	(1)  "Broker" means any person not possessing a license
3492	under chapter 395, chapter 400, chapter 429, chapter 458,
3493	chapter 459, chapter 460, chapter 461, or chapter 641 who
3494	charges or receives compensation for any use of medical
3495	equipment and is not the 100-percent owner or the 100-percent
3496	lessee of such equipment. For purposes of this section, such
3497	owner or lessee may be an individual, a corporation, a
3498	partnership, or any other entity and any of its 100-percent-
3499	owned affiliates and subsidiaries. For purposes of this
3500	subsection, the term "lessee" means a long-term lessee under a
3501	capital or operating lease, but does not include a part-time
3502	lessee. The term "broker" does not include a hospital or
3503	physician management company whose medical equipment is
3504	ancillary to the practices managed, a debt collection agency, or
3505	an entity that has contracted with the insurer to obtain a
3506	discounted rate for such services; nor does the term include a
3507	management company that has contracted to provide general
3508	management services for a licensed physician or health care
3509	facility and whose compensation is not materially affected by
3510	the usage or frequency of usage of medical equipment or an
3511	entity that is 100-percent owned by one or more hospitals or
3512	physicians. The term "broker" does not include a person or
3513	entity that certifies, upon request of an insurer, that:
3514	(a)  It is a clinic registered under s. 456.0375 or
3515	licensed under ss. 400.990-400.995;
3516	(b)  It is a 100-percent owner of medical equipment; and
3517	(c)  The owner's only part-time lease of medical equipment
3518	for personal injury protection patients is on a temporary basis
3519	not to exceed 30 days in a 12-month period, and such lease is
3520	solely for the purposes of necessary repair or maintenance of
3521	the 100-percent-owned medical equipment or pending the arrival
3522	and installation of the newly purchased or a replacement for the
3523	100-percent-owned medical equipment, or for patients for whom,
3524	because of physical size or claustrophobia, it is determined by
3525	the medical director or clinical director to be medically
3526	necessary that the test be performed in medical equipment that
3527	is open-style. The leased medical equipment cannot be used by
3528	patients who are not patients of the registered clinic for
3529	medical treatment of services. Any person or entity making a
3530	false certification under this subsection commits insurance
3531	fraud as defined in s. 817.234. However, the 30-day period
3532	provided in this paragraph may be extended for an additional 60
3533	days as applicable to magnetic resonance imaging equipment if
3534	the owner certifies that the extension otherwise complies with
3535	this paragraph.
3536	Section 114.  Subsection (2) of section 651.011, Florida
3537	Statutes, is amended to read:
3538	651.011  Definitions.--For the purposes of this chapter,
3539	the term:
3540	(2)  "Continuing care" or "care" means furnishing pursuant
3541	to a contract shelter and either nursing care or personal
3542	services as defined in s. 429.02 400.402, whether such nursing
3543	care or personal services are provided in the facility or in
3544	another setting designated by the contract for continuing care,
3545	to an individual not related by consanguinity or affinity to the
3546	provider furnishing such care, upon payment of an entrance fee.
3547	Other personal services provided shall be designated in the
3548	continuing care contract. Contracts to provide continuing care
3549	include agreements to provide care for any duration, including
3550	contracts that are terminable by either party.
3551	Section 115.  Paragraph (c) of subsection (2) of section
3552	651.022, Florida Statutes, is amended to read:
3553	651.022  Provisional certificate of authority;
3554	application.--
3555	(2)  The application for a provisional certificate of
3556	authority shall be on a form prescribed by the commission and
3557	shall contain the following information:
3558	(c)1.  Evidence that the applicant is reputable and of
3559	responsible character.  If the applicant is a firm, association,
3560	organization, partnership, business trust, corporation, or
3561	company, the form shall require evidence that the members or
3562	shareholders are reputable and of responsible character, and the
3563	person in charge of providing care under a certificate of
3564	authority shall likewise be required to produce evidence of
3565	being reputable and of responsible character.
3566	2.  Evidence satisfactory to the office of the ability of
3567	the applicant to comply with the provisions of this chapter and
3568	with rules adopted by the commission pursuant to this chapter.
3569	3.  A statement of whether a person identified in the
3570	application for a provisional certificate of authority or the
3571	administrator or manager of the facility, if such person has
3572	been designated, or any such person living in the same location:
3573	a.  Has been convicted of a felony or has pleaded nolo
3574	contendere to a felony charge, or has been held liable or has
3575	been enjoined in a civil action by final judgment, if the felony
3576	or civil action involved fraud, embezzlement, fraudulent
3577	conversion, or misappropriation of property.
3578	b.  Is subject to a currently effective injunctive or
3579	restrictive order or federal or state administrative order
3580	relating to business activity or health care as a result of an
3581	action brought by a public agency or department, including,
3582	without limitation, an action affecting a license under chapter
3583	400 or chapter 429.
3584
3585	The statement shall set forth the court or agency, the date of
3586	conviction or judgment, and the penalty imposed or damages
3587	assessed, or the date, nature, and issuer of the order.  Before
3588	determining whether a provisional certificate of authority is to
3589	be issued, the office may make an inquiry to determine the
3590	accuracy of the information submitted pursuant to subparagraphs
3591	1. and 2.
3592	Section 116.  Subsection (6) of section 651.023, Florida
3593	Statutes, is amended to read:
3594	651.023  Certificate of authority; application.--
3595	(6)  The timeframes provided under s. 651.022(5) and (6)
3596	apply to applications submitted under s. 651.021(2). The office
3597	may not issue a certificate of authority under this chapter to
3598	any facility which does not have a component which is to be
3599	licensed pursuant to part II or part III of chapter 400 or to
3600	chapter 429 or which will not offer personal services or nursing
3601	services through written contractual agreement. Any written
3602	contractual agreement must be disclosed in the continuing care
3603	contract and is subject to the provisions of s. 651.1151,
3604	relating to administrative, vendor, and management contracts.
3605	Section 117.  Subsection (8) of section 651.055, Florida
3606	Statutes, is amended to read:
3607	651.055  Contracts; right to rescind.--
3608	(8)  The provisions of this section shall control over any
3609	conflicting provisions contained in part II or part III of
3610	chapter 400 or in chapter 429.
3611	Section 118.  Subsection (5) of section 651.095, Florida
3612	Statutes, is amended to read:
3613	651.095  Advertisements; requirements; penalties.--
3614	(5)  The provisions of this section shall control over any
3615	conflicting provisions contained in part II or part III of
3616	chapter 400 or in chapter 429.
3617	Section 119.  Subsections (1), (4), (6), and (8) of section
3618	651.118, Florida Statutes, are amended to read:
3619	651.118  Agency for Health Care Administration;
3620	certificates of need; sheltered beds; community beds.--
3621	(1)  The provisions of this section shall control in the
3622	case of conflict with the provisions of the Health Facility and
3623	Services Development Act, ss. 408.031-408.045; the provisions of
3624	chapter 395; or the provisions of part II parts II and III of
3625	chapter 400; or the provisions of chapter 429.
3626	(4)  The Agency for Health Care Administration shall
3627	approve one sheltered nursing home bed for every four proposed
3628	residential units, including those that are licensed under
3629	chapter 429 part III of chapter 400, in the continuing care
3630	facility unless the provider demonstrates the need for a lesser
3631	number of sheltered nursing home beds based on proposed
3632	utilization by prospective residents or demonstrates the need
3633	for additional sheltered nursing home beds based on actual
3634	utilization and demand by current residents.
3635	(6)  Unless the provider already has a component that is to
3636	be a part of the continuing care facility and that is licensed
3637	under chapter 395, or part II or part III of chapter 400, or
3638	chapter 429 at the time of construction of the continuing care
3639	facility, the provider must construct the nonnursing home
3640	portion of the facility and the nursing home portion of the
3641	facility at the same time. If a provider constructs less than
3642	the number of residential units approved in the certificate of
3643	authority, the number of licensed sheltered nursing home beds
3644	shall be reduced by a proportionate share.
3645	(8)  A provider may petition the Agency for Health Care
3646	Administration to use a designated number of sheltered nursing
3647	home beds to provide extended congregate care as defined in s.
3648	429.02 400.402 if the beds are in a distinct area of the nursing
3649	home which can be adapted to meet the requirements for extended
3650	congregate care. The provider may subsequently use such beds as
3651	sheltered beds after notifying the agency of the intended
3652	change. Any sheltered beds used to provide extended congregate
3653	care pursuant to this subsection may not qualify for funding
3654	under the Medicaid waiver. Any sheltered beds used to provide
3655	extended congregate care pursuant to this subsection may share
3656	common areas, services, and staff with beds designated for
3657	nursing home care, provided that all of the beds are under
3658	common ownership. For the purposes of this subsection, fire and
3659	life safety codes applicable to nursing home facilities shall
3660	apply.
3661	Section 120.  Subsection (2) of section 765.1103, Florida
3662	Statutes, is amended to read:
3663	765.1103  Pain management and palliative care.--
3664	(2)  Health care providers and practitioners regulated
3665	under chapter 458, chapter 459, or chapter 464 must, as
3666	appropriate, comply with a request for pain management or
3667	palliative care from a patient under their care or, for an
3668	incapacitated patient under their care, from a surrogate, proxy,
3669	guardian, or other representative permitted to make health care
3670	decisions for the incapacitated patient. Facilities regulated
3671	under chapter 395, or chapter 400, or chapter 429 must comply
3672	with the pain management or palliative care measures ordered by
3673	the patient's physician.
3674	Section 121.  Subsection (2) of section 765.205, Florida
3675	Statutes, is amended to read:
3676	765.205  Responsibility of the surrogate.--
3677	(2)  The surrogate may authorize the release of information
3678	and medical records to appropriate persons to ensure the
3679	continuity of the principal's health care and may authorize the
3680	admission, discharge, or transfer of the principal to or from a
3681	health care facility or other facility or program licensed under
3682	chapter 400 or chapter 429.
3683	Section 122.  Subsection (1) of section 768.735, Florida
3684	Statutes, is amended to read:
3685	768.735  Punitive damages; exceptions; limitation.--
3686	(1)  Sections 768.72(2)-(4), 768.725, and 768.73 do not
3687	apply to any civil action based upon child abuse, abuse of the
3688	elderly under chapter 415, or abuse of the developmentally
3689	disabled. Such actions are governed by applicable statutes and
3690	controlling judicial precedent. This section does not apply to
3691	claims brought pursuant to s. 400.023 or s. 429.29 400.429.
3692	Section 123.  Paragraph (a) of subsection (4) of section
3693	943.0585, Florida Statutes, is amended to read:
3694	943.0585  Court-ordered expunction of criminal history
3695	records.--The courts of this state have jurisdiction over their
3696	own procedures, including the maintenance, expunction, and
3697	correction of judicial records containing criminal history
3698	information to the extent such procedures are not inconsistent
3699	with the conditions, responsibilities, and duties established by
3700	this section. Any court of competent jurisdiction may order a
3701	criminal justice agency to expunge the criminal history record
3702	of a minor or an adult who complies with the requirements of
3703	this section. The court shall not order a criminal justice
3704	agency to expunge a criminal history record until the person
3705	seeking to expunge a criminal history record has applied for and
3706	received a certificate of eligibility for expunction pursuant to
3707	subsection (2). A criminal history record that relates to a
3708	violation of s. 393.135, s. 394.4593, s. 787.025, chapter 794,
3709	s. 796.03, s. 800.04, s. 817.034, s. 825.1025, s. 827.071,
3710	chapter 839, s. 847.0133, s. 847.0135, s. 847.0145, s. 893.135,
3711	s. 916.1075, or a violation enumerated in s. 907.041 may not be
3712	expunged, without regard to whether adjudication was withheld,
3713	if the defendant was found guilty of or pled guilty or nolo
3714	contendere to the offense, or if the defendant, as a minor, was
3715	found to have committed, or pled guilty or nolo contendere to
3716	committing, the offense as a delinquent act. The court may only
3717	order expunction of a criminal history record pertaining to one
3718	arrest or one incident of alleged criminal activity, except as
3719	provided in this section. The court may, at its sole discretion,
3720	order the expunction of a criminal history record pertaining to
3721	more than one arrest if the additional arrests directly relate
3722	to the original arrest. If the court intends to order the
3723	expunction of records pertaining to such additional arrests,
3724	such intent must be specified in the order. A criminal justice
3725	agency may not expunge any record pertaining to such additional
3726	arrests if the order to expunge does not articulate the
3727	intention of the court to expunge a record pertaining to more
3728	than one arrest. This section does not prevent the court from
3729	ordering the expunction of only a portion of a criminal history
3730	record pertaining to one arrest or one incident of alleged
3731	criminal activity. Notwithstanding any law to the contrary, a
3732	criminal justice agency may comply with laws, court orders, and
3733	official requests of other jurisdictions relating to expunction,
3734	correction, or confidential handling of criminal history records
3735	or information derived therefrom. This section does not confer
3736	any right to the expunction of any criminal history record, and
3737	any request for expunction of a criminal history record may be
3738	denied at the sole discretion of the court.
3739	(4)  EFFECT OF CRIMINAL HISTORY RECORD EXPUNCTION.--Any
3740	criminal history record of a minor or an adult which is ordered
3741	expunged by a court of competent jurisdiction pursuant to this
3742	section must be physically destroyed or obliterated by any
3743	criminal justice agency having custody of such record; except
3744	that any criminal history record in the custody of the
3745	department must be retained in all cases. A criminal history
3746	record ordered expunged that is retained by the department is
3747	confidential and exempt from the provisions of s. 119.07(1) and
3748	s. 24(a), Art. I of the State Constitution and not available to
3749	any person or entity except upon order of a court of competent
3750	jurisdiction. A criminal justice agency may retain a notation
3751	indicating compliance with an order to expunge.
3752	(a)  The person who is the subject of a criminal history
3753	record that is expunged under this section or under other
3754	provisions of law, including former s. 893.14, former s. 901.33,
3755	and former s. 943.058, may lawfully deny or fail to acknowledge
3756	the arrests covered by the expunged record, except when the
3757	subject of the record:
3758	1.  Is a candidate for employment with a criminal justice
3759	agency;
3760	2.  Is a defendant in a criminal prosecution;
3761	3.  Concurrently or subsequently petitions for relief under
3762	this section or s. 943.059;
3763	4.  Is a candidate for admission to The Florida Bar;
3764	5.  Is seeking to be employed or licensed by or to contract
3765	with the Department of Children and Family Services or the
3766	Department of Juvenile Justice or to be employed or used by such
3767	contractor or licensee in a sensitive position having direct
3768	contact with children, the developmentally disabled, the aged,
3769	or the elderly as provided in s. 110.1127(3), s. 393.063, s.
3770	394.4572(1), s. 397.451, s. 402.302(3), s. 402.313(3), s.
3771	409.175(2)(i), s. 415.102(4), s. 916.106(10) and (13), s.
3772	985.407, or chapter 400, or chapter 429; or
3773	6.  Is seeking to be employed or licensed by the Department
3774	of Education, any district school board, any university
3775	laboratory school, any charter school, any private or parochial
3776	school, or any local governmental entity that licenses child
3777	care facilities.
3778	Section 124.  The Division of Statutory Revision of the
3779	Office of Legislative Services shall prepare a reviser's bill
3780	for introduction at a subsequent session of the Legislature to
3781	conform the Florida Statutes to changes made by this act.
3782	Section 125.  This act shall take effect July 1, 2005.

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