HB 467

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

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