Senate Bill sb1358

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    Florida Senate - 2006                                  SB 1358

    By Senator Rich





    34-682-06

  1                      A bill to be entitled

  2         An act relating to hospitals; providing

  3         legislative findings; providing definitions;

  4         providing that information concerning nursing

  5         care for patients be made available to the

  6         public; providing for staffing schedules and

  7         patterns; providing criteria for staffing

  8         schedules of nursing personnel and a daily

  9         census for patient-care units; requiring each

10         hospital to make staffing levels and schedules

11         available to the public for a certain period of

12         time; requiring that records be made available

13         to the public upon request; requiring hospitals

14         to provide quarterly reports; requiring the

15         Agency for Health Care Administration to make

16         certain information regarding nursing personnel

17         available to the public on its Internet

18         website; providing rights for hospital

19         employees; authorizing the agency to inspect

20         and audit certain books and records of a

21         hospital; providing a penalty for a hospital's

22         refusal to file a report, timely file a report,

23         file a false report, file an incomplete report,

24         or produce certain requested documents or

25         records to the agency; authorizing the agency

26         to grant an extension of a deadline for a

27         hospital to file a report; providing an

28         effective date.

29  

30  Be It Enacted by the Legislature of the State of Florida:

31  

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    Florida Senate - 2006                                  SB 1358
    34-682-06




 1         Section 1.  (1)  SHORT TITLE.--This section may be

 2  cited as the "Patients' Right-to-Know Act."

 3         (2)  LEGISLATIVE FINDINGS.--The Legislature finds that

 4  consumers in this state have a right to obtain access to

 5  information concerning the quality and safety of the health

 6  care provided in Florida hospitals in order to make better

 7  decisions about their choice of health care provider.

 8         (3)  DEFINITIONS.--As used in this section, the term:

 9         (a)  "Agency" means Agency for Health Care

10  Administration.

11         (b)  "Average daily census" means the average number of

12  inpatients receiving services in any given 24-hour period,

13  beginning at midnight, in each clinical service area of the

14  hospital.

15         (c)  "Agency nurse" means any direct-care nurse who is

16  not directly employed by the hospital, who provides care in

17  the hospital, and who is working for purposes of providing

18  supplemental staffing in a hospital.

19         (d)  "Direct-care nurse" means any registered nurse who

20  has direct responsibility to oversee or carry out medical

21  regimens or nursing care for one or more patients. A nurse

22  administrator, nurse supervisor, nurse educator, charge nurse,

23  or other registered nurse who does not have a specific patient

24  assignment may not be included in calculating the staffing

25  level.

26         (e)  "Hospital" means an acute care hospital that is

27  licensed under s. 395.003, Florida Statutes.

28         (f)  "Nurse" means a registered nurse.

29         (g)  "Nursing care" means care that falls within the

30  scope of practice set forth in chapter 464, Florida Statutes,

31  and other laws and rules or care that is otherwise encompassed

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    Florida Senate - 2006                                  SB 1358
    34-682-06




 1  within recognized professional standards of nursing practice,

 2  including assessment, nursing diagnosis, planning,

 3  intervention, evaluation, and patient advocacy.

 4         (h)  "Retaliate" means to discipline, discharge,

 5  suspend, demote, harass, deny employment or promotion, lay

 6  off, or take any other adverse action against a direct-care

 7  nurse as a result of that nurse taking any action described in

 8  this section.

 9         (i)  "Staffing level" means the actual numerical

10  registered nurse-to-patient ratio within a nursing department

11  or unit.

12         (j)  "Unit" means a functional division or area of a

13  hospital in which nursing care is provided.

14         (4)  PUBLIC AVAILABILITY OF STAFFING LEVELS AND

15  SCHEDULES.--

16         (a)  The number of registered professional nurses,

17  licensed practical nurses, and other nursing personnel

18  assigned to each patient-care unit shall be consistent with

19  the types of nursing care needed by the patients and the

20  capabilities of the staff. Patients on each unit shall be

21  evaluated near the end of each change of shift by criteria

22  developed by the hospital. There shall be staffing schedules

23  reflecting the actual nursing personnel required for the

24  hospital and for each patient unit. Staffing patterns must

25  reflect consideration of nursing goals, standards of nursing

26  practice, and the needs of the patients.

27         (b)  The current staffing level and anticipated

28  staffing schedule shall be available upon request for each

29  patient-care unit for the effective date of that schedule.

30  Each schedule must list the assigned nursing personnel and the

31  average daily census for each patient-care unit. The hospital

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    Florida Senate - 2006                                  SB 1358
    34-682-06




 1  shall retain and make available to the public the historic

 2  staffing level and schedules for the prior 5 years.

 3         (c)  All records required under this section, including

 4  anticipated staffing schedules and the methods to determine

 5  and adjust staffing levels, shall be made available to the

 6  public upon request.

 7         (d)  All records required under this section shall be

 8  maintained by the facility for at least 5 years.

 9         (5)  HOSPITAL REPORTS.--Each hospital shall prepare a

10  quarterly report that includes the average daily staffing

11  levels by unit, the percentage of nursing hours that are

12  completed by agency nurses by unit, the number and description

13  of OSHA violations, the nurse vacancy rate, the nurse turnover

14  rate, and the number and description of complaints made to the

15  Joint Commission on Accreditation of Healthcare Organizations

16  or to the agency.

17         (6)  AVAILABILITY ONLINE.--The agency shall make

18  available on its Internet website no later than October 1,

19  2006, and in a hard-copy format upon request, the average

20  daily staffing levels by unit; the percentage of nursing hours

21  that are completed by contract or agency nurses by unit,

22  number, and description of OSHA violations; the number and

23  description of complaints; the vacancy rate; and the turnover

24  rate for each hospital. The website shall also list each

25  hospital's system affiliations if the hospital is affiliated

26  with a nonprofit, for-profit, or public health care system or

27  corporation. Such public data shall be updated quarterly.

28         (7)  EMPLOYEE RIGHTS.--

29         (a)  A hospital may not penalize, discriminate against,

30  or retaliate in any manner against a direct-care nurse for

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    Florida Senate - 2006                                  SB 1358
    34-682-06




 1  refusing an assignment that would violate requirements set

 2  forth in this section.

 3         (b)  A hospital may not penalize, discriminate against,

 4  or retaliate in any manner against an employee with respect to

 5  compensation for, or terms, conditions, or privileges of,

 6  employment if such an employee in good faith, individually or

 7  in conjunction with another persons or persons:

 8         1.  Reports a violation or suspected violation of this

 9  section to a regulatory agency, a private accreditation body,

10  or management personnel of the hospital;

11         2.  Initiates, cooperates in, or otherwise participates

12  in an investigation or proceeding brought by a regulatory

13  agency or private accreditation body concerning matters

14  covered by this section;

15         3.  Informs or discusses violations or suspected

16  violations of this section with other employees, with any

17  representative of the employees, with a patient or patient

18  representative, or with the public; or

19         4.  Otherwise avails himself or herself of the rights

20  set forth in this section.

21  

22  For purposes of this paragraph, an employee is acting in good

23  faith if the employee reasonably believes that the information

24  reported or disclosed is true and that a violation has

25  occurred or may occur.

26         (8)  IMPLEMENTATION AND ENFORCEMENT.--

27         (a)  In order to ensure compliance with this section,

28  the agency may inspect and audit books and records of

29  individual or corporate hospitals, including books and records

30  of related organizations with which a health care provider or

31  a hospital had transactions. Upon presentation of a written

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    Florida Senate - 2006                                  SB 1358
    34-682-06




 1  request for inspection to a health care provider or a hospital

 2  by the agency or its staff, the health care provider or the

 3  hospital shall make available to the agency or its staff for

 4  inspection, copying, and review all books and records relevant

 5  to the determination of whether the health care provider or

 6  the hospital has complied with this section.

 7         (b)  Any hospital that refuses to file a report, fails

 8  to timely file a report, files a false report, or files an

 9  incomplete report and, upon notification, fails to timely file

10  a complete report required under this section, or rule adopted

11  thereunder, or that fails to provide documents or records

12  requested by the agency under this section shall be punished

13  by a fine not exceeding $1,000 per day for each day in

14  violation, to be imposed and collected by the agency. Pursuant

15  to rules adopted by the agency, it may, upon a showing of good

16  cause, grant a one-time extension of any deadline for a

17  hospital to timely file a report as required by this section.

18         Section 2.  This act shall take effect upon becoming a

19  law.

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    Florida Senate - 2006                                  SB 1358
    34-682-06




 1            *****************************************

 2                          SENATE SUMMARY

 3    Requires that information concerning nursing care for
      patients be made available to the public. Provides
 4    staffing schedules and patterns. Provides criteria for
      staffing schedules for nursing personnel and a daily
 5    census for patient-care units. Requires each hospital to
      make staffing levels and schedules available to the
 6    public for a certain period of time. Provides that
      records are available to the public upon request.
 7    Requires hospitals to provide quarterly reports. Requires
      that the Agency for Health Care Administration make
 8    certain information regarding nursing personnel available
      to the public on its Internet website. Provides rights
 9    for hospital employees. Authorizes the agency to inspect
      and audit certain books and records of a hospital.
10    Provides a penalty for a hospital's refusal to file a
      report, to timely file a report, to file a false report,
11    to file an incomplete report, or to produce certain
      requested documents or records to the agency. Authorizes
12    the agency to grant an extension of a deadline for a
      hospital to file a report.
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