HB 1605

1	A bill to be entitled
2	An act relating to hospitals; providing a short title;
3	providing legislative findings; providing definitions;
4	providing that information concerning nursing care for
5	patients be made available to the public; providing for
6	staffing schedules and patterns; providing criteria for
7	staffing schedules of nursing personnel and a daily census
8	for patient-care units; requiring each hospital to make
9	staffing levels and schedules available to the public for
10	a certain period of time; requiring that records be made
11	available to the public upon request; requiring hospitals
12	to provide quarterly reports; requiring the Agency for
13	Health Care Administration to make certain information
14	regarding nursing personnel available to the public on its
15	Internet website; providing rights for hospital employees;
16	authorizing the agency to inspect and audit certain books
17	and records of a hospital; providing a penalty for a
18	hospital that refuses to file a report, fails to timely
19	file a report, files a false report, files an incomplete
20	report, or fails to produce certain requested documents or
21	records to the agency; authorizing the agency to grant an
22	extension of a deadline for a hospital to file a report;
23	granting rulemaking authority to the agency; providing an
24	effective date.
25
26	Be It Enacted by the Legislature of the State of Florida:
27
28	Section 1.  (1)  SHORT TITLE.--This section may be cited as
29	the "Patients' Right to Know Act."
30	(2)  LEGISLATIVE FINDINGS.--The Legislature finds that
31	consumers in this state have a right to obtain access to
32	information concerning the quality and safety of the health care
33	provided in Florida hospitals in order to make better decisions
34	about their choice of health care provider.
35	(3)  DEFINITIONS.--As used in this section, the term:
36	(a)  "Agency" means Agency for Health Care Administration.
37	(b)  "Average daily census" means the average number of
38	inpatients receiving services in any given 24-hour period,
39	beginning at midnight, in each clinical service area of the
40	hospital.
41	(c)  "Agency nurse" means any direct-care nurse who is not
42	directly employed by the hospital, who provides care in the
43	hospital, and who is working for purposes of providing
44	supplemental staffing in a hospital.
45	(d)  "Direct-care nurse" means any registered nurse who has
46	direct responsibility to oversee or carry out medical regimens
47	or nursing care for one or more patients. A nurse administrator,
48	nurse supervisor, nurse educator, charge nurse, or other
49	registered nurse who does not have a specific patient assignment
50	may not be included in calculating the staffing level.
51	(e)  "Hospital" means an acute care hospital that is
52	licensed under s. 395.003, Florida Statutes.
53	(f)  "Nurse" means a registered nurse.
54	(g)  "Nursing care" means care that falls within the scope
55	of practice set forth in chapter 464, Florida Statutes, and
56	other laws and rules or care that is otherwise encompassed
57	within recognized professional standards of nursing practice,
58	including assessment, nursing diagnosis, planning, intervention,
59	evaluation, and patient advocacy.
60	(h)  "Retaliate" means to discipline, discharge, suspend,
61	demote, harass, deny employment or promotion, lay off, or take
62	any other adverse action against a direct-care nurse as a result
63	of that nurse's taking any action described in this section.
64	(i)  "Staffing level" means the actual numerical registered
65	nurse-to-patient ratio within a nursing department or unit.
66	(j)  "Unit" means a functional division or area of a
67	hospital in which nursing care is provided.
68	(4)  PUBLIC AVAILABILITY OF STAFFING LEVELS AND
69	SCHEDULES.--
70	(a)  The number of registered professional nurses, licensed
71	practical nurses, and other nursing personnel assigned to each
72	patient-care unit shall be consistent with the types of nursing
73	care needed by the patients and the capabilities of the staff.
74	Patients on each unit shall be evaluated near the end of each
75	change of shift by criteria developed by the hospital. There
76	shall be staffing schedules reflecting the actual nursing
77	personnel required for the hospital and for each patient unit.
78	Staffing patterns must reflect consideration of nursing goals,
79	standards of nursing practice, and the needs of the patients.
80	(b)  The current staffing level and anticipated staffing
81	schedule shall be available upon request for each patient-care
82	unit for the effective date of that schedule. Each schedule must
83	list the assigned nursing personnel and the average daily census
84	for each patient-care unit. The hospital shall retain and make
85	available to the public the historic staffing level and
86	schedules for the prior 5 years.
87	(c)  All records required under this section, including
88	anticipated staffing schedules and the methods to determine and
89	adjust staffing levels, shall be made available to the public
90	upon request.
91	(d)  All records required under this section shall be
92	maintained by the facility for at least 5 years.
93	(5)  HOSPITAL REPORTS.--Each hospital shall prepare a
94	quarterly report that includes the average daily staffing levels
95	by unit, the percentage of nursing hours that are completed by
96	agency nurses by unit, the number and description of OSHA
97	violations, the nurse vacancy rate, the nurse turnover rate, and
98	the number and description of complaints made to the Joint
99	Commission on Accreditation of Healthcare Organizations or to
100	the agency.
101	(6)  AVAILABILITY ONLINE.--The agency shall make available
102	on its Internet website no later than October 1, 2006, and in a
103	hard-copy format upon request, the average daily staffing levels
104	by unit; the percentage of nursing hours that are completed by
105	contract or agency nurses by unit, number, and description of
106	OSHA violations; the number and description of complaints; the
107	vacancy rate; and the turnover rate for each hospital. The
108	website shall also list each hospital's system affiliations if
109	the hospital is affiliated with a nonprofit, for-profit, or
110	public health care system or corporation. Such public data shall
111	be updated quarterly.
112	(7)  EMPLOYEE RIGHTS.--
113	(a)  A hospital may not penalize, discriminate against, or
114	retaliate in any manner against a direct-care nurse for refusing
115	an assignment that would violate requirements set forth in this
116	section.
117	(b)  A hospital may not penalize, discriminate against, or
118	retaliate in any manner against an employee with respect to
119	compensation for, or terms, conditions, or privileges of,
120	employment if such an employee in good faith, individually or in
121	conjunction with another person or persons:
122	1.  Reports a violation or suspected violation of this
123	section to a regulatory agency, a private accreditation body, or
124	management personnel of the hospital;
125	2.  Initiates, cooperates in, or otherwise participates in
126	an investigation or proceeding brought by a regulatory agency or
127	private accreditation body concerning matters covered by this
128	section;
129	3.  Informs or discusses violations or suspected violations
130	of this section with other employees, with any representative of
131	the employees, with a patient or patient representative, or with
132	the public; or
133	4.  Otherwise avails himself or herself of the rights set
134	forth in this section.
135
136	For purposes of this paragraph, an employee is acting in good
137	faith if the employee reasonably believes that the information
138	reported or disclosed is true and that a violation has occurred
139	or may occur.
140	(8)  IMPLEMENTATION AND ENFORCEMENT.--
141	(a)  In order to ensure compliance with this section, the
142	agency may inspect and audit books and records of individual or
143	corporate hospitals, including books and records of related
144	organizations with which a health care provider or a hospital
145	had transactions. Upon presentation of a written request for
146	inspection to a health care provider or a hospital by the agency
147	or its staff, the health care provider or the hospital shall
148	make available to the agency or its staff for inspection,
149	copying, and review all books and records relevant to the
150	determination of whether the health care provider or the
151	hospital has complied with this section.
152	(b)  Any hospital that refuses to file a report, fails to
153	timely file a report, files a false report, or files an
154	incomplete report and, upon notification, fails to timely file a
155	complete report required under this section, or rule adopted
156	thereunder, or that fails to provide documents or records
157	requested by the agency under this section shall be punished by
158	a fine not exceeding $1,000 per day for each day in violation,
159	to be imposed and collected by the agency. Pursuant to rules
160	adopted by the agency, it may, upon a showing of good cause,
161	grant a one-time extension of any deadline for a hospital to
162	timely file a report as required by this section. The agency
163	shall adopt rules to implement the provisions of this paragraph.
164	Section 2.  This act shall take effect upon becoming a law.

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