HB 501

1	A bill to be entitled
2	An act relating to assisted care communities; creating ch.
3	429, F.S.; transferring pt. III of ch. 400, F.S., relating
4	to assisted living facilities, to pt. I of ch. 429, F.S.;
5	transferring pt. VII of ch. 400, F.S., relating to adult
6	family-care homes, to pt. II of ch. 429, F.S.;
7	transferring pt. V of ch. 400, F.S., relating to adult day
8	care centers, to pt. III of ch. 429, F.S.; amending ss.
9	101.655, 189.428, 196.1975, 202.125, 205.1965, 212.031,
10	212.08, 296.02, 381.0035, 381.745, 393.063, 393.506,
11	394.455, 394.4574, 394.463, 400.0063, 400.0069, 400.0073,
12	400.0077, 400.0239, 400.119, 400.141, 400.142, 400.191,
13	400.215, 400.402, 400.404, 400.407, 400.4071, 400.408,
14	400.411, 400.412, 400.414, 400.415, 400.417, 400.4174,
15	400.4176, 400.4178, 400.418, 400.419, 400.42, 400.422,
16	400.424, 400.4255, 400.4256, 400.426, 400.427, 400.428,
17	400.429, 400.4293, 400.431, 400.441, 400.442, 400.444,
18	400.447, 400.452, 400.462, 400.464, 400.497, 400.552,
19	400.555, 400.556, 400.557, 400.5572, 400.601, 400.618,
20	400.6194, 400.621, 400.628, 400.93, 400.962, 400.980,
21	400.9905, 400.9935, 401.23, 402.164, 408.032, 408.033,
22	408.034, 408.07, 408.831, 409.212, 409.221, 409.905,
23	409.906, 409.907, 409.912, 410.031, 410.034, 413.20,
24	415.1111, 419.001, 430.601, 430.703, 435.03, 435.04,
25	440.13, 468.1685, 468.505, 477.025, 483.285, 509.032,
26	509.241, 627.6617, 627.732, 651.011, 651.022, 651.023,
27	651.055, 651.095, 651.118, 765.1103, 765.205, 768.735,
28	893.13, 943.0585, and 943.059, F.S., to conform references
29	to changes made by the act; requesting the Division of
30	Statutory Revision to make necessary conforming changes to
31	the Florida Statutes; providing an effective date.
32
33	Be It Enacted by the Legislature of the State of Florida:
34
35	Section 1.  Chapter 429, Florida Statutes, is created, to
36	be entitled "Assisted Care Communities."
37	Section 2.  Sections 400.401, 400.402, 400.404, 400.407,
38	400.4071, 400.4075, 400.408, 400.411, 400.412, 400.414, 400.415,
39	400.417, 400.4174, 400.4176, 400.4177, 400.4178, 400.418,
40	400.419, 400.4195, 400.42, 400.421, 400.422, 400.423, 400.424,
41	400.4255, 400.4256, 400.426, 400.427, 400.4275, 400.428,
42	400.429, 400.4293, 400.4294, 400.4295, 400.4296, 400.4297,
43	400.4298, 400.431, 400.434, 400.435, 400.441, 400.442, 400.444,
44	400.4445, 400.447, 400.449, 400.451, 400.452, 400.453, and
45	400.454, Florida Statutes, are renumbered as sections 429.01,
46	429.02, 429.04, 429.07, 429.071, 429.075, 429.08, 429.11,
47	429.12, 429.14, 429.15, 429.17, 429.174, 429.176, 429.177,
48	429.178, 429.18, 429.19, 429.195, 429.20, 429.21, 429.22,
49	429.23, 429.24, 429.255, 429.256, 429.26, 429.27, 429.275,
50	429.28, 429.29, 429.293, 429.294, 429.295, 429.296, 429.297,
51	429.298, 429.31, 429.34, 429.35, 429.41, 429.42, 429.44,
52	429.445, 429.47, 429.49, 429.51, 429.52, 429.53, and 429.54,
53	Florida Statutes, respectively, designated as part I of chapter
54	429, Florida Statutes, and entitled "ASSISTED LIVING
55	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, designated as part II of chapter
62	429, Florida Statutes, and entitled "ADULT FAMILY-CARE HOMES."
63	Section 4.  Sections 400.55, 400.551, 400.552, 400.553,
64	400.554, 400.555, 400.556, 400.5565, 400.557, 400.5571,
65	400.5572, 400.5575, 400.558, 400.559, 400.56, 400.562, 400.563,
66	and 400.564, Florida Statutes, are renumbered as sections
67	429.90, 429.901, 429.903, 429.905, 429.907, 429.909, 429.911,
68	429.913, 429.915, 429.917, 429.919, 429.921, 429.923, 429.925,
69	429.927, 429.929, 429.931, and 429.933, Florida Statutes,
70	designated as part III of chapter 429, Florida Statutes, and
71	entitled "ADULT DAY CARE CENTERS."
72	Section 5.  Subsection (1) of section 101.655, Florida
73	Statutes, is amended to read:
74	101.655  Supervised voting by absent electors in certain
75	facilities.--
76	(1)  The supervisor of elections of a county shall provide
77	supervised voting for absent electors residing in any assisted
78	living facility, as defined in s. 429.02 s. 400.402, or nursing
79	home facility, as defined in s. 400.021, within that county at
80	the request of any administrator of such a facility. Such
81	request for supervised voting in the facility shall be made by
82	submitting a written request to the supervisor of elections no
83	later than 21 days prior to the election for which that request
84	is submitted. The request shall specify the name and address of
85	the facility and the name of the electors who wish to vote
86	absentee in that election. If the request contains the names of
87	fewer than five voters, the supervisor of elections is not
88	required to provide supervised voting.
89	Section 6.  Subsection (9) of section 189.428, Florida
90	Statutes, is amended to read:
91	189.428  Special districts; oversight review process.--
92	(9)  This section does not apply to a deepwater port listed
93	in s. 311.09(1) which is in compliance with a port master plan
94	adopted pursuant to s. 163.3178(2)(k), or to an airport
95	authority operating in compliance with an airport master plan
96	approved by the Federal Aviation Administration, or to any
97	special district organized to operate health systems and
98	facilities licensed under chapter 395, or chapter 400, or
99	chapter 429.
100	Section 7.  Paragraph (b) of subsection (2) of section
101	196.1975, Florida Statutes, is amended to read:
102	196.1975  Exemption for property used by nonprofit homes
103	for the aged.--Nonprofit homes for the aged are exempt to the
104	extent that they meet the following criteria:
105	(2)  A facility will not qualify as a "home for the aged"
106	unless at least 75 percent of the occupants are over the age of
107	62 years or totally and permanently disabled.  For homes for the
108	aged which are exempt from paying income taxes to the United
109	States as specified in subsection (1), licensing by the Agency
110	for Health Care Administration is required for ad valorem tax
111	exemption hereunder only if the home:
112	(b)  Qualifies as an assisted living facility under part
113	III of chapter 429 400.
114	Section 8.  Paragraph (c) of subsection (4) of section
115	202.125, Florida Statutes, is amended to read:
116	202.125  Sales of communications services; specified
117	exemptions.--
118	(4)  The sale of communications services to a home for the
119	aged, religious institution or educational institution that is
120	exempt from federal income tax under s. 501(c)(3) of the
121	Internal Revenue Code, or by a religious institution that is
122	exempt from federal income tax under s. 501(c)(3) of the
123	Internal Revenue Code having an established physical place for
124	worship at which nonprofit religious services and activities are
125	regularly conducted and carried on, is exempt from the taxes
126	imposed or administered pursuant to ss. 202.12 and 202.19. As
127	used in this subsection, the term:
128	(c)  "Home for the aged" includes any nonprofit
129	corporation:
130	1.  In which at least 75 percent of the occupants are 62
131	years of age or older or totally and permanently disabled; which
132	qualifies for an ad valorem property tax exemption under s.
133	196.196, s. 196.197, or s. 196.1975; and which is exempt from
134	the sales tax imposed under chapter 212.
135	2.  Licensed as a nursing home under chapter 400 or an
136	assisted living facility under chapter 429 400 and which is
137	exempt from the sales tax imposed under chapter 212.
138	Section 9.  Section 205.1965, Florida Statutes, is amended
139	to read:
140	205.1965  Assisted living facilities.--A county or
141	municipality may not issue an occupational license for the
142	operation of an assisted living facility pursuant to part III of
143	chapter 429 400 without first ascertaining that the applicant
144	has been licensed by the Agency for Health Care Administration
145	to operate such facility at the specified location or locations.
146	The Agency for Health Care Administration shall furnish to
147	local agencies responsible for issuing occupational licenses
148	sufficient instructions for making the above required
149	determinations.
150	Section 10.  Paragraph (b) of subsection (1) of section
151	212.031, Florida Statutes, is amended to read:
152	212.031  Tax on rental or license fee for use of real
153	property.--
154	(1)
155	(b)  When a lease involves multiple use of real property
156	wherein a part of the real property is subject to the tax
157	herein, and a part of the property would be excluded from the
158	tax under subparagraph (a)1., subparagraph (a)2., subparagraph
159	(a)3., or subparagraph (a)5., the department shall determine,
160	from the lease or license and such other information as may be
161	available, that portion of the total rental charge which is
162	exempt from the tax imposed by this section. The portion of the
163	premises leased or rented by a for-profit entity providing a
164	residential facility for the aged will be exempt on the basis of
165	a pro rata portion calculated by combining the square footage of
166	the areas used for residential units by the aged and for the
167	care of such residents and dividing the resultant sum by the
168	total square footage of the rented premises. For purposes of
169	this section, the term "residential facility for the aged" means
170	a facility that is licensed or certified in whole or in part
171	under chapter 400, chapter 429, or chapter 651; or that provides
172	residences to the elderly and is financed by a mortgage or loan
173	made or insured by the United States Department of Housing and
174	Urban Development under s. 202, s. 202 with a s. 8 subsidy, s.
175	221(d)(3) or (4), s. 232, or s. 236 of the National Housing Act;
176	or other such similar facility that provides residences
177	primarily for the elderly.
178	Section 11.  Paragraph (i) of subsection (7) of section
179	212.08, Florida Statutes, is amended to read:
180	212.08  Sales, rental, use, consumption, distribution, and
181	storage tax; specified exemptions.--The sale at retail, the
182	rental, the use, the consumption, the distribution, and the
183	storage to be used or consumed in this state of the following
184	are hereby specifically exempt from the tax imposed by this
185	chapter.
186	(7)  MISCELLANEOUS EXEMPTIONS.--Exemptions provided to any
187	entity by this chapter do not inure to any transaction that is
188	otherwise taxable under this chapter when payment is made by a
189	representative or employee of the entity by any means,
190	including, but not limited to, cash, check, or credit card, even
191	when that representative or employee is subsequently reimbursed
192	by the entity. In addition, exemptions provided to any entity by
193	this subsection do not inure to any transaction that is
194	otherwise taxable under this chapter unless the entity has
195	obtained a sales tax exemption certificate from the department
196	or the entity obtains or provides other documentation as
197	required by the department. Eligible purchases or leases made
198	with such a certificate must be in strict compliance with this
199	subsection and departmental rules, and any person who makes an
200	exempt purchase with a certificate that is not in strict
201	compliance with this subsection and the rules is liable for and
202	shall pay the tax. The department may adopt rules to administer
203	this subsection.
204	(i)  Hospital meals and rooms.--Also exempt from payment of
205	the tax imposed by this chapter on rentals and meals are
206	patients and inmates of any hospital or other physical plant or
207	facility designed and operated primarily for the care of persons
208	who are ill, aged, infirm, mentally or physically incapacitated,
209	or otherwise dependent on special care or attention. Residents
210	of a home for the aged are exempt from payment of taxes on meals
211	provided through the facility.  A home for the aged is defined
212	as a facility that is licensed or certified in part or in whole
213	under chapter 400, chapter 429, or chapter 651, or that is
214	financed by a mortgage loan made or insured by the United States
215	Department of Housing and Urban Development under s. 202, s. 202
216	with a s. 8 subsidy, s. 221(d)(3) or (4), s. 232, or s. 236 of
217	the National Housing Act, or other such similar facility
218	designed and operated primarily for the care of the aged.
219	Section 12.  Subsection (5) of section 296.02, Florida
220	Statutes, is amended to read:
221	296.02  Definitions.--For the purposes of this part, except
222	where the context clearly indicates otherwise:
223	(5)  "Extended congregate care" has the meaning given to
224	that term under s. 429.02 s. 400.402.
225	Section 13.  Subsections (1) and (3) of section 381.0035,
226	Florida Statutes, are amended to read:
227	381.0035  Educational course on HIV and AIDS; employees and
228	clients of certain health care facilities.--
229	(1)  The Department of Health shall require all employees
230	and clients of facilities licensed under chapters 393, 394, and
231	397 and employees of facilities licensed under chapter 395, and
232	parts II, III, and IV, and VI of chapter 400, and part I of
233	chapter 429 to complete, biennially, a continuing educational
234	course on the modes of transmission, infection control
235	procedures, clinical management, and prevention of human
236	immunodeficiency virus and acquired immune deficiency syndrome
237	with an emphasis on appropriate behavior and attitude change.
238	Such instruction shall include information on current Florida
239	law and its impact on testing, confidentiality of test results,
240	and treatment of patients and any protocols and procedures
241	applicable to human immunodeficiency counseling and testing,
242	reporting, the offering of HIV testing to pregnant women, and
243	partner notification issues pursuant to ss. 381.004 and 384.25.
244	(3)  Facilities licensed under chapters 393, 394, 395, and
245	397, and parts II, III, and IV, and VI of chapter 400, and part
246	I of chapter 429 shall maintain a record of employees and dates
247	of attendance at human immunodeficiency virus and acquired
248	immune deficiency syndrome educational courses.
249	Section 14.  Subsection (9) of section 381.745, Florida
250	Statutes, is amended to read:
251	381.745  Definitions; ss. 381.739-381.79.--As used in ss.
252	381.739-381.79, the term:
253	(9)  "Transitional living facility" means a state-approved
254	facility, as defined and licensed under chapter 400 or chapter
255	429, or a facility approved by the brain and spinal cord injury
256	program in accordance with this chapter.
257	Section 15.  Subsection (24) of section 393.063, Florida
258	Statutes, is amended to read:
259	393.063  Definitions.--For the purposes of this chapter:
260	(24)  "Intermediate care facility for the developmentally
261	disabled" or "ICF/DD" means a residential facility licensed and
262	certified pursuant to part VIII XI of chapter 400.
263	Section 16.  Paragraph (b) of subsection (1) of section
264	393.506, Florida Statutes, is amended to read:
265	393.506  Administration of medication.--
266	(1)  Notwithstanding the provisions of part I of chapter
267	464, the Nurse Practice Act, unlicensed direct care services
268	staff providing services to persons with developmental
269	disabilities may administer oral, transdermal, inhaled, or
270	topical prescription medications as provided in this section.
271	(b)  For intermediate care facilities for the
272	developmentally disabled licensed pursuant to part VIII XI of
273	chapter 400, unlicensed staff designated by the director may
274	provide medication assistance under the general supervision of a
275	registered nurse licensed pursuant to chapter 464.
276	Section 17.  Subsection (10) of section 394.455, Florida
277	Statutes, is amended to read:
278	394.455  Definitions.--As used in this part, unless the
279	context clearly requires otherwise, the term:
280	(10)  "Facility" means any hospital, community facility,
281	public or private facility, or receiving or treatment facility
282	providing for the evaluation, diagnosis, care, treatment,
283	training, or hospitalization of persons who appear to have a
284	mental illness or have been diagnosed as having a mental
285	illness.  "Facility" does not include any program or entity
286	licensed pursuant to chapter 400 or chapter 429.
287	Section 18.  Paragraphs (b), (c), and (e) of subsection (2)
288	of section 394.4574, Florida Statutes, are amended to read:
289	394.4574  Department responsibilities for a mental health
290	resident who resides in an assisted living facility that holds a
291	limited mental health license.--
292	(2)  The department must ensure that:
293	(b)  A cooperative agreement, as required in s. 429.075 s.
294	400.4075, is developed between the mental health care services
295	provider that serves a mental health resident and the
296	administrator of the assisted living facility with a limited
297	mental health license in which the mental health resident is
298	living. Any entity that provides Medicaid prepaid health plan
299	services shall ensure the appropriate coordination of health
300	care services with an assisted living facility in cases where a
301	Medicaid recipient is both a member of the entity's prepaid
302	health plan and a resident of the assisted living facility. If
303	the entity is at risk for Medicaid targeted case management and
304	behavioral health services, the entity shall inform the assisted
305	living facility of the procedures to follow should an emergent
306	condition arise.
307	(c)  The community living support plan, as defined in s.
308	429.02 s. 400.402, has been prepared by a mental health resident
309	and a mental health case manager of that resident in
310	consultation with the administrator of the facility or the
311	administrator's designee. The plan must be provided to the
312	administrator of the assisted living facility with a limited
313	mental health license in which the mental health resident lives.
314	The support plan and the agreement may be in one document.
315	(e)  The mental health services provider assigns a case
316	manager to each mental health resident who lives in an assisted
317	living facility with a limited mental health license. The case
318	manager is responsible for coordinating the development of and
319	implementation of the community living support plan defined in
320	s. 429.02 s. 400.402. The plan must be updated at least
321	annually.
322	Section 19.  Paragraph (b) of subsection (2) of section
323	394.463, Florida Statutes, is amended to read:
324	394.463  Involuntary examination.--
325	(2)  INVOLUNTARY EXAMINATION.--
326	(b)  A person shall not be removed from any program or
327	residential placement licensed under chapter 400 or chapter 429
328	and transported to a receiving facility for involuntary
329	examination unless an ex parte order, a professional
330	certificate, or a law enforcement officer's report is first
331	prepared.  If the condition of the person is such that
332	preparation of a law enforcement officer's report is not
333	practicable before removal, the report shall be completed as
334	soon as possible after removal, but in any case before the
335	person is transported to a receiving facility.  A receiving
336	facility admitting a person for involuntary examination who is
337	not accompanied by the required ex parte order, professional
338	certificate, or law enforcement officer's report shall notify
339	the Agency for Health Care Administration of such admission by
340	certified mail no later than the next working day.  The
341	provisions of this paragraph do not apply when transportation is
342	provided by the patient's family or guardian.
343	Section 20.  Paragraph (b) of subsection (3) of section
344	400.0063, Florida Statutes, is amended to read:
345	400.0063  Establishment of Office of State Long-Term Care
346	Ombudsman; designation of ombudsman and legal advocate.--
347	(3)
348	(b)  The duties of the legal advocate shall include, but
349	not be limited to:
350	1.  Assisting the ombudsman in carrying out the duties of
351	the office with respect to the abuse, neglect, or violation of
352	rights of residents of long-term care facilities.
353	2.  Assisting the state and local ombudsman councils in
354	carrying out their responsibilities under this part.
355	3.  Initiating and prosecuting legal and equitable actions
356	to enforce the rights of long-term care facility residents as
357	defined in this chapter or chapter 429.
358	4.  Serving as legal counsel to the state and local
359	ombudsman councils, or individual members thereof, against whom
360	any suit or other legal action is initiated in connection with
361	the performance of the official duties of the councils or an
362	individual member.
363	Section 21.  Subsection (3) of section 400.0069, Florida
364	Statutes, is amended to read:
365	400.0069  Local long-term care ombudsman councils; duties;
366	membership.--
367	(3)  In order to carry out the duties specified in
368	subsection (2), the local ombudsman council is authorized,
369	pursuant to ss. 400.19(1) and 429.34 400.434, to enter any long-
370	term care facility without notice or first obtaining a warrant,
371	subject to the provisions of s. 400.0073(5).
372	Section 22.  Paragraphs (c) and (f) of subsection (5) and
373	subsection (6) of section 400.0073, Florida Statutes, are
374	amended to read:
375	400.0073  State and local ombudsman council
376	investigations.--
377	(5)  Any onsite administrative inspection conducted by an
378	ombudsman council shall be subject to the following:
379	(c)  Inspections shall be conducted in a manner which will
380	impose no unreasonable burden on nursing homes or long-term care
381	facilities, consistent with the underlying purposes of this part
382	and chapter 429. Unnecessary duplication of efforts among
383	council members or the councils shall be reduced to the extent
384	possible.
385	(f)  All inspections shall be limited to compliance with
386	part parts II, III, and VII of this chapter, chapter 429, and 42
387	U.S.C. ss. 1396(a) et seq., and any rules or regulations
388	promulgated pursuant to such laws.
389	(6)  An inspection may not be accomplished by forcible
390	entry. Refusal of a long-term care facility to allow entry of
391	any ombudsman council member constitutes a violation of part II,
392	part III, or part VII of this chapter or chapter 429.
393	Section 23.  Subsection (4) of section 400.0077, Florida
394	Statutes, is amended to read:
395	400.0077  Confidentiality.--
396	(4)  Members of any state or local ombudsman council shall
397	not be required to testify in any court with respect to matters
398	held to be confidential under s. 429.14 s. 400.414 except as may
399	be necessary to enforce the provisions of this act.
400	Section 24.  Subsection (1) of section 400.0239, Florida
401	Statutes, is amended to read:
402	400.0239  Quality of Long-Term Care Facility Improvement
403	Trust Fund.--
404	(1)  There is created within the Agency for Health Care
405	Administration a Quality of Long-Term Care Facility Improvement
406	Trust Fund to support activities and programs directly related
407	to improvement of the care of nursing home and assisted living
408	facility residents. The trust fund shall be funded through
409	proceeds generated pursuant to ss. 400.0238 and 429.298
410	400.4298, through funds specifically appropriated by the
411	Legislature, through gifts, endowments, and other charitable
412	contributions allowed under federal and state law, and through
413	federal nursing home civil monetary penalties collected by the
414	Centers for Medicare and Medicaid Services and returned to the
415	state. These funds must be utilized in accordance with federal
416	requirements.
417	Section 25.  Subsections (1) and (4) of section 400.119,
418	Florida Statutes, are amended to read:
419	400.119  Confidentiality of records and meetings of risk
420	management and quality assurance committees.--
421	(1)  Records of meetings of the risk management and quality
422	assurance committee of a long-term care facility licensed under
423	this part or part I III of this chapter 429, as well as incident
424	reports filed with the facility's risk manager and
425	administrator, notifications of the occurrence of an adverse
426	incident, and adverse incident reports from the facility are
427	confidential and exempt from s. 119.07(1) and s. 24(a), Art. I
428	of the State Constitution. However, if the Agency for Health
429	Care Administration has a reasonable belief that conduct by a
430	staff member or employee of a facility is criminal activity or
431	grounds for disciplinary action by a regulatory board, the
432	agency may disclose such records to the appropriate law
433	enforcement agency or regulatory board.
434	(4)  The meetings of an internal risk management and
435	quality assurance committee of a long-term care facility
436	licensed under this part or part I III of this chapter 429 are
437	exempt from s. 286.011 and s. 24(b), Art. I of the State
438	Constitution and are not open to the public.
439	Section 26.  Subsections (4) and (7) of section 400.141,
440	Florida Statutes, are amended to read:
441	400.141  Administration and management of nursing home
442	facilities.--Every licensed facility shall comply with all
443	applicable standards and rules of the agency and shall:
444	(4)  Provide for resident use of a community pharmacy as
445	specified in s. 400.022(1)(q). Any other law to the contrary
446	notwithstanding, a registered pharmacist licensed in Florida,
447	that is under contract with a facility licensed under this
448	chapter or chapter 429, shall repackage a nursing facility
449	resident's bulk prescription medication which has been packaged
450	by another pharmacist licensed in any state in the United States
451	into a unit dose system compatible with the system used by the
452	nursing facility, if the pharmacist is requested to offer such
453	service. In order to be eligible for the repackaging, a resident
454	or the resident's spouse must receive prescription medication
455	benefits provided through a former employer as part of his or
456	her retirement benefits, a qualified pension plan as specified
457	in s. 4972 of the Internal Revenue Code, a federal retirement
458	program as specified under 5 C.F.R. s. 831, or a long-term care
459	policy as defined in s. 627.9404(1). A pharmacist who correctly
460	repackages and relabels the medication and the nursing facility
461	which correctly administers such repackaged medication under the
462	provisions of this subsection shall not be held liable in any
463	civil or administrative action arising from the repackaging. In
464	order to be eligible for the repackaging, a nursing facility
465	resident for whom the medication is to be repackaged shall sign
466	an informed consent form provided by the facility which includes
467	an explanation of the repackaging process and which notifies the
468	resident of the immunities from liability provided herein. A
469	pharmacist who repackages and relabels prescription medications,
470	as authorized under this subsection, may charge a reasonable fee
471	for costs resulting from the implementation of this provision.
472	(7)  If the facility has a standard license or is a Gold
473	Seal facility, exceeds the minimum required hours of licensed
474	nursing and certified nursing assistant direct care per resident
475	per day, and is part of a continuing care facility licensed
476	under chapter 651 or a retirement community that offers other
477	services pursuant to part III of this chapter or chapter 429,
478	part IV, or part V on a single campus, be allowed to share
479	programming and staff. At the time of inspection and in the
480	semiannual report required pursuant to subsection (15), a
481	continuing care facility or retirement community that uses this
482	option must demonstrate through staffing records that minimum
483	staffing requirements for the facility were met. Licensed nurses
484	and certified nursing assistants who work in the nursing home
485	facility may be used to provide services elsewhere on campus if
486	the facility exceeds the minimum number of direct care hours
487	required per resident per day and the total number of residents
488	receiving direct care services from a licensed nurse or a
489	certified nursing assistant does not cause the facility to
490	violate the staffing ratios required under s. 400.23(3)(a).
491	Compliance with the minimum staffing ratios shall be based on
492	total number of residents receiving direct care services,
493	regardless of where they reside on campus. If the facility
494	receives a conditional license, it may not share staff until the
495	conditional license status ends. This subsection does not
496	restrict the agency's authority under federal or state law to
497	require additional staff if a facility is cited for deficiencies
498	in care which are caused by an insufficient number of certified
499	nursing assistants or licensed nurses. The agency may adopt
500	rules for the documentation necessary to determine compliance
501	with this provision.
502
503	Facilities that have been awarded a Gold Seal under the program
504	established in s. 400.235 may develop a plan to provide
505	certified nursing assistant training as prescribed by federal
506	regulations and state rules and may apply to the agency for
507	approval of their program.
508	Section 27.  Subsection (1) of section 400.142, Florida
509	Statutes, is amended to read:
510	400.142  Emergency medication kits; orders not to
511	resuscitate.--
512	(1)  Other provisions of this chapter or of chapter 429,
513	chapter 465, chapter 499, or chapter 893 to the contrary
514	notwithstanding, each nursing home operating pursuant to a
515	license issued by the agency may maintain an emergency
516	medication kit for the purpose of storing medicinal drugs to be
517	administered under emergency conditions to residents residing in
518	such facility.
519	Section 28.  Paragraph (a) of subsection (2) of section
520	400.191, Florida Statutes, is amended to read:
521	400.191  Availability, distribution, and posting of reports
522	and records.--
523	(2)  The agency shall provide additional information in
524	consumer-friendly printed and electronic formats to assist
525	consumers and their families in comparing and evaluating nursing
526	home facilities.
527	(a)  The agency shall provide an Internet site which shall
528	include at least the following information either directly or
529	indirectly through a link to another established site or sites
530	of the agency's choosing:
531	1.  A list by name and address of all nursing home
532	facilities in this state.
533	2.  Whether such nursing home facilities are proprietary or
534	nonproprietary.
535	3.  The current owner of the facility's license and the
536	year that that entity became the owner of the license.
537	4.  The name of the owner or owners of each facility and
538	whether the facility is affiliated with a company or other
539	organization owning or managing more than one nursing facility
540	in this state.
541	5.  The total number of beds in each facility.
542	6.  The number of private and semiprivate rooms in each
543	facility.
544	7.  The religious affiliation, if any, of each facility.
545	8.  The languages spoken by the administrator and staff of
546	each facility.
547	9.  Whether or not each facility accepts Medicare or
548	Medicaid recipients or insurance, health maintenance
549	organization, Veterans Administration, CHAMPUS program, or
550	workers' compensation coverage.
551	10.  Recreational and other programs available at each
552	facility.
553	11.  Special care units or programs offered at each
554	facility.
555	12.  Whether the facility is a part of a retirement
556	community that offers other services pursuant to part III of
557	this chapter or part I or part III of chapter 429, part IV, or
558	part V.
559	13.  Survey and deficiency information contained on the
560	Online Survey Certification and Reporting (OSCAR) system of the
561	federal Health Care Financing Administration, including annual
562	survey, revisit, and complaint survey information, for each
563	facility for the past 45 months.  For noncertified nursing
564	homes, state survey and deficiency information, including annual
565	survey, revisit, and complaint survey information for the past
566	45 months shall be provided.
567	14.  A summary of the Online Survey Certification and
568	Reporting (OSCAR) data for each facility over the past 45
569	months. Such summary may include a score, rating, or comparison
570	ranking with respect to other facilities based on the number of
571	citations received by the facility of annual, revisit, and
572	complaint surveys; the severity and scope of the citations; and
573	the number of annual recertification surveys the facility has
574	had during the past 45 months. The score, rating, or comparison
575	ranking may be presented in either numeric or symbolic form for
576	the intended consumer audience.
577	Section 29.  Paragraph (b) of subsection (2) of section
578	400.215, Florida Statutes, is amended to read:
579	400.215  Personnel screening requirement.--
580	(2)  Employers and employees shall comply with the
581	requirements of s. 435.05.
582	(b)  Employees qualified under the provisions of paragraph
583	(a) who have not maintained continuous residency within the
584	state for the 5 years immediately preceding the date of request
585	for background screening must complete level 2 screening, as
586	provided in chapter 435. Such employees may work in a
587	conditional status up to 180 days pending the receipt of written
588	findings evidencing the completion of level 2 screening. Level 2
589	screening shall not be required of employees or prospective
590	employees who attest in writing under penalty of perjury that
591	they meet the residency requirement. Completion of level 2
592	screening shall require the employee or prospective employee to
593	furnish to the nursing facility a full set of fingerprints to
594	enable a criminal background investigation to be conducted. The
595	nursing facility shall submit the completed fingerprint card to
596	the agency. The agency shall establish a record of the request
597	in the database provided for in paragraph (c) and forward the
598	request to the Department of Law Enforcement, which is
599	authorized to submit the fingerprints to the Federal Bureau of
600	Investigation for a national criminal history records check. The
601	results of the national criminal history records check shall be
602	returned to the agency, which shall maintain the results in the
603	database provided for in paragraph (c). The agency shall notify
604	the administrator of the requesting nursing facility or the
605	administrator of any other facility licensed under chapter 393,
606	chapter 394, chapter 395, chapter 397, chapter 429, or this
607	chapter, as requested by such facility, as to whether or not the
608	employee has qualified under level 1 or level 2 screening. An
609	employee or prospective employee who has qualified under level 2
610	screening and has maintained such continuous residency within
611	the state shall not be required to complete a subsequent level 2
612	screening as a condition of employment at another facility.
613	Section 30.  Section 400.402, Florida Statutes, is
614	renumbered as section 429.02, Florida Statutes, and amended to
615	read:
616	429.02 400.402  Definitions.--When used in this part, the
617	term:
618	(1)  "Activities of daily living" means functions and tasks
619	for self-care, including ambulation, bathing, dressing, eating,
620	grooming, and toileting, and other similar tasks.
621	(2)  "Administrator" means an individual at least 21 years
622	of age who is responsible for the operation and maintenance of
623	an assisted living facility.
624	(3)  "Agency" means the Agency for Health Care
625	Administration.
626	(4)  "Aging in place" or "age in place" means the process
627	of providing increased or adjusted services to a person to
628	compensate for the physical or mental decline that may occur
629	with the aging process, in order to maximize the person's
630	dignity and independence and permit them to remain in a
631	familiar, noninstitutional, residential environment for as long
632	as possible. Such services may be provided by facility staff,
633	volunteers, family, or friends, or through contractual
634	arrangements with a third party.
635	(5)  "Applicant" means an individual owner, corporation,
636	partnership, firm, association, or governmental entity that
637	applies for a license.
638	(6)  "Assisted living facility" means any building or
639	buildings, section or distinct part of a building, private home,
640	boarding home, home for the aged, or other residential facility,
641	whether operated for profit or not, which undertakes through its
642	ownership or management to provide housing, meals, and one or
643	more personal services for a period exceeding 24 hours to one or
644	more adults who are not relatives of the owner or administrator.
645	(7)  "Chemical restraint" means a pharmacologic drug that
646	physically limits, restricts, or deprives an individual of
647	movement or mobility, and is used for discipline or convenience
648	and not required for the treatment of medical symptoms.
649	(8)  "Community living support plan" means a written
650	document prepared by a mental health resident and the resident's
651	mental health case manager in consultation with the
652	administrator of an assisted living facility with a limited
653	mental health license or the administrator's designee. A copy
654	must be provided to the administrator. The plan must include
655	information about the supports, services, and special needs of
656	the resident which enable the resident to live in the assisted
657	living facility and a method by which facility staff can
658	recognize and respond to the signs and symptoms particular to
659	that resident which indicate the need for professional services.
660	(9)  "Cooperative agreement" means a written statement of
661	understanding between a mental health care provider and the
662	administrator of the assisted living facility with a limited
663	mental health license in which a mental health resident is
664	living. The agreement must specify directions for accessing
665	emergency and after-hours care for the mental health resident. A
666	single cooperative agreement may service all mental health
667	residents who are clients of the same mental health care
668	provider.
669	(10)  "Department" means the Department of Elderly Affairs.
670	(11)  "Emergency" means a situation, physical condition, or
671	method of operation which presents imminent danger of death or
672	serious physical or mental harm to facility residents.
673	(12)  "Extended congregate care" means acts beyond those
674	authorized in subsection (17) that may be performed pursuant to
675	part I of chapter 464 by persons licensed thereunder while
676	carrying out their professional duties, and other supportive
677	services which may be specified by rule.  The purpose of such
678	services is to enable residents to age in place in a residential
679	environment despite mental or physical limitations that might
680	otherwise disqualify them from residency in a facility licensed
681	under this part.
682	(13)  "Guardian" means a person to whom the law has
683	entrusted the custody and control of the person or property, or
684	both, of a person who has been legally adjudged incapacitated.
685	(14)  "Limited nursing services" means acts that may be
686	performed pursuant to part I of chapter 464 by persons licensed
687	thereunder while carrying out their professional duties but
688	limited to those acts which the department specifies by rule.
689	Acts which may be specified by rule as allowable limited nursing
690	services shall be for persons who meet the admission criteria
691	established by the department for assisted living facilities and
692	shall not be complex enough to require 24-hour nursing
693	supervision and may include such services as the application and
694	care of routine dressings, and care of casts, braces, and
695	splints.
696	(15)  "Managed risk" means the process by which the
697	facility staff discuss the service plan and the needs of the
698	resident with the resident and, if applicable, the resident's
699	representative or designee or the resident's surrogate,
700	guardian, or attorney in fact, in such a way that the
701	consequences of a decision, including any inherent risk, are
702	explained to all parties and reviewed periodically in
703	conjunction with the service plan, taking into account changes
704	in the resident's status and the ability of the facility to
705	respond accordingly.
706	(16)  "Mental health resident" means an individual who
707	receives social security disability income due to a mental
708	disorder as determined by the Social Security Administration or
709	receives supplemental security income due to a mental disorder
710	as determined by the Social Security Administration and receives
711	optional state supplementation.
712	(17)  "Personal services" means direct physical assistance
713	with or supervision of the activities of daily living and the
714	self-administration of medication and other similar services
715	which the department may define by rule.  "Personal services"
716	shall not be construed to mean the provision of medical,
717	nursing, dental, or mental health services.
718	(18)  "Physical restraint" means a device which physically
719	limits, restricts, or deprives an individual of movement or
720	mobility, including, but not limited to, a half-bed rail, a
721	full-bed rail, a geriatric chair, and a posey restraint. The
722	term "physical restraint" shall also include any device which
723	was not specifically manufactured as a restraint but which has
724	been altered, arranged, or otherwise used for this purpose. The
725	term shall not include bandage material used for the purpose of
726	binding a wound or injury.
727	(19)  "Relative" means an individual who is the father,
728	mother, stepfather, stepmother, son, daughter, brother, sister,
729	grandmother, grandfather, great-grandmother, great-grandfather,
730	grandson, granddaughter, uncle, aunt, first cousin, nephew,
731	niece, husband, wife, father-in-law, mother-in-law, son-in-law,
732	daughter-in-law, brother-in-law, sister-in-law, stepson,
733	stepdaughter, stepbrother, stepsister, half brother, or half
734	sister of an owner or administrator.
735	(20)  "Resident" means a person 18 years of age or older,
736	residing in and receiving care from a facility.
737	(21)  "Resident's representative or designee" means a
738	person other than the owner, or an agent or employee of the
739	facility, designated in writing by the resident, if legally
740	competent, to receive notice of changes in the contract executed
741	pursuant to s. 429.24 s. 400.424; to receive notice of and to
742	participate in meetings between the resident and the facility
743	owner, administrator, or staff concerning the rights of the
744	resident; to assist the resident in contacting the ombudsman
745	council if the resident has a complaint against the facility; or
746	to bring legal action on behalf of the resident pursuant to s.
747	429.29 s. 400.429.
748	(22)  "Service plan" means a written plan, developed and
749	agreed upon by the resident and, if applicable, the resident's
750	representative or designee or the resident's surrogate,
751	guardian, or attorney in fact, if any, and the administrator or
752	designee representing the facility, which addresses the unique
753	physical and psychosocial needs, abilities, and personal
754	preferences of each resident receiving extended congregate care
755	services. The plan shall include a brief written description, in
756	easily understood language, of what services shall be provided,
757	who shall provide the services, when the services shall be
758	rendered, and the purposes and benefits of the services.
759	(23)  "Shared responsibility" means exploring the options
760	available to a resident within a facility and the risks involved
761	with each option when making decisions pertaining to the
762	resident's abilities, preferences, and service needs, thereby
763	enabling the resident and, if applicable, the resident's
764	representative or designee, or the resident's surrogate,
765	guardian, or attorney in fact, and the facility to develop a
766	service plan which best meets the resident's needs and seeks to
767	improve the resident's quality of life.
768	(24)  "Supervision" means reminding residents to engage in
769	activities of daily living and the self-administration of
770	medication, and, when necessary, observing or providing verbal
771	cuing to residents while they perform these activities.
772	(25)  "Supplemental security income," Title XVI of the
773	Social Security Act, means a program through which the Federal
774	Government guarantees a minimum monthly income to every person
775	who is age 65 or older, or disabled, or blind and meets the
776	income and asset requirements.
777	(26)  "Supportive services" means services designed to
778	encourage and assist aged persons or adults with disabilities to
779	remain in the least restrictive living environment and to
780	maintain their independence as long as possible.
781	(27)  "Twenty-four-hour nursing supervision" means services
782	that are ordered by a physician for a resident whose condition
783	requires the supervision of a physician and continued monitoring
784	of vital signs and physical status.  Such services shall be:
785	medically complex enough to require constant supervision,
786	assessment, planning, or intervention by a nurse; required to be
787	performed by or under the direct supervision of licensed nursing
788	personnel or other professional personnel for safe and effective
789	performance; required on a daily basis; and consistent with the
790	nature and severity of the resident's condition or the disease
791	state or stage.
792	Section 31.  Section 400.404, Florida Statutes, is
793	renumbered as section 429.04, Florida Statutes, and amended to
794	read:
795	429.04 400.404  Facilities to be licensed; exemptions.--
796	(1)  For the administration of this part, facilities to be
797	licensed by the agency shall include all assisted living
798	facilities as defined in this part.
799	(2)  The following are exempt from licensure under this
800	part:
801	(a)  Any facility, institution, or other place operated by
802	the Federal Government or any agency of the Federal Government.
803	(b)  Any facility or part of a facility licensed under
804	chapter 393 or chapter 394.
805	(c)  Any facility licensed as an adult family-care home
806	under part II of chapter 429 VII.
807	(d)  Any person who provides housing, meals, and one or
808	more personal services on a 24-hour basis in the person's own
809	home to not more than two adults who do not receive optional
810	state supplementation. The person who provides the housing,
811	meals, and personal services must own or rent the home and
812	reside therein.
813	(e)  Any home or facility approved by the United States
814	Department of Veterans Affairs as a residential care home
815	wherein care is provided exclusively to three or fewer veterans.
816	(f)  Any facility that has been incorporated in this state
817	for 50 years or more on or before July 1, 1983, and the board of
818	directors of which is nominated or elected by the residents,
819	until the facility is sold or its ownership is transferred; or
820	any facility, with improvements or additions thereto, which has
821	existed and operated continuously in this state for 60 years or
822	more on or before July 1, 1989, is directly or indirectly owned
823	and operated by a nationally recognized fraternal organization,
824	is not open to the public, and accepts only its own members and
825	their spouses as residents.
826	(g)  Any facility certified under chapter 651, or a
827	retirement community, may provide services authorized under this
828	part or part III IV of this chapter 400 to its residents who
829	live in single-family homes, duplexes, quadruplexes, or
830	apartments located on the campus without obtaining a license to
831	operate an assisted living facility if residential units within
832	such buildings are used by residents who do not require staff
833	supervision for that portion of the day when personal services
834	are not being delivered and the owner obtains a home health
835	license to provide such services.  However, any building or
836	distinct part of a building on the campus that is designated for
837	persons who receive personal services and require supervision
838	beyond that which is available while such services are being
839	rendered must be licensed in accordance with this part. If a
840	facility provides personal services to residents who do not
841	otherwise require supervision and the owner is not licensed as a
842	home health agency, the buildings or distinct parts of buildings
843	where such services are rendered must be licensed under this
844	part. A resident of a facility that obtains a home health
845	license may contract with a home health agency of his or her
846	choice, provided that the home health agency provides liability
847	insurance and workers' compensation coverage for its employees.
848	Facilities covered by this exemption may establish policies that
849	give residents the option of contracting for services and care
850	beyond that which is provided by the facility to enable them to
851	age in place.  For purposes of this section, a retirement
852	community consists of a facility licensed under this part or
853	under part II of chapter 400, and apartments designed for
854	independent living located on the same campus.
855	(h)  Any residential unit for independent living which is
856	located within a facility certified under chapter 651, or any
857	residential unit which is colocated with a nursing home licensed
858	under part II of chapter 400 or colocated with a facility
859	licensed under this part in which services are provided through
860	an outpatient clinic or a nursing home on an outpatient basis.
861	Section 32.  Section 400.407, Florida Statutes, is
862	renumbered as section 429.07, Florida Statutes, and amended to
863	read:
864	429.07 400.407  License required; fee, display.--
865	(1)  A license issued by the agency is required for an
866	assisted living facility operating in this state.
867	(2)  Separate licenses shall be required for facilities
868	maintained in separate premises, even though operated under the
869	same management.  A separate license shall not be required for
870	separate buildings on the same grounds.
871	(3)  Any license granted by the agency must state the
872	maximum resident capacity of the facility, the type of care for
873	which the license is granted, the date the license is issued,
874	the expiration date of the license, and any other information
875	deemed necessary by the agency. Licenses shall be issued for one
876	or more of the following categories of care: standard, extended
877	congregate care, limited nursing services, or limited mental
878	health.
879	(a)  A standard license shall be issued to facilities
880	providing one or more of the personal services identified in s.
881	429.02 s. 400.402. Such facilities may also employ or contract
882	with a person licensed under part I of chapter 464 to administer
883	medications and perform other tasks as specified in s. 429.255
884	s. 400.4255.
885	(b)  An extended congregate care license shall be issued to
886	facilities providing, directly or through contract, services
887	beyond those authorized in paragraph (a), including acts
888	performed pursuant to part I of chapter 464 by persons licensed
889	thereunder, and supportive services defined by rule to persons
890	who otherwise would be disqualified from continued residence in
891	a facility licensed under this part.
892	1.  In order for extended congregate care services to be
893	provided in a facility licensed under this part, the agency must
894	first determine that all requirements established in law and
895	rule are met and must specifically designate, on the facility's
896	license, that such services may be provided and whether the
897	designation applies to all or part of a facility.  Such
898	designation may be made at the time of initial licensure or
899	relicensure, or upon request in writing by a licensee under this
900	part. Notification of approval or denial of such request shall
901	be made within 90 days after receipt of such request and all
902	necessary documentation. Existing facilities qualifying to
903	provide extended congregate care services must have maintained a
904	standard license and may not have been subject to administrative
905	sanctions during the previous 2 years, or since initial
906	licensure if the facility has been licensed for less than 2
907	years, for any of the following reasons:
908	a.  A class I or class II violation;
909	b.  Three or more repeat or recurring class III violations
910	of identical or similar resident care standards as specified in
911	rule from which a pattern of noncompliance is found by the
912	agency;
913	c.  Three or more class III violations that were not
914	corrected in accordance with the corrective action plan approved
915	by the agency;
916	d.  Violation of resident care standards resulting in a
917	requirement to employ the services of a consultant pharmacist or
918	consultant dietitian;
919	e.  Denial, suspension, or revocation of a license for
920	another facility under this part in which the applicant for an
921	extended congregate care license has at least 25 percent
922	ownership interest; or
923	f.  Imposition of a moratorium on admissions or initiation
924	of injunctive proceedings.
925	2.  Facilities that are licensed to provide extended
926	congregate care services shall maintain a written progress
927	report on each person who receives such services, which report
928	describes the type, amount, duration, scope, and outcome of
929	services that are rendered and the general status of the
930	resident's health.  A registered nurse, or appropriate designee,
931	representing the agency shall visit such facilities at least
932	quarterly to monitor residents who are receiving extended
933	congregate care services and to determine if the facility is in
934	compliance with this part and with rules that relate to extended
935	congregate care. One of these visits may be in conjunction with
936	the regular survey.  The monitoring visits may be provided
937	through contractual arrangements with appropriate community
938	agencies.  A registered nurse shall serve as part of the team
939	that inspects such facility. The agency may waive one of the
940	required yearly monitoring visits for a facility that has been
941	licensed for at least 24 months to provide extended congregate
942	care services, if, during the inspection, the registered nurse
943	determines that extended congregate care services are being
944	provided appropriately, and if the facility has no class I or
945	class II violations and no uncorrected class III violations.
946	Before such decision is made, the agency shall consult with the
947	long-term care ombudsman council for the area in which the
948	facility is located to determine if any complaints have been
949	made and substantiated about the quality of services or care.
950	The agency may not waive one of the required yearly monitoring
951	visits if complaints have been made and substantiated.
952	3.  Facilities that are licensed to provide extended
953	congregate care services shall:
954	a.  Demonstrate the capability to meet unanticipated
955	resident service needs.
956	b.  Offer a physical environment that promotes a homelike
957	setting, provides for resident privacy, promotes resident
958	independence, and allows sufficient congregate space as defined
959	by rule.
960	c.  Have sufficient staff available, taking into account
961	the physical plant and firesafety features of the building, to
962	assist with the evacuation of residents in an emergency, as
963	necessary.
964	d.  Adopt and follow policies and procedures that maximize
965	resident independence, dignity, choice, and decisionmaking to
966	permit residents to age in place to the extent possible, so that
967	moves due to changes in functional status are minimized or
968	avoided.
969	e.  Allow residents or, if applicable, a resident's
970	representative, designee, surrogate, guardian, or attorney in
971	fact to make a variety of personal choices, participate in
972	developing service plans, and share responsibility in
973	decisionmaking.
974	f.  Implement the concept of managed risk.
975	g.  Provide, either directly or through contract, the
976	services of a person licensed pursuant to part I of chapter 464.
977	h.  In addition to the training mandated in s. 429.52 s.
978	400.452, provide specialized training as defined by rule for
979	facility staff.
980	4.  Facilities licensed to provide extended congregate care
981	services are exempt from the criteria for continued residency as
982	set forth in rules adopted under s. 429.41 s. 400.441.
983	Facilities so licensed shall adopt their own requirements within
984	guidelines for continued residency set forth by the department
985	in rule. However, such facilities may not serve residents who
986	require 24-hour nursing supervision. Facilities licensed to
987	provide extended congregate care services shall provide each
988	resident with a written copy of facility policies governing
989	admission and retention.
990	5.  The primary purpose of extended congregate care
991	services is to allow residents, as they become more impaired,
992	the option of remaining in a familiar setting from which they
993	would otherwise be disqualified for continued residency.  A
994	facility licensed to provide extended congregate care services
995	may also admit an individual who exceeds the admission criteria
996	for a facility with a standard license, if the individual is
997	determined appropriate for admission to the extended congregate
998	care facility.
999	6.  Before admission of an individual to a facility
1000	licensed to provide extended congregate care services, the
1001	individual must undergo a medical examination as provided in s.
1002	400.26(4) s. 400.426(4) and the facility must develop a
1003	preliminary service plan for the individual.
1004	7.  When a facility can no longer provide or arrange for
1005	services in accordance with the resident's service plan and
1006	needs and the facility's policy, the facility shall make
1007	arrangements for relocating the person in accordance with s.
1008	429.28(1)(k) s. 400.428(1)(k).
1009	8.  Failure to provide extended congregate care services
1010	may result in denial of extended congregate care license
1011	renewal.
1012	9.  No later than January 1 of each year, the department,
1013	in consultation with the agency, shall prepare and submit to the
1014	Governor, the President of the Senate, the Speaker of the House
1015	of Representatives, and the chairs of appropriate legislative
1016	committees, a report on the status of, and recommendations
1017	related to, extended congregate care services. The status report
1018	must include, but need not be limited to, the following
1019	information:
1020	a.  A description of the facilities licensed to provide
1021	such services, including total number of beds licensed under
1022	this part.
1023	b.  The number and characteristics of residents receiving
1024	such services.
1025	c.  The types of services rendered that could not be
1026	provided through a standard license.
1027	d.  An analysis of deficiencies cited during licensure
1028	inspections.
1029	e.  The number of residents who required extended
1030	congregate care services at admission and the source of
1031	admission.
1032	f.  Recommendations for statutory or regulatory changes.
1033	g.  The availability of extended congregate care to state
1034	clients residing in facilities licensed under this part and in
1035	need of additional services, and recommendations for
1036	appropriations to subsidize extended congregate care services
1037	for such persons.
1038	h.  Such other information as the department considers
1039	appropriate.
1040	(c)  A limited nursing services license shall be issued to
1041	a facility that provides services beyond those authorized in
1042	paragraph (a) and as specified in this paragraph.
1043	1.  In order for limited nursing services to be provided in
1044	a facility licensed under this part, the agency must first
1045	determine that all requirements established in law and rule are
1046	met and must specifically designate, on the facility's license,
1047	that such services may be provided. Such designation may be made
1048	at the time of initial licensure or relicensure, or upon request
1049	in writing by a licensee under this part. Notification of
1050	approval or denial of such request shall be made within 90 days
1051	after receipt of such request and all necessary documentation.
1052	Existing facilities qualifying to provide limited nursing
1053	services shall have maintained a standard license and may not
1054	have been subject to administrative sanctions that affect the
1055	health, safety, and welfare of residents for the previous 2
1056	years or since initial licensure if the facility has been
1057	licensed for less than 2 years.
1058	2.  Facilities that are licensed to provide limited nursing
1059	services shall maintain a written progress report on each person
1060	who receives such nursing services, which report describes the
1061	type, amount, duration, scope, and outcome of services that are
1062	rendered and the general status of the resident's health.  A
1063	registered nurse representing the agency shall visit such
1064	facilities at least twice a year to monitor residents who are
1065	receiving limited nursing services and to determine if the
1066	facility is in compliance with applicable provisions of this
1067	part and with related rules. The monitoring visits may be
1068	provided through contractual arrangements with appropriate
1069	community agencies.  A registered nurse shall also serve as part
1070	of the team that inspects such facility.
1071	3.  A person who receives limited nursing services under
1072	this part must meet the admission criteria established by the
1073	agency for assisted living facilities.  When a resident no
1074	longer meets the admission criteria for a facility licensed
1075	under this part, arrangements for relocating the person shall be
1076	made in accordance with s. 429.28(1)(k) s. 400.428(1)(k), unless
1077	the facility is licensed to provide extended congregate care
1078	services.
1079	(4)(a)  The biennial license fee required of a facility is
1080	$300 per license, with an additional fee of $50 per resident
1081	based on the total licensed resident capacity of the facility,
1082	except that no additional fee will be assessed for beds
1083	designated for recipients of optional state supplementation
1084	payments provided for in s. 409.212. The total fee may not
1085	exceed $10,000, no part of which shall be returned to the
1086	facility.  The agency shall adjust the per bed license fee and
1087	the total licensure fee annually by not more than the change in
1088	the consumer price index based on the 12 months immediately
1089	preceding the increase.
1090	(b)  In addition to the total fee assessed under paragraph
1091	(a), the agency shall require facilities that are licensed to
1092	provide extended congregate care services under this part to pay
1093	an additional fee per licensed facility.  The amount of the
1094	biennial fee shall be $400 per license, with an additional fee
1095	of $10 per resident based on the total licensed resident
1096	capacity of the facility. No part of this fee shall be returned
1097	to the facility. The agency may adjust the per bed license fee
1098	and the annual license fee once each year by not more than the
1099	average rate of inflation for the 12 months immediately
1100	preceding the increase.
1101	(c)  In addition to the total fee assessed under paragraph
1102	(a), the agency shall require facilities that are licensed to
1103	provide limited nursing services under this part to pay an
1104	additional fee per licensed facility.  The amount of the
1105	biennial fee shall be $250 per license, with an additional fee
1106	of $10 per resident based on the total licensed resident
1107	capacity of the facility.  No part of this fee shall be returned
1108	to the facility.  The agency may adjust the per bed license fee
1109	and the biennial license fee once each year by not more than the
1110	average rate of inflation for the 12 months immediately
1111	preceding the increase.
1112	(5)  Counties or municipalities applying for licenses under
1113	this part are exempt from the payment of license fees.
1114	(6)  The license shall be displayed in a conspicuous place
1115	inside the facility.
1116	(7)  A license shall be valid only in the possession of the
1117	individual, firm, partnership, association, or corporation to
1118	which it is issued and shall not be subject to sale, assignment,
1119	or other transfer, voluntary or involuntary; nor shall a license
1120	be valid for any premises other than that for which originally
1121	issued.
1122	(8)  A fee may be charged to a facility requesting a
1123	duplicate license.  The fee shall not exceed the actual cost of
1124	duplication and postage.
1125	Section 33.  Section 400.4071, Florida Statutes, is
1126	renumbered as section 429.071, Florida Statutes, and amended to
1127	read:
1128	429.071 400.4071  Intergenerational respite care assisted
1129	living facility pilot program.--
1130	(1)  It is the intent of the Legislature to establish a
1131	pilot program to:
1132	(a)  Facilitate the receipt of in-home, family-based care
1133	by minors and adults with disabilities and elderly persons with
1134	special needs through respite care for up to 14 days.
1135	(b)  Prevent caregiver "burnout," in which the caregiver's
1136	health declines and he or she is unable to continue to provide
1137	care so that the only option for the person with disabilities or
1138	special needs is to receive institutional care.
1139	(c)  Foster the development of intergenerational respite
1140	care assisted living facilities to temporarily care for minors
1141	and adults with disabilities and elderly persons with special
1142	needs in the same facility and to give caregivers the time they
1143	need for rejuvenation and healing.
1144	(2)  The Agency for Health Care Administration shall
1145	establish a 5-year pilot program, which shall license an
1146	intergenerational respite care assisted living facility that
1147	will provide temporary personal, respite, and custodial care to
1148	minors and adults with disabilities and elderly persons with
1149	special needs who do not require 24-hour nursing services. The
1150	intergenerational respite care assisted living facility must:
1151	(a)  Meet all applicable requirements and standards
1152	contained in this part III of this chapter, except that, for
1153	purposes of this section, the term "resident" means a person of
1154	any age temporarily residing in and receiving care from the
1155	facility.
1156	(b)  Provide respite care services for minors and adults
1157	with disabilities and elderly persons with special needs for a
1158	period of at least 24 hours but not for more than 14 consecutive
1159	days.
1160	(c)  Provide a facility or facilities in which minors and
1161	adults reside in distinct and separate living units.
1162	(d)  Provide a facility that has a maximum of 48 beds, is
1163	located in Miami-Dade County, and is operated by a not-for-
1164	profit entity.
1165	(3)  The agency may establish policies necessary to achieve
1166	the objectives specific to the pilot program and may adopt rules
1167	necessary to implement the program.
1168	(4)  After 4 years, the agency shall present its report on
1169	the effectiveness of the pilot program to the President of the
1170	Senate and the Speaker of the House of Representatives and its
1171	recommendation as to whether the Legislature should make the
1172	program permanent.
1173	Section 34.  Section 400.408, Florida Statutes, is
1174	renumbered as section 429.08, Florida Statutes, and amended to
1175	read:
1176	429.08 400.408  Unlicensed facilities; referral of person
1177	for residency to unlicensed facility; penalties; verification of
1178	licensure status.--
1179	(1)(a)  It is unlawful to own, operate, or maintain an
1180	assisted living facility without obtaining a license under this
1181	part.
1182	(b)  Except as provided under paragraph (d), any person who
1183	owns, operates, or maintains an unlicensed assisted living
1184	facility commits a felony of the third degree, punishable as
1185	provided in s. 775.082, s. 775.083, or s. 775.084. Each day of
1186	continued operation is a separate offense.
1187	(c)  Any person found guilty of violating paragraph (a) a
1188	second or subsequent time commits a felony of the second degree,
1189	punishable as provided under s. 775.082, s. 775.083, or s.
1190	775.084. Each day of continued operation is a separate offense.
1191	(d)  Any person who owns, operates, or maintains an
1192	unlicensed assisted living facility due to a change in this part
1193	or a modification in department rule within 6 months after the
1194	effective date of such change and who, within 10 working days
1195	after receiving notification from the agency, fails to cease
1196	operation or apply for a license under this part commits a
1197	felony of the third degree, punishable as provided in s.
1198	775.082, s. 775.083, or s. 775.084. Each day of continued
1199	operation is a separate offense.
1200	(e)  Any facility that fails to cease operation after
1201	agency notification may be fined for each day of noncompliance
1202	pursuant to s. 429.19 s. 400.419.
1203	(f)  When a licensee has an interest in more than one
1204	assisted living facility, and fails to license any one of these
1205	facilities, the agency may revoke the license, impose a
1206	moratorium, or impose a fine pursuant to s. 429.19 s. 400.419,
1207	on any or all of the licensed facilities until such time as the
1208	unlicensed facility is licensed or ceases operation.
1209	(g)  If the agency determines that an owner is operating or
1210	maintaining an assisted living facility without obtaining a
1211	license and determines that a condition exists in the facility
1212	that poses a threat to the health, safety, or welfare of a
1213	resident of the facility, the owner is subject to the same
1214	actions and fines imposed against a licensed facility as
1215	specified in ss. 429.14 and 429.19 ss. 400.414 and 400.419.
1216	(h)  Any person aware of the operation of an unlicensed
1217	assisted living facility must report that facility to the
1218	agency. The agency shall provide to the department's elder
1219	information and referral providers a list, by county, of
1220	licensed assisted living facilities, to assist persons who are
1221	considering an assisted living facility placement in locating a
1222	licensed facility.
1223	(i)  Each field office of the Agency for Health Care
1224	Administration shall establish a local coordinating workgroup
1225	which includes representatives of local law enforcement
1226	agencies, state attorneys, the Medicaid Fraud Control Unit of
1227	the Department of Legal Affairs, local fire authorities, the
1228	Department of Children and Family Services, the district long-
1229	term care ombudsman council, and the district human rights
1230	advocacy committee to assist in identifying the operation of
1231	unlicensed facilities and to develop and implement a plan to
1232	ensure effective enforcement of state laws relating to such
1233	facilities. The workgroup shall report its findings, actions,
1234	and recommendations semiannually to the Director of Health
1235	Facility Regulation of the agency.
1236	(2)  It is unlawful to knowingly refer a person for
1237	residency to an unlicensed assisted living facility; to an
1238	assisted living facility the license of which is under denial or
1239	has been suspended or revoked; or to an assisted living facility
1240	that has a moratorium on admissions.  Any person who violates
1241	this subsection commits a noncriminal violation, punishable by a
1242	fine not exceeding $500 as provided in s. 775.083.
1243	(a)  Any health care practitioner, as defined in s.
1244	456.001, who is aware of the operation of an unlicensed facility
1245	shall report that facility to the agency. Failure to report a
1246	facility that the practitioner knows or has reasonable cause to
1247	suspect is unlicensed shall be reported to the practitioner's
1248	licensing board.
1249	(b)  Any hospital or community mental health center
1250	licensed under chapter 395 or chapter 394 which knowingly
1251	discharges a patient or client to an unlicensed facility is
1252	subject to sanction by the agency.
1253	(c)  Any employee of the agency or department, or the
1254	Department of Children and Family Services, who knowingly refers
1255	a person for residency to an unlicensed facility; to a facility
1256	the license of which is under denial or has been suspended or
1257	revoked; or to a facility that has a moratorium on admissions is
1258	subject to disciplinary action by the agency or department, or
1259	the Department of Children and Family Services.
1260	(d)  The employer of any person who is under contract with
1261	the agency or department, or the Department of Children and
1262	Family Services, and who knowingly refers a person for residency
1263	to an unlicensed facility; to a facility the license of which is
1264	under denial or has been suspended or revoked; or to a facility
1265	that has a moratorium on admissions shall be fined and required
1266	to prepare a corrective action plan designed to prevent such
1267	referrals.
1268	(e)  The agency shall provide the department and the
1269	Department of Children and Family Services with a list of
1270	licensed facilities within each county and shall update the list
1271	at least quarterly.
1272	(f)  At least annually, the agency shall notify, in
1273	appropriate trade publications, physicians licensed under
1274	chapter 458 or chapter 459, hospitals licensed under chapter
1275	395, nursing home facilities licensed under part II of this
1276	chapter 400, and employees of the agency or the department, or
1277	the Department of Children and Family Services, who are
1278	responsible for referring persons for residency, that it is
1279	unlawful to knowingly refer a person for residency to an
1280	unlicensed assisted living facility and shall notify them of the
1281	penalty for violating such prohibition. The department and the
1282	Department of Children and Family Services shall, in turn,
1283	notify service providers under contract to the respective
1284	departments who have responsibility for resident referrals to
1285	facilities. Further, the notice must direct each noticed
1286	facility and individual to contact the appropriate agency office
1287	in order to verify the licensure status of any facility prior to
1288	referring any person for residency. Each notice must include the
1289	name, telephone number, and mailing address of the appropriate
1290	office to contact.
1291	Section 35.  Section 400.411, Florida Statutes, is
1292	renumbered as section 429.11, Florida Statutes, and amended to
1293	read:
1294	429.11 400.411  Initial application for license;
1295	provisional license.--
1296	(1)  Application for a license shall be made to the agency
1297	on forms furnished by it and shall be accompanied by the
1298	appropriate license fee.
1299	(2)  The applicant may be an individual owner, a
1300	corporation, a partnership, a firm, an association, or a
1301	governmental entity.
1302	(3)  The application must be signed by the applicant under
1303	oath and must contain the following:
1304	(a)  The name, address, date of birth, and social security
1305	number of the applicant and the name by which the facility is to
1306	be known. If the applicant is a firm, partnership, or
1307	association, the application shall contain the name, address,
1308	date of birth, and social security number of every member
1309	thereof. If the applicant is a corporation, the application
1310	shall contain the corporation's name and address; the name,
1311	address, date of birth, and social security number of each of
1312	its directors and officers; and the name and address of each
1313	person having at least a 5-percent ownership interest in the
1314	corporation.
1315	(b)  The name and address of any professional service,
1316	firm, association, partnership, or corporation that is to
1317	provide goods, leases, or services to the facility if a 5-
1318	percent or greater ownership interest in the service, firm,
1319	association, partnership, or corporation is owned by a person
1320	whose name must be listed on the application under paragraph
1321	(a).
1322	(c)  The name and address of any long-term care facility
1323	with which the applicant, administrator, or financial officer
1324	has been affiliated through ownership or employment within 5
1325	years of the date of this license application; and a signed
1326	affidavit disclosing any financial or ownership interest that
1327	the applicant, or any person listed in paragraph (a), holds or
1328	has held within the last 5 years in any facility licensed under
1329	this part, or in any other entity licensed by this state or
1330	another state to provide health or residential care, which
1331	facility or entity closed or ceased to operate as a result of
1332	financial problems, or has had a receiver appointed or a license
1333	denied, suspended or revoked, or was subject to a moratorium on
1334	admissions, or has had an injunctive proceeding initiated
1335	against it.
1336	(d)  A description and explanation of any exclusions,
1337	permanent suspensions, or terminations of the applicant from the
1338	Medicare or Medicaid programs. Proof of compliance with
1339	disclosure of ownership and control interest requirements of the
1340	Medicaid or Medicare programs shall be accepted in lieu of this
1341	submission.
1342	(e)  The names and addresses of persons of whom the agency
1343	may inquire as to the character, reputation, and financial
1344	responsibility of the owner and, if different from the
1345	applicant, the administrator and financial officer.
1346	(f)  Identification of all other homes or facilities,
1347	including the addresses and the license or licenses under which
1348	they operate, if applicable, which are currently operated by the
1349	applicant or administrator and which provide housing, meals, and
1350	personal services to residents.
1351	(g)  The location of the facility for which a license is
1352	sought and documentation, signed by the appropriate local
1353	government official, which states that the applicant has met
1354	local zoning requirements.
1355	(h)  The name, address, date of birth, social security
1356	number, education, and experience of the administrator, if
1357	different from the applicant.
1358	(4)  The applicant shall furnish satisfactory proof of
1359	financial ability to operate and conduct the facility in
1360	accordance with the requirements of this part. A certificate of
1361	authority, pursuant to chapter 651, may be provided as proof of
1362	financial ability.
1363	(5)  If the applicant is a continuing care facility
1364	certified under chapter 651, a copy of the facility's
1365	certificate of authority must be provided.
1366	(6)  The applicant shall provide proof of liability
1367	insurance as defined in s. 624.605.
1368	(7)  If the applicant is a community residential home, the
1369	applicant must provide proof that it has met the requirements
1370	specified in chapter 419.
1371	(8)  The applicant must provide the agency with proof of
1372	legal right to occupy the property.
1373	(9)  The applicant must furnish proof that the facility has
1374	received a satisfactory firesafety inspection.  The local
1375	authority having jurisdiction or the State Fire Marshal must
1376	conduct the inspection within 30 days after written request by
1377	the applicant.
1378	(10)  The applicant must furnish documentation of a
1379	satisfactory sanitation inspection of the facility by the county
1380	health department.
1381	(11)  The applicant must furnish proof of compliance with
1382	level 2 background screening as required under s. 429.174 s.
1383	400.4174.
1384	(12)  A provisional license may be issued to an applicant
1385	making initial application for licensure or making application
1386	for a change of ownership.  A provisional license shall be
1387	limited in duration to a specific period of time not to exceed 6
1388	months, as determined by the agency.
1389	(13)  A county or municipality may not issue an
1390	occupational license that is being obtained for the purpose of
1391	operating a facility regulated under this part without first
1392	ascertaining that the applicant has been licensed to operate
1393	such facility at the specified location or locations by the
1394	agency.  The agency shall furnish to local agencies responsible
1395	for issuing occupational licenses sufficient instruction for
1396	making such determinations.
1397	Section 36.  Section 400.412, Florida Statutes, is
1398	renumbered as section 429.12, Florida Statutes, and amended to
1399	read:
1400	429.12 400.412  Sale or transfer of ownership of a
1401	facility.--It is the intent of the Legislature to protect the
1402	rights of the residents of an assisted living facility when the
1403	facility is sold or the ownership thereof is transferred.
1404	Therefore, whenever a facility is sold or the ownership thereof
1405	is transferred, including leasing:
1406	(1)  The transferee shall make application to the agency
1407	for a new license at least 60 days before the date of transfer
1408	of ownership.  The application must comply with the provisions
1409	of s. 429.11 s. 400.411.
1410	(2)(a)  The transferor shall notify the agency in writing
1411	at least 60 days before the date of transfer of ownership.
1412	(b)  The new owner shall notify the residents, in writing,
1413	of the transfer of ownership within 7 days of his or her receipt
1414	of the license.
1415	(3)  The transferor shall be responsible and liable for:
1416	(a)  The lawful operation of the facility and the welfare
1417	of the residents domiciled in the facility until the date the
1418	transferee is licensed by the agency.
1419	(b)  Any and all penalties imposed against the facility for
1420	violations occurring before the date of transfer of ownership
1421	unless the penalty imposed is a moratorium on admissions or
1422	denial of licensure.  The moratorium on admissions or denial of
1423	licensure remains in effect after the transfer of ownership,
1424	unless the agency has approved the transferee's corrective
1425	action plan or the conditions which created the moratorium or
1426	denial have been corrected, and may be grounds for denial of
1427	license to the transferee in accordance with chapter 120.
1428	(c)  Any outstanding liability to the state, unless the
1429	transferee has agreed, as a condition of sale or transfer, to
1430	accept the outstanding liabilities and to guarantee payment
1431	therefor; except that, if the transferee fails to meet these
1432	obligations, the transferor shall remain liable for the
1433	outstanding liability.
1434	(4)  The transferor of a facility the license of which is
1435	denied pending an administrative hearing shall, as a part of the
1436	written transfer-of-ownership contract, advise the transferee
1437	that a plan of correction must be submitted by the transferee
1438	and approved by the agency at least 7 days before the transfer
1439	of ownership and that failure to correct the condition which
1440	resulted in the moratorium on admissions or denial of licensure
1441	is grounds for denial of the transferee's license.
1442	(5)  The transferee must provide the agency with proof of
1443	legal right to occupy the property before a license may be
1444	issued.  Proof may include, but is not limited to, copies of
1445	warranty deeds, or copies of lease or rental agreements,
1446	contracts for deeds, quitclaim deeds, or other such
1447	documentation.
1448	Section 37.  Section 400.414, Florida Statutes, is
1449	renumbered as section 429.14, Florida Statutes, and amended to
1450	read:
1451	429.14 400.414  Denial, revocation, or suspension of
1452	license; imposition of administrative fine; grounds.--
1453	(1)  The agency may deny, revoke, or suspend any license
1454	issued under this part, or impose an administrative fine in the
1455	manner provided in chapter 120, for any of the following actions
1456	by an assisted living facility, for the actions of any person
1457	subject to level 2 background screening under s. 429.174 s.
1458	400.4174, or for the actions of any facility employee:
1459	(a)  An intentional or negligent act seriously affecting
1460	the health, safety, or welfare of a resident of the facility.
1461	(b)  The determination by the agency that the owner lacks
1462	the financial ability to provide continuing adequate care to
1463	residents.
1464	(c)  Misappropriation or conversion of the property of a
1465	resident of the facility.
1466	(d)  Failure to follow the criteria and procedures provided
1467	under part I of chapter 394 relating to the transportation,
1468	voluntary admission, and involuntary examination of a facility
1469	resident.
1470	(e)  A citation of any of the following deficiencies as
1471	defined in s. 429.19 s. 400.419:
1472	1.  One or more cited class I deficiencies.
1473	2.  Three or more cited class II deficiencies.
1474	3.  Five or more cited class III deficiencies that have
1475	been cited on a single survey and have not been corrected within
1476	the times specified.
1477	(f)  A determination that a person subject to level 2
1478	background screening under s. 429.174(1) s. 400.4174(1) does not
1479	meet the screening standards of s. 435.04 or that the facility
1480	is retaining an employee subject to level 1 background screening
1481	standards under s. 429.174(2) s. 400.4174(2) who does not meet
1482	the screening standards of s. 435.03 and for whom exemptions
1483	from disqualification have not been provided by the agency.
1484	(g)  A determination that an employee, volunteer,
1485	administrator, or owner, or person who otherwise has access to
1486	the residents of a facility does not meet the criteria specified
1487	in s. 435.03(2), and the owner or administrator has not taken
1488	action to remove the person. Exemptions from disqualification
1489	may be granted as set forth in s. 435.07. No administrative
1490	action may be taken against the facility if the person is
1491	granted an exemption.
1492	(h)  Violation of a moratorium.
1493	(i)  Failure of the license applicant, the licensee during
1494	relicensure, or a licensee that holds a provisional license to
1495	meet the minimum license requirements of this part, or related
1496	rules, at the time of license application or renewal.
1497	(j)  A fraudulent statement or omission of any material
1498	fact on an application for a license or any other document
1499	required by the agency, including the submission of a license
1500	application that conceals the fact that any board member,
1501	officer, or person owning 5 percent or more of the facility may
1502	not meet the background screening requirements of s. 429.174 s.
1503	400.4174, or that the applicant has been excluded, permanently
1504	suspended, or terminated from the Medicaid or Medicare programs.
1505	(k)  An intentional or negligent life-threatening act in
1506	violation of the uniform firesafety standards for assisted
1507	living facilities or other firesafety standards that threatens
1508	the health, safety, or welfare of a resident of a facility, as
1509	communicated to the agency by the local authority having
1510	jurisdiction or the State Fire Marshal.
1511	(l)  Exclusion, permanent suspension, or termination from
1512	the Medicare or Medicaid programs.
1513	(m)  Knowingly operating any unlicensed facility or
1514	providing without a license any service that must be licensed
1515	under this part or under chapter 400.
1516	(n)  Any act constituting a ground upon which application
1517	for a license may be denied.
1518
1519	Administrative proceedings challenging agency action under this
1520	subsection shall be reviewed on the basis of the facts and
1521	conditions that resulted in the agency action.
1522	(2)  Upon notification by the local authority having
1523	jurisdiction or by the State Fire Marshal, the agency may deny
1524	or revoke the license of an assisted living facility that fails
1525	to correct cited fire code violations that affect or threaten
1526	the health, safety, or welfare of a resident of a facility.
1527	(3)  The agency may deny a license to any applicant or to
1528	any officer or board member of an applicant who is a firm,
1529	corporation, partnership, or association or who owns 5 percent
1530	or more of the facility, if the applicant, officer, or board
1531	member has or had a 25-percent or greater financial or ownership
1532	interest in any other facility licensed under this part, or in
1533	any entity licensed by this state or another state to provide
1534	health or residential care, which facility or entity during the
1535	5 years prior to the application for a license closed due to
1536	financial inability to operate; had a receiver appointed or a
1537	license denied, suspended, or revoked; was subject to a
1538	moratorium on admissions; had an injunctive proceeding initiated
1539	against it; or has an outstanding fine assessed under this part
1540	or under chapter 400.
1541	(4)  The agency shall deny or revoke the license of an
1542	assisted living facility that has two or more class I violations
1543	that are similar or identical to violations identified by the
1544	agency during a survey, inspection, monitoring visit, or
1545	complaint investigation occurring within the previous 2 years.
1546	(5)  An action taken by the agency to suspend, deny, or
1547	revoke a facility's license under this part, in which the agency
1548	claims that the facility owner or an employee of the facility
1549	has threatened the health, safety, or welfare of a resident of
1550	the facility be heard by the Division of Administrative Hearings
1551	of the Department of Management Services within 120 days after
1552	receipt of the facility's request for a hearing, unless that
1553	time limitation is waived by both parties. The administrative
1554	law judge must render a decision within 30 days after receipt of
1555	a proposed recommended order.
1556	(6)  The agency shall provide to the Division of Hotels and
1557	Restaurants of the Department of Business and Professional
1558	Regulation, on a monthly basis, a list of those assisted living
1559	facilities that have had their licenses denied, suspended, or
1560	revoked or that are involved in an appellate proceeding pursuant
1561	to s. 120.60 related to the denial, suspension, or revocation of
1562	a license.
1563	(7)  Agency notification of a license suspension or
1564	revocation, or denial of a license renewal, shall be posted and
1565	visible to the public at the facility.
1566	(8)  The agency may issue a temporary license pending final
1567	disposition of a proceeding involving the suspension or
1568	revocation of an assisted living facility license.
1569	Section 38.  Section 400.415, Florida Statutes, is
1570	renumbered as section 429.15, Florida Statutes, and amended to
1571	read:
1572	429.15 400.415  Moratorium on admissions; notice.--The
1573	agency may impose an immediate moratorium on admissions to any
1574	assisted living facility if the agency determines that any
1575	condition in the facility presents a threat to the health,
1576	safety, or welfare of the residents in the facility.
1577	(1)  A facility the license of which is denied, revoked, or
1578	suspended pursuant to s. 429.14 s. 400.414 may be subject to
1579	immediate imposition of a moratorium on admissions to run
1580	concurrently with licensure denial, revocation, or suspension.
1581	(2)  When a moratorium is placed on a facility, notice of
1582	the moratorium shall be posted and visible to the public at the
1583	facility until the moratorium is lifted.
1584	(3)  The department may by rule establish conditions that
1585	constitute grounds for imposing a moratorium on a facility and
1586	procedures for imposing and lifting a moratorium, as necessary
1587	to administer this section.
1588	Section 39.  Section 400.417, Florida Statutes, is
1589	renumbered as section 429.17, Florida Statutes, and amended to
1590	read:
1591	429.17 400.417  Expiration of license; renewal; conditional
1592	license.--
1593	(1)  Biennial licenses, unless sooner suspended or revoked,
1594	shall expire 2 years from the date of issuance. Limited nursing,
1595	extended congregate care, and limited mental health licenses
1596	shall expire at the same time as the facility's standard
1597	license, regardless of when issued. The agency shall notify the
1598	facility at least 120 days prior to expiration that a renewal
1599	license is necessary to continue operation. The notification
1600	must be provided electronically or by mail delivery. Ninety days
1601	prior to the expiration date, an application for renewal shall
1602	be submitted to the agency. Fees must be prorated. The failure
1603	to file a timely renewal application shall result in a late fee
1604	charged to the facility in an amount equal to 50 percent of the
1605	current fee.
1606	(2)  A license shall be renewed within 90 days upon the
1607	timely filing of an application on forms furnished by the agency
1608	and the provision of satisfactory proof of ability to operate
1609	and conduct the facility in accordance with the requirements of
1610	this part and adopted rules, including proof that the facility
1611	has received a satisfactory firesafety inspection, conducted by
1612	the local authority having jurisdiction or the State Fire
1613	Marshal, within the preceding 12 months and an affidavit of
1614	compliance with the background screening requirements of s.
1615	429.174 s. 400.4174.
1616	(3)  An applicant for renewal of a license who has complied
1617	with the provisions of s. 429.11 s. 400.411 with respect to
1618	proof of financial ability to operate shall not be required to
1619	provide further proof unless the facility or any other facility
1620	owned or operated in whole or in part by the same person has
1621	demonstrated financial instability as provided under s.
1622	429.47(2) s. 400.447(2) or unless the agency suspects that the
1623	facility is not financially stable as a result of the annual
1624	survey or complaints from the public or a report from the State
1625	Long-Term Care Ombudsman Council.  Each facility must report to
1626	the agency any adverse court action concerning the facility's
1627	financial viability, within 7 days after its occurrence.  The
1628	agency shall have access to books, records, and any other
1629	financial documents maintained by the facility to the extent
1630	necessary to determine the facility's financial stability.  A
1631	license for the operation of a facility shall not be renewed if
1632	the licensee has any outstanding fines assessed pursuant to this
1633	part which are in final order status.
1634	(4)  A licensee against whom a revocation or suspension
1635	proceeding is pending at the time of license renewal may be
1636	issued a conditional license effective until final disposition
1637	by the agency.  If judicial relief is sought from the final
1638	disposition, the court having jurisdiction may issue a
1639	conditional license for the duration of the judicial proceeding.
1640	(5)  A conditional license may be issued to an applicant
1641	for license renewal if the applicant fails to meet all standards
1642	and requirements for licensure.  A conditional license issued
1643	under this subsection shall be limited in duration to a specific
1644	period of time not to exceed 6 months, as determined by the
1645	agency, and shall be accompanied by an agency-approved plan of
1646	correction.
1647	(6)  When an extended care or limited nursing license is
1648	requested during a facility's biennial license period, the fee
1649	shall be prorated in order to permit the additional license to
1650	expire at the end of the biennial license period. The fee shall
1651	be calculated as of the date the additional license application
1652	is received by the agency.
1653	(7)  The department may by rule establish renewal
1654	procedures, identify forms, and specify documentation necessary
1655	to administer this section.
1656	Section 40.  Section 400.4174, Florida Statutes, is
1657	renumbered as section 429.174, Florida Statutes, and amended to
1658	read:
1659	429.174 400.4174  Background screening; exemptions.--
1660	(1)(a)  Level 2 background screening must be conducted on
1661	each of the following persons, who shall be considered employees
1662	for the purposes of conducting screening under chapter 435:
1663	1.  The facility owner if an individual, the administrator,
1664	and the financial officer.
1665	2.  An officer or board member if the facility owner is a
1666	firm, corporation, partnership, or association, or any person
1667	owning 5 percent or more of the facility if the agency has
1668	probable cause to believe that such person has been convicted of
1669	any offense prohibited by s. 435.04. For each officer, board
1670	member, or person owning 5 percent or more who has been
1671	convicted of any such offense, the facility shall submit to the
1672	agency a description and explanation of the conviction at the
1673	time of license application. This subparagraph does not apply to
1674	a board member of a not-for-profit corporation or organization
1675	if the board member serves solely in a voluntary capacity, does
1676	not regularly take part in the day-to-day operational decisions
1677	of the corporation or organization, receives no remuneration for
1678	his or her services, and has no financial interest and has no
1679	family members with a financial interest in the corporation or
1680	organization, provided that the board member and facility submit
1681	a statement affirming that the board member's relationship to
1682	the facility satisfies the requirements of this subparagraph.
1683	(b)  Proof of compliance with level 2 screening standards
1684	which has been submitted within the previous 5 years to meet any
1685	facility or professional licensure requirements of the agency or
1686	the Department of Health satisfies the requirements of this
1687	subsection, provided that such proof is accompanied, under
1688	penalty of perjury, by an affidavit of compliance with the
1689	provisions of chapter 435. Proof of compliance with the
1690	background screening requirements of the Financial Services
1691	Commission and the Office of Insurance Regulation for applicants
1692	for a certificate of authority to operate a continuing care
1693	retirement community under chapter 651, submitted within the
1694	last 5 years, satisfies the Department of Law Enforcement and
1695	Federal Bureau of Investigation portions of a level 2 background
1696	check.
1697	(c)  The agency may grant a provisional license to a
1698	facility applying for an initial license when each individual
1699	required by this subsection to undergo screening has completed
1700	the Department of Law Enforcement background checks, but has not
1701	yet received results from the Federal Bureau of Investigation,
1702	or when a request for an exemption from disqualification has
1703	been submitted to the agency pursuant to s. 435.07, but a
1704	response has not been issued.
1705	(2)  The owner or administrator of an assisted living
1706	facility must conduct level 1 background screening, as set forth
1707	in chapter 435, on all employees hired on or after October 1,
1708	1998, who perform personal services as defined in s. 429.02(17)
1709	s. 400.402(17). The agency may exempt an individual from
1710	employment disqualification as set forth in chapter 435. Such
1711	persons shall be considered as having met this requirement if:
1712	(a)  Proof of compliance with level 1 screening
1713	requirements obtained to meet any professional license
1714	requirements in this state is provided and accompanied, under
1715	penalty of perjury, by a copy of the person's current
1716	professional license and an affidavit of current compliance with
1717	the background screening requirements.
1718	(b)  The person required to be screened has been
1719	continuously employed in the same type of occupation for which
1720	the person is seeking employment without a breach in service
1721	which exceeds 180 days, and proof of compliance with the level 1
1722	screening requirement which is no more than 2 years old is
1723	provided. Proof of compliance shall be provided directly from
1724	one employer or contractor to another, and not from the person
1725	screened. Upon request, a copy of screening results shall be
1726	provided by the employer retaining documentation of the
1727	screening to the person screened.
1728	(c)  The person required to be screened is employed by a
1729	corporation or business entity or related corporation or
1730	business entity that owns, operates, or manages more than one
1731	facility or agency licensed under this chapter, and for whom a
1732	level 1 screening was conducted by the corporation or business
1733	entity as a condition of initial or continued employment.
1734	Section 41.  Section 400.4176, Florida Statutes, is
1735	renumbered as section 429.176, Florida Statutes, and amended to
1736	read:
1737	429.176 400.4176  Notice of change of administrator.--If,
1738	during the period for which a license is issued, the owner
1739	changes administrators, the owner must notify the agency of the
1740	change within 10 days and provide documentation within 90 days
1741	that the new administrator has completed the applicable core
1742	educational requirements under s. 429.52 s. 400.452. Background
1743	screening shall be completed on any new administrator as
1744	specified in s. 429.174 s. 400.4174.
1745	Section 42.  Section 400.4178, Florida Statutes, is
1746	renumbered as section 429.178, Florida Statutes, and amended to
1747	read:
1748	429.178 400.4178  Special care for persons with Alzheimer's
1749	disease or other related disorders.--
1750	(1)  A facility which advertises that it provides special
1751	care for persons with Alzheimer's disease or other related
1752	disorders must meet the following standards of operation:
1753	(a)1.  If the facility has 17 or more residents, have an
1754	awake staff member on duty at all hours of the day and night; or
1755	2.  If the facility has fewer than 17 residents, have an
1756	awake staff member on duty at all hours of the day and night or
1757	have mechanisms in place to monitor and ensure the safety of the
1758	facility's residents.
1759	(b)  Offer activities specifically designed for persons who
1760	are cognitively impaired.
1761	(c)  Have a physical environment that provides for the
1762	safety and welfare of the facility's residents.
1763	(d)  Employ staff who have completed the training and
1764	continuing education required in subsection (2).
1765	(2)(a)  An individual who is employed by a facility that
1766	provides special care for residents with Alzheimer's disease or
1767	other related disorders, and who has regular contact with such
1768	residents, must complete up to 4 hours of initial dementia-
1769	specific training developed or approved by the department. The
1770	training shall be completed within 3 months after beginning
1771	employment and shall satisfy the core training requirements of
1772	s. 429.52(2)(g) s. 400.452(2)(g).
1773	(b)  A direct caregiver who is employed by a facility that
1774	provides special care for residents with Alzheimer's disease or
1775	other related disorders, and who provides direct care to such
1776	residents, must complete the required initial training and 4
1777	additional hours of training developed or approved by the
1778	department.  The training shall be completed within 9 months
1779	after beginning employment and shall satisfy the core training
1780	requirements of s. 429.52(2)(g) s. 400.452(2)(g).
1781	(c)  An individual who is employed by a facility that
1782	provides special care for residents with Alzheimer's disease or
1783	other related disorders, but who only has incidental contact
1784	with such residents, must be given, at a minimum, general
1785	information on interacting with individuals with Alzheimer's
1786	disease or other related disorders, within 3 months after
1787	beginning employment.
1788	(3)  In addition to the training required under subsection
1789	(2), a direct caregiver must participate in a minimum of 4
1790	contact hours of continuing education each calendar year.  The
1791	continuing education must include one or more topics included in
1792	the dementia-specific training developed or approved by the
1793	department, in which the caregiver has not received previous
1794	training.
1795	(4)  Upon completing any training listed in subsection (2),
1796	the employee or direct caregiver shall be issued a certificate
1797	that includes the name of the training provider, the topic
1798	covered, and the date and signature of the training provider.
1799	The certificate is evidence of completion of training in the
1800	identified topic, and the employee or direct caregiver is not
1801	required to repeat training in that topic if the employee or
1802	direct caregiver changes employment to a different facility.
1803	The employee or direct caregiver must comply with other
1804	applicable continuing education requirements.
1805	(5)  The department, or its designee, shall approve the
1806	initial and continuing education courses and providers.
1807	(6)  The department shall keep a current list of providers
1808	who are approved to provide initial and continuing education for
1809	staff of facilities that provide special care for persons with
1810	Alzheimer's disease or other related disorders.
1811	(7)  Any facility more than 90 percent of whose residents
1812	receive monthly optional supplementation payments is not
1813	required to pay for the training and education programs required
1814	under this section.  A facility that has one or more such
1815	residents shall pay a reduced fee that is proportional to the
1816	percentage of such residents in the facility.  A facility that
1817	does not have any residents who receive monthly optional
1818	supplementation payments must pay a reasonable fee, as
1819	established by the department, for such training and education
1820	programs.
1821	(8)  The department shall adopt rules to establish
1822	standards for trainers and training and to implement this
1823	section.
1824	Section 43.  Section 400.418, Florida Statutes, is
1825	renumbered as section 429.18, Florida Statutes, and amended to
1826	read:
1827	429.18 400.418  Disposition of fees and administrative
1828	fines.--
1829	(1)  Income from license fees, inspection fees, late fees,
1830	and administrative fines generated pursuant to ss. 429.07,
1831	429.08, 429.17, 429.19, and 429.31 ss. 400.407, 400.408,
1832	400.417, 400.419, and 400.431 shall be deposited in the Health
1833	Care Trust Fund administered by the agency.  Such funds shall be
1834	directed to and used by the agency for the following purposes:
1835	(a)  Up to 50 percent of the trust funds accrued each
1836	fiscal year under this part may be used to offset the expenses
1837	of receivership, pursuant to s. 429.22 s. 400.422, if the court
1838	determines that the income and assets of the facility are
1839	insufficient to provide for adequate management and operation.
1840	(b)  An amount of $5,000 of the trust funds accrued each
1841	year under this part shall be allocated to pay for inspection-
1842	related physical and mental health examinations requested by the
1843	agency pursuant to s. 429.26 s. 400.426 for residents who are
1844	either recipients of supplemental security income or have
1845	monthly incomes not in excess of the maximum combined federal
1846	and state cash subsidies available to supplemental security
1847	income recipients, as provided for in s. 409.212.  Such funds
1848	shall only be used where the resident is ineligible for
1849	Medicaid.
1850	(c)  Any trust funds accrued each year under this part and
1851	not used for the purposes specified in paragraphs (a) and (b)
1852	shall be used to offset the costs of the licensure program,
1853	including the costs of conducting background investigations,
1854	verifying information submitted, defraying the costs of
1855	processing the names of applicants, and conducting inspections
1856	and monitoring visits pursuant to this part.
1857	(2)  Income from fees generated pursuant to s. 429.41(5) s.
1858	400.441(5) shall be deposited in the Health Care Trust Fund and
1859	used to offset the costs of printing and postage.
1860	Section 44.  Section 400.419, Florida Statutes, is
1861	renumbered as section 429.19, Florida Statutes, and amended to
1862	read:
1863	429.19 400.419  Violations; imposition of administrative
1864	fines; grounds.--
1865	(1)  The agency shall impose an administrative fine in the
1866	manner provided in chapter 120 for any of the actions or
1867	violations as set forth within this section by an assisted
1868	living facility, for the actions of any person subject to level
1869	2 background screening under s. 429.174 s. 400.4174, for the
1870	actions of any facility employee, or for an intentional or
1871	negligent act seriously affecting the health, safety, or welfare
1872	of a resident of the facility.
1873	(2)  Each violation of this part and adopted rules shall be
1874	classified according to the nature of the violation and the
1875	gravity of its probable effect on facility residents. The agency
1876	shall indicate the classification on the written notice of the
1877	violation as follows:
1878	(a)  Class "I" violations are those conditions or
1879	occurrences related to the operation and maintenance of a
1880	facility or to the personal care of residents which the agency
1881	determines present an imminent danger to the residents or guests
1882	of the facility or a substantial probability that death or
1883	serious physical or emotional harm would result therefrom. The
1884	condition or practice constituting a class I violation shall be
1885	abated or eliminated within 24 hours, unless a fixed period, as
1886	determined by the agency, is required for correction. The agency
1887	shall impose an administrative fine for a cited class I
1888	violation in an amount not less than $5,000 and not exceeding
1889	$10,000 for each violation. A fine may be levied notwithstanding
1890	the correction of the violation.
1891	(b)  Class "II" violations are those conditions or
1892	occurrences related to the operation and maintenance of a
1893	facility or to the personal care of residents which the agency
1894	determines directly threaten the physical or emotional health,
1895	safety, or security of the facility residents, other than class
1896	I violations. The agency shall impose an administrative fine for
1897	a cited class II violation in an amount not less than $1,000 and
1898	not exceeding $5,000 for each violation. A fine shall be levied
1899	notwithstanding the correction of the violation.
1900	(c)  Class "III" violations are those conditions or
1901	occurrences related to the operation and maintenance of a
1902	facility or to the personal care of residents which the agency
1903	determines indirectly or potentially threaten the physical or
1904	emotional health, safety, or security of facility residents,
1905	other than class I or class II violations. The agency shall
1906	impose an administrative fine for a cited class III violation in
1907	an amount not less than $500 and not exceeding $1,000 for each
1908	violation. A citation for a class III violation must specify the
1909	time within which the violation is required to be corrected. If
1910	a class III violation is corrected within the time specified, no
1911	fine may be imposed, unless it is a repeated offense.
1912	(d)  Class "IV" violations are those conditions or
1913	occurrences related to the operation and maintenance of a
1914	building or to required reports, forms, or documents that do not
1915	have the potential of negatively affecting residents. These
1916	violations are of a type that the agency determines do not
1917	threaten the health, safety, or security of residents of the
1918	facility. The agency shall impose an administrative fine for a
1919	cited class IV violation in an amount not less than $100 and not
1920	exceeding $200 for each violation. A citation for a class IV
1921	violation must specify the time within which the violation is
1922	required to be corrected. If a class IV violation is corrected
1923	within the time specified, no fine shall be imposed. Any class
1924	IV violation that is corrected during the time an agency survey
1925	is being conducted will be identified as an agency finding and
1926	not as a violation.
1927	(3)  In determining if a penalty is to be imposed and in
1928	fixing the amount of the fine, the agency shall consider the
1929	following factors:
1930	(a)  The gravity of the violation, including the
1931	probability that death or serious physical or emotional harm to
1932	a resident will result or has resulted, the severity of the
1933	action or potential harm, and the extent to which the provisions
1934	of the applicable laws or rules were violated.
1935	(b)  Actions taken by the owner or administrator to correct
1936	violations.
1937	(c)  Any previous violations.
1938	(d)  The financial benefit to the facility of committing or
1939	continuing the violation.
1940	(e)  The licensed capacity of the facility.
1941	(4)  Each day of continuing violation after the date fixed
1942	for termination of the violation, as ordered by the agency,
1943	constitutes an additional, separate, and distinct violation.
1944	(5)  Any action taken to correct a violation shall be
1945	documented in writing by the owner or administrator of the
1946	facility and verified through followup visits by agency
1947	personnel. The agency may impose a fine and, in the case of an
1948	owner-operated facility, revoke or deny a facility's license
1949	when a facility administrator fraudulently misrepresents action
1950	taken to correct a violation.
1951	(6)  For fines that are upheld following administrative or
1952	judicial review, the violator shall pay the fine, plus interest
1953	at the rate as specified in s. 55.03, for each day beyond the
1954	date set by the agency for payment of the fine.
1955	(7)  Any unlicensed facility that continues to operate
1956	after agency notification is subject to a $1,000 fine per day.
1957	(8)  Any licensed facility whose owner or administrator
1958	concurrently operates an unlicensed facility shall be subject to
1959	an administrative fine of $5,000 per day.
1960	(9)  Any facility whose owner fails to apply for a change-
1961	of-ownership license in accordance with s. 429.12 s. 400.412 and
1962	operates the facility under the new ownership is subject to a
1963	fine of $5,000.
1964	(10)  In addition to any administrative fines imposed, the
1965	agency may assess a survey fee, equal to the lesser of one half
1966	of the facility's biennial license and bed fee or $500, to cover
1967	the cost of conducting initial complaint investigations that
1968	result in the finding of a violation that was the subject of the
1969	complaint or monitoring visits conducted under s. 429.28(3)(c)
1970	s. 400.428(3)(c) to verify the correction of the violations.
1971	(11)  The agency, as an alternative to or in conjunction
1972	with an administrative action against a facility for violations
1973	of this part and adopted rules, shall make a reasonable attempt
1974	to discuss each violation and recommended corrective action with
1975	the owner or administrator of the facility, prior to written
1976	notification. The agency, instead of fixing a period within
1977	which the facility shall enter into compliance with standards,
1978	may request a plan of corrective action from the facility which
1979	demonstrates a good faith effort to remedy each violation by a
1980	specific date, subject to the approval of the agency.
1981	(12)  Administrative fines paid by any facility under this
1982	section shall be deposited into the Health Care Trust Fund and
1983	expended as provided in s. 429.18 s. 400.418.
1984	(13)  The agency shall develop and disseminate an annual
1985	list of all facilities sanctioned or fined $5,000 or more for
1986	violations of state standards, the number and class of
1987	violations involved, the penalties imposed, and the current
1988	status of cases. The list shall be disseminated, at no charge,
1989	to the Department of Elderly Affairs, the Department of Health,
1990	the Department of Children and Family Services, the area
1991	agencies on aging, the Florida Statewide Advocacy Council, and
1992	the state and local ombudsman councils. The Department of
1993	Children and Family Services shall disseminate the list to
1994	service providers under contract to the department who are
1995	responsible for referring persons to a facility for residency.
1996	The agency may charge a fee commensurate with the cost of
1997	printing and postage to other interested parties requesting a
1998	copy of this list.
1999	Section 45.  Section 400.42, Florida Statutes, is
2000	renumbered as section 429.20, Florida Statutes, and amended to
2001	read:
2002	429.20 400.42  Certain solicitation prohibited; third-party
2003	supplementation.--
2004	(1)  A person may not, in connection with the solicitation
2005	of contributions by or on behalf of an assisted living facility
2006	or facilities, misrepresent or mislead any person, by any
2007	manner, means, practice, or device whatsoever, to believe that
2008	the receipts of such solicitation will be used for charitable
2009	purposes, if that is not the fact.
2010	(2)  Solicitation of contributions of any kind in a
2011	threatening, coercive, or unduly forceful manner by or on behalf
2012	of an assisted living facility or facilities by any agent,
2013	employee, owner, or representative of any assisted living
2014	facility or facilities is grounds for denial, suspension, or
2015	revocation of the license of the assisted living facility or
2016	facilities by or on behalf of which such contributions were
2017	solicited.
2018	(3)  The admission or maintenance of assisted living
2019	facility residents whose care is supported, in whole or in part,
2020	by state funds may not be conditioned upon the receipt of any
2021	manner of contribution or donation from any person. The
2022	solicitation or receipt of contributions in violation of this
2023	subsection is grounds for denial, suspension, or revocation of
2024	license, as provided in s. 429.14 s. 400.414, for any assisted
2025	living facility by or on behalf of which such contributions were
2026	solicited.
2027	(4)  An assisted living facility may accept additional
2028	supplementation from third parties on behalf of residents
2029	receiving optional state supplementation in accordance with s.
2030	409.212.
2031	Section 46.  Section 400.422, Florida Statutes, is
2032	renumbered as section 429.22, Florida Statutes, and amended to
2033	read:
2034	429.22 400.422  Receivership proceedings.--
2035	(1)  As an alternative to or in conjunction with an
2036	injunctive proceeding, the agency may petition a court of
2037	competent jurisdiction for the appointment of a receiver, if
2038	suitable alternate placements are not available, when any of the
2039	following conditions exist:
2040	(a)  The facility is operating without a license and
2041	refuses to make application for a license as required by ss.
2042	429.07 and 429.08 ss. 400.407 and 400.408.
2043	(b)  The facility is closing or has informed the agency
2044	that it intends to close and adequate arrangements have not been
2045	made for relocation of the residents within 7 days, exclusive of
2046	weekends and holidays, of the closing of the facility.
2047	(c)  The agency determines there exist in the facility
2048	conditions which present an imminent danger to the health,
2049	safety, or welfare of the residents of the facility or a
2050	substantial probability that death or serious physical harm
2051	would result therefrom.
2052	(d)  The facility cannot meet its financial obligation for
2053	providing food, shelter, care, and utilities.
2054	(2)  Petitions for receivership shall take precedence over
2055	other court business unless the court determines that some other
2056	pending proceeding, having similar statutory precedence, shall
2057	have priority.  A hearing shall be conducted within 5 days of
2058	the filing of the petition, at which time all interested parties
2059	shall have the opportunity to present evidence pertaining to the
2060	petition.  The agency shall notify, by certified mail, the owner
2061	or administrator of the facility named in the petition and the
2062	facility resident or, if applicable, the resident's
2063	representative or designee, or the resident's surrogate,
2064	guardian, or attorney in fact, of its filing, the substance of
2065	the violation, and the date and place set for the hearing.  The
2066	court shall grant the petition only upon finding that the
2067	health, safety, or welfare of facility residents would be
2068	threatened if a condition existing at the time the petition was
2069	filed is permitted to continue.  A receiver shall not be
2070	appointed ex parte unless the court determines that one or more
2071	of the conditions in subsection (1) exist; that the facility
2072	owner or administrator cannot be found; that all reasonable
2073	means of locating the owner or administrator and notifying him
2074	or her of the petition and hearing have been exhausted; or that
2075	the owner or administrator after notification of the hearing
2076	chooses not to attend.  After such findings, the court may
2077	appoint any qualified person as a receiver, except it may not
2078	appoint any owner or affiliate of the facility which is in
2079	receivership.  The receiver may be selected from a list of
2080	persons qualified to act as receivers developed by the agency
2081	and presented to the court with each petition for receivership.
2082	Under no circumstances may the agency or designated agency
2083	employee be appointed as a receiver for more than 60 days;
2084	however, the receiver may petition the court, one time only, for
2085	a 30-day extension.  The court shall grant the extension upon a
2086	showing of good cause.
2087	(3)  The receiver must make provisions for the continued
2088	health, safety, and welfare of all residents of the facility
2089	and:
2090	(a)  Shall exercise those powers and perform those duties
2091	set out by the court.
2092	(b)  Shall operate the facility in such a manner as to
2093	assure safety and adequate health care for the residents.
2094	(c)  Shall take such action as is reasonably necessary to
2095	protect or conserve the assets or property of the facility for
2096	which the receiver is appointed, or the proceeds from any
2097	transfer thereof, and may use them only in the performance of
2098	the powers and duties set forth in this section and by order of
2099	the court.
2100	(d)  May use the building, fixtures, furnishings, and any
2101	accompanying consumable goods in the provision of care and
2102	services to residents and to any other persons receiving
2103	services from the facility at the time the petition for
2104	receivership was filed.  The receiver shall collect payments for
2105	all goods and services provided to residents or others during
2106	the period of the receivership at the same rate of payment
2107	charged by the owners at the time the petition for receivership
2108	was filed, or at a fair and reasonable rate otherwise approved
2109	by the court.
2110	(e)  May correct or eliminate any deficiency in the
2111	structure or furnishings of the facility which endangers the
2112	safety or health of residents while they remain in the facility,
2113	if the total cost of correction does not exceed $10,000.  The
2114	court may order expenditures for this purpose in excess of
2115	$10,000 on application from the receiver after notice to the
2116	owner and a hearing.
2117	(f)  May let contracts and hire agents and employees to
2118	carry out the powers and duties of the receiver.
2119	(g)  Shall honor all leases, mortgages, and secured
2120	transactions governing the building in which the facility is
2121	located and all goods and fixtures in the building of which the
2122	receiver has taken possession, but only to the extent of
2123	payments which, in the case of a rental agreement, are for the
2124	use of the property during the period of the receivership, or
2125	which, in the case of a purchase agreement, become due during
2126	the period of the receivership.
2127	(h)  Shall have full power to direct and manage and to
2128	discharge employees of the facility, subject to any contract
2129	rights they may have.  The receiver shall pay employees at the
2130	rate of compensation, including benefits, approved by the court.
2131	A receivership does not relieve the owner of any obligation to
2132	employees made prior to the appointment of a receiver and not
2133	carried out by the receiver.
2134	(i)  Shall be entitled to and take possession of all
2135	property or assets of residents which are in the possession of a
2136	facility or its owner. The receiver shall preserve all property,
2137	assets, and records of residents of which the receiver takes
2138	possession and shall provide for the prompt transfer of the
2139	property, assets, and records to the new placement of any
2140	transferred resident.  An inventory list certified by the owner
2141	and receiver shall be made immediately at the time the receiver
2142	takes possession of the facility.
2143	(4)(a)  A person who is served with notice of an order of
2144	the court appointing a receiver and of the receiver's name and
2145	address shall be liable to pay the receiver for any goods or
2146	services provided by the receiver after the date of the order if
2147	the person would have been liable for the goods or services as
2148	supplied by the owner.  The receiver shall give a receipt for
2149	each payment and shall keep a copy of each receipt on file.  The
2150	receiver shall deposit accounts received in a separate account
2151	and shall use this account for all disbursements.
2152	(b)  The receiver may bring an action to enforce the
2153	liability created by paragraph (a).
2154	(c)  A payment to the receiver of any sum owing to the
2155	facility or its owner shall discharge any obligation to the
2156	facility to the extent of the payment.
2157	(5)(a)  A receiver may petition the court that he or she
2158	not be required to honor any lease, mortgage, secured
2159	transaction, or other wholly or partially executory contract
2160	entered into by the owner of the facility if the rent, price, or
2161	rate of interest required to be paid under the agreement was
2162	substantially in excess of a reasonable rent, price, or rate of
2163	interest at the time the contract was entered into, or if any
2164	material provision of the agreement was unreasonable, when
2165	compared to contracts negotiated under similar conditions.  Any
2166	relief in this form provided by the court shall be limited to
2167	the life of the receivership, unless otherwise determined by the
2168	court.
2169	(b)  If the receiver is in possession of real estate or
2170	goods subject to a lease, mortgage, or security interest which
2171	the receiver has obtained a court order to avoid under paragraph
2172	(a), and if the real estate or goods are necessary for the
2173	continued operation of the facility under this section, the
2174	receiver may apply to the court to set a reasonable rental,
2175	price, or rate of interest to be paid by the receiver during the
2176	duration of the receivership. The court shall hold a hearing on
2177	the application within 15 days.  The receiver shall send notice
2178	of the application to any known persons who own the property
2179	involved at least 10 days prior to the hearing. Payment by the
2180	receiver of the amount determined by the court to be reasonable
2181	is a defense to any action against the receiver for payment or
2182	for possession of the goods or real estate subject to the lease,
2183	security interest, or mortgage involved by any person who
2184	received such notice, but the payment does not relieve the owner
2185	of the facility of any liability for the difference between the
2186	amount paid by the receiver and the amount due under the
2187	original lease, security interest, or mortgage involved.
2188	(6)  The court shall set the compensation of the receiver,
2189	which will be considered a necessary expense of a receivership.
2190	(7)  A receiver may be held liable in a personal capacity
2191	only for the receiver's own gross negligence, intentional acts,
2192	or breach of fiduciary duty.
2193	(8)  The court may require a receiver to post a bond.
2194	(9)  The court may direct the agency to allocate funds from
2195	the Health Care Trust Fund to the receiver, subject to the
2196	provisions of s. 429.18(1) s. 400.418(1).
2197	(10)  The court may terminate a receivership when:
2198	(a)  The court determines that the receivership is no
2199	longer necessary because the conditions which gave rise to the
2200	receivership no longer exist or the agency grants the facility a
2201	new license; or
2202	(b)  All of the residents in the facility have been
2203	transferred or discharged.
2204	(11)  Within 30 days after termination, the receiver shall
2205	give the court a complete accounting of all property of which
2206	the receiver has taken possession, of all funds collected, and
2207	of the expenses of the receivership.
2208	(12)  Nothing in this section shall be deemed to relieve
2209	any owner, administrator, or employee of a facility placed in
2210	receivership of any civil or criminal liability incurred, or any
2211	duty imposed by law, by reason of acts or omissions of the
2212	owner, administrator, or employee prior to the appointment of a
2213	receiver; nor shall anything contained in this section be
2214	construed to suspend during the receivership any obligation of
2215	the owner, administrator, or employee for payment of taxes or
2216	other operating and maintenance expenses of the facility or of
2217	the owner, administrator, employee, or any other person for the
2218	payment of mortgages or liens.  The owner shall retain the right
2219	to sell or mortgage any facility under receivership, subject to
2220	approval of the court which ordered the receivership.
2221	Section 47.  Section 400.424, Florida Statutes, is
2222	renumbered as section 429.24, Florida Statutes, and amended to
2223	read:
2224	429.24 400.424  Contracts.--
2225	(1)  The presence of each resident in a facility shall be
2226	covered by a contract, executed at the time of admission or
2227	prior thereto, between the licensee and the resident or his or
2228	her designee or legal representative. Each party to the contract
2229	shall be provided with a duplicate original thereof, and the
2230	licensee shall keep on file in the facility all such contracts.
2231	The licensee may not destroy or otherwise dispose of any such
2232	contract until 5 years after its expiration.
2233	(2)  Each contract must contain express provisions
2234	specifically setting forth the services and accommodations to be
2235	provided by the facility; the rates or charges; provision for at
2236	least 30 days' written notice of a rate increase; the rights,
2237	duties, and obligations of the residents, other than those
2238	specified in s. 429.28 s. 400.428; and other matters that the
2239	parties deem appropriate. Whenever money is deposited or
2240	advanced by a resident in a contract as security for performance
2241	of the contract agreement or as advance rent for other than the
2242	next immediate rental period:
2243	(a)  Such funds shall be deposited in a banking institution
2244	in this state that is located, if possible, in the same
2245	community in which the facility is located; shall be kept
2246	separate from the funds and property of the facility; may not be
2247	represented as part of the assets of the facility on financial
2248	statements; and shall be used, or otherwise expended, only for
2249	the account of the resident.
2250	(b)  The licensee shall, within 30 days of receipt of
2251	advance rent or a security deposit, notify the resident or
2252	residents in writing of the manner in which the licensee is
2253	holding the advance rent or security deposit and state the name
2254	and address of the depository where the moneys are being held.
2255	The licensee shall notify residents of the facility's policy on
2256	advance deposits.
2257	(3)(a)  The contract shall include a refund policy to be
2258	implemented at the time of a resident's transfer, discharge, or
2259	death.  The refund policy shall provide that the resident or
2260	responsible party is entitled to a prorated refund based on the
2261	daily rate for any unused portion of payment beyond the
2262	termination date after all charges, including the cost of
2263	damages to the residential unit resulting from circumstances
2264	other than normal use, have been paid to the licensee.  For the
2265	purpose of this paragraph, the termination date shall be the
2266	date the unit is vacated by the resident and cleared of all
2267	personal belongings.  If the amount of belongings does not
2268	preclude renting the unit, the facility may clear the unit and
2269	charge the resident or his or her estate for moving and storing
2270	the items at a rate equal to the actual cost to the facility,
2271	not to exceed 20 percent of the regular rate for the unit,
2272	provided that 14 days' advance written notification is given.
2273	If the resident's possessions are not claimed within 45 days
2274	after notification, the facility may dispose of them.  The
2275	contract shall also specify any other conditions under which
2276	claims will be made against the refund due the resident.  Except
2277	in the case of death or a discharge due to medical reasons, the
2278	refunds shall be computed in accordance with the notice of
2279	relocation requirements specified in the contract.  However, a
2280	resident may not be required to provide the licensee with more
2281	than 30 days' notice of termination.  If after a contract is
2282	terminated, the facility intends to make a claim against a
2283	refund due the resident, the facility shall notify the resident
2284	or responsible party in writing of the claim and shall provide
2285	said party with a reasonable time period of no less than 14
2286	calendar days to respond.  The facility shall provide a refund
2287	to the resident or responsible party within 45 days after the
2288	transfer, discharge, or death of the resident. The agency shall
2289	impose a fine upon a facility that fails to comply with the
2290	refund provisions of the paragraph, which fine shall be equal to
2291	three times the amount due to the resident. One-half of the fine
2292	shall be remitted to the resident or his or her estate, and the
2293	other half to the Health Care Trust Fund to be used for the
2294	purpose specified in s. 429.18 s. 400.418.
2295	(b)  If a licensee agrees to reserve a bed for a resident
2296	who is admitted to a medical facility, including, but not
2297	limited to, a nursing home, health care facility, or psychiatric
2298	facility, the resident or his or her responsible party shall
2299	notify the licensee of any change in status that would prevent
2300	the resident from returning to the facility.  Until such notice
2301	is received, the agreed-upon daily rate may be charged by the
2302	licensee.
2303	(c)  The purpose of any advance payment and a refund policy
2304	for such payment, including any advance payment for housing,
2305	meals, or personal services, shall be covered in the contract.
2306	(4)  The contract shall state whether or not the facility
2307	is affiliated with any religious organization and, if so, which
2308	organization and its general responsibility to the facility.
2309	(5)  Neither the contract nor any provision thereof
2310	relieves any licensee of any requirement or obligation imposed
2311	upon it by this part or rules adopted under this part.
2312	(6)  In lieu of the provisions of this section, facilities
2313	certified under chapter 651 shall comply with the requirements
2314	of s. 651.055.
2315	(7)  Notwithstanding the provisions of this section,
2316	facilities which consist of 60 or more apartments may require
2317	refund policies and termination notices in accordance with the
2318	provisions of part II of chapter 83, provided that the lease is
2319	terminated automatically without financial penalty in the event
2320	of a resident's death or relocation due to psychiatric
2321	hospitalization or to medical reasons which necessitate services
2322	or care beyond which the facility is licensed to provide.  The
2323	date of termination in such instances shall be the date the unit
2324	is fully vacated.  A lease may be substituted for the contract
2325	if it meets the disclosure requirements of this section.  For
2326	the purpose of this section, the term "apartment" means a room
2327	or set of rooms with a kitchen or kitchenette and lavatory
2328	located within one or more buildings containing other similar or
2329	like residential units.
2330	(8)  The department may by rule clarify terms, establish
2331	procedures, clarify refund policies and contract provisions, and
2332	specify documentation as necessary to administer this section.
2333	Section 48.  Section 400.4255, Florida Statutes, is
2334	renumbered as section 429.255, Florida Statutes, and amended to
2335	read:
2336	429.255 400.4255  Use of personnel; emergency care.--
2337	(1)(a)  Persons under contract to the facility, facility
2338	staff, or volunteers, who are licensed according to part I of
2339	chapter 464, or those persons exempt under s. 464.022(1), and
2340	others as defined by rule, may administer medications to
2341	residents, take residents' vital signs, manage individual weekly
2342	pill organizers for residents who self-administer medication,
2343	give prepackaged enemas ordered by a physician, observe
2344	residents, document observations on the appropriate resident's
2345	record, report observations to the resident's physician, and
2346	contract or allow residents or a resident's representative,
2347	designee, surrogate, guardian, or attorney in fact to contract
2348	with a third party, provided residents meet the criteria for
2349	appropriate placement as defined in s. 429.26 s. 400.426.
2350	Nursing assistants certified pursuant to part II of chapter 464
2351	may take residents' vital signs as directed by a licensed nurse
2352	or physician.
2353	(b)  All staff in facilities licensed under this part shall
2354	exercise their professional responsibility to observe residents,
2355	to document observations on the appropriate resident's record,
2356	and to report the observations to the resident's physician.
2357	However, the owner or administrator of the facility shall be
2358	responsible for determining that the resident receiving services
2359	is appropriate for residence in the facility.
2360	(c)  In an emergency situation, licensed personnel may
2361	carry out their professional duties pursuant to part I of
2362	chapter 464 until emergency medical personnel assume
2363	responsibility for care.
2364	(2)  In facilities licensed to provide extended congregate
2365	care, persons under contract to the facility, facility staff, or
2366	volunteers, who are licensed according to part I of chapter 464,
2367	or those persons exempt under s. 464.022(1), or those persons
2368	certified as nursing assistants pursuant to part II of chapter
2369	464, may also perform all duties within the scope of their
2370	license or certification, as approved by the facility
2371	administrator and pursuant to this part.
2372	(3)  Facility staff may withhold or withdraw
2373	cardiopulmonary resuscitation if presented with an order not to
2374	resuscitate executed pursuant to s. 401.45. The department shall
2375	adopt rules providing for the implementation of such orders.
2376	Facility staff and facilities shall not be subject to criminal
2377	prosecution or civil liability, nor be considered to have
2378	engaged in negligent or unprofessional conduct, for withholding
2379	or withdrawing cardiopulmonary resuscitation pursuant to such an
2380	order and rules adopted by the department. The absence of an
2381	order to resuscitate executed pursuant to s. 401.45 does not
2382	preclude a physician from withholding or withdrawing
2383	cardiopulmonary resuscitation as otherwise permitted by law.
2384	Section 49.  Section 400.4256, Florida Statutes, is
2385	renumbered as section 429.256, Florida Statutes, and amended to
2386	read:
2387	429.256 400.4256  Assistance with self-administration of
2388	medication.--
2389	(1)  For the purposes of this section, the term:
2390	(a)  "Informed consent" means advising the resident, or the
2391	resident's surrogate, guardian, or attorney in fact, that an
2392	assisted living facility is not required to have a licensed
2393	nurse on staff, that the resident may be receiving assistance
2394	with self-administration of medication from an unlicensed
2395	person, and that such assistance, if provided by an unlicensed
2396	person, will or will not be overseen by a licensed nurse.
2397	(b)  "Unlicensed person" means an individual not currently
2398	licensed to practice nursing or medicine who is employed by or
2399	under contract to an assisted living facility and who has
2400	received training with respect to assisting with the self-
2401	administration of medication in an assisted living facility as
2402	provided under s. 429.52 s. 400.452 prior to providing such
2403	assistance as described in this section.
2404	(2)  Residents who are capable of self-administering their
2405	own medications without assistance shall be encouraged and
2406	allowed to do so. However, an unlicensed person may, consistent
2407	with a dispensed prescription's label or the package directions
2408	of an over-the-counter medication, assist a resident whose
2409	condition is medically stable with the self-administration of
2410	routine, regularly scheduled medications that are intended to be
2411	self-administered. Assistance with self-medication by an
2412	unlicensed person may occur only upon a documented request by,
2413	and the written informed consent of, a resident or the
2414	resident's surrogate, guardian, or attorney in fact. For the
2415	purposes of this section, self-administered medications include
2416	both legend and over-the-counter oral dosage forms, topical
2417	dosage forms and topical ophthalmic, otic, and nasal dosage
2418	forms including solutions, suspensions, sprays, and inhalers.
2419	(3)  Assistance with self-administration of medication
2420	includes:
2421	(a)  Taking the medication, in its previously dispensed,
2422	properly labeled container, from where it is stored, and
2423	bringing it to the resident.
2424	(b)  In the presence of the resident, reading the label,
2425	opening the container, removing a prescribed amount of
2426	medication from the container, and closing the container.
2427	(c)  Placing an oral dosage in the resident's hand or
2428	placing the dosage in another container and helping the resident
2429	by lifting the container to his or her mouth.
2430	(d)  Applying topical medications.
2431	(e)  Returning the medication container to proper storage.
2432	(f)  Keeping a record of when a resident receives
2433	assistance with self-administration under this section.
2434	(4)  Assistance with self-administration does not include:
2435	(a)  Mixing, compounding, converting, or calculating
2436	medication doses, except for measuring a prescribed amount of
2437	liquid medication or breaking a scored tablet or crushing a
2438	tablet as prescribed.
2439	(b)  The preparation of syringes for injection or the
2440	administration of medications by any injectable route.
2441	(c)  Administration of medications through intermittent
2442	positive pressure breathing machines or a nebulizer.
2443	(d)  Administration of medications by way of a tube
2444	inserted in a cavity of the body.
2445	(e)  Administration of parenteral preparations.
2446	(f)  Irrigations or debriding agents used in the treatment
2447	of a skin condition.
2448	(g)  Rectal, urethral, or vaginal preparations.
2449	(h)  Medications ordered by the physician or health care
2450	professional with prescriptive authority to be given "as
2451	needed," unless the order is written with specific parameters
2452	that preclude independent judgment on the part of the unlicensed
2453	person, and at the request of a competent resident.
2454	(i)  Medications for which the time of administration, the
2455	amount, the strength of dosage, the method of administration, or
2456	the reason for administration requires judgment or discretion on
2457	the part of the unlicensed person.
2458	(5)  Assistance with the self-administration of medication
2459	by an unlicensed person as described in this section shall not
2460	be considered administration as defined in s. 465.003.
2461	(6)  The department may by rule establish facility
2462	procedures and interpret terms as necessary to implement this
2463	section.
2464	Section 50.  Section 400.426, Florida Statutes, is
2465	renumbered as section 429.26, Florida Statutes, and amended to
2466	read:
2467	429.26 400.426  Appropriateness of placements; examinations
2468	of residents.--
2469	(1)  The owner or administrator of a facility is
2470	responsible for determining the appropriateness of admission of
2471	an individual to the facility and for determining the continued
2472	appropriateness of residence of an individual in the facility.
2473	A determination shall be based upon an assessment of the
2474	strengths, needs, and preferences of the resident, the care and
2475	services offered or arranged for by the facility in accordance
2476	with facility policy, and any limitations in law or rule related
2477	to admission criteria or continued residency for the type of
2478	license held by the facility under this part.  A resident may
2479	not be moved from one facility to another without consultation
2480	with and agreement from the resident or, if applicable, the
2481	resident's representative or designee or the resident's family,
2482	guardian, surrogate, or attorney in fact.  In the case of a
2483	resident who has been placed by the department or the Department
2484	of Children and Family Services, the administrator must notify
2485	the appropriate contact person in the applicable department.
2486	(2)  A physician or nurse practitioner who is employed by
2487	an assisted living facility to provide an initial examination
2488	for admission purposes may not have financial interest in the
2489	facility.
2490	(3)  Persons licensed under part I of chapter 464 who are
2491	employed by or under contract with a facility shall, on a
2492	routine basis or at least monthly, perform a nursing assessment
2493	of the residents for whom they are providing nursing services
2494	ordered by a physician, except administration of medication, and
2495	shall document such assessment, including any substantial
2496	changes in a resident's status which may necessitate relocation
2497	to a nursing home, hospital, or specialized health care
2498	facility.  Such records shall be maintained in the facility for
2499	inspection by the agency and shall be forwarded to the
2500	resident's case manager, if applicable.
2501	(4)  If possible, each resident shall have been examined by
2502	a licensed physician or a licensed nurse practitioner within 60
2503	days before admission to the facility.  The signed and completed
2504	medical examination report shall be submitted to the owner or
2505	administrator of the facility who shall use the information
2506	contained therein to assist in the determination of the
2507	appropriateness of the resident's admission and continued stay
2508	in the facility.  The medical examination report shall become a
2509	permanent part of the record of the resident at the facility and
2510	shall be made available to the agency during inspection or upon
2511	request.  An assessment that has been completed through the
2512	Comprehensive Assessment and Review for Long-Term Care Services
2513	(CARES) Program fulfills the requirements for a medical
2514	examination under this subsection and s. 429.07(3)(b)6. s.
2515	400.407(3)(b)6.
2516	(5)  Except as provided in s. 429.07 s. 400.407, if a
2517	medical examination has not been completed within 60 days before
2518	the admission of the resident to the facility, a licensed
2519	physician or licensed nurse practitioner shall examine the
2520	resident and complete a medical examination form provided by the
2521	agency within 30 days following the admission to the facility to
2522	enable the facility owner or administrator to determine the
2523	appropriateness of the admission. The medical examination form
2524	shall become a permanent part of the record of the resident at
2525	the facility and shall be made available to the agency during
2526	inspection by the agency or upon request.
2527	(6)  Any resident accepted in a facility and placed by the
2528	department or the Department of Children and Family Services
2529	shall have been examined by medical personnel within 30 days
2530	before placement in the facility. The examination shall include
2531	an assessment of the appropriateness of placement in a facility.
2532	The findings of this examination shall be recorded on the
2533	examination form provided by the agency. The completed form
2534	shall accompany the resident and shall be submitted to the
2535	facility owner or administrator. Additionally, in the case of a
2536	mental health resident, the Department of Children and Family
2537	Services must provide documentation that the individual has been
2538	assessed by a psychiatrist, clinical psychologist, clinical
2539	social worker, or psychiatric nurse, or an individual who is
2540	supervised by one of these professionals, and determined to be
2541	appropriate to reside in an assisted living facility. The
2542	documentation must be in the facility within 30 days after the
2543	mental health resident has been admitted to the facility. An
2544	evaluation completed upon discharge from a state mental hospital
2545	meets the requirements of this subsection related to
2546	appropriateness for placement as a mental health resident
2547	providing it was completed within 90 days prior to admission to
2548	the facility.  The applicable department shall provide to the
2549	facility administrator any information about the resident that
2550	would help the administrator meet his or her responsibilities
2551	under subsection (1).  Further, department personnel shall
2552	explain to the facility operator any special needs of the
2553	resident and advise the operator whom to call should problems
2554	arise. The applicable department shall advise and assist the
2555	facility administrator where the special needs of residents who
2556	are recipients of optional state supplementation require such
2557	assistance.
2558	(7)  The facility must notify a licensed physician when a
2559	resident exhibits signs of dementia or cognitive impairment or
2560	has a change of condition in order to rule out the presence of
2561	an underlying physiological condition that may be contributing
2562	to such dementia or impairment. The notification must occur
2563	within 30 days after the acknowledgment of such signs by
2564	facility staff. If an underlying condition is determined to
2565	exist, the facility shall arrange, with the appropriate health
2566	care provider, the necessary care and services to treat the
2567	condition.
2568	(8)  The Department of Children and Family Services may
2569	require an examination for supplemental security income and
2570	optional state supplementation recipients residing in facilities
2571	at any time and shall provide the examination whenever a
2572	resident's condition requires it.  Any facility administrator;
2573	personnel of the agency, the department, or the Department of
2574	Children and Family Services; or long-term care ombudsman
2575	council member who believes a resident needs to be evaluated
2576	shall notify the resident's case manager, who shall take
2577	appropriate action.  A report of the examination findings shall
2578	be provided to the resident's case manager and the facility
2579	administrator to help the administrator meet his or her
2580	responsibilities under subsection (1).
2581	(9)  If, at any time after admission to a facility, a
2582	resident appears to need care beyond that which the facility is
2583	licensed to provide, the agency shall require the resident to be
2584	physically examined by a licensed physician or licensed nurse
2585	practitioner.  This examination shall, to the extent possible,
2586	be performed by the resident's preferred physician or nurse
2587	practitioner and shall be paid for by the resident with personal
2588	funds, except as provided in s. 429.18(1)(b) s. 400.418(1)(b).
2589	Following this examination, the examining physician or licensed
2590	nurse practitioner shall complete and sign a medical form
2591	provided by the agency. The completed medical form shall be
2592	submitted to the agency within 30 days after the date the
2593	facility owner or administrator is notified by the agency that
2594	the physical examination is required.  After consultation with
2595	the physician or licensed nurse practitioner who performed the
2596	examination, a medical review team designated by the agency
2597	shall then determine whether the resident is appropriately
2598	residing in the facility.  The medical review team shall base
2599	its decision on a comprehensive review of the resident's
2600	physical and functional status, including the resident's
2601	preferences, and not on an isolated health-related problem.  In
2602	the case of a mental health resident, if the resident appears to
2603	have needs in addition to those identified in the community
2604	living support plan, the agency may require an evaluation by a
2605	mental health professional, as determined by the Department of
2606	Children and Family Services.  A facility may not be required to
2607	retain a resident who requires more services or care than the
2608	facility is able to provide in accordance with its policies and
2609	criteria for admission and continued residency. Members of the
2610	medical review team making the final determination may not
2611	include the agency personnel who initially questioned the
2612	appropriateness of a resident's placement. Such determination is
2613	final and binding upon the facility and the resident. Any
2614	resident who is determined by the medical review team to be
2615	inappropriately residing in a facility shall be given 30 days'
2616	written notice to relocate by the owner or administrator, unless
2617	the resident's continued residence in the facility presents an
2618	imminent danger to the health, safety, or welfare of the
2619	resident or a substantial probability exists that death or
2620	serious physical harm would result to the resident if allowed to
2621	remain in the facility.
2622	(10)  A terminally ill resident who no longer meets the
2623	criteria for continued residency may remain in the facility if
2624	the arrangement is mutually agreeable to the resident and the
2625	facility; additional care is rendered through a licensed
2626	hospice, and the resident is under the care of a physician who
2627	agrees that the physical needs of the resident are being met.
2628	(11)  Facilities licensed to provide extended congregate
2629	care services shall promote aging in place by determining
2630	appropriateness of continued residency based on a comprehensive
2631	review of the resident's physical and functional status; the
2632	ability of the facility, family members, friends, or any other
2633	pertinent individuals or agencies to provide the care and
2634	services required; and documentation that a written service plan
2635	consistent with facility policy has been developed and
2636	implemented to ensure that the resident's needs and preferences
2637	are addressed.
2638	(12)  No resident who requires 24-hour nursing supervision,
2639	except for a resident who is an enrolled hospice patient
2640	pursuant to part IV VI of this chapter 400, shall be retained in
2641	a facility licensed under this part.
2642	Section 51.  Section 400.427, Florida Statutes, is
2643	renumbered as section 429.27, Florida Statutes, and amended to
2644	read:
2645	429.27 400.427  Property and personal affairs of
2646	residents.--
2647	(1)(a)  A resident shall be given the option of using his
2648	or her own belongings, as space permits; choosing his or her
2649	roommate; and, whenever possible, unless the resident is
2650	adjudicated incompetent or incapacitated under state law,
2651	managing his or her own affairs.
2652	(b)  The admission of a resident to a facility and his or
2653	her presence therein shall not confer on the facility or its
2654	owner, administrator, employees, or representatives any
2655	authority to manage, use, or dispose of any property of the
2656	resident; nor shall such admission or presence confer on any of
2657	such persons any authority or responsibility for the personal
2658	affairs of the resident, except that which may be necessary for
2659	the safe management of the facility or for the safety of the
2660	resident.
2661	(2)  A facility, or an owner, administrator, employee, or
2662	representative thereof, may not act as the guardian, trustee, or
2663	conservator for any resident of the assisted living facility or
2664	any of such resident's property. An owner, administrator, or
2665	staff member, or representative thereof, may not act as a
2666	competent resident's payee for social security, veteran's, or
2667	railroad benefits without the consent of the resident.  Any
2668	facility whose owner, administrator, or staff, or representative
2669	thereof, serves as representative payee for any resident of the
2670	facility shall file a surety bond with the agency in an amount
2671	equal to twice the average monthly aggregate income or personal
2672	funds due to residents, or expendable for their account, which
2673	are received by a facility.  Any facility whose owner,
2674	administrator, or staff, or a representative thereof, is granted
2675	power of attorney for any resident of the facility shall file a
2676	surety bond with the agency for each resident for whom such
2677	power of attorney is granted.  The surety bond shall be in an
2678	amount equal to twice the average monthly income of the
2679	resident, plus the value of any resident's property under the
2680	control of the attorney in fact.  The bond shall be executed by
2681	the facility as principal and a licensed surety company.  The
2682	bond shall be conditioned upon the faithful compliance of the
2683	facility with this section and shall run to the agency for the
2684	benefit of any resident who suffers a financial loss as a result
2685	of the misuse or misappropriation by a facility of funds held
2686	pursuant to this subsection.  Any surety company that cancels or
2687	does not renew the bond of any licensee shall notify the agency
2688	in writing not less than 30 days in advance of such action,
2689	giving the reason for the cancellation or nonrenewal.  Any
2690	facility owner, administrator, or staff, or representative
2691	thereof, who is granted power of attorney for any resident of
2692	the facility shall, on a monthly basis, be required to provide
2693	the resident a written statement of any transaction made on
2694	behalf of the resident pursuant to this subsection, and a copy
2695	of such statement given to the resident shall be retained in
2696	each resident's file and available for agency inspection.
2697	(3)  A facility, upon mutual consent with the resident,
2698	shall provide for the safekeeping in the facility of personal
2699	effects not in excess of $500 and funds of the resident not in
2700	excess of $200 cash, and shall keep complete and accurate
2701	records of all such funds and personal effects received. If a
2702	resident is absent from a facility for 24 hours or more, the
2703	facility may provide for the safekeeping of the resident's
2704	personal effects in excess of $500.
2705	(4)  Any funds or other property belonging to or due to a
2706	resident, or expendable for his or her account, which is
2707	received by a facility shall be trust funds which shall be kept
2708	separate from the funds and property of the facility and other
2709	residents or shall be specifically credited to such resident.
2710	Such trust funds shall be used or otherwise expended only for
2711	the account of the resident. At least once every 3 months,
2712	unless upon order of a court of competent jurisdiction, the
2713	facility shall furnish the resident and his or her guardian,
2714	trustee, or conservator, if any, a complete and verified
2715	statement of all funds and other property to which this
2716	subsection applies, detailing the amount and items received,
2717	together with their sources and disposition.  In any event, the
2718	facility shall furnish such statement annually and upon the
2719	discharge or transfer of a resident.  Any governmental agency or
2720	private charitable agency contributing funds or other property
2721	to the account of a resident shall also be entitled to receive
2722	such statement annually and upon the discharge or transfer of
2723	the resident.
2724	(5)  Any personal funds available to facility residents may
2725	be used by residents as they choose to obtain clothing, personal
2726	items, leisure activities, and other supplies and services for
2727	their personal use.  A facility may not demand, require, or
2728	contract for payment of all or any part of the personal funds in
2729	satisfaction of the facility rate for supplies and services
2730	beyond that amount agreed to in writing and may not levy an
2731	additional charge to the individual or the account for any
2732	supplies or services that the facility has agreed by contract to
2733	provide as part of the standard monthly rate.  Any service or
2734	supplies provided by the facility which are charged separately
2735	to the individual or the account may be provided only with the
2736	specific written consent of the individual, who shall be
2737	furnished in advance of the provision of the services or
2738	supplies with an itemized written statement to be attached to
2739	the contract setting forth the charges for the services or
2740	supplies.
2741	(6)(a)  In addition to any damages or civil penalties to
2742	which a person is subject, any person who:
2743	1.  Intentionally withholds a resident's personal funds,
2744	personal property, or personal needs allowance, or who demands,
2745	beneficially receives, or contracts for payment of all or any
2746	part of a resident's personal property or personal needs
2747	allowance in satisfaction of the facility rate for supplies and
2748	services; or
2749	2.  Borrows from or pledges any personal funds of a
2750	resident, other than the amount agreed to by written contract
2751	under s. 429.24 s. 400.424,
2752
2753	commits a misdemeanor of the first degree, punishable as
2754	provided in s. 775.082 or s. 775.083.
2755	(b)  Any facility owner, administrator, or staff, or
2756	representative thereof, who is granted power of attorney for any
2757	resident of the facility and who misuses or misappropriates
2758	funds obtained through this power commits a felony of the third
2759	degree, punishable as provided in s. 775.082, s. 775.083, or s.
2760	775.084.
2761	(7)  In the event of the death of a resident, a licensee
2762	shall return all refunds, funds, and property held in trust to
2763	the resident's personal representative, if one has been
2764	appointed at the time the facility disburses such funds, and, if
2765	not, to the resident's spouse or adult next of kin named in a
2766	beneficiary designation form provided by the facility to the
2767	resident. If the resident has no spouse or adult next of kin or
2768	such person cannot be located, funds due the resident shall be
2769	placed in an interest-bearing account, and all property held in
2770	trust by the facility shall be safeguarded until such time as
2771	the funds and property are disbursed pursuant to the Florida
2772	Probate Code.  Such funds shall be kept separate from the funds
2773	and property of the facility and other residents of the
2774	facility. If the funds of the deceased resident are not
2775	disbursed pursuant to the Florida Probate Code within 2 years
2776	after the resident's death, the funds shall be deposited in the
2777	Health Care Trust Fund administered by the agency.
2778	(8)  The department may by rule clarify terms and specify
2779	procedures and documentation necessary to administer the
2780	provisions of this section relating to the proper management of
2781	residents' funds and personal property and the execution of
2782	surety bonds.
2783	Section 52.  Section 400.428, Florida Statutes, is
2784	renumbered as section 429.28, Florida Statutes, and amended to
2785	read:
2786	429.28 400.428  Resident bill of rights.--
2787	(1)  No resident of a facility shall be deprived of any
2788	civil or legal rights, benefits, or privileges guaranteed by
2789	law, the Constitution of the State of Florida, or the
2790	Constitution of the United States as a resident of a facility.
2791	Every resident of a facility shall have the right to:
2792	(a)  Live in a safe and decent living environment, free
2793	from abuse and neglect.
2794	(b)  Be treated with consideration and respect and with due
2795	recognition of personal dignity, individuality, and the need for
2796	privacy.
2797	(c)  Retain and use his or her own clothes and other
2798	personal property in his or her immediate living quarters, so as
2799	to maintain individuality and personal dignity, except when the
2800	facility can demonstrate that such would be unsafe, impractical,
2801	or an infringement upon the rights of other residents.
2802	(d)  Unrestricted private communication, including
2803	receiving and sending unopened correspondence, access to a
2804	telephone, and visiting with any person of his or her choice, at
2805	any time between the hours of 9 a.m. and 9 p.m. at a minimum.
2806	Upon request, the facility shall make provisions to extend
2807	visiting hours for caregivers and out-of-town guests, and in
2808	other similar situations.
2809	(e)  Freedom to participate in and benefit from community
2810	services and activities and to achieve the highest possible
2811	level of independence, autonomy, and interaction within the
2812	community.
2813	(f)  Manage his or her financial affairs unless the
2814	resident or, if applicable, the resident's representative,
2815	designee, surrogate, guardian, or attorney in fact authorizes
2816	the administrator of the facility to provide safekeeping for
2817	funds as provided in s. 429.27 s. 400.427.
2818	(g)  Share a room with his or her spouse if both are
2819	residents of the facility.
2820	(h)  Reasonable opportunity for regular exercise several
2821	times a week and to be outdoors at regular and frequent
2822	intervals except when prevented by inclement weather.
2823	(i)  Exercise civil and religious liberties, including the
2824	right to independent personal decisions.  No religious beliefs
2825	or practices, nor any attendance at religious services, shall be
2826	imposed upon any resident.
2827	(j)  Access to adequate and appropriate health care
2828	consistent with established and recognized standards within the
2829	community.
2830	(k)  At least 45 days' notice of relocation or termination
2831	of residency from the facility unless, for medical reasons, the
2832	resident is certified by a physician to require an emergency
2833	relocation to a facility providing a more skilled level of care
2834	or the resident engages in a pattern of conduct that is harmful
2835	or offensive to other residents.  In the case of a resident who
2836	has been adjudicated mentally incapacitated, the guardian shall
2837	be given at least 45 days' notice of a nonemergency relocation
2838	or residency termination.  Reasons for relocation shall be set
2839	forth in writing.  In order for a facility to terminate the
2840	residency of an individual without notice as provided herein,
2841	the facility shall show good cause in a court of competent
2842	jurisdiction.
2843	(l)  Present grievances and recommend changes in policies,
2844	procedures, and services to the staff of the facility, governing
2845	officials, or any other person without restraint, interference,
2846	coercion, discrimination, or reprisal. Each facility shall
2847	establish a grievance procedure to facilitate the residents'
2848	exercise of this right.  This right includes access to ombudsman
2849	volunteers and advocates and the right to be a member of, to be
2850	active in, and to associate with advocacy or special interest
2851	groups.
2852	(2)  The administrator of a facility shall ensure that a
2853	written notice of the rights, obligations, and prohibitions set
2854	forth in this part is posted in a prominent place in each
2855	facility and read or explained to residents who cannot read.
2856	This notice shall include the name, address, and telephone
2857	numbers of the local ombudsman council and central abuse hotline
2858	and, when applicable, the Advocacy Center for Persons with
2859	Disabilities, Inc., and the Florida local advocacy council,
2860	where complaints may be lodged.  The facility must ensure a
2861	resident's access to a telephone to call the local ombudsman
2862	council, central abuse hotline, Advocacy Center for Persons with
2863	Disabilities, Inc., and the Florida local advocacy council.
2864	(3)(a)  The agency shall conduct a survey to determine
2865	general compliance with facility standards and compliance with
2866	residents' rights as a prerequisite to initial licensure or
2867	licensure renewal.
2868	(b)  In order to determine whether the facility is
2869	adequately protecting residents' rights, the biennial survey
2870	shall include private informal conversations with a sample of
2871	residents and consultation with the ombudsman council in the
2872	planning and service area in which the facility is located to
2873	discuss residents' experiences within the facility.
2874	(c)  During any calendar year in which no survey is
2875	conducted, the agency shall conduct at least one monitoring
2876	visit of each facility cited in the previous year for a class I
2877	or class II violation, or more than three uncorrected class III
2878	violations.
2879	(d)  The agency may conduct periodic followup inspections
2880	as necessary to monitor the compliance of facilities with a
2881	history of any class I, class II, or class III violations that
2882	threaten the health, safety, or security of residents.
2883	(e)  The agency may conduct complaint investigations as
2884	warranted to investigate any allegations of noncompliance with
2885	requirements required under this part or rules adopted under
2886	this part.
2887	(4)  The facility shall not hamper or prevent residents
2888	from exercising their rights as specified in this section.
2889	(5)  No facility or employee of a facility may serve notice
2890	upon a resident to leave the premises or take any other
2891	retaliatory action against any person who:
2892	(a)  Exercises any right set forth in this section.
2893	(b)  Appears as a witness in any hearing, inside or outside
2894	the facility.
2895	(c)  Files a civil action alleging a violation of the
2896	provisions of this part or notifies a state attorney or the
2897	Attorney General of a possible violation of such provisions.
2898	(6)  Any facility which terminates the residency of an
2899	individual who participated in activities specified in
2900	subsection (5) shall show good cause in a court of competent
2901	jurisdiction.
2902	(7)  Any person who submits or reports a complaint
2903	concerning a suspected violation of the provisions of this part
2904	or concerning services and conditions in facilities, or who
2905	testifies in any administrative or judicial proceeding arising
2906	from such a complaint, shall have immunity from any civil or
2907	criminal liability therefor, unless such person has acted in bad
2908	faith or with malicious purpose or the court finds that there
2909	was a complete absence of a justiciable issue of either law or
2910	fact raised by the losing party.
2911	Section 53.  Section 400.429, Florida Statutes, is
2912	renumbered as section 429.29, Florida Statutes, and amended to
2913	read:
2914	429.29 400.429  Civil actions to enforce rights.--
2915	(1)  Any person or resident whose rights as specified in
2916	this part are violated shall have a cause of action.  The action
2917	may be brought by the resident or his or her guardian, or by a
2918	person or organization acting on behalf of a resident with the
2919	consent of the resident or his or her guardian, or by the
2920	personal representative of the estate of a deceased resident
2921	regardless of the cause of death. If the action alleges a claim
2922	for the resident's rights or for negligence that caused the
2923	death of the resident, the claimant shall be required to elect
2924	either survival damages pursuant to s. 46.021 or wrongful death
2925	damages pursuant to s. 768.21. If the action alleges a claim for
2926	the resident's rights or for negligence that did not cause the
2927	death of the resident, the personal representative of the estate
2928	may recover damages for the negligence that caused injury to the
2929	resident. The action may be brought in any court of competent
2930	jurisdiction to enforce such rights and to recover actual
2931	damages, and punitive damages for violation of the rights of a
2932	resident or negligence. Any resident who prevails in seeking
2933	injunctive relief or a claim for an administrative remedy is
2934	entitled to recover the costs of the action and a reasonable
2935	attorney's fee assessed against the defendant not to exceed
2936	$25,000. Fees shall be awarded solely for the injunctive or
2937	administrative relief and not for any claim or action for
2938	damages whether such claim or action is brought together with a
2939	request for an injunction or administrative relief or as a
2940	separate action, except as provided under s. 768.79 or the
2941	Florida Rules of Civil Procedure. Sections 429.29-429.298
2942	400.429-400.4303 provide the exclusive remedy for a cause of
2943	action for recovery of damages for the personal injury or death
2944	of a resident arising out of negligence or a violation of rights
2945	specified in s. 429.28 s. 400.428. This section does not
2946	preclude theories of recovery not arising out of negligence or
2947	s. 429.28 s. 400.428 which are available to a resident or to the
2948	agency. The provisions of chapter 766 do not apply to any cause
2949	of action brought under ss. 429.29-429.298 ss. 400.429-400.4303.
2950	(2)  In any claim brought pursuant to this part alleging a
2951	violation of resident's rights or negligence causing injury to
2952	or the death of a resident, the claimant shall have the burden
2953	of proving, by a preponderance of the evidence, that:
2954	(a)  The defendant owed a duty to the resident;
2955	(b)  The defendant breached the duty to the resident;
2956	(c)  The breach of the duty is a legal cause of loss,
2957	injury, death, or damage to the resident; and
2958	(d)  The resident sustained loss, injury, death, or damage
2959	as a result of the breach.
2960
2961	Nothing in this part shall be interpreted to create strict
2962	liability. A violation of the rights set forth in s. 429.28 s.
2963	400.428 or in any other standard or guidelines specified in this
2964	part or in any applicable administrative standard or guidelines
2965	of this state or a federal regulatory agency shall be evidence
2966	of negligence but shall not be considered negligence per se.
2967	(3)  In any claim brought pursuant to this section, a
2968	licensee, person, or entity shall have a duty to exercise
2969	reasonable care.  Reasonable care is that degree of care which a
2970	reasonably careful licensee, person, or entity would use under
2971	like circumstances.
2972	(4)  In any claim for resident's rights violation or
2973	negligence by a nurse licensed under part I of chapter 464, such
2974	nurse shall have the duty to exercise care consistent with the
2975	prevailing professional standard of care for a nurse. The
2976	prevailing professional standard of care for a nurse shall be
2977	that level of care, skill, and treatment which, in light of all
2978	relevant surrounding circumstances, is recognized as acceptable
2979	and appropriate by reasonably prudent similar nurses.
2980	(5)  Discovery of financial information for the purpose of
2981	determining the value of punitive damages may not be had unless
2982	the plaintiff shows the court by proffer or evidence in the
2983	record that a reasonable basis exists to support a claim for
2984	punitive damages.
2985	(6)  In addition to any other standards for punitive
2986	damages, any award of punitive damages must be reasonable in
2987	light of the actual harm suffered by the resident and the
2988	egregiousness of the conduct that caused the actual harm to the
2989	resident.
2990	(7)  The resident or the resident's legal representative
2991	shall serve a copy of any complaint alleging in whole or in part
2992	a violation of any rights specified in this part to the Agency
2993	for Health Care Administration at the time of filing the initial
2994	complaint with the clerk of the court for the county in which
2995	the action is pursued. The requirement of providing a copy of
2996	the complaint to the agency does not impair the resident's legal
2997	rights or ability to seek relief for his or her claim.
2998	Section 54.  Section 400.4293, Florida Statutes, is
2999	renumbered as section 429.293, Florida Statutes, and amended to
3000	read:
3001	429.293 400.4293  Presuit notice; investigation;
3002	notification of violation of residents' rights or alleged
3003	negligence; claims evaluation procedure; informal discovery;
3004	review; settlement offer; mediation.--
3005	(1)  As used in this section, the term:
3006	(a)  "Claim for residents' rights violation or negligence"
3007	means a negligence claim alleging injury to or the death of a
3008	resident arising out of an asserted violation of the rights of a
3009	resident under s. 429.28 s. 400.428 or an asserted deviation
3010	from the applicable standard of care.
3011	(b)  "Insurer" means any self-insurer authorized under s.
3012	627.357, liability insurance carrier, joint underwriting
3013	association, or uninsured prospective defendant.
3014	(2)  Prior to filing a claim for a violation of a
3015	resident's rights or a claim for negligence, a claimant alleging
3016	injury to or the death of a resident shall notify each
3017	prospective defendant by certified mail, return receipt
3018	requested, of an asserted violation of a resident's rights
3019	provided in s. 429.28 s. 400.428 or deviation from the standard
3020	of care. Such notification shall include an identification of
3021	the rights the prospective defendant has violated and the
3022	negligence alleged to have caused the incident or incidents and
3023	a brief description of the injuries sustained by the resident
3024	which are reasonably identifiable at the time of notice. The
3025	notice shall contain a certificate of counsel that counsel's
3026	reasonable investigation gave rise to a good faith belief that
3027	grounds exist for an action against each prospective defendant.
3028	(3)(a)  No suit may be filed for a period of 75 days after
3029	notice is mailed to any prospective defendant. During the 75-day
3030	period, the prospective defendants or their insurers shall
3031	conduct an evaluation of the claim to determine the liability of
3032	each defendant and to evaluate the damages of the claimants.
3033	Each defendant or insurer of the defendant shall have a
3034	procedure for the prompt evaluation of claims during the 75-day
3035	period. The procedure shall include one or more of the
3036	following:
3037	1.  Internal review by a duly qualified facility risk
3038	manager or claims adjuster;
3039	2.  Internal review by counsel for each prospective
3040	defendant;
3041	3.  A quality assurance committee authorized under any
3042	applicable state or federal statutes or regulations; or
3043	4.  Any other similar procedure that fairly and promptly
3044	evaluates the claims.
3045
3046	Each defendant or insurer of the defendant shall evaluate the
3047	claim in good faith.
3048	(b)  At or before the end of the 75 days, the defendant or
3049	insurer of the defendant shall provide the claimant with a
3050	written response:
3051	1.  Rejecting the claim; or
3052	2.  Making a settlement offer.
3053	(c)  The response shall be delivered to the claimant if not
3054	represented by counsel or to the claimant's attorney, by
3055	certified mail, return receipt requested. Failure of the
3056	prospective defendant or insurer of the defendant to reply to
3057	the notice within 75 days after receipt shall be deemed a
3058	rejection of the claim for purposes of this section.
3059	(4)  The notification of a violation of a resident's rights
3060	or alleged negligence shall be served within the applicable
3061	statute of limitations period; however, during the 75-day
3062	period, the statute of limitations is tolled as to all
3063	prospective defendants. Upon stipulation by the parties, the 75-
3064	day period may be extended and the statute of limitations is
3065	tolled during any such extension. Upon receiving written notice
3066	by certified mail, return receipt requested, of termination of
3067	negotiations in an extended period, the claimant shall have 60
3068	days or the remainder of the period of the statute of
3069	limitations, whichever is greater, within which to file suit.
3070	(5)  No statement, discussion, written document, report, or
3071	other work product generated by presuit claims evaluation
3072	procedures under this section is discoverable or admissible in
3073	any civil action for any purpose by the opposing party. All
3074	participants, including, but not limited to, physicians,
3075	investigators, witnesses, and employees or associates of the
3076	defendant, are immune from civil liability arising from
3077	participation in the presuit claims evaluation procedure. Any
3078	licensed physician or registered nurse may be retained by either
3079	party to provide an opinion regarding the reasonable basis of
3080	the claim. The presuit opinions of the expert are not
3081	discoverable or admissible in any civil action for any purpose
3082	by the opposing party.
3083	(6)  Upon receipt by a prospective defendant of a notice of
3084	claim, the parties shall make discoverable information available
3085	without formal discovery as provided in subsection (7).
3086	(7)  Informal discovery may be used by a party to obtain
3087	unsworn statements and the production of documents or things, as
3088	follows:
3089	(a)  Unsworn statements.--Any party may require other
3090	parties to appear for the taking of an unsworn statement. Such
3091	statements may be used only for the purpose of claims evaluation
3092	and are not discoverable or admissible in any civil action for
3093	any purpose by any party. A party seeking to take the unsworn
3094	statement of any party must give reasonable notice in writing to
3095	all parties. The notice must state the time and place for taking
3096	the statement and the name and address of the party to be
3097	examined. Unless otherwise impractical, the examination of any
3098	party must be done at the same time by all other parties. Any
3099	party may be represented by counsel at the taking of an unsworn
3100	statement. An unsworn statement may be recorded electronically,
3101	stenographically, or on videotape. The taking of unsworn
3102	statements is subject to the provisions of the Florida Rules of
3103	Civil Procedure and may be terminated for abuses.
3104	(b)  Documents or things.--Any party may request discovery
3105	of relevant documents or things. The documents or things must be
3106	produced, at the expense of the requesting party, within 20 days
3107	after the date of receipt of the request. A party is required to
3108	produce relevant and discoverable documents or things within
3109	that party's possession or control, if in good faith it can
3110	reasonably be done within the timeframe of the claims evaluation
3111	process.
3112	(8)  Each request for and notice concerning informal
3113	discovery pursuant to this section must be in writing, and a
3114	copy thereof must be sent to all parties. Such a request or
3115	notice must bear a certificate of service identifying the name
3116	and address of the person to whom the request or notice is
3117	served, the date of the request or notice, and the manner of
3118	service thereof.
3119	(9)  If a prospective defendant makes a written settlement
3120	offer, the claimant shall have 15 days from the date of receipt
3121	to accept the offer. An offer shall be deemed rejected unless
3122	accepted by delivery of a written notice of acceptance.
3123	(10)  To the extent not inconsistent with this part, the
3124	provisions of the Florida Mediation Code, Florida Rules of Civil
3125	Procedure, shall be applicable to such proceedings.
3126	(11)  Within 30 days after the claimant's receipt of
3127	defendant's response to the claim, the parties or their
3128	designated representatives shall meet in mediation to discuss
3129	the issues of liability and damages in accordance with the
3130	mediation rules of practice and procedures adopted by the
3131	Supreme Court. Upon stipulation of the parties, this 30-day
3132	period may be extended and the statute of limitations is tolled
3133	during the mediation and any such extension. At the conclusion
3134	of mediation, the claimant shall have 60 days or the remainder
3135	of the period of the statute of limitations, whichever is
3136	greater, within which to file suit.
3137	Section 55.  Section 400.431, Florida Statutes, is
3138	renumbered as section 429.31, Florida Statutes, and amended to
3139	read:
3140	429.31 400.431  Closing of facility; notice; penalty.--
3141	(1)  Whenever a facility voluntarily discontinues
3142	operation, it shall inform the agency in writing at least 90
3143	days prior to the discontinuance of operation.  The facility
3144	shall also inform each resident or the next of kin, legal
3145	representative, or agency acting on each resident's behalf, of
3146	the fact and the proposed time of such discontinuance, following
3147	the notification requirements provided in s. 429.28(1)(k) s.
3148	400.428(1)(k).  In the event a resident has no person to
3149	represent him or her, the facility shall be responsible for
3150	referral to an appropriate social service agency for placement.
3151	(2)  Immediately upon the notice by the agency of the
3152	voluntary or involuntary termination of such operation, the
3153	agency shall monitor the transfer of residents to other
3154	facilities and ensure that residents' rights are being
3155	protected.  The department, in consultation with the Department
3156	of Children and Family Services, shall specify procedures for
3157	ensuring that all residents who receive services are
3158	appropriately relocated.
3159	(3)  All charges shall be prorated as of the date on which
3160	the facility discontinues operation, and if any payments have
3161	been made in advance, the payments for services not received
3162	shall be refunded to the resident or the resident's guardian
3163	within 10 working days of voluntary or involuntary closure of
3164	the facility, whether or not such refund is requested by the
3165	resident or guardian.
3166	(4)  Immediately upon discontinuance of the operation of a
3167	facility, the owner shall surrender the license therefor to the
3168	agency, and the license shall be canceled.
3169	(5)  The agency may levy a fine in an amount no greater
3170	than $5,000 upon each person or business entity that owns any
3171	interest in a facility that terminates operation without
3172	providing notice to the agency and the residents of the facility
3173	at least 30 days before operation ceases.  This fine shall not
3174	be levied against any facility involuntarily closed at the
3175	initiation of the agency.  The agency shall use the proceeds of
3176	the fines to operate the facility until all residents of the
3177	facility are relocated and shall deposit any balance of the
3178	proceeds into the Health Care Trust Fund established pursuant to
3179	s. 429.18 s. 400.418.
3180	Section 56.  Section 400.441, Florida Statutes, is
3181	renumbered as section 429.41, Florida Statutes, and amended to
3182	read:
3183	429.41 400.441  Rules establishing standards.--
3184	(1)  It is the intent of the Legislature that rules
3185	published and enforced pursuant to this section shall include
3186	criteria by which a reasonable and consistent quality of
3187	resident care and quality of life may be ensured and the results
3188	of such resident care may be demonstrated.  Such rules shall
3189	also ensure a safe and sanitary environment that is residential
3190	and noninstitutional in design or nature.  It is further
3191	intended that reasonable efforts be made to accommodate the
3192	needs and preferences of residents to enhance the quality of
3193	life in a facility. In order to provide safe and sanitary
3194	facilities and the highest quality of resident care
3195	accommodating the needs and preferences of residents, the
3196	department, in consultation with the agency, the Department of
3197	Children and Family Services, and the Department of Health,
3198	shall adopt rules, policies, and procedures to administer this
3199	part, which must include reasonable and fair minimum standards
3200	in relation to:
3201	(a)  The requirements for and maintenance of facilities,
3202	not in conflict with the provisions of chapter 553, relating to
3203	plumbing, heating, cooling, lighting, ventilation, living space,
3204	and other housing conditions, which will ensure the health,
3205	safety, and comfort of residents and protection from fire
3206	hazard, including adequate provisions for fire alarm and other
3207	fire protection suitable to the size of the structure. Uniform
3208	firesafety standards shall be established and enforced by the
3209	State Fire Marshal in cooperation with the agency, the
3210	department, and the Department of Health.
3211	1.  Evacuation capability determination.--
3212	a.  The provisions of the National Fire Protection
3213	Association, NFPA 101A, Chapter 5, 1995 edition, shall be used
3214	for determining the ability of the residents, with or without
3215	staff assistance, to relocate from or within a licensed facility
3216	to a point of safety as provided in the fire codes adopted
3217	herein. An evacuation capability evaluation for initial
3218	licensure shall be conducted within 6 months after the date of
3219	licensure. For existing licensed facilities that are not
3220	equipped with an automatic fire sprinkler system, the
3221	administrator shall evaluate the evacuation capability of
3222	residents at least annually. The evacuation capability
3223	evaluation for each facility not equipped with an automatic fire
3224	sprinkler system shall be validated, without liability, by the
3225	State Fire Marshal, by the local fire marshal, or by the local
3226	authority having jurisdiction over firesafety, before the
3227	license renewal date. If the State Fire Marshal, local fire
3228	marshal, or local authority having jurisdiction over firesafety
3229	has reason to believe that the evacuation capability of a
3230	facility as reported by the administrator may have changed, it
3231	may, with assistance from the facility administrator, reevaluate
3232	the evacuation capability through timed exiting drills.
3233	Translation of timed fire exiting drills to evacuation
3234	capability may be determined:
3235	(I)  Three minutes or less: prompt.
3236	(II)  More than 3 minutes, but not more than 13 minutes:
3237	slow.
3238	(III)  More than 13 minutes: impractical.
3239	b.  The Office of the State Fire Marshal shall provide or
3240	cause the provision of training and education on the proper
3241	application of Chapter 5, NFPA 101A, 1995 edition, to its
3242	employees, to staff of the Agency for Health Care Administration
3243	who are responsible for regulating facilities under this part,
3244	and to local governmental inspectors. The Office of the State
3245	Fire Marshal shall provide or cause the provision of this
3246	training within its existing budget, but may charge a fee for
3247	this training to offset its costs. The initial training must be
3248	delivered within 6 months after July 1, 1995, and as needed
3249	thereafter.
3250	c.  The Office of the State Fire Marshal, in cooperation
3251	with provider associations, shall provide or cause the provision
3252	of a training program designed to inform facility operators on
3253	how to properly review bid documents relating to the
3254	installation of automatic fire sprinklers. The Office of the
3255	State Fire Marshal shall provide or cause the provision of this
3256	training within its existing budget, but may charge a fee for
3257	this training to offset its costs. The initial training must be
3258	delivered within 6 months after July 1, 1995, and as needed
3259	thereafter.
3260	d.  The administrator of a licensed facility shall sign an
3261	affidavit verifying the number of residents occupying the
3262	facility at the time of the evacuation capability evaluation.
3263	2.  Firesafety requirements.--
3264	a.  Except for the special applications provided herein,
3265	effective January 1, 1996, the provisions of the National Fire
3266	Protection Association, Life Safety Code, NFPA 101, 1994
3267	edition, Chapter 22 for new facilities and Chapter 23 for
3268	existing facilities shall be the uniform fire code applied by
3269	the State Fire Marshal for assisted living facilities, pursuant
3270	to s. 633.022.
3271	b.  Any new facility, regardless of size, that applies for
3272	a license on or after January 1, 1996, must be equipped with an
3273	automatic fire sprinkler system. The exceptions as provided in
3274	section 22-2.3.5.1, NFPA 101, 1994 edition, as adopted herein,
3275	apply to any new facility housing eight or fewer residents. On
3276	July 1, 1995, local governmental entities responsible for the
3277	issuance of permits for construction shall inform, without
3278	liability, any facility whose permit for construction is
3279	obtained prior to January 1, 1996, of this automatic fire
3280	sprinkler requirement. As used in this part, the term "a new
3281	facility" does not mean an existing facility that has undergone
3282	change of ownership.
3283	c.  Notwithstanding any provision of s. 633.022 or of the
3284	National Fire Protection Association, NFPA 101A, Chapter 5, 1995
3285	edition, to the contrary, any existing facility housing eight or
3286	fewer residents is not required to install an automatic fire
3287	sprinkler system, nor to comply with any other requirement in
3288	Chapter 23, NFPA 101, 1994 edition, that exceeds the firesafety
3289	requirements of NFPA 101, 1988 edition, that applies to this
3290	size facility, unless the facility has been classified as
3291	impractical to evacuate. Any existing facility housing eight or
3292	fewer residents that is classified as impractical to evacuate
3293	must install an automatic fire sprinkler system within the
3294	timeframes granted in this section.
3295	d.  Any existing facility that is required to install an
3296	automatic fire sprinkler system under this paragraph need not
3297	meet other firesafety requirements of Chapter 23, NFPA 101, 1994
3298	edition, which exceed the provisions of NFPA 101, 1988 edition.
3299	The mandate contained in this paragraph which requires certain
3300	facilities to install an automatic fire sprinkler system
3301	supersedes any other requirement.
3302	e.  This paragraph does not supersede the exceptions
3303	granted in NFPA 101, 1988 edition or 1994 edition.
3304	f.  This paragraph does not exempt facilities from other
3305	firesafety provisions adopted under s. 633.022 and local
3306	building code requirements in effect before July 1, 1995.
3307	g.  A local government may charge fees only in an amount
3308	not to exceed the actual expenses incurred by local government
3309	relating to the installation and maintenance of an automatic
3310	fire sprinkler system in an existing and properly licensed
3311	assisted living facility structure as of January 1, 1996.
3312	h.  If a licensed facility undergoes major reconstruction
3313	or addition to an existing building on or after January 1, 1996,
3314	the entire building must be equipped with an automatic fire
3315	sprinkler system. Major reconstruction of a building means
3316	repair or restoration that costs in excess of 50 percent of the
3317	value of the building as reported on the tax rolls, excluding
3318	land, before reconstruction. Multiple reconstruction projects
3319	within a 5-year period the total costs of which exceed 50
3320	percent of the initial value of the building at the time the
3321	first reconstruction project was permitted are to be considered
3322	as major reconstruction. Application for a permit for an
3323	automatic fire sprinkler system is required upon application for
3324	a permit for a reconstruction project that creates costs that go
3325	over the 50-percent threshold.
3326	i.  Any facility licensed before January 1, 1996, that is
3327	required to install an automatic fire sprinkler system shall
3328	ensure that the installation is completed within the following
3329	timeframes based upon evacuation capability of the facility as
3330	determined under subparagraph 1.:
3331	(I)  Impractical evacuation capability, 24 months.
3332	(II)  Slow evacuation capability, 48 months.
3333	(III)  Prompt evacuation capability, 60 months.
3334
3335	The beginning date from which the deadline for the automatic
3336	fire sprinkler installation requirement must be calculated is
3337	upon receipt of written notice from the local fire official that
3338	an automatic fire sprinkler system must be installed. The local
3339	fire official shall send a copy of the document indicating the
3340	requirement of a fire sprinkler system to the Agency for Health
3341	Care Administration.
3342	j.  It is recognized that the installation of an automatic
3343	fire sprinkler system may create financial hardship for some
3344	facilities. The appropriate local fire official shall, without
3345	liability, grant two 1-year extensions to the timeframes for
3346	installation established herein, if an automatic fire sprinkler
3347	installation cost estimate and proof of denial from two
3348	financial institutions for a construction loan to install the
3349	automatic fire sprinkler system are submitted. However, for any
3350	facility with a class I or class II, or a history of uncorrected
3351	class III, firesafety deficiencies, an extension must not be
3352	granted. The local fire official shall send a copy of the
3353	document granting the time extension to the Agency for Health
3354	Care Administration.
3355	k.  A facility owner whose facility is required to be
3356	equipped with an automatic fire sprinkler system under Chapter
3357	23, NFPA 101, 1994 edition, as adopted herein, must disclose to
3358	any potential buyer of the facility that an installation of an
3359	automatic fire sprinkler requirement exists. The sale of the
3360	facility does not alter the timeframe for the installation of
3361	the automatic fire sprinkler system.
3362	l.  Existing facilities required to install an automatic
3363	fire sprinkler system as a result of construction-type
3364	restrictions in Chapter 23, NFPA 101, 1994 edition, as adopted
3365	herein, or evacuation capability requirements shall be notified
3366	by the local fire official in writing of the automatic fire
3367	sprinkler requirement, as well as the appropriate date for final
3368	compliance as provided in this subparagraph. The local fire
3369	official shall send a copy of the document to the Agency for
3370	Health Care Administration.
3371	m.  Except in cases of life-threatening fire hazards, if an
3372	existing facility experiences a change in the evacuation
3373	capability, or if the local authority having jurisdiction
3374	identifies a construction-type restriction, such that an
3375	automatic fire sprinkler system is required, it shall be
3376	afforded time for installation as provided in this subparagraph.
3377
3378	Facilities that are fully sprinkled and in compliance with other
3379	firesafety standards are not required to conduct more than one
3380	of the required fire drills between the hours of 11 p.m. and 7
3381	a.m., per year. In lieu of the remaining drills, staff
3382	responsible for residents during such hours may be required to
3383	participate in a mock drill that includes a review of evacuation
3384	procedures. Such standards must be included or referenced in the
3385	rules adopted by the State Fire Marshal. Pursuant to s.
3386	633.022(1)(b), the State Fire Marshal is the final
3387	administrative authority for firesafety standards established
3388	and enforced pursuant to this section. All licensed facilities
3389	must have an annual fire inspection conducted by the local fire
3390	marshal or authority having jurisdiction.
3391	3.  Resident elopement requirements.--Facilities are
3392	required to conduct a minimum of two resident elopement
3393	prevention and response drills per year. All administrators and
3394	direct care staff must participate in the drills which shall
3395	include a review of procedures to address resident elopement.
3396	Facilities must document the implementation of the drills and
3397	ensure that the drills are conducted in a manner consistent with
3398	the facility's resident elopement policies and procedures.
3399	(b)  The preparation and annual update of a comprehensive
3400	emergency management plan.  Such standards must be included in
3401	the rules adopted by the department after consultation with the
3402	Department of Community Affairs.  At a minimum, the rules must
3403	provide for plan components that address emergency evacuation
3404	transportation; adequate sheltering arrangements; postdisaster
3405	activities, including provision of emergency power, food, and
3406	water; postdisaster transportation; supplies; staffing;
3407	emergency equipment; individual identification of residents and
3408	transfer of records; communication with families; and responses
3409	to family inquiries.  The comprehensive emergency management
3410	plan is subject to review and approval by the local emergency
3411	management agency. During its review, the local emergency
3412	management agency shall ensure that the following agencies, at a
3413	minimum, are given the opportunity to review the plan:  the
3414	Department of Elderly Affairs, the Department of Health, the
3415	Agency for Health Care Administration, and the Department of
3416	Community Affairs.  Also, appropriate volunteer organizations
3417	must be given the opportunity to review the plan.  The local
3418	emergency management agency shall complete its review within 60
3419	days and either approve the plan or advise the facility of
3420	necessary revisions.
3421	(c)  The number, training, and qualifications of all
3422	personnel having responsibility for the care of residents.  The
3423	rules must require adequate staff to provide for the safety of
3424	all residents.  Facilities licensed for 17 or more residents are
3425	required to maintain an alert staff for 24 hours per day.
3426	(d)  All sanitary conditions within the facility and its
3427	surroundings which will ensure the health and comfort of
3428	residents.  The rules must clearly delineate the
3429	responsibilities of the agency's licensure and survey staff, the
3430	county health departments, and the local authority having
3431	jurisdiction over fire safety and ensure that inspections are
3432	not duplicative.  The agency may collect fees for food service
3433	inspections conducted by the county health departments and
3434	transfer such fees to the Department of Health.
3435	(e)  License application and license renewal, transfer of
3436	ownership, proper management of resident funds and personal
3437	property, surety bonds, resident contracts, refund policies,
3438	financial ability to operate, and facility and staff records.
3439	(f)  Inspections, complaint investigations, moratoriums,
3440	classification of deficiencies, levying and enforcement of
3441	penalties, and use of income from fees and fines.
3442	(g)  The enforcement of the resident bill of rights
3443	specified in s. 429.28 s. 400.428.
3444	(h)  The care and maintenance of residents, which must
3445	include, but is not limited to:
3446	1.  The supervision of residents;
3447	2.  The provision of personal services;
3448	3.  The provision of, or arrangement for, social and
3449	leisure activities;
3450	4.  The arrangement for appointments and transportation to
3451	appropriate medical, dental, nursing, or mental health services,
3452	as needed by residents;
3453	5.  The management of medication;
3454	6.  The nutritional needs of residents;
3455	7.  Resident records; and
3456	8.  Internal risk management and quality assurance.
3457	(i)  Facilities holding a limited nursing, extended
3458	congregate care, or limited mental health license.
3459	(j)  The establishment of specific criteria to define
3460	appropriateness of resident admission and continued residency in
3461	a facility holding a standard, limited nursing, extended
3462	congregate care, and limited mental health license.
3463	(k)  The use of physical or chemical restraints.  The use
3464	of physical restraints is limited to half-bed rails as
3465	prescribed and documented by the resident's physician with the
3466	consent of the resident or, if applicable, the resident's
3467	representative or designee or the resident's surrogate,
3468	guardian, or attorney in fact.  The use of chemical restraints
3469	is limited to prescribed dosages of medications authorized by
3470	the resident's physician and must be consistent with the
3471	resident's diagnosis. Residents who are receiving medications
3472	that can serve as chemical restraints must be evaluated by their
3473	physician at least annually to assess:
3474	1.  The continued need for the medication.
3475	2.  The level of the medication in the resident's blood.
3476	3.  The need for adjustments in the prescription.
3477	(l)  The establishment of specific policies and procedures
3478	on resident elopement. Facilities shall conduct a minimum of two
3479	resident elopement drills each year. All administrators and
3480	direct care staff shall participate in the drills. Facilities
3481	shall document the drills.
3482	(2)  In adopting any rules pursuant to this part, the
3483	department, in conjunction with the agency, shall make distinct
3484	standards for facilities based upon facility size; the types of
3485	care provided; the physical and mental capabilities and needs of
3486	residents; the type, frequency, and amount of services and care
3487	offered; and the staffing characteristics of the facility. Rules
3488	developed pursuant to this section shall not restrict the use of
3489	shared staffing and shared programming in facilities that are
3490	part of retirement communities that provide multiple levels of
3491	care and otherwise meet the requirements of law and rule.
3492	Except for uniform firesafety standards, the department shall
3493	adopt by rule separate and distinct standards for facilities
3494	with 16 or fewer beds and for facilities with 17 or more beds.
3495	The standards for facilities with 16 or fewer beds shall be
3496	appropriate for a noninstitutional residential environment,
3497	provided that the structure is no more than two stories in
3498	height and all persons who cannot exit the facility unassisted
3499	in an emergency reside on the first floor.  The department, in
3500	conjunction with the agency, may make other distinctions among
3501	types of facilities as necessary to enforce the provisions of
3502	this part. Where appropriate, the agency shall offer alternate
3503	solutions for complying with established standards, based on
3504	distinctions made by the department and the agency relative to
3505	the physical characteristics of facilities and the types of care
3506	offered therein.
3507	(3)  The department shall submit a copy of proposed rules
3508	to the Speaker of the House of Representatives, the President of
3509	the Senate, and appropriate committees of substance for review
3510	and comment prior to the promulgation thereof.
3511	(a)  Rules promulgated by the department shall encourage
3512	the development of homelike facilities which promote the
3513	dignity, individuality, personal strengths, and decisionmaking
3514	ability of residents.
3515	(b)  The agency, in consultation with the department, may
3516	waive rules promulgated pursuant to this part in order to
3517	demonstrate and evaluate innovative or cost-effective congregate
3518	care alternatives which enable individuals to age in place.
3519	Such waivers may be granted only in instances where there is
3520	reasonable assurance that the health, safety, or welfare of
3521	residents will not be endangered.  To apply for a waiver, the
3522	licensee shall submit to the agency a written description of the
3523	concept to be demonstrated, including goals, objectives, and
3524	anticipated benefits; the number and types of residents who will
3525	be affected, if applicable; a brief description of how the
3526	demonstration will be evaluated; and any other information
3527	deemed appropriate by the agency.  Any facility granted a waiver
3528	shall submit a report of findings to the agency and the
3529	department within 12 months.  At such time, the agency may renew
3530	or revoke the waiver or pursue any regulatory or statutory
3531	changes necessary to allow other facilities to adopt the same
3532	practices. The department may by rule clarify terms and
3533	establish waiver application procedures, criteria for reviewing
3534	waiver proposals, and procedures for reporting findings, as
3535	necessary to implement this subsection.
3536	(4)  The agency may use an abbreviated biennial standard
3537	licensure inspection that consists of a review of key quality-
3538	of-care standards in lieu of a full inspection in facilities
3539	which have a good record of past performance. However, a full
3540	inspection shall be conducted in facilities which have had a
3541	history of class I or class II violations, uncorrected class III
3542	violations, confirmed ombudsman council complaints, or confirmed
3543	licensure complaints, within the previous licensure period
3544	immediately preceding the inspection or when a potentially
3545	serious problem is identified during the abbreviated inspection.
3546	The agency, in consultation with the department, shall develop
3547	the key quality-of-care standards with input from the State
3548	Long-Term Care Ombudsman Council and representatives of provider
3549	groups for incorporation into its rules. The department, in
3550	consultation with the agency, shall report annually to the
3551	Legislature concerning its implementation of this subsection.
3552	The report shall include, at a minimum, the key quality-of-care
3553	standards which have been developed; the number of facilities
3554	identified as being eligible for the abbreviated inspection; the
3555	number of facilities which have received the abbreviated
3556	inspection and, of those, the number that were converted to full
3557	inspection; the number and type of subsequent complaints
3558	received by the agency or department on facilities which have
3559	had abbreviated inspections; any recommendations for
3560	modification to this subsection; any plans by the agency to
3561	modify its implementation of this subsection; and any other
3562	information which the department believes should be reported.
3563	(5)  A fee shall be charged by the department to any person
3564	requesting a copy of this part or rules promulgated under this
3565	part.  Such fees shall not exceed the actual cost of duplication
3566	and postage.
3567	Section 57.  Section 400.442, Florida Statutes, is
3568	renumbered as section 429.42, Florida Statutes, and amended to
3569	read:
3570	429.42 400.442  Pharmacy and dietary services.--
3571	(1)  Any assisted living facility in which the agency has
3572	documented a class I or class II deficiency or uncorrected class
3573	III deficiencies regarding medicinal drugs or over-the-counter
3574	preparations, including their storage, use, delivery, or
3575	administration, or dietary services, or both, during a biennial
3576	survey or a monitoring visit or an investigation in response to
3577	a complaint, shall, in addition to or as an alternative to any
3578	penalties imposed under s. 429.19 s. 400.419, be required to
3579	employ the consultant services of a licensed pharmacist, a
3580	licensed registered nurse, or a registered or licensed
3581	dietitian, as applicable.  The consultant shall, at a minimum,
3582	provide onsite quarterly consultation until the inspection team
3583	from the agency determines that such consultation services are
3584	no longer required.
3585	(2)  A corrective action plan for deficiencies related to
3586	assistance with the self-administration of medication or the
3587	administration of medication must be developed and implemented
3588	by the facility within 48 hours after notification of such
3589	deficiency, or sooner if the deficiency is determined by the
3590	agency to be life-threatening.
3591	(3)  The agency shall employ at least two pharmacists
3592	licensed pursuant to chapter 465 among its personnel who
3593	biennially inspect assisted living facilities licensed under
3594	this part, to participate in biennial inspections or consult
3595	with the agency regarding deficiencies relating to medicinal
3596	drugs or over-the-counter preparations.
3597	(4)  The department may by rule establish procedures and
3598	specify documentation as necessary to implement this section.
3599	Section 58.  Section 400.444, Florida Statutes, is
3600	renumbered as section 429.44, Florida Statutes, and amended to
3601	read:
3602	429.44 400.444  Construction and renovation;
3603	requirements.--
3604	(1)  The requirements for the construction and renovation
3605	of a facility shall comply with the provisions of chapter 553
3606	which pertain to building construction standards, including
3607	plumbing, electrical code, glass, manufactured buildings,
3608	accessibility for persons with disabilities, and the state
3609	minimum building code and with the provisions of s. 633.022,
3610	which pertain to uniform firesafety standards.
3611	(2)  Upon notification by the local authority having
3612	jurisdiction over life-threatening violations which seriously
3613	threaten the health, safety, or welfare of a resident of a
3614	facility, the agency shall take action as specified in s. 429.14
3615	s. 400.414.
3616	(3)  The department may adopt rules to establish procedures
3617	and specify the documentation necessary to implement this
3618	section.
3619	Section 59.  Section 400.447, Florida Statutes, is
3620	renumbered as section 429.47, Florida Statutes, and amended to
3621	read:
3622	429.47 400.447  Prohibited acts; penalties for violation.--
3623	(1)  It is unlawful for any person or public body to offer
3624	or advertise to the public, in any way by any medium whatever,
3625	personal services as defined in this act, without obtaining a
3626	valid current license.  It is unlawful for any holder of a
3627	license issued pursuant to the provisions of this act to
3628	advertise or hold out to the public that it holds a license for
3629	a facility other than that for which it actually holds a
3630	license.
3631	(2)  It is unlawful for any holder of a license issued
3632	pursuant to the provisions of this act to withhold from the
3633	agency any evidence of financial instability, including, but not
3634	limited to, bad checks, delinquent accounts, nonpayment of
3635	withholding taxes, unpaid utility expenses, nonpayment for
3636	essential services, or adverse court action concerning the
3637	financial viability of the facility or any other facility
3638	licensed under this part or under part II of chapter 400 or part
3639	III of this chapter which is owned by the licensee.
3640	(3)  Any person found guilty of violating subsection (1) or
3641	subsection (2) commits a misdemeanor of the second degree,
3642	punishable as provided in s. 775.083.  Each day of continuing
3643	violation shall be considered a separate offense.
3644	(4)  While a facility is under construction, the owner may
3645	advertise to the public prior to obtaining a license. Facilities
3646	that are certified under chapter 651 shall comply with the
3647	advertising provisions of s. 651.095 rather than those provided
3648	for in this subsection.
3649	(5)  A freestanding facility shall not advertise or imply
3650	that any part of it is a nursing home.  For the purpose of this
3651	subsection, "freestanding facility" means a facility that is not
3652	operated in conjunction with a nursing home to which residents
3653	of the facility are given priority when nursing care is
3654	required.  A person who violates this subsection is subject to
3655	fine as specified in s. 429.19 s. 400.419.
3656	(6)  Any facility which is affiliated with any religious
3657	organization or which has a name implying religious affiliation
3658	shall include in its advertising whether or not it is affiliated
3659	with any religious organization and, if so, which organization.
3660	(7)  A facility licensed under this part which is not part
3661	of a facility authorized under chapter 651 shall include the
3662	facility's license number as given by the agency in all
3663	advertising.  A company or person owning more than one facility
3664	shall include at least one license number per advertisement.
3665	All advertising shall include the term "assisted living
3666	facility" before the license number.
3667	Section 60.  Section 400.452, Florida Statutes, is
3668	renumbered as section 429.52, Florida Statutes, and amended to
3669	read:
3670	429.52 400.452  Staff training and educational programs;
3671	core educational requirement.--
3672	(1)  Administrators and other assisted living facility
3673	staff must meet minimum training and education requirements
3674	established by the Department of Elderly Affairs by rule. This
3675	training and education is intended to assist facilities to
3676	appropriately respond to the needs of residents, to maintain
3677	resident care and facility standards, and to meet licensure
3678	requirements.
3679	(2)  The department shall establish a competency test and a
3680	minimum required score to indicate successful completion of the
3681	training and educational requirements. The competency test must
3682	be developed by the department in conjunction with the agency
3683	and providers. The required training and education must cover at
3684	least the following topics:
3685	(a)  State law and rules relating to assisted living
3686	facilities.
3687	(b)  Resident rights and identifying and reporting abuse,
3688	neglect, and exploitation.
3689	(c)  Special needs of elderly persons, persons with mental
3690	illness, and persons with developmental disabilities and how to
3691	meet those needs.
3692	(d)  Nutrition and food service, including acceptable
3693	sanitation practices for preparing, storing, and serving food.
3694	(e)  Medication management, recordkeeping, and proper
3695	techniques for assisting residents with self-administered
3696	medication.
3697	(f)  Firesafety requirements, including fire evacuation
3698	drill procedures and other emergency procedures.
3699	(g)  Care of persons with Alzheimer's disease and related
3700	disorders.
3701	(3)  Effective January 1, 2004, a new facility
3702	administrator must complete the required training and education,
3703	including the competency test, within a reasonable time after
3704	being employed as an administrator, as determined by the
3705	department.  Failure to do so is a violation of this part and
3706	subjects the violator to an administrative fine as prescribed in
3707	s. 429.19 s. 400.419. Administrators licensed in accordance with
3708	chapter 468, part II, are exempt from this requirement. Other
3709	licensed professionals may be exempted, as determined by the
3710	department by rule.
3711	(4)  Administrators are required to participate in
3712	continuing education for a minimum of 12 contact hours every 2
3713	years.
3714	(5)  Staff involved with the management of medications and
3715	assisting with the self-administration of medications under s.
3716	429.256 s. 400.4256 must complete a minimum of 4 additional
3717	hours of training provided by a registered nurse, licensed
3718	pharmacist, or department staff. The department shall establish
3719	by rule the minimum requirements of this additional training.
3720	(6)  Other facility staff shall participate in training
3721	relevant to their job duties as specified by rule of the
3722	department.
3723	(7)  If the department or the agency determines that there
3724	are problems in a facility that could be reduced through
3725	specific staff training or education beyond that already
3726	required under this section, the department or the agency may
3727	require, and provide, or cause to be provided, the training or
3728	education of any personal care staff in the facility.
3729	(8)  The department shall adopt rules related to these
3730	training requirements, the competency test, necessary
3731	procedures, and competency test fees.
3732	Section 61.  Subsections (1), (10), and (18) of section
3733	400.462, Florida Statutes, are amended to read:
3734	400.462  Definitions.--As used in this part, the term:
3735	(1)  "Administrator" means a direct employee, as defined in
3736	subsection (9). The administrator must be a licensed physician,
3737	physician assistant, or registered nurse licensed to practice in
3738	this state or an individual having at least 1 year of
3739	supervisory or administrative experience in home health care or
3740	in a facility licensed under chapter 395, or under part II or
3741	part III of this chapter, or under part I of chapter 429. An
3742	administrator may manage a maximum of five licensed home health
3743	agencies located within one agency service district or within an
3744	immediately contiguous county. If the home health agency is
3745	licensed under this chapter and is part of a retirement
3746	community that provides multiple levels of care, an employee of
3747	the retirement community may administer the home health agency
3748	and up to a maximum of four entities licensed under this chapter
3749	or under part I of chapter 429 that are owned, operated, or
3750	managed by the same corporate entity. An administrator shall
3751	designate, in writing, for each licensed entity, a qualified
3752	alternate administrator to serve during absences.
3753	(10)  "Director of nursing" means a registered nurse who is
3754	a direct employee, as defined in subsection (9), of the agency
3755	and who is a graduate of an approved school of nursing and is
3756	licensed in this state; who has at least 1 year of supervisory
3757	experience as a registered nurse; and who is responsible for
3758	overseeing the professional nursing and home health aid delivery
3759	of services of the agency. A director of nursing may be the
3760	director of a maximum of five licensed home health agencies
3761	operated by a related business entity and located within one
3762	agency service district or within an immediately contiguous
3763	county. If the home health agency is licensed under this chapter
3764	and is part of a retirement community that provides multiple
3765	levels of care, an employee of the retirement community may
3766	serve as the director of nursing of the home health agency and
3767	of up to four entities licensed under this chapter or under part
3768	I of chapter 429 which are owned, operated, or managed by the
3769	same corporate entity.
3770	(18)  "Nurse registry" means any person that procures,
3771	offers, promises, or attempts to secure health-care-related
3772	contracts for registered nurses, licensed practical nurses,
3773	certified nursing assistants, home health aides, companions, or
3774	homemakers, who are compensated by fees as independent
3775	contractors, including, but not limited to, contracts for the
3776	provision of services to patients and contracts to provide
3777	private duty or staffing services to health care facilities
3778	licensed under chapter 395, under or this chapter, or under part
3779	I of chapter 429 or other business entities.
3780	Section 62.  Paragraphs (h), (i), and (n) of subsection (5)
3781	of section 400.464, Florida Statutes, are amended to read:
3782	400.464  Home health agencies to be licensed; expiration of
3783	license; exemptions; unlawful acts; penalties.--
3784	(5)  The following are exempt from the licensure
3785	requirements of this part:
3786	(h)  The delivery of assisted living facility services for
3787	which the assisted living facility is licensed under part I III
3788	of this chapter 429, to serve its residents in its facility.
3789	(i)  The delivery of hospice services for which the hospice
3790	is licensed under part IV VI of this chapter, to serve hospice
3791	patients admitted to its service.
3792	(n)  The delivery of adult family care home services for
3793	which the adult family care home is licensed under part II VII
3794	of this chapter 429, to serve the residents in its facility.
3795	Section 63.  Subsection (2) of section 400.497, Florida
3796	Statutes, is amended to read:
3797	400.497  Rules establishing minimum standards.--The agency
3798	shall adopt, publish, and enforce rules to implement this part,
3799	including, as applicable, ss. 400.506 and 400.509, which must
3800	provide reasonable and fair minimum standards relating to:
3801	(2)  Shared staffing. The agency shall allow shared
3802	staffing if the home health agency is part of a retirement
3803	community that provides multiple levels of care, is located on
3804	one campus, is licensed under this chapter or chapter 429, and
3805	otherwise meets the requirements of law and rule.
3806	Section 64.  Section 400.552, Florida Statutes, is
3807	renumbered as section 429.903, Florida Statutes, and amended to
3808	read:
3809	429.903 400.552  Applicability.--Any facility that comes
3810	within the definition of an adult day care center which is not
3811	exempt under s. 429.905 s. 400.553 must be licensed by the
3812	agency as an adult day care center.
3813	Section 65.  Section 400.555, Florida Statutes, is
3814	renumbered as section 429.909, Florida Statutes, and amended to
3815	read:
3816	429.909 400.555  Application for license.--
3817	(1)  An application for a license to operate an adult day
3818	care center must be made to the agency on forms furnished by the
3819	agency and must be accompanied by the appropriate license fee
3820	unless the applicant is exempt from payment of the fee as
3821	provided in s. 429.907(4) s. 400.554(4).
3822	(2)  The applicant for licensure must furnish:
3823	(a)  A description of the physical and mental capabilities
3824	and needs of the participants to be served and the availability,
3825	frequency, and intensity of basic services and of supportive and
3826	optional services to be provided;
3827	(b)  Satisfactory proof of financial ability to operate and
3828	conduct the center in accordance with the requirements of this
3829	part, which must include, in the case of an initial application,
3830	a 1-year operating plan and proof of a 3-month operating reserve
3831	fund; and
3832	(c)  Proof of adequate liability insurance coverage.
3833	(d)  Proof of compliance with level 2 background screening
3834	as required under s. 429.919 s. 400.5572.
3835	(e)  A description and explanation of any exclusions,
3836	permanent suspensions, or terminations of the application from
3837	the Medicare or Medicaid programs. Proof of compliance with
3838	disclosure of ownership and control interest requirements of the
3839	Medicare or Medicaid programs shall be accepted in lieu of this
3840	submission.
3841	Section 66.  Section 400.556, Florida Statutes, is
3842	renumbered as section 429.911, Florida Statutes, and amended to
3843	read:
3844	429.911 400.556  Denial, suspension, revocation of license;
3845	administrative fines; investigations and inspections.--
3846	(1)  The agency may deny, revoke, or suspend a license
3847	under this part or may impose an administrative fine against the
3848	owner of an adult day care center or its operator or employee in
3849	the manner provided in chapter 120.
3850	(2)  Each of the following actions by the owner of an adult
3851	day care center or by its operator or employee is a ground for
3852	action by the agency against the owner of the center or its
3853	operator or employee:
3854	(a)  An intentional or negligent act materially affecting
3855	the health or safety of center participants.
3856	(b)  A violation of this part or of any standard or rule
3857	under this part.
3858	(c)  A failure of persons subject to level 2 background
3859	screening under s. 429.174(1) s. 400.4174(1) to meet the
3860	screening standards of s. 435.04, or the retention by the center
3861	of an employee subject to level 1 background screening standards
3862	under s. 429.174(2) s. 400.4174(2) who does not meet the
3863	screening standards of s. 435.03 and for whom exemptions from
3864	disqualification have not been provided by the agency.
3865	(d)  Failure to follow the criteria and procedures provided
3866	under part I of chapter 394 relating to the transportation,
3867	voluntary admission, and involuntary examination of center
3868	participants.
3869	(e)  Multiple or repeated violations of this part or of any
3870	standard or rule adopted under this part.
3871	(f)  Exclusion, permanent suspension, or termination of the
3872	owner, if an individual, officer, or board member of the adult
3873	day care center, if the owner is a firm, corporation,
3874	partnership, or association, or any person owning 5 percent or
3875	more of the center, from the Medicare or Medicaid program.
3876	(3)  The agency is responsible for all investigations and
3877	inspections conducted pursuant to this part.
3878	Section 67.  Section 400.557, Florida Statutes, is
3879	renumbered as section 429.915, Florida Statutes, and amended to
3880	read:
3881	429.915 400.557  Expiration of license; renewal;
3882	conditional license or permit.--
3883	(1)  A license issued for the operation of an adult day
3884	care center, unless sooner suspended or revoked, expires 2 years
3885	after the date of issuance. The agency shall notify a licensee
3886	at least 120 days before the expiration date that license
3887	renewal is required to continue operation. The notification must
3888	be provided electronically or by mail delivery. At least 90 days
3889	prior to the expiration date, an application for renewal must be
3890	submitted to the agency. A license shall be renewed, upon the
3891	filing of an application on forms furnished by the agency, if
3892	the applicant has first met the requirements of this part and of
3893	the rules adopted under this part. The applicant must file with
3894	the application satisfactory proof of financial ability to
3895	operate the center in accordance with the requirements of this
3896	part and in accordance with the needs of the participants to be
3897	served and an affidavit of compliance with the background
3898	screening requirements of s. 429.919 s. 400.5572.
3899	(2)  A licensee against whom a revocation or suspension
3900	proceeding is pending at the time for license renewal may be
3901	issued a conditional license effective until final disposition
3902	by the agency of the proceeding. If judicial relief is sought
3903	from the final disposition, the court having jurisdiction may
3904	issue a conditional permit effective for the duration of the
3905	judicial proceeding.
3906	(3)  The agency may issue a conditional license to an
3907	applicant for license renewal or change of ownership if the
3908	applicant fails to meet all standards and requirements for
3909	licensure. A conditional license issued under this subsection
3910	must be limited to a specific period not exceeding 6 months, as
3911	determined by the agency, and must be accompanied by an approved
3912	plan of correction.
3913	Section 68.  Section 400.5572, Florida Statutes, is
3914	renumbered as section 429.919, Florida Statutes, and amended to
3915	read:
3916	429.919 400.5572  Background screening.--
3917	(1)(a)  Level 2 background screening must be conducted on
3918	each of the following persons, who shall be considered employees
3919	for the purposes of conducting screening under chapter 435:
3920	1.  The adult day care center owner if an individual, the
3921	operator, and the financial officer.
3922	2.  An officer or board member if the owner of the adult
3923	day care center is a firm, corporation, partnership, or
3924	association, or any person owning 5 percent or more of the
3925	facility, if the agency has probable cause to believe that such
3926	person has been convicted of any offense prohibited by s.
3927	435.04. For each officer, board member, or person owning 5
3928	percent or more who has been convicted of any such offense, the
3929	facility shall submit to the agency a description and
3930	explanation of the conviction at the time of license
3931	application. This subparagraph does not apply to a board member
3932	of a not-for-profit corporation or organization if the board
3933	member serves solely in a voluntary capacity, does not regularly
3934	take part in the day-to-day operational decisions of the
3935	corporation or organization, receives no remuneration for his or
3936	her services, and has no financial interest and has no family
3937	members with a financial interest in the corporation or
3938	organization, provided that the board member and facility submit
3939	a statement affirming that the board member's relationship to
3940	the facility satisfies the requirements of this subparagraph.
3941	(b)  Proof of compliance with level 2 screening standards
3942	which has been submitted within the previous 5 years to meet any
3943	facility or professional licensure requirements of the agency or
3944	the Department of Health satisfies the requirements of this
3945	subsection.
3946	(c)  The agency may grant a provisional license to an adult
3947	day care center applying for an initial license when each
3948	individual required by this subsection to undergo screening has
3949	completed the Department of Law Enforcement background check,
3950	but has not yet received results from the Federal Bureau of
3951	Investigation, or when a request for an exemption from
3952	disqualification has been submitted to the agency pursuant to s.
3953	435.07, but a response has not been issued.
3954	(2)  The owner or administrator of an adult day care center
3955	must conduct level 1 background screening as set forth in
3956	chapter 435 on all employees hired on or after October 1, 1998,
3957	who provide basic services or supportive and optional services
3958	to the participants. Such persons satisfy this requirement if:
3959	(a)  Proof of compliance with level 1 screening
3960	requirements obtained to meet any professional license
3961	requirements in this state is provided and accompanied, under
3962	penalty of perjury, by a copy of the person's current
3963	professional license and an affidavit of current compliance with
3964	the background screening requirements.
3965	(b)  The person required to be screened has been
3966	continuously employed, without a breach in service that exceeds
3967	180 days, in the same type of occupation for which the person is
3968	seeking employment and provides proof of compliance with the
3969	level 1 screening requirement which is no more than 2 years old.
3970	Proof of compliance must be provided directly from one employer
3971	or contractor to another, and not from the person screened. Upon
3972	request, a copy of screening results shall be provided to the
3973	person screened by the employer retaining documentation of the
3974	screening.
3975	(c)  The person required to be screened is employed by a
3976	corporation or business entity or related corporation or
3977	business entity that owns, operates, or manages more than one
3978	facility or agency licensed under this chapter or under chapter
3979	400, and for whom a level 1 screening was conducted by the
3980	corporation or business entity as a condition of initial or
3981	continued employment.
3982	Section 69.  Subsection (5) of section 400.601, Florida
3983	Statutes, is amended to read:
3984	400.601  Definitions.--As used in this part, the term:
3985	(5)  "Hospice residential unit" means a homelike living
3986	facility, other than a facility licensed under other parts of
3987	this chapter, or under chapter 395, or under chapter 429, that
3988	is operated by a hospice for the benefit of its patients and is
3989	considered by a patient who lives there to be his or her primary
3990	residence.
3991	Section 70.  Section 400.618, Florida Statutes, is
3992	renumbered as section 429.65, Florida Statutes, and amended to
3993	read:
3994	429.65 400.618  Definitions.--As used in this part, the
3995	term:
3996	(1)  "Activities of daily living" means functions and tasks
3997	for self-care, including eating, bathing, grooming, dressing,
3998	ambulating, and other similar tasks.
3999	(2)  "Adult family-care home" means a full-time, family-
4000	type living arrangement, in a private home, under which a person
4001	who owns or rents the home provides room, board, and personal
4002	care, on a 24-hour basis, for no more than five disabled adults
4003	or frail elders who are not relatives. The following family-type
4004	living arrangements are not required to be licensed as an adult
4005	family-care home:
4006	(a)  An arrangement whereby the person who owns or rents
4007	the home provides room, board, and personal services for not
4008	more than two adults who do not receive optional state
4009	supplementation under s. 409.212. The person who provides the
4010	housing, meals, and personal care must own or rent the home and
4011	reside therein.
4012	(b)  An arrangement whereby the person who owns or rents
4013	the home provides room, board, and personal services only to his
4014	or her relatives.
4015	(c)  An establishment that is licensed as an assisted
4016	living facility under this chapter part III.
4017	(3)  "Agency" means the Agency for Health Care
4018	Administration.
4019	(4)  "Aging in place" means remaining in a noninstitutional
4020	living environment despite the physical or mental changes that
4021	may occur in a person who is aging. For aging in place to occur,
4022	needed services are added, increased, or adjusted to compensate
4023	for a person's physical or mental changes.
4024	(5)  "Appropriate placement" means that the resident's
4025	needs can be met by the adult family-care home or can be met by
4026	services arranged by the adult family-care home or the resident.
4027	(6)  "Chemical restraint" means a pharmacologic drug that
4028	physically limits, restricts, or deprives an individual of
4029	movement or mobility, and is used for discipline or convenience
4030	and not required for the treatment of medical symptoms.
4031	(7)  "Department" means the Department of Elderly Affairs.
4032	(8)  "Disabled adult" means any person between 18 and 59
4033	years of age, inclusive, who is a resident of the state and who
4034	has one or more permanent physical or mental limitations that
4035	restrict the person's ability to perform the normal activities
4036	of daily living.
4037	(9)  "Frail elder" means a functionally impaired elderly
4038	person who is 60 years of age or older and who has physical or
4039	mental limitations that restrict the person's ability to perform
4040	the normal activities of daily living and that impede the
4041	person's capacity to live independently.
4042	(10)  "Personal services" or "personal care" includes
4043	individual assistance with or supervision of the activities of
4044	daily living and the self-administration of medication, and
4045	other similar services.
4046	(11)  "Provider" means a person who is licensed to operate
4047	an adult family-care home.
4048	(12)  "Relative" means an individual who is the father,
4049	mother, son, daughter, brother, sister, grandfather,
4050	grandmother, great-grandfather, great-grandmother, uncle, aunt,
4051	first cousin, nephew, niece, husband, wife, father-in-law,
4052	mother-in-law, son-in-law, daughter-in-law, brother-in-law,
4053	sister-in-law, stepfather, stepmother, stepson, stepdaughter,
4054	stepbrother, stepsister, half brother, or half sister of a
4055	provider.
4056	(13)  "Relief person" means an adult designated by the
4057	provider to supervise the residents during the provider's
4058	absence.
4059	(14)  "Resident" means a person receiving room, board, and
4060	personal care in an adult family-care home.
4061	Section 71.  Section 400.6194, Florida Statutes, is
4062	renumbered as section 429.69, Florida Statutes, and amended to
4063	read:
4064	429.69 400.6194  Denial, revocation, or suspension of a
4065	license.--The agency may deny, suspend, or revoke a license for
4066	any of the following reasons:
4067	(1)  Failure of any of the persons required to undergo
4068	background screening under s. 429.67 s. 400.619 to meet the
4069	level 1 screening standards of s. 435.03, unless an exemption
4070	from disqualification has been provided by the agency.
4071	(2)  An intentional or negligent act materially affecting
4072	the health, safety, or welfare of the adult family-care home
4073	residents.
4074	(3)  Submission of fraudulent information or omission of
4075	any material fact on a license application or any other document
4076	required by the agency.
4077	(4)  Failure to pay an administrative fine assessed under
4078	this part.
4079	(5)  A violation of this part or adopted rules which
4080	results in conditions or practices that directly threaten the
4081	physical or emotional health, safety, or welfare of residents.
4082	(6)  Failure to correct cited fire code violations that
4083	threaten the health, safety, or welfare of residents.
4084	(7)  Failure to submit a completed initial license
4085	application or to complete an application for license renewal
4086	within the specified timeframes.
4087	(8)  Exclusion, permanent suspension, or termination of the
4088	provider from the Medicare or Medicaid program.
4089	Section 72.  Section 400.621, Florida Statutes, is
4090	renumbered as section 429.73, Florida Statutes, and amended to
4091	read:
4092	429.73 400.621  Rules and standards relating to adult
4093	family-care homes.--
4094	(1)  The department, in consultation with the Department of
4095	Health, the Department of Children and Family Services, and the
4096	agency shall, by rule, establish minimum standards to ensure the
4097	health, safety, and well-being of each resident in the adult
4098	family-care home. The rules must address:
4099	(a)  Requirements for the physical site of the facility and
4100	facility maintenance.
4101	(b)  Services that must be provided to all residents of an
4102	adult family-care home and standards for such services, which
4103	must include, but need not be limited to:
4104	1.  Room and board.
4105	2.  Assistance necessary to perform the activities of daily
4106	living.
4107	3.  Assistance necessary to administer medication.
4108	4.  Supervision of residents.
4109	5.  Health monitoring.
4110	6.  Social and leisure activities.
4111	(c)  Standards and procedures for license application and
4112	annual license renewal, advertising, proper management of each
4113	resident's funds and personal property and personal affairs,
4114	financial ability to operate, medication management,
4115	inspections, complaint investigations, and facility, staff, and
4116	resident records.
4117	(d)  Qualifications, training, standards, and
4118	responsibilities for providers and staff.
4119	(e)  Compliance with chapter 419, relating to community
4120	residential homes.
4121	(f)  Criteria and procedures for determining the
4122	appropriateness of a resident's placement and continued
4123	residency in an adult family-care home. A resident who requires
4124	24-hour nursing supervision may not be retained in an adult
4125	family-care home unless such resident is an enrolled hospice
4126	patient and the resident's continued residency is mutually
4127	agreeable to the resident and the provider.
4128	(g)  Procedures for providing notice and assuring the least
4129	possible disruption of residents' lives when residents are
4130	relocated, an adult family-care home is closed, or the ownership
4131	of an adult family-care home is transferred.
4132	(h)  Procedures to protect the residents' rights as
4133	provided in s. 429.85 s. 400.628.
4134	(i)  Procedures to promote the growth of adult family-care
4135	homes as a component of a long-term care system.
4136	(j)  Procedures to promote the goal of aging in place for
4137	residents of adult family-care homes.
4138	(2)  The department shall by rule provide minimum standards
4139	and procedures for emergencies. Pursuant to s. 633.022, the
4140	State Fire Marshal, in consultation with the department and the
4141	agency, shall adopt uniform firesafety standards for adult
4142	family-care homes.
4143	(3)  The department shall adopt rules providing for the
4144	implementation of orders not to resuscitate. The provider may
4145	withhold or withdraw cardiopulmonary resuscitation if presented
4146	with an order not to resuscitate executed pursuant to s. 401.45.
4147	The provider shall not be subject to criminal prosecution or
4148	civil liability, nor be considered to have engaged in negligent
4149	or unprofessional conduct, for withholding or withdrawing
4150	cardiopulmonary resuscitation pursuant to such an order and
4151	rules adopted by the department.
4152	(4)  The provider of any adult family-care home that is in
4153	operation at the time any rules are adopted or amended under
4154	this part may be given a reasonable time, not exceeding 6
4155	months, within which to comply with the new or revised rules and
4156	standards.
4157	Section 73.  Section 400.628, Florida Statutes, is
4158	renumbered as section 429.85, Florida Statutes, and amended to
4159	read:
4160	429.85 400.628  Residents' bill of rights.--
4161	(1)  A resident of an adult family-care home may not be
4162	deprived of any civil or legal rights, benefits, or privileges
4163	guaranteed by law, the State Constitution, or the Constitution
4164	of the United States solely by reason of status as a resident of
4165	the home. Each resident has the right to:
4166	(a)  Live in a safe and decent living environment, free
4167	from abuse and neglect.
4168	(b)  Be treated with consideration and respect and with due
4169	recognition of personal dignity, individuality, and privacy.
4170	(c)  Keep and use the resident's own clothes and other
4171	personal property in the resident's immediate living quarters,
4172	so as to maintain individuality and personal dignity, except
4173	when the provider can demonstrate that to do so would be unsafe
4174	or an infringement upon the rights of other residents.
4175	(d)  Have unrestricted private communication, including
4176	receiving and sending unopened correspondence, having access to
4177	a telephone, and visiting with any person of his or her choice,
4178	at any time between the hours of 9 a.m. and 9 p.m. at a minimum.
4179	(e)  Be free to participate in and benefit from community
4180	services and activities and to achieve the highest possible
4181	level of independence, autonomy, and interaction within the
4182	community.
4183	(f)  Manage the resident's own financial affairs unless the
4184	resident or the resident's guardian authorizes the provider to
4185	provide safekeeping for funds in accordance with procedures
4186	equivalent to those provided in s. 429.27 s. 400.427.
4187	(g)  Share a room with the resident's spouse if both are
4188	residents of the home.
4189	(h)  Have reasonable opportunity for regular exercise
4190	several times a week and to be outdoors at regular and frequent
4191	intervals.
4192	(i)  Exercise civil and religious liberties, including the
4193	right to independent personal decisions. Religious beliefs or
4194	practices and attendance at religious services may not be
4195	imposed upon a resident.
4196	(j)  Have access to adequate and appropriate health care.
4197	(k)  Be free from chemical and physical restraints.
4198	(l)  Have at least 30 days' notice of relocation or
4199	termination of residency from the home unless, for medical
4200	reasons, the resident is certified by a physician to require an
4201	emergency relocation to a facility providing a more skilled
4202	level of care or the resident engages in a pattern of conduct
4203	that is harmful or offensive to other residents. If a resident
4204	has been adjudicated mentally incompetent, the resident's
4205	guardian must be given at least 30 days' notice, except in an
4206	emergency, of the relocation of a resident or of the termination
4207	of a residency. The reasons for relocating a resident must be
4208	set forth in writing.
4209	(m)  Present grievances and recommend changes to the
4210	provider, to staff, or to any other person without restraint,
4211	interference, coercion, discrimination, or reprisal. This right
4212	includes the right to have access to ombudsman volunteers and
4213	advocates and the right to be a member of, to be active in, and
4214	to associate with advocacy or special interest groups.
4215	(2)  The provider shall ensure that residents and their
4216	legal representatives are made aware of the rights, obligations,
4217	and prohibitions set forth in this part. Residents must also be
4218	given the names, addresses, and telephone numbers of the local
4219	ombudsman council and the central abuse hotline where they may
4220	lodge complaints.
4221	(3)  The adult family-care home may not hamper or prevent
4222	residents from exercising the rights specified in this section.
4223	(4)  A provider or staff of an adult family-care home may
4224	not serve notice upon a resident to leave the premises or take
4225	any other retaliatory action against any person who:
4226	(a)  Exercises any right set forth in this section.
4227	(b)  Appears as a witness in any hearing, in or out of the
4228	adult family-care home.
4229	(c)  Files a civil action alleging a violation of this part
4230	or notifies a state attorney or the Attorney General of a
4231	possible violation of this part.
4232	(5)  Any adult family-care home that terminates the
4233	residency of an individual who has participated in activities
4234	specified in subsection (4) must show good cause for the
4235	termination in a court of competent jurisdiction.
4236	(6)  Any person who reports a complaint concerning a
4237	suspected violation of this part or the services and conditions
4238	in an adult family-care home, or who testifies in any
4239	administrative or judicial proceeding arising from such a
4240	complaint, is immune from any civil or criminal liability
4241	therefor, unless the person acted in bad faith or with malicious
4242	purpose or the court finds that there was a complete absence of
4243	a justiciable issue of either law or fact raised by the losing
4244	party.
4245	Section 74.  Paragraphs (c), (d), (e), and (f) of
4246	subsection (5) of section 400.93, Florida Statutes, are amended
4247	to read:
4248	400.93  Licensure required; exemptions; unlawful acts;
4249	penalties.--
4250	(5)  The following are exempt from home medical equipment
4251	provider licensure, unless they have a separate company,
4252	corporation, or division that is in the business of providing
4253	home medical equipment and services for sale or rent to
4254	consumers at their regular or temporary place of residence
4255	pursuant to the provisions of this part:
4256	(c)  Assisted living facilities licensed under chapter 429
4257	part III, when serving their residents.
4258	(d)  Home health agencies licensed under part III IV.
4259	(e)  Hospices licensed under part IV VI.
4260	(f)  Intermediate care facilities, homes for special
4261	services, and transitional living facilities licensed under part
4262	V VIII.
4263	Section 75.  Subsection (3) and paragraph (c) of subsection
4264	(10) of section 400.962, Florida Statutes, are amended to read:
4265	400.962  License required; license application.--
4266	(3)  The basic license fee collected shall be deposited in
4267	the Health Care Trust Fund, established for carrying out the
4268	purposes of this chapter or chapter 429.
4269	(10)
4270	(c)  Proof of compliance with the level 2 background
4271	screening requirements of chapter 435 which has been submitted
4272	within the previous 5 years in compliance with any other
4273	licensure requirements under this chapter or chapter 429
4274	satisfies the requirements of paragraph (a). Proof of compliance
4275	with background screening which has been submitted within the
4276	previous 5 years to fulfill the requirements of the Financial
4277	Services Commission and the Office of Insurance Regulation under
4278	chapter 651 as part of an application for a certificate of
4279	authority to operate a continuing care retirement community
4280	satisfies the requirements for the Department of Law Enforcement
4281	and Federal Bureau of Investigation background checks.
4282	Section 76.  Paragraph (b) of subsection (1) of section
4283	400.980, Florida Statutes, is amended to read:
4284	400.980  Health care services pools.--
4285	(1)  As used in this section, the term:
4286	(b)  "Health care services pool" means any person, firm,
4287	corporation, partnership, or association engaged for hire in the
4288	business of providing temporary employment in health care
4289	facilities, residential facilities, and agencies for licensed,
4290	certified, or trained health care personnel including, without
4291	limitation, nursing assistants, nurses' aides, and orderlies.
4292	However, the term does not include nursing registries, a
4293	facility licensed under this chapter or chapter 429 400, a
4294	health care services pool established within a health care
4295	facility to provide services only within the confines of such
4296	facility, or any individual contractor directly providing
4297	temporary services to a health care facility without use or
4298	benefit of a contracting agent.
4299	Section 77.  Paragraphs (a), (b), (c), and (d) of
4300	subsection (4) of section 400.9905, Florida Statutes, are
4301	amended to read:
4302	400.9905  Definitions.--
4303	(4)  "Clinic" means an entity at which health care services
4304	are provided to individuals and which tenders charges for
4305	reimbursement for such services, including a mobile clinic and a
4306	portable equipment provider. For purposes of this part, the term
4307	does not include and the licensure requirements of this part do
4308	not apply to:
4309	(a)  Entities licensed or registered by the state under
4310	chapter 395; or entities licensed or registered by the state and
4311	providing only health care services within the scope of services
4312	authorized under their respective licenses granted under ss.
4313	383.30-383.335, chapter 390, chapter 394, chapter 397, this
4314	chapter except part X XIII, chapter 429, chapter 463, chapter
4315	465, chapter 466, chapter 478, part I of chapter 483, chapter
4316	484, or chapter 651; end-stage renal disease providers
4317	authorized under 42 C.F.R. part 405, subpart U; or providers
4318	certified under 42 C.F.R. part 485, subpart B or subpart H; or
4319	any entity that provides neonatal or pediatric hospital-based
4320	health care services by licensed practitioners solely within a
4321	hospital licensed under chapter 395.
4322	(b)  Entities that own, directly or indirectly, entities
4323	licensed or registered by the state pursuant to chapter 395; or
4324	entities that own, directly or indirectly, entities licensed or
4325	registered by the state and providing only health care services
4326	within the scope of services authorized pursuant to their
4327	respective licenses granted under ss. 383.30-383.335, chapter
4328	390, chapter 394, chapter 397, this chapter except part X XIII,
4329	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
4330	part I of chapter 483, chapter 484, chapter 651; end-stage renal
4331	disease providers authorized under 42 C.F.R. part 405, subpart
4332	U; or providers certified under 42 C.F.R. part 485, subpart B or
4333	subpart H; or any entity that provides neonatal or pediatric
4334	hospital-based health care services by licensed practitioners
4335	solely within a hospital licensed under chapter 395.
4336	(c)  Entities that are owned, directly or indirectly, by an
4337	entity licensed or registered by the state pursuant to chapter
4338	395; or entities that are owned, directly or indirectly, by an
4339	entity licensed or registered by the state and providing only
4340	health care services within the scope of services authorized
4341	pursuant to their respective licenses granted under ss. 383.30-
4342	383.335, chapter 390, chapter 394, chapter 397, this chapter
4343	except part X XIII, chapter 429, chapter 463, chapter 465,
4344	chapter 466, chapter 478, part I of chapter 483, chapter 484, or
4345	chapter 651; end-stage renal disease providers authorized under
4346	42 C.F.R. part 405, subpart U; or providers certified under 42
4347	C.F.R. part 485, subpart B or subpart H; or any entity that
4348	provides neonatal or pediatric hospital-based health care
4349	services by licensed practitioners solely within a hospital
4350	under chapter 395.
4351	(d)  Entities that are under common ownership, directly or
4352	indirectly, with an entity licensed or registered by the state
4353	pursuant to chapter 395; or entities that are under common
4354	ownership, directly or indirectly, with an entity licensed or
4355	registered by the state and providing only health care services
4356	within the scope of services authorized pursuant to their
4357	respective licenses granted under ss. 383.30-383.335, chapter
4358	390, chapter 394, chapter 397, this chapter except part X XIII,
4359	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
4360	part I of chapter 483, chapter 484, or chapter 651; end-stage
4361	renal disease providers authorized under 42 C.F.R. part 405,
4362	subpart U; or providers certified under 42 C.F.R. part 485,
4363	subpart B or subpart H; or any entity that provides neonatal or
4364	pediatric hospital-based health care services by licensed
4365	practitioners solely within a hospital licensed under chapter
4366	395.
4367	Section 78.  Subsection (6) of section 400.9935, Florida
4368	Statutes, is amended to read:
4369	400.9935  Clinic responsibilities.--
4370	(6)  Any licensed health care provider who violates this
4371	part is subject to discipline in accordance with this chapter or
4372	chapter 429 and his or her respective practice act.
4373	Section 79.  Subsection (12) of section 401.23, Florida
4374	Statutes, is amended to read:
4375	401.23  Definitions.--As used in this part, the term:
4376	(12)  "Interfacility transfer" means the transportation by
4377	ambulance of a patient between two facilities licensed under
4378	chapter 393, chapter 395, or chapter 400, or chapter 429,
4379	pursuant to this part.
4380	Section 80.  Paragraph (b) of subsection (2) of section
4381	402.164, Florida Statutes, is amended to read:
4382	402.164  Legislative intent; definitions.--
4383	(2)  As used in ss. 402.164-402.167, the term:
4384	(b)  "Client" means a client as defined in s. 393.063, s.
4385	394.67, s. 397.311, or s. 400.960, a forensic client or client
4386	as defined in s. 916.106, a child or youth as defined in s.
4387	39.01, a child as defined in s. 827.01, a family as defined in
4388	s. 414.0252, a participant as defined in s. 429.901 s. 400.551,
4389	a resident as defined in s. 429.02 s. 400.402, a Medicaid
4390	recipient or recipient as defined in s. 409.901, a child
4391	receiving child care as defined in s. 402.302, a disabled adult
4392	as defined in s. 410.032 or s. 410.603, or a victim as defined
4393	in s. 39.01 or s. 415.102 as each definition applies within its
4394	respective chapter.
4395	Section 81.  Subsection (10) of section 408.032, Florida
4396	Statutes, is amended to read:
4397	408.032  Definitions relating to Health Facility and
4398	Services Development Act.--As used in ss. 408.031-408.045, the
4399	term:
4400	(10)  "Hospice" or "hospice program" means a hospice as
4401	defined in part IV VI of chapter 400.
4402	Section 82.  Paragraph (b) of subsection (2) of section
4403	408.033, Florida Statutes, is amended to read:
4404	408.033  Local and state health planning.--
4405	(2)  FUNDING.--
4406	(b)1.  A hospital licensed under chapter 395, a nursing
4407	home licensed under chapter 400, and an assisted living facility
4408	licensed under chapter 429 400 shall be assessed an annual fee
4409	based on number of beds.
4410	2.  All other facilities and organizations listed in
4411	paragraph (a) shall each be assessed an annual fee of $150.
4412	3.  Facilities operated by the Department of Children and
4413	Family Services, the Department of Health, or the Department of
4414	Corrections and any hospital which meets the definition of rural
4415	hospital pursuant to s. 395.602 are exempt from the assessment
4416	required in this subsection.
4417	Section 83.  Subsection (2) of section 408.034, Florida
4418	Statutes, is amended to read:
4419	408.034  Duties and responsibilities of agency; rules.--
4420	(2)  In the exercise of its authority to issue licenses to
4421	health care facilities and health service providers, as provided
4422	under chapters 393 and, 395, and parts II and IV VI of chapter
4423	400, the agency may not issue a license to any health care
4424	facility or health service provider that fails to receive a
4425	certificate of need or an exemption for the licensed facility or
4426	service.
4427	Section 84.  Subsections (28) and (29) of section 408.07,
4428	Florida Statutes, are amended to read:
4429	408.07  Definitions.--As used in this chapter, with the
4430	exception of ss. 408.031-408.045, the term:
4431	(28)  "Home health agency" means an organization licensed
4432	under part III IV of chapter 400.
4433	(29)  "Hospice" means an organization licensed under part
4434	IV VI of chapter 400.
4435	Section 85.  Subsection (3) of section 408.831, Florida
4436	Statutes, is amended to read:
4437	408.831  Denial, suspension, or revocation of a license,
4438	registration, certificate, or application.--
4439	(3)  This section provides standards of enforcement
4440	applicable to all entities licensed or regulated by the Agency
4441	for Health Care Administration. This section controls over any
4442	conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
4443	394, 395, 400, 408, 429, 468, 483, and 641 or rules adopted
4444	pursuant to those chapters.
4445	Section 86.  Subsection (2) of section 409.212, Florida
4446	Statutes, is amended to read:
4447	409.212  Optional supplementation.--
4448	(2)  The base rate of payment for optional state
4449	supplementation shall be established by the department within
4450	funds appropriated. Additional amounts may be provided for
4451	mental health residents in facilities designed to provide
4452	limited mental health services as provided for in s. 429.075 s.
4453	400.4075. The base rate of payment does not include the personal
4454	needs allowance.
4455	Section 87.  Paragraph (e) of subsection (4) of section
4456	409.221, Florida Statutes, is amended to read:
4457	409.221  Consumer-directed care program.--
4458	(4)  CONSUMER-DIRECTED CARE.--
4459	(e)  Services.--Consumers shall use the budget allowance
4460	only to pay for home and community-based services that meet the
4461	consumer's long-term care needs and are a cost-efficient use of
4462	funds. Such services may include, but are not limited to, the
4463	following:
4464	1.  Personal care.
4465	2.  Homemaking and chores, including housework, meals,
4466	shopping, and transportation.
4467	3.  Home modifications and assistive devices which may
4468	increase the consumer's independence or make it possible to
4469	avoid institutional placement.
4470	4.  Assistance in taking self-administered medication.
4471	5.  Day care and respite care services, including those
4472	provided by nursing home facilities pursuant to s. 400.141(6) or
4473	by adult day care facilities licensed pursuant to s. 429.907 s.
4474	400.554.
4475	6.  Personal care and support services provided in an
4476	assisted living facility.
4477	Section 88.  Subsection (4) of section 409.905, Florida
4478	Statutes, is amended to read:
4479	409.905  Mandatory Medicaid services.--The agency may make
4480	payments for the following services, which are required of the
4481	state by Title XIX of the Social Security Act, furnished by
4482	Medicaid providers to recipients who are determined to be
4483	eligible on the dates on which the services were provided. Any
4484	service under this section shall be provided only when medically
4485	necessary and in accordance with state and federal law.
4486	Mandatory services rendered by providers in mobile units to
4487	Medicaid recipients may be restricted by the agency. Nothing in
4488	this section shall be construed to prevent or limit the agency
4489	from adjusting fees, reimbursement rates, lengths of stay,
4490	number of visits, number of services, or any other adjustments
4491	necessary to comply with the availability of moneys and any
4492	limitations or directions provided for in the General
4493	Appropriations Act or chapter 216.
4494	(4)  HOME HEALTH CARE SERVICES.--The agency shall pay for
4495	nursing and home health aide services, supplies, appliances, and
4496	durable medical equipment, necessary to assist a recipient
4497	living at home. An entity that provides services pursuant to
4498	this subsection shall be licensed under part III IV of chapter
4499	400. These services, equipment, and supplies, or reimbursement
4500	therefor, may be limited as provided in the General
4501	Appropriations Act and do not include services, equipment, or
4502	supplies provided to a person residing in a hospital or nursing
4503	facility.
4504	(a)  In providing home health care services, the agency may
4505	require prior authorization of care based on diagnosis.
4506	(b)  The agency shall implement a comprehensive utilization
4507	management program that requires prior authorization of all
4508	private duty nursing services, an individualized treatment plan
4509	that includes information about medication and treatment orders,
4510	treatment goals, methods of care to be used, and plans for care
4511	coordination by nurses and other health professionals. The
4512	utilization management program shall also include a process for
4513	periodically reviewing the ongoing use of private duty nursing
4514	services. The assessment of need shall be based on a child's
4515	condition, family support and care supplements, a family's
4516	ability to provide care, and a family's and child's schedule
4517	regarding work, school, sleep, and care for other family
4518	dependents. When implemented, the private duty nursing
4519	utilization management program shall replace the current
4520	authorization program used by the Agency for Health Care
4521	Administration and the Children's Medical Services program of
4522	the Department of Health. The agency may competitively bid on a
4523	contract to select a qualified organization to provide
4524	utilization management of private duty nursing services. The
4525	agency is authorized to seek federal waivers to implement this
4526	initiative.
4527	Section 89.  Subsection (14) of section 409.906, Florida
4528	Statutes, is amended to read:
4529	409.906  Optional Medicaid services.--Subject to specific
4530	appropriations, the agency may make payments for services which
4531	are optional to the state under Title XIX of the Social Security
4532	Act and are furnished by Medicaid providers to recipients who
4533	are determined to be eligible on the dates on which the services
4534	were provided. Any optional service that is provided shall be
4535	provided only when medically necessary and in accordance with
4536	state and federal law. Optional services rendered by providers
4537	in mobile units to Medicaid recipients may be restricted or
4538	prohibited by the agency. Nothing in this section shall be
4539	construed to prevent or limit the agency from adjusting fees,
4540	reimbursement rates, lengths of stay, number of visits, or
4541	number of services, or making any other adjustments necessary to
4542	comply with the availability of moneys and any limitations or
4543	directions provided for in the General Appropriations Act or
4544	chapter 216. If necessary to safeguard the state's systems of
4545	providing services to elderly and disabled persons and subject
4546	to the notice and review provisions of s. 216.177, the Governor
4547	may direct the Agency for Health Care Administration to amend
4548	the Medicaid state plan to delete the optional Medicaid service
4549	known as "Intermediate Care Facilities for the Developmentally
4550	Disabled." Optional services may include:
4551	(14)  HOSPICE CARE SERVICES.--The agency may pay for all
4552	reasonable and necessary services for the palliation or
4553	management of a recipient's terminal illness, if the services
4554	are provided by a hospice that is licensed under part IV VI of
4555	chapter 400 and meets Medicare certification requirements.
4556	Section 90.  Subsection (7) and paragraph (a) of subsection
4557	(8) of section 409.907, Florida Statutes, are amended to read:
4558	409.907  Medicaid provider agreements.--The agency may make
4559	payments for medical assistance and related services rendered to
4560	Medicaid recipients only to an individual or entity who has a
4561	provider agreement in effect with the agency, who is performing
4562	services or supplying goods in accordance with federal, state,
4563	and local law, and who agrees that no person shall, on the
4564	grounds of handicap, race, color, or national origin, or for any
4565	other reason, be subjected to discrimination under any program
4566	or activity for which the provider receives payment from the
4567	agency.
4568	(7)  The agency may require, as a condition of
4569	participating in the Medicaid program and before entering into
4570	the provider agreement, that the provider submit information, in
4571	an initial and any required renewal applications, concerning the
4572	professional, business, and personal background of the provider
4573	and permit an onsite inspection of the provider's service
4574	location by agency staff or other personnel designated by the
4575	agency to perform this function. The agency shall perform a
4576	random onsite inspection, within 60 days after receipt of a
4577	fully complete new provider's application, of the provider's
4578	service location prior to making its first payment to the
4579	provider for Medicaid services to determine the applicant's
4580	ability to provide the services that the applicant is proposing
4581	to provide for Medicaid reimbursement. The agency is not
4582	required to perform an onsite inspection of a provider or
4583	program that is licensed by the agency, that provides services
4584	under waiver programs for home and community-based services, or
4585	that is licensed as a medical foster home by the Department of
4586	Children and Family Services. As a continuing condition of
4587	participation in the Medicaid program, a provider shall
4588	immediately notify the agency of any current or pending
4589	bankruptcy filing. Before entering into the provider agreement,
4590	or as a condition of continuing participation in the Medicaid
4591	program, the agency may also require that Medicaid providers
4592	reimbursed on a fee-for-services basis or fee schedule basis
4593	which is not cost-based, post a surety bond not to exceed
4594	$50,000 or the total amount billed by the provider to the
4595	program during the current or most recent calendar year,
4596	whichever is greater. For new providers, the amount of the
4597	surety bond shall be determined by the agency based on the
4598	provider's estimate of its first year's billing. If the
4599	provider's billing during the first year exceeds the bond
4600	amount, the agency may require the provider to acquire an
4601	additional bond equal to the actual billing level of the
4602	provider. A provider's bond shall not exceed $50,000 if a
4603	physician or group of physicians licensed under chapter 458,
4604	chapter 459, or chapter 460 has a 50 percent or greater
4605	ownership interest in the provider or if the provider is an
4606	assisted living facility licensed under part III of chapter 429
4607	400. The bonds permitted by this section are in addition to the
4608	bonds referenced in s. 400.179(5)(d). If the provider is a
4609	corporation, partnership, association, or other entity, the
4610	agency may require the provider to submit information concerning
4611	the background of that entity and of any principal of the
4612	entity, including any partner or shareholder having an ownership
4613	interest in the entity equal to 5 percent or greater, and any
4614	treating provider who participates in or intends to participate
4615	in Medicaid through the entity. The information must include:
4616	(a)  Proof of holding a valid license or operating
4617	certificate, as applicable, if required by the state or local
4618	jurisdiction in which the provider is located or if required by
4619	the Federal Government.
4620	(b)  Information concerning any prior violation, fine,
4621	suspension, termination, or other administrative action taken
4622	under the Medicaid laws, rules, or regulations of this state or
4623	of any other state or the Federal Government; any prior
4624	violation of the laws, rules, or regulations relating to the
4625	Medicare program; any prior violation of the rules or
4626	regulations of any other public or private insurer; and any
4627	prior violation of the laws, rules, or regulations of any
4628	regulatory body of this or any other state.
4629	(c)  Full and accurate disclosure of any financial or
4630	ownership interest that the provider, or any principal, partner,
4631	or major shareholder thereof, may hold in any other Medicaid
4632	provider or health care related entity or any other entity that
4633	is licensed by the state to provide health or residential care
4634	and treatment to persons.
4635	(d)  If a group provider, identification of all members of
4636	the group and attestation that all members of the group are
4637	enrolled in or have applied to enroll in the Medicaid program.
4638	(8)(a)  Each provider, or each principal of the provider if
4639	the provider is a corporation, partnership, association, or
4640	other entity, seeking to participate in the Medicaid program
4641	must submit a complete set of his or her fingerprints to the
4642	agency for the purpose of conducting a criminal history record
4643	check.  Principals of the provider include any officer,
4644	director, billing agent, managing employee, or affiliated
4645	person, or any partner or shareholder who has an ownership
4646	interest equal to 5 percent or more in the provider. However, a
4647	director of a not-for-profit corporation or organization is not
4648	a principal for purposes of a background investigation as
4649	required by this section if the director: serves solely in a
4650	voluntary capacity for the corporation or organization, does not
4651	regularly take part in the day-to-day operational decisions of
4652	the corporation or organization, receives no remuneration from
4653	the not-for-profit corporation or organization for his or her
4654	service on the board of directors, has no financial interest in
4655	the not-for-profit corporation or organization, and has no
4656	family members with a financial interest in the not-for-profit
4657	corporation or organization; and if the director submits an
4658	affidavit, under penalty of perjury, to this effect to the
4659	agency and the not-for-profit corporation or organization
4660	submits an affidavit, under penalty of perjury, to this effect
4661	to the agency as part of the corporation's or organization's
4662	Medicaid provider agreement application. Notwithstanding the
4663	above, the agency may require a background check for any person
4664	reasonably suspected by the agency to have been convicted of a
4665	crime. This subsection shall not apply to:
4666	1.  A hospital licensed under chapter 395;
4667	2.  A nursing home licensed under chapter 400;
4668	3.  A hospice licensed under chapter 400;
4669	4.  An assisted living facility licensed under chapter 429;
4670	400.
4671	5.  A unit of local government, except that requirements of
4672	this subsection apply to nongovernmental providers and entities
4673	when contracting with the local government to provide Medicaid
4674	services. The actual cost of the state and national criminal
4675	history record checks must be borne by the nongovernmental
4676	provider or entity; or
4677	6.  Any business that derives more than 50 percent of its
4678	revenue from the sale of goods to the final consumer, and the
4679	business or its controlling parent either is required to file a
4680	form 10-K or other similar statement with the Securities and
4681	Exchange Commission or has a net worth of $50 million or more.
4682	Section 91.  Paragraph (c) of subsection (5) of section
4683	409.912, Florida Statutes, is amended to read:
4684	409.912  Cost-effective purchasing of health care.--The
4685	agency shall purchase goods and services for Medicaid recipients
4686	in the most cost-effective manner consistent with the delivery
4687	of quality medical care. To ensure that medical services are
4688	effectively utilized, the agency may, in any case, require a
4689	confirmation or second physician's opinion of the correct
4690	diagnosis for purposes of authorizing future services under the
4691	Medicaid program. This section does not restrict access to
4692	emergency services or poststabilization care services as defined
4693	in 42 C.F.R. part 438.114. Such confirmation or second opinion
4694	shall be rendered in a manner approved by the agency. The agency
4695	shall maximize the use of prepaid per capita and prepaid
4696	aggregate fixed-sum basis services when appropriate and other
4697	alternative service delivery and reimbursement methodologies,
4698	including competitive bidding pursuant to s. 287.057, designed
4699	to facilitate the cost-effective purchase of a case-managed
4700	continuum of care. The agency shall also require providers to
4701	minimize the exposure of recipients to the need for acute
4702	inpatient, custodial, and other institutional care and the
4703	inappropriate or unnecessary use of high-cost services. The
4704	agency shall contract with a vendor to monitor and evaluate the
4705	clinical practice patterns of providers in order to identify
4706	trends that are outside the normal practice patterns of a
4707	provider's professional peers or the national guidelines of a
4708	provider's professional association. The vendor must be able to
4709	provide information and counseling to a provider whose practice
4710	patterns are outside the norms, in consultation with the agency,
4711	to improve patient care and reduce inappropriate utilization.
4712	The agency may mandate prior authorization, drug therapy
4713	management, or disease management participation for certain
4714	populations of Medicaid beneficiaries, certain drug classes, or
4715	particular drugs to prevent fraud, abuse, overuse, and possible
4716	dangerous drug interactions. The Pharmaceutical and Therapeutics
4717	Committee shall make recommendations to the agency on drugs for
4718	which prior authorization is required. The agency shall inform
4719	the Pharmaceutical and Therapeutics Committee of its decisions
4720	regarding drugs subject to prior authorization. The agency is
4721	authorized to limit the entities it contracts with or enrolls as
4722	Medicaid providers by developing a provider network through
4723	provider credentialing. The agency may competitively bid single-
4724	source-provider contracts if procurement of goods or services
4725	results in demonstrated cost savings to the state without
4726	limiting access to care. The agency may limit its network based
4727	on the assessment of beneficiary access to care, provider
4728	availability, provider quality standards, time and distance
4729	standards for access to care, the cultural competence of the
4730	provider network, demographic characteristics of Medicaid
4731	beneficiaries, practice and provider-to-beneficiary standards,
4732	appointment wait times, beneficiary use of services, provider
4733	turnover, provider profiling, provider licensure history,
4734	previous program integrity investigations and findings, peer
4735	review, provider Medicaid policy and billing compliance records,
4736	clinical and medical record audits, and other factors. Providers
4737	shall not be entitled to enrollment in the Medicaid provider
4738	network. The agency shall determine instances in which allowing
4739	Medicaid beneficiaries to purchase durable medical equipment and
4740	other goods is less expensive to the Medicaid program than long-
4741	term rental of the equipment or goods. The agency may establish
4742	rules to facilitate purchases in lieu of long-term rentals in
4743	order to protect against fraud and abuse in the Medicaid program
4744	as defined in s. 409.913. The agency may seek federal waivers
4745	necessary to administer these policies.
4746	(5)  By December 1, 2005, the Agency for Health Care
4747	Administration, in partnership with the Department of Elderly
4748	Affairs, shall create an integrated, fixed-payment delivery
4749	system for Medicaid recipients who are 60 years of age or older.
4750	The Agency for Health Care Administration shall implement the
4751	integrated system initially on a pilot basis in two areas of the
4752	state. In one of the areas enrollment shall be on a voluntary
4753	basis. The program must transfer all Medicaid services for
4754	eligible elderly individuals who choose to participate into an
4755	integrated-care management model designed to serve Medicaid
4756	recipients in the community. The program must combine all
4757	funding for Medicaid services provided to individuals 60 years
4758	of age or older into the integrated system, including funds for
4759	Medicaid home and community-based waiver services; all Medicaid
4760	services authorized in ss. 409.905 and 409.906, excluding funds
4761	for Medicaid nursing home services unless the agency is able to
4762	demonstrate how the integration of the funds will improve
4763	coordinated care for these services in a less costly manner; and
4764	Medicare coinsurance and deductibles for persons dually eligible
4765	for Medicaid and Medicare as prescribed in s. 409.908(13).
4766	(c)  The agency must ensure that the capitation-rate-
4767	setting methodology for the integrated system is actuarially
4768	sound and reflects the intent to provide quality care in the
4769	least restrictive setting. The agency must also require
4770	integrated-system providers to develop a credentialing system
4771	for service providers and to contract with all Gold Seal nursing
4772	homes, where feasible, and exclude, where feasible, chronically
4773	poor-performing facilities and providers as defined by the
4774	agency. The integrated system must provide that if the recipient
4775	resides in a noncontracted residential facility licensed under
4776	chapter 400 or chapter 429 at the time the integrated system is
4777	initiated, the recipient must be permitted to continue to reside
4778	in the noncontracted facility as long as the recipient desires.
4779	The integrated system must also provide that, in the absence of
4780	a contract between the integrated-system provider and the
4781	residential facility licensed under chapter 400 or chapter 429,
4782	current Medicaid rates must prevail. The agency and the
4783	Department of Elderly Affairs must jointly develop procedures to
4784	manage the services provided through the integrated system in
4785	order to ensure quality and recipient choice.
4786	Section 92.  Section 410.031, Florida Statutes, is amended
4787	to read:
4788	410.031  Legislative intent.--It is the intent of the
4789	Legislature to encourage the provision of care for disabled
4790	adults in family-type living arrangements in private homes as an
4791	alternative to institutional or nursing home care for such
4792	persons. The provisions of ss. 410.031-410.036 are intended to
4793	be supplemental to the provisions of chapters chapter 400 and
4794	429, relating to the licensing and regulation of nursing homes
4795	and assisted living facilities, and do not exempt any person who
4796	is otherwise subject to regulation under chapter 400 or chapter
4797	429.
4798	Section 93.  Section 410.034, Florida Statutes, is amended
4799	to read:
4800	410.034  Department determination of fitness to provide
4801	home care.--In accordance with s. 429.02 s. 400.402, a person
4802	caring for an adult who is related to such person by blood or
4803	marriage is not subject to the Assisted Living Facilities Act.
4804	If, however, the person who plans to provide home care under
4805	this act is found by the department to be unable to provide this
4806	care, the department shall notify the person wishing to provide
4807	home care of this determination, and the person shall not be
4808	eligible for subsidy payments under ss. 410.031-410.036.
4809	Section 94.  Subsection (31) of section 413.20, Florida
4810	Statutes, is amended to read:
4811	413.20  Definitions.--As used in this part, the term:
4812	(31)  "Transitional living facility" means a state-approved
4813	facility as defined and licensed pursuant to chapter 400 or
4814	chapter 429 and division-approved in accord with this part.
4815	Section 95.  Section 415.1111, Florida Statutes, is amended
4816	to read:
4817	415.1111  Civil actions.--A vulnerable adult who has been
4818	abused, neglected, or exploited as specified in this chapter has
4819	a cause of action against any perpetrator and may recover actual
4820	and punitive damages for such abuse, neglect, or exploitation.
4821	The action may be brought by the vulnerable adult, or that
4822	person's guardian, by a person or organization acting on behalf
4823	of the vulnerable adult with the consent of that person or that
4824	person's guardian, or by the personal representative of the
4825	estate of a deceased victim without regard to whether the cause
4826	of death resulted from the abuse, neglect, or exploitation. The
4827	action may be brought in any court of competent jurisdiction to
4828	enforce such action and to recover actual and punitive damages
4829	for any deprivation of or infringement on the rights of a
4830	vulnerable adult. A party who prevails in any such action may be
4831	entitled to recover reasonable attorney's fees, costs of the
4832	action, and damages. The remedies provided in this section are
4833	in addition to and cumulative with other legal and
4834	administrative remedies available to a vulnerable adult.
4835	Notwithstanding the foregoing, any civil action for damages
4836	against any licensee or entity who establishes, controls,
4837	conducts, manages, or operates a facility licensed under part II
4838	of chapter 400 relating to its operation of the licensed
4839	facility shall be brought pursuant to s. 400.023, or against any
4840	licensee or entity who establishes, controls, conducts, manages,
4841	or operates a facility licensed under part I III of chapter 429
4842	400 relating to its operation of the licensed facility shall be
4843	brought pursuant to s. 429.29 s. 400.429. Such licensee or
4844	entity shall not be vicariously liable for the acts or omissions
4845	of its employees or agents or any other third party in an action
4846	brought under this section.
4847	Section 96.  Paragraph (d) of subsection (1) of section
4848	419.001, Florida Statutes, is amended to read:
4849	419.001  Site selection of community residential homes.--
4850	(1)  For the purposes of this section, the following
4851	definitions shall apply:
4852	(d)  "Resident" means any of the following: a frail elder
4853	as defined in s. 429.65 s. 400.618; a physically disabled or
4854	handicapped person as defined in s. 760.22(7)(a); a
4855	developmentally disabled person as defined in s. 393.063; a
4856	nondangerous mentally ill person as defined in s. 394.455(18);
4857	or a child as defined in s. 39.01(14), s. 984.03(9) or (12), or
4858	s. 985.03(8).
4859	Section 97.  Section 430.601, Florida Statutes, is amended
4860	to read:
4861	430.601  Home care for the elderly; legislative intent.--It
4862	is the intent of the Legislature to encourage the provision of
4863	care for the elderly in family-type living arrangements in
4864	private homes as an alternative to institutional or nursing home
4865	care for such persons. The provisions of ss. 430.601-430.606 are
4866	intended to be supplemental to the provisions of chapters
4867	chapter 400 and 429, relating to the licensing and regulation of
4868	nursing homes and assisted living facilities, and do not exempt
4869	any person who is otherwise subject to regulation under those
4870	chapters the provisions of that chapter.
4871	Section 98.  Subsection (7) of section 430.703, Florida
4872	Statutes, is amended to read:
4873	430.703  Definitions.--As used in this act, the term:
4874	(7)  "Other qualified provider" means an entity licensed
4875	under chapter 400 or chapter 429 that demonstrates a long-term
4876	care continuum and meets all requirements pursuant to an
4877	interagency agreement between the agency and the department.
4878	Section 99.  Paragraph (a) of subsection (3) of section
4879	435.03, Florida Statutes, is amended to read:
4880	435.03  Level 1 screening standards.--
4881	(3)  Standards must also ensure that the person:
4882	(a)  For employees and employers licensed or registered
4883	pursuant to chapter 400 or chapter 429, and for employees and
4884	employers of developmental services institutions as defined in
4885	s. 393.063, intermediate care facilities for the developmentally
4886	disabled as defined in s. 393.063, and mental health treatment
4887	facilities as defined in s. 394.455, meets the requirements of
4888	this chapter.
4889	Section 100.  Paragraph (a) of subsection (4) of section
4890	435.04, Florida Statutes, is amended to read:
4891	435.04  Level 2 screening standards.--
4892	(4)  Standards must also ensure that the person:
4893	(a)  For employees or employers licensed or registered
4894	pursuant to chapter 400 or chapter 429, does not have a
4895	confirmed report of abuse, neglect, or exploitation as defined
4896	in s. 415.102(6), which has been uncontested or upheld under s.
4897	415.103.
4898	Section 101.  Paragraph (g) of subsection (1) of section
4899	440.13, Florida Statutes, is amended to read:
4900	440.13  Medical services and supplies; penalty for
4901	violations; limitations.--
4902	(1)  DEFINITIONS.--As used in this section, the term:
4903	(g)  "Health care facility" means any hospital licensed
4904	under chapter 395 and any health care institution licensed under
4905	chapter 400 or chapter 429.
4906	Section 102.  Subsection (8) of section 468.1685, Florida
4907	Statutes, is amended to read:
4908	468.1685  Powers and duties of board and department.--It is
4909	the function and duty of the board, together with the
4910	department, to:
4911	(8)  Set up procedures by rule for advising and acting
4912	together with the Department of Health and other boards of other
4913	health professions in matters affecting procedures and methods
4914	for effectively enforcing the purpose of this part and the
4915	administration of chapters chapter 400 and 429.
4916	Section 103.  Paragraph (k) of subsection (1) of section
4917	468.505, Florida Statutes, is amended to read:
4918	468.505  Exemptions; exceptions.--
4919	(1)  Nothing in this part may be construed as prohibiting
4920	or restricting the practice, services, or activities of:
4921	(k)  A person employed by a hospital licensed under chapter
4922	395, or by a nursing home or assisted living facility licensed
4923	under part II or part III of chapter 400, by an assisted living
4924	facility licensed under chapter 429, or by a continuing care
4925	facility certified under chapter 651, if the person is employed
4926	in compliance with the laws and rules adopted thereunder
4927	regarding the operation of its dietetic department.
4928	Section 104.  Subsection (11) of section 477.025, Florida
4929	Statutes, is amended to read:
4930	477.025  Cosmetology salons; specialty salons; requisites;
4931	licensure; inspection; mobile cosmetology salons.--
4932	(11)  Facilities licensed under part II or part III of
4933	chapter 400 or under chapter 429 are shall be exempt from the
4934	provisions of this section, and a cosmetologist licensed
4935	pursuant to s. 477.019 may provide salon services exclusively
4936	for facility residents.
4937	Section 105.  Subsection (5) of section 483.285, Florida
4938	Statutes, is amended to read:
4939	483.285  Application of part; exemptions.--This part
4940	applies to all multiphasic health testing centers within the
4941	state, but does not apply to:
4942	(5)  A home health agency licensed under part III IV of
4943	chapter 400.
4944	Section 106.  Paragraph (a) of subsection (2) of section
4945	509.032, Florida Statutes, is amended to read:
4946	509.032  Duties.--
4947	(2)  INSPECTION OF PREMISES.--
4948	(a)  The division has responsibility and jurisdiction for
4949	all inspections required by this chapter.  The division has
4950	responsibility for quality assurance.  Each licensed
4951	establishment shall be inspected at least biannually, except for
4952	transient and nontransient apartments, which shall be inspected
4953	at least annually, and shall be inspected at such other times as
4954	the division determines is necessary to ensure the public's
4955	health, safety, and welfare.  The division shall establish a
4956	system to determine inspection frequency.  Public lodging units
4957	classified as resort condominiums or resort dwellings are not
4958	subject to this requirement, but shall be made available to the
4959	division upon request.  If, during the inspection of a public
4960	lodging establishment classified for renting to transient or
4961	nontransient tenants, an inspector identifies vulnerable adults
4962	who appear to be victims of neglect, as defined in s. 415.102,
4963	or, in the case of a building that is not equipped with
4964	automatic sprinkler systems, tenants or clients who may be
4965	unable to self-preserve in an emergency, the division shall
4966	convene meetings with the following agencies as appropriate to
4967	the individual situation: the Department of Health, the
4968	Department of Elderly Affairs, the area agency on aging, the
4969	local fire marshal, the landlord and affected tenants and
4970	clients, and other relevant organizations, to develop a plan
4971	which improves the prospects for safety of affected residents
4972	and, if necessary, identifies alternative living arrangements
4973	such as facilities licensed under part II or part III of chapter
4974	400 or under chapter 429.
4975	Section 107.  Subsection (1) of section 509.241, Florida
4976	Statutes, is amended to read:
4977	509.241  Licenses required; exceptions.--
4978	(1)  LICENSES; ANNUAL RENEWALS.--Each public lodging
4979	establishment and public food service establishment shall obtain
4980	a license from the division. Such license may not be transferred
4981	from one place or individual to another. It shall be a
4982	misdemeanor of the second degree, punishable as provided in s.
4983	775.082 or s. 775.083, for such an establishment to operate
4984	without a license. Local law enforcement shall provide immediate
4985	assistance in pursuing an illegally operating establishment. The
4986	division may refuse a license, or a renewal thereof, to any
4987	establishment that is not constructed and maintained in
4988	accordance with law and with the rules of the division. The
4989	division may refuse to issue a license, or a renewal thereof, to
4990	any establishment an operator of which, within the preceding 5
4991	years, has been adjudicated guilty of, or has forfeited a bond
4992	when charged with, any crime reflecting on professional
4993	character, including soliciting for prostitution, pandering,
4994	letting premises for prostitution, keeping a disorderly place,
4995	or illegally dealing in controlled substances as defined in
4996	chapter 893, whether in this state or in any other jurisdiction
4997	within the United States, or has had a license denied, revoked,
4998	or suspended pursuant to s. 429.14 s. 400.414. Licenses shall be
4999	renewed annually, and the division shall adopt a rule
5000	establishing a staggered schedule for license renewals. If any
5001	license expires while administrative charges are pending against
5002	the license, the proceedings against the license shall continue
5003	to conclusion as if the license were still in effect.
5004	Section 108.  Subsection (1) of section 627.6617, Florida
5005	Statutes, is amended to read:
5006	627.6617  Coverage for home health care services.--
5007	(1)  Any group health insurance policy providing coverage
5008	on an expense-incurred basis shall provide coverage for home
5009	health care by a home health care agency licensed pursuant to
5010	part III IV of chapter 400. Such coverage may be limited to home
5011	health care under a plan of treatment prescribed by a licensed
5012	physician. Services may be performed by a registered graduate
5013	nurse, a licensed practical nurse, a physical therapist, a
5014	speech therapist, an occupational therapist, or a home health
5015	aide. Provisions for utilization review may be imposed, provided
5016	that similar provisions apply to all other types of health care
5017	services.
5018	Section 109.  Subsection (1) of section 627.732, Florida
5019	Statutes, is amended to read:
5020	627.732  Definitions.--As used in ss. 627.730-627.7405, the
5021	term:
5022	(1)  "Broker" means any person not possessing a license
5023	under chapter 395, chapter 400, chapter 429, chapter 458,
5024	chapter 459, chapter 460, chapter 461, or chapter 641 who
5025	charges or receives compensation for any use of medical
5026	equipment and is not the 100-percent owner or the 100-percent
5027	lessee of such equipment. For purposes of this section, such
5028	owner or lessee may be an individual, a corporation, a
5029	partnership, or any other entity and any of its 100-percent-
5030	owned affiliates and subsidiaries. For purposes of this
5031	subsection, the term "lessee" means a long-term lessee under a
5032	capital or operating lease, but does not include a part-time
5033	lessee. The term "broker" does not include a hospital or
5034	physician management company whose medical equipment is
5035	ancillary to the practices managed, a debt collection agency, or
5036	an entity that has contracted with the insurer to obtain a
5037	discounted rate for such services; nor does the term include a
5038	management company that has contracted to provide general
5039	management services for a licensed physician or health care
5040	facility and whose compensation is not materially affected by
5041	the usage or frequency of usage of medical equipment or an
5042	entity that is 100-percent owned by one or more hospitals or
5043	physicians. The term "broker" does not include a person or
5044	entity that certifies, upon request of an insurer, that:
5045	(a)  It is a clinic licensed under ss. 400.990-400.995;
5046	(b)  It is a 100-percent owner of medical equipment; and
5047	(c)  The owner's only part-time lease of medical equipment
5048	for personal injury protection patients is on a temporary basis
5049	not to exceed 30 days in a 12-month period, and such lease is
5050	solely for the purposes of necessary repair or maintenance of
5051	the 100-percent-owned medical equipment or pending the arrival
5052	and installation of the newly purchased or a replacement for the
5053	100-percent-owned medical equipment, or for patients for whom,
5054	because of physical size or claustrophobia, it is determined by
5055	the medical director or clinical director to be medically
5056	necessary that the test be performed in medical equipment that
5057	is open-style. The leased medical equipment cannot be used by
5058	patients who are not patients of the registered clinic for
5059	medical treatment of services. Any person or entity making a
5060	false certification under this subsection commits insurance
5061	fraud as defined in s. 817.234. However, the 30-day period
5062	provided in this paragraph may be extended for an additional 60
5063	days as applicable to magnetic resonance imaging equipment if
5064	the owner certifies that the extension otherwise complies with
5065	this paragraph.
5066	Section 110.  Subsection (2) of section 651.011, Florida
5067	Statutes, is amended to read:
5068	651.011  Definitions.--For the purposes of this chapter,
5069	the term:
5070	(2)  "Continuing care" or "care" means furnishing pursuant
5071	to a contract shelter and either nursing care or personal
5072	services as defined in s. 429.02 s. 400.402, whether such
5073	nursing care or personal services are provided in the facility
5074	or in another setting designated by the contract for continuing
5075	care, to an individual not related by consanguinity or affinity
5076	to the provider furnishing such care, upon payment of an
5077	entrance fee. Other personal services provided shall be
5078	designated in the continuing care contract. Contracts to provide
5079	continuing care include agreements to provide care for any
5080	duration, including contracts that are terminable by either
5081	party.
5082	Section 111.  Paragraph (c) of subsection (2) of section
5083	651.022, Florida Statutes, is amended to read:
5084	651.022  Provisional certificate of authority;
5085	application.--
5086	(2)  The application for a provisional certificate of
5087	authority shall be on a form prescribed by the commission and
5088	shall contain the following information:
5089	(c)1.  Evidence that the applicant is reputable and of
5090	responsible character.  If the applicant is a firm, association,
5091	organization, partnership, business trust, corporation, or
5092	company, the form shall require evidence that the members or
5093	shareholders are reputable and of responsible character, and the
5094	person in charge of providing care under a certificate of
5095	authority shall likewise be required to produce evidence of
5096	being reputable and of responsible character.
5097	2.  Evidence satisfactory to the office of the ability of
5098	the applicant to comply with the provisions of this chapter and
5099	with rules adopted by the commission pursuant to this chapter.
5100	3.  A statement of whether a person identified in the
5101	application for a provisional certificate of authority or the
5102	administrator or manager of the facility, if such person has
5103	been designated, or any such person living in the same location:
5104	a.  Has been convicted of a felony or has pleaded nolo
5105	contendere to a felony charge, or has been held liable or has
5106	been enjoined in a civil action by final judgment, if the felony
5107	or civil action involved fraud, embezzlement, fraudulent
5108	conversion, or misappropriation of property.
5109	b.  Is subject to a currently effective injunctive or
5110	restrictive order or federal or state administrative order
5111	relating to business activity or health care as a result of an
5112	action brought by a public agency or department, including,
5113	without limitation, an action affecting a license under chapter
5114	400 or chapter 429.
5115
5116	The statement shall set forth the court or agency, the date of
5117	conviction or judgment, and the penalty imposed or damages
5118	assessed, or the date, nature, and issuer of the order.  Before
5119	determining whether a provisional certificate of authority is to
5120	be issued, the office may make an inquiry to determine the
5121	accuracy of the information submitted pursuant to subparagraphs
5122	1. and 2.
5123	Section 112.  Subsection (6) of section 651.023, Florida
5124	Statutes, is amended to read:
5125	651.023  Certificate of authority; application.--
5126	(6)  The timeframes provided under s. 651.022(5) and (6)
5127	apply to applications submitted under s. 651.021(2). The office
5128	may not issue a certificate of authority under this chapter to
5129	any facility which does not have a component which is to be
5130	licensed pursuant to part II or part III of chapter 400 or
5131	chapter 429 or which will not offer personal services or nursing
5132	services through written contractual agreement. Any written
5133	contractual agreement must be disclosed in the continuing care
5134	contract and is subject to the provisions of s. 651.1151,
5135	relating to administrative, vendor, and management contracts.
5136	Section 113.  Subsection (8) of section 651.055, Florida
5137	Statutes, is amended to read:
5138	651.055  Contracts; right to rescind.--
5139	(8)  The provisions of this section shall control over any
5140	conflicting provisions contained in part II or part III of
5141	chapter 400 or in chapter 429.
5142	Section 114.  Subsection (5) of section 651.095, Florida
5143	Statutes, is amended to read:
5144	651.095  Advertisements; requirements; penalties.--
5145	(5)  The provisions of this section shall control over any
5146	conflicting provisions contained in part II or part III of
5147	chapter 400 or in chapter 429.
5148	Section 115.  Subsections (1), (4), (6), (7), and (8) of
5149	section 651.118, Florida Statutes, are amended to read:
5150	651.118  Agency for Health Care Administration;
5151	certificates of need; sheltered beds; community beds.--
5152	(1)  The provisions of this section shall control in the
5153	case of conflict with the provisions of the Health Facility and
5154	Services Development Act, ss. 408.031-408.045; the provisions of
5155	chapter 395; or the provisions of part II parts II and III of
5156	chapter 400; or the provisions of chapter 429.
5157	(4)  The Agency for Health Care Administration shall
5158	approve one sheltered nursing home bed for every four proposed
5159	residential units, including those that are licensed under
5160	chapter 429 part III of chapter 400, in the continuing care
5161	facility unless the provider demonstrates the need for a lesser
5162	number of sheltered nursing home beds based on proposed
5163	utilization by prospective residents or demonstrates the need
5164	for additional sheltered nursing home beds based on actual
5165	utilization and demand by current residents.
5166	(6)  Unless the provider already has a component that is to
5167	be a part of the continuing care facility and that is licensed
5168	under chapter 395, or part II or part III of chapter 400, or
5169	chapter 429 at the time of construction of the continuing care
5170	facility, the provider must construct the nonnursing home
5171	portion of the facility and the nursing home portion of the
5172	facility at the same time. If a provider constructs less than
5173	the number of residential units approved in the certificate of
5174	authority, the number of licensed sheltered nursing home beds
5175	shall be reduced by a proportionate share.
5176	(7)  Notwithstanding the provisions of subsection (2), at
5177	the discretion of the continuing care provider, sheltered
5178	nursing home beds may be used for persons who are not residents
5179	of the continuing care facility and who are not parties to a
5180	continuing care contract for a period of up to 5 years after the
5181	date of issuance of the initial nursing home license. A provider
5182	whose 5-year period has expired or is expiring may request the
5183	Agency for Health Care Administration for an extension, not to
5184	exceed 30 percent of the total sheltered nursing home beds, if
5185	the utilization by residents of the nursing home facility in the
5186	sheltered beds will not generate sufficient income to cover
5187	nursing home facility expenses, as evidenced by one of the
5188	following:
5189	(a)  The nursing home facility has a net loss for the most
5190	recent fiscal year as determined under generally accepted
5191	accounting principles, excluding the effects of extraordinary or
5192	unusual items, as demonstrated in the most recently audited
5193	financial statement; or
5194	(b)  The nursing home facility would have had a pro forma
5195	loss for the most recent fiscal year, excluding the effects of
5196	extraordinary or unusual items, if revenues were reduced by the
5197	amount of revenues from persons in sheltered beds who were not
5198	residents, as reported on by a certified public accountant.
5199
5200	The agency shall be authorized to grant an extension to the
5201	provider based on the evidence required in this subsection. The
5202	agency may request a continuing care facility to use up to 25
5203	percent of the patient days generated by new admissions of
5204	nonresidents during the extension period to serve Medicaid
5205	recipients for those beds authorized for extended use if there
5206	is a demonstrated need in the respective service area and if
5207	funds are available. A provider who obtains an extension is
5208	prohibited from applying for additional sheltered beds under the
5209	provision of subsection (2), unless additional residential units
5210	are built or the provider can demonstrate need by continuing
5211	care facility residents to the Agency for Health Care
5212	Administration. The 5-year limit does not apply to up to five
5213	sheltered beds designated for inpatient hospice care as part of
5214	a contractual arrangement with a hospice licensed under part IV
5215	VI of chapter 400. A continuing care facility that uses such
5216	beds after the 5-year period shall report such use to the Agency
5217	for Health Care Administration. For purposes of this subsection,
5218	"resident" means a person who, upon admission to the continuing
5219	care facility, initially resides in a part of the continuing
5220	care facility not licensed under part II of chapter 400.
5221	(8)  A provider may petition the Agency for Health Care
5222	Administration to use a designated number of sheltered nursing
5223	home beds to provide extended congregate care as defined in s.
5224	429.02 s. 400.402 if the beds are in a distinct area of the
5225	nursing home which can be adapted to meet the requirements for
5226	extended congregate care. The provider may subsequently use such
5227	beds as sheltered beds after notifying the agency of the
5228	intended change. Any sheltered beds used to provide extended
5229	congregate care pursuant to this subsection may not qualify for
5230	funding under the Medicaid waiver. Any sheltered beds used to
5231	provide extended congregate care pursuant to this subsection may
5232	share common areas, services, and staff with beds designated for
5233	nursing home care, provided that all of the beds are under
5234	common ownership. For the purposes of this subsection, fire and
5235	life safety codes applicable to nursing home facilities shall
5236	apply.
5237	Section 116.  Subsection (2) of section 765.1103, Florida
5238	Statutes, is amended to read:
5239	765.1103  Pain management and palliative care.--
5240	(2)  Health care providers and practitioners regulated
5241	under chapter 458, chapter 459, or chapter 464 must, as
5242	appropriate, comply with a request for pain management or
5243	palliative care from a patient under their care or, for an
5244	incapacitated patient under their care, from a surrogate, proxy,
5245	guardian, or other representative permitted to make health care
5246	decisions for the incapacitated patient. Facilities regulated
5247	under chapter 395, or chapter 400, or chapter 429 must comply
5248	with the pain management or palliative care measures ordered by
5249	the patient's physician.
5250	Section 117.  Subsection (2) of section 765.205, Florida
5251	Statutes, is amended to read:
5252	765.205  Responsibility of the surrogate.--
5253	(2)  The surrogate may authorize the release of information
5254	and medical records to appropriate persons to ensure the
5255	continuity of the principal's health care and may authorize the
5256	admission, discharge, or transfer of the principal to or from a
5257	health care facility or other facility or program licensed under
5258	chapter 400 or chapter 429.
5259	Section 118.  Subsection (1) of section 768.735, Florida
5260	Statutes, is amended to read:
5261	768.735  Punitive damages; exceptions; limitation.--
5262	(1)  Sections 768.72(2)-(4), 768.725, and 768.73 do not
5263	apply to any civil action based upon child abuse, abuse of the
5264	elderly under chapter 415, or abuse of the developmentally
5265	disabled. Such actions are governed by applicable statutes and
5266	controlling judicial precedent. This section does not apply to
5267	claims brought pursuant to s. 400.023 or s. 429.29 s. 400.429.
5268	Section 119.  Paragraph (h) of subsection (1) of section
5269	893.13, Florida Statutes, is amended to read:
5270	893.13  Prohibited acts; penalties.--
5271	(1)
5272	(h)  Except as authorized by this chapter, it is unlawful
5273	for any person to sell, manufacture, or deliver, or possess with
5274	intent to sell, manufacture, or deliver, a controlled substance
5275	in, on, or within 1,000 feet of the real property comprising an
5276	assisted living facility, as that term is used in chapter 429
5277	400. Any person who violates this paragraph with respect to:
5278	1.  A controlled substance named or described in s.
5279	893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4.
5280	commits a felony of the first degree, punishable as provided in
5281	s. 775.082, s. 775.083, or s. 775.084.
5282	2.  A controlled substance named or described in s.
5283	893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6.,
5284	(2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) commits a felony of
5285	the second degree, punishable as provided in s. 775.082, s.
5286	775.083, or s. 775.084.
5287	Section 120.  Paragraph (a) of subsection (4) of section
5288	943.0585, Florida Statutes, is amended to read:
5289	943.0585  Court-ordered expunction of criminal history
5290	records.--The courts of this state have jurisdiction over their
5291	own procedures, including the maintenance, expunction, and
5292	correction of judicial records containing criminal history
5293	information to the extent such procedures are not inconsistent
5294	with the conditions, responsibilities, and duties established by
5295	this section. Any court of competent jurisdiction may order a
5296	criminal justice agency to expunge the criminal history record
5297	of a minor or an adult who complies with the requirements of
5298	this section. The court shall not order a criminal justice
5299	agency to expunge a criminal history record until the person
5300	seeking to expunge a criminal history record has applied for and
5301	received a certificate of eligibility for expunction pursuant to
5302	subsection (2). A criminal history record that relates to a
5303	violation of s. 393.135, s. 394.4593, s. 787.025, chapter 794,
5304	s. 796.03, s. 800.04, s. 817.034, s. 825.1025, s. 827.071,
5305	chapter 839, s. 847.0133, s. 847.0135, s. 847.0145, s. 893.135,
5306	s. 916.1075, or a violation enumerated in s. 907.041 may not be
5307	expunged, without regard to whether adjudication was withheld,
5308	if the defendant was found guilty of or pled guilty or nolo
5309	contendere to the offense, or if the defendant, as a minor, was
5310	found to have committed, or pled guilty or nolo contendere to
5311	committing, the offense as a delinquent act. The court may only
5312	order expunction of a criminal history record pertaining to one
5313	arrest or one incident of alleged criminal activity, except as
5314	provided in this section. The court may, at its sole discretion,
5315	order the expunction of a criminal history record pertaining to
5316	more than one arrest if the additional arrests directly relate
5317	to the original arrest. If the court intends to order the
5318	expunction of records pertaining to such additional arrests,
5319	such intent must be specified in the order. A criminal justice
5320	agency may not expunge any record pertaining to such additional
5321	arrests if the order to expunge does not articulate the
5322	intention of the court to expunge a record pertaining to more
5323	than one arrest. This section does not prevent the court from
5324	ordering the expunction of only a portion of a criminal history
5325	record pertaining to one arrest or one incident of alleged
5326	criminal activity. Notwithstanding any law to the contrary, a
5327	criminal justice agency may comply with laws, court orders, and
5328	official requests of other jurisdictions relating to expunction,
5329	correction, or confidential handling of criminal history records
5330	or information derived therefrom. This section does not confer
5331	any right to the expunction of any criminal history record, and
5332	any request for expunction of a criminal history record may be
5333	denied at the sole discretion of the court.
5334	(4)  EFFECT OF CRIMINAL HISTORY RECORD EXPUNCTION.--Any
5335	criminal history record of a minor or an adult which is ordered
5336	expunged by a court of competent jurisdiction pursuant to this
5337	section must be physically destroyed or obliterated by any
5338	criminal justice agency having custody of such record; except
5339	that any criminal history record in the custody of the
5340	department must be retained in all cases. A criminal history
5341	record ordered expunged that is retained by the department is
5342	confidential and exempt from the provisions of s. 119.07(1) and
5343	s. 24(a), Art. I of the State Constitution and not available to
5344	any person or entity except upon order of a court of competent
5345	jurisdiction. A criminal justice agency may retain a notation
5346	indicating compliance with an order to expunge.
5347	(a)  The person who is the subject of a criminal history
5348	record that is expunged under this section or under other
5349	provisions of law, including former s. 893.14, former s. 901.33,
5350	and former s. 943.058, may lawfully deny or fail to acknowledge
5351	the arrests covered by the expunged record, except when the
5352	subject of the record:
5353	1.  Is a candidate for employment with a criminal justice
5354	agency;
5355	2.  Is a defendant in a criminal prosecution;
5356	3.  Concurrently or subsequently petitions for relief under
5357	this section or s. 943.059;
5358	4.  Is a candidate for admission to The Florida Bar;
5359	5.  Is seeking to be employed or licensed by or to contract
5360	with the Department of Children and Family Services or the
5361	Department of Juvenile Justice or to be employed or used by such
5362	contractor or licensee in a sensitive position having direct
5363	contact with children, the developmentally disabled, the aged,
5364	or the elderly as provided in s. 110.1127(3), s. 393.063, s.
5365	394.4572(1), s. 397.451, s. 402.302(3), s. 402.313(3), s.
5366	409.175(2)(i), s. 415.102(4), s. 916.106(10) and (13), s.
5367	985.407, or chapter 400, or chapter 429; or
5368	6.  Is seeking to be employed or licensed by the Department
5369	of Education, any district school board, any university
5370	laboratory school, any charter school, any private or parochial
5371	school, or any local governmental entity that licenses child
5372	care facilities.
5373	Section 121.  Paragraph (a) of subsection (4) of section
5374	943.059, Florida Statutes, is amended to read:
5375	943.059  Court-ordered sealing of criminal history
5376	records.--The courts of this state shall continue to have
5377	jurisdiction over their own procedures, including the
5378	maintenance, sealing, and correction of judicial records
5379	containing criminal history information to the extent such
5380	procedures are not inconsistent with the conditions,
5381	responsibilities, and duties established by this section. Any
5382	court of competent jurisdiction may order a criminal justice
5383	agency to seal the criminal history record of a minor or an
5384	adult who complies with the requirements of this section. The
5385	court shall not order a criminal justice agency to seal a
5386	criminal history record until the person seeking to seal a
5387	criminal history record has applied for and received a
5388	certificate of eligibility for sealing pursuant to subsection
5389	(2). A criminal history record that relates to a violation of s.
5390	393.135, s. 394.4593, s. 787.025, chapter 794, s. 796.03, s.
5391	800.04, s. 817.034, s. 825.1025, s. 827.071, chapter 839, s.
5392	847.0133, s. 847.0135, s. 847.0145, s. 893.135, s. 916.1075, or
5393	a violation enumerated in s. 907.041 may not be sealed, without
5394	regard to whether adjudication was withheld, if the defendant
5395	was found guilty of or pled guilty or nolo contendere to the
5396	offense, or if the defendant, as a minor, was found to have
5397	committed or pled guilty or nolo contendere to committing the
5398	offense as a delinquent act. The court may only order sealing of
5399	a criminal history record pertaining to one arrest or one
5400	incident of alleged criminal activity, except as provided in
5401	this section. The court may, at its sole discretion, order the
5402	sealing of a criminal history record pertaining to more than one
5403	arrest if the additional arrests directly relate to the original
5404	arrest. If the court intends to order the sealing of records
5405	pertaining to such additional arrests, such intent must be
5406	specified in the order. A criminal justice agency may not seal
5407	any record pertaining to such additional arrests if the order to
5408	seal does not articulate the intention of the court to seal
5409	records pertaining to more than one arrest. This section does
5410	not prevent the court from ordering the sealing of only a
5411	portion of a criminal history record pertaining to one arrest or
5412	one incident of alleged criminal activity. Notwithstanding any
5413	law to the contrary, a criminal justice agency may comply with
5414	laws, court orders, and official requests of other jurisdictions
5415	relating to sealing, correction, or confidential handling of
5416	criminal history records or information derived therefrom. This
5417	section does not confer any right to the sealing of any criminal
5418	history record, and any request for sealing a criminal history
5419	record may be denied at the sole discretion of the court.
5420	(4)  EFFECT OF CRIMINAL HISTORY RECORD SEALING.--A criminal
5421	history record of a minor or an adult which is ordered sealed by
5422	a court of competent jurisdiction pursuant to this section is
5423	confidential and exempt from the provisions of s. 119.07(1) and
5424	s. 24(a), Art. I of the State Constitution and is available only
5425	to the person who is the subject of the record, to the subject's
5426	attorney, to criminal justice agencies for their respective
5427	criminal justice purposes, or to those entities set forth in
5428	subparagraphs (a)1., 4., 5., and 6. for their respective
5429	licensing and employment purposes.
5430	(a)  The subject of a criminal history record sealed under
5431	this section or under other provisions of law, including former
5432	s. 893.14, former s. 901.33, and former s. 943.058, may lawfully
5433	deny or fail to acknowledge the arrests covered by the sealed
5434	record, except when the subject of the record:
5435	1.  Is a candidate for employment with a criminal justice
5436	agency;
5437	2.  Is a defendant in a criminal prosecution;
5438	3.  Concurrently or subsequently petitions for relief under
5439	this section or s. 943.0585;
5440	4.  Is a candidate for admission to The Florida Bar;
5441	5.  Is seeking to be employed or licensed by or to contract
5442	with the Department of Children and Family Services or the
5443	Department of Juvenile Justice or to be employed or used by such
5444	contractor or licensee in a sensitive position having direct
5445	contact with children, the developmentally disabled, the aged,
5446	or the elderly as provided in s. 110.1127(3), s. 393.063, s.
5447	394.4572(1), s. 397.451, s. 402.302(3), s. 402.313(3), s.
5448	409.175(2)(i), s. 415.102(4), s. 415.103, s. 916.106(10) and
5449	(13), s. 985.407, or chapter 400, or chapter 429; or
5450	6.  Is seeking to be employed or licensed by the Department
5451	of Education, any district school board, any university
5452	laboratory school, any charter school, any private or parochial
5453	school, or any local governmental entity that licenses child
5454	care facilities.
5455	Section 122.  The Division of Statutory Revision of the
5456	Office of Legislative Services is requested to prepare a
5457	reviser's bill for introduction at a subsequent session of the
5458	Legislature to conform the Florida Statutes to changes made by
5459	this act.
5460	Section 123.  This act shall take effect July 1, 2006.

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