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 |
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33 | Be It Enacted by the Legislature of the State of Florida: |
34 |
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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. |