HB 0501

CS

CHAMBER ACTION

1	The Health & Families Council recommends the following:
2
3	Council/Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to assisted care communities; creating ch.
7	429, F.S.; transferring pt. III of ch. 400, F.S., relating
8	to assisted living facilities, to pt. I of ch. 429, F.S.;
9	transferring pt. VII of ch. 400, F.S., relating to adult
10	family-care homes, to pt. II of ch. 429, F.S.;
11	transferring pt. V of ch. 400, F.S., relating to adult day
12	care centers, to pt. III of ch. 429, F.S.; amending ss.
13	101.655, 189.428, 196.1975, 202.125, 205.1965, 212.031,
14	212.08, 296.02, 381.0035, 381.745, 393.063, 393.506,
15	394.455, 394.4574, 394.463, 400.0063, 400.0069, 400.0073,
16	400.0077, 400.0239, 400.119, 400.141, 400.142, 400.191,
17	400.215, 400.402, 400.404, 400.407, 400.4071, 400.408,
18	400.411, 400.412, 400.414, 400.415, 400.417, 400.4174,
19	400.4176, 400.4178, 400.418, 400.419, 400.42, 400.422,
20	400.424, 400.4255, 400.4256, 400.427, 400.428, 400.429,
21	400.4293, 400.431, 400.441, 400.442, 400.444, 400.447,
22	400.452, 400.462, 400.464, 400.497, 400.552, 400.555,
23	400.556, 400.557, 400.5572, 400.601, 400.618, 400.6194,
24	400.621, 400.628, 400.93, 400.962, 400.980, 400.9905,
25	401.23, 402.164, 408.032, 408.033, 408.034, 408.07,
26	408.831, 409.212, 409.221, 409.905, 409.906, 409.907,
27	409.912, 410.031, 410.034, 415.1111, 419.001, 430.601,
28	430.703, 435.03, 435.04, 440.13, 465.0235, 468.1685,
29	468.505, 477.025, 483.285, 509.032, 509.241, 627.6617,
30	627.732, 651.011, 651.022, 651.023, 651.055, 651.095,
31	651.118, 765.1103, 765.205, 768.735, 893.13, 943.0585, and
32	943.059, F.S., to conform references to changes made by
33	the act; renumbering and amending s. 400.426, F.S.;
34	providing that physician assistants are subject to certain
35	requirements in the same manner as physicians; requesting
36	the Division of Statutory Revision to make necessary
37	conforming changes to the Florida Statutes; providing an
38	effective date.
39
40	Be It Enacted by the Legislature of the State of Florida:
41
42	Section 1.  Chapter 429, Florida Statutes, is created, to
43	be entitled "Assisted Care Communities."
44	Section 2.  Sections 400.401, 400.402, 400.404, 400.407,
45	400.4071, 400.4075, 400.408, 400.411, 400.412, 400.414, 400.415,
46	400.417, 400.4174, 400.4176, 400.4177, 400.4178, 400.418,
47	400.419, 400.4195, 400.42, 400.421, 400.422, 400.423, 400.424,
48	400.4255, 400.4256, 400.426, 400.427, 400.4275, 400.428,
49	400.429, 400.4293, 400.4294, 400.4295, 400.4296, 400.4297,
50	400.4298, 400.431, 400.434, 400.435, 400.441, 400.442, 400.444,
51	400.4445, 400.447, 400.449, 400.451, 400.452, 400.453, and
52	400.454, Florida Statutes, are renumbered as sections 429.01,
53	429.02, 429.04, 429.07, 429.071, 429.075, 429.08, 429.11,
54	429.12, 429.14, 429.15, 429.17, 429.174, 429.176, 429.177,
55	429.178, 429.18, 429.19, 429.195, 429.20, 429.21, 429.22,
56	429.23, 429.24, 429.255, 429.256, 429.26, 429.27, 429.275,
57	429.28, 429.29, 429.293, 429.294, 429.295, 429.296, 429.297,
58	429.298, 429.31, 429.34, 429.35, 429.41, 429.42, 429.44,
59	429.445, 429.47, 429.49, 429.51, 429.52, 429.53, and 429.54,
60	Florida Statutes, respectively, designated as part I of chapter
61	429, Florida Statutes, and entitled "ASSISTED LIVING
62	FACILITIES."
63	Section 3.  Sections 400.616, 400.617, 400.618, 400.619,
64	400.6194, 400.6196, 400.621, 400.6211, 400.622, 400.625,
65	400.6255, 400.628, and 400.629, Florida Statutes, are renumbered
66	as sections 429.60, 429.63, 429.65, 429.67, 429.69, 429.71,
67	429.73, 429.75, 429.77, 429.81, 429.83, 429.85, and 429.87,
68	Florida Statutes, respectively, designated as part II of chapter
69	429, Florida Statutes, and entitled "ADULT FAMILY-CARE HOMES."
70	Section 4.  Sections 400.55, 400.551, 400.552, 400.553,
71	400.554, 400.555, 400.556, 400.5565, 400.557, 400.5571,
72	400.5572, 400.5575, 400.558, 400.559, 400.56, 400.562, 400.563,
73	and 400.564, Florida Statutes, are renumbered as sections
74	429.90, 429.901, 429.903, 429.905, 429.907, 429.909, 429.911,
75	429.913, 429.915, 429.917, 429.919, 429.921, 429.923, 429.925,
76	429.927, 429.929, 429.931, and 429.933, Florida Statutes,
77	designated as part III of chapter 429, Florida Statutes, and
78	entitled "ADULT DAY CARE CENTERS."
79	Section 5.  Subsection (1) of section 101.655, Florida
80	Statutes, is amended to read:
81	101.655  Supervised voting by absent electors in certain
82	facilities.--
83	(1)  The supervisor of elections of a county shall provide
84	supervised voting for absent electors residing in any assisted
85	living facility, as defined in s. 429.02 s. 400.402, or nursing
86	home facility, as defined in s. 400.021, within that county at
87	the request of any administrator of such a facility. Such
88	request for supervised voting in the facility shall be made by
89	submitting a written request to the supervisor of elections no
90	later than 21 days prior to the election for which that request
91	is submitted. The request shall specify the name and address of
92	the facility and the name of the electors who wish to vote
93	absentee in that election. If the request contains the names of
94	fewer than five voters, the supervisor of elections is not
95	required to provide supervised voting.
96	Section 6.  Subsection (9) of section 189.428, Florida
97	Statutes, is amended to read:
98	189.428  Special districts; oversight review process.--
99	(9)  This section does not apply to a deepwater port listed
100	in s. 311.09(1) which is in compliance with a port master plan
101	adopted pursuant to s. 163.3178(2)(k), or to an airport
102	authority operating in compliance with an airport master plan
103	approved by the Federal Aviation Administration, or to any
104	special district organized to operate health systems and
105	facilities licensed under chapter 395, or chapter 400, or
106	chapter 429.
107	Section 7.  Paragraph (b) of subsection (2) of section
108	196.1975, Florida Statutes, is amended to read:
109	196.1975  Exemption for property used by nonprofit homes
110	for the aged.--Nonprofit homes for the aged are exempt to the
111	extent that they meet the following criteria:
112	(2)  A facility will not qualify as a "home for the aged"
113	unless at least 75 percent of the occupants are over the age of
114	62 years or totally and permanently disabled. For homes for the
115	aged which are exempt from paying income taxes to the United
116	States as specified in subsection (1), licensing by the Agency
117	for Health Care Administration is required for ad valorem tax
118	exemption hereunder only if the home:
119	(b)  Qualifies as an assisted living facility under part
120	III of chapter 429 400.
121	Section 8.  Paragraph (c) of subsection (4) of section
122	202.125, Florida Statutes, is amended to read:
123	202.125  Sales of communications services; specified
124	exemptions.--
125	(4)  The sale of communications services to a home for the
126	aged, religious institution or educational institution that is
127	exempt from federal income tax under s. 501(c)(3) of the
128	Internal Revenue Code, or by a religious institution that is
129	exempt from federal income tax under s. 501(c)(3) of the
130	Internal Revenue Code having an established physical place for
131	worship at which nonprofit religious services and activities are
132	regularly conducted and carried on, is exempt from the taxes
133	imposed or administered pursuant to ss. 202.12 and 202.19. As
134	used in this subsection, the term:
135	(c)  "Home for the aged" includes any nonprofit
136	corporation:
137	1.  In which at least 75 percent of the occupants are 62
138	years of age or older or totally and permanently disabled; which
139	qualifies for an ad valorem property tax exemption under s.
140	196.196, s. 196.197, or s. 196.1975; and which is exempt from
141	the sales tax imposed under chapter 212.
142	2.  Licensed as a nursing home under chapter 400 or an
143	assisted living facility under chapter 429 400 and which is
144	exempt from the sales tax imposed under chapter 212.
145	Section 9.  Section 205.1965, Florida Statutes, is amended
146	to read:
147	205.1965  Assisted living facilities.--A county or
148	municipality may not issue an occupational license for the
149	operation of an assisted living facility pursuant to part III of
150	chapter 429 400 without first ascertaining that the applicant
151	has been licensed by the Agency for Health Care Administration
152	to operate such facility at the specified location or locations.
153	The Agency for Health Care Administration shall furnish to local
154	agencies responsible for issuing occupational licenses
155	sufficient instructions for making the above required
156	determinations.
157	Section 10.  Paragraph (b) of subsection (1) of section
158	212.031, Florida Statutes, is amended to read:
159	212.031  Tax on rental or license fee for use of real
160	property.--
161	(1)
162	(b)  When a lease involves multiple use of real property
163	wherein a part of the real property is subject to the tax
164	herein, and a part of the property would be excluded from the
165	tax under subparagraph (a)1., subparagraph (a)2., subparagraph
166	(a)3., or subparagraph (a)5., the department shall determine,
167	from the lease or license and such other information as may be
168	available, that portion of the total rental charge which is
169	exempt from the tax imposed by this section. The portion of the
170	premises leased or rented by a for-profit entity providing a
171	residential facility for the aged will be exempt on the basis of
172	a pro rata portion calculated by combining the square footage of
173	the areas used for residential units by the aged and for the
174	care of such residents and dividing the resultant sum by the
175	total square footage of the rented premises. For purposes of
176	this section, the term "residential facility for the aged" means
177	a facility that is licensed or certified in whole or in part
178	under chapter 400, chapter 429, or chapter 651; or that provides
179	residences to the elderly and is financed by a mortgage or loan
180	made or insured by the United States Department of Housing and
181	Urban Development under s. 202, s. 202 with a s. 8 subsidy, s.
182	221(d)(3) or (4), s. 232, or s. 236 of the National Housing Act;
183	or other such similar facility that provides residences
184	primarily for the elderly.
185	Section 11.  Paragraph (i) of subsection (7) of section
186	212.08, Florida Statutes, is amended to read:
187	212.08  Sales, rental, use, consumption, distribution, and
188	storage tax; specified exemptions.--The sale at retail, the
189	rental, the use, the consumption, the distribution, and the
190	storage to be used or consumed in this state of the following
191	are hereby specifically exempt from the tax imposed by this
192	chapter.
193	(7)  MISCELLANEOUS EXEMPTIONS.--Exemptions provided to any
194	entity by this chapter do not inure to any transaction that is
195	otherwise taxable under this chapter when payment is made by a
196	representative or employee of the entity by any means,
197	including, but not limited to, cash, check, or credit card, even
198	when that representative or employee is subsequently reimbursed
199	by the entity. In addition, exemptions provided to any entity by
200	this subsection do not inure to any transaction that is
201	otherwise taxable under this chapter unless the entity has
202	obtained a sales tax exemption certificate from the department
203	or the entity obtains or provides other documentation as
204	required by the department. Eligible purchases or leases made
205	with such a certificate must be in strict compliance with this
206	subsection and departmental rules, and any person who makes an
207	exempt purchase with a certificate that is not in strict
208	compliance with this subsection and the rules is liable for and
209	shall pay the tax. The department may adopt rules to administer
210	this subsection.
211	(i)  Hospital meals and rooms.--Also exempt from payment of
212	the tax imposed by this chapter on rentals and meals are
213	patients and inmates of any hospital or other physical plant or
214	facility designed and operated primarily for the care of persons
215	who are ill, aged, infirm, mentally or physically incapacitated,
216	or otherwise dependent on special care or attention. Residents
217	of a home for the aged are exempt from payment of taxes on meals
218	provided through the facility. A home for the aged is defined as
219	a facility that is licensed or certified in part or in whole
220	under chapter 400, chapter 429, or chapter 651, or that is
221	financed by a mortgage loan made or insured by the United States
222	Department of Housing and Urban Development under s. 202, s. 202
223	with a s. 8 subsidy, s. 221(d)(3) or (4), s. 232, or s. 236 of
224	the National Housing Act, or other such similar facility
225	designed and operated primarily for the care of the aged.
226	Section 12.  Subsection (5) of section 296.02, Florida
227	Statutes, is amended to read:
228	296.02  Definitions.--For the purposes of this part, except
229	where the context clearly indicates otherwise:
230	(5)  "Extended congregate care" has the meaning given to
231	that term under s. 429.02 s. 400.402.
232	Section 13.  Subsections (1) and (3) of section 381.0035,
233	Florida Statutes, are amended to read:
234	381.0035  Educational course on HIV and AIDS; employees and
235	clients of certain health care facilities.--
236	(1)  The Department of Health shall require all employees
237	and clients of facilities licensed under chapters 393, 394, and
238	397 and employees of facilities licensed under chapter 395, and
239	parts II and, III, IV, and VI of chapter 400, and parts I and IV
240	of chapter 429 to complete, biennially, a continuing educational
241	course on the modes of transmission, infection control
242	procedures, clinical management, and prevention of human
243	immunodeficiency virus and acquired immune deficiency syndrome
244	with an emphasis on appropriate behavior and attitude change.
245	Such instruction shall include information on current Florida
246	law and its impact on testing, confidentiality of test results,
247	and treatment of patients and any protocols and procedures
248	applicable to human immunodeficiency counseling and testing,
249	reporting, the offering of HIV testing to pregnant women, and
250	partner notification issues pursuant to ss. 381.004 and 384.25.
251	(3)  Facilities licensed under chapters 393, 394, 395, and
252	397, and parts II, III, and IV, and VI of chapter 400, and part
253	I of chapter 429 shall maintain a record of employees and dates
254	of attendance at human immunodeficiency virus and acquired
255	immune deficiency syndrome educational courses.
256	Section 14.  Subsection (9) of section 381.745, Florida
257	Statutes, is amended to read:
258	381.745  Definitions; ss. 381.739-381.79.--As used in ss.
259	381.739-381.79, the term:
260	(9)  "Transitional living facility" means a state-approved
261	facility, as defined and licensed under chapter 400 or chapter
262	429, or a facility approved by the brain and spinal cord injury
263	program in accordance with this chapter.
264	Section 15.  Subsection (24) of section 393.063, Florida
265	Statutes, is amended to read:
266	393.063  Definitions.--For the purposes of this chapter:
267	(24)  "Intermediate care facility for the developmentally
268	disabled" or "ICF/DD" means a residential facility licensed and
269	certified pursuant to part VIII XI of chapter 400.
270	Section 16.  Paragraph (b) of subsection (1) of section
271	393.506, Florida Statutes, is amended to read:
272	393.506  Administration of medication.--
273	(1)  Notwithstanding the provisions of part I of chapter
274	464, the Nurse Practice Act, unlicensed direct care services
275	staff providing services to persons with developmental
276	disabilities may administer oral, transdermal, inhaled, or
277	topical prescription medications as provided in this section.
278	(b)  For intermediate care facilities for the
279	developmentally disabled licensed pursuant to part VIII XI of
280	chapter 400, unlicensed staff designated by the director may
281	provide medication assistance under the general supervision of a
282	registered nurse licensed pursuant to chapter 464.
283	Section 17.  Subsection (10) of section 394.455, Florida
284	Statutes, is amended to read:
285	394.455  Definitions.--As used in this part, unless the
286	context clearly requires otherwise, the term:
287	(10)  "Facility" means any hospital, community facility,
288	public or private facility, or receiving or treatment facility
289	providing for the evaluation, diagnosis, care, treatment,
290	training, or hospitalization of persons who appear to have a
291	mental illness or have been diagnosed as having a mental
292	illness. "Facility" does not include any program or entity
293	licensed pursuant to chapter 400 or chapter 429.
294	Section 18.  Paragraphs (b), (c), and (e) of subsection (2)
295	of section 394.4574, Florida Statutes, are amended to read:
296	394.4574  Department responsibilities for a mental health
297	resident who resides in an assisted living facility that holds a
298	limited mental health license.--
299	(2)  The department must ensure that:
300	(b)  A cooperative agreement, as required in s. 429.075 s.
301	400.4075, is developed between the mental health care services
302	provider that serves a mental health resident and the
303	administrator of the assisted living facility with a limited
304	mental health license in which the mental health resident is
305	living. Any entity that provides Medicaid prepaid health plan
306	services shall ensure the appropriate coordination of health
307	care services with an assisted living facility in cases where a
308	Medicaid recipient is both a member of the entity's prepaid
309	health plan and a resident of the assisted living facility. If
310	the entity is at risk for Medicaid targeted case management and
311	behavioral health services, the entity shall inform the assisted
312	living facility of the procedures to follow should an emergent
313	condition arise.
314	(c)  The community living support plan, as defined in s.
315	429.02 s. 400.402, has been prepared by a mental health resident
316	and a mental health case manager of that resident in
317	consultation with the administrator of the facility or the
318	administrator's designee. The plan must be provided to the
319	administrator of the assisted living facility with a limited
320	mental health license in which the mental health resident lives.
321	The support plan and the agreement may be in one document.
322	(e)  The mental health services provider assigns a case
323	manager to each mental health resident who lives in an assisted
324	living facility with a limited mental health license. The case
325	manager is responsible for coordinating the development of and
326	implementation of the community living support plan defined in
327	s. 429.02 s. 400.402. The plan must be updated at least
328	annually.
329	Section 19.  Paragraph (b) of subsection (2) of section
330	394.463, Florida Statutes, is amended to read:
331	394.463  Involuntary examination.--
332	(2)  INVOLUNTARY EXAMINATION.--
333	(b)  A person shall not be removed from any program or
334	residential placement licensed under chapter 400 or chapter 429
335	and transported to a receiving facility for involuntary
336	examination unless an ex parte order, a professional
337	certificate, or a law enforcement officer's report is first
338	prepared. If the condition of the person is such that
339	preparation of a law enforcement officer's report is not
340	practicable before removal, the report shall be completed as
341	soon as possible after removal, but in any case before the
342	person is transported to a receiving facility. A receiving
343	facility admitting a person for involuntary examination who is
344	not accompanied by the required ex parte order, professional
345	certificate, or law enforcement officer's report shall notify
346	the Agency for Health Care Administration of such admission by
347	certified mail no later than the next working day. The
348	provisions of this paragraph do not apply when transportation is
349	provided by the patient's family or guardian.
350	Section 20.  Paragraph (b) of subsection (3) of section
351	400.0063, Florida Statutes, is amended to read:
352	400.0063  Establishment of Office of State Long-Term Care
353	Ombudsman; designation of ombudsman and legal advocate.--
354	(3)
355	(b)  The duties of the legal advocate shall include, but
356	not be limited to:
357	1.  Assisting the ombudsman in carrying out the duties of
358	the office with respect to the abuse, neglect, or violation of
359	rights of residents of long-term care facilities.
360	2.  Assisting the state and local ombudsman councils in
361	carrying out their responsibilities under this part.
362	3.  Initiating and prosecuting legal and equitable actions
363	to enforce the rights of long-term care facility residents as
364	defined in this chapter or chapter 429.
365	4.  Serving as legal counsel to the state and local
366	ombudsman councils, or individual members thereof, against whom
367	any suit or other legal action is initiated in connection with
368	the performance of the official duties of the councils or an
369	individual member.
370	Section 21.  Subsection (3) of section 400.0069, Florida
371	Statutes, is amended to read:
372	400.0069  Local long-term care ombudsman councils; duties;
373	membership.--
374	(3)  In order to carry out the duties specified in
375	subsection (2), the local ombudsman council is authorized,
376	pursuant to ss. 400.19(1) and 429.34 400.434, to enter any long-
377	term care facility without notice or first obtaining a warrant,
378	subject to the provisions of s. 400.0073(5).
379	Section 22.  Paragraphs (c) and (f) of subsection (5) and
380	subsection (6) of section 400.0073, Florida Statutes, are
381	amended to read:
382	400.0073  State and local ombudsman council
383	investigations.--
384	(5)  Any onsite administrative inspection conducted by an
385	ombudsman council shall be subject to the following:
386	(c)  Inspections shall be conducted in a manner which will
387	impose no unreasonable burden on nursing homes or long-term care
388	facilities, consistent with the underlying purposes of this part
389	and chapter 429. Unnecessary duplication of efforts among
390	council members or the councils shall be reduced to the extent
391	possible.
392	(f)  All inspections shall be limited to compliance with
393	part parts II, III, and VII of this chapter, chapter 429, and 42
394	U.S.C. ss. 1396(a) et seq., and any rules or regulations
395	promulgated pursuant to such laws.
396	(6)  An inspection may not be accomplished by forcible
397	entry. Refusal of a long-term care facility to allow entry of
398	any ombudsman council member constitutes a violation of part II,
399	part III, or part VII of this chapter or chapter 429.
400	Section 23.  Subsection (4) of section 400.0077, Florida
401	Statutes, is amended to read:
402	400.0077  Confidentiality.--
403	(4)  Members of any state or local ombudsman council shall
404	not be required to testify in any court with respect to matters
405	held to be confidential under s. 429.14 s. 400.414 except as may
406	be necessary to enforce the provisions of this act.
407	Section 24.  Subsection (1) of section 400.0239, Florida
408	Statutes, is amended to read:
409	400.0239  Quality of Long-Term Care Facility Improvement
410	Trust Fund.--
411	(1)  There is created within the Agency for Health Care
412	Administration a Quality of Long-Term Care Facility Improvement
413	Trust Fund to support activities and programs directly related
414	to improvement of the care of nursing home and assisted living
415	facility residents. The trust fund shall be funded through
416	proceeds generated pursuant to ss. 400.0238 and 429.298
417	400.4298, through funds specifically appropriated by the
418	Legislature, through gifts, endowments, and other charitable
419	contributions allowed under federal and state law, and through
420	federal nursing home civil monetary penalties collected by the
421	Centers for Medicare and Medicaid Services and returned to the
422	state. These funds must be utilized in accordance with federal
423	requirements.
424	Section 25.  Subsections (1) and (4) of section 400.119,
425	Florida Statutes, are amended to read:
426	400.119  Confidentiality of records and meetings of risk
427	management and quality assurance committees.--
428	(1)  Records of meetings of the risk management and quality
429	assurance committee of a long-term care facility licensed under
430	this part or part I III of this chapter 429, as well as incident
431	reports filed with the facility's risk manager and
432	administrator, notifications of the occurrence of an adverse
433	incident, and adverse incident reports from the facility are
434	confidential and exempt from s. 119.07(1) and s. 24(a), Art. I
435	of the State Constitution. However, if the Agency for Health
436	Care Administration has a reasonable belief that conduct by a
437	staff member or employee of a facility is criminal activity or
438	grounds for disciplinary action by a regulatory board, the
439	agency may disclose such records to the appropriate law
440	enforcement agency or regulatory board.
441	(4)  The meetings of an internal risk management and
442	quality assurance committee of a long-term care facility
443	licensed under this part or part I III of this chapter 429 are
444	exempt from s. 286.011 and s. 24(b), Art. I of the State
445	Constitution and are not open to the public.
446	Section 26.  Subsections (4) and (7) of section 400.141,
447	Florida Statutes, are amended to read:
448	400.141  Administration and management of nursing home
449	facilities.--Every licensed facility shall comply with all
450	applicable standards and rules of the agency and shall:
451	(4)  Provide for resident use of a community pharmacy as
452	specified in s. 400.022(1)(q). Any other law to the contrary
453	notwithstanding, a registered pharmacist licensed in Florida,
454	that is under contract with a facility licensed under this
455	chapter or chapter 429, shall repackage a nursing facility
456	resident's bulk prescription medication which has been packaged
457	by another pharmacist licensed in any state in the United States
458	into a unit dose system compatible with the system used by the
459	nursing facility, if the pharmacist is requested to offer such
460	service. In order to be eligible for the repackaging, a resident
461	or the resident's spouse must receive prescription medication
462	benefits provided through a former employer as part of his or
463	her retirement benefits, a qualified pension plan as specified
464	in s. 4972 of the Internal Revenue Code, a federal retirement
465	program as specified under 5 C.F.R. s. 831, or a long-term care
466	policy as defined in s. 627.9404(1). A pharmacist who correctly
467	repackages and relabels the medication and the nursing facility
468	which correctly administers such repackaged medication under the
469	provisions of this subsection shall not be held liable in any
470	civil or administrative action arising from the repackaging. In
471	order to be eligible for the repackaging, a nursing facility
472	resident for whom the medication is to be repackaged shall sign
473	an informed consent form provided by the facility which includes
474	an explanation of the repackaging process and which notifies the
475	resident of the immunities from liability provided herein. A
476	pharmacist who repackages and relabels prescription medications,
477	as authorized under this subsection, may charge a reasonable fee
478	for costs resulting from the implementation of this provision.
479	(7)  If the facility has a standard license or is a Gold
480	Seal facility, exceeds the minimum required hours of licensed
481	nursing and certified nursing assistant direct care per resident
482	per day, and is part of a continuing care facility licensed
483	under chapter 651 or a retirement community that offers other
484	services pursuant to part III of this chapter or part I or part
485	III of chapter 429, part IV, or part V on a single campus, be
486	allowed to share programming and staff. At the time of
487	inspection and in the semiannual report required pursuant to
488	subsection (15), a continuing care facility or retirement
489	community that uses this option must demonstrate through
490	staffing records that minimum staffing requirements for the
491	facility were met. Licensed nurses and certified nursing
492	assistants who work in the nursing home facility may be used to
493	provide services elsewhere on campus if the facility exceeds the
494	minimum number of direct care hours required per resident per
495	day and the total number of residents receiving direct care
496	services from a licensed nurse or a certified nursing assistant
497	does not cause the facility to violate the staffing ratios
498	required under s. 400.23(3)(a). Compliance with the minimum
499	staffing ratios shall be based on total number of residents
500	receiving direct care services, regardless of where they reside
501	on campus. If the facility receives a conditional license, it
502	may not share staff until the conditional license status ends.
503	This subsection does not restrict the agency's authority under
504	federal or state law to require additional staff if a facility
505	is cited for deficiencies in care which are caused by an
506	insufficient number of certified nursing assistants or licensed
507	nurses. The agency may adopt rules for the documentation
508	necessary to determine compliance with this provision.
509
510	Facilities that have been awarded a Gold Seal under the program
511	established in s. 400.235 may develop a plan to provide
512	certified nursing assistant training as prescribed by federal
513	regulations and state rules and may apply to the agency for
514	approval of their program.
515	Section 27.  Subsection (1) of section 400.142, Florida
516	Statutes, is amended to read:
517	400.142  Emergency medication kits; orders not to
518	resuscitate.--
519	(1)  Other provisions of this chapter or of chapter 429,
520	chapter 465, chapter 499, or chapter 893 to the contrary
521	notwithstanding, each nursing home operating pursuant to a
522	license issued by the agency may maintain an emergency
523	medication kit for the purpose of storing medicinal drugs to be
524	administered under emergency conditions to residents residing in
525	such facility.
526	Section 28.  Paragraph (a) of subsection (2) of section
527	400.191, Florida Statutes, is amended to read:
528	400.191  Availability, distribution, and posting of reports
529	and records.--
530	(2)  The agency shall provide additional information in
531	consumer-friendly printed and electronic formats to assist
532	consumers and their families in comparing and evaluating nursing
533	home facilities.
534	(a)  The agency shall provide an Internet site which shall
535	include at least the following information either directly or
536	indirectly through a link to another established site or sites
537	of the agency's choosing:
538	1.  A list by name and address of all nursing home
539	facilities in this state.
540	2.  Whether such nursing home facilities are proprietary or
541	nonproprietary.
542	3.  The current owner of the facility's license and the
543	year that that entity became the owner of the license.
544	4.  The name of the owner or owners of each facility and
545	whether the facility is affiliated with a company or other
546	organization owning or managing more than one nursing facility
547	in this state.
548	5.  The total number of beds in each facility.
549	6.  The number of private and semiprivate rooms in each
550	facility.
551	7.  The religious affiliation, if any, of each facility.
552	8.  The languages spoken by the administrator and staff of
553	each facility.
554	9.  Whether or not each facility accepts Medicare or
555	Medicaid recipients or insurance, health maintenance
556	organization, Veterans Administration, CHAMPUS program, or
557	workers' compensation coverage.
558	10.  Recreational and other programs available at each
559	facility.
560	11.  Special care units or programs offered at each
561	facility.
562	12.  Whether the facility is a part of a retirement
563	community that offers other services pursuant to part III of
564	this chapter or part I or part III of chapter 429, part IV, or
565	part V.
566	13.  Survey and deficiency information contained on the
567	Online Survey Certification and Reporting (OSCAR) system of the
568	federal Health Care Financing Administration, including annual
569	survey, revisit, and complaint survey information, for each
570	facility for the past 45 months. For noncertified nursing homes,
571	state survey and deficiency information, including annual
572	survey, revisit, and complaint survey information for the past
573	45 months shall be provided.
574	14.  A summary of the Online Survey Certification and
575	Reporting (OSCAR) data for each facility over the past 45
576	months. Such summary may include a score, rating, or comparison
577	ranking with respect to other facilities based on the number of
578	citations received by the facility of annual, revisit, and
579	complaint surveys; the severity and scope of the citations; and
580	the number of annual recertification surveys the facility has
581	had during the past 45 months. The score, rating, or comparison
582	ranking may be presented in either numeric or symbolic form for
583	the intended consumer audience.
584	Section 29.  Paragraph (b) of subsection (2) of section
585	400.215, Florida Statutes, is amended to read:
586	400.215  Personnel screening requirement.--
587	(2)  Employers and employees shall comply with the
588	requirements of s. 435.05.
589	(b)  Employees qualified under the provisions of paragraph
590	(a) who have not maintained continuous residency within the
591	state for the 5 years immediately preceding the date of request
592	for background screening must complete level 2 screening, as
593	provided in chapter 435. Such employees may work in a
594	conditional status up to 180 days pending the receipt of written
595	findings evidencing the completion of level 2 screening. Level 2
596	screening shall not be required of employees or prospective
597	employees who attest in writing under penalty of perjury that
598	they meet the residency requirement. Completion of level 2
599	screening shall require the employee or prospective employee to
600	furnish to the nursing facility a full set of fingerprints to
601	enable a criminal background investigation to be conducted. The
602	nursing facility shall submit the completed fingerprint card to
603	the agency. The agency shall establish a record of the request
604	in the database provided for in paragraph (c) and forward the
605	request to the Department of Law Enforcement, which is
606	authorized to submit the fingerprints to the Federal Bureau of
607	Investigation for a national criminal history records check. The
608	results of the national criminal history records check shall be
609	returned to the agency, which shall maintain the results in the
610	database provided for in paragraph (c). The agency shall notify
611	the administrator of the requesting nursing facility or the
612	administrator of any other facility licensed under chapter 393,
613	chapter 394, chapter 395, chapter 397, chapter 429, or this
614	chapter, as requested by such facility, as to whether or not the
615	employee has qualified under level 1 or level 2 screening. An
616	employee or prospective employee who has qualified under level 2
617	screening and has maintained such continuous residency within
618	the state shall not be required to complete a subsequent level 2
619	screening as a condition of employment at another facility.
620	Section 30.  Section 400.402, Florida Statutes, is
621	renumbered as section 429.02, Florida Statutes, and amended to
622	read:
623	429.02 400.402  Definitions.--When used in this part, the
624	term:
625	(1)  "Activities of daily living" means functions and tasks
626	for self-care, including ambulation, bathing, dressing, eating,
627	grooming, and toileting, and other similar tasks.
628	(2)  "Administrator" means an individual at least 21 years
629	of age who is responsible for the operation and maintenance of
630	an assisted living facility.
631	(3)  "Agency" means the Agency for Health Care
632	Administration.
633	(4)  "Aging in place" or "age in place" means the process
634	of providing increased or adjusted services to a person to
635	compensate for the physical or mental decline that may occur
636	with the aging process, in order to maximize the person's
637	dignity and independence and permit them to remain in a
638	familiar, noninstitutional, residential environment for as long
639	as possible. Such services may be provided by facility staff,
640	volunteers, family, or friends, or through contractual
641	arrangements with a third party.
642	(5)  "Applicant" means an individual owner, corporation,
643	partnership, firm, association, or governmental entity that
644	applies for a license.
645	(6)  "Assisted living facility" means any building or
646	buildings, section or distinct part of a building, private home,
647	boarding home, home for the aged, or other residential facility,
648	whether operated for profit or not, which undertakes through its
649	ownership or management to provide housing, meals, and one or
650	more personal services for a period exceeding 24 hours to one or
651	more adults who are not relatives of the owner or administrator.
652	(7)  "Chemical restraint" means a pharmacologic drug that
653	physically limits, restricts, or deprives an individual of
654	movement or mobility, and is used for discipline or convenience
655	and not required for the treatment of medical symptoms.
656	(8)  "Community living support plan" means a written
657	document prepared by a mental health resident and the resident's
658	mental health case manager in consultation with the
659	administrator of an assisted living facility with a limited
660	mental health license or the administrator's designee. A copy
661	must be provided to the administrator. The plan must include
662	information about the supports, services, and special needs of
663	the resident which enable the resident to live in the assisted
664	living facility and a method by which facility staff can
665	recognize and respond to the signs and symptoms particular to
666	that resident which indicate the need for professional services.
667	(9)  "Cooperative agreement" means a written statement of
668	understanding between a mental health care provider and the
669	administrator of the assisted living facility with a limited
670	mental health license in which a mental health resident is
671	living. The agreement must specify directions for accessing
672	emergency and after-hours care for the mental health resident. A
673	single cooperative agreement may service all mental health
674	residents who are clients of the same mental health care
675	provider.
676	(10)  "Department" means the Department of Elderly Affairs.
677	(11)  "Emergency" means a situation, physical condition, or
678	method of operation which presents imminent danger of death or
679	serious physical or mental harm to facility residents.
680	(12)  "Extended congregate care" means acts beyond those
681	authorized in subsection (17) that may be performed pursuant to
682	part I of chapter 464 by persons licensed thereunder while
683	carrying out their professional duties, and other supportive
684	services which may be specified by rule. The purpose of such
685	services is to enable residents to age in place in a residential
686	environment despite mental or physical limitations that might
687	otherwise disqualify them from residency in a facility licensed
688	under this part.
689	(13)  "Guardian" means a person to whom the law has
690	entrusted the custody and control of the person or property, or
691	both, of a person who has been legally adjudged incapacitated.
692	(14)  "Limited nursing services" means acts that may be
693	performed pursuant to part I of chapter 464 by persons licensed
694	thereunder while carrying out their professional duties but
695	limited to those acts which the department specifies by rule.
696	Acts which may be specified by rule as allowable limited nursing
697	services shall be for persons who meet the admission criteria
698	established by the department for assisted living facilities and
699	shall not be complex enough to require 24-hour nursing
700	supervision and may include such services as the application and
701	care of routine dressings, and care of casts, braces, and
702	splints.
703	(15)  "Managed risk" means the process by which the
704	facility staff discuss the service plan and the needs of the
705	resident with the resident and, if applicable, the resident's
706	representative or designee or the resident's surrogate,
707	guardian, or attorney in fact, in such a way that the
708	consequences of a decision, including any inherent risk, are
709	explained to all parties and reviewed periodically in
710	conjunction with the service plan, taking into account changes
711	in the resident's status and the ability of the facility to
712	respond accordingly.
713	(16)  "Mental health resident" means an individual who
714	receives social security disability income due to a mental
715	disorder as determined by the Social Security Administration or
716	receives supplemental security income due to a mental disorder
717	as determined by the Social Security Administration and receives
718	optional state supplementation.
719	(17)  "Personal services" means direct physical assistance
720	with or supervision of the activities of daily living and the
721	self-administration of medication and other similar services
722	which the department may define by rule. "Personal services"
723	shall not be construed to mean the provision of medical,
724	nursing, dental, or mental health services.
725	(18)  "Physical restraint" means a device which physically
726	limits, restricts, or deprives an individual of movement or
727	mobility, including, but not limited to, a half-bed rail, a
728	full-bed rail, a geriatric chair, and a posey restraint. The
729	term "physical restraint" shall also include any device which
730	was not specifically manufactured as a restraint but which has
731	been altered, arranged, or otherwise used for this purpose. The
732	term shall not include bandage material used for the purpose of
733	binding a wound or injury.
734	(19)  "Relative" means an individual who is the father,
735	mother, stepfather, stepmother, son, daughter, brother, sister,
736	grandmother, grandfather, great-grandmother, great-grandfather,
737	grandson, granddaughter, uncle, aunt, first cousin, nephew,
738	niece, husband, wife, father-in-law, mother-in-law, son-in-law,
739	daughter-in-law, brother-in-law, sister-in-law, stepson,
740	stepdaughter, stepbrother, stepsister, half brother, or half
741	sister of an owner or administrator.
742	(20)  "Resident" means a person 18 years of age or older,
743	residing in and receiving care from a facility.
744	(21)  "Resident's representative or designee" means a
745	person other than the owner, or an agent or employee of the
746	facility, designated in writing by the resident, if legally
747	competent, to receive notice of changes in the contract executed
748	pursuant to s. 429.24 s. 400.424; to receive notice of and to
749	participate in meetings between the resident and the facility
750	owner, administrator, or staff concerning the rights of the
751	resident; to assist the resident in contacting the ombudsman
752	council if the resident has a complaint against the facility; or
753	to bring legal action on behalf of the resident pursuant to s.
754	429.29 s. 400.429.
755	(22)  "Service plan" means a written plan, developed and
756	agreed upon by the resident and, if applicable, the resident's
757	representative or designee or the resident's surrogate,
758	guardian, or attorney in fact, if any, and the administrator or
759	designee representing the facility, which addresses the unique
760	physical and psychosocial needs, abilities, and personal
761	preferences of each resident receiving extended congregate care
762	services. The plan shall include a brief written description, in
763	easily understood language, of what services shall be provided,
764	who shall provide the services, when the services shall be
765	rendered, and the purposes and benefits of the services.
766	(23)  "Shared responsibility" means exploring the options
767	available to a resident within a facility and the risks involved
768	with each option when making decisions pertaining to the
769	resident's abilities, preferences, and service needs, thereby
770	enabling the resident and, if applicable, the resident's
771	representative or designee, or the resident's surrogate,
772	guardian, or attorney in fact, and the facility to develop a
773	service plan which best meets the resident's needs and seeks to
774	improve the resident's quality of life.
775	(24)  "Supervision" means reminding residents to engage in
776	activities of daily living and the self-administration of
777	medication, and, when necessary, observing or providing verbal
778	cuing to residents while they perform these activities.
779	(25)  "Supplemental security income," Title XVI of the
780	Social Security Act, means a program through which the Federal
781	Government guarantees a minimum monthly income to every person
782	who is age 65 or older, or disabled, or blind and meets the
783	income and asset requirements.
784	(26)  "Supportive services" means services designed to
785	encourage and assist aged persons or adults with disabilities to
786	remain in the least restrictive living environment and to
787	maintain their independence as long as possible.
788	(27)  "Twenty-four-hour nursing supervision" means services
789	that are ordered by a physician for a resident whose condition
790	requires the supervision of a physician and continued monitoring
791	of vital signs and physical status. Such services shall be:
792	medically complex enough to require constant supervision,
793	assessment, planning, or intervention by a nurse; required to be
794	performed by or under the direct supervision of licensed nursing
795	personnel or other professional personnel for safe and effective
796	performance; required on a daily basis; and consistent with the
797	nature and severity of the resident's condition or the disease
798	state or stage.
799	Section 31.  Section 400.404, Florida Statutes, is
800	renumbered as section 429.04, Florida Statutes, and amended to
801	read:
802	429.04 400.404  Facilities to be licensed; exemptions.--
803	(1)  For the administration of this part, facilities to be
804	licensed by the agency shall include all assisted living
805	facilities as defined in this part.
806	(2)  The following are exempt from licensure under this
807	part:
808	(a)  Any facility, institution, or other place operated by
809	the Federal Government or any agency of the Federal Government.
810	(b)  Any facility or part of a facility licensed under
811	chapter 393 or chapter 394.
812	(c)  Any facility licensed as an adult family-care home
813	under part II VII.
814	(d)  Any person who provides housing, meals, and one or
815	more personal services on a 24-hour basis in the person's own
816	home to not more than two adults who do not receive optional
817	state supplementation. The person who provides the housing,
818	meals, and personal services must own or rent the home and
819	reside therein.
820	(e)  Any home or facility approved by the United States
821	Department of Veterans Affairs as a residential care home
822	wherein care is provided exclusively to three or fewer veterans.
823	(f)  Any facility that has been incorporated in this state
824	for 50 years or more on or before July 1, 1983, and the board of
825	directors of which is nominated or elected by the residents,
826	until the facility is sold or its ownership is transferred; or
827	any facility, with improvements or additions thereto, which has
828	existed and operated continuously in this state for 60 years or
829	more on or before July 1, 1989, is directly or indirectly owned
830	and operated by a nationally recognized fraternal organization,
831	is not open to the public, and accepts only its own members and
832	their spouses as residents.
833	(g)  Any facility certified under chapter 651, or a
834	retirement community, may provide services authorized under this
835	part or part III IV of this chapter 400 to its residents who
836	live in single-family homes, duplexes, quadruplexes, or
837	apartments located on the campus without obtaining a license to
838	operate an assisted living facility if residential units within
839	such buildings are used by residents who do not require staff
840	supervision for that portion of the day when personal services
841	are not being delivered and the owner obtains a home health
842	license to provide such services. However, any building or
843	distinct part of a building on the campus that is designated for
844	persons who receive personal services and require supervision
845	beyond that which is available while such services are being
846	rendered must be licensed in accordance with this part. If a
847	facility provides personal services to residents who do not
848	otherwise require supervision and the owner is not licensed as a
849	home health agency, the buildings or distinct parts of buildings
850	where such services are rendered must be licensed under this
851	part. A resident of a facility that obtains a home health
852	license may contract with a home health agency of his or her
853	choice, provided that the home health agency provides liability
854	insurance and workers' compensation coverage for its employees.
855	Facilities covered by this exemption may establish policies that
856	give residents the option of contracting for services and care
857	beyond that which is provided by the facility to enable them to
858	age in place. For purposes of this section, a retirement
859	community consists of a facility licensed under this part or
860	under part II of chapter 400, and apartments designed for
861	independent living located on the same campus.
862	(h)  Any residential unit for independent living which is
863	located within a facility certified under chapter 651, or any
864	residential unit which is colocated with a nursing home licensed
865	under part II of chapter 400 or colocated with a facility
866	licensed under this part in which services are provided through
867	an outpatient clinic or a nursing home on an outpatient basis.
868	Section 32.  Section 400.407, Florida Statutes, is
869	renumbered as section 429.07, Florida Statutes, and amended to
870	read:
871	429.07 400.407  License required; fee, display.--
872	(1)  A license issued by the agency is required for an
873	assisted living facility operating in this state.
874	(2)  Separate licenses shall be required for facilities
875	maintained in separate premises, even though operated under the
876	same management. A separate license shall not be required for
877	separate buildings on the same grounds.
878	(3)  Any license granted by the agency must state the
879	maximum resident capacity of the facility, the type of care for
880	which the license is granted, the date the license is issued,
881	the expiration date of the license, and any other information
882	deemed necessary by the agency. Licenses shall be issued for one
883	or more of the following categories of care: standard, extended
884	congregate care, limited nursing services, or limited mental
885	health.
886	(a)  A standard license shall be issued to facilities
887	providing one or more of the personal services identified in s.
888	429.02 s. 400.402. Such facilities may also employ or contract
889	with a person licensed under part I of chapter 464 to administer
890	medications and perform other tasks as specified in s. 429.255
891	s. 400.4255.
892	(b)  An extended congregate care license shall be issued to
893	facilities providing, directly or through contract, services
894	beyond those authorized in paragraph (a), including acts
895	performed pursuant to part I of chapter 464 by persons licensed
896	thereunder, and supportive services defined by rule to persons
897	who otherwise would be disqualified from continued residence in
898	a facility licensed under this part.
899	1.  In order for extended congregate care services to be
900	provided in a facility licensed under this part, the agency must
901	first determine that all requirements established in law and
902	rule are met and must specifically designate, on the facility's
903	license, that such services may be provided and whether the
904	designation applies to all or part of a facility. Such
905	designation may be made at the time of initial licensure or
906	relicensure, or upon request in writing by a licensee under this
907	part. Notification of approval or denial of such request shall
908	be made within 90 days after receipt of such request and all
909	necessary documentation. Existing facilities qualifying to
910	provide extended congregate care services must have maintained a
911	standard license and may not have been subject to administrative
912	sanctions during the previous 2 years, or since initial
913	licensure if the facility has been licensed for less than 2
914	years, for any of the following reasons:
915	a.  A class I or class II violation;
916	b.  Three or more repeat or recurring class III violations
917	of identical or similar resident care standards as specified in
918	rule from which a pattern of noncompliance is found by the
919	agency;
920	c.  Three or more class III violations that were not
921	corrected in accordance with the corrective action plan approved
922	by the agency;
923	d.  Violation of resident care standards resulting in a
924	requirement to employ the services of a consultant pharmacist or
925	consultant dietitian;
926	e.  Denial, suspension, or revocation of a license for
927	another facility under this part in which the applicant for an
928	extended congregate care license has at least 25 percent
929	ownership interest; or
930	f.  Imposition of a moratorium on admissions or initiation
931	of injunctive proceedings.
932	2.  Facilities that are licensed to provide extended
933	congregate care services shall maintain a written progress
934	report on each person who receives such services, which report
935	describes the type, amount, duration, scope, and outcome of
936	services that are rendered and the general status of the
937	resident's health. A registered nurse, or appropriate designee,
938	representing the agency shall visit such facilities at least
939	quarterly to monitor residents who are receiving extended
940	congregate care services and to determine if the facility is in
941	compliance with this part and with rules that relate to extended
942	congregate care. One of these visits may be in conjunction with
943	the regular survey. The monitoring visits may be provided
944	through contractual arrangements with appropriate community
945	agencies. A registered nurse shall serve as part of the team
946	that inspects such facility. The agency may waive one of the
947	required yearly monitoring visits for a facility that has been
948	licensed for at least 24 months to provide extended congregate
949	care services, if, during the inspection, the registered nurse
950	determines that extended congregate care services are being
951	provided appropriately, and if the facility has no class I or
952	class II violations and no uncorrected class III violations.
953	Before such decision is made, the agency shall consult with the
954	long-term care ombudsman council for the area in which the
955	facility is located to determine if any complaints have been
956	made and substantiated about the quality of services or care.
957	The agency may not waive one of the required yearly monitoring
958	visits if complaints have been made and substantiated.
959	3.  Facilities that are licensed to provide extended
960	congregate care services shall:
961	a.  Demonstrate the capability to meet unanticipated
962	resident service needs.
963	b.  Offer a physical environment that promotes a homelike
964	setting, provides for resident privacy, promotes resident
965	independence, and allows sufficient congregate space as defined
966	by rule.
967	c.  Have sufficient staff available, taking into account
968	the physical plant and firesafety features of the building, to
969	assist with the evacuation of residents in an emergency, as
970	necessary.
971	d.  Adopt and follow policies and procedures that maximize
972	resident independence, dignity, choice, and decisionmaking to
973	permit residents to age in place to the extent possible, so that
974	moves due to changes in functional status are minimized or
975	avoided.
976	e.  Allow residents or, if applicable, a resident's
977	representative, designee, surrogate, guardian, or attorney in
978	fact to make a variety of personal choices, participate in
979	developing service plans, and share responsibility in
980	decisionmaking.
981	f.  Implement the concept of managed risk.
982	g.  Provide, either directly or through contract, the
983	services of a person licensed pursuant to part I of chapter 464.
984	h.  In addition to the training mandated in s. 429.52 s.
985	400.452, provide specialized training as defined by rule for
986	facility staff.
987	4.  Facilities licensed to provide extended congregate care
988	services are exempt from the criteria for continued residency as
989	set forth in rules adopted under s. 429.41 s. 400.441.
990	Facilities so licensed shall adopt their own requirements within
991	guidelines for continued residency set forth by the department
992	in rule. However, such facilities may not serve residents who
993	require 24-hour nursing supervision. Facilities licensed to
994	provide extended congregate care services shall provide each
995	resident with a written copy of facility policies governing
996	admission and retention.
997	5.  The primary purpose of extended congregate care
998	services is to allow residents, as they become more impaired,
999	the option of remaining in a familiar setting from which they
1000	would otherwise be disqualified for continued residency. A
1001	facility licensed to provide extended congregate care services
1002	may also admit an individual who exceeds the admission criteria
1003	for a facility with a standard license, if the individual is
1004	determined appropriate for admission to the extended congregate
1005	care facility.
1006	6.  Before admission of an individual to a facility
1007	licensed to provide extended congregate care services, the
1008	individual must undergo a medical examination as provided in s.
1009	429.26(4) s. 400.426(4) and the facility must develop a
1010	preliminary service plan for the individual.
1011	7.  When a facility can no longer provide or arrange for
1012	services in accordance with the resident's service plan and
1013	needs and the facility's policy, the facility shall make
1014	arrangements for relocating the person in accordance with s.
1015	429.28(1)(k) s. 400.428(1)(k).
1016	8.  Failure to provide extended congregate care services
1017	may result in denial of extended congregate care license
1018	renewal.
1019	9.  No later than January 1 of each year, the department,
1020	in consultation with the agency, shall prepare and submit to the
1021	Governor, the President of the Senate, the Speaker of the House
1022	of Representatives, and the chairs of appropriate legislative
1023	committees, a report on the status of, and recommendations
1024	related to, extended congregate care services. The status report
1025	must include, but need not be limited to, the following
1026	information:
1027	a.  A description of the facilities licensed to provide
1028	such services, including total number of beds licensed under
1029	this part.
1030	b.  The number and characteristics of residents receiving
1031	such services.
1032	c.  The types of services rendered that could not be
1033	provided through a standard license.
1034	d.  An analysis of deficiencies cited during licensure
1035	inspections.
1036	e.  The number of residents who required extended
1037	congregate care services at admission and the source of
1038	admission.
1039	f.  Recommendations for statutory or regulatory changes.
1040	g.  The availability of extended congregate care to state
1041	clients residing in facilities licensed under this part and in
1042	need of additional services, and recommendations for
1043	appropriations to subsidize extended congregate care services
1044	for such persons.
1045	h.  Such other information as the department considers
1046	appropriate.
1047	(c)  A limited nursing services license shall be issued to
1048	a facility that provides services beyond those authorized in
1049	paragraph (a) and as specified in this paragraph.
1050	1.  In order for limited nursing services to be provided in
1051	a facility licensed under this part, the agency must first
1052	determine that all requirements established in law and rule are
1053	met and must specifically designate, on the facility's license,
1054	that such services may be provided. Such designation may be made
1055	at the time of initial licensure or relicensure, or upon request
1056	in writing by a licensee under this part. Notification of
1057	approval or denial of such request shall be made within 90 days
1058	after receipt of such request and all necessary documentation.
1059	Existing facilities qualifying to provide limited nursing
1060	services shall have maintained a standard license and may not
1061	have been subject to administrative sanctions that affect the
1062	health, safety, and welfare of residents for the previous 2
1063	years or since initial licensure if the facility has been
1064	licensed for less than 2 years.
1065	2.  Facilities that are licensed to provide limited nursing
1066	services shall maintain a written progress report on each person
1067	who receives such nursing services, which report describes the
1068	type, amount, duration, scope, and outcome of services that are
1069	rendered and the general status of the resident's health. A
1070	registered nurse representing the agency shall visit such
1071	facilities at least twice a year to monitor residents who are
1072	receiving limited nursing services and to determine if the
1073	facility is in compliance with applicable provisions of this
1074	part and with related rules. The monitoring visits may be
1075	provided through contractual arrangements with appropriate
1076	community agencies. A registered nurse shall also serve as part
1077	of the team that inspects such facility.
1078	3.  A person who receives limited nursing services under
1079	this part must meet the admission criteria established by the
1080	agency for assisted living facilities. When a resident no longer
1081	meets the admission criteria for a facility licensed under this
1082	part, arrangements for relocating the person shall be made in
1083	accordance with s. 429.28(1)(k) s. 400.428(1)(k), unless the
1084	facility is licensed to provide extended congregate care
1085	services.
1086	(4)(a)  The biennial license fee required of a facility is
1087	$300 per license, with an additional fee of $50 per resident
1088	based on the total licensed resident capacity of the facility,
1089	except that no additional fee will be assessed for beds
1090	designated for recipients of optional state supplementation
1091	payments provided for in s. 409.212. The total fee may not
1092	exceed $10,000, no part of which shall be returned to the
1093	facility. The agency shall adjust the per bed license fee and
1094	the total licensure fee annually by not more than the change in
1095	the consumer price index based on the 12 months immediately
1096	preceding the increase.
1097	(b)  In addition to the total fee assessed under paragraph
1098	(a), the agency shall require facilities that are licensed to
1099	provide extended congregate care services under this part to pay
1100	an additional fee per licensed facility. The amount of the
1101	biennial fee shall be $400 per license, with an additional fee
1102	of $10 per resident based on the total licensed resident
1103	capacity of the facility. No part of this fee shall be returned
1104	to the facility. The agency may adjust the per bed license fee
1105	and the annual license fee once each year by not more than the
1106	average rate of inflation for the 12 months immediately
1107	preceding the increase.
1108	(c)  In addition to the total fee assessed under paragraph
1109	(a), the agency shall require facilities that are licensed to
1110	provide limited nursing services under this part to pay an
1111	additional fee per licensed facility. The amount of the biennial
1112	fee shall be $250 per license, with an additional fee of $10 per
1113	resident based on the total licensed resident capacity of the
1114	facility. No part of this fee shall be returned to the facility.
1115	The agency may adjust the per bed license fee and the biennial
1116	license fee once each year by not more than the average rate of
1117	inflation for the 12 months immediately preceding the increase.
1118	(5)  Counties or municipalities applying for licenses under
1119	this part are exempt from the payment of license fees.
1120	(6)  The license shall be displayed in a conspicuous place
1121	inside the facility.
1122	(7)  A license shall be valid only in the possession of the
1123	individual, firm, partnership, association, or corporation to
1124	which it is issued and shall not be subject to sale, assignment,
1125	or other transfer, voluntary or involuntary; nor shall a license
1126	be valid for any premises other than that for which originally
1127	issued.
1128	(8)  A fee may be charged to a facility requesting a
1129	duplicate license. The fee shall not exceed the actual cost of
1130	duplication and postage.
1131	Section 33.  Section 400.4071, Florida Statutes, is
1132	renumbered as section 429.071, Florida Statutes, and amended to
1133	read:
1134	429.071 400.4071  Intergenerational respite care assisted
1135	living facility pilot program.--
1136	(1)  It is the intent of the Legislature to establish a
1137	pilot program to:
1138	(a)  Facilitate the receipt of in-home, family-based care
1139	by minors and adults with disabilities and elderly persons with
1140	special needs through respite care for up to 14 days.
1141	(b)  Prevent caregiver "burnout," in which the caregiver's
1142	health declines and he or she is unable to continue to provide
1143	care so that the only option for the person with disabilities or
1144	special needs is to receive institutional care.
1145	(c)  Foster the development of intergenerational respite
1146	care assisted living facilities to temporarily care for minors
1147	and adults with disabilities and elderly persons with special
1148	needs in the same facility and to give caregivers the time they
1149	need for rejuvenation and healing.
1150	(2)  The Agency for Health Care Administration shall
1151	establish a 5-year pilot program, which shall license an
1152	intergenerational respite care assisted living facility that
1153	will provide temporary personal, respite, and custodial care to
1154	minors and adults with disabilities and elderly persons with
1155	special needs who do not require 24-hour nursing services. The
1156	intergenerational respite care assisted living facility must:
1157	(a)  Meet all applicable requirements and standards
1158	contained in this part III of this chapter, except that, for
1159	purposes of this section, the term "resident" means a person of
1160	any age temporarily residing in and receiving care from the
1161	facility.
1162	(b)  Provide respite care services for minors and adults
1163	with disabilities and elderly persons with special needs for a
1164	period of at least 24 hours but not for more than 14 consecutive
1165	days.
1166	(c)  Provide a facility or facilities in which minors and
1167	adults reside in distinct and separate living units.
1168	(d)  Provide a facility that has a maximum of 48 beds, is
1169	located in Miami-Dade County, and is operated by a not-for-
1170	profit entity.
1171	(3)  The agency may establish policies necessary to achieve
1172	the objectives specific to the pilot program and may adopt rules
1173	necessary to implement the program.
1174	(4)  After 4 years, the agency shall present its report on
1175	the effectiveness of the pilot program to the President of the
1176	Senate and the Speaker of the House of Representatives and its
1177	recommendation as to whether the Legislature should make the
1178	program permanent.
1179	Section 34.  Section 400.408, Florida Statutes, is
1180	renumbered as section 429.08, Florida Statutes, and amended to
1181	read:
1182	429.08 400.408  Unlicensed facilities; referral of person
1183	for residency to unlicensed facility; penalties; verification of
1184	licensure status.--
1185	(1)(a)  It is unlawful to own, operate, or maintain an
1186	assisted living facility without obtaining a license under this
1187	part.
1188	(b)  Except as provided under paragraph (d), any person who
1189	owns, operates, or maintains an unlicensed assisted living
1190	facility commits a felony of the third degree, punishable as
1191	provided in s. 775.082, s. 775.083, or s. 775.084. Each day of
1192	continued operation is a separate offense.
1193	(c)  Any person found guilty of violating paragraph (a) a
1194	second or subsequent time commits a felony of the second degree,
1195	punishable as provided under s. 775.082, s. 775.083, or s.
1196	775.084. Each day of continued operation is a separate offense.
1197	(d)  Any person who owns, operates, or maintains an
1198	unlicensed assisted living facility due to a change in this part
1199	or a modification in department rule within 6 months after the
1200	effective date of such change and who, within 10 working days
1201	after receiving notification from the agency, fails to cease
1202	operation or apply for a license under this part commits a
1203	felony of the third degree, punishable as provided in s.
1204	775.082, s. 775.083, or s. 775.084. Each day of continued
1205	operation is a separate offense.
1206	(e)  Any facility that fails to cease operation after
1207	agency notification may be fined for each day of noncompliance
1208	pursuant to s. 429.19 s. 400.419.
1209	(f)  When a licensee has an interest in more than one
1210	assisted living facility, and fails to license any one of these
1211	facilities, the agency may revoke the license, impose a
1212	moratorium, or impose a fine pursuant to s. 429.19 s. 400.419,
1213	on any or all of the licensed facilities until such time as the
1214	unlicensed facility is licensed or ceases operation.
1215	(g)  If the agency determines that an owner is operating or
1216	maintaining an assisted living facility without obtaining a
1217	license and determines that a condition exists in the facility
1218	that poses a threat to the health, safety, or welfare of a
1219	resident of the facility, the owner is subject to the same
1220	actions and fines imposed against a licensed facility as
1221	specified in ss. 429.14 and 429.19 ss. 400.414 and 400.419.
1222	(h)  Any person aware of the operation of an unlicensed
1223	assisted living facility must report that facility to the
1224	agency. The agency shall provide to the department's elder
1225	information and referral providers a list, by county, of
1226	licensed assisted living facilities, to assist persons who are
1227	considering an assisted living facility placement in locating a
1228	licensed facility.
1229	(i)  Each field office of the Agency for Health Care
1230	Administration shall establish a local coordinating workgroup
1231	which includes representatives of local law enforcement
1232	agencies, state attorneys, the Medicaid Fraud Control Unit of
1233	the Department of Legal Affairs, local fire authorities, the
1234	Department of Children and Family Services, the district long-
1235	term care ombudsman council, and the district human rights
1236	advocacy committee to assist in identifying the operation of
1237	unlicensed facilities and to develop and implement a plan to
1238	ensure effective enforcement of state laws relating to such
1239	facilities. The workgroup shall report its findings, actions,
1240	and recommendations semiannually to the Director of Health
1241	Facility Regulation of the agency.
1242	(2)  It is unlawful to knowingly refer a person for
1243	residency to an unlicensed assisted living facility; to an
1244	assisted living facility the license of which is under denial or
1245	has been suspended or revoked; or to an assisted living facility
1246	that has a moratorium on admissions. Any person who violates
1247	this subsection commits a noncriminal violation, punishable by a
1248	fine not exceeding $500 as provided in s. 775.083.
1249	(a)  Any health care practitioner, as defined in s.
1250	456.001, who is aware of the operation of an unlicensed facility
1251	shall report that facility to the agency. Failure to report a
1252	facility that the practitioner knows or has reasonable cause to
1253	suspect is unlicensed shall be reported to the practitioner's
1254	licensing board.
1255	(b)  Any hospital or community mental health center
1256	licensed under chapter 395 or chapter 394 which knowingly
1257	discharges a patient or client to an unlicensed facility is
1258	subject to sanction by the agency.
1259	(c)  Any employee of the agency or department, or the
1260	Department of Children and Family Services, who knowingly refers
1261	a person for residency to an unlicensed facility; to a facility
1262	the license of which is under denial or has been suspended or
1263	revoked; or to a facility that has a moratorium on admissions is
1264	subject to disciplinary action by the agency or department, or
1265	the Department of Children and Family Services.
1266	(d)  The employer of any person who is under contract with
1267	the agency or department, or the Department of Children and
1268	Family Services, and who knowingly refers a person for residency
1269	to an unlicensed facility; to a facility the license of which is
1270	under denial or has been suspended or revoked; or to a facility
1271	that has a moratorium on admissions shall be fined and required
1272	to prepare a corrective action plan designed to prevent such
1273	referrals.
1274	(e)  The agency shall provide the department and the
1275	Department of Children and Family Services with a list of
1276	licensed facilities within each county and shall update the list
1277	at least quarterly.
1278	(f)  At least annually, the agency shall notify, in
1279	appropriate trade publications, physicians licensed under
1280	chapter 458 or chapter 459, hospitals licensed under chapter
1281	395, nursing home facilities licensed under part II of this
1282	chapter 400, and employees of the agency or the department, or
1283	the Department of Children and Family Services, who are
1284	responsible for referring persons for residency, that it is
1285	unlawful to knowingly refer a person for residency to an
1286	unlicensed assisted living facility and shall notify them of the
1287	penalty for violating such prohibition. The department and the
1288	Department of Children and Family Services shall, in turn,
1289	notify service providers under contract to the respective
1290	departments who have responsibility for resident referrals to
1291	facilities. Further, the notice must direct each noticed
1292	facility and individual to contact the appropriate agency office
1293	in order to verify the licensure status of any facility prior to
1294	referring any person for residency. Each notice must include the
1295	name, telephone number, and mailing address of the appropriate
1296	office to contact.
1297	Section 35.  Section 400.411, Florida Statutes, is
1298	renumbered as section 429.11, Florida Statutes, and amended to
1299	read:
1300	429.11 400.411  Initial application for license;
1301	provisional license.--
1302	(1)  Application for a license shall be made to the agency
1303	on forms furnished by it and shall be accompanied by the
1304	appropriate license fee.
1305	(2)  The applicant may be an individual owner, a
1306	corporation, a partnership, a firm, an association, or a
1307	governmental entity.
1308	(3)  The application must be signed by the applicant under
1309	oath and must contain the following:
1310	(a)  The name, address, date of birth, and social security
1311	number of the applicant and the name by which the facility is to
1312	be known. If the applicant is a firm, partnership, or
1313	association, the application shall contain the name, address,
1314	date of birth, and social security number of every member
1315	thereof. If the applicant is a corporation, the application
1316	shall contain the corporation's name and address; the name,
1317	address, date of birth, and social security number of each of
1318	its directors and officers; and the name and address of each
1319	person having at least a 5-percent ownership interest in the
1320	corporation.
1321	(b)  The name and address of any professional service,
1322	firm, association, partnership, or corporation that is to
1323	provide goods, leases, or services to the facility if a 5-
1324	percent or greater ownership interest in the service, firm,
1325	association, partnership, or corporation is owned by a person
1326	whose name must be listed on the application under paragraph
1327	(a).
1328	(c)  The name and address of any long-term care facility
1329	with which the applicant, administrator, or financial officer
1330	has been affiliated through ownership or employment within 5
1331	years of the date of this license application; and a signed
1332	affidavit disclosing any financial or ownership interest that
1333	the applicant, or any person listed in paragraph (a), holds or
1334	has held within the last 5 years in any facility licensed under
1335	this part, or in any other entity licensed by this state or
1336	another state to provide health or residential care, which
1337	facility or entity closed or ceased to operate as a result of
1338	financial problems, or has had a receiver appointed or a license
1339	denied, suspended or revoked, or was subject to a moratorium on
1340	admissions, or has had an injunctive proceeding initiated
1341	against it.
1342	(d)  A description and explanation of any exclusions,
1343	permanent suspensions, or terminations of the applicant from the
1344	Medicare or Medicaid programs. Proof of compliance with
1345	disclosure of ownership and control interest requirements of the
1346	Medicaid or Medicare programs shall be accepted in lieu of this
1347	submission.
1348	(e)  The names and addresses of persons of whom the agency
1349	may inquire as to the character, reputation, and financial
1350	responsibility of the owner and, if different from the
1351	applicant, the administrator and financial officer.
1352	(f)  Identification of all other homes or facilities,
1353	including the addresses and the license or licenses under which
1354	they operate, if applicable, which are currently operated by the
1355	applicant or administrator and which provide housing, meals, and
1356	personal services to residents.
1357	(g)  The location of the facility for which a license is
1358	sought and documentation, signed by the appropriate local
1359	government official, which states that the applicant has met
1360	local zoning requirements.
1361	(h)  The name, address, date of birth, social security
1362	number, education, and experience of the administrator, if
1363	different from the applicant.
1364	(4)  The applicant shall furnish satisfactory proof of
1365	financial ability to operate and conduct the facility in
1366	accordance with the requirements of this part. A certificate of
1367	authority, pursuant to chapter 651, may be provided as proof of
1368	financial ability.
1369	(5)  If the applicant is a continuing care facility
1370	certified under chapter 651, a copy of the facility's
1371	certificate of authority must be provided.
1372	(6)  The applicant shall provide proof of liability
1373	insurance as defined in s. 624.605.
1374	(7)  If the applicant is a community residential home, the
1375	applicant must provide proof that it has met the requirements
1376	specified in chapter 419.
1377	(8)  The applicant must provide the agency with proof of
1378	legal right to occupy the property.
1379	(9)  The applicant must furnish proof that the facility has
1380	received a satisfactory firesafety inspection. The local
1381	authority having jurisdiction or the State Fire Marshal must
1382	conduct the inspection within 30 days after written request by
1383	the applicant.
1384	(10)  The applicant must furnish documentation of a
1385	satisfactory sanitation inspection of the facility by the county
1386	health department.
1387	(11)  The applicant must furnish proof of compliance with
1388	level 2 background screening as required under s. 429.174 s.
1389	400.4174.
1390	(12)  A provisional license may be issued to an applicant
1391	making initial application for licensure or making application
1392	for a change of ownership. A provisional license shall be
1393	limited in duration to a specific period of time not to exceed 6
1394	months, as determined by the agency.
1395	(13)  A county or municipality may not issue an
1396	occupational license that is being obtained for the purpose of
1397	operating a facility regulated under this part without first
1398	ascertaining that the applicant has been licensed to operate
1399	such facility at the specified location or locations by the
1400	agency. The agency shall furnish to local agencies responsible
1401	for issuing occupational licenses sufficient instruction for
1402	making such determinations.
1403	Section 36.  Section 400.412, Florida Statutes, is
1404	renumbered as section 429.12, Florida Statutes, and amended to
1405	read:
1406	429.12 400.412  Sale or transfer of ownership of a
1407	facility.--It is the intent of the Legislature to protect the
1408	rights of the residents of an assisted living facility when the
1409	facility is sold or the ownership thereof is transferred.
1410	Therefore, whenever a facility is sold or the ownership thereof
1411	is transferred, including leasing:
1412	(1)  The transferee shall make application to the agency
1413	for a new license at least 60 days before the date of transfer
1414	of ownership. The application must comply with the provisions of
1415	s. 429.11 s. 400.411.
1416	(2)(a)  The transferor shall notify the agency in writing
1417	at least 60 days before the date of transfer of ownership.
1418	(b)  The new owner shall notify the residents, in writing,
1419	of the transfer of ownership within 7 days of his or her receipt
1420	of the license.
1421	(3)  The transferor shall be responsible and liable for:
1422	(a)  The lawful operation of the facility and the welfare
1423	of the residents domiciled in the facility until the date the
1424	transferee is licensed by the agency.
1425	(b)  Any and all penalties imposed against the facility for
1426	violations occurring before the date of transfer of ownership
1427	unless the penalty imposed is a moratorium on admissions or
1428	denial of licensure. The moratorium on admissions or denial of
1429	licensure remains in effect after the transfer of ownership,
1430	unless the agency has approved the transferee's corrective
1431	action plan or the conditions which created the moratorium or
1432	denial have been corrected, and may be grounds for denial of
1433	license to the transferee in accordance with chapter 120.
1434	(c)  Any outstanding liability to the state, unless the
1435	transferee has agreed, as a condition of sale or transfer, to
1436	accept the outstanding liabilities and to guarantee payment
1437	therefor; except that, if the transferee fails to meet these
1438	obligations, the transferor shall remain liable for the
1439	outstanding liability.
1440	(4)  The transferor of a facility the license of which is
1441	denied pending an administrative hearing shall, as a part of the
1442	written transfer-of-ownership contract, advise the transferee
1443	that a plan of correction must be submitted by the transferee
1444	and approved by the agency at least 7 days before the transfer
1445	of ownership and that failure to correct the condition which
1446	resulted in the moratorium on admissions or denial of licensure
1447	is grounds for denial of the transferee's license.
1448	(5)  The transferee must provide the agency with proof of
1449	legal right to occupy the property before a license may be
1450	issued. Proof may include, but is not limited to, copies of
1451	warranty deeds, or copies of lease or rental agreements,
1452	contracts for deeds, quitclaim deeds, or other such
1453	documentation.
1454	Section 37.  Section 400.414, Florida Statutes, is
1455	renumbered as section 429.14, Florida Statutes, and amended to
1456	read:
1457	429.14 400.414  Denial, revocation, or suspension of
1458	license; imposition of administrative fine; grounds.--
1459	(1)  The agency may deny, revoke, or suspend any license
1460	issued under this part, or impose an administrative fine in the
1461	manner provided in chapter 120, for any of the following actions
1462	by an assisted living facility, for the actions of any person
1463	subject to level 2 background screening under s. 429.174 s.
1464	400.4174, or for the actions of any facility employee:
1465	(a)  An intentional or negligent act seriously affecting
1466	the health, safety, or welfare of a resident of the facility.
1467	(b)  The determination by the agency that the owner lacks
1468	the financial ability to provide continuing adequate care to
1469	residents.
1470	(c)  Misappropriation or conversion of the property of a
1471	resident of the facility.
1472	(d)  Failure to follow the criteria and procedures provided
1473	under part I of chapter 394 relating to the transportation,
1474	voluntary admission, and involuntary examination of a facility
1475	resident.
1476	(e)  A citation of any of the following deficiencies as
1477	defined in s. 429.19 s. 400.419:
1478	1.  One or more cited class I deficiencies.
1479	2.  Three or more cited class II deficiencies.
1480	3.  Five or more cited class III deficiencies that have
1481	been cited on a single survey and have not been corrected within
1482	the times specified.
1483	(f)  A determination that a person subject to level 2
1484	background screening under s. 429.174(1) s. 400.4174(1) does not
1485	meet the screening standards of s. 435.04 or that the facility
1486	is retaining an employee subject to level 1 background screening
1487	standards under s. 429.174(2) s. 400.4174(2) who does not meet
1488	the screening standards of s. 435.03 and for whom exemptions
1489	from disqualification have not been provided by the agency.
1490	(g)  A determination that an employee, volunteer,
1491	administrator, or owner, or person who otherwise has access to
1492	the residents of a facility does not meet the criteria specified
1493	in s. 435.03(2), and the owner or administrator has not taken
1494	action to remove the person. Exemptions from disqualification
1495	may be granted as set forth in s. 435.07. No administrative
1496	action may be taken against the facility if the person is
1497	granted an exemption.
1498	(h)  Violation of a moratorium.
1499	(i)  Failure of the license applicant, the licensee during
1500	relicensure, or a licensee that holds a provisional license to
1501	meet the minimum license requirements of this part, or related
1502	rules, at the time of license application or renewal.
1503	(j)  A fraudulent statement or omission of any material
1504	fact on an application for a license or any other document
1505	required by the agency, including the submission of a license
1506	application that conceals the fact that any board member,
1507	officer, or person owning 5 percent or more of the facility may
1508	not meet the background screening requirements of s. 429.174 s.
1509	400.4174, or that the applicant has been excluded, permanently
1510	suspended, or terminated from the Medicaid or Medicare programs.
1511	(k)  An intentional or negligent life-threatening act in
1512	violation of the uniform firesafety standards for assisted
1513	living facilities or other firesafety standards that threatens
1514	the health, safety, or welfare of a resident of a facility, as
1515	communicated to the agency by the local authority having
1516	jurisdiction or the State Fire Marshal.
1517	(l)  Exclusion, permanent suspension, or termination from
1518	the Medicare or Medicaid programs.
1519	(m)  Knowingly operating any unlicensed facility or
1520	providing without a license any service that must be licensed
1521	under this chapter or chapter 400.
1522	(n)  Any act constituting a ground upon which application
1523	for a license may be denied.
1524
1525	Administrative proceedings challenging agency action under this
1526	subsection shall be reviewed on the basis of the facts and
1527	conditions that resulted in the agency action.
1528	(2)  Upon notification by the local authority having
1529	jurisdiction or by the State Fire Marshal, the agency may deny
1530	or revoke the license of an assisted living facility that fails
1531	to correct cited fire code violations that affect or threaten
1532	the health, safety, or welfare of a resident of a facility.
1533	(3)  The agency may deny a license to any applicant or to
1534	any officer or board member of an applicant who is a firm,
1535	corporation, partnership, or association or who owns 5 percent
1536	or more of the facility, if the applicant, officer, or board
1537	member has or had a 25-percent or greater financial or ownership
1538	interest in any other facility licensed under this part, or in
1539	any entity licensed by this state or another state to provide
1540	health or residential care, which facility or entity during the
1541	5 years prior to the application for a license closed due to
1542	financial inability to operate; had a receiver appointed or a
1543	license denied, suspended, or revoked; was subject to a
1544	moratorium on admissions; had an injunctive proceeding initiated
1545	against it; or has an outstanding fine assessed under this
1546	chapter or chapter 400.
1547	(4)  The agency shall deny or revoke the license of an
1548	assisted living facility that has two or more class I violations
1549	that are similar or identical to violations identified by the
1550	agency during a survey, inspection, monitoring visit, or
1551	complaint investigation occurring within the previous 2 years.
1552	(5)  An action taken by the agency to suspend, deny, or
1553	revoke a facility's license under this part, in which the agency
1554	claims that the facility owner or an employee of the facility
1555	has threatened the health, safety, or welfare of a resident of
1556	the facility be heard by the Division of Administrative Hearings
1557	of the Department of Management Services within 120 days after
1558	receipt of the facility's request for a hearing, unless that
1559	time limitation is waived by both parties. The administrative
1560	law judge must render a decision within 30 days after receipt of
1561	a proposed recommended order.
1562	(6)  The agency shall provide to the Division of Hotels and
1563	Restaurants of the Department of Business and Professional
1564	Regulation, on a monthly basis, a list of those assisted living
1565	facilities that have had their licenses denied, suspended, or
1566	revoked or that are involved in an appellate proceeding pursuant
1567	to s. 120.60 related to the denial, suspension, or revocation of
1568	a license.
1569	(7)  Agency notification of a license suspension or
1570	revocation, or denial of a license renewal, shall be posted and
1571	visible to the public at the facility.
1572	(8)  The agency may issue a temporary license pending final
1573	disposition of a proceeding involving the suspension or
1574	revocation of an assisted living facility license.
1575	Section 38.  Section 400.415, Florida Statutes, is
1576	renumbered as section 429.15, Florida Statutes, and amended to
1577	read:
1578	429.15 400.415  Moratorium on admissions; notice.--The
1579	agency may impose an immediate moratorium on admissions to any
1580	assisted living facility if the agency determines that any
1581	condition in the facility presents a threat to the health,
1582	safety, or welfare of the residents in the facility.
1583	(1)  A facility the license of which is denied, revoked, or
1584	suspended pursuant to s. 429.14 s. 400.414 may be subject to
1585	immediate imposition of a moratorium on admissions to run
1586	concurrently with licensure denial, revocation, or suspension.
1587	(2)  When a moratorium is placed on a facility, notice of
1588	the moratorium shall be posted and visible to the public at the
1589	facility until the moratorium is lifted.
1590	(3)  The department may by rule establish conditions that
1591	constitute grounds for imposing a moratorium on a facility and
1592	procedures for imposing and lifting a moratorium, as necessary
1593	to administer this section.
1594	Section 39.  Section 400.417, Florida Statutes, is
1595	renumbered as section 429.17, Florida Statutes, and amended to
1596	read:
1597	429.17 400.417  Expiration of license; renewal; conditional
1598	license.--
1599	(1)  Biennial licenses, unless sooner suspended or revoked,
1600	shall expire 2 years from the date of issuance. Limited nursing,
1601	extended congregate care, and limited mental health licenses
1602	shall expire at the same time as the facility's standard
1603	license, regardless of when issued. The agency shall notify the
1604	facility at least 120 days prior to expiration that a renewal
1605	license is necessary to continue operation. The notification
1606	must be provided electronically or by mail delivery. Ninety days
1607	prior to the expiration date, an application for renewal shall
1608	be submitted to the agency. Fees must be prorated. The failure
1609	to file a timely renewal application shall result in a late fee
1610	charged to the facility in an amount equal to 50 percent of the
1611	current fee.
1612	(2)  A license shall be renewed within 90 days upon the
1613	timely filing of an application on forms furnished by the agency
1614	and the provision of satisfactory proof of ability to operate
1615	and conduct the facility in accordance with the requirements of
1616	this part and adopted rules, including proof that the facility
1617	has received a satisfactory firesafety inspection, conducted by
1618	the local authority having jurisdiction or the State Fire
1619	Marshal, within the preceding 12 months and an affidavit of
1620	compliance with the background screening requirements of s.
1621	429.174 s. 400.4174.
1622	(3)  An applicant for renewal of a license who has complied
1623	with the provisions of s. 429.11 s. 400.411 with respect to
1624	proof of financial ability to operate shall not be required to
1625	provide further proof unless the facility or any other facility
1626	owned or operated in whole or in part by the same person has
1627	demonstrated financial instability as provided under s.
1628	429.47(2) s. 400.447(2) or unless the agency suspects that the
1629	facility is not financially stable as a result of the annual
1630	survey or complaints from the public or a report from the State
1631	Long-Term Care Ombudsman Council. Each facility must report to
1632	the agency any adverse court action concerning the facility's
1633	financial viability, within 7 days after its occurrence. The
1634	agency shall have access to books, records, and any other
1635	financial documents maintained by the facility to the extent
1636	necessary to determine the facility's financial stability. A
1637	license for the operation of a facility shall not be renewed if
1638	the licensee has any outstanding fines assessed pursuant to this
1639	part which are in final order status.
1640	(4)  A licensee against whom a revocation or suspension
1641	proceeding is pending at the time of license renewal may be
1642	issued a conditional license effective until final disposition
1643	by the agency. If judicial relief is sought from the final
1644	disposition, the court having jurisdiction may issue a
1645	conditional license for the duration of the judicial proceeding.
1646	(5)  A conditional license may be issued to an applicant
1647	for license renewal if the applicant fails to meet all standards
1648	and requirements for licensure. A conditional license issued
1649	under this subsection shall be limited in duration to a specific
1650	period of time not to exceed 6 months, as determined by the
1651	agency, and shall be accompanied by an agency-approved plan of
1652	correction.
1653	(6)  When an extended care or limited nursing license is
1654	requested during a facility's biennial license period, the fee
1655	shall be prorated in order to permit the additional license to
1656	expire at the end of the biennial license period. The fee shall
1657	be calculated as of the date the additional license application
1658	is received by the agency.
1659	(7)  The department may by rule establish renewal
1660	procedures, identify forms, and specify documentation necessary
1661	to administer this section.
1662	Section 40.  Section 400.4174, Florida Statutes, is
1663	renumbered as section 429.174, Florida Statutes, and amended to
1664	read:
1665	429.174 400.4174  Background screening; exemptions.--
1666	(1)(a)  Level 2 background screening must be conducted on
1667	each of the following persons, who shall be considered employees
1668	for the purposes of conducting screening under chapter 435:
1669	1.  The facility owner if an individual, the administrator,
1670	and the financial officer.
1671	2.  An officer or board member if the facility owner is a
1672	firm, corporation, partnership, or association, or any person
1673	owning 5 percent or more of the facility if the agency has
1674	probable cause to believe that such person has been convicted of
1675	any offense prohibited by s. 435.04. For each officer, board
1676	member, or person owning 5 percent or more who has been
1677	convicted of any such offense, the facility shall submit to the
1678	agency a description and explanation of the conviction at the
1679	time of license application. This subparagraph does not apply to
1680	a board member of a not-for-profit corporation or organization
1681	if the board member serves solely in a voluntary capacity, does
1682	not regularly take part in the day-to-day operational decisions
1683	of the corporation or organization, receives no remuneration for
1684	his or her services, and has no financial interest and has no
1685	family members with a financial interest in the corporation or
1686	organization, provided that the board member and facility submit
1687	a statement affirming that the board member's relationship to
1688	the facility satisfies the requirements of this subparagraph.
1689	(b)  Proof of compliance with level 2 screening standards
1690	which has been submitted within the previous 5 years to meet any
1691	facility or professional licensure requirements of the agency or
1692	the Department of Health satisfies the requirements of this
1693	subsection, provided that such proof is accompanied, under
1694	penalty of perjury, by an affidavit of compliance with the
1695	provisions of chapter 435. Proof of compliance with the
1696	background screening requirements of the Financial Services
1697	Commission and the Office of Insurance Regulation for applicants
1698	for a certificate of authority to operate a continuing care
1699	retirement community under chapter 651, submitted within the
1700	last 5 years, satisfies the Department of Law Enforcement and
1701	Federal Bureau of Investigation portions of a level 2 background
1702	check.
1703	(c)  The agency may grant a provisional license to a
1704	facility applying for an initial license when each individual
1705	required by this subsection to undergo screening has completed
1706	the Department of Law Enforcement background checks, but has not
1707	yet received results from the Federal Bureau of Investigation,
1708	or when a request for an exemption from disqualification has
1709	been submitted to the agency pursuant to s. 435.07, but a
1710	response has not been issued.
1711	(2)  The owner or administrator of an assisted living
1712	facility must conduct level 1 background screening, as set forth
1713	in chapter 435, on all employees hired on or after October 1,
1714	1998, who perform personal services as defined in s. 429.02(17)
1715	s. 400.402(17). The agency may exempt an individual from
1716	employment disqualification as set forth in chapter 435. Such
1717	persons shall be considered as having met this requirement if:
1718	(a)  Proof of compliance with level 1 screening
1719	requirements obtained to meet any professional license
1720	requirements in this state is provided and accompanied, under
1721	penalty of perjury, by a copy of the person's current
1722	professional license and an affidavit of current compliance with
1723	the background screening requirements.
1724	(b)  The person required to be screened has been
1725	continuously employed in the same type of occupation for which
1726	the person is seeking employment without a breach in service
1727	which exceeds 180 days, and proof of compliance with the level 1
1728	screening requirement which is no more than 2 years old is
1729	provided. Proof of compliance shall be provided directly from
1730	one employer or contractor to another, and not from the person
1731	screened. Upon request, a copy of screening results shall be
1732	provided by the employer retaining documentation of the
1733	screening to the person screened.
1734	(c)  The person required to be screened is employed by a
1735	corporation or business entity or related corporation or
1736	business entity that owns, operates, or manages more than one
1737	facility or agency licensed under this chapter, and for whom a
1738	level 1 screening was conducted by the corporation or business
1739	entity as a condition of initial or continued employment.
1740	Section 41.  Section 400.4176, Florida Statutes, is
1741	renumbered as section 429.176, Florida Statutes, and amended to
1742	read:
1743	429.176 400.4176  Notice of change of administrator.--If,
1744	during the period for which a license is issued, the owner
1745	changes administrators, the owner must notify the agency of the
1746	change within 10 days and provide documentation within 90 days
1747	that the new administrator has completed the applicable core
1748	educational requirements under s. 429.52 s. 400.452. Background
1749	screening shall be completed on any new administrator as
1750	specified in s. 429.174 s. 400.4174.
1751	Section 42.  Section 400.4178, Florida Statutes, is
1752	renumbered as section 429.178, Florida Statutes, and amended to
1753	read:
1754	429.178 400.4178  Special care for persons with Alzheimer's
1755	disease or other related disorders.--
1756	(1)  A facility which advertises that it provides special
1757	care for persons with Alzheimer's disease or other related
1758	disorders must meet the following standards of operation:
1759	(a)1.  If the facility has 17 or more residents, have an
1760	awake staff member on duty at all hours of the day and night; or
1761	2.  If the facility has fewer than 17 residents, have an
1762	awake staff member on duty at all hours of the day and night or
1763	have mechanisms in place to monitor and ensure the safety of the
1764	facility's residents.
1765	(b)  Offer activities specifically designed for persons who
1766	are cognitively impaired.
1767	(c)  Have a physical environment that provides for the
1768	safety and welfare of the facility's residents.
1769	(d)  Employ staff who have completed the training and
1770	continuing education required in subsection (2).
1771	(2)(a)  An individual who is employed by a facility that
1772	provides special care for residents with Alzheimer's disease or
1773	other related disorders, and who has regular contact with such
1774	residents, must complete up to 4 hours of initial dementia-
1775	specific training developed or approved by the department. The
1776	training shall be completed within 3 months after beginning
1777	employment and shall satisfy the core training requirements of
1778	s. 429.52(2)(g) s. 400.452(2)(g).
1779	(b)  A direct caregiver who is employed by a facility that
1780	provides special care for residents with Alzheimer's disease or
1781	other related disorders, and who provides direct care to such
1782	residents, must complete the required initial training and 4
1783	additional hours of training developed or approved by the
1784	department. The training shall be completed within 9 months
1785	after beginning employment and shall satisfy the core training
1786	requirements of s. 429.52(2)(g) s. 400.452(2)(g).
1787	(c)  An individual who is employed by a facility that
1788	provides special care for residents with Alzheimer's disease or
1789	other related disorders, but who only has incidental contact
1790	with such residents, must be given, at a minimum, general
1791	information on interacting with individuals with Alzheimer's
1792	disease or other related disorders, within 3 months after
1793	beginning employment.
1794	(3)  In addition to the training required under subsection
1795	(2), a direct caregiver must participate in a minimum of 4
1796	contact hours of continuing education each calendar year. The
1797	continuing education must include one or more topics included in
1798	the dementia-specific training developed or approved by the
1799	department, in which the caregiver has not received previous
1800	training.
1801	(4)  Upon completing any training listed in subsection (2),
1802	the employee or direct caregiver shall be issued a certificate
1803	that includes the name of the training provider, the topic
1804	covered, and the date and signature of the training provider.
1805	The certificate is evidence of completion of training in the
1806	identified topic, and the employee or direct caregiver is not
1807	required to repeat training in that topic if the employee or
1808	direct caregiver changes employment to a different facility. The
1809	employee or direct caregiver must comply with other applicable
1810	continuing education requirements.
1811	(5)  The department, or its designee, shall approve the
1812	initial and continuing education courses and providers.
1813	(6)  The department shall keep a current list of providers
1814	who are approved to provide initial and continuing education for
1815	staff of facilities that provide special care for persons with
1816	Alzheimer's disease or other related disorders.
1817	(7)  Any facility more than 90 percent of whose residents
1818	receive monthly optional supplementation payments is not
1819	required to pay for the training and education programs required
1820	under this section. A facility that has one or more such
1821	residents shall pay a reduced fee that is proportional to the
1822	percentage of such residents in the facility. A facility that
1823	does not have any residents who receive monthly optional
1824	supplementation payments must pay a reasonable fee, as
1825	established by the department, for such training and education
1826	programs.
1827	(8)  The department shall adopt rules to establish
1828	standards for trainers and training and to implement this
1829	section.
1830	Section 43.  Section 400.418, Florida Statutes, is
1831	renumbered as section 429.18, Florida Statutes, and amended to
1832	read:
1833	429.18 400.418  Disposition of fees and administrative
1834	fines.--
1835	(1)  Income from license fees, inspection fees, late fees,
1836	and administrative fines generated pursuant to ss. 429.07,
1837	429.08, 429.17, 429.19, and 429.31 ss. 400.407, 400.408,
1838	400.417, 400.419, and 400.431 shall be deposited in the Health
1839	Care Trust Fund administered by the agency. Such funds shall be
1840	directed to and used by the agency for the following purposes:
1841	(a)  Up to 50 percent of the trust funds accrued each
1842	fiscal year under this part may be used to offset the expenses
1843	of receivership, pursuant to s. 429.22 s. 400.422, if the court
1844	determines that the income and assets of the facility are
1845	insufficient to provide for adequate management and operation.
1846	(b)  An amount of $5,000 of the trust funds accrued each
1847	year under this part shall be allocated to pay for inspection-
1848	related physical and mental health examinations requested by the
1849	agency pursuant to s. 429.26 s. 400.426 for residents who are
1850	either recipients of supplemental security income or have
1851	monthly incomes not in excess of the maximum combined federal
1852	and state cash subsidies available to supplemental security
1853	income recipients, as provided for in s. 409.212. Such funds
1854	shall only be used where the resident is ineligible for
1855	Medicaid.
1856	(c)  Any trust funds accrued each year under this part and
1857	not used for the purposes specified in paragraphs (a) and (b)
1858	shall be used to offset the costs of the licensure program,
1859	including the costs of conducting background investigations,
1860	verifying information submitted, defraying the costs of
1861	processing the names of applicants, and conducting inspections
1862	and monitoring visits pursuant to this part.
1863	(2)  Income from fees generated pursuant to s. 429.41(5) s.
1864	400.441(5) shall be deposited in the Health Care Trust Fund and
1865	used to offset the costs of printing and postage.
1866	Section 44.  Section 400.419, Florida Statutes, is
1867	renumbered as section 429.19, Florida Statutes, and amended to
1868	read:
1869	429.19 400.419  Violations; imposition of administrative
1870	fines; grounds.--
1871	(1)  The agency shall impose an administrative fine in the
1872	manner provided in chapter 120 for any of the actions or
1873	violations as set forth within this section by an assisted
1874	living facility, for the actions of any person subject to level
1875	2 background screening under s. 429.174 s. 400.4174, for the
1876	actions of any facility employee, or for an intentional or
1877	negligent act seriously affecting the health, safety, or welfare
1878	of a resident of the facility.
1879	(2)  Each violation of this part and adopted rules shall be
1880	classified according to the nature of the violation and the
1881	gravity of its probable effect on facility residents. The agency
1882	shall indicate the classification on the written notice of the
1883	violation as follows:
1884	(a)  Class "I" violations are those conditions or
1885	occurrences related to the operation and maintenance of a
1886	facility or to the personal care of residents which the agency
1887	determines present an imminent danger to the residents or guests
1888	of the facility or a substantial probability that death or
1889	serious physical or emotional harm would result therefrom. The
1890	condition or practice constituting a class I violation shall be
1891	abated or eliminated within 24 hours, unless a fixed period, as
1892	determined by the agency, is required for correction. The agency
1893	shall impose an administrative fine for a cited class I
1894	violation in an amount not less than $5,000 and not exceeding
1895	$10,000 for each violation. A fine may be levied notwithstanding
1896	the correction of the violation.
1897	(b)  Class "II" violations are those conditions or
1898	occurrences related to the operation and maintenance of a
1899	facility or to the personal care of residents which the agency
1900	determines directly threaten the physical or emotional health,
1901	safety, or security of the facility residents, other than class
1902	I violations. The agency shall impose an administrative fine for
1903	a cited class II violation in an amount not less than $1,000 and
1904	not exceeding $5,000 for each violation. A fine shall be levied
1905	notwithstanding the correction of the violation.
1906	(c)  Class "III" violations are those conditions or
1907	occurrences related to the operation and maintenance of a
1908	facility or to the personal care of residents which the agency
1909	determines indirectly or potentially threaten the physical or
1910	emotional health, safety, or security of facility residents,
1911	other than class I or class II violations. The agency shall
1912	impose an administrative fine for a cited class III violation in
1913	an amount not less than $500 and not exceeding $1,000 for each
1914	violation. A citation for a class III violation must specify the
1915	time within which the violation is required to be corrected. If
1916	a class III violation is corrected within the time specified, no
1917	fine may be imposed, unless it is a repeated offense.
1918	(d)  Class "IV" violations are those conditions or
1919	occurrences related to the operation and maintenance of a
1920	building or to required reports, forms, or documents that do not
1921	have the potential of negatively affecting residents. These
1922	violations are of a type that the agency determines do not
1923	threaten the health, safety, or security of residents of the
1924	facility. The agency shall impose an administrative fine for a
1925	cited class IV violation in an amount not less than $100 and not
1926	exceeding $200 for each violation. A citation for a class IV
1927	violation must specify the time within which the violation is
1928	required to be corrected. If a class IV violation is corrected
1929	within the time specified, no fine shall be imposed. Any class
1930	IV violation that is corrected during the time an agency survey
1931	is being conducted will be identified as an agency finding and
1932	not as a violation.
1933	(3)  In determining if a penalty is to be imposed and in
1934	fixing the amount of the fine, the agency shall consider the
1935	following factors:
1936	(a)  The gravity of the violation, including the
1937	probability that death or serious physical or emotional harm to
1938	a resident will result or has resulted, the severity of the
1939	action or potential harm, and the extent to which the provisions
1940	of the applicable laws or rules were violated.
1941	(b)  Actions taken by the owner or administrator to correct
1942	violations.
1943	(c)  Any previous violations.
1944	(d)  The financial benefit to the facility of committing or
1945	continuing the violation.
1946	(e)  The licensed capacity of the facility.
1947	(4)  Each day of continuing violation after the date fixed
1948	for termination of the violation, as ordered by the agency,
1949	constitutes an additional, separate, and distinct violation.
1950	(5)  Any action taken to correct a violation shall be
1951	documented in writing by the owner or administrator of the
1952	facility and verified through followup visits by agency
1953	personnel. The agency may impose a fine and, in the case of an
1954	owner-operated facility, revoke or deny a facility's license
1955	when a facility administrator fraudulently misrepresents action
1956	taken to correct a violation.
1957	(6)  For fines that are upheld following administrative or
1958	judicial review, the violator shall pay the fine, plus interest
1959	at the rate as specified in s. 55.03, for each day beyond the
1960	date set by the agency for payment of the fine.
1961	(7)  Any unlicensed facility that continues to operate
1962	after agency notification is subject to a $1,000 fine per day.
1963	(8)  Any licensed facility whose owner or administrator
1964	concurrently operates an unlicensed facility shall be subject to
1965	an administrative fine of $5,000 per day.
1966	(9)  Any facility whose owner fails to apply for a change-
1967	of-ownership license in accordance with s. 429.12 s. 400.412 and
1968	operates the facility under the new ownership is subject to a
1969	fine of $5,000.
1970	(10)  In addition to any administrative fines imposed, the
1971	agency may assess a survey fee, equal to the lesser of one half
1972	of the facility's biennial license and bed fee or $500, to cover
1973	the cost of conducting initial complaint investigations that
1974	result in the finding of a violation that was the subject of the
1975	complaint or monitoring visits conducted under s. 429.28(3)(c)
1976	s. 400.428(3)(c) to verify the correction of the violations.
1977	(11)  The agency, as an alternative to or in conjunction
1978	with an administrative action against a facility for violations
1979	of this part and adopted rules, shall make a reasonable attempt
1980	to discuss each violation and recommended corrective action with
1981	the owner or administrator of the facility, prior to written
1982	notification. The agency, instead of fixing a period within
1983	which the facility shall enter into compliance with standards,
1984	may request a plan of corrective action from the facility which
1985	demonstrates a good faith effort to remedy each violation by a
1986	specific date, subject to the approval of the agency.
1987	(12)  Administrative fines paid by any facility under this
1988	section shall be deposited into the Health Care Trust Fund and
1989	expended as provided in s. 429.18 s. 400.418.
1990	(13)  The agency shall develop and disseminate an annual
1991	list of all facilities sanctioned or fined $5,000 or more for
1992	violations of state standards, the number and class of
1993	violations involved, the penalties imposed, and the current
1994	status of cases. The list shall be disseminated, at no charge,
1995	to the Department of Elderly Affairs, the Department of Health,
1996	the Department of Children and Family Services, the area
1997	agencies on aging, the Florida Statewide Advocacy Council, and
1998	the state and local ombudsman councils. The Department of
1999	Children and Family Services shall disseminate the list to
2000	service providers under contract to the department who are
2001	responsible for referring persons to a facility for residency.
2002	The agency may charge a fee commensurate with the cost of
2003	printing and postage to other interested parties requesting a
2004	copy of this list.
2005	Section 45.  Section 400.42, Florida Statutes, is
2006	renumbered as section 429.20, Florida Statutes, and amended to
2007	read:
2008	429.20 400.42  Certain solicitation prohibited; third-party
2009	supplementation.--
2010	(1)  A person may not, in connection with the solicitation
2011	of contributions by or on behalf of an assisted living facility
2012	or facilities, misrepresent or mislead any person, by any
2013	manner, means, practice, or device whatsoever, to believe that
2014	the receipts of such solicitation will be used for charitable
2015	purposes, if that is not the fact.
2016	(2)  Solicitation of contributions of any kind in a
2017	threatening, coercive, or unduly forceful manner by or on behalf
2018	of an assisted living facility or facilities by any agent,
2019	employee, owner, or representative of any assisted living
2020	facility or facilities is grounds for denial, suspension, or
2021	revocation of the license of the assisted living facility or
2022	facilities by or on behalf of which such contributions were
2023	solicited.
2024	(3)  The admission or maintenance of assisted living
2025	facility residents whose care is supported, in whole or in part,
2026	by state funds may not be conditioned upon the receipt of any
2027	manner of contribution or donation from any person. The
2028	solicitation or receipt of contributions in violation of this
2029	subsection is grounds for denial, suspension, or revocation of
2030	license, as provided in s. 429.14 s. 400.414, for any assisted
2031	living facility by or on behalf of which such contributions were
2032	solicited.
2033	(4)  An assisted living facility may accept additional
2034	supplementation from third parties on behalf of residents
2035	receiving optional state supplementation in accordance with s.
2036	409.212.
2037	Section 46.  Section 400.422, Florida Statutes, is
2038	renumbered as section 429.22, Florida Statutes, and amended to
2039	read:
2040	429.22 400.422  Receivership proceedings.--
2041	(1)  As an alternative to or in conjunction with an
2042	injunctive proceeding, the agency may petition a court of
2043	competent jurisdiction for the appointment of a receiver, if
2044	suitable alternate placements are not available, when any of the
2045	following conditions exist:
2046	(a)  The facility is operating without a license and
2047	refuses to make application for a license as required by ss.
2048	429.07 and 429.08 ss. 400.407 and 400.408.
2049	(b)  The facility is closing or has informed the agency
2050	that it intends to close and adequate arrangements have not been
2051	made for relocation of the residents within 7 days, exclusive of
2052	weekends and holidays, of the closing of the facility.
2053	(c)  The agency determines there exist in the facility
2054	conditions which present an imminent danger to the health,
2055	safety, or welfare of the residents of the facility or a
2056	substantial probability that death or serious physical harm
2057	would result therefrom.
2058	(d)  The facility cannot meet its financial obligation for
2059	providing food, shelter, care, and utilities.
2060	(2)  Petitions for receivership shall take precedence over
2061	other court business unless the court determines that some other
2062	pending proceeding, having similar statutory precedence, shall
2063	have priority. A hearing shall be conducted within 5 days of the
2064	filing of the petition, at which time all interested parties
2065	shall have the opportunity to present evidence pertaining to the
2066	petition. The agency shall notify, by certified mail, the owner
2067	or administrator of the facility named in the petition and the
2068	facility resident or, if applicable, the resident's
2069	representative or designee, or the resident's surrogate,
2070	guardian, or attorney in fact, of its filing, the substance of
2071	the violation, and the date and place set for the hearing. The
2072	court shall grant the petition only upon finding that the
2073	health, safety, or welfare of facility residents would be
2074	threatened if a condition existing at the time the petition was
2075	filed is permitted to continue. A receiver shall not be
2076	appointed ex parte unless the court determines that one or more
2077	of the conditions in subsection (1) exist; that the facility
2078	owner or administrator cannot be found; that all reasonable
2079	means of locating the owner or administrator and notifying him
2080	or her of the petition and hearing have been exhausted; or that
2081	the owner or administrator after notification of the hearing
2082	chooses not to attend. After such findings, the court may
2083	appoint any qualified person as a receiver, except it may not
2084	appoint any owner or affiliate of the facility which is in
2085	receivership. The receiver may be selected from a list of
2086	persons qualified to act as receivers developed by the agency
2087	and presented to the court with each petition for receivership.
2088	Under no circumstances may the agency or designated agency
2089	employee be appointed as a receiver for more than 60 days;
2090	however, the receiver may petition the court, one time only, for
2091	a 30-day extension. The court shall grant the extension upon a
2092	showing of good cause.
2093	(3)  The receiver must make provisions for the continued
2094	health, safety, and welfare of all residents of the facility
2095	and:
2096	(a)  Shall exercise those powers and perform those duties
2097	set out by the court.
2098	(b)  Shall operate the facility in such a manner as to
2099	assure safety and adequate health care for the residents.
2100	(c)  Shall take such action as is reasonably necessary to
2101	protect or conserve the assets or property of the facility for
2102	which the receiver is appointed, or the proceeds from any
2103	transfer thereof, and may use them only in the performance of
2104	the powers and duties set forth in this section and by order of
2105	the court.
2106	(d)  May use the building, fixtures, furnishings, and any
2107	accompanying consumable goods in the provision of care and
2108	services to residents and to any other persons receiving
2109	services from the facility at the time the petition for
2110	receivership was filed. The receiver shall collect payments for
2111	all goods and services provided to residents or others during
2112	the period of the receivership at the same rate of payment
2113	charged by the owners at the time the petition for receivership
2114	was filed, or at a fair and reasonable rate otherwise approved
2115	by the court.
2116	(e)  May correct or eliminate any deficiency in the
2117	structure or furnishings of the facility which endangers the
2118	safety or health of residents while they remain in the facility,
2119	if the total cost of correction does not exceed $10,000. The
2120	court may order expenditures for this purpose in excess of
2121	$10,000 on application from the receiver after notice to the
2122	owner and a hearing.
2123	(f)  May let contracts and hire agents and employees to
2124	carry out the powers and duties of the receiver.
2125	(g)  Shall honor all leases, mortgages, and secured
2126	transactions governing the building in which the facility is
2127	located and all goods and fixtures in the building of which the
2128	receiver has taken possession, but only to the extent of
2129	payments which, in the case of a rental agreement, are for the
2130	use of the property during the period of the receivership, or
2131	which, in the case of a purchase agreement, become due during
2132	the period of the receivership.
2133	(h)  Shall have full power to direct and manage and to
2134	discharge employees of the facility, subject to any contract
2135	rights they may have. The receiver shall pay employees at the
2136	rate of compensation, including benefits, approved by the court.
2137	A receivership does not relieve the owner of any obligation to
2138	employees made prior to the appointment of a receiver and not
2139	carried out by the receiver.
2140	(i)  Shall be entitled to and take possession of all
2141	property or assets of residents which are in the possession of a
2142	facility or its owner. The receiver shall preserve all property,
2143	assets, and records of residents of which the receiver takes
2144	possession and shall provide for the prompt transfer of the
2145	property, assets, and records to the new placement of any
2146	transferred resident. An inventory list certified by the owner
2147	and receiver shall be made immediately at the time the receiver
2148	takes possession of the facility.
2149	(4)(a)  A person who is served with notice of an order of
2150	the court appointing a receiver and of the receiver's name and
2151	address shall be liable to pay the receiver for any goods or
2152	services provided by the receiver after the date of the order if
2153	the person would have been liable for the goods or services as
2154	supplied by the owner. The receiver shall give a receipt for
2155	each payment and shall keep a copy of each receipt on file. The
2156	receiver shall deposit accounts received in a separate account
2157	and shall use this account for all disbursements.
2158	(b)  The receiver may bring an action to enforce the
2159	liability created by paragraph (a).
2160	(c)  A payment to the receiver of any sum owing to the
2161	facility or its owner shall discharge any obligation to the
2162	facility to the extent of the payment.
2163	(5)(a)  A receiver may petition the court that he or she
2164	not be required to honor any lease, mortgage, secured
2165	transaction, or other wholly or partially executory contract
2166	entered into by the owner of the facility if the rent, price, or
2167	rate of interest required to be paid under the agreement was
2168	substantially in excess of a reasonable rent, price, or rate of
2169	interest at the time the contract was entered into, or if any
2170	material provision of the agreement was unreasonable, when
2171	compared to contracts negotiated under similar conditions. Any
2172	relief in this form provided by the court shall be limited to
2173	the life of the receivership, unless otherwise determined by the
2174	court.
2175	(b)  If the receiver is in possession of real estate or
2176	goods subject to a lease, mortgage, or security interest which
2177	the receiver has obtained a court order to avoid under paragraph
2178	(a), and if the real estate or goods are necessary for the
2179	continued operation of the facility under this section, the
2180	receiver may apply to the court to set a reasonable rental,
2181	price, or rate of interest to be paid by the receiver during the
2182	duration of the receivership. The court shall hold a hearing on
2183	the application within 15 days. The receiver shall send notice
2184	of the application to any known persons who own the property
2185	involved at least 10 days prior to the hearing. Payment by the
2186	receiver of the amount determined by the court to be reasonable
2187	is a defense to any action against the receiver for payment or
2188	for possession of the goods or real estate subject to the lease,
2189	security interest, or mortgage involved by any person who
2190	received such notice, but the payment does not relieve the owner
2191	of the facility of any liability for the difference between the
2192	amount paid by the receiver and the amount due under the
2193	original lease, security interest, or mortgage involved.
2194	(6)  The court shall set the compensation of the receiver,
2195	which will be considered a necessary expense of a receivership.
2196	(7)  A receiver may be held liable in a personal capacity
2197	only for the receiver's own gross negligence, intentional acts,
2198	or breach of fiduciary duty.
2199	(8)  The court may require a receiver to post a bond.
2200	(9)  The court may direct the agency to allocate funds from
2201	the Health Care Trust Fund to the receiver, subject to the
2202	provisions of s. 429.18(1) s. 400.418(1).
2203	(10)  The court may terminate a receivership when:
2204	(a)  The court determines that the receivership is no
2205	longer necessary because the conditions which gave rise to the
2206	receivership no longer exist or the agency grants the facility a
2207	new license; or
2208	(b)  All of the residents in the facility have been
2209	transferred or discharged.
2210	(11)  Within 30 days after termination, the receiver shall
2211	give the court a complete accounting of all property of which
2212	the receiver has taken possession, of all funds collected, and
2213	of the expenses of the receivership.
2214	(12)  Nothing in this section shall be deemed to relieve
2215	any owner, administrator, or employee of a facility placed in
2216	receivership of any civil or criminal liability incurred, or any
2217	duty imposed by law, by reason of acts or omissions of the
2218	owner, administrator, or employee prior to the appointment of a
2219	receiver; nor shall anything contained in this section be
2220	construed to suspend during the receivership any obligation of
2221	the owner, administrator, or employee for payment of taxes or
2222	other operating and maintenance expenses of the facility or of
2223	the owner, administrator, employee, or any other person for the
2224	payment of mortgages or liens. The owner shall retain the right
2225	to sell or mortgage any facility under receivership, subject to
2226	approval of the court which ordered the receivership.
2227	Section 47.  Section 400.424, Florida Statutes, is
2228	renumbered as section 429.24, Florida Statutes, and amended to
2229	read:
2230	429.24 400.424  Contracts.--
2231	(1)  The presence of each resident in a facility shall be
2232	covered by a contract, executed at the time of admission or
2233	prior thereto, between the licensee and the resident or his or
2234	her designee or legal representative. Each party to the contract
2235	shall be provided with a duplicate original thereof, and the
2236	licensee shall keep on file in the facility all such contracts.
2237	The licensee may not destroy or otherwise dispose of any such
2238	contract until 5 years after its expiration.
2239	(2)  Each contract must contain express provisions
2240	specifically setting forth the services and accommodations to be
2241	provided by the facility; the rates or charges; provision for at
2242	least 30 days' written notice of a rate increase; the rights,
2243	duties, and obligations of the residents, other than those
2244	specified in s. 429.28 s. 400.428; and other matters that the
2245	parties deem appropriate. Whenever money is deposited or
2246	advanced by a resident in a contract as security for performance
2247	of the contract agreement or as advance rent for other than the
2248	next immediate rental period:
2249	(a)  Such funds shall be deposited in a banking institution
2250	in this state that is located, if possible, in the same
2251	community in which the facility is located; shall be kept
2252	separate from the funds and property of the facility; may not be
2253	represented as part of the assets of the facility on financial
2254	statements; and shall be used, or otherwise expended, only for
2255	the account of the resident.
2256	(b)  The licensee shall, within 30 days of receipt of
2257	advance rent or a security deposit, notify the resident or
2258	residents in writing of the manner in which the licensee is
2259	holding the advance rent or security deposit and state the name
2260	and address of the depository where the moneys are being held.
2261	The licensee shall notify residents of the facility's policy on
2262	advance deposits.
2263	(3)(a)  The contract shall include a refund policy to be
2264	implemented at the time of a resident's transfer, discharge, or
2265	death. The refund policy shall provide that the resident or
2266	responsible party is entitled to a prorated refund based on the
2267	daily rate for any unused portion of payment beyond the
2268	termination date after all charges, including the cost of
2269	damages to the residential unit resulting from circumstances
2270	other than normal use, have been paid to the licensee. For the
2271	purpose of this paragraph, the termination date shall be the
2272	date the unit is vacated by the resident and cleared of all
2273	personal belongings. If the amount of belongings does not
2274	preclude renting the unit, the facility may clear the unit and
2275	charge the resident or his or her estate for moving and storing
2276	the items at a rate equal to the actual cost to the facility,
2277	not to exceed 20 percent of the regular rate for the unit,
2278	provided that 14 days' advance written notification is given. If
2279	the resident's possessions are not claimed within 45 days after
2280	notification, the facility may dispose of them. The contract
2281	shall also specify any other conditions under which claims will
2282	be made against the refund due the resident. Except in the case
2283	of death or a discharge due to medical reasons, the refunds
2284	shall be computed in accordance with the notice of relocation
2285	requirements specified in the contract. However, a resident may
2286	not be required to provide the licensee with more than 30 days'
2287	notice of termination. If after a contract is terminated, the
2288	facility intends to make a claim against a refund due the
2289	resident, the facility shall notify the resident or responsible
2290	party in writing of the claim and shall provide said party with
2291	a reasonable time period of no less than 14 calendar days to
2292	respond. The facility shall provide a refund to the resident or
2293	responsible party within 45 days after the transfer, discharge,
2294	or death of the resident. The agency shall impose a fine upon a
2295	facility that fails to comply with the refund provisions of the
2296	paragraph, which fine shall be equal to three times the amount
2297	due to the resident. One-half of the fine shall be remitted to
2298	the resident or his or her estate, and the other half to the
2299	Health Care Trust Fund to be used for the purpose specified in
2300	s. 429.18 s. 400.418.
2301	(b)  If a licensee agrees to reserve a bed for a resident
2302	who is admitted to a medical facility, including, but not
2303	limited to, a nursing home, health care facility, or psychiatric
2304	facility, the resident or his or her responsible party shall
2305	notify the licensee of any change in status that would prevent
2306	the resident from returning to the facility. Until such notice
2307	is received, the agreed-upon daily rate may be charged by the
2308	licensee.
2309	(c)  The purpose of any advance payment and a refund policy
2310	for such payment, including any advance payment for housing,
2311	meals, or personal services, shall be covered in the contract.
2312	(4)  The contract shall state whether or not the facility
2313	is affiliated with any religious organization and, if so, which
2314	organization and its general responsibility to the facility.
2315	(5)  Neither the contract nor any provision thereof
2316	relieves any licensee of any requirement or obligation imposed
2317	upon it by this part or rules adopted under this part.
2318	(6)  In lieu of the provisions of this section, facilities
2319	certified under chapter 651 shall comply with the requirements
2320	of s. 651.055.
2321	(7)  Notwithstanding the provisions of this section,
2322	facilities which consist of 60 or more apartments may require
2323	refund policies and termination notices in accordance with the
2324	provisions of part II of chapter 83, provided that the lease is
2325	terminated automatically without financial penalty in the event
2326	of a resident's death or relocation due to psychiatric
2327	hospitalization or to medical reasons which necessitate services
2328	or care beyond which the facility is licensed to provide. The
2329	date of termination in such instances shall be the date the unit
2330	is fully vacated. A lease may be substituted for the contract if
2331	it meets the disclosure requirements of this section. For the
2332	purpose of this section, the term "apartment" means a room or
2333	set of rooms with a kitchen or kitchenette and lavatory located
2334	within one or more buildings containing other similar or like
2335	residential units.
2336	(8)  The department may by rule clarify terms, establish
2337	procedures, clarify refund policies and contract provisions, and
2338	specify documentation as necessary to administer this section.
2339	Section 48.  Section 400.4255, Florida Statutes, is
2340	renumbered as section 429.255, Florida Statutes, and amended to
2341	read:
2342	429.255 400.4255  Use of personnel; emergency care.--
2343	(1)(a)  Persons under contract to the facility, facility
2344	staff, or volunteers, who are licensed according to part I of
2345	chapter 464, or those persons exempt under s. 464.022(1), and
2346	others as defined by rule, may administer medications to
2347	residents, take residents' vital signs, manage individual weekly
2348	pill organizers for residents who self-administer medication,
2349	give prepackaged enemas ordered by a physician, observe
2350	residents, document observations on the appropriate resident's
2351	record, report observations to the resident's physician, and
2352	contract or allow residents or a resident's representative,
2353	designee, surrogate, guardian, or attorney in fact to contract
2354	with a third party, provided residents meet the criteria for
2355	appropriate placement as defined in s. 429.26 s. 400.426.
2356	Nursing assistants certified pursuant to part II of chapter 464
2357	may take residents' vital signs as directed by a licensed nurse
2358	or physician.
2359	(b)  All staff in facilities licensed under this part shall
2360	exercise their professional responsibility to observe residents,
2361	to document observations on the appropriate resident's record,
2362	and to report the observations to the resident's physician.
2363	However, the owner or administrator of the facility shall be
2364	responsible for determining that the resident receiving services
2365	is appropriate for residence in the facility.
2366	(c)  In an emergency situation, licensed personnel may
2367	carry out their professional duties pursuant to part I of
2368	chapter 464 until emergency medical personnel assume
2369	responsibility for care.
2370	(2)  In facilities licensed to provide extended congregate
2371	care, persons under contract to the facility, facility staff, or
2372	volunteers, who are licensed according to part I of chapter 464,
2373	or those persons exempt under s. 464.022(1), or those persons
2374	certified as nursing assistants pursuant to part II of chapter
2375	464, may also perform all duties within the scope of their
2376	license or certification, as approved by the facility
2377	administrator and pursuant to this part.
2378	(3)  Facility staff may withhold or withdraw
2379	cardiopulmonary resuscitation if presented with an order not to
2380	resuscitate executed pursuant to s. 401.45. The department shall
2381	adopt rules providing for the implementation of such orders.
2382	Facility staff and facilities shall not be subject to criminal
2383	prosecution or civil liability, nor be considered to have
2384	engaged in negligent or unprofessional conduct, for withholding
2385	or withdrawing cardiopulmonary resuscitation pursuant to such an
2386	order and rules adopted by the department. The absence of an
2387	order to resuscitate executed pursuant to s. 401.45 does not
2388	preclude a physician from withholding or withdrawing
2389	cardiopulmonary resuscitation as otherwise permitted by law.
2390	Section 49.  Section 400.4256, Florida Statutes, is
2391	renumbered as section 429.256, Florida Statutes, and amended to
2392	read:
2393	429.256 400.4256  Assistance with self-administration of
2394	medication.--
2395	(1)  For the purposes of this section, the term:
2396	(a)  "Informed consent" means advising the resident, or the
2397	resident's surrogate, guardian, or attorney in fact, that an
2398	assisted living facility is not required to have a licensed
2399	nurse on staff, that the resident may be receiving assistance
2400	with self-administration of medication from an unlicensed
2401	person, and that such assistance, if provided by an unlicensed
2402	person, will or will not be overseen by a licensed nurse.
2403	(b)  "Unlicensed person" means an individual not currently
2404	licensed to practice nursing or medicine who is employed by or
2405	under contract to an assisted living facility and who has
2406	received training with respect to assisting with the self-
2407	administration of medication in an assisted living facility as
2408	provided under s. 429.52 s. 400.452 prior to providing such
2409	assistance as described in this section.
2410	(2)  Residents who are capable of self-administering their
2411	own medications without assistance shall be encouraged and
2412	allowed to do so. However, an unlicensed person may, consistent
2413	with a dispensed prescription's label or the package directions
2414	of an over-the-counter medication, assist a resident whose
2415	condition is medically stable with the self-administration of
2416	routine, regularly scheduled medications that are intended to be
2417	self-administered. Assistance with self-medication by an
2418	unlicensed person may occur only upon a documented request by,
2419	and the written informed consent of, a resident or the
2420	resident's surrogate, guardian, or attorney in fact. For the
2421	purposes of this section, self-administered medications include
2422	both legend and over-the-counter oral dosage forms, topical
2423	dosage forms and topical ophthalmic, otic, and nasal dosage
2424	forms including solutions, suspensions, sprays, and inhalers.
2425	(3)  Assistance with self-administration of medication
2426	includes:
2427	(a)  Taking the medication, in its previously dispensed,
2428	properly labeled container, from where it is stored, and
2429	bringing it to the resident.
2430	(b)  In the presence of the resident, reading the label,
2431	opening the container, removing a prescribed amount of
2432	medication from the container, and closing the container.
2433	(c)  Placing an oral dosage in the resident's hand or
2434	placing the dosage in another container and helping the resident
2435	by lifting the container to his or her mouth.
2436	(d)  Applying topical medications.
2437	(e)  Returning the medication container to proper storage.
2438	(f)  Keeping a record of when a resident receives
2439	assistance with self-administration under this section.
2440	(4)  Assistance with self-administration does not include:
2441	(a)  Mixing, compounding, converting, or calculating
2442	medication doses, except for measuring a prescribed amount of
2443	liquid medication or breaking a scored tablet or crushing a
2444	tablet as prescribed.
2445	(b)  The preparation of syringes for injection or the
2446	administration of medications by any injectable route.
2447	(c)  Administration of medications through intermittent
2448	positive pressure breathing machines or a nebulizer.
2449	(d)  Administration of medications by way of a tube
2450	inserted in a cavity of the body.
2451	(e)  Administration of parenteral preparations.
2452	(f)  Irrigations or debriding agents used in the treatment
2453	of a skin condition.
2454	(g)  Rectal, urethral, or vaginal preparations.
2455	(h)  Medications ordered by the physician or health care
2456	professional with prescriptive authority to be given "as
2457	needed," unless the order is written with specific parameters
2458	that preclude independent judgment on the part of the unlicensed
2459	person, and at the request of a competent resident.
2460	(i)  Medications for which the time of administration, the
2461	amount, the strength of dosage, the method of administration, or
2462	the reason for administration requires judgment or discretion on
2463	the part of the unlicensed person.
2464	(5)  Assistance with the self-administration of medication
2465	by an unlicensed person as described in this section shall not
2466	be considered administration as defined in s. 465.003.
2467	(6)  The department may by rule establish facility
2468	procedures and interpret terms as necessary to implement this
2469	section.
2470	Section 50.  Section 400.426, Florida Statutes, is
2471	renumbered as section 429.26, Florida Statutes, and amended to
2472	read:
2473	429.26 400.426  Appropriateness of placements; examinations
2474	of residents.--
2475	(1)  The owner or administrator of a facility is
2476	responsible for determining the appropriateness of admission of
2477	an individual to the facility and for determining the continued
2478	appropriateness of residence of an individual in the facility. A
2479	determination shall be based upon an assessment of the
2480	strengths, needs, and preferences of the resident, the care and
2481	services offered or arranged for by the facility in accordance
2482	with facility policy, and any limitations in law or rule related
2483	to admission criteria or continued residency for the type of
2484	license held by the facility under this part. A resident may not
2485	be moved from one facility to another without consultation with
2486	and agreement from the resident or, if applicable, the
2487	resident's representative or designee or the resident's family,
2488	guardian, surrogate, or attorney in fact. In the case of a
2489	resident who has been placed by the department or the Department
2490	of Children and Family Services, the administrator must notify
2491	the appropriate contact person in the applicable department.
2492	(2)  A physician, licensed physician assistant, or nurse
2493	practitioner who is employed by an assisted living facility to
2494	provide an initial examination for admission purposes may not
2495	have financial interest in the facility.
2496	(3)  Persons licensed under part I of chapter 464 who are
2497	employed by or under contract with a facility shall, on a
2498	routine basis or at least monthly, perform a nursing assessment
2499	of the residents for whom they are providing nursing services
2500	ordered by a physician, except administration of medication, and
2501	shall document such assessment, including any substantial
2502	changes in a resident's status which may necessitate relocation
2503	to a nursing home, hospital, or specialized health care
2504	facility. Such records shall be maintained in the facility for
2505	inspection by the agency and shall be forwarded to the
2506	resident's case manager, if applicable.
2507	(4)  If possible, each resident shall have been examined by
2508	a licensed physician, a licensed physician assistant, or a
2509	licensed nurse practitioner within 60 days before admission to
2510	the facility. The signed and completed medical examination
2511	report shall be submitted to the owner or administrator of the
2512	facility who shall use the information contained therein to
2513	assist in the determination of the appropriateness of the
2514	resident's admission and continued stay in the facility. The
2515	medical examination report shall become a permanent part of the
2516	record of the resident at the facility and shall be made
2517	available to the agency during inspection or upon request. An
2518	assessment that has been completed through the Comprehensive
2519	Assessment and Review for Long-Term Care Services (CARES)
2520	Program fulfills the requirements for a medical examination
2521	under this subsection and s. 429.07(3)(b)6. s. 400.407(3)(b)6.
2522	(5)  Except as provided in s. 429.07 s. 400.407, if a
2523	medical examination has not been completed within 60 days before
2524	the admission of the resident to the facility, a licensed
2525	physician or licensed nurse practitioner shall examine the
2526	resident and complete a medical examination form provided by the
2527	agency within 30 days following the admission to the facility to
2528	enable the facility owner or administrator to determine the
2529	appropriateness of the admission. The medical examination form
2530	shall become a permanent part of the record of the resident at
2531	the facility and shall be made available to the agency during
2532	inspection by the agency or upon request.
2533	(6)  Any resident accepted in a facility and placed by the
2534	department or the Department of Children and Family Services
2535	shall have been examined by medical personnel within 30 days
2536	before placement in the facility. The examination shall include
2537	an assessment of the appropriateness of placement in a facility.
2538	The findings of this examination shall be recorded on the
2539	examination form provided by the agency. The completed form
2540	shall accompany the resident and shall be submitted to the
2541	facility owner or administrator. Additionally, in the case of a
2542	mental health resident, the Department of Children and Family
2543	Services must provide documentation that the individual has been
2544	assessed by a psychiatrist, clinical psychologist, clinical
2545	social worker, or psychiatric nurse, or an individual who is
2546	supervised by one of these professionals, and determined to be
2547	appropriate to reside in an assisted living facility. The
2548	documentation must be in the facility within 30 days after the
2549	mental health resident has been admitted to the facility. An
2550	evaluation completed upon discharge from a state mental hospital
2551	meets the requirements of this subsection related to
2552	appropriateness for placement as a mental health resident
2553	providing it was completed within 90 days prior to admission to
2554	the facility. The applicable department shall provide to the
2555	facility administrator any information about the resident that
2556	would help the administrator meet his or her responsibilities
2557	under subsection (1). Further, department personnel shall
2558	explain to the facility operator any special needs of the
2559	resident and advise the operator whom to call should problems
2560	arise. The applicable department shall advise and assist the
2561	facility administrator where the special needs of residents who
2562	are recipients of optional state supplementation require such
2563	assistance.
2564	(7)  The facility must notify a licensed physician when a
2565	resident exhibits signs of dementia or cognitive impairment or
2566	has a change of condition in order to rule out the presence of
2567	an underlying physiological condition that may be contributing
2568	to such dementia or impairment. The notification must occur
2569	within 30 days after the acknowledgment of such signs by
2570	facility staff. If an underlying condition is determined to
2571	exist, the facility shall arrange, with the appropriate health
2572	care provider, the necessary care and services to treat the
2573	condition.
2574	(8)  The Department of Children and Family Services may
2575	require an examination for supplemental security income and
2576	optional state supplementation recipients residing in facilities
2577	at any time and shall provide the examination whenever a
2578	resident's condition requires it. Any facility administrator;
2579	personnel of the agency, the department, or the Department of
2580	Children and Family Services; or long-term care ombudsman
2581	council member who believes a resident needs to be evaluated
2582	shall notify the resident's case manager, who shall take
2583	appropriate action. A report of the examination findings shall
2584	be provided to the resident's case manager and the facility
2585	administrator to help the administrator meet his or her
2586	responsibilities under subsection (1).
2587	(9)  If, at any time after admission to a facility, a
2588	resident appears to need care beyond that which the facility is
2589	licensed to provide, the agency shall require the resident to be
2590	physically examined by a licensed physician, physician
2591	assistant, or licensed nurse practitioner. This examination
2592	shall, to the extent possible, be performed by the resident's
2593	preferred physician or nurse practitioner and shall be paid for
2594	by the resident with personal funds, except as provided in s.
2595	429.18(1)(b) s. 400.418(1)(b). Following this examination, the
2596	examining physician, physician assistant, or licensed nurse
2597	practitioner shall complete and sign a medical form provided by
2598	the agency. The completed medical form shall be submitted to the
2599	agency within 30 days after the date the facility owner or
2600	administrator is notified by the agency that the physical
2601	examination is required. After consultation with the physician,
2602	physician assistant, or licensed nurse practitioner who
2603	performed the examination, a medical review team designated by
2604	the agency shall then determine whether the resident is
2605	appropriately residing in the facility. The medical review team
2606	shall base its decision on a comprehensive review of the
2607	resident's physical and functional status, including the
2608	resident's preferences, and not on an isolated health-related
2609	problem. In the case of a mental health resident, if the
2610	resident appears to have needs in addition to those identified
2611	in the community living support plan, the agency may require an
2612	evaluation by a mental health professional, as determined by the
2613	Department of Children and Family Services. A facility may not
2614	be required to retain a resident who requires more services or
2615	care than the facility is able to provide in accordance with its
2616	policies and criteria for admission and continued residency.
2617	Members of the medical review team making the final
2618	determination may not include the agency personnel who initially
2619	questioned the appropriateness of a resident's placement. Such
2620	determination is final and binding upon the facility and the
2621	resident. Any resident who is determined by the medical review
2622	team to be inappropriately residing in a facility shall be given
2623	30 days' written notice to relocate by the owner or
2624	administrator, unless the resident's continued residence in the
2625	facility presents an imminent danger to the health, safety, or
2626	welfare of the resident or a substantial probability exists that
2627	death or serious physical harm would result to the resident if
2628	allowed to remain in the facility.
2629	(10)  A terminally ill resident who no longer meets the
2630	criteria for continued residency may remain in the facility if
2631	the arrangement is mutually agreeable to the resident and the
2632	facility; additional care is rendered through a licensed
2633	hospice, and the resident is under the care of a physician who
2634	agrees that the physical needs of the resident are being met.
2635	(11)  Facilities licensed to provide extended congregate
2636	care services shall promote aging in place by determining
2637	appropriateness of continued residency based on a comprehensive
2638	review of the resident's physical and functional status; the
2639	ability of the facility, family members, friends, or any other
2640	pertinent individuals or agencies to provide the care and
2641	services required; and documentation that a written service plan
2642	consistent with facility policy has been developed and
2643	implemented to ensure that the resident's needs and preferences
2644	are addressed.
2645	(12)  No resident who requires 24-hour nursing supervision,
2646	except for a resident who is an enrolled hospice patient
2647	pursuant to part IV VI of this chapter 400, shall be retained in
2648	a facility licensed under this part.
2649	Section 51.  Section 400.427, Florida Statutes, is
2650	renumbered as section 429.27, Florida Statutes, and amended to
2651	read:
2652	429.27 400.427  Property and personal affairs of
2653	residents.--
2654	(1)(a)  A resident shall be given the option of using his
2655	or her own belongings, as space permits; choosing his or her
2656	roommate; and, whenever possible, unless the resident is
2657	adjudicated incompetent or incapacitated under state law,
2658	managing his or her own affairs.
2659	(b)  The admission of a resident to a facility and his or
2660	her presence therein shall not confer on the facility or its
2661	owner, administrator, employees, or representatives any
2662	authority to manage, use, or dispose of any property of the
2663	resident; nor shall such admission or presence confer on any of
2664	such persons any authority or responsibility for the personal
2665	affairs of the resident, except that which may be necessary for
2666	the safe management of the facility or for the safety of the
2667	resident.
2668	(2)  A facility, or an owner, administrator, employee, or
2669	representative thereof, may not act as the guardian, trustee, or
2670	conservator for any resident of the assisted living facility or
2671	any of such resident's property. An owner, administrator, or
2672	staff member, or representative thereof, may not act as a
2673	competent resident's payee for social security, veteran's, or
2674	railroad benefits without the consent of the resident. Any
2675	facility whose owner, administrator, or staff, or representative
2676	thereof, serves as representative payee for any resident of the
2677	facility shall file a surety bond with the agency in an amount
2678	equal to twice the average monthly aggregate income or personal
2679	funds due to residents, or expendable for their account, which
2680	are received by a facility. Any facility whose owner,
2681	administrator, or staff, or a representative thereof, is granted
2682	power of attorney for any resident of the facility shall file a
2683	surety bond with the agency for each resident for whom such
2684	power of attorney is granted. The surety bond shall be in an
2685	amount equal to twice the average monthly income of the
2686	resident, plus the value of any resident's property under the
2687	control of the attorney in fact. The bond shall be executed by
2688	the facility as principal and a licensed surety company. The
2689	bond shall be conditioned upon the faithful compliance of the
2690	facility with this section and shall run to the agency for the
2691	benefit of any resident who suffers a financial loss as a result
2692	of the misuse or misappropriation by a facility of funds held
2693	pursuant to this subsection. Any surety company that cancels or
2694	does not renew the bond of any licensee shall notify the agency
2695	in writing not less than 30 days in advance of such action,
2696	giving the reason for the cancellation or nonrenewal. Any
2697	facility owner, administrator, or staff, or representative
2698	thereof, who is granted power of attorney for any resident of
2699	the facility shall, on a monthly basis, be required to provide
2700	the resident a written statement of any transaction made on
2701	behalf of the resident pursuant to this subsection, and a copy
2702	of such statement given to the resident shall be retained in
2703	each resident's file and available for agency inspection.
2704	(3)  A facility, upon mutual consent with the resident,
2705	shall provide for the safekeeping in the facility of personal
2706	effects not in excess of $500 and funds of the resident not in
2707	excess of $200 cash, and shall keep complete and accurate
2708	records of all such funds and personal effects received. If a
2709	resident is absent from a facility for 24 hours or more, the
2710	facility may provide for the safekeeping of the resident's
2711	personal effects in excess of $500.
2712	(4)  Any funds or other property belonging to or due to a
2713	resident, or expendable for his or her account, which is
2714	received by a facility shall be trust funds which shall be kept
2715	separate from the funds and property of the facility and other
2716	residents or shall be specifically credited to such resident.
2717	Such trust funds shall be used or otherwise expended only for
2718	the account of the resident. At least once every 3 months,
2719	unless upon order of a court of competent jurisdiction, the
2720	facility shall furnish the resident and his or her guardian,
2721	trustee, or conservator, if any, a complete and verified
2722	statement of all funds and other property to which this
2723	subsection applies, detailing the amount and items received,
2724	together with their sources and disposition. In any event, the
2725	facility shall furnish such statement annually and upon the
2726	discharge or transfer of a resident. Any governmental agency or
2727	private charitable agency contributing funds or other property
2728	to the account of a resident shall also be entitled to receive
2729	such statement annually and upon the discharge or transfer of
2730	the resident.
2731	(5)  Any personal funds available to facility residents may
2732	be used by residents as they choose to obtain clothing, personal
2733	items, leisure activities, and other supplies and services for
2734	their personal use. A facility may not demand, require, or
2735	contract for payment of all or any part of the personal funds in
2736	satisfaction of the facility rate for supplies and services
2737	beyond that amount agreed to in writing and may not levy an
2738	additional charge to the individual or the account for any
2739	supplies or services that the facility has agreed by contract to
2740	provide as part of the standard monthly rate. Any service or
2741	supplies provided by the facility which are charged separately
2742	to the individual or the account may be provided only with the
2743	specific written consent of the individual, who shall be
2744	furnished in advance of the provision of the services or
2745	supplies with an itemized written statement to be attached to
2746	the contract setting forth the charges for the services or
2747	supplies.
2748	(6)(a)  In addition to any damages or civil penalties to
2749	which a person is subject, any person who:
2750	1.  Intentionally withholds a resident's personal funds,
2751	personal property, or personal needs allowance, or who demands,
2752	beneficially receives, or contracts for payment of all or any
2753	part of a resident's personal property or personal needs
2754	allowance in satisfaction of the facility rate for supplies and
2755	services; or
2756	2.  Borrows from or pledges any personal funds of a
2757	resident, other than the amount agreed to by written contract
2758	under s. 429.24 s. 400.424,
2759
2760	commits a misdemeanor of the first degree, punishable as
2761	provided in s. 775.082 or s. 775.083.
2762	(b)  Any facility owner, administrator, or staff, or
2763	representative thereof, who is granted power of attorney for any
2764	resident of the facility and who misuses or misappropriates
2765	funds obtained through this power commits a felony of the third
2766	degree, punishable as provided in s. 775.082, s. 775.083, or s.
2767	775.084.
2768	(7)  In the event of the death of a resident, a licensee
2769	shall return all refunds, funds, and property held in trust to
2770	the resident's personal representative, if one has been
2771	appointed at the time the facility disburses such funds, and, if
2772	not, to the resident's spouse or adult next of kin named in a
2773	beneficiary designation form provided by the facility to the
2774	resident. If the resident has no spouse or adult next of kin or
2775	such person cannot be located, funds due the resident shall be
2776	placed in an interest-bearing account, and all property held in
2777	trust by the facility shall be safeguarded until such time as
2778	the funds and property are disbursed pursuant to the Florida
2779	Probate Code. Such funds shall be kept separate from the funds
2780	and property of the facility and other residents of the
2781	facility. If the funds of the deceased resident are not
2782	disbursed pursuant to the Florida Probate Code within 2 years
2783	after the resident's death, the funds shall be deposited in the
2784	Health Care Trust Fund administered by the agency.
2785	(8)  The department may by rule clarify terms and specify
2786	procedures and documentation necessary to administer the
2787	provisions of this section relating to the proper management of
2788	residents' funds and personal property and the execution of
2789	surety bonds.
2790	Section 52.  Section 400.428, Florida Statutes, is
2791	renumbered as section 429.28, Florida Statutes, and amended to
2792	read:
2793	429.28 400.428  Resident bill of rights.--
2794	(1)  No resident of a facility shall be deprived of any
2795	civil or legal rights, benefits, or privileges guaranteed by
2796	law, the Constitution of the State of Florida, or the
2797	Constitution of the United States as a resident of a facility.
2798	Every resident of a facility shall have the right to:
2799	(a)  Live in a safe and decent living environment, free
2800	from abuse and neglect.
2801	(b)  Be treated with consideration and respect and with due
2802	recognition of personal dignity, individuality, and the need for
2803	privacy.
2804	(c)  Retain and use his or her own clothes and other
2805	personal property in his or her immediate living quarters, so as
2806	to maintain individuality and personal dignity, except when the
2807	facility can demonstrate that such would be unsafe, impractical,
2808	or an infringement upon the rights of other residents.
2809	(d)  Unrestricted private communication, including
2810	receiving and sending unopened correspondence, access to a
2811	telephone, and visiting with any person of his or her choice, at
2812	any time between the hours of 9 a.m. and 9 p.m. at a minimum.
2813	Upon request, the facility shall make provisions to extend
2814	visiting hours for caregivers and out-of-town guests, and in
2815	other similar situations.
2816	(e)  Freedom to participate in and benefit from community
2817	services and activities and to achieve the highest possible
2818	level of independence, autonomy, and interaction within the
2819	community.
2820	(f)  Manage his or her financial affairs unless the
2821	resident or, if applicable, the resident's representative,
2822	designee, surrogate, guardian, or attorney in fact authorizes
2823	the administrator of the facility to provide safekeeping for
2824	funds as provided in s. 429.27 s. 400.427.
2825	(g)  Share a room with his or her spouse if both are
2826	residents of the facility.
2827	(h)  Reasonable opportunity for regular exercise several
2828	times a week and to be outdoors at regular and frequent
2829	intervals except when prevented by inclement weather.
2830	(i)  Exercise civil and religious liberties, including the
2831	right to independent personal decisions. No religious beliefs or
2832	practices, nor any attendance at religious services, shall be
2833	imposed upon any resident.
2834	(j)  Access to adequate and appropriate health care
2835	consistent with established and recognized standards within the
2836	community.
2837	(k)  At least 45 days' notice of relocation or termination
2838	of residency from the facility unless, for medical reasons, the
2839	resident is certified by a physician to require an emergency
2840	relocation to a facility providing a more skilled level of care
2841	or the resident engages in a pattern of conduct that is harmful
2842	or offensive to other residents. In the case of a resident who
2843	has been adjudicated mentally incapacitated, the guardian shall
2844	be given at least 45 days' notice of a nonemergency relocation
2845	or residency termination. Reasons for relocation shall be set
2846	forth in writing. In order for a facility to terminate the
2847	residency of an individual without notice as provided herein,
2848	the facility shall show good cause in a court of competent
2849	jurisdiction.
2850	(l)  Present grievances and recommend changes in policies,
2851	procedures, and services to the staff of the facility, governing
2852	officials, or any other person without restraint, interference,
2853	coercion, discrimination, or reprisal. Each facility shall
2854	establish a grievance procedure to facilitate the residents'
2855	exercise of this right. This right includes access to ombudsman
2856	volunteers and advocates and the right to be a member of, to be
2857	active in, and to associate with advocacy or special interest
2858	groups.
2859	(2)  The administrator of a facility shall ensure that a
2860	written notice of the rights, obligations, and prohibitions set
2861	forth in this part is posted in a prominent place in each
2862	facility and read or explained to residents who cannot read.
2863	This notice shall include the name, address, and telephone
2864	numbers of the local ombudsman council and central abuse hotline
2865	and, when applicable, the Advocacy Center for Persons with
2866	Disabilities, Inc., and the Florida local advocacy council,
2867	where complaints may be lodged. The facility must ensure a
2868	resident's access to a telephone to call the local ombudsman
2869	council, central abuse hotline, Advocacy Center for Persons with
2870	Disabilities, Inc., and the Florida local advocacy council.
2871	(3)(a)  The agency shall conduct a survey to determine
2872	general compliance with facility standards and compliance with
2873	residents' rights as a prerequisite to initial licensure or
2874	licensure renewal.
2875	(b)  In order to determine whether the facility is
2876	adequately protecting residents' rights, the biennial survey
2877	shall include private informal conversations with a sample of
2878	residents and consultation with the ombudsman council in the
2879	planning and service area in which the facility is located to
2880	discuss residents' experiences within the facility.
2881	(c)  During any calendar year in which no survey is
2882	conducted, the agency shall conduct at least one monitoring
2883	visit of each facility cited in the previous year for a class I
2884	or class II violation, or more than three uncorrected class III
2885	violations.
2886	(d)  The agency may conduct periodic followup inspections
2887	as necessary to monitor the compliance of facilities with a
2888	history of any class I, class II, or class III violations that
2889	threaten the health, safety, or security of residents.
2890	(e)  The agency may conduct complaint investigations as
2891	warranted to investigate any allegations of noncompliance with
2892	requirements required under this part or rules adopted under
2893	this part.
2894	(4)  The facility shall not hamper or prevent residents
2895	from exercising their rights as specified in this section.
2896	(5)  No facility or employee of a facility may serve notice
2897	upon a resident to leave the premises or take any other
2898	retaliatory action against any person who:
2899	(a)  Exercises any right set forth in this section.
2900	(b)  Appears as a witness in any hearing, inside or outside
2901	the facility.
2902	(c)  Files a civil action alleging a violation of the
2903	provisions of this part or notifies a state attorney or the
2904	Attorney General of a possible violation of such provisions.
2905	(6)  Any facility which terminates the residency of an
2906	individual who participated in activities specified in
2907	subsection (5) shall show good cause in a court of competent
2908	jurisdiction.
2909	(7)  Any person who submits or reports a complaint
2910	concerning a suspected violation of the provisions of this part
2911	or concerning services and conditions in facilities, or who
2912	testifies in any administrative or judicial proceeding arising
2913	from such a complaint, shall have immunity from any civil or
2914	criminal liability therefor, unless such person has acted in bad
2915	faith or with malicious purpose or the court finds that there
2916	was a complete absence of a justiciable issue of either law or
2917	fact raised by the losing party.
2918	Section 53.  Section 400.429, Florida Statutes, is
2919	renumbered as section 429.29, Florida Statutes, and amended to
2920	read:
2921	429.29 400.429  Civil actions to enforce rights.--
2922	(1)  Any person or resident whose rights as specified in
2923	this part are violated shall have a cause of action. The action
2924	may be brought by the resident or his or her guardian, or by a
2925	person or organization acting on behalf of a resident with the
2926	consent of the resident or his or her guardian, or by the
2927	personal representative of the estate of a deceased resident
2928	regardless of the cause of death. If the action alleges a claim
2929	for the resident's rights or for negligence that caused the
2930	death of the resident, the claimant shall be required to elect
2931	either survival damages pursuant to s. 46.021 or wrongful death
2932	damages pursuant to s. 768.21. If the action alleges a claim for
2933	the resident's rights or for negligence that did not cause the
2934	death of the resident, the personal representative of the estate
2935	may recover damages for the negligence that caused injury to the
2936	resident. The action may be brought in any court of competent
2937	jurisdiction to enforce such rights and to recover actual
2938	damages, and punitive damages for violation of the rights of a
2939	resident or negligence. Any resident who prevails in seeking
2940	injunctive relief or a claim for an administrative remedy is
2941	entitled to recover the costs of the action and a reasonable
2942	attorney's fee assessed against the defendant not to exceed
2943	$25,000. Fees shall be awarded solely for the injunctive or
2944	administrative relief and not for any claim or action for
2945	damages whether such claim or action is brought together with a
2946	request for an injunction or administrative relief or as a
2947	separate action, except as provided under s. 768.79 or the
2948	Florida Rules of Civil Procedure. Sections 429.29-429.298
2949	400.429-400.4303 provide the exclusive remedy for a cause of
2950	action for recovery of damages for the personal injury or death
2951	of a resident arising out of negligence or a violation of rights
2952	specified in s. 429.28 s. 400.428. This section does not
2953	preclude theories of recovery not arising out of negligence or
2954	s. 429.28 s. 400.428 which are available to a resident or to the
2955	agency. The provisions of chapter 766 do not apply to any cause
2956	of action brought under ss. 429.29-429.298 ss. 400.429-400.4303.
2957	(2)  In any claim brought pursuant to this part alleging a
2958	violation of resident's rights or negligence causing injury to
2959	or the death of a resident, the claimant shall have the burden
2960	of proving, by a preponderance of the evidence, that:
2961	(a)  The defendant owed a duty to the resident;
2962	(b)  The defendant breached the duty to the resident;
2963	(c)  The breach of the duty is a legal cause of loss,
2964	injury, death, or damage to the resident; and
2965	(d)  The resident sustained loss, injury, death, or damage
2966	as a result of the breach.
2967
2968	Nothing in this part shall be interpreted to create strict
2969	liability. A violation of the rights set forth in s. 429.28 s.
2970	400.428 or in any other standard or guidelines specified in this
2971	part or in any applicable administrative standard or guidelines
2972	of this state or a federal regulatory agency shall be evidence
2973	of negligence but shall not be considered negligence per se.
2974	(3)  In any claim brought pursuant to this section, a
2975	licensee, person, or entity shall have a duty to exercise
2976	reasonable care. Reasonable care is that degree of care which a
2977	reasonably careful licensee, person, or entity would use under
2978	like circumstances.
2979	(4)  In any claim for resident's rights violation or
2980	negligence by a nurse licensed under part I of chapter 464, such
2981	nurse shall have the duty to exercise care consistent with the
2982	prevailing professional standard of care for a nurse. The
2983	prevailing professional standard of care for a nurse shall be
2984	that level of care, skill, and treatment which, in light of all
2985	relevant surrounding circumstances, is recognized as acceptable
2986	and appropriate by reasonably prudent similar nurses.
2987	(5)  Discovery of financial information for the purpose of
2988	determining the value of punitive damages may not be had unless
2989	the plaintiff shows the court by proffer or evidence in the
2990	record that a reasonable basis exists to support a claim for
2991	punitive damages.
2992	(6)  In addition to any other standards for punitive
2993	damages, any award of punitive damages must be reasonable in
2994	light of the actual harm suffered by the resident and the
2995	egregiousness of the conduct that caused the actual harm to the
2996	resident.
2997	(7)  The resident or the resident's legal representative
2998	shall serve a copy of any complaint alleging in whole or in part
2999	a violation of any rights specified in this part to the Agency
3000	for Health Care Administration at the time of filing the initial
3001	complaint with the clerk of the court for the county in which
3002	the action is pursued. The requirement of providing a copy of
3003	the complaint to the agency does not impair the resident's legal
3004	rights or ability to seek relief for his or her claim.
3005	Section 54.  Section 400.4293, Florida Statutes, is
3006	renumbered as section 429.293, Florida Statutes, and amended to
3007	read:
3008	429.293 400.4293  Presuit notice; investigation;
3009	notification of violation of residents' rights or alleged
3010	negligence; claims evaluation procedure; informal discovery;
3011	review; settlement offer; mediation.--
3012	(1)  As used in this section, the term:
3013	(a)  "Claim for residents' rights violation or negligence"
3014	means a negligence claim alleging injury to or the death of a
3015	resident arising out of an asserted violation of the rights of a
3016	resident under s. 429.28 s. 400.428 or an asserted deviation
3017	from the applicable standard of care.
3018	(b)  "Insurer" means any self-insurer authorized under s.
3019	627.357, liability insurance carrier, joint underwriting
3020	association, or uninsured prospective defendant.
3021	(2)  Prior to filing a claim for a violation of a
3022	resident's rights or a claim for negligence, a claimant alleging
3023	injury to or the death of a resident shall notify each
3024	prospective defendant by certified mail, return receipt
3025	requested, of an asserted violation of a resident's rights
3026	provided in s. 429.28 s. 400.428 or deviation from the standard
3027	of care. Such notification shall include an identification of
3028	the rights the prospective defendant has violated and the
3029	negligence alleged to have caused the incident or incidents and
3030	a brief description of the injuries sustained by the resident
3031	which are reasonably identifiable at the time of notice. The
3032	notice shall contain a certificate of counsel that counsel's
3033	reasonable investigation gave rise to a good faith belief that
3034	grounds exist for an action against each prospective defendant.
3035	(3)(a)  No suit may be filed for a period of 75 days after
3036	notice is mailed to any prospective defendant. During the 75-day
3037	period, the prospective defendants or their insurers shall
3038	conduct an evaluation of the claim to determine the liability of
3039	each defendant and to evaluate the damages of the claimants.
3040	Each defendant or insurer of the defendant shall have a
3041	procedure for the prompt evaluation of claims during the 75-day
3042	period. The procedure shall include one or more of the
3043	following:
3044	1.  Internal review by a duly qualified facility risk
3045	manager or claims adjuster;
3046	2.  Internal review by counsel for each prospective
3047	defendant;
3048	3.  A quality assurance committee authorized under any
3049	applicable state or federal statutes or regulations; or
3050	4.  Any other similar procedure that fairly and promptly
3051	evaluates the claims.
3052
3053	Each defendant or insurer of the defendant shall evaluate the
3054	claim in good faith.
3055	(b)  At or before the end of the 75 days, the defendant or
3056	insurer of the defendant shall provide the claimant with a
3057	written response:
3058	1.  Rejecting the claim; or
3059	2.  Making a settlement offer.
3060	(c)  The response shall be delivered to the claimant if not
3061	represented by counsel or to the claimant's attorney, by
3062	certified mail, return receipt requested. Failure of the
3063	prospective defendant or insurer of the defendant to reply to
3064	the notice within 75 days after receipt shall be deemed a
3065	rejection of the claim for purposes of this section.
3066	(4)  The notification of a violation of a resident's rights
3067	or alleged negligence shall be served within the applicable
3068	statute of limitations period; however, during the 75-day
3069	period, the statute of limitations is tolled as to all
3070	prospective defendants. Upon stipulation by the parties, the 75-
3071	day period may be extended and the statute of limitations is
3072	tolled during any such extension. Upon receiving written notice
3073	by certified mail, return receipt requested, of termination of
3074	negotiations in an extended period, the claimant shall have 60
3075	days or the remainder of the period of the statute of
3076	limitations, whichever is greater, within which to file suit.
3077	(5)  No statement, discussion, written document, report, or
3078	other work product generated by presuit claims evaluation
3079	procedures under this section is discoverable or admissible in
3080	any civil action for any purpose by the opposing party. All
3081	participants, including, but not limited to, physicians,
3082	investigators, witnesses, and employees or associates of the
3083	defendant, are immune from civil liability arising from
3084	participation in the presuit claims evaluation procedure. Any
3085	licensed physician or registered nurse may be retained by either
3086	party to provide an opinion regarding the reasonable basis of
3087	the claim. The presuit opinions of the expert are not
3088	discoverable or admissible in any civil action for any purpose
3089	by the opposing party.
3090	(6)  Upon receipt by a prospective defendant of a notice of
3091	claim, the parties shall make discoverable information available
3092	without formal discovery as provided in subsection (7).
3093	(7)  Informal discovery may be used by a party to obtain
3094	unsworn statements and the production of documents or things, as
3095	follows:
3096	(a)  Unsworn statements.--Any party may require other
3097	parties to appear for the taking of an unsworn statement. Such
3098	statements may be used only for the purpose of claims evaluation
3099	and are not discoverable or admissible in any civil action for
3100	any purpose by any party. A party seeking to take the unsworn
3101	statement of any party must give reasonable notice in writing to
3102	all parties. The notice must state the time and place for taking
3103	the statement and the name and address of the party to be
3104	examined. Unless otherwise impractical, the examination of any
3105	party must be done at the same time by all other parties. Any
3106	party may be represented by counsel at the taking of an unsworn
3107	statement. An unsworn statement may be recorded electronically,
3108	stenographically, or on videotape. The taking of unsworn
3109	statements is subject to the provisions of the Florida Rules of
3110	Civil Procedure and may be terminated for abuses.
3111	(b)  Documents or things.--Any party may request discovery
3112	of relevant documents or things. The documents or things must be
3113	produced, at the expense of the requesting party, within 20 days
3114	after the date of receipt of the request. A party is required to
3115	produce relevant and discoverable documents or things within
3116	that party's possession or control, if in good faith it can
3117	reasonably be done within the timeframe of the claims evaluation
3118	process.
3119	(8)  Each request for and notice concerning informal
3120	discovery pursuant to this section must be in writing, and a
3121	copy thereof must be sent to all parties. Such a request or
3122	notice must bear a certificate of service identifying the name
3123	and address of the person to whom the request or notice is
3124	served, the date of the request or notice, and the manner of
3125	service thereof.
3126	(9)  If a prospective defendant makes a written settlement
3127	offer, the claimant shall have 15 days from the date of receipt
3128	to accept the offer. An offer shall be deemed rejected unless
3129	accepted by delivery of a written notice of acceptance.
3130	(10)  To the extent not inconsistent with this part, the
3131	provisions of the Florida Mediation Code, Florida Rules of Civil
3132	Procedure, shall be applicable to such proceedings.
3133	(11)  Within 30 days after the claimant's receipt of
3134	defendant's response to the claim, the parties or their
3135	designated representatives shall meet in mediation to discuss
3136	the issues of liability and damages in accordance with the
3137	mediation rules of practice and procedures adopted by the
3138	Supreme Court. Upon stipulation of the parties, this 30-day
3139	period may be extended and the statute of limitations is tolled
3140	during the mediation and any such extension. At the conclusion
3141	of mediation, the claimant shall have 60 days or the remainder
3142	of the period of the statute of limitations, whichever is
3143	greater, within which to file suit.
3144	Section 55.  Section 400.431, Florida Statutes, is
3145	renumbered as section 429.31, Florida Statutes, and amended to
3146	read:
3147	429.31 400.431  Closing of facility; notice; penalty.--
3148	(1)  Whenever a facility voluntarily discontinues
3149	operation, it shall inform the agency in writing at least 90
3150	days prior to the discontinuance of operation. The facility
3151	shall also inform each resident or the next of kin, legal
3152	representative, or agency acting on each resident's behalf, of
3153	the fact and the proposed time of such discontinuance, following
3154	the notification requirements provided in s. 429.28(1)(k) s.
3155	400.428(1)(k). In the event a resident has no person to
3156	represent him or her, the facility shall be responsible for
3157	referral to an appropriate social service agency for placement.
3158	(2)  Immediately upon the notice by the agency of the
3159	voluntary or involuntary termination of such operation, the
3160	agency shall monitor the transfer of residents to other
3161	facilities and ensure that residents' rights are being
3162	protected. The department, in consultation with the Department
3163	of Children and Family Services, shall specify procedures for
3164	ensuring that all residents who receive services are
3165	appropriately relocated.
3166	(3)  All charges shall be prorated as of the date on which
3167	the facility discontinues operation, and if any payments have
3168	been made in advance, the payments for services not received
3169	shall be refunded to the resident or the resident's guardian
3170	within 10 working days of voluntary or involuntary closure of
3171	the facility, whether or not such refund is requested by the
3172	resident or guardian.
3173	(4)  Immediately upon discontinuance of the operation of a
3174	facility, the owner shall surrender the license therefor to the
3175	agency, and the license shall be canceled.
3176	(5)  The agency may levy a fine in an amount no greater
3177	than $5,000 upon each person or business entity that owns any
3178	interest in a facility that terminates operation without
3179	providing notice to the agency and the residents of the facility
3180	at least 30 days before operation ceases. This fine shall not be
3181	levied against any facility involuntarily closed at the
3182	initiation of the agency. The agency shall use the proceeds of
3183	the fines to operate the facility until all residents of the
3184	facility are relocated and shall deposit any balance of the
3185	proceeds into the Health Care Trust Fund established pursuant to
3186	s. 429.18 s. 400.418.
3187	Section 56.  Section 400.441, Florida Statutes, is
3188	renumbered as section 429.41, Florida Statutes, and amended to
3189	read:
3190	429.41 400.441  Rules establishing standards.--
3191	(1)  It is the intent of the Legislature that rules
3192	published and enforced pursuant to this section shall include
3193	criteria by which a reasonable and consistent quality of
3194	resident care and quality of life may be ensured and the results
3195	of such resident care may be demonstrated. Such rules shall also
3196	ensure a safe and sanitary environment that is residential and
3197	noninstitutional in design or nature. It is further intended
3198	that reasonable efforts be made to accommodate the needs and
3199	preferences of residents to enhance the quality of life in a
3200	facility. In order to provide safe and sanitary facilities and
3201	the highest quality of resident care accommodating the needs and
3202	preferences of residents, the department, in consultation with
3203	the agency, the Department of Children and Family Services, and
3204	the Department of Health, shall adopt rules, policies, and
3205	procedures to administer this part, which must include
3206	reasonable and fair minimum standards in relation to:
3207	(a)  The requirements for and maintenance of facilities,
3208	not in conflict with the provisions of chapter 553, relating to
3209	plumbing, heating, cooling, lighting, ventilation, living space,
3210	and other housing conditions, which will ensure the health,
3211	safety, and comfort of residents and protection from fire
3212	hazard, including adequate provisions for fire alarm and other
3213	fire protection suitable to the size of the structure. Uniform
3214	firesafety standards shall be established and enforced by the
3215	State Fire Marshal in cooperation with the agency, the
3216	department, and the Department of Health.
3217	1.  Evacuation capability determination.--
3218	a.  The provisions of the National Fire Protection
3219	Association, NFPA 101A, Chapter 5, 1995 edition, shall be used
3220	for determining the ability of the residents, with or without
3221	staff assistance, to relocate from or within a licensed facility
3222	to a point of safety as provided in the fire codes adopted
3223	herein. An evacuation capability evaluation for initial
3224	licensure shall be conducted within 6 months after the date of
3225	licensure. For existing licensed facilities that are not
3226	equipped with an automatic fire sprinkler system, the
3227	administrator shall evaluate the evacuation capability of
3228	residents at least annually. The evacuation capability
3229	evaluation for each facility not equipped with an automatic fire
3230	sprinkler system shall be validated, without liability, by the
3231	State Fire Marshal, by the local fire marshal, or by the local
3232	authority having jurisdiction over firesafety, before the
3233	license renewal date. If the State Fire Marshal, local fire
3234	marshal, or local authority having jurisdiction over firesafety
3235	has reason to believe that the evacuation capability of a
3236	facility as reported by the administrator may have changed, it
3237	may, with assistance from the facility administrator, reevaluate
3238	the evacuation capability through timed exiting drills.
3239	Translation of timed fire exiting drills to evacuation
3240	capability may be determined:
3241	(I)  Three minutes or less: prompt.
3242	(II)  More than 3 minutes, but not more than 13 minutes:
3243	slow.
3244	(III)  More than 13 minutes: impractical.
3245	b.  The Office of the State Fire Marshal shall provide or
3246	cause the provision of training and education on the proper
3247	application of Chapter 5, NFPA 101A, 1995 edition, to its
3248	employees, to staff of the Agency for Health Care Administration
3249	who are responsible for regulating facilities under this part,
3250	and to local governmental inspectors. The Office of the State
3251	Fire Marshal shall provide or cause the provision of this
3252	training within its existing budget, but may charge a fee for
3253	this training to offset its costs. The initial training must be
3254	delivered within 6 months after July 1, 1995, and as needed
3255	thereafter.
3256	c.  The Office of the State Fire Marshal, in cooperation
3257	with provider associations, shall provide or cause the provision
3258	of a training program designed to inform facility operators on
3259	how to properly review bid documents relating to the
3260	installation of automatic fire sprinklers. The Office of the
3261	State Fire Marshal shall provide or cause the provision of this
3262	training within its existing budget, but may charge a fee for
3263	this training to offset its costs. The initial training must be
3264	delivered within 6 months after July 1, 1995, and as needed
3265	thereafter.
3266	d.  The administrator of a licensed facility shall sign an
3267	affidavit verifying the number of residents occupying the
3268	facility at the time of the evacuation capability evaluation.
3269	2.  Firesafety requirements.--
3270	a.  Except for the special applications provided herein,
3271	effective January 1, 1996, the provisions of the National Fire
3272	Protection Association, Life Safety Code, NFPA 101, 1994
3273	edition, Chapter 22 for new facilities and Chapter 23 for
3274	existing facilities shall be the uniform fire code applied by
3275	the State Fire Marshal for assisted living facilities, pursuant
3276	to s. 633.022.
3277	b.  Any new facility, regardless of size, that applies for
3278	a license on or after January 1, 1996, must be equipped with an
3279	automatic fire sprinkler system. The exceptions as provided in
3280	section 22-2.3.5.1, NFPA 101, 1994 edition, as adopted herein,
3281	apply to any new facility housing eight or fewer residents. On
3282	July 1, 1995, local governmental entities responsible for the
3283	issuance of permits for construction shall inform, without
3284	liability, any facility whose permit for construction is
3285	obtained prior to January 1, 1996, of this automatic fire
3286	sprinkler requirement. As used in this part, the term "a new
3287	facility" does not mean an existing facility that has undergone
3288	change of ownership.
3289	c.  Notwithstanding any provision of s. 633.022 or of the
3290	National Fire Protection Association, NFPA 101A, Chapter 5, 1995
3291	edition, to the contrary, any existing facility housing eight or
3292	fewer residents is not required to install an automatic fire
3293	sprinkler system, nor to comply with any other requirement in
3294	Chapter 23, NFPA 101, 1994 edition, that exceeds the firesafety
3295	requirements of NFPA 101, 1988 edition, that applies to this
3296	size facility, unless the facility has been classified as
3297	impractical to evacuate. Any existing facility housing eight or
3298	fewer residents that is classified as impractical to evacuate
3299	must install an automatic fire sprinkler system within the
3300	timeframes granted in this section.
3301	d.  Any existing facility that is required to install an
3302	automatic fire sprinkler system under this paragraph need not
3303	meet other firesafety requirements of Chapter 23, NFPA 101, 1994
3304	edition, which exceed the provisions of NFPA 101, 1988 edition.
3305	The mandate contained in this paragraph which requires certain
3306	facilities to install an automatic fire sprinkler system
3307	supersedes any other requirement.
3308	e.  This paragraph does not supersede the exceptions
3309	granted in NFPA 101, 1988 edition or 1994 edition.
3310	f.  This paragraph does not exempt facilities from other
3311	firesafety provisions adopted under s. 633.022 and local
3312	building code requirements in effect before July 1, 1995.
3313	g.  A local government may charge fees only in an amount
3314	not to exceed the actual expenses incurred by local government
3315	relating to the installation and maintenance of an automatic
3316	fire sprinkler system in an existing and properly licensed
3317	assisted living facility structure as of January 1, 1996.
3318	h.  If a licensed facility undergoes major reconstruction
3319	or addition to an existing building on or after January 1, 1996,
3320	the entire building must be equipped with an automatic fire
3321	sprinkler system. Major reconstruction of a building means
3322	repair or restoration that costs in excess of 50 percent of the
3323	value of the building as reported on the tax rolls, excluding
3324	land, before reconstruction. Multiple reconstruction projects
3325	within a 5-year period the total costs of which exceed 50
3326	percent of the initial value of the building at the time the
3327	first reconstruction project was permitted are to be considered
3328	as major reconstruction. Application for a permit for an
3329	automatic fire sprinkler system is required upon application for
3330	a permit for a reconstruction project that creates costs that go
3331	over the 50-percent threshold.
3332	i.  Any facility licensed before January 1, 1996, that is
3333	required to install an automatic fire sprinkler system shall
3334	ensure that the installation is completed within the following
3335	timeframes based upon evacuation capability of the facility as
3336	determined under subparagraph 1.:
3337	(I)  Impractical evacuation capability, 24 months.
3338	(II)  Slow evacuation capability, 48 months.
3339	(III)  Prompt evacuation capability, 60 months.
3340
3341	The beginning date from which the deadline for the automatic
3342	fire sprinkler installation requirement must be calculated is
3343	upon receipt of written notice from the local fire official that
3344	an automatic fire sprinkler system must be installed. The local
3345	fire official shall send a copy of the document indicating the
3346	requirement of a fire sprinkler system to the Agency for Health
3347	Care Administration.
3348	j.  It is recognized that the installation of an automatic
3349	fire sprinkler system may create financial hardship for some
3350	facilities. The appropriate local fire official shall, without
3351	liability, grant two 1-year extensions to the timeframes for
3352	installation established herein, if an automatic fire sprinkler
3353	installation cost estimate and proof of denial from two
3354	financial institutions for a construction loan to install the
3355	automatic fire sprinkler system are submitted. However, for any
3356	facility with a class I or class II, or a history of uncorrected
3357	class III, firesafety deficiencies, an extension must not be
3358	granted. The local fire official shall send a copy of the
3359	document granting the time extension to the Agency for Health
3360	Care Administration.
3361	k.  A facility owner whose facility is required to be
3362	equipped with an automatic fire sprinkler system under Chapter
3363	23, NFPA 101, 1994 edition, as adopted herein, must disclose to
3364	any potential buyer of the facility that an installation of an
3365	automatic fire sprinkler requirement exists. The sale of the
3366	facility does not alter the timeframe for the installation of
3367	the automatic fire sprinkler system.
3368	l.  Existing facilities required to install an automatic
3369	fire sprinkler system as a result of construction-type
3370	restrictions in Chapter 23, NFPA 101, 1994 edition, as adopted
3371	herein, or evacuation capability requirements shall be notified
3372	by the local fire official in writing of the automatic fire
3373	sprinkler requirement, as well as the appropriate date for final
3374	compliance as provided in this subparagraph. The local fire
3375	official shall send a copy of the document to the Agency for
3376	Health Care Administration.
3377	m.  Except in cases of life-threatening fire hazards, if an
3378	existing facility experiences a change in the evacuation
3379	capability, or if the local authority having jurisdiction
3380	identifies a construction-type restriction, such that an
3381	automatic fire sprinkler system is required, it shall be
3382	afforded time for installation as provided in this subparagraph.
3383
3384	Facilities that are fully sprinkled and in compliance with other
3385	firesafety standards are not required to conduct more than one
3386	of the required fire drills between the hours of 11 p.m. and 7
3387	a.m., per year. In lieu of the remaining drills, staff
3388	responsible for residents during such hours may be required to
3389	participate in a mock drill that includes a review of evacuation
3390	procedures. Such standards must be included or referenced in the
3391	rules adopted by the State Fire Marshal. Pursuant to s.
3392	633.022(1)(b), the State Fire Marshal is the final
3393	administrative authority for firesafety standards established
3394	and enforced pursuant to this section. All licensed facilities
3395	must have an annual fire inspection conducted by the local fire
3396	marshal or authority having jurisdiction.
3397	3.  Resident elopement requirements.--Facilities are
3398	required to conduct a minimum of two resident elopement
3399	prevention and response drills per year. All administrators and
3400	direct care staff must participate in the drills which shall
3401	include a review of procedures to address resident elopement.
3402	Facilities must document the implementation of the drills and
3403	ensure that the drills are conducted in a manner consistent with
3404	the facility's resident elopement policies and procedures.
3405	(b)  The preparation and annual update of a comprehensive
3406	emergency management plan. Such standards must be included in
3407	the rules adopted by the department after consultation with the
3408	Department of Community Affairs. At a minimum, the rules must
3409	provide for plan components that address emergency evacuation
3410	transportation; adequate sheltering arrangements; postdisaster
3411	activities, including provision of emergency power, food, and
3412	water; postdisaster transportation; supplies; staffing;
3413	emergency equipment; individual identification of residents and
3414	transfer of records; communication with families; and responses
3415	to family inquiries. The comprehensive emergency management plan
3416	is subject to review and approval by the local emergency
3417	management agency. During its review, the local emergency
3418	management agency shall ensure that the following agencies, at a
3419	minimum, are given the opportunity to review the plan: the
3420	Department of Elderly Affairs, the Department of Health, the
3421	Agency for Health Care Administration, and the Department of
3422	Community Affairs. Also, appropriate volunteer organizations
3423	must be given the opportunity to review the plan. The local
3424	emergency management agency shall complete its review within 60
3425	days and either approve the plan or advise the facility of
3426	necessary revisions.
3427	(c)  The number, training, and qualifications of all
3428	personnel having responsibility for the care of residents. The
3429	rules must require adequate staff to provide for the safety of
3430	all residents. Facilities licensed for 17 or more residents are
3431	required to maintain an alert staff for 24 hours per day.
3432	(d)  All sanitary conditions within the facility and its
3433	surroundings which will ensure the health and comfort of
3434	residents. The rules must clearly delineate the responsibilities
3435	of the agency's licensure and survey staff, the county health
3436	departments, and the local authority having jurisdiction over
3437	fire safety and ensure that inspections are not duplicative. The
3438	agency may collect fees for food service inspections conducted
3439	by the county health departments and transfer such fees to the
3440	Department of Health.
3441	(e)  License application and license renewal, transfer of
3442	ownership, proper management of resident funds and personal
3443	property, surety bonds, resident contracts, refund policies,
3444	financial ability to operate, and facility and staff records.
3445	(f)  Inspections, complaint investigations, moratoriums,
3446	classification of deficiencies, levying and enforcement of
3447	penalties, and use of income from fees and fines.
3448	(g)  The enforcement of the resident bill of rights
3449	specified in s. 429.28 s. 400.428.
3450	(h)  The care and maintenance of residents, which must
3451	include, but is not limited to:
3452	1.  The supervision of residents;
3453	2.  The provision of personal services;
3454	3.  The provision of, or arrangement for, social and
3455	leisure activities;
3456	4.  The arrangement for appointments and transportation to
3457	appropriate medical, dental, nursing, or mental health services,
3458	as needed by residents;
3459	5.  The management of medication;
3460	6.  The nutritional needs of residents;
3461	7.  Resident records; and
3462	8.  Internal risk management and quality assurance.
3463	(i)  Facilities holding a limited nursing, extended
3464	congregate care, or limited mental health license.
3465	(j)  The establishment of specific criteria to define
3466	appropriateness of resident admission and continued residency in
3467	a facility holding a standard, limited nursing, extended
3468	congregate care, and limited mental health license.
3469	(k)  The use of physical or chemical restraints. The use of
3470	physical restraints is limited to half-bed rails as prescribed
3471	and documented by the resident's physician with the consent of
3472	the resident or, if applicable, the resident's representative or
3473	designee or the resident's surrogate, guardian, or attorney in
3474	fact. The use of chemical restraints is limited to prescribed
3475	dosages of medications authorized by the resident's physician
3476	and must be consistent with the resident's diagnosis. Residents
3477	who are receiving medications that can serve as chemical
3478	restraints must be evaluated by their physician at least
3479	annually to assess:
3480	1.  The continued need for the medication.
3481	2.  The level of the medication in the resident's blood.
3482	3.  The need for adjustments in the prescription.
3483	(l)  The establishment of specific policies and procedures
3484	on resident elopement. Facilities shall conduct a minimum of two
3485	resident elopement drills each year. All administrators and
3486	direct care staff shall participate in the drills. Facilities
3487	shall document the drills.
3488	(2)  In adopting any rules pursuant to this part, the
3489	department, in conjunction with the agency, shall make distinct
3490	standards for facilities based upon facility size; the types of
3491	care provided; the physical and mental capabilities and needs of
3492	residents; the type, frequency, and amount of services and care
3493	offered; and the staffing characteristics of the facility. Rules
3494	developed pursuant to this section shall not restrict the use of
3495	shared staffing and shared programming in facilities that are
3496	part of retirement communities that provide multiple levels of
3497	care and otherwise meet the requirements of law and rule. Except
3498	for uniform firesafety standards, the department shall adopt by
3499	rule separate and distinct standards for facilities with 16 or
3500	fewer beds and for facilities with 17 or more beds. The
3501	standards for facilities with 16 or fewer beds shall be
3502	appropriate for a noninstitutional residential environment,
3503	provided that the structure is no more than two stories in
3504	height and all persons who cannot exit the facility unassisted
3505	in an emergency reside on the first floor. The department, in
3506	conjunction with the agency, may make other distinctions among
3507	types of facilities as necessary to enforce the provisions of
3508	this part. Where appropriate, the agency shall offer alternate
3509	solutions for complying with established standards, based on
3510	distinctions made by the department and the agency relative to
3511	the physical characteristics of facilities and the types of care
3512	offered therein.
3513	(3)  The department shall submit a copy of proposed rules
3514	to the Speaker of the House of Representatives, the President of
3515	the Senate, and appropriate committees of substance for review
3516	and comment prior to the promulgation thereof.
3517	(a)  Rules promulgated by the department shall encourage
3518	the development of homelike facilities which promote the
3519	dignity, individuality, personal strengths, and decisionmaking
3520	ability of residents.
3521	(b)  The agency, in consultation with the department, may
3522	waive rules promulgated pursuant to this part in order to
3523	demonstrate and evaluate innovative or cost-effective congregate
3524	care alternatives which enable individuals to age in place. Such
3525	waivers may be granted only in instances where there is
3526	reasonable assurance that the health, safety, or welfare of
3527	residents will not be endangered. To apply for a waiver, the
3528	licensee shall submit to the agency a written description of the
3529	concept to be demonstrated, including goals, objectives, and
3530	anticipated benefits; the number and types of residents who will
3531	be affected, if applicable; a brief description of how the
3532	demonstration will be evaluated; and any other information
3533	deemed appropriate by the agency. Any facility granted a waiver
3534	shall submit a report of findings to the agency and the
3535	department within 12 months. At such time, the agency may renew
3536	or revoke the waiver or pursue any regulatory or statutory
3537	changes necessary to allow other facilities to adopt the same
3538	practices. The department may by rule clarify terms and
3539	establish waiver application procedures, criteria for reviewing
3540	waiver proposals, and procedures for reporting findings, as
3541	necessary to implement this subsection.
3542	(4)  The agency may use an abbreviated biennial standard
3543	licensure inspection that consists of a review of key quality-
3544	of-care standards in lieu of a full inspection in facilities
3545	which have a good record of past performance. However, a full
3546	inspection shall be conducted in facilities which have had a
3547	history of class I or class II violations, uncorrected class III
3548	violations, confirmed ombudsman council complaints, or confirmed
3549	licensure complaints, within the previous licensure period
3550	immediately preceding the inspection or when a potentially
3551	serious problem is identified during the abbreviated inspection.
3552	The agency, in consultation with the department, shall develop
3553	the key quality-of-care standards with input from the State
3554	Long-Term Care Ombudsman Council and representatives of provider
3555	groups for incorporation into its rules. The department, in
3556	consultation with the agency, shall report annually to the
3557	Legislature concerning its implementation of this subsection.
3558	The report shall include, at a minimum, the key quality-of-care
3559	standards which have been developed; the number of facilities
3560	identified as being eligible for the abbreviated inspection; the
3561	number of facilities which have received the abbreviated
3562	inspection and, of those, the number that were converted to full
3563	inspection; the number and type of subsequent complaints
3564	received by the agency or department on facilities which have
3565	had abbreviated inspections; any recommendations for
3566	modification to this subsection; any plans by the agency to
3567	modify its implementation of this subsection; and any other
3568	information which the department believes should be reported.
3569	(5)  A fee shall be charged by the department to any person
3570	requesting a copy of this part or rules promulgated under this
3571	part. Such fees shall not exceed the actual cost of duplication
3572	and postage.
3573	Section 57.  Section 400.442, Florida Statutes, is
3574	renumbered as section 429.42, Florida Statutes, and amended to
3575	read:
3576	429.42 400.442  Pharmacy and dietary services.--
3577	(1)  Any assisted living facility in which the agency has
3578	documented a class I or class II deficiency or uncorrected class
3579	III deficiencies regarding medicinal drugs or over-the-counter
3580	preparations, including their storage, use, delivery, or
3581	administration, or dietary services, or both, during a biennial
3582	survey or a monitoring visit or an investigation in response to
3583	a complaint, shall, in addition to or as an alternative to any
3584	penalties imposed under s. 429.19 s. 400.419, be required to
3585	employ the consultant services of a licensed pharmacist, a
3586	licensed registered nurse, or a registered or licensed
3587	dietitian, as applicable. The consultant shall, at a minimum,
3588	provide onsite quarterly consultation until the inspection team
3589	from the agency determines that such consultation services are
3590	no longer required.
3591	(2)  A corrective action plan for deficiencies related to
3592	assistance with the self-administration of medication or the
3593	administration of medication must be developed and implemented
3594	by the facility within 48 hours after notification of such
3595	deficiency, or sooner if the deficiency is determined by the
3596	agency to be life-threatening.
3597	(3)  The agency shall employ at least two pharmacists
3598	licensed pursuant to chapter 465 among its personnel who
3599	biennially inspect assisted living facilities licensed under
3600	this part, to participate in biennial inspections or consult
3601	with the agency regarding deficiencies relating to medicinal
3602	drugs or over-the-counter preparations.
3603	(4)  The department may by rule establish procedures and
3604	specify documentation as necessary to implement this section.
3605	Section 58.  Section 400.444, Florida Statutes, is
3606	renumbered as section 429.44, Florida Statutes, and amended to
3607	read:
3608	429.44 400.444  Construction and renovation;
3609	requirements.--
3610	(1)  The requirements for the construction and renovation
3611	of a facility shall comply with the provisions of chapter 553
3612	which pertain to building construction standards, including
3613	plumbing, electrical code, glass, manufactured buildings,
3614	accessibility for persons with disabilities, and the state
3615	minimum building code and with the provisions of s. 633.022,
3616	which pertain to uniform firesafety standards.
3617	(2)  Upon notification by the local authority having
3618	jurisdiction over life-threatening violations which seriously
3619	threaten the health, safety, or welfare of a resident of a
3620	facility, the agency shall take action as specified in s. 429.14
3621	s. 400.414.
3622	(3)  The department may adopt rules to establish procedures
3623	and specify the documentation necessary to implement this
3624	section.
3625	Section 59.  Section 400.447, Florida Statutes, is
3626	renumbered as section 429.47, Florida Statutes, and amended to
3627	read:
3628	429.47 400.447  Prohibited acts; penalties for violation.--
3629	(1)  It is unlawful for any person or public body to offer
3630	or advertise to the public, in any way by any medium whatever,
3631	personal services as defined in this act, without obtaining a
3632	valid current license. It is unlawful for any holder of a
3633	license issued pursuant to the provisions of this act to
3634	advertise or hold out to the public that it holds a license for
3635	a facility other than that for which it actually holds a
3636	license.
3637	(2)  It is unlawful for any holder of a license issued
3638	pursuant to the provisions of this act to withhold from the
3639	agency any evidence of financial instability, including, but not
3640	limited to, bad checks, delinquent accounts, nonpayment of
3641	withholding taxes, unpaid utility expenses, nonpayment for
3642	essential services, or adverse court action concerning the
3643	financial viability of the facility or any other facility
3644	licensed under this part or under part II of chapter 400 or part
3645	III of this chapter which is owned by the licensee.
3646	(3)  Any person found guilty of violating subsection (1) or
3647	subsection (2) commits a misdemeanor of the second degree,
3648	punishable as provided in s. 775.083. Each day of continuing
3649	violation shall be considered a separate offense.
3650	(4)  While a facility is under construction, the owner may
3651	advertise to the public prior to obtaining a license. Facilities
3652	that are certified under chapter 651 shall comply with the
3653	advertising provisions of s. 651.095 rather than those provided
3654	for in this subsection.
3655	(5)  A freestanding facility shall not advertise or imply
3656	that any part of it is a nursing home. For the purpose of this
3657	subsection, "freestanding facility" means a facility that is not
3658	operated in conjunction with a nursing home to which residents
3659	of the facility are given priority when nursing care is
3660	required. A person who violates this subsection is subject to
3661	fine as specified in s. 429.19 s. 400.419.
3662	(6)  Any facility which is affiliated with any religious
3663	organization or which has a name implying religious affiliation
3664	shall include in its advertising whether or not it is affiliated
3665	with any religious organization and, if so, which organization.
3666	(7)  A facility licensed under this part which is not part
3667	of a facility authorized under chapter 651 shall include the
3668	facility's license number as given by the agency in all
3669	advertising. A company or person owning more than one facility
3670	shall include at least one license number per advertisement. All
3671	advertising shall include the term "assisted living facility"
3672	before the license number.
3673	Section 60.  Section 400.452, Florida Statutes, is
3674	renumbered as section 429.52, Florida Statutes, and amended to
3675	read:
3676	429.52 400.452  Staff training and educational programs;
3677	core educational requirement.--
3678	(1)  Administrators and other assisted living facility
3679	staff must meet minimum training and education requirements
3680	established by the Department of Elderly Affairs by rule. This
3681	training and education is intended to assist facilities to
3682	appropriately respond to the needs of residents, to maintain
3683	resident care and facility standards, and to meet licensure
3684	requirements.
3685	(2)  The department shall establish a competency test and a
3686	minimum required score to indicate successful completion of the
3687	training and educational requirements. The competency test must
3688	be developed by the department in conjunction with the agency
3689	and providers. The required training and education must cover at
3690	least the following topics:
3691	(a)  State law and rules relating to assisted living
3692	facilities.
3693	(b)  Resident rights and identifying and reporting abuse,
3694	neglect, and exploitation.
3695	(c)  Special needs of elderly persons, persons with mental
3696	illness, and persons with developmental disabilities and how to
3697	meet those needs.
3698	(d)  Nutrition and food service, including acceptable
3699	sanitation practices for preparing, storing, and serving food.
3700	(e)  Medication management, recordkeeping, and proper
3701	techniques for assisting residents with self-administered
3702	medication.
3703	(f)  Firesafety requirements, including fire evacuation
3704	drill procedures and other emergency procedures.
3705	(g)  Care of persons with Alzheimer's disease and related
3706	disorders.
3707	(3)  Effective January 1, 2004, a new facility
3708	administrator must complete the required training and education,
3709	including the competency test, within a reasonable time after
3710	being employed as an administrator, as determined by the
3711	department. Failure to do so is a violation of this part and
3712	subjects the violator to an administrative fine as prescribed in
3713	s. 429.19 s. 400.419. Administrators licensed in accordance with
3714	chapter 468, part II, are exempt from this requirement. Other
3715	licensed professionals may be exempted, as determined by the
3716	department by rule.
3717	(4)  Administrators are required to participate in
3718	continuing education for a minimum of 12 contact hours every 2
3719	years.
3720	(5)  Staff involved with the management of medications and
3721	assisting with the self-administration of medications under s.
3722	429.256 s. 400.4256 must complete a minimum of 4 additional
3723	hours of training provided by a registered nurse, licensed
3724	pharmacist, or department staff. The department shall establish
3725	by rule the minimum requirements of this additional training.
3726	(6)  Other facility staff shall participate in training
3727	relevant to their job duties as specified by rule of the
3728	department.
3729	(7)  If the department or the agency determines that there
3730	are problems in a facility that could be reduced through
3731	specific staff training or education beyond that already
3732	required under this section, the department or the agency may
3733	require, and provide, or cause to be provided, the training or
3734	education of any personal care staff in the facility.
3735	(8)  The department shall adopt rules related to these
3736	training requirements, the competency test, necessary
3737	procedures, and competency test fees.
3738	Section 61.  Subsections (1), (10), and (18) of section
3739	400.462, Florida Statutes, are amended to read:
3740	400.462  Definitions.--As used in this part, the term:
3741	(1)  "Administrator" means a direct employee, as defined in
3742	subsection (9). The administrator must be a licensed physician,
3743	physician assistant, or registered nurse licensed to practice in
3744	this state or an individual having at least 1 year of
3745	supervisory or administrative experience in home health care or
3746	in a facility licensed under chapter 395, or under part II or
3747	part III of this chapter, or chapter 429. An administrator may
3748	manage a maximum of five licensed home health agencies located
3749	within one agency service district or within an immediately
3750	contiguous county. If the home health agency is licensed under
3751	this chapter and is part of a retirement community that provides
3752	multiple levels of care, an employee of the retirement community
3753	may administer the home health agency and up to a maximum of
3754	four entities licensed under this chapter or chapter 429 that
3755	are owned, operated, or managed by the same corporate entity. An
3756	administrator shall designate, in writing, for each licensed
3757	entity, a qualified alternate administrator to serve during
3758	absences.
3759	(10)  "Director of nursing" means a registered nurse who is
3760	a direct employee, as defined in subsection (9), of the agency
3761	and who is a graduate of an approved school of nursing and is
3762	licensed in this state; who has at least 1 year of supervisory
3763	experience as a registered nurse; and who is responsible for
3764	overseeing the professional nursing and home health aid delivery
3765	of services of the agency. A director of nursing may be the
3766	director of a maximum of five licensed home health agencies
3767	operated by a related business entity and located within one
3768	agency service district or within an immediately contiguous
3769	county. If the home health agency is licensed under this chapter
3770	and is part of a retirement community that provides multiple
3771	levels of care, an employee of the retirement community may
3772	serve as the director of nursing of the home health agency and
3773	of up to four entities licensed under this chapter or chapter
3774	429 which are owned, operated, or managed by the same corporate
3775	entity.
3776	(18)  "Nurse registry" means any person that procures,
3777	offers, promises, or attempts to secure health-care-related
3778	contracts for registered nurses, licensed practical nurses,
3779	certified nursing assistants, home health aides, companions, or
3780	homemakers, who are compensated by fees as independent
3781	contractors, including, but not limited to, contracts for the
3782	provision of services to patients and contracts to provide
3783	private duty or staffing services to health care facilities
3784	licensed under chapter 395, or this chapter, or chapter 429 or
3785	other business entities.
3786	Section 62.  Paragraphs (h), (i), and (n) of subsection (5)
3787	of section 400.464, Florida Statutes, are amended to read:
3788	400.464  Home health agencies to be licensed; expiration of
3789	license; exemptions; unlawful acts; penalties.--
3790	(5)  The following are exempt from the licensure
3791	requirements of this part:
3792	(h)  The delivery of assisted living facility services for
3793	which the assisted living facility is licensed under part I III
3794	of this chapter 429, to serve its residents in its facility.
3795	(i)  The delivery of hospice services for which the hospice
3796	is licensed under part IV VI of this chapter, to serve hospice
3797	patients admitted to its service.
3798	(n)  The delivery of adult family care home services for
3799	which the adult family care home is licensed under part II VII
3800	of this chapter 429, to serve the residents in its facility.
3801	Section 63.  Subsection (2) of section 400.497, Florida
3802	Statutes, is amended to read:
3803	400.497  Rules establishing minimum standards.--The agency
3804	shall adopt, publish, and enforce rules to implement this part,
3805	including, as applicable, ss. 400.506 and 400.509, which must
3806	provide reasonable and fair minimum standards relating to:
3807	(2)  Shared staffing. The agency shall allow shared
3808	staffing if the home health agency is part of a retirement
3809	community that provides multiple levels of care, is located on
3810	one campus, is licensed under this chapter or chapter 429, and
3811	otherwise meets the requirements of law and rule.
3812	Section 64.  Section 400.552, Florida Statutes, is
3813	renumbered as section 429.903, Florida Statutes, and amended to
3814	read:
3815	429.903 400.552  Applicability.--Any facility that comes
3816	within the definition of an adult day care center which is not
3817	exempt under s. 429.905 s. 400.553 must be licensed by the
3818	agency as an adult day care center.
3819	Section 65.  Section 400.555, Florida Statutes, is
3820	renumbered as section 429.909, Florida Statutes, and amended to
3821	read:
3822	429.909 400.555  Application for license.--
3823	(1)  An application for a license to operate an adult day
3824	care center must be made to the agency on forms furnished by the
3825	agency and must be accompanied by the appropriate license fee
3826	unless the applicant is exempt from payment of the fee as
3827	provided in s. 429.907(4) s. 400.554(4).
3828	(2)  The applicant for licensure must furnish:
3829	(a)  A description of the physical and mental capabilities
3830	and needs of the participants to be served and the availability,
3831	frequency, and intensity of basic services and of supportive and
3832	optional services to be provided;
3833	(b)  Satisfactory proof of financial ability to operate and
3834	conduct the center in accordance with the requirements of this
3835	part, which must include, in the case of an initial application,
3836	a 1-year operating plan and proof of a 3-month operating reserve
3837	fund; and
3838	(c)  Proof of adequate liability insurance coverage.
3839	(d)  Proof of compliance with level 2 background screening
3840	as required under s. 429.919 s. 400.5572.
3841	(e)  A description and explanation of any exclusions,
3842	permanent suspensions, or terminations of the application from
3843	the Medicare or Medicaid programs. Proof of compliance with
3844	disclosure of ownership and control interest requirements of the
3845	Medicare or Medicaid programs shall be accepted in lieu of this
3846	submission.
3847	Section 66.  Section 400.556, Florida Statutes, is
3848	renumbered as section 429.911, Florida Statutes, and amended to
3849	read:
3850	429.911 400.556  Denial, suspension, revocation of license;
3851	administrative fines; investigations and inspections.--
3852	(1)  The agency may deny, revoke, or suspend a license
3853	under this part or may impose an administrative fine against the
3854	owner of an adult day care center or its operator or employee in
3855	the manner provided in chapter 120.
3856	(2)  Each of the following actions by the owner of an adult
3857	day care center or by its operator or employee is a ground for
3858	action by the agency against the owner of the center or its
3859	operator or employee:
3860	(a)  An intentional or negligent act materially affecting
3861	the health or safety of center participants.
3862	(b)  A violation of this part or of any standard or rule
3863	under this part.
3864	(c)  A failure of persons subject to level 2 background
3865	screening under s. 429.174(1) s. 400.4174(1) to meet the
3866	screening standards of s. 435.04, or the retention by the center
3867	of an employee subject to level 1 background screening standards
3868	under s. 429.174(2) s. 400.4174(2) who does not meet the
3869	screening standards of s. 435.03 and for whom exemptions from
3870	disqualification have not been provided by the agency.
3871	(d)  Failure to follow the criteria and procedures provided
3872	under part I of chapter 394 relating to the transportation,
3873	voluntary admission, and involuntary examination of center
3874	participants.
3875	(e)  Multiple or repeated violations of this part or of any
3876	standard or rule adopted under this part.
3877	(f)  Exclusion, permanent suspension, or termination of the
3878	owner, if an individual, officer, or board member of the adult
3879	day care center, if the owner is a firm, corporation,
3880	partnership, or association, or any person owning 5 percent or
3881	more of the center, from the Medicare or Medicaid program.
3882	(3)  The agency is responsible for all investigations and
3883	inspections conducted pursuant to this part.
3884	Section 67.  Section 400.557, Florida Statutes, is
3885	renumbered as section 429.915, Florida Statutes, and amended to
3886	read:
3887	429.915 400.557  Expiration of license; renewal;
3888	conditional license or permit.--
3889	(1)  A license issued for the operation of an adult day
3890	care center, unless sooner suspended or revoked, expires 2 years
3891	after the date of issuance. The agency shall notify a licensee
3892	at least 120 days before the expiration date that license
3893	renewal is required to continue operation. The notification must
3894	be provided electronically or by mail delivery. At least 90 days
3895	prior to the expiration date, an application for renewal must be
3896	submitted to the agency. A license shall be renewed, upon the
3897	filing of an application on forms furnished by the agency, if
3898	the applicant has first met the requirements of this part and of
3899	the rules adopted under this part. The applicant must file with
3900	the application satisfactory proof of financial ability to
3901	operate the center in accordance with the requirements of this
3902	part and in accordance with the needs of the participants to be
3903	served and an affidavit of compliance with the background
3904	screening requirements of s. 429.919 s. 400.5572.
3905	(2)  A licensee against whom a revocation or suspension
3906	proceeding is pending at the time for license renewal may be
3907	issued a conditional license effective until final disposition
3908	by the agency of the proceeding. If judicial relief is sought
3909	from the final disposition, the court having jurisdiction may
3910	issue a conditional permit effective for the duration of the
3911	judicial proceeding.
3912	(3)  The agency may issue a conditional license to an
3913	applicant for license renewal or change of ownership if the
3914	applicant fails to meet all standards and requirements for
3915	licensure. A conditional license issued under this subsection
3916	must be limited to a specific period not exceeding 6 months, as
3917	determined by the agency, and must be accompanied by an approved
3918	plan of correction.
3919	Section 68.  Section 400.5572, Florida Statutes, is
3920	renumbered as section 429.919, Florida Statutes, and amended to
3921	read:
3922	429.919 400.5572  Background screening.--
3923	(1)(a)  Level 2 background screening must be conducted on
3924	each of the following persons, who shall be considered employees
3925	for the purposes of conducting screening under chapter 435:
3926	1.  The adult day care center owner if an individual, the
3927	operator, and the financial officer.
3928	2.  An officer or board member if the owner of the adult
3929	day care center is a firm, corporation, partnership, or
3930	association, or any person owning 5 percent or more of the
3931	facility, if the agency has probable cause to believe that such
3932	person has been convicted of any offense prohibited by s.
3933	435.04. For each officer, board member, or person owning 5
3934	percent or more who has been convicted of any such offense, the
3935	facility shall submit to the agency a description and
3936	explanation of the conviction at the time of license
3937	application. This subparagraph does not apply to a board member
3938	of a not-for-profit corporation or organization if the board
3939	member serves solely in a voluntary capacity, does not regularly
3940	take part in the day-to-day operational decisions of the
3941	corporation or organization, receives no remuneration for his or
3942	her services, and has no financial interest and has no family
3943	members with a financial interest in the corporation or
3944	organization, provided that the board member and facility submit
3945	a statement affirming that the board member's relationship to
3946	the facility satisfies the requirements of this subparagraph.
3947	(b)  Proof of compliance with level 2 screening standards
3948	which has been submitted within the previous 5 years to meet any
3949	facility or professional licensure requirements of the agency or
3950	the Department of Health satisfies the requirements of this
3951	subsection.
3952	(c)  The agency may grant a provisional license to an adult
3953	day care center applying for an initial license when each
3954	individual required by this subsection to undergo screening has
3955	completed the Department of Law Enforcement background check,
3956	but has not yet received results from the Federal Bureau of
3957	Investigation, or when a request for an exemption from
3958	disqualification has been submitted to the agency pursuant to s.
3959	435.07, but a response has not been issued.
3960	(2)  The owner or administrator of an adult day care center
3961	must conduct level 1 background screening as set forth in
3962	chapter 435 on all employees hired on or after October 1, 1998,
3963	who provide basic services or supportive and optional services
3964	to the participants. Such persons satisfy this requirement if:
3965	(a)  Proof of compliance with level 1 screening
3966	requirements obtained to meet any professional license
3967	requirements in this state is provided and accompanied, under
3968	penalty of perjury, by a copy of the person's current
3969	professional license and an affidavit of current compliance with
3970	the background screening requirements.
3971	(b)  The person required to be screened has been
3972	continuously employed, without a breach in service that exceeds
3973	180 days, in the same type of occupation for which the person is
3974	seeking employment and provides proof of compliance with the
3975	level 1 screening requirement which is no more than 2 years old.
3976	Proof of compliance must be provided directly from one employer
3977	or contractor to another, and not from the person screened. Upon
3978	request, a copy of screening results shall be provided to the
3979	person screened by the employer retaining documentation of the
3980	screening.
3981	(c)  The person required to be screened is employed by a
3982	corporation or business entity or related corporation or
3983	business entity that owns, operates, or manages more than one
3984	facility or agency licensed under this chapter or under chapter
3985	400, and for whom a level 1 screening was conducted by the
3986	corporation or business entity as a condition of initial or
3987	continued employment.
3988	Section 69.  Subsection (5) of section 400.601, Florida
3989	Statutes, is amended to read:
3990	400.601  Definitions.--As used in this part, the term:
3991	(5)  "Hospice residential unit" means a homelike living
3992	facility, other than a facility licensed under other parts of
3993	this chapter, or under chapter 395, or under chapter 429, that
3994	is operated by a hospice for the benefit of its patients and is
3995	considered by a patient who lives there to be his or her primary
3996	residence.
3997	Section 70.  Section 400.618, Florida Statutes, is
3998	renumbered as section 429.65, Florida Statutes, and amended to
3999	read:
4000	429.65 400.618  Definitions.--As used in this part, the
4001	term:
4002	(1)  "Activities of daily living" means functions and tasks
4003	for self-care, including eating, bathing, grooming, dressing,
4004	ambulating, and other similar tasks.
4005	(2)  "Adult family-care home" means a full-time, family-
4006	type living arrangement, in a private home, under which a person
4007	who owns or rents the home provides room, board, and personal
4008	care, on a 24-hour basis, for no more than five disabled adults
4009	or frail elders who are not relatives. The following family-type
4010	living arrangements are not required to be licensed as an adult
4011	family-care home:
4012	(a)  An arrangement whereby the person who owns or rents
4013	the home provides room, board, and personal services for not
4014	more than two adults who do not receive optional state
4015	supplementation under s. 409.212. The person who provides the
4016	housing, meals, and personal care must own or rent the home and
4017	reside therein.
4018	(b)  An arrangement whereby the person who owns or rents
4019	the home provides room, board, and personal services only to his
4020	or her relatives.
4021	(c)  An establishment that is licensed as an assisted
4022	living facility under this chapter part III.
4023	(3)  "Agency" means the Agency for Health Care
4024	Administration.
4025	(4)  "Aging in place" means remaining in a noninstitutional
4026	living environment despite the physical or mental changes that
4027	may occur in a person who is aging. For aging in place to occur,
4028	needed services are added, increased, or adjusted to compensate
4029	for a person's physical or mental changes.
4030	(5)  "Appropriate placement" means that the resident's
4031	needs can be met by the adult family-care home or can be met by
4032	services arranged by the adult family-care home or the resident.
4033	(6)  "Chemical restraint" means a pharmacologic drug that
4034	physically limits, restricts, or deprives an individual of
4035	movement or mobility, and is used for discipline or convenience
4036	and not required for the treatment of medical symptoms.
4037	(7)  "Department" means the Department of Elderly Affairs.
4038	(8)  "Disabled adult" means any person between 18 and 59
4039	years of age, inclusive, who is a resident of the state and who
4040	has one or more permanent physical or mental limitations that
4041	restrict the person's ability to perform the normal activities
4042	of daily living.
4043	(9)  "Frail elder" means a functionally impaired elderly
4044	person who is 60 years of age or older and who has physical or
4045	mental limitations that restrict the person's ability to perform
4046	the normal activities of daily living and that impede the
4047	person's capacity to live independently.
4048	(10)  "Personal services" or "personal care" includes
4049	individual assistance with or supervision of the activities of
4050	daily living and the self-administration of medication, and
4051	other similar services.
4052	(11)  "Provider" means a person who is licensed to operate
4053	an adult family-care home.
4054	(12)  "Relative" means an individual who is the father,
4055	mother, son, daughter, brother, sister, grandfather,
4056	grandmother, great-grandfather, great-grandmother, uncle, aunt,
4057	first cousin, nephew, niece, husband, wife, father-in-law,
4058	mother-in-law, son-in-law, daughter-in-law, brother-in-law,
4059	sister-in-law, stepfather, stepmother, stepson, stepdaughter,
4060	stepbrother, stepsister, half brother, or half sister of a
4061	provider.
4062	(13)  "Relief person" means an adult designated by the
4063	provider to supervise the residents during the provider's
4064	absence.
4065	(14)  "Resident" means a person receiving room, board, and
4066	personal care in an adult family-care home.
4067	Section 71.  Section 400.6194, Florida Statutes, is
4068	renumbered as section 429.69, Florida Statutes, and amended to
4069	read:
4070	429.69 400.6194  Denial, revocation, or suspension of a
4071	license.--The agency may deny, suspend, or revoke a license for
4072	any of the following reasons:
4073	(1)  Failure of any of the persons required to undergo
4074	background screening under s. 429.67 s. 400.619 to meet the
4075	level 1 screening standards of s. 435.03, unless an exemption
4076	from disqualification has been provided by the agency.
4077	(2)  An intentional or negligent act materially affecting
4078	the health, safety, or welfare of the adult family-care home
4079	residents.
4080	(3)  Submission of fraudulent information or omission of
4081	any material fact on a license application or any other document
4082	required by the agency.
4083	(4)  Failure to pay an administrative fine assessed under
4084	this part.
4085	(5)  A violation of this part or adopted rules which
4086	results in conditions or practices that directly threaten the
4087	physical or emotional health, safety, or welfare of residents.
4088	(6)  Failure to correct cited fire code violations that
4089	threaten the health, safety, or welfare of residents.
4090	(7)  Failure to submit a completed initial license
4091	application or to complete an application for license renewal
4092	within the specified timeframes.
4093	(8)  Exclusion, permanent suspension, or termination of the
4094	provider from the Medicare or Medicaid program.
4095	Section 72.  Section 400.621, Florida Statutes, is
4096	renumbered as section 429.73, Florida Statutes, and amended to
4097	read:
4098	429.73 400.621  Rules and standards relating to adult
4099	family-care homes.--
4100	(1)  The department, in consultation with the Department of
4101	Health, the Department of Children and Family Services, and the
4102	agency shall, by rule, establish minimum standards to ensure the
4103	health, safety, and well-being of each resident in the adult
4104	family-care home. The rules must address:
4105	(a)  Requirements for the physical site of the facility and
4106	facility maintenance.
4107	(b)  Services that must be provided to all residents of an
4108	adult family-care home and standards for such services, which
4109	must include, but need not be limited to:
4110	1.  Room and board.
4111	2.  Assistance necessary to perform the activities of daily
4112	living.
4113	3.  Assistance necessary to administer medication.
4114	4.  Supervision of residents.
4115	5.  Health monitoring.
4116	6.  Social and leisure activities.
4117	(c)  Standards and procedures for license application and
4118	annual license renewal, advertising, proper management of each
4119	resident's funds and personal property and personal affairs,
4120	financial ability to operate, medication management,
4121	inspections, complaint investigations, and facility, staff, and
4122	resident records.
4123	(d)  Qualifications, training, standards, and
4124	responsibilities for providers and staff.
4125	(e)  Compliance with chapter 419, relating to community
4126	residential homes.
4127	(f)  Criteria and procedures for determining the
4128	appropriateness of a resident's placement and continued
4129	residency in an adult family-care home. A resident who requires
4130	24-hour nursing supervision may not be retained in an adult
4131	family-care home unless such resident is an enrolled hospice
4132	patient and the resident's continued residency is mutually
4133	agreeable to the resident and the provider.
4134	(g)  Procedures for providing notice and assuring the least
4135	possible disruption of residents' lives when residents are
4136	relocated, an adult family-care home is closed, or the ownership
4137	of an adult family-care home is transferred.
4138	(h)  Procedures to protect the residents' rights as
4139	provided in s. 429.85 s. 400.628.
4140	(i)  Procedures to promote the growth of adult family-care
4141	homes as a component of a long-term care system.
4142	(j)  Procedures to promote the goal of aging in place for
4143	residents of adult family-care homes.
4144	(2)  The department shall by rule provide minimum standards
4145	and procedures for emergencies. Pursuant to s. 633.022, the
4146	State Fire Marshal, in consultation with the department and the
4147	agency, shall adopt uniform firesafety standards for adult
4148	family-care homes.
4149	(3)  The department shall adopt rules providing for the
4150	implementation of orders not to resuscitate. The provider may
4151	withhold or withdraw cardiopulmonary resuscitation if presented
4152	with an order not to resuscitate executed pursuant to s. 401.45.
4153	The provider shall not be subject to criminal prosecution or
4154	civil liability, nor be considered to have engaged in negligent
4155	or unprofessional conduct, for withholding or withdrawing
4156	cardiopulmonary resuscitation pursuant to such an order and
4157	rules adopted by the department.
4158	(4)  The provider of any adult family-care home that is in
4159	operation at the time any rules are adopted or amended under
4160	this part may be given a reasonable time, not exceeding 6
4161	months, within which to comply with the new or revised rules and
4162	standards.
4163	Section 73.  Section 400.628, Florida Statutes, is
4164	renumbered as section 429.85, Florida Statutes, and amended to
4165	read:
4166	429.85 400.628  Residents' bill of rights.--
4167	(1)  A resident of an adult family-care home may not be
4168	deprived of any civil or legal rights, benefits, or privileges
4169	guaranteed by law, the State Constitution, or the Constitution
4170	of the United States solely by reason of status as a resident of
4171	the home. Each resident has the right to:
4172	(a)  Live in a safe and decent living environment, free
4173	from abuse and neglect.
4174	(b)  Be treated with consideration and respect and with due
4175	recognition of personal dignity, individuality, and privacy.
4176	(c)  Keep and use the resident's own clothes and other
4177	personal property in the resident's immediate living quarters,
4178	so as to maintain individuality and personal dignity, except
4179	when the provider can demonstrate that to do so would be unsafe
4180	or an infringement upon the rights of other residents.
4181	(d)  Have unrestricted private communication, including
4182	receiving and sending unopened correspondence, having access to
4183	a telephone, and visiting with any person of his or her choice,
4184	at any time between the hours of 9 a.m. and 9 p.m. at a minimum.
4185	(e)  Be free to participate in and benefit from community
4186	services and activities and to achieve the highest possible
4187	level of independence, autonomy, and interaction within the
4188	community.
4189	(f)  Manage the resident's own financial affairs unless the
4190	resident or the resident's guardian authorizes the provider to
4191	provide safekeeping for funds in accordance with procedures
4192	equivalent to those provided in s. 429.27 s. 400.427.
4193	(g)  Share a room with the resident's spouse if both are
4194	residents of the home.
4195	(h)  Have reasonable opportunity for regular exercise
4196	several times a week and to be outdoors at regular and frequent
4197	intervals.
4198	(i)  Exercise civil and religious liberties, including the
4199	right to independent personal decisions. Religious beliefs or
4200	practices and attendance at religious services may not be
4201	imposed upon a resident.
4202	(j)  Have access to adequate and appropriate health care.
4203	(k)  Be free from chemical and physical restraints.
4204	(l)  Have at least 30 days' notice of relocation or
4205	termination of residency from the home unless, for medical
4206	reasons, the resident is certified by a physician to require an
4207	emergency relocation to a facility providing a more skilled
4208	level of care or the resident engages in a pattern of conduct
4209	that is harmful or offensive to other residents. If a resident
4210	has been adjudicated mentally incompetent, the resident's
4211	guardian must be given at least 30 days' notice, except in an
4212	emergency, of the relocation of a resident or of the termination
4213	of a residency. The reasons for relocating a resident must be
4214	set forth in writing.
4215	(m)  Present grievances and recommend changes to the
4216	provider, to staff, or to any other person without restraint,
4217	interference, coercion, discrimination, or reprisal. This right
4218	includes the right to have access to ombudsman volunteers and
4219	advocates and the right to be a member of, to be active in, and
4220	to associate with advocacy or special interest groups.
4221	(2)  The provider shall ensure that residents and their
4222	legal representatives are made aware of the rights, obligations,
4223	and prohibitions set forth in this part. Residents must also be
4224	given the names, addresses, and telephone numbers of the local
4225	ombudsman council and the central abuse hotline where they may
4226	lodge complaints.
4227	(3)  The adult family-care home may not hamper or prevent
4228	residents from exercising the rights specified in this section.
4229	(4)  A provider or staff of an adult family-care home may
4230	not serve notice upon a resident to leave the premises or take
4231	any other retaliatory action against any person who:
4232	(a)  Exercises any right set forth in this section.
4233	(b)  Appears as a witness in any hearing, in or out of the
4234	adult family-care home.
4235	(c)  Files a civil action alleging a violation of this part
4236	or notifies a state attorney or the Attorney General of a
4237	possible violation of this part.
4238	(5)  Any adult family-care home that terminates the
4239	residency of an individual who has participated in activities
4240	specified in subsection (4) must show good cause for the
4241	termination in a court of competent jurisdiction.
4242	(6)  Any person who reports a complaint concerning a
4243	suspected violation of this part or the services and conditions
4244	in an adult family-care home, or who testifies in any
4245	administrative or judicial proceeding arising from such a
4246	complaint, is immune from any civil or criminal liability
4247	therefor, unless the person acted in bad faith or with malicious
4248	purpose or the court finds that there was a complete absence of
4249	a justiciable issue of either law or fact raised by the losing
4250	party.
4251	Section 74.  Paragraphs (c), (d), (e), and (f) of
4252	subsection (5) of section 400.93, Florida Statutes, are amended
4253	to read:
4254	400.93  Licensure required; exemptions; unlawful acts;
4255	penalties.--
4256	(5)  The following are exempt from home medical equipment
4257	provider licensure, unless they have a separate company,
4258	corporation, or division that is in the business of providing
4259	home medical equipment and services for sale or rent to
4260	consumers at their regular or temporary place of residence
4261	pursuant to the provisions of this part:
4262	(c)  Assisted living facilities licensed under chapter 429
4263	part III, when serving their residents.
4264	(d)  Home health agencies licensed under part III IV.
4265	(e)  Hospices licensed under part IV VI.
4266	(f)  Intermediate care facilities, homes for special
4267	services, and transitional living facilities licensed under part
4268	V VIII.
4269	Section 75.  Paragraph (c) of subsection (10) of section
4270	400.962, Florida Statutes, is amended to read:
4271	400.962  License required; license application.--
4272	(10)
4273	(c)  Proof of compliance with the level 2 background
4274	screening requirements of chapter 435 which has been submitted
4275	within the previous 5 years in compliance with any other
4276	licensure requirements under this chapter or chapter 429
4277	satisfies the requirements of paragraph (a). Proof of compliance
4278	with background screening which has been submitted within the
4279	previous 5 years to fulfill the requirements of the Financial
4280	Services Commission and the Office of Insurance Regulation under
4281	chapter 651 as part of an application for a certificate of
4282	authority to operate a continuing care retirement community
4283	satisfies the requirements for the Department of Law Enforcement
4284	and Federal Bureau of Investigation background checks.
4285	Section 76.  Paragraph (b) of subsection (1) of section
4286	400.980, Florida Statutes, is amended to read:
4287	400.980  Health care services pools.--
4288	(1)  As used in this section, the term:
4289	(b)  "Health care services pool" means any person, firm,
4290	corporation, partnership, or association engaged for hire in the
4291	business of providing temporary employment in health care
4292	facilities, residential facilities, and agencies for licensed,
4293	certified, or trained health care personnel including, without
4294	limitation, nursing assistants, nurses' aides, and orderlies.
4295	However, the term does not include nursing registries, a
4296	facility licensed under this chapter or chapter 429 400, a
4297	health care services pool established within a health care
4298	facility to provide services only within the confines of such
4299	facility, or any individual contractor directly providing
4300	temporary services to a health care facility without use or
4301	benefit of a contracting agent.
4302	Section 77.  Paragraphs (a), (b), (c), and (d) of
4303	subsection (4) of section 400.9905, Florida Statutes, are
4304	amended to read:
4305	400.9905  Definitions.--
4306	(4)  "Clinic" means an entity at which health care services
4307	are provided to individuals and which tenders charges for
4308	reimbursement for such services, including a mobile clinic and a
4309	portable equipment provider. For purposes of this part, the term
4310	does not include and the licensure requirements of this part do
4311	not apply to:
4312	(a)  Entities licensed or registered by the state under
4313	chapter 395; or entities licensed or registered by the state and
4314	providing only health care services within the scope of services
4315	authorized under their respective licenses granted under ss.
4316	383.30-383.335, chapter 390, chapter 394, chapter 397, this
4317	chapter except part X XIII, chapter 429, chapter 463, chapter
4318	465, chapter 466, chapter 478, part I of chapter 483, chapter
4319	484, or chapter 651; end-stage renal disease providers
4320	authorized under 42 C.F.R. part 405, subpart U; or providers
4321	certified under 42 C.F.R. part 485, subpart B or subpart H; or
4322	any entity that provides neonatal or pediatric hospital-based
4323	health care services by licensed practitioners solely within a
4324	hospital licensed under chapter 395.
4325	(b)  Entities that own, directly or indirectly, entities
4326	licensed or registered by the state pursuant to chapter 395; or
4327	entities that own, directly or indirectly, entities licensed or
4328	registered by the state and providing only health care services
4329	within the scope of services authorized pursuant to their
4330	respective licenses granted under ss. 383.30-383.335, chapter
4331	390, chapter 394, chapter 397, this chapter except part X XIII,
4332	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
4333	part I of chapter 483, chapter 484, chapter 651; end-stage renal
4334	disease providers authorized under 42 C.F.R. part 405, subpart
4335	U; or providers certified under 42 C.F.R. part 485, subpart B or
4336	subpart H; or any entity that provides neonatal or pediatric
4337	hospital-based health care services by licensed practitioners
4338	solely within a hospital licensed under chapter 395.
4339	(c)  Entities that are owned, directly or indirectly, by an
4340	entity licensed or registered by the state pursuant to chapter
4341	395; or entities that are owned, directly or indirectly, by an
4342	entity licensed or registered by the state and providing only
4343	health care services within the scope of services authorized
4344	pursuant to their respective licenses granted under ss. 383.30-
4345	383.335, chapter 390, chapter 394, chapter 397, this chapter
4346	except part X XIII, chapter 429, chapter 463, chapter 465,
4347	chapter 466, chapter 478, part I of chapter 483, chapter 484, or
4348	chapter 651; end-stage renal disease providers authorized under
4349	42 C.F.R. part 405, subpart U; or providers certified under 42
4350	C.F.R. part 485, subpart B or subpart H; or any entity that
4351	provides neonatal or pediatric hospital-based health care
4352	services by licensed practitioners solely within a hospital
4353	under chapter 395.
4354	(d)  Entities that are under common ownership, directly or
4355	indirectly, with an entity licensed or registered by the state
4356	pursuant to chapter 395; or entities that are under common
4357	ownership, directly or indirectly, with an entity licensed or
4358	registered by the state and providing only health care services
4359	within the scope of services authorized pursuant to their
4360	respective licenses granted under ss. 383.30-383.335, chapter
4361	390, chapter 394, chapter 397, this chapter except part X XIII,
4362	chapter 429, chapter 463, chapter 465, chapter 466, chapter 478,
4363	part I of chapter 483, chapter 484, or chapter 651; end-stage
4364	renal disease providers authorized under 42 C.F.R. part 405,
4365	subpart U; or providers certified under 42 C.F.R. part 485,
4366	subpart B or subpart H; or any entity that provides neonatal or
4367	pediatric hospital-based health care services by licensed
4368	practitioners solely within a hospital licensed under chapter
4369	395.
4370	Section 78.  Subsection (12) of section 401.23, Florida
4371	Statutes, is amended to read:
4372	401.23  Definitions.--As used in this part, the term:
4373	(12)  "Interfacility transfer" means the transportation by
4374	ambulance of a patient between two facilities licensed under
4375	chapter 393, chapter 395, or chapter 400, or chapter 429,
4376	pursuant to this part.
4377	Section 79.  Paragraph (b) of subsection (2) of section
4378	402.164, Florida Statutes, is amended to read:
4379	402.164  Legislative intent; definitions.--
4380	(2)  As used in ss. 402.164-402.167, the term:
4381	(b)  "Client" means a client as defined in s. 393.063, s.
4382	394.67, s. 397.311, or s. 400.960, a forensic client or client
4383	as defined in s. 916.106, a child or youth as defined in s.
4384	39.01, a child as defined in s. 827.01, a family as defined in
4385	s. 414.0252, a participant as defined in s. 429.901 s. 400.551,
4386	a resident as defined in s. 429.02 s. 400.402, a Medicaid
4387	recipient or recipient as defined in s. 409.901, a child
4388	receiving child care as defined in s. 402.302, a disabled adult
4389	as defined in s. 410.032 or s. 410.603, or a victim as defined
4390	in s. 39.01 or s. 415.102 as each definition applies within its
4391	respective chapter.
4392	Section 80.  Subsection (10) of section 408.032, Florida
4393	Statutes, is amended to read:
4394	408.032  Definitions relating to Health Facility and
4395	Services Development Act.--As used in ss. 408.031-408.045, the
4396	term:
4397	(10)  "Hospice" or "hospice program" means a hospice as
4398	defined in part IV VI of chapter 400.
4399	Section 81.  Paragraph (b) of subsection (2) of section
4400	408.033, Florida Statutes, is amended to read:
4401	408.033  Local and state health planning.--
4402	(2)  FUNDING.--
4403	(b)1.  A hospital licensed under chapter 395, a nursing
4404	home licensed under chapter 400, and an assisted living facility
4405	licensed under chapter 429 400 shall be assessed an annual fee
4406	based on number of beds.
4407	2.  All other facilities and organizations listed in
4408	paragraph (a) shall each be assessed an annual fee of $150.
4409	3.  Facilities operated by the Department of Children and
4410	Family Services, the Department of Health, or the Department of
4411	Corrections and any hospital which meets the definition of rural
4412	hospital pursuant to s. 395.602 are exempt from the assessment
4413	required in this subsection.
4414	Section 82.  Subsection (2) of section 408.034, Florida
4415	Statutes, is amended to read:
4416	408.034  Duties and responsibilities of agency; rules.--
4417	(2)  In the exercise of its authority to issue licenses to
4418	health care facilities and health service providers, as provided
4419	under chapters 393 and, 395, and parts II and IV VI of chapter
4420	400, the agency may not issue a license to any health care
4421	facility or health service provider that fails to receive a
4422	certificate of need or an exemption for the licensed facility or
4423	service.
4424	Section 83.  Subsections (28) and (29) of section 408.07,
4425	Florida Statutes, are amended to read:
4426	408.07  Definitions.--As used in this chapter, with the
4427	exception of ss. 408.031-408.045, the term:
4428	(28)  "Home health agency" means an organization licensed
4429	under part III IV of chapter 400.
4430	(29)  "Hospice" means an organization licensed under part
4431	IV VI of chapter 400.
4432	Section 84.  Subsection (3) of section 408.831, Florida
4433	Statutes, is amended to read:
4434	408.831  Denial, suspension, or revocation of a license,
4435	registration, certificate, or application.--
4436	(3)  This section provides standards of enforcement
4437	applicable to all entities licensed or regulated by the Agency
4438	for Health Care Administration. This section controls over any
4439	conflicting provisions of chapters 39, 381, 383, 390, 391, 393,
4440	394, 395, 400, 408, 429, 468, 483, and 641 or rules adopted
4441	pursuant to those chapters.
4442	Section 85.  Subsection (2) of section 409.212, Florida
4443	Statutes, is amended to read:
4444	409.212  Optional supplementation.--
4445	(2)  The base rate of payment for optional state
4446	supplementation shall be established by the department within
4447	funds appropriated. Additional amounts may be provided for
4448	mental health residents in facilities designed to provide
4449	limited mental health services as provided for in s. 429.075 s.
4450	400.4075. The base rate of payment does not include the personal
4451	needs allowance.
4452	Section 86.  Paragraph (e) of subsection (4) of section
4453	409.221, Florida Statutes, is amended to read:
4454	409.221  Consumer-directed care program.--
4455	(4)  CONSUMER-DIRECTED CARE.--
4456	(e)  Services.--Consumers shall use the budget allowance
4457	only to pay for home and community-based services that meet the
4458	consumer's long-term care needs and are a cost-efficient use of
4459	funds. Such services may include, but are not limited to, the
4460	following:
4461	1.  Personal care.
4462	2.  Homemaking and chores, including housework, meals,
4463	shopping, and transportation.
4464	3.  Home modifications and assistive devices which may
4465	increase the consumer's independence or make it possible to
4466	avoid institutional placement.
4467	4.  Assistance in taking self-administered medication.
4468	5.  Day care and respite care services, including those
4469	provided by nursing home facilities pursuant to s. 400.141(6) or
4470	by adult day care facilities licensed pursuant to s. 429.907 s.
4471	400.554.
4472	6.  Personal care and support services provided in an
4473	assisted living facility.
4474	Section 87.  Subsection (4) of section 409.905, Florida
4475	Statutes, is amended to read:
4476	409.905  Mandatory Medicaid services.--The agency may make
4477	payments for the following services, which are required of the
4478	state by Title XIX of the Social Security Act, furnished by
4479	Medicaid providers to recipients who are determined to be
4480	eligible on the dates on which the services were provided. Any
4481	service under this section shall be provided only when medically
4482	necessary and in accordance with state and federal law.
4483	Mandatory services rendered by providers in mobile units to
4484	Medicaid recipients may be restricted by the agency. Nothing in
4485	this section shall be construed to prevent or limit the agency
4486	from adjusting fees, reimbursement rates, lengths of stay,
4487	number of visits, number of services, or any other adjustments
4488	necessary to comply with the availability of moneys and any
4489	limitations or directions provided for in the General
4490	Appropriations Act or chapter 216.
4491	(4)  HOME HEALTH CARE SERVICES.--The agency shall pay for
4492	nursing and home health aide services, supplies, appliances, and
4493	durable medical equipment, necessary to assist a recipient
4494	living at home. An entity that provides services pursuant to
4495	this subsection shall be licensed under part III IV of chapter
4496	400. These services, equipment, and supplies, or reimbursement
4497	therefor, may be limited as provided in the General
4498	Appropriations Act and do not include services, equipment, or
4499	supplies provided to a person residing in a hospital or nursing
4500	facility.
4501	(a)  In providing home health care services, the agency may
4502	require prior authorization of care based on diagnosis.
4503	(b)  The agency shall implement a comprehensive utilization
4504	management program that requires prior authorization of all
4505	private duty nursing services, an individualized treatment plan
4506	that includes information about medication and treatment orders,
4507	treatment goals, methods of care to be used, and plans for care
4508	coordination by nurses and other health professionals. The
4509	utilization management program shall also include a process for
4510	periodically reviewing the ongoing use of private duty nursing
4511	services. The assessment of need shall be based on a child's
4512	condition, family support and care supplements, a family's
4513	ability to provide care, and a family's and child's schedule
4514	regarding work, school, sleep, and care for other family
4515	dependents. When implemented, the private duty nursing
4516	utilization management program shall replace the current
4517	authorization program used by the Agency for Health Care
4518	Administration and the Children's Medical Services program of
4519	the Department of Health. The agency may competitively bid on a
4520	contract to select a qualified organization to provide
4521	utilization management of private duty nursing services. The
4522	agency is authorized to seek federal waivers to implement this
4523	initiative.
4524	Section 88.  Subsection (14) of section 409.906, Florida
4525	Statutes, is amended to read:
4526	409.906  Optional Medicaid services.--Subject to specific
4527	appropriations, the agency may make payments for services which
4528	are optional to the state under Title XIX of the Social Security
4529	Act and are furnished by Medicaid providers to recipients who
4530	are determined to be eligible on the dates on which the services
4531	were provided. Any optional service that is provided shall be
4532	provided only when medically necessary and in accordance with
4533	state and federal law. Optional services rendered by providers
4534	in mobile units to Medicaid recipients may be restricted or
4535	prohibited by the agency. Nothing in this section shall be
4536	construed to prevent or limit the agency from adjusting fees,
4537	reimbursement rates, lengths of stay, number of visits, or
4538	number of services, or making any other adjustments necessary to
4539	comply with the availability of moneys and any limitations or
4540	directions provided for in the General Appropriations Act or
4541	chapter 216. If necessary to safeguard the state's systems of
4542	providing services to elderly and disabled persons and subject
4543	to the notice and review provisions of s. 216.177, the Governor
4544	may direct the Agency for Health Care Administration to amend
4545	the Medicaid state plan to delete the optional Medicaid service
4546	known as "Intermediate Care Facilities for the Developmentally
4547	Disabled." Optional services may include:
4548	(14)  HOSPICE CARE SERVICES.--The agency may pay for all
4549	reasonable and necessary services for the palliation or
4550	management of a recipient's terminal illness, if the services
4551	are provided by a hospice that is licensed under part IV VI of
4552	chapter 400 and meets Medicare certification requirements.
4553	Section 89.  Subsection (7) and paragraph (a) of subsection
4554	(8) of section 409.907, Florida Statutes, are amended to read:
4555	409.907  Medicaid provider agreements.--The agency may make
4556	payments for medical assistance and related services rendered to
4557	Medicaid recipients only to an individual or entity who has a
4558	provider agreement in effect with the agency, who is performing
4559	services or supplying goods in accordance with federal, state,
4560	and local law, and who agrees that no person shall, on the
4561	grounds of handicap, race, color, or national origin, or for any
4562	other reason, be subjected to discrimination under any program
4563	or activity for which the provider receives payment from the
4564	agency.
4565	(7)  The agency may require, as a condition of
4566	participating in the Medicaid program and before entering into
4567	the provider agreement, that the provider submit information, in
4568	an initial and any required renewal applications, concerning the
4569	professional, business, and personal background of the provider
4570	and permit an onsite inspection of the provider's service
4571	location by agency staff or other personnel designated by the
4572	agency to perform this function. The agency shall perform a
4573	random onsite inspection, within 60 days after receipt of a
4574	fully complete new provider's application, of the provider's
4575	service location prior to making its first payment to the
4576	provider for Medicaid services to determine the applicant's
4577	ability to provide the services that the applicant is proposing
4578	to provide for Medicaid reimbursement. The agency is not
4579	required to perform an onsite inspection of a provider or
4580	program that is licensed by the agency, that provides services
4581	under waiver programs for home and community-based services, or
4582	that is licensed as a medical foster home by the Department of
4583	Children and Family Services. As a continuing condition of
4584	participation in the Medicaid program, a provider shall
4585	immediately notify the agency of any current or pending
4586	bankruptcy filing. Before entering into the provider agreement,
4587	or as a condition of continuing participation in the Medicaid
4588	program, the agency may also require that Medicaid providers
4589	reimbursed on a fee-for-services basis or fee schedule basis
4590	which is not cost-based, post a surety bond not to exceed
4591	$50,000 or the total amount billed by the provider to the
4592	program during the current or most recent calendar year,
4593	whichever is greater. For new providers, the amount of the
4594	surety bond shall be determined by the agency based on the
4595	provider's estimate of its first year's billing. If the
4596	provider's billing during the first year exceeds the bond
4597	amount, the agency may require the provider to acquire an
4598	additional bond equal to the actual billing level of the
4599	provider. A provider's bond shall not exceed $50,000 if a
4600	physician or group of physicians licensed under chapter 458,
4601	chapter 459, or chapter 460 has a 50 percent or greater
4602	ownership interest in the provider or if the provider is an
4603	assisted living facility licensed under part III of chapter 429
4604	400. The bonds permitted by this section are in addition to the
4605	bonds referenced in s. 400.179(5)(d). If the provider is a
4606	corporation, partnership, association, or other entity, the
4607	agency may require the provider to submit information concerning
4608	the background of that entity and of any principal of the
4609	entity, including any partner or shareholder having an ownership
4610	interest in the entity equal to 5 percent or greater, and any
4611	treating provider who participates in or intends to participate
4612	in Medicaid through the entity. The information must include:
4613	(a)  Proof of holding a valid license or operating
4614	certificate, as applicable, if required by the state or local
4615	jurisdiction in which the provider is located or if required by
4616	the Federal Government.
4617	(b)  Information concerning any prior violation, fine,
4618	suspension, termination, or other administrative action taken
4619	under the Medicaid laws, rules, or regulations of this state or
4620	of any other state or the Federal Government; any prior
4621	violation of the laws, rules, or regulations relating to the
4622	Medicare program; any prior violation of the rules or
4623	regulations of any other public or private insurer; and any
4624	prior violation of the laws, rules, or regulations of any
4625	regulatory body of this or any other state.
4626	(c)  Full and accurate disclosure of any financial or
4627	ownership interest that the provider, or any principal, partner,
4628	or major shareholder thereof, may hold in any other Medicaid
4629	provider or health care related entity or any other entity that
4630	is licensed by the state to provide health or residential care
4631	and treatment to persons.
4632	(d)  If a group provider, identification of all members of
4633	the group and attestation that all members of the group are
4634	enrolled in or have applied to enroll in the Medicaid program.
4635	(8)(a)  Each provider, or each principal of the provider if
4636	the provider is a corporation, partnership, association, or
4637	other entity, seeking to participate in the Medicaid program
4638	must submit a complete set of his or her fingerprints to the
4639	agency for the purpose of conducting a criminal history record
4640	check. Principals of the provider include any officer, director,
4641	billing agent, managing employee, or affiliated person, or any
4642	partner or shareholder who has an ownership interest equal to 5
4643	percent or more in the provider. However, a director of a not-
4644	for-profit corporation or organization is not a principal for
4645	purposes of a background investigation as required by this
4646	section if the director: serves solely in a voluntary capacity
4647	for the corporation or organization, does not regularly take
4648	part in the day-to-day operational decisions of the corporation
4649	or organization, receives no remuneration from the not-for-
4650	profit corporation or organization for his or her service on the
4651	board of directors, has no financial interest in the not-for-
4652	profit corporation or organization, and has no family members
4653	with a financial interest in the not-for-profit corporation or
4654	organization; and if the director submits an affidavit, under
4655	penalty of perjury, to this effect to the agency and the not-
4656	for-profit corporation or organization submits an affidavit,
4657	under penalty of perjury, to this effect to the agency as part
4658	of the corporation's or organization's Medicaid provider
4659	agreement application. Notwithstanding the above, the agency may
4660	require a background check for any person reasonably suspected
4661	by the agency to have been convicted of a crime. This subsection
4662	shall not apply to:
4663	1.  A hospital licensed under chapter 395;
4664	2.  A nursing home licensed under chapter 400;
4665	3.  A hospice licensed under chapter 400;
4666	4.  An assisted living facility licensed under chapter 429;
4667	400.
4668	5.  A unit of local government, except that requirements of
4669	this subsection apply to nongovernmental providers and entities
4670	when contracting with the local government to provide Medicaid
4671	services. The actual cost of the state and national criminal
4672	history record checks must be borne by the nongovernmental
4673	provider or entity; or
4674	6.  Any business that derives more than 50 percent of its
4675	revenue from the sale of goods to the final consumer, and the
4676	business or its controlling parent either is required to file a
4677	form 10-K or other similar statement with the Securities and
4678	Exchange Commission or has a net worth of $50 million or more.
4679	Section 90.  Paragraph (c) of subsection (5) of section
4680	409.912, Florida Statutes, is amended to read:
4681	409.912  Cost-effective purchasing of health care.--The
4682	agency shall purchase goods and services for Medicaid recipients
4683	in the most cost-effective manner consistent with the delivery
4684	of quality medical care. To ensure that medical services are
4685	effectively utilized, the agency may, in any case, require a
4686	confirmation or second physician's opinion of the correct
4687	diagnosis for purposes of authorizing future services under the
4688	Medicaid program. This section does not restrict access to
4689	emergency services or poststabilization care services as defined
4690	in 42 C.F.R. part 438.114. Such confirmation or second opinion
4691	shall be rendered in a manner approved by the agency. The agency
4692	shall maximize the use of prepaid per capita and prepaid
4693	aggregate fixed-sum basis services when appropriate and other
4694	alternative service delivery and reimbursement methodologies,
4695	including competitive bidding pursuant to s. 287.057, designed
4696	to facilitate the cost-effective purchase of a case-managed
4697	continuum of care. The agency shall also require providers to
4698	minimize the exposure of recipients to the need for acute
4699	inpatient, custodial, and other institutional care and the
4700	inappropriate or unnecessary use of high-cost services. The
4701	agency shall contract with a vendor to monitor and evaluate the
4702	clinical practice patterns of providers in order to identify
4703	trends that are outside the normal practice patterns of a
4704	provider's professional peers or the national guidelines of a
4705	provider's professional association. The vendor must be able to
4706	provide information and counseling to a provider whose practice
4707	patterns are outside the norms, in consultation with the agency,
4708	to improve patient care and reduce inappropriate utilization.
4709	The agency may mandate prior authorization, drug therapy
4710	management, or disease management participation for certain
4711	populations of Medicaid beneficiaries, certain drug classes, or
4712	particular drugs to prevent fraud, abuse, overuse, and possible
4713	dangerous drug interactions. The Pharmaceutical and Therapeutics
4714	Committee shall make recommendations to the agency on drugs for
4715	which prior authorization is required. The agency shall inform
4716	the Pharmaceutical and Therapeutics Committee of its decisions
4717	regarding drugs subject to prior authorization. The agency is
4718	authorized to limit the entities it contracts with or enrolls as
4719	Medicaid providers by developing a provider network through
4720	provider credentialing. The agency may competitively bid single-
4721	source-provider contracts if procurement of goods or services
4722	results in demonstrated cost savings to the state without
4723	limiting access to care. The agency may limit its network based
4724	on the assessment of beneficiary access to care, provider
4725	availability, provider quality standards, time and distance
4726	standards for access to care, the cultural competence of the
4727	provider network, demographic characteristics of Medicaid
4728	beneficiaries, practice and provider-to-beneficiary standards,
4729	appointment wait times, beneficiary use of services, provider
4730	turnover, provider profiling, provider licensure history,
4731	previous program integrity investigations and findings, peer
4732	review, provider Medicaid policy and billing compliance records,
4733	clinical and medical record audits, and other factors. Providers
4734	shall not be entitled to enrollment in the Medicaid provider
4735	network. The agency shall determine instances in which allowing
4736	Medicaid beneficiaries to purchase durable medical equipment and
4737	other goods is less expensive to the Medicaid program than long-
4738	term rental of the equipment or goods. The agency may establish
4739	rules to facilitate purchases in lieu of long-term rentals in
4740	order to protect against fraud and abuse in the Medicaid program
4741	as defined in s. 409.913. The agency may seek federal waivers
4742	necessary to administer these policies.
4743	(5)  By December 1, 2005, the Agency for Health Care
4744	Administration, in partnership with the Department of Elderly
4745	Affairs, shall create an integrated, fixed-payment delivery
4746	system for Medicaid recipients who are 60 years of age or older.
4747	The Agency for Health Care Administration shall implement the
4748	integrated system initially on a pilot basis in two areas of the
4749	state. In one of the areas enrollment shall be on a voluntary
4750	basis. The program must transfer all Medicaid services for
4751	eligible elderly individuals who choose to participate into an
4752	integrated-care management model designed to serve Medicaid
4753	recipients in the community. The program must combine all
4754	funding for Medicaid services provided to individuals 60 years
4755	of age or older into the integrated system, including funds for
4756	Medicaid home and community-based waiver services; all Medicaid
4757	services authorized in ss. 409.905 and 409.906, excluding funds
4758	for Medicaid nursing home services unless the agency is able to
4759	demonstrate how the integration of the funds will improve
4760	coordinated care for these services in a less costly manner; and
4761	Medicare coinsurance and deductibles for persons dually eligible
4762	for Medicaid and Medicare as prescribed in s. 409.908(13).
4763	(c)  The agency must ensure that the capitation-rate-
4764	setting methodology for the integrated system is actuarially
4765	sound and reflects the intent to provide quality care in the
4766	least restrictive setting. The agency must also require
4767	integrated-system providers to develop a credentialing system
4768	for service providers and to contract with all Gold Seal nursing
4769	homes, where feasible, and exclude, where feasible, chronically
4770	poor-performing facilities and providers as defined by the
4771	agency. The integrated system must provide that if the recipient
4772	resides in a noncontracted residential facility licensed under
4773	chapter 400 or chapter 429 at the time the integrated system is
4774	initiated, the recipient must be permitted to continue to reside
4775	in the noncontracted facility as long as the recipient desires.
4776	The integrated system must also provide that, in the absence of
4777	a contract between the integrated-system provider and the
4778	residential facility licensed under chapter 400 or chapter 429,
4779	current Medicaid rates must prevail. The agency and the
4780	Department of Elderly Affairs must jointly develop procedures to
4781	manage the services provided through the integrated system in
4782	order to ensure quality and recipient choice.
4783	Section 91.  Section 410.031, Florida Statutes, is amended
4784	to read:
4785	410.031  Legislative intent.--It is the intent of the
4786	Legislature to encourage the provision of care for disabled
4787	adults in family-type living arrangements in private homes as an
4788	alternative to institutional or nursing home care for such
4789	persons. The provisions of ss. 410.031-410.036 are intended to
4790	be supplemental to the provisions of chapters chapter 400 and
4791	429, relating to the licensing and regulation of nursing homes
4792	and assisted living facilities, and do not exempt any person who
4793	is otherwise subject to regulation under chapter 400 or chapter
4794	429.
4795	Section 92.  Section 410.034, Florida Statutes, is amended
4796	to read:
4797	410.034  Department determination of fitness to provide
4798	home care.--In accordance with s. 429.02 s. 400.402, a person
4799	caring for an adult who is related to such person by blood or
4800	marriage is not subject to the Assisted Living Facilities Act.
4801	If, however, the person who plans to provide home care under
4802	this act is found by the department to be unable to provide this
4803	care, the department shall notify the person wishing to provide
4804	home care of this determination, and the person shall not be
4805	eligible for subsidy payments under ss. 410.031-410.036.
4806	Section 93.  Section 415.1111, Florida Statutes, is amended
4807	to read:
4808	415.1111  Civil actions.--A vulnerable adult who has been
4809	abused, neglected, or exploited as specified in this chapter has
4810	a cause of action against any perpetrator and may recover actual
4811	and punitive damages for such abuse, neglect, or exploitation.
4812	The action may be brought by the vulnerable adult, or that
4813	person's guardian, by a person or organization acting on behalf
4814	of the vulnerable adult with the consent of that person or that
4815	person's guardian, or by the personal representative of the
4816	estate of a deceased victim without regard to whether the cause
4817	of death resulted from the abuse, neglect, or exploitation. The
4818	action may be brought in any court of competent jurisdiction to
4819	enforce such action and to recover actual and punitive damages
4820	for any deprivation of or infringement on the rights of a
4821	vulnerable adult. A party who prevails in any such action may be
4822	entitled to recover reasonable attorney's fees, costs of the
4823	action, and damages. The remedies provided in this section are
4824	in addition to and cumulative with other legal and
4825	administrative remedies available to a vulnerable adult.
4826	Notwithstanding the foregoing, any civil action for damages
4827	against any licensee or entity who establishes, controls,
4828	conducts, manages, or operates a facility licensed under part II
4829	of chapter 400 relating to its operation of the licensed
4830	facility shall be brought pursuant to s. 400.023, or against any
4831	licensee or entity who establishes, controls, conducts, manages,
4832	or operates a facility licensed under part I III of chapter 429
4833	400 relating to its operation of the licensed facility shall be
4834	brought pursuant to s. 429.29 s. 400.429. Such licensee or
4835	entity shall not be vicariously liable for the acts or omissions
4836	of its employees or agents or any other third party in an action
4837	brought under this section.
4838	Section 94.  Paragraph (d) of subsection (1) of section
4839	419.001, Florida Statutes, is amended to read:
4840	419.001  Site selection of community residential homes.--
4841	(1)  For the purposes of this section, the following
4842	definitions shall apply:
4843	(d)  "Resident" means any of the following: a frail elder
4844	as defined in s. 429.65 s. 400.618; a physically disabled or
4845	handicapped person as defined in s. 760.22(7)(a); a
4846	developmentally disabled person as defined in s. 393.063; a
4847	nondangerous mentally ill person as defined in s. 394.455(18);
4848	or a child as defined in s. 39.01(14), s. 984.03(9) or (12), or
4849	s. 985.03(8).
4850	Section 95.  Section 430.601, Florida Statutes, is amended
4851	to read:
4852	430.601  Home care for the elderly; legislative intent.--It
4853	is the intent of the Legislature to encourage the provision of
4854	care for the elderly in family-type living arrangements in
4855	private homes as an alternative to institutional or nursing home
4856	care for such persons. The provisions of ss. 430.601-430.606 are
4857	intended to be supplemental to the provisions of chapters
4858	chapter 400 and 429, relating to the licensing and regulation of
4859	nursing homes and assisted living facilities, and do not exempt
4860	any person who is otherwise subject to regulation under those
4861	chapters the provisions of that chapter.
4862	Section 96.  Subsection (7) of section 430.703, Florida
4863	Statutes, is amended to read:
4864	430.703  Definitions.--As used in this act, the term:
4865	(7)  "Other qualified provider" means an entity licensed
4866	under chapter 400 or chapter 429 that demonstrates a long-term
4867	care continuum and meets all requirements pursuant to an
4868	interagency agreement between the agency and the department.
4869	Section 97.  Paragraph (a) of subsection (3) of section
4870	435.03, Florida Statutes, is amended to read:
4871	435.03  Level 1 screening standards.--
4872	(3)  Standards must also ensure that the person:
4873	(a)  For employees and employers licensed or registered
4874	pursuant to chapter 400 or chapter 429, and for employees and
4875	employers of developmental services institutions as defined in
4876	s. 393.063, intermediate care facilities for the developmentally
4877	disabled as defined in s. 393.063, and mental health treatment
4878	facilities as defined in s. 394.455, meets the requirements of
4879	this chapter.
4880	Section 98.  Paragraph (a) of subsection (4) of section
4881	435.04, Florida Statutes, is amended to read:
4882	435.04  Level 2 screening standards.--
4883	(4)  Standards must also ensure that the person:
4884	(a)  For employees or employers licensed or registered
4885	pursuant to chapter 400 or chapter 429, does not have a
4886	confirmed report of abuse, neglect, or exploitation as defined
4887	in s. 415.102(6), which has been uncontested or upheld under s.
4888	415.103.
4889	Section 99.  Paragraph (g) of subsection (1) of section
4890	440.13, Florida Statutes, is amended to read:
4891	440.13  Medical services and supplies; penalty for
4892	violations; limitations.--
4893	(1)  DEFINITIONS.--As used in this section, the term:
4894	(g)  "Health care facility" means any hospital licensed
4895	under chapter 395 and any health care institution licensed under
4896	chapter 400 or chapter 429.
4897	Section 100.  Subsection (1) of section 465.0235, Florida
4898	Statutes, is amended to read:
4899	465.0235  Automated pharmacy systems used by long-term care
4900	facilities, hospices, or state correctional institutions.--
4901	(1)  A pharmacy may provide pharmacy services to a
4902	long-term care facility or hospice licensed under chapter 400 or
4903	chapter 429 or a state correctional institution operated under
4904	chapter 944 through the use of an automated pharmacy system that
4905	need not be located at the same location as the pharmacy.
4906	Section 101.  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 102.  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 103.  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 part I of chapter 429 are shall be exempt from
4934	the 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 104.  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 105.  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 106.  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 107.  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 108.  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 109.  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 110.  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 111.  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 part
5131	I of chapter 429 or which will not offer personal services or
5132	nursing services through written contractual agreement. Any
5133	written contractual agreement must be disclosed in the
5134	continuing care contract and is subject to the provisions of s.
5135	651.1151, relating to administrative, vendor, and management
5136	contracts.
5137	Section 112.  Subsection (8) of section 651.055, Florida
5138	Statutes, is amended to read:
5139	651.055  Contracts; right to rescind.--
5140	(8)  The provisions of this section shall control over any
5141	conflicting provisions contained in part II or part III of
5142	chapter 400 or in part I of chapter 429.
5143	Section 113.  Subsection (5) of section 651.095, Florida
5144	Statutes, is amended to read:
5145	651.095  Advertisements; requirements; penalties.--
5146	(5)  The provisions of this section shall control over any
5147	conflicting provisions contained in part II or part III of
5148	chapter 400 or in part I of chapter 429.
5149	Section 114.  Subsections (1), (4), (6), (7), and (8) of
5150	section 651.118, Florida Statutes, are amended to read:
5151	651.118  Agency for Health Care Administration;
5152	certificates of need; sheltered beds; community beds.--
5153	(1)  The provisions of this section shall control in the
5154	case of conflict with the provisions of the Health Facility and
5155	Services Development Act, ss. 408.031-408.045; the provisions of
5156	chapter 395; or the provisions of part II parts II and III of
5157	chapter 400; or the provisions of part I of chapter 429.
5158	(4)  The Agency for Health Care Administration shall
5159	approve one sheltered nursing home bed for every four proposed
5160	residential units, including those that are licensed under part
5161	I of chapter 429 part III of chapter 400, in the continuing care
5162	facility unless the provider demonstrates the need for a lesser
5163	number of sheltered nursing home beds based on proposed
5164	utilization by prospective residents or demonstrates the need
5165	for additional sheltered nursing home beds based on actual
5166	utilization and demand by current residents.
5167	(6)  Unless the provider already has a component that is to
5168	be a part of the continuing care facility and that is licensed
5169	under chapter 395, or part II or part III of chapter 400, or
5170	part I of chapter 429 at the time of construction of the
5171	continuing care facility, the provider must construct the
5172	nonnursing home portion of the facility and the nursing home
5173	portion of the facility at the same time. If a provider
5174	constructs less than the number of residential units approved in
5175	the certificate of authority, the number of licensed sheltered
5176	nursing home beds shall be reduced by a proportionate share.
5177	(7)  Notwithstanding the provisions of subsection (2), at
5178	the discretion of the continuing care provider, sheltered
5179	nursing home beds may be used for persons who are not residents
5180	of the continuing care facility and who are not parties to a
5181	continuing care contract for a period of up to 5 years after the
5182	date of issuance of the initial nursing home license. A provider
5183	whose 5-year period has expired or is expiring may request the
5184	Agency for Health Care Administration for an extension, not to
5185	exceed 30 percent of the total sheltered nursing home beds, if
5186	the utilization by residents of the nursing home facility in the
5187	sheltered beds will not generate sufficient income to cover
5188	nursing home facility expenses, as evidenced by one of the
5189	following:
5190	(a)  The nursing home facility has a net loss for the most
5191	recent fiscal year as determined under generally accepted
5192	accounting principles, excluding the effects of extraordinary or
5193	unusual items, as demonstrated in the most recently audited
5194	financial statement; or
5195	(b)  The nursing home facility would have had a pro forma
5196	loss for the most recent fiscal year, excluding the effects of
5197	extraordinary or unusual items, if revenues were reduced by the
5198	amount of revenues from persons in sheltered beds who were not
5199	residents, as reported on by a certified public accountant.
5200
5201	The agency shall be authorized to grant an extension to the
5202	provider based on the evidence required in this subsection. The
5203	agency may request a continuing care facility to use up to 25
5204	percent of the patient days generated by new admissions of
5205	nonresidents during the extension period to serve Medicaid
5206	recipients for those beds authorized for extended use if there
5207	is a demonstrated need in the respective service area and if
5208	funds are available. A provider who obtains an extension is
5209	prohibited from applying for additional sheltered beds under the
5210	provision of subsection (2), unless additional residential units
5211	are built or the provider can demonstrate need by continuing
5212	care facility residents to the Agency for Health Care
5213	Administration. The 5-year limit does not apply to up to five
5214	sheltered beds designated for inpatient hospice care as part of
5215	a contractual arrangement with a hospice licensed under part IV
5216	VI of chapter 400. A continuing care facility that uses such
5217	beds after the 5-year period shall report such use to the Agency
5218	for Health Care Administration. For purposes of this subsection,
5219	"resident" means a person who, upon admission to the continuing
5220	care facility, initially resides in a part of the continuing
5221	care facility not licensed under part II of chapter 400.
5222	(8)  A provider may petition the Agency for Health Care
5223	Administration to use a designated number of sheltered nursing
5224	home beds to provide extended congregate care as defined in s.
5225	429.02 s. 400.402 if the beds are in a distinct area of the
5226	nursing home which can be adapted to meet the requirements for
5227	extended congregate care. The provider may subsequently use such
5228	beds as sheltered beds after notifying the agency of the
5229	intended change. Any sheltered beds used to provide extended
5230	congregate care pursuant to this subsection may not qualify for
5231	funding under the Medicaid waiver. Any sheltered beds used to
5232	provide extended congregate care pursuant to this subsection may
5233	share common areas, services, and staff with beds designated for
5234	nursing home care, provided that all of the beds are under
5235	common ownership. For the purposes of this subsection, fire and
5236	life safety codes applicable to nursing home facilities shall
5237	apply.
5238	Section 115.  Subsection (2) of section 765.1103, Florida
5239	Statutes, is amended to read:
5240	765.1103  Pain management and palliative care.--
5241	(2)  Health care providers and practitioners regulated
5242	under chapter 458, chapter 459, or chapter 464 must, as
5243	appropriate, comply with a request for pain management or
5244	palliative care from a patient under their care or, for an
5245	incapacitated patient under their care, from a surrogate, proxy,
5246	guardian, or other representative permitted to make health care
5247	decisions for the incapacitated patient. Facilities regulated
5248	under chapter 395, or chapter 400, or chapter 429 must comply
5249	with the pain management or palliative care measures ordered by
5250	the patient's physician.
5251	Section 116.  Subsection (2) of section 765.205, Florida
5252	Statutes, is amended to read:
5253	765.205  Responsibility of the surrogate.--
5254	(2)  The surrogate may authorize the release of information
5255	and medical records to appropriate persons to ensure the
5256	continuity of the principal's health care and may authorize the
5257	admission, discharge, or transfer of the principal to or from a
5258	health care facility or other facility or program licensed under
5259	chapter 400 or chapter 429.
5260	Section 117.  Subsection (1) of section 768.735, Florida
5261	Statutes, is amended to read:
5262	768.735  Punitive damages; exceptions; limitation.--
5263	(1)  Sections 768.72(2)-(4), 768.725, and 768.73 do not
5264	apply to any civil action based upon child abuse, abuse of the
5265	elderly under chapter 415, or abuse of the developmentally
5266	disabled. Such actions are governed by applicable statutes and
5267	controlling judicial precedent. This section does not apply to
5268	claims brought pursuant to s. 400.023 or s. 429.29 s. 400.429.
5269	Section 118.  Paragraph (h) of subsection (1) of section
5270	893.13, Florida Statutes, is amended to read:
5271	893.13  Prohibited acts; penalties.--
5272	(1)
5273	(h)  Except as authorized by this chapter, it is unlawful
5274	for any person to sell, manufacture, or deliver, or possess with
5275	intent to sell, manufacture, or deliver, a controlled substance
5276	in, on, or within 1,000 feet of the real property comprising an
5277	assisted living facility, as that term is used in chapter 429
5278	400. Any person who violates this paragraph with respect to:
5279	1.  A controlled substance named or described in s.
5280	893.03(1)(a), (1)(b), (1)(d), (2)(a), (2)(b), or (2)(c)4.
5281	commits a felony of the first degree, punishable as provided in
5282	s. 775.082, s. 775.083, or s. 775.084.
5283	2.  A controlled substance named or described in s.
5284	893.03(1)(c), (2)(c)1., (2)(c)2., (2)(c)3., (2)(c)5., (2)(c)6.,
5285	(2)(c)7., (2)(c)8., (2)(c)9., (3), or (4) commits a felony of
5286	the second degree, punishable as provided in s. 775.082, s.
5287	775.083, or s. 775.084.
5288	Section 119.  Paragraph (a) of subsection (4) of section
5289	943.0585, Florida Statutes, is amended to read:
5290	943.0585  Court-ordered expunction of criminal history
5291	records.--The courts of this state have jurisdiction over their
5292	own procedures, including the maintenance, expunction, and
5293	correction of judicial records containing criminal history
5294	information to the extent such procedures are not inconsistent
5295	with the conditions, responsibilities, and duties established by
5296	this section. Any court of competent jurisdiction may order a
5297	criminal justice agency to expunge the criminal history record
5298	of a minor or an adult who complies with the requirements of
5299	this section. The court shall not order a criminal justice
5300	agency to expunge a criminal history record until the person
5301	seeking to expunge a criminal history record has applied for and
5302	received a certificate of eligibility for expunction pursuant to
5303	subsection (2). A criminal history record that relates to a
5304	violation of s. 393.135, s. 394.4593, s. 787.025, chapter 794,
5305	s. 796.03, s. 800.04, s. 817.034, s. 825.1025, s. 827.071,
5306	chapter 839, s. 847.0133, s. 847.0135, s. 847.0145, s. 893.135,
5307	s. 916.1075, or a violation enumerated in s. 907.041 may not be
5308	expunged, without regard to whether adjudication was withheld,
5309	if the defendant was found guilty of or pled guilty or nolo
5310	contendere to the offense, or if the defendant, as a minor, was
5311	found to have committed, or pled guilty or nolo contendere to
5312	committing, the offense as a delinquent act. The court may only
5313	order expunction of a criminal history record pertaining to one
5314	arrest or one incident of alleged criminal activity, except as
5315	provided in this section. The court may, at its sole discretion,
5316	order the expunction of a criminal history record pertaining to
5317	more than one arrest if the additional arrests directly relate
5318	to the original arrest. If the court intends to order the
5319	expunction of records pertaining to such additional arrests,
5320	such intent must be specified in the order. A criminal justice
5321	agency may not expunge any record pertaining to such additional
5322	arrests if the order to expunge does not articulate the
5323	intention of the court to expunge a record pertaining to more
5324	than one arrest. This section does not prevent the court from
5325	ordering the expunction of only a portion of a criminal history
5326	record pertaining to one arrest or one incident of alleged
5327	criminal activity. Notwithstanding any law to the contrary, a
5328	criminal justice agency may comply with laws, court orders, and
5329	official requests of other jurisdictions relating to expunction,
5330	correction, or confidential handling of criminal history records
5331	or information derived therefrom. This section does not confer
5332	any right to the expunction of any criminal history record, and
5333	any request for expunction of a criminal history record may be
5334	denied at the sole discretion of the court.
5335	(4)  EFFECT OF CRIMINAL HISTORY RECORD EXPUNCTION.--Any
5336	criminal history record of a minor or an adult which is ordered
5337	expunged by a court of competent jurisdiction pursuant to this
5338	section must be physically destroyed or obliterated by any
5339	criminal justice agency having custody of such record; except
5340	that any criminal history record in the custody of the
5341	department must be retained in all cases. A criminal history
5342	record ordered expunged that is retained by the department is
5343	confidential and exempt from the provisions of s. 119.07(1) and
5344	s. 24(a), Art. I of the State Constitution and not available to
5345	any person or entity except upon order of a court of competent
5346	jurisdiction. A criminal justice agency may retain a notation
5347	indicating compliance with an order to expunge.
5348	(a)  The person who is the subject of a criminal history
5349	record that is expunged under this section or under other
5350	provisions of law, including former s. 893.14, former s. 901.33,
5351	and former s. 943.058, may lawfully deny or fail to acknowledge
5352	the arrests covered by the expunged record, except when the
5353	subject of the record:
5354	1.  Is a candidate for employment with a criminal justice
5355	agency;
5356	2.  Is a defendant in a criminal prosecution;
5357	3.  Concurrently or subsequently petitions for relief under
5358	this section or s. 943.059;
5359	4.  Is a candidate for admission to The Florida Bar;
5360	5.  Is seeking to be employed or licensed by or to contract
5361	with the Department of Children and Family Services or the
5362	Department of Juvenile Justice or to be employed or used by such
5363	contractor or licensee in a sensitive position having direct
5364	contact with children, the developmentally disabled, the aged,
5365	or the elderly as provided in s. 110.1127(3), s. 393.063, s.
5366	394.4572(1), s. 397.451, s. 402.302(3), s. 402.313(3), s.
5367	409.175(2)(i), s. 415.102(4), s. 916.106(10) and (13), s.
5368	985.407, or chapter 400, or chapter 429; or
5369	6.  Is seeking to be employed or licensed by the Department
5370	of Education, any district school board, any university
5371	laboratory school, any charter school, any private or parochial
5372	school, or any local governmental entity that licenses child
5373	care facilities.
5374	Section 120.  Paragraph (a) of subsection (4) of section
5375	943.059, Florida Statutes, is amended to read:
5376	943.059  Court-ordered sealing of criminal history
5377	records.--The courts of this state shall continue to have
5378	jurisdiction over their own procedures, including the
5379	maintenance, sealing, and correction of judicial records
5380	containing criminal history information to the extent such
5381	procedures are not inconsistent with the conditions,
5382	responsibilities, and duties established by this section. Any
5383	court of competent jurisdiction may order a criminal justice
5384	agency to seal the criminal history record of a minor or an
5385	adult who complies with the requirements of this section. The
5386	court shall not order a criminal justice agency to seal a
5387	criminal history record until the person seeking to seal a
5388	criminal history record has applied for and received a
5389	certificate of eligibility for sealing pursuant to subsection
5390	(2). A criminal history record that relates to a violation of s.
5391	393.135, s. 394.4593, s. 787.025, chapter 794, s. 796.03, s.
5392	800.04, s. 817.034, s. 825.1025, s. 827.071, chapter 839, s.
5393	847.0133, s. 847.0135, s. 847.0145, s. 893.135, s. 916.1075, or
5394	a violation enumerated in s. 907.041 may not be sealed, without
5395	regard to whether adjudication was withheld, if the defendant
5396	was found guilty of or pled guilty or nolo contendere to the
5397	offense, or if the defendant, as a minor, was found to have
5398	committed or pled guilty or nolo contendere to committing the
5399	offense as a delinquent act. The court may only order sealing of
5400	a criminal history record pertaining to one arrest or one
5401	incident of alleged criminal activity, except as provided in
5402	this section. The court may, at its sole discretion, order the
5403	sealing of a criminal history record pertaining to more than one
5404	arrest if the additional arrests directly relate to the original
5405	arrest. If the court intends to order the sealing of records
5406	pertaining to such additional arrests, such intent must be
5407	specified in the order. A criminal justice agency may not seal
5408	any record pertaining to such additional arrests if the order to
5409	seal does not articulate the intention of the court to seal
5410	records pertaining to more than one arrest. This section does
5411	not prevent the court from ordering the sealing of only a
5412	portion of a criminal history record pertaining to one arrest or
5413	one incident of alleged criminal activity. Notwithstanding any
5414	law to the contrary, a criminal justice agency may comply with
5415	laws, court orders, and official requests of other jurisdictions
5416	relating to sealing, correction, or confidential handling of
5417	criminal history records or information derived therefrom. This
5418	section does not confer any right to the sealing of any criminal
5419	history record, and any request for sealing a criminal history
5420	record may be denied at the sole discretion of the court.
5421	(4)  EFFECT OF CRIMINAL HISTORY RECORD SEALING.--A criminal
5422	history record of a minor or an adult which is ordered sealed by
5423	a court of competent jurisdiction pursuant to this section is
5424	confidential and exempt from the provisions of s. 119.07(1) and
5425	s. 24(a), Art. I of the State Constitution and is available only
5426	to the person who is the subject of the record, to the subject's
5427	attorney, to criminal justice agencies for their respective
5428	criminal justice purposes, or to those entities set forth in
5429	subparagraphs (a)1., 4., 5., and 6. for their respective
5430	licensing and employment purposes.
5431	(a)  The subject of a criminal history record sealed under
5432	this section or under other provisions of law, including former
5433	s. 893.14, former s. 901.33, and former s. 943.058, may lawfully
5434	deny or fail to acknowledge the arrests covered by the sealed
5435	record, except when the subject of the record:
5436	1.  Is a candidate for employment with a criminal justice
5437	agency;
5438	2.  Is a defendant in a criminal prosecution;
5439	3.  Concurrently or subsequently petitions for relief under
5440	this section or s. 943.0585;
5441	4.  Is a candidate for admission to The Florida Bar;
5442	5.  Is seeking to be employed or licensed by or to contract
5443	with the Department of Children and Family Services or the
5444	Department of Juvenile Justice or to be employed or used by such
5445	contractor or licensee in a sensitive position having direct
5446	contact with children, the developmentally disabled, the aged,
5447	or the elderly as provided in s. 110.1127(3), s. 393.063, s.
5448	394.4572(1), s. 397.451, s. 402.302(3), s. 402.313(3), s.
5449	409.175(2)(i), s. 415.102(4), s. 415.103, s. 916.106(10) and
5450	(13), s. 985.407, or chapter 400, or chapter 429; or
5451	6.  Is seeking to be employed or licensed by the Department
5452	of Education, any district school board, any university
5453	laboratory school, any charter school, any private or parochial
5454	school, or any local governmental entity that licenses child
5455	care facilities.
5456	Section 121.  The Division of Statutory Revision of the
5457	Office of Legislative Services is requested to prepare a
5458	reviser's bill for introduction at a subsequent session of the
5459	Legislature to conform the Florida Statutes to changes made by
5460	this act.
5461	Section 122.  This act shall take effect July 1, 2006.

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