HB 7051

1	A bill to be entitled
2	An act relating to certificates of need; transferring,
3	renumbering, and amending s. 651.1185, F.S.; extending the
4	moratorium on certificates of need for additional
5	community nursing home beds until July 1, 2011; specifying
6	nonapplication of a moratorium for the addition of nursing
7	home beds in certain specified facilities; providing
8	requirements and limitations; providing for repeal upon
9	expiration of the moratorium; amending s. 408.040, F.S.;
10	authorizing nursing homes in certain counties to request a
11	reduction in their annual Medicaid patient days; requiring
12	the Agency for Health Care Administration to automatically
13	grant such a request if the nursing home meets certain
14	conditions; providing for future repeal; providing an
15	effective date.
16
17	Be It Enacted by the Legislature of the State of Florida:
18
19	Section 1.  Section 651.1185, Florida Statutes, is
20	transferred, renumbered as section 408.0435, Florida Statutes,
21	and amended to read:
22	408.0435 651.1185  Moratorium on nursing home certificates
23	of need.--
24	(1)  Notwithstanding the establishment of need as provided
25	for in this chapter 408, a no certificate of need for additional
26	community nursing home beds may not shall be approved by the
27	agency until July 1, 2011 2006.
28	(2)  The Legislature finds that the continued growth in the
29	Medicaid budget for nursing home care has constrained the
30	ability of the state to meet the needs of its elderly residents
31	through the use of less restrictive and less institutional
32	methods of long-term care. It is therefore the intent of the
33	Legislature to limit the increase in Medicaid nursing home
34	expenditures in order to provide funds to invest in long-term
35	care that is community-based and provides supportive services in
36	a manner that is both more cost-effective and more in keeping
37	with the wishes of the elderly residents of this state.
38	(3)  This moratorium on certificates of need shall not
39	apply to sheltered nursing home beds in a continuing care
40	retirement community certified by the former Department of
41	Insurance or by the Office of Insurance Regulation pursuant to
42	chapter 651.
43	(4)(a)  The moratorium on certificates of need does not
44	apply and a certificate of need for additional community nursing
45	home beds may be approved for a county that meets the following
46	circumstances:
47	1.  The county has no community nursing home beds; and
48	2.  The lack of community nursing home beds occurs because
49	all nursing home beds in the county that were licensed on July
50	1, 2001, have subsequently closed.
51	(b)  The certificate-of-need review for such circumstances
52	shall be subject to the comparative review process consistent
53	with the provisions of s. 408.039, and the number of beds may
54	not exceed the number of beds lost by the county after July 1,
55	2001.
56
57	This subsection shall be repealed upon the expiration of the
58	moratorium established in subsection (1).
59	(5)  The moratorium on certificates of need does not apply
60	for the addition of nursing home beds licensed under chapter 400
61	to a nursing home located in a county having up to 50,000
62	residents, in a number not exceeding 10 total beds or 10 percent
63	of the number of beds licensed in the facility being expanded,
64	whichever is greater. In addition to any other documentation
65	required by the agency, a request submitted under this
66	subsection must:
67	(a)  Certify that the facility has not had any class I or
68	class II deficiencies within the 30 months preceding the request
69	for addition.
70	(b)  Certify that the prior 12-month average occupancy rate
71	for the nursing home beds at the facility meets or exceeds 94
72	percent and the facility had not had any class I or class II
73	deficiencies since its initial licensure.
74	(c)  For a facility that has been licensed for less than 24
75	months, certify that the prior 6-month average occupancy rate
76	for the nursing home beds at the facility meets or exceeds 94
77	percent and that the facility has not had any class I or class
78	II deficiencies since its initial licensure.
79
80	This subsection shall be repealed upon the expiration of the
81	moratorium established in subsection (1).
82	(6)  The moratorium on certificates of need does not apply
83	for the addition of nursing home beds licensed under chapter 400
84	in a number not exceeding 10 total beds or 10 percent of the
85	number of beds licensed in the facility being expanded,
86	whichever is greater, if the facility meets the requirements of
87	paragraph (a).
88	(a)  In addition to any other documentation required by the
89	agency, a request for the addition of beds under this subsection
90	must certify that:
91	1.  The facility has not had any class I or class II
92	deficiencies within the 30 months preceding the request for
93	addition;
94	2.  The prior 12-month average occupancy rate for the
95	nursing home beds at the facility meets or exceeds 96 percent;
96	3.  The occupancy rate for nursing home beds in the
97	subdistrict is 94 percent or greater; and
98	4.  Any beds authorized for the facility under this
99	subsection before the date of the current request for additional
100	beds have been licensed and operational for at least 12 months.
101	(b)  A nursing home may request additional beds under this
102	subsection as an exemption from the provisions of s. 408.036(1).
103	The timeframes and monitoring process specified in s.
104	408.040(2)(a)-(c) apply to any exemption issued under this
105	subsection.
106	(c)  The agency shall count beds authorized under this
107	subsection as approved beds in the published inventory of
108	nursing home beds until the beds are licensed.
109
110	This subsection shall be repealed upon the expiration of the
111	moratorium established in subsection (1).
112	Section 2.  Paragraph (d) of subsection (1) of section
113	408.040, Florida Statutes, is redesignated as paragraph (e), and
114	a new paragraph (d) is added to that subsection to read:
115	408.040  Conditions and monitoring.--
116	(1)
117	(d)  If a nursing home is located in a county in which a
118	long-term care community diversion pilot project has been
119	implemented under s. 430.705 or in a county in which an
120	integrated, fixed-payment delivery system for Medicaid
121	recipients who are 60 years of age or older has been implemented
122	under s. 409.912(5), the nursing home may request a reduction in
123	the percentage of annual patient days used by residents who are
124	eligible for care under Title XIX of the Social Security Act,
125	which is a condition of the nursing home's certificate of need.
126	The agency shall automatically grant the nursing home's request
127	if the reduction is not more than 15 percent of the nursing
128	home's annual Medicaid-patient-days condition. A nursing home
129	may submit only one request every 2 years for an automatic
130	reduction. A requesting nursing home must notify the agency in
131	writing at least 60 days in advance of its intent to reduce its
132	annual Medicaid-patient-days condition by not more than 15
133	percent. The agency must acknowledge the request in writing and
134	must change its records to reflect the revised certificate-of-
135	need condition. This paragraph expires June 30, 2011.
136	Section 3.  This act shall take effect upon becoming a law.

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